Category: Nevin Manimala

J Transl Med. 2024 May 7;22(1):432. doi: 10.1186/s12967-024-05147-1.

ABSTRACT

BACKGROUND: SARS-CoV-2 mRNA vaccines are highly immunogenic in people living with HIV (PLWH) on effective antiretroviral therapy (ART). However, whether viro-immunologic parameters or other factors affect immune responses to vaccination is debated. This study aimed to develop a machine learning-based model able to predict the humoral response to mRNA vaccines in PLWH and to assess the impact of demographic and clinical variables on antibody production over time.

METHODS: Different machine learning algorithms have been compared in the setting of a longitudinal observational study involving 497 PLWH, after primary and booster SARS-CoV-2 mRNA vaccination. Both Generalized Linear Models and non-linear Models (Tree Regression and Random Forest) were trained and tested.

RESULTS: Non-linear algorithms showed better ability to predict vaccine-elicited humoral responses. The best-performing Random Forest model identified a few variables as more influential, within 39 clinical, demographic, and immunological factors. In particular, previous SARS-CoV-2 infection, BMI, CD4 T-cell count and CD4/CD8 ratio were positively associated with the primary cycle immunogenicity, yet their predictive value diminished with the administration of booster doses.

CONCLUSIONS: In the present work we have built a non-linear Random Forest model capable of accurately predicting humoral responses to SARS-CoV-2 mRNA vaccination, and identifying relevant factors that influence the vaccine response in PLWH. In clinical contexts, the application of this model provides promising opportunities for predicting individual vaccine responses, thus facilitating the development of vaccination strategies tailored for PLWH.

PMID:38715088 | DOI:10.1186/s12967-024-05147-1

Environ Microbiome. 2024 May 7;19(1):30. doi: 10.1186/s40793-024-00571-8.

ABSTRACT

BACKGROUND: Soil microbial communities are difficult to measure and critical to soil processes. The bulk soil microbiome is highly diverse and spatially heterogeneous, which can make it difficult to detect and monitor the responses of microbial communities to differences or changes in management, such as different crop rotations in agricultural research. Sampling a subset of actively growing microbes should promote monitoring how soil microbial communities respond to management by reducing the variation contributed by high microbial spatial and temporal heterogeneity and less active microbes. We tested an in-growth bag method using sterilized soil in root-excluding mesh, “sterile sentinels,” for the capacity to differentiate between crop rotations. We assessed the utility of different incubation times and compared colonized sentinels to concurrently sampled bulk soils for the statistical power to differentiate microbial community composition in low and high diversity crop rotations. We paired this method with Oxford Nanopore MinION sequencing to assess sterile sentinels as a standardized, fast turn-around monitoring method.

RESULTS: Compared to bulk soil, sentinels provided greater statistical power to distinguish between crop rotations for bacterial communities and equivalent power for fungal communities. The incubation time did not affect the statistical power to detect treatment differences in community composition, although longer incubation time increased total biomass. Bulk and sentinel soil samples contained shared and unique microbial taxa that were differentially abundant between crop rotations.

CONCLUSIONS: Overall, compared to bulk soils, the sentinels captured taxa with copiotrophic or ruderal traits, and plant-associated taxa. The sentinels show promise as a sensitive, scalable method to monitor soil microbial communities and provide information complementary to traditional soil sampling.

PMID:38715076 | DOI:10.1186/s40793-024-00571-8

Orphanet J Rare Dis. 2024 May 7;19(1):190. doi: 10.1186/s13023-024-03189-8.

NO ABSTRACT

PMID:38715067 | DOI:10.1186/s13023-024-03189-8

J Orthop Surg Res. 2024 May 7;19(1):283. doi: 10.1186/s13018-024-04760-6.

ABSTRACT

BACKGROUND: The disparity in patient-reported outcomes between total knee arthroplasty (TKA) following high tibial osteotomy (HTO) and primary TKA has yet to be fully comprehended. This study aims to compare the patient-reported outcomes, radiological parameters and complication rates between TKA following HTO and primary TKA.

METHODS: Sixty-five patients who underwent TKA following lateral closing-wedge HTO were compared to a matched group of primary TKA at postoperative 6-months and 1-year. Between-group confounders of age, gender, smoking status, Body Mass index, preoperative Numeric Rating Scale (NRS) pain in rest, Knee injury and Osteoarthritis Outcome Score-Physical function Shortform (KOOS-PS), EuroQol five-dimensional (EQ-5D) overall health score, and Oxford Knee Score (OKS) were balanced by propensity score matching. Patient-reported outcome measures were NRS pain in rest, KOOS-PS, EQ-5D overall health score, and OKS. Radiological parameters were femorotibial angle, medial proximal tibial angle, anatomical lateral distal femoral angle, posterior tibial slope, and patellar height assessed by Insall-Salvati ratio. The complication rates of TKA were compared between the two groups. The HTO survival time, the choice of staple removal before or during TKA in patients who underwent TKA following HTO patients, and the rate of patellar resurfacing were assessed. The p value < 0.0125 indicates statistical significance after Bonferroni correction.

RESULTS: After propensity score matching, no significant between-group differences in the patient-reported outcome measures, radiographical parameters and complication rates were found (p > 0.0125). In the TKA following HTO group, with an average HTO survival time of 8.7 years, staples were removed before TKA in 46 patients (71%) and during TKA in 19 patients, and 11 cases (17%) had patella resurfacing. In the primary TKA group, 15 cases (23%) had patella resurfacing.

CONCLUSION: The short-term assessment of TKA following HTO indicates outcomes similar to primary TKA. A previous HTO does not impact the early results of subsequent TKA, suggesting that the previous HTO has minimal influence on TKA outcomes.

LEVEL OF EVIDENCE: III, cohort study.

PMID:38715064 | DOI:10.1186/s13018-024-04760-6

BMC Nurs. 2024 May 7;23(1):310. doi: 10.1186/s12912-024-01961-6.

ABSTRACT

PURPOSE: This study conducts a systematic review and meta-analysis to understand the characteristics and contents of studies on spiritual nursing education programmes and their effects.

METHODS: The literature search included five databases (RISS, KISS, DBpia, Science ON, and KmBase) published in South Korea until September 30, 2021. Nine studies were included in the final review, with six for the meta-analysis using the RevMan 5.4. 1 programme. The programmes targeted nursing students and nurses in the RN-BSN course and employed methods such as lecturing, discussions, and case presentations. The contents focused on self-spirituality awareness, spirituality-related concepts, understanding others’ spirituality, and the process and application of spiritual nursing.

RESULTS: The meta-analysis revealed statistically significant effects on spiritual nursing competencies, spirituality, spiritual well-being, existential well-being, and spiritual needs, except self-esteem. Spiritual nursing education was effective in enhancing spiritual nursing competencies.

CONCLUSION: The study confirmed that spiritual nursing education effectively improves spiritual nursing competency, indicating a need for increased focus and administrative and financial support for such education in schools and hospitals. Furthermore, future studies should employ randomised experimental designs to examine the effects of online education programmes with short training time on clinical nurses in hospitals.

PMID:38715058 | DOI:10.1186/s12912-024-01961-6

BMC Health Serv Res. 2024 May 7;24(1):593. doi: 10.1186/s12913-024-11044-6.

ABSTRACT

BACKGROUND: In-hospital mortality from acute myocardial infarction (AMI) is widely used in international comparisons as an indicator of health system performance. Because of the high risk of early death after AMI, international comparisons may be biased by differences in the recording of early death cases in hospital inpatient data. This study examined whether differences in the recording of early deaths affect international comparisons of AMI in-hospital mortality by using the example of Germany and the United States, and explored approaches to address this issue.

METHODS: The German Diagnosis-Related Groups Statistics (DRG Statistics), the U.S. National Inpatient Sample (NIS) and the U.S. Nationwide Emergency Department Sample (NEDS) were analysed from 2014 to 2019. Cases with treatment for AMI were identified in German and U.S. inpatient data. AMI deaths occurring in the emergency department (ED) without inpatient admission were extracted from NEDS data. 30-day in-hospital mortality figures were calculated according to the OECD indicator definition (unlinked data) and modified by including ED deaths, or excluding all same-day cases.

RESULTS: German age-and-sex standardized 30-day in-hospital mortality was substantially higher compared to the U.S. (in 2019, 7.3% vs. 4.6%). The ratio of German vs. U.S. mortality was 1.6. After inclusion of ED deaths in U.S. data this ratio declined to 1.4. Exclusion of same-day cases in German and U.S. data led to a similar ratio.

CONCLUSIONS: While short-duration treatments due to early death are generally recorded in German inpatient data, in U.S. inpatient data those cases are partially missing. Excluding cases with short-duration treatment from the calculation of mortality indicators could be a feasible approach to account for differences in the recording of early deaths, that might be existent in other countries as well.

PMID:38715041 | DOI:10.1186/s12913-024-11044-6

BMC Nurs. 2024 May 7;23(1):312. doi: 10.1186/s12912-024-01979-w.

ABSTRACT

BACKGROUND: Optimizing the performance level of nursing staff is crucial for the efficient functioning of hospitals and better patient health outcomes. However, published data on the job performance levels and associated factors of nurses in Ethiopia is limited. Therefore, this study aimed to assess the job performance and associated factors of nurses working in adult emergency departments at selected public hospitals in Addis Ababa, Ethiopia.

METHODS: A facility-based cross-sectional study was conducted from March 25 to April 25, 2023, among 172 nurses working in the adult emergency departments of selected public hospitals in Addis Ababa, Ethiopia. A simple random sampling technique was used to select the study participants. Data were collected using pretested, self-administered structured questionnaires. Data were coded, entered into Epi-data version 4.6, and analyzed using Statistical Package for Service Solution (SPSS) Version 27.0.1 software. Data were summarized using descriptive statistics, including mean, frequency, and standard deviation. A binary logistic regression analysis was done to determine factors associated with the performance of nurses. The strength of the association was measured using an adjusted odd ratio (AOR) with a 95% confidence interval (CI), and a P-value < 0.05 was considered statistically significant.

RESULTS: The majority of nurses, 70.5% (95% CI: 63.7-77.3), rated their job performance as good. Workload [AOR = 1.70 (95% CI: 1.19-2.44)], remuneration [AOR = 1.89 (95% CI: 1.35-2.67)], rewards [AOR = 1.50 (95% CI: 1.01-2.23)], objectives to be achieved [AOR = 1.88 (95% CI: 1.32-2.67)], and feedback on performance appraisals [AOR = 1.65 (95% CI: 1.17-2.33)] were identified as significantly associated with nurses’ performance.

CONCLUSION: While the majority of nurses rated their job performance as good, it is important to note that a relevant proportion of nurses rated their job performance as poor. The findings of this study identified that nurses’ performance is influenced by several key factors, including workload, remuneration, rewards, objectives to be achieved, and feedback on performance appraisals. Our findings call for improving nurses’ job performance; therefore, hospitals should consider implementing systems that effectively utilize performance appraisal results and recognize and encourage hardworking nurses.

PMID:38715029 | DOI:10.1186/s12912-024-01979-w

BMC Nurs. 2024 May 7;23(1):309. doi: 10.1186/s12912-024-01975-0.

ABSTRACT

BACKGROUND: Standards contribute to comprehensive and programmatic implementation of educational strategies, such as scaffolding. Although the development of educational standards follows a rigorous consensus approach, they are socially constructed and could result in varied interpretations by users. Reports of varied implementation of standards in health professions education underscore the need to test the developed standards for scaffolding in health sciences programmes. Usability entails determining whether a product like standards works as intended under the expected conditions and contexts. This study aimed to describe the usability of standards for scaffolding in a health sciences programme through a pilot study.

METHODS: A multi-method design employing user and expert-based usability evaluation techniques sought to describe the usability of the standards for scaffolding in a three-year pre-registration nursing programme. The user sample of nurse educators drawn from the programme, conducted a self-assessment on scaffolding practices in the programme using a developed standards checklist. For the expert sample, three-panel members with an understanding of the discipline and programme context were purposively sampled. These panelists studied the users’ self-assessment reports before completing an author-generated heuristics checklist to support or refute any of the standards. Descriptive statistics, comparative and content analysis were applied to analyse data from users’ interviews and expert’s completed heuristics checklist, determining the standards’ usability, and identifying the usability flaws or strengths.

RESULTS: The users had three or more years of teaching experience in the competency-based curriculum for nursing. The experts shared an average of 16 years of experience in teaching in higher education, and seven years of experience in quality assurance and programme accreditation. The four standards had a usability score of above average (68%). Seven usability strengths and four usability flaws were identified. Usability flaws related to misinterpretation of some criteria statements and terminologies, multiple meanings, and users’ challenges in generating evidence for some criteria.

CONCLUSIONS: The pilot study revealed the context-based ‘truth’ regarding the fidelity of a health sciences programme evaluation on scaffolding, as well as identifying the ideal contextual conditions in which the standards for scaffolding health sciences programmes would work best. The identified usability flaws highlighted the need for further revisions of the standards. Future research on the feasibility of the standards in other health sciences programmes and contexts is recommended.

PMID:38715024 | DOI:10.1186/s12912-024-01975-0

BMC Med Educ. 2024 May 7;24(1):506. doi: 10.1186/s12909-024-05444-9.

ABSTRACT

BACKGROUND: Medical students face significant psychological stress, impacting their academic performance and well-being. The Systematic Assessment for Resilience (SAR) framework is designed to enhance resilience and mitigate stress among medical students, addressing the need for interventions within the assessment system in medical education. The aim of this study was to evaluate the implementation of SAR framework on medical students’ resilience, anxiety, depression, burnout, and academic stress.

METHODS: This study employed a quasi-experimental design with pre- and post-testing. It involved the training of course coordinators in implementing the SAR framework and its integration into the daily learning activities. Fourth-year medical students were assessed before and after the intervention using standardized measures of resilience, anxiety, depression, burnout, and academic stress. Data were analyzed using quantitative methods and thematic analysis for qualitative feedback.

RESULTS: Post-intervention, students demonstrated a significant increase in resilience scores (p < 0.001) and a notable decrease in measures of anxiety, depression, and academic stress (p < 0.001). The burnout types were also statistically different (p < 0.001) except client-related burnout (p > 0.05). Qualitative feedback of the course coordinators highlighted an improved learning environment, increased coping strategies, and a more supportive academic culture.

CONCLUSION: The SAR framework significantly contributes to enhancing medical students’ resilience and reducing psychological distress. Its implementation suggests a promising approach to fostering a supportive educational environment that not only addresses the psychological challenges faced by medical students but also enhances their academic performance and overall well-being. Further research is warranted to explore the long-term impacts of SAR across different medical education contexts.

PMID:38715022 | DOI:10.1186/s12909-024-05444-9

Virol J. 2024 May 7;21(1):106. doi: 10.1186/s12985-024-02373-3.

ABSTRACT

INTRODUCTION: Human papillomavirus (HPV) presents a potential threat to the onset of carcinogenesis in the cervix, anogenital regions, and oropharynx. HPV encompasses over 200 types, with at least 12 having the potential to cause cancer, impacting the majority of sexually active individuals. In this current research, we explore the occurrence and spread of HPV genotypes.

MATERIAL AND METHODS: During this cross-sectional study conducted in Sanandaj, Iran from Feb 2022 to Aug 2023, diverse samples including oral, vaginal, and genital were collected from individuals referred to private laboratories in Sanandaj, Iran. After sample collection and DNA extraction (FAVORGEN, Taiwan), they were subjected to PCR and genotyping (MehrViru, Iran). The subsequent statistical analysis unveiled infection rates across different demographics and age groups. STATA (version 17) were used for statistical analysis. We examined infection rates across demographics using t-tests and Odds Ratio.

RESULTS: Overall, 26% (249) out of 950 cases tested positive for HPV, with 69% of these classified as high-risk. Among the examined population, 98% (933) were female, and 2% (17) were male. Females aged 31-40 exhibited the highest percentage of HPV prevalence (115/460) in the study with the majority of positive cases belonging to HR genotypes. The overall most frequent genotypes identified were 6, 16, 52, 53, 51, 58, and 56. HPV-16 exhibited the highest frequency among HR genotypes, accounting for 42 (17%) occurrences, followed by HPV-52 with a frequency of 32 (13%).

CONCLUSION: Our findings emphasize the significant prevalence of HPV among females, particularly in the 21-30 age group. The identification of high-risk genotypes, underscores the importance of targeted interventions for specific age cohorts. The age-stratified analysis highlights a consistent predominance of high-risk HPV across age groups, indicating the need for age-specific preventive measures. These results contribute valuable information for designing effective screening and vaccination strategies, to alleviate the impact of diseases associated with HPV.

PMID:38715018 | DOI:10.1186/s12985-024-02373-3