Category: Nevin Manimala

Endokrynol Pol. 2023 Nov 23. doi: 10.5603/ep.96715. Online ahead of print.

ABSTRACT

INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is a global disease estimated to affect one-third of the world’s population. NAFLD is the hepatic manifestation of metabolic syndrome. In recent years, formulations have been made using haematological laboratory parameters, and it has been reported to be associated with inflammation and fibrosis in the liver. In this study, we aimed to evaluate the neutrophil to high-density lipoprotein (HDL) cholesterol (HDL-C) ratio (NHR) in patients diagnosed with NAFLD by ultrasonographic imaging for the first time in the literature.

MATERIAL AND METHODS: The study was carried out by recruiting men and women between the ages of 18 and 65 years who applied to the check-up outpatient clinic of our hospital. Ultrasonography was used as the diagnostic method for hepatosteatosis in all cases. Venous blood samples were taken from the patients for haematological and biochemical measurements.

RESULTS: The study population consisted of 155 patients, 115 of whom were fatty liver patients and 40 were controls. NHR was determined as 99.6 ± 56.8 in those with grade 1 fatty liver, 114.98 ± 39.2 in those with grade 2, 122.9 ± 51.1 in those with grade 3, and 86.17 ± 35.2 in the control group. In the analysis, NHR was statistically significantly higher in grade 2 and 3 fatty liver patients compared with the control group (p = 0.03 and 0.01, respectively). However, there was no statistical difference between grade 1 fatty liver patients and the control group (p = 0.53).

CONCLUSIONS: We found higher NHR in patients with NAFLD. NHR is a cheap and easy to access parameter. An elevated NHR with FIB-4 in patients with NAFLD may be a marker of liver inflammation or fibrosis.

PMID:37994581 | DOI:10.5603/ep.96715

Eur J Haematol. 2023 Nov 23. doi: 10.1111/ejh.14139. Online ahead of print.

ABSTRACT

OBJECTIVES: To describe real-world use/effectiveness of pegcetacoplan (PEG) in paroxysmal nocturnal haemoglobinuria (PNH).

METHODS: Data were drawn from the Adelphi PNH Disease Specific Programme™, a cross-sectional survey conducted in France, Italy, Germany, Spain and the United States from January to November 2022. Patients had a confirmed PNH diagnosis and received PEG for ≥1 month. Physicians reported patient characteristics, treatment use/satisfaction and their perception of patients’ fatigue and health-related quality of life (HRQoL). Patients reported treatment satisfaction and completed questionnaires assessing fatigue, HRQoL and productivity. Descriptive statistics were reported.

RESULTS: Overall, 14 physicians provided data for 61 patients who had received 1080 mg/dose PEG for 1.3-14.8 months. At data collection compared to PEG initiation: haemoglobin was 2.5 g/dL higher on average; proportion of patients with lactate dehydrogenase (LDH) ≥1.5 × upper limit of normal was reduced by 27.4%; physician-perceived fatigue was lower and HRQoL better. Physician- and patient-reported treatment satisfaction was high for >90% of patients. Physicians and patients were more satisfied with PEG than previously prescribed C5 complement inhibitors. Mean work impairment and activity impairment in the 7 days prior to data collection were 32.9% and 22.4%, respectively.

CONCLUSIONS: These real-world data support the effectiveness of PEG through positive effects on haemoglobin, LDH, fatigue and HRQoL.

PMID:37994576 | DOI:10.1111/ejh.14139

J Sch Health. 2023 Nov 23. doi: 10.1111/josh.13412. Online ahead of print.

ABSTRACT

BACKGROUND: The National School Lunch and School Breakfast programs reduce food insecurity and improve dietary intake. During the COVID-19 pandemic, school meals were provided to all children at no cost, regardless of income. This policy is known as Healthy School Meals For All (HSMFA). The purpose of the study was to examine the feasibility of a HSMFA policy in Utah.

METHODS: A mixed-methods approach was used, including qualitative interviews for policymakers, surveys for school foodservice directors, and financial modeling of Utah Child Nutrition Programs data. Analysis included a phenomenological analytic approach for qualitative data, descriptive statistics for surveys, and development of a cost model with 6 scenarios.

RESULTS: Qualitative data revealed themes of (1) awareness; (2) responsibility; (3) perspectives on school meals; and (4) new opportunities. Most (81%) foodservice directors believed HSMFA should continue post-pandemic. HSMFA would cost $51,341,436 to $82,358,375 per year.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: HSMFA would result in the equitable treatment of all children regarding access to healthy school meals.

CONCLUSIONS: Given the support of foodservice directors but the lack of political consensus, considering stepwise implementation and providing cost estimates may increase feasibility of a HSMFA policy in Utah.

PMID:37994552 | DOI:10.1111/josh.13412

Infect Control Hosp Epidemiol. 2023 Nov 23:1-7. doi: 10.1017/ice.2023.243. Online ahead of print.

ABSTRACT

OBJECTIVE: The gold standard for hand hygiene (HH) while wearing gloves requires removing gloves, performing HH, and donning new gloves between WHO moments. The novel strategy of applying alcohol-based hand rub (ABHR) directly to gloved hands might be effective and efficient.

DESIGN: A mixed-method, multicenter, 3-arm, randomized trial.

SETTING: Adult and pediatric medical-surgical, intermediate, and intensive care units at 4 hospitals.

PARTICIPANTS: Healthcare personnel (HCP).

INTERVENTIONS: HCP were randomized to 3 groups: ABHR applied directly to gloved hands, the current standard, or usual care.

METHODS: Gloved hands were sampled via direct imprint. Gold-standard and usual-care arms were compared with the ABHR intervention.

RESULTS: Bacteria were identified on gloved hands after 432 (67.4%) of 641 observations in the gold-standard arm versus 548 (82.8%) of 662 observations in the intervention arm (P < .01). HH required a mean of 14 seconds in the intervention and a mean of 28.7 seconds in the gold-standard arm (P < .01). Bacteria were identified on gloved hands after 133 (98.5%) of 135 observations in the usual-care arm versus 173 (76.6%) of 226 observations in the intervention arm (P < .01). Of 331 gloves tested 6 (1.8%) were found to have microperforations; all were identified in the intervention arm [6 (2.9%) of 205].

CONCLUSIONS: Compared with usual care, contamination of gloved hands was significantly reduced by applying ABHR directly to gloved hands but statistically higher than the gold standard. Given time savings and microbiological benefit over usual care and lack of feasibility of adhering to the gold standard, the Centers for Disease Control and Prevention and the World Health Organization should consider advising HCP to decontaminate gloved hands with ABHR when HH moments arise during single-patient encounters.Trial Registration: NCT03445676.

PMID:37994538 | DOI:10.1017/ice.2023.243

Ear Nose Throat J. 2023 Nov 23:1455613231204210. doi: 10.1177/01455613231204210. Online ahead of print.

ABSTRACT

Introduction: Radiotherapy causes significant nasal comorbidity in nasopharynx cancer (NPC) patients. However, the literature addressing the sino-nasal quality of life (QoL) of those patients, especially on structural and functional changes after radiotherapy, is limited. Method: It is a case-control study with 14 NPC groups and 14 healthy control group. The sino-nasal QoL, including the olfactory threshold using Butanol Threshold Test (BTT), the olfactory identification level using the University of Pennsylvania Smell Identification Test (UPSIT), nasal symptoms using the sino-nasal outcome test (SNOT-22) questionnaire, nasal cross-sectional area, nasal flow, and nasal resistance using the acoustic rhinometry and rhinomanometry, were measured and compared. Result: The mean BTT score of the control group was higher than that of the NPC group (5.17 vs 2.71). The UPSIT score of the control group was higher than that of the NPC group (31.93 vs 25.14). The mean SNOT-22 score of control group was lower than that of the NPC group of (16.71 vs 37.71). All 3 results are statistically significant (P < .05). However, there is no statistical difference in nasal cross-sectional area, nasal flow, and nasal resistance between these 2 groups. Conclusion: In this study, we concluded that NPC patients who received radiotherapy suffered a worsening of sino-nasal functional changes, including the olfaction threshold, olfaction identification, and nasal symptoms. However, the sino-nasal structural changes on nasal cross-sectional area, nasal flow, and nasal resistance after radiation remain questionable.

PMID:37994527 | DOI:10.1177/01455613231204210

Nurse Educ. 2023 Nov 22. doi: 10.1097/NNE.0000000000001566. Online ahead of print.

ABSTRACT

BACKGROUND: The research on ChatGPT-generated nursing care planning texts is critical for enhancing nursing education through innovative and accessible learning methods, improving reliability and quality.

PURPOSE: The aim of the study was to examine the quality, authenticity, and reliability of the nursing care planning texts produced using ChatGPT.

METHODS: The study sample comprised 40 texts generated by ChatGPT selected nursing diagnoses that were included in NANDA 2021-2023. The texts were evaluated by using a descriptive criteria form and the DISCERN tool to evaluate health information.

RESULTS: DISCERN total average score of the texts was 45.93 ± 4.72. All texts had a moderate level of reliability and 97.5% of them provided moderate quality subscale score of information. A statistically significant relationship was found among the number of accessible references, reliability (r = 0.408), and quality subscale score (r = 0.379) of the texts (P < .05).

CONCLUSION: ChatGPT-generated texts exhibited moderate reliability, quality of nursing care information, and overall quality despite low similarity rates.

PMID:37994523 | DOI:10.1097/NNE.0000000000001566

Sci Context. 2023 Nov 23:1-20. doi: 10.1017/S0269889723000133. Online ahead of print.

ABSTRACT

The sociological study of knowledge infrastructures and classification has traditionally focused on the politics and practices of classifying things or people. However, actors’ work to escape dominant infrastructures and pre-established classification systems has received little attention. In response to this, this article argues that it is crucial to analyze, not only the practices and politics of classification, but also actors’ work to escape dominant classification systems. The article has two aims: First, to make a theoretical contribution to the study of classification by proposing to pay analytical attention to practices of escaping classification, what the article dubs classification egress. This concept directs our attention not only to the practices and politics of classifying things, but also to how actors work to escape or resist classification systems in practice. Second, the article aims to increase our understanding of the history of quantified and statistical health surveillance. In this, the article investigates how actors in health surveillance assembled a knowledge infrastructure for surveilling, quantifying, and detecting unknown patterns of congenital malformations in the wake of the thalidomide disaster in the early 1960s. The empirical account centers on the actors’ work to detect congenital malformations and escape the dominant nosological classification of diseases, the International Classification of Diseases (ICD), by replacing it with a procedural standard for reporting of symptoms. Thus, the article investigates how actors deal with the tension between the-already-known-and-classified and the unknown-unclassified-phenomenon in health surveillance practice.

PMID:37994507 | DOI:10.1017/S0269889723000133

J Am Acad Orthop Surg. 2023 Nov 22. doi: 10.5435/JAAOS-D-23-00296. Online ahead of print.

ABSTRACT

INTRODUCTION: Health inequities remain a notable barrier for pediatric patients, especially in conditions such as adolescent idiopathic scoliosis (AIS), where the efficacy of nonsurgical treatment is dependent on early diagnosis and referral to a specialist. Social determinants of health (SDOH) are nonmedical factors that affect health outcomes, such as economic stability, neighborhood environment, and discrimination. Although these factors have been studied throughout the AIS literature, considerable inconsistencies remain across studies regarding the investigation of SDOH for this population. Through a scoping review, we analyze the existing literature to propose a comprehensive framework to consider when designing future prospective and retrospective studies of healthcare equity in AIS.

METHODS: A systematic review was executed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. A meta-analysis was performed for each reported SDOH (race, ethnicity, insurance provider, and socioeconomic status) including only studies with complete and consistent variables and outcomes. Cobb angle measurements were aggregated and summarized as the weighted mean difference with 95% confidence interval using a fixed or random-effects model (substantial heterogeneity identified).

RESULTS: Of 7,539 studies reviewed, nine studies met all the inclusion criteria. As expected, considerable inconsistencies were found across the nine studies making it difficult to aggregate data. Within the meta-analyses, the mean difference between White non-Hispanic and Hispanic patients was statistically significant (1.71; 95% confidence interval 0.78 to 2.65; P < 0.001). No other statistically significant differences were identified among the SDOH and presenting main Cobb angle magnitude.

CONCLUSION: These studies provide insight into healthcare inequities in AIS, although notable inconsistencies make it difficult to aggregate data and draw the conclusions needed to drive necessary public health changes. However, our proposed framework can provide a guideline for future prospective and retrospective studies to standardize data reporting and allow for improved collaboration, study design, and future systematic reviews and meta-analyses.

PMID:37994490 | DOI:10.5435/JAAOS-D-23-00296

J Laryngol Otol. 2023 Apr 26:1-7. doi: 10.1017/S0022215123000683. Online ahead of print.

ABSTRACT

OBJECTIVE: To propose a scoring system based on laryngoscopic characteristics for the differential diagnosis of benign and malignant vocal fold leukoplakia.

METHODS: Laryngoscopic images from 200 vocal fold leukoplakia cases were retrospectively analysed. The laryngoscopic signs of benign and malignant vocal fold leukoplakia were compared, and statistically significant features were assigned and accumulated to establish the leukoplakia finding score.

RESULTS: A total of five indicators associated with malignant vocal fold leukoplakia were included to construct the leukoplakia finding score, with a possible range of 0-10 points. A score of 6 points or more was indicative of a diagnosis of malignant vocal fold leukoplakia. The sensitivity, specificity and accuracy values of the leukoplakia finding score were 93.8 per cent, 83.6 per cent and 86.0 per cent, respectively. The consistency in the leukoplakia finding score obtained by different laryngologists was strong (kappa = 0.809).

CONCLUSION: This scoring system based on laryngoscopic characteristics has high diagnostic value for distinguishing benign and malignant vocal fold leukoplakia.

PMID:37994484 | DOI:10.1017/S0022215123000683

J Sep Sci. 2023 Nov 23:e2300281. doi: 10.1002/jssc.202300281. Online ahead of print.

ABSTRACT

Qingpi, a well-known traditional Chinese medicine for qi-regulating and commonly processed into three types of pieces, has been widely used in the clinical application of liver disease for thousands of years. In this study, an ultra-high-performance liquid chromatography-quadrupole-time of flight-mass spectrometry approach along with multivariate statistical analysis was developed to assess and characterize the differentiations of three processed products and confirm the potential quality markers of Qingpi. In addition, a systematic analysis combined with network pharmacology and molecular docking was performed to clarify the potential mechanism of Qingpi for the treatment of liver disease. As a result, 18 components were identified and an integrated network of Qingpi-Components-Target-Pathway-Liver Disease was constructed. Eight compounds were finally screened out as the potential quality markers acting on ten main targets and pathways of liver disease. Molecular docking analysis results indicated that the quality markers had a good binding activity with the targets. Overall, this work preliminarily identified the potential quality markers of three processed products of Qingpi, and predicted its targets in the prevention and treatment of liver disease, which can provide supporting information for further study of the pharmacodynamic substances and mechanisms of Qingpi.

PMID:37994479 | DOI:10.1002/jssc.202300281