Category: Nevin Manimala

J Obstet Gynaecol Res. 2023 Jul 17. doi: 10.1111/jog.15746. Online ahead of print.

ABSTRACT

OBJECTIVE: The study aimed to determine whether maternal serum haptoglobin values could have an effect on predicting diagnosis and neonatal outcomes in preeclampsia and HELLP syndrome.

MATERIALS AND METHODS: Hundred sixteen pregnant women who met the inclusion criteria were included in the study. To evaluate whether serum haptoglobin level in maternal blood could be used in early diagnosis of preeclampsia and HELLP syndrome, 49 pregnant women diagnosed with preeclampsia and 13 pregnant women diagnosed with HELLP syndrome were included in the study group, and 54 healthy pregnant women in the control group. The groups were compared regarding maternal serum haptoglobin level, platelet count, ALT, AST, LDH, and uric acid levels. Moreover, the age, obstetric histories, and newborn outcomes of all pregnant women were recorded and compared between groups.

RESULTS: The mean haptoglobin values were 0.29 ± 0.23 g/L in the HELLP syndrome group, 1.01 ± 0.52 g/L in the preeclampsia group, and 1.16 ± 0.37 g/L in the control group. The mean haptoglobin result was lower in the HELLP syndrome group compared to the preeclampsia and control groups (p < 0.001). While the differences between HELLP syndrome and the control and preeclampsia groups were statistically significant, no significant difference was determined between the preeclampsia and control groups. There was a significant positive correlation between haptoglobin value with the week of delivery, umbilical cord pH value, and the first and fifth-minute Apgar scores (p < 0.05).

CONCLUSION: It was concluded that haptoglobin values could be used together with other biochemical parameters to diagnose HELLP syndrome and predict newborn outcomes.

PMID:37461123 | DOI:10.1111/jog.15746

Arch Public Health. 2023 Jul 17;81(1):134. doi: 10.1186/s13690-023-01149-5.

ABSTRACT

BACKGROUND: Hospital cleaners are the unsung heroes in the fight against the COVID-19 pandemic. This study aimed to assess the knowledge, attitudes, and practices (KAP) of hospital cleaners towards COVID-19 and determine factors associated with good practices.

METHODS: A cross-sectional study was conducted in Lebanon between the 1st and 14th November 2020. Using a snowball sampling technique, data were collected through an online survey that was sent to governmental and private hospitals. The questionnaire consisted of socio-demographic characteristics and KAP of hospital cleaners towards COVID-19. Descriptive statistics and logistic regression analysis were performed.

RESULTS: A total of 453 cleaners completed the survey, of whom 54.3% were females. Most participants had a good level of COVID-19 knowledge (98%) and good preventive practices (89.7%). Regarding attitude, 90.7% had a positive attitude toward health facilities, 78.8% toward cleaning and disinfection, and 73.5% toward health authorities. Sociodemographic characteristics, including younger age, higher levels of education, working in private hospitals, and having more than 3 years of experience, were positively associated with good preventive practices. Our results also showed that participants who had good knowledge about COVID-19, COVID-19 prevention and treatment, cleaning and disinfection processes, and COVID-19 risk factors had a higher likelihood of positive preventive practices. Finally, a positive attitude toward health facilities, health authorities, and cleaning and disinfection was positively associated with good practices.

CONCLUSION: The surveyed cleaners have a high level of knowledge and expressed positive attitudes toward health facilities and health authorities, as well as good preventive practices. Understanding the determinants of cleaning performance is critical in tailoring interventions to improve hospital cleaning.

PMID:37461121 | DOI:10.1186/s13690-023-01149-5

Blood Purif. 2023 Jul 17:1-7. doi: 10.1159/000531274. Online ahead of print.

ABSTRACT

BACKGROUND: Anemia is a common finding among patients with advanced chronic kidney disease, especially those on dialysis. The recent introduction of hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) has raised some concerns about the cardiovascular and thrombotic complications of this class of drugs.

OBJECTIVES: This meta-analysis aimed to assess the safety of HIF-PHIs in patients with end-stage kidney disease (ESKD) versus standard therapy with erythropoiesis-stimulating agents (ESAs).

METHODS: Databases were searched on April 2022. Studies that reported incidence of all-cause mortality; major cardiovascular adverse events (MACEs); myocardial infarction (MI); stroke and thrombotic events in the use of HIF-PHIs or ESA on ESKD patients in hemodialysis or peritoneal dialysis were evaluated. Data were extracted from published reports, and quality assessment was performed per Cochrane recommendations.

RESULTS: 12,821 patients from ten randomized controlled trials were included in this study. Most patients (83%) were on hemodialysis. 6,461 (50.3%) were using HIF-PHIs, and 6,360 (49.6%) were in the ESA group. The pooled estimated incidence of all-cause mortality was 769 in the HIF-PHIs group (relative-risk ratios (RR): 1.04; confidence interval (CI): 0.95-1.14; p = 0.52; I2 = 0%). There was no difference in the groups regarding the outcomes of MACE in the analysis of the three studies that reported this outcome (RR: 0.95; CI: 0.87-1.04; p = 0.69; I2 = 0%). In addition, there was no statistical difference among the outcomes of MI, stroke, or thrombotic events.

CONCLUSIONS: Among patients with ESKD on dialysis, the use of HIF-PHIs was non-inferior regarding the safety outcomes when compared to standard of care therapy.

PMID:37459846 | DOI:10.1159/000531274

Swiss Med Wkly. 2023 Jul 17;153:40091. doi: 10.57187/smw.2023.40091.

ABSTRACT

AIMS: There is a lack of national and international publicly available long-term survival outcome data from individual healthcare providers in medical oncology. In this study, the overall survival at a medium-sized medical oncology service at Olten Cantonal Hospital was evaluated and compared as a local benchmark report with national data from the Swiss Cancer Registries. Furthermore, adherence to treatment guidelines was investigated as an additional quality indicator.

METHODS: The 1- and 5-year overall survival of all patients with breast cancer, testicular cancer, colon cancer, non-small-cell lung cancer, Hodgkin lymphoma, and diffuse large B-cell lymphoma in Switzerland from 2008 to 2017 with at least one outpatient visit at the in-house medical oncology service at Olten Cantonal Hospital was analysed and compared with the specific overall population-based outcome data provided by the National Agency for Cancer Registration (NACR), which were set as a national benchmark. Until 2020, no data from the Canton of Solothurn, to which Olten belongs, were reported to the NACR. Further, adherence to internationally recognized clinical guidelines for stage-specific treatment was assessed.

RESULTS: Until September 8, 2020, data on 842 patients with a median follow-up period of 70 months were collected and analysed. The 1- and 5-year overall survival for colon and non-small cell cancer, Hodgkin lymphoma, and diffuse large B-cell lymphoma and the 5-year overall survival for testicular cancer in the Olten cohort did not significantly differ from the NACR data. The 1-year overall survival for testicular cancer was not comparable statistically. The 5-year overall survival for breast cancer (unadjusted for stage) was significantly higher in the NACR collective (84.5%) than in the Olten collective (79.7%) but not for the individual breast cancer stages. The Olten collective included approximately 2.5 times as many patients with stage 4 breast cancer (17.5%) as the NACR collective (6.9%). Approximately 92.4% of the patients in the curative setting and 85.8% of the patients in the palliative setting received first-line treatment according to guidelines.

CONCLUSIONS: The statistically comparable local 1- and 5-year overall survival of the analysed malignancies, with adjustment for stage for the 5-year overall survival for breast cancer, is in line with the national benchmark. Adherence to treatment guidelines is high.

PMID:37459836 | DOI:10.57187/smw.2023.40091

Nurse Educ Today. 2023 Jul 5;129:105893. doi: 10.1016/j.nedt.2023.105893. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the preferences for case-based learning programmes among undergraduate nursing students.

METHOD: A questionnaire was designed based on a discrete choice experiment, and 227 undergraduate nursing students were investigated. In STATA 15.0 software, the data were statistically analysed using a mixed logit model.

RESULT: All attributes in our study were found to have a significant influence on undergraduate nursing students’ preferences for case-based learning programmes. The students’ preference for the CBL programme was influenced by the clinical internship experience and type of university. Furthermore, the most ideal scenario was found to be video case modality, unfolding delivery, provided by academic experts and clinical instructors, group size 9-11, adequate feedback, and fragmented case content.

CONCLUSION: The undergraduate nursing students’ preferences for case-based learning programmes were affected by the provider, case modality, modality, group size, feedback, and case content. Our results can provide useful information for nursing educators to gain insight into student preferences and formulate case-based learning programs.

PMID:37459830 | DOI:10.1016/j.nedt.2023.105893

Nurse Educ Today. 2023 Jul 15;129:105902. doi: 10.1016/j.nedt.2023.105902. Online ahead of print.

ABSTRACT

BACKGROUND: Nursing students in their final year of study will soon become responsible for the care and management of people with diabetes, and they need to be knowledgeable to provide adequate information.

OBJECTIVES: The aim of this study was to assess nursing students’ knowledge regarding diabetes care and management.

DESIGN: A descriptive cross-sectional multicenter study.

SETTINGS AND PARTICIPANTS: A convenience sample of all nursing students’ internship enrolled at three government universities in Saudi Arabia.

METHODS: 306 Saudi nursing students were surveyed with a self-administered questionnaire of the sociodemographic characteristics of the participants. The second part contained 23 multiple-choice questions of the Michigan Diabetes Knowledge Test. Data were collected from July to September 2022.

RESULTS: The overall percentage of correct responses was 49.28 %. There was a significant difference between sex, the university attended, attendance in courses related to diabetes, and diabetes management guidelines in any course and their knowledge about diabetes care and management (p = 0.024, 0.001, 0.036, and 0.038, respectively). There was a significant difference between nursing students’ general knowledge and insulin use knowledge (p = 0.001). A multiple regression analysis revealed that the university attended was the only statistically significant factor (p = 0.001).

CONCLUSION: Nursing internship students are likely to be responsible for providing people with diabetes care and management once they qualify. Inappropriate knowledge negatively affects the care and management of people with diabetes. Information related to diabetic insulin therapy should be provided in more detail in the nursing curriculum.

PMID:37459829 | DOI:10.1016/j.nedt.2023.105902

J Environ Manage. 2023 Jul 15;344:118604. doi: 10.1016/j.jenvman.2023.118604. Online ahead of print.

ABSTRACT

This study analyzes the regional implications of China’s 2017 import ban on plastic waste by examining U.S. census data. A statistically significant decrease in total U.S. plastic waste exports was found, dropping from about 1.4 million tons to 0.6 million tons in the post-ban period. California remained the top exporter, throughout both pre- and post-ban periods, while South Carolina exhibited the highest per capita exports. Malaysia emerged as the largest importer of U.S. plastic waste, followed by Vietnam, Indonesia, and Thailand. The ban also led to a change in the composition of the exported plastic waste. Ethylene polymers increased from 32.6% of total exports in the pre-ban period to 46.9% in the post-ban period. Other plastics (vinyl chloride polymers, styrene polymers, and for plastics not elsewhere specified or included) decreased from 67.4% of total exports in the pre-ban period to 53.1% in the post-ban period. Moreover, we found that exporting plastic waste has significant environmental and human health impacts. For example, the Global Warming Potential (GWP) decreased from 20 million tons CO_2-eq in the scenario where 100% of plastics are exported, or 25 million tons exported from the U.S. since 2002, to -11.1 million tons CO_2-eq in the scenario where 100% of plastics are treated domestically. Transportation exacerbates these impacts for exported waste scenarios, increasing to 5.4 million tons CO_2-eq when plastics are exported by ship while decreasing to 0.9 million tons CO_2-eq for domestic treatment. Although exporting plastic waste is initially cost-effective, our study highlights that investing in domestic waste management can yield significant long-term benefits, considering the environmental and public health impacts. Therefore, it is crucial to prioritize context-specific solutions to address the challenges of the evolving global plastic waste landscape.

PMID:37459814 | DOI:10.1016/j.jenvman.2023.118604

Comput Biol Med. 2023 Jun 16;164:107094. doi: 10.1016/j.compbiomed.2023.107094. Online ahead of print.

ABSTRACT

In recent years, research in the field of bioinformatics has focused on predicting the raw sequences of proteins, and some scholars consider DNA-binding protein prediction as a classification task. Many statistical and machine learning-based methods have been widely used in DNA-binding proteins research. The aforementioned methods are indeed more efficient than those based on manual classification, but there is still room for improvement in terms of prediction accuracy and speed. In this study, researchers used Average Blocks, Discrete Cosine Transform, Discrete Wavelet Transform, Global encoding, Normalized Moreau-Broto Autocorrelation and Pseudo position-specific scoring matrix to extract evolutionary features. A dynamic deep network based on lifelong learning architecture was then proposed in order to fuse six features and thus allow for more efficient classification of DNA-binding proteins. The multi-feature fusion allows for a more accurate description of the desired protein information than single features. This model offers a fresh perspective on the dichotomous classification problem in bioinformatics and broadens the application field of lifelong learning. The researchers ran trials on three datasets and contrasted them with other classification techniques to show the model’s effectiveness in this study. The findings demonstrated that the model used in this research was superior to other approaches in terms of single-sample specificity (81.0%, 83.0%) and single-sample sensitivity (82.4%, 90.7%), and achieves high accuracy on the benchmark dataset (88.4%, 80.0%, and 76.6%).

PMID:37459792 | DOI:10.1016/j.compbiomed.2023.107094

J Diabetes Complications. 2023 Jun 6;37(8):108528. doi: 10.1016/j.jdiacomp.2023.108528. Online ahead of print.

ABSTRACT

OBJECTIVE: Children with type one diabetes mellitus (T1DM) may have subclinical myocardial insults but large heterogeneity exists among the reports. This study aimed to compare myocardial strain values of the left ventricle (LV) in paediatric patients with T1DM without overt cardiac disease and healthy controls.

METHODS: Five databases (MEDLINE, Embase, Scopus, Web of Science and Cochrane central register of controlled trials) were searched from inception to March 30, 2020. The studies reporting two-dimensional speckle tracking echocardiography in asymptomatic T1DM paediatric patients and control groups were included. Pooled mean strain values in each group and mean difference (MD) between the two groups for LV global longitudinal strain (LVGLS) and LV global circumferential strain (LVGCS) were assessed using a random effects model.

RESULTS: Ten studies (755 T1DM and 610 control) with LVGLS were included with 6 studies having LVGCS (534 T1DM and 403 control). Patients with T1DM had overall 3 percentage points lower LVGLS than healthy subjects (18.4 %, 95 % confidence interval [17.1, 19.6] vs 21.5 % [20.3, 22.7], MD = -3.01 [-4.30, -1.71]). A similar result was seen in LVGCS (18.7 % [15.4, 22.0] vs. 21.4 % [18.1, 24.6], MD = -3.10[-6.47, 0.26]) but not statistically significant. Meta-regression identified those with higher Haemoglobin A1c (HbA1c) had worse GLS.

CONCLUSIONS: Subclinical LV dysfunction among patients with T1DM occurs as early as in their childhood, while even EF is preserved. The longitudinal cardiac function is altered, but not the circumferential. GLS can be used to detect subclinical LV systolic dysfunction in paediatric population.

PMID:37459780 | DOI:10.1016/j.jdiacomp.2023.108528

J Psychiatr Res. 2023 Jul 10;165:34-40. doi: 10.1016/j.jpsychires.2023.07.009. Online ahead of print.

ABSTRACT

There is a widening disparity in suicide deaths between United States (U.S.) military veterans and nonveterans. However, it is unclear if there are similar differences in suicidal ideation, planning, and attempts that often precipitate these deaths. A better understanding of trends in suicidal thoughts and behaviors could illuminate opportunities for prevention. We examined pooled cross-sectional data (N = 479,801 adults) from the 2008 to 2019 National Survey on Drug Use and Health. We examined differences in past-year suicidal ideation, suicide planning, and suicide attempts between U.S. veterans (n = 26,508) and nonveterans (n = 453,293). We conducted post hoc analyses to examine for differences in these relationships by race/ethnicity and sex. Lastly, we examined trends in these outcomes over time and tested for differences in trends by veteran status. Overall, veterans had significantly greater odds of past-year suicidal ideation (aOR = 1.33, 95% CI 1.20 to 1.47) and suicide planning (aOR = 1.52, 95% CI 1.30 to 1.78) compared to nonveterans. However, the association between veteran status and past-year suicide attempt was not statistically significant (aOR = 1.29, 95% CI 1.00 to 1.68). These relationships did not differ by race/ethnicity or sex (ps > 0.05). Among all adults, there were significant linear increases in past-year suicidal ideation, planning, and attempts (ps < 0.001). However, these trends did not differ between veterans and nonveterans (ps > 0.05). Veterans may be more likely to experience suicidal thoughts and behaviors than nonveteran adults. Upward trends in suicidal thoughts and behaviors among both veterans and nonveterans from 2008 to 2019 highlight opportunities for intervention.

PMID:37459776 | DOI:10.1016/j.jpsychires.2023.07.009