Category: Nevin Manimala

J Osteopath Med. 2023 May 16. doi: 10.1515/jom-2023-0038. Online ahead of print.

ABSTRACT

CONTEXT: Previous studies document that both osteopathic physicians and third-party observers identify an approach to the patient that is consistent with the philosophy and tenets of osteopathic medicine, often without investigating whether patients identify or are satisfied with it. Osteopathic physicians and the medical education community understand the distinctiveness of an osteopathic approach to the patient. Understanding the outcomes of an osteopathic approach to patient care includes confirming whether patients experience the tenets of osteopathic medicine in physician visits and, if so, how it relates to their experience of physician empathy and satisfaction with the visit.

OBJECTIVES: The objectives of this study were to assess patient experience of the tenets of osteopathic medicine, physician empathy, and satisfaction with the visit and to compare the results for patients who saw DOs with those who saw MD physicians.

METHODS: More than 2000 patients at four outpatient clinic facilities were surveyed after a clinical visit on 22 prompts regarding their experiences of physician behaviors, physician empathy, and their own satisfaction with the encounter. Adult patients who were treated by an osteopathic or allopathic physician for a nonemergency encounter and who were not pregnant were included in the analysis. Survey results for 1,330 patient-physician encounters were analyzed utilizing linear regression models comparing constructs representing patient experiences of the tenets of osteopathic medicine (Tenets), physician empathy (Physician Empathy), satisfaction (Satisfaction) with the encounter, as well as additional demographic and encounter variables.

RESULTS: Approximately 23.8 % of patients approached during the study period completed a survey (n=2,793), and among those, 54.7 % of patients who consented to the study and who saw a physician provider (n=1,330/2,431) were included. Significant (p≤0.01), positive associations among patient experiences of Satisfaction with the visit and Physician Empathy were observed among those who saw both DO and MD physicians. Patients experienced the Tenets during encounters with both DO and MD physicians, but linear regression showed that their experience of the Tenets was significantly (p≤0.01) and positively explained by their experience of Physician Empathy (β=0.332, p=0.00, se=0.052) and Satisfaction with the visit (β=0.209, p=0.01, se=0.081) only when the physician was a DO.

CONCLUSIONS: Patients identified physician behaviors consistent with the Tenets and positively associated their experiences of Physician Empathy and Satisfaction with the visit regardless of physician training background. Patient experience of the Tenets significantly explained their experiences of Physician Empathy and Satisfaction after visits with a DO but not after visits with an MD.

PMID:37192547 | DOI:10.1515/jom-2023-0038

Int J Biostat. 2023 May 17. doi: 10.1515/ijb-2022-0073. Online ahead of print.

ABSTRACT

In this work, we examine recently developed methods for Bayesian inference of optimal dynamic treatment regimes (DTRs). DTRs are a set of treatment decision rules aimed at tailoring patient care to patient-specific characteristics, thereby falling within the realm of precision medicine. In this field, researchers seek to tailor therapy with the intention of improving health outcomes; therefore, they are most interested in identifying optimal DTRs. Recent work has developed Bayesian methods for identifying optimal DTRs in a family indexed by ψ via Bayesian dynamic marginal structural models (MSMs) (Rodriguez Duque D, Stephens DA, Moodie EEM, Klein MB. Semiparametric Bayesian inference for dynamic treatment regimes via dynamic regime marginal structural models. Biostatistics; 2022. (In Press)); we review the proposed estimation procedure and illustrate its use via the new BayesDTR R package. Although methods in Rodriguez Duque D, Stephens DA, Moodie EEM, Klein MB. (Semiparametric Bayesian inference for dynamic treatment regimes via dynamic regime marginal structural models. Biostatistics; 2022. (In Press)) can estimate optimal DTRs well, they may lead to biased estimators when the model for the expected outcome if everyone in a population were to follow a given treatment strategy, known as a value function, is misspecified or when a grid search for the optimum is employed. We describe recent work that uses a Gaussian process $\left(GP\right)$ prior on the value function as a means to robustly identify optimal DTRs (Rodriguez Duque D, Stephens DA, Moodie EEM. Estimation of optimal dynamic treatment regimes using Gaussian processes; 2022. Available from: https://doi.org/10.48550/arXiv.2105.12259). We demonstrate how a $GP$ approach may be implemented with the BayesDTR package and contrast it with other value-search approaches to identifying optimal DTRs. We use data from an HIV therapeutic trial in order to illustrate a standard analysis with these methods, using both the original observed trial data and an additional simulated component to showcase a longitudinal (two-stage DTR) analysis.

PMID:37192544 | DOI:10.1515/ijb-2022-0073

J Pharm Pract. 2023 May 16:8971900231177201. doi: 10.1177/08971900231177201. Online ahead of print.

ABSTRACT

Background: Promotional videos are an effective means of marketing products or services in this era of social media. However, little is known if such videos can be a useful tool to promote pharmacy services. Objective: To assess the impact of promotional videos on public awareness of the health services provided by New Zealand pharmacists. Methods: This experimental study used an online questionnaire and promotional videos developed by the Pharmaceutical Society of New Zealand as an intervention to assess the public’s perspectives about pharmacy services before and after the intervention. The survey was sent out to 1 127 randomly selected members of the public aged 18 and above from all over New Zealand. Data were analysed using descriptive statistics and thematic analysis. Results: A total of 313 participants completed the survey. The majority (95.8%) had not heard of the promotional videos before. However, 84.3% found the videos informative and nearly three-quarters (74.1%) reported a change in their perception of pharmacy services after watching the video. Similarly, 63.2% reported that they or a family member would be more likely to visit a pharmacy in the future after watching the promotional video. Less than half (40%) of the participants reported that the videos were too long and only 11.5% found them boring. Conclusion: The PSNZ videos were found to be an effective tool for educating New Zealanders on different pharmacy services and the pharmacy profession, however, there is a need to choose the advertising platform carefully so as to enhance the coverage.

PMID:37192543 | DOI:10.1177/08971900231177201

Int J Adolesc Med Health. 2023 May 16. doi: 10.1515/ijamh-2023-0001. Online ahead of print.

ABSTRACT

OBJECTIVES: Smoking habit is known to be a risk factor for the development of multiple diseases and conditions, premature death, and worse quality of life. The prevalence of smoking in PLWH is 2-3 times higher than in the general population. The study aimed to evaluate how the prevalence of smoking has changed among PLWH over the past decade.

METHODS: The data of n=204 PLWH hospitalized from November 2018 to November 2019 was analyzed. All patients filled out the survey including age, gender, the number of cigarettes smoked, the number of years as a smoker, and the impact of HIV diagnosis on the number of cigarettes smoked. The data was compared to a similar analysis performed in our department in 2009.

RESULTS: The study showed a decrease in the prevalence of smoking among PLWH over the past decade. In comparison to 2009, a statistically significant (p<0.05) reduction in the number of smoking individuals among ever and never smokers was observed both in males and in females.

CONCLUSIONS: The prevalence of smoking cigarettes among PLWH in our department has significantly decreased since 2009 but remains much higher than in the general population. Smoking cessation interventions provided by HIV care professionals are necessary and should be continued among PLWH.

PMID:37192541 | DOI:10.1515/ijamh-2023-0001

Omega (Westport). 2023 May 16:302228231176307. doi: 10.1177/00302228231176307. Online ahead of print.

ABSTRACT

This research paper aimed to identify the level of psychological hardiness, the level of death anxiety, and the level of existential vacuum among the elderly, also the role of the predictive ability of death anxiety and existential vacuum in the psychological hardiness of the elderly at the governorates of Tafilyah and Ma’an in light of the Corona pandemic in Jordan. The descriptive-analytical approach was utilized. sample consists (500) elderly, that were selected by a simple random approach. Then the needed statistical measure was operated to achieve the required results. The results indicated a low level of psychological hardiness, a high level of death anxiety, and an existential vacuum in the elderly. The results show a suitable predictive ability for each of death anxiety and the existential vacuum in reducing psychological hardiness. The research paper recommended the necessity of rehabilitating the elderly in Jordan regarding the mental and psychological aspects.

PMID:37192525 | DOI:10.1177/00302228231176307

Biom J. 2023 May 16:e2200270. doi: 10.1002/bimj.202200270. Online ahead of print.

ABSTRACT

When screening a population for infectious diseases, pooling individual specimens (e.g., blood, swabs, urine, etc.) can provide enormous cost savings when compared to testing specimens individually. In the biostatistics literature, testing pools of specimens is commonly known as group testing or pooled testing. Although estimating a population-level prevalence with group testing data has received a large amount of attention, most of this work has focused on applications involving a single disease, such as human immunodeficiency virus. Modern methods of screening now involve testing pools and individuals for multiple diseases simultaneously through the use of multiplex assays. Hou et al. (2017, Biometrics, 73, 656-665) and Hou et al. (2020, Biostatistics, 21, 417-431) recently proposed group testing protocols for multiplex assays and derived relevant case identification characteristics, including the expected number of tests and those which quantify classification accuracy. In this article, we describe Bayesian methods to estimate population-level disease probabilities from implementing these protocols or any other multiplex group testing protocol which might be carried out in practice. Our estimation methods can be used with multiplex assays for two or more diseases while incorporating the possibility of test misclassification for each disease. We use chlamydia and gonorrhea testing data collected at the State Hygienic Laboratory at the University of Iowa to illustrate our work. We also provide an online R resource practitioners can use to implement the methods in this article.

PMID:37192524 | DOI:10.1002/bimj.202200270

J Pediatr Endocrinol Metab. 2023 May 18. doi: 10.1515/jpem-2023-0146. Online ahead of print.

ABSTRACT

OBJECTIVES: Compare the efficacy and safety of daily vs. monthly oral vitamin D₃ in treating symptomatic vitamin D deficiency in infants.

METHODS: 90 infants with symptomatic vitamin D deficiency were randomized into Daily (D) [46 infants] and Bolus (B) [44 infants] groups to receive oral vitamin D₃, daily (2000 IU/day) and bolus (60,000 IU/month) for three months respectively. Both groups received daily oral calcium @50 mg/kg/day. Serum calcium (Ca), phosphate (P), alkaline phosphatase (ALP), 25-hydroxy cholecalciferol [25(OH)D], parathyroid hormone (PTH) levels, urine calcium: creatinine ratio and radiological score were assessed at baseline, 4 and 12 weeks. At the end of 12 weeks, 78 infants were available for evaluation of efficacy and safety of both regimens.

RESULTS: Both regimens led to a statistically significant increase in Ca and P levels and fall in ALP and PTH levels from baseline to 4 and 12 weeks of therapy, with no inter-group difference. Infants in group D had statistically significant higher mean 25(OH)D levels as compared to group B at 4 weeks (group D 130.89 ± 43.43 nmol/L, group B – 108.25 ± 32.40 nmol/L; p – 0.012) and 12 weeks (group D – 193.69 ± 32.47 nmol/L, group B – 153.85 ± 33.60 nmol/L; p<0.001). Eight infants [group D – 6/41 (14.6 %); group B – 2/37 (5.4 %), p=0.268] developed mild asymptomatic hypercalcemia without hypercalciuria at 12 weeks that corrected spontaneously within a week.

CONCLUSIONS: Both daily and monthly oral vitamin D₃ in equivalent doses are efficacious and safe for treating symptomatic vitamin D deficiency in infants.

PMID:37192500 | DOI:10.1515/jpem-2023-0146

Microb Drug Resist. 2023 May 16. doi: 10.1089/mdr.2022.0248. Online ahead of print.

ABSTRACT

Introduction: The use of tigecycline (TG) for the treatment of Acinetobacter baumannii is controversial. In this systematic review and meta-analysis, we aimed to better explore the safety and efficacy of TG for the treatment of multi drug-resistant (MDR) Acinetobacter. Methods: We searched PubMed/MEDLINE, Scopus, Cochrane Central, and Web of Science to identify studies reporting the clinical and microbiological efficacy and safety of regimens containing TG in patients with drug susceptibility testing (DST)-confirmed MDR A. baumannii, published until December 30, 2022. Observational studies were included if they reported clinical and microbiological efficacy of TG-based regimens. The Newcastle-Ottawa Scale (NOS) and Joana Briggs Institute (JBI) critical appraisal tool were used to assess the quality of included studies. Results: There were 30 observational studies, of which 19 studies were cohort and 11 studies were single group studies. Pooled clinical response and failure rates in the TG-containing regimens group were 58.1 (95% confidence interval [CI] 49.2-66.6) and 40.2 (95% CI 31.1-50.0), respectively. The pooled microbiological response rate was 32.1 (95% CI 19.8-47.5), and the pooled all-cause mortality rate was 41.1 (95% CI 34.1-48.4). Pooled clinical response and failure rates in the colistin-based regimens group were 52.7 (42.7-62.5) and 43.1 (33.1-53.8), respectively. The pooled microbiological response rate was 42.9 (16.2-74.5), and the pooled all-cause mortality rate was 34.3 (26.1-43.5). Conclusions: According to our results, the efficacy of the TG-based regimen is the same as other antibiotics. However, our study showed a high mortality rate and a lower rate of microbiological eradication for TG compared with colistin-based regimen. Therefore, our study does not recommend it for the treatment of MDR A. baumannii. However, this was a prevalence meta-analysis of observational studies, and for better conclusion experimental studies are required.

PMID:37192494 | DOI:10.1089/mdr.2022.0248

J Med Food. 2023 May 16. doi: 10.1089/jmf.2022.0136. Online ahead of print.

ABSTRACT

Sepsis is a life-threatening organ dysfunction caused by a dysregulated and unbalanced immune response to microbial infection. Restoring immune homeostasis and infection control are considered the primary strategies to manage sepsis. Natural bioactives such as polysaccharide and polyphenols from botanicals are known for their immune modulation activity. In this study, we evaluated a standardized aloe-based composition, UP360 (constitute of polysaccharides from Aloe barbadense and Poria cocos and polyphenols from Rosemary officinalis) in lipopolysaccharide (LPS)-induced sepsis and acute inflammatory lung injury murine models. Prophylactic oral administration of UP360 for 7 days at an oral dose of 500 mg/kg improved the survival rate of mice by 62.5%, whereas all mice in the vehicle control group were deceased 82 h after LPS injection. The merit of combining these traditional herbs to yield the standardized composition UP360 was also demonstrated in this model with a mortality rate of only 30.8%, whereas 76.9%, 53.9%, and 61.5% were recorded for each individual constituents A. barbadense, P. cocos, and R. officinalis, respectively. Dose-correlated statistically significant reductions in proinflammatory cytokines and chemokine tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β, IL-6, and cytokine-induced neutrophil chemoattractant (CINC)-3 were observed for UP360 when administered at 250 and 500 mg/kg orally for 7 days before induction of acute lung injury (ALI) model in rats. The histopathology data from lung showed statistically significant 37.9% and 37% reductions in the overall lung damage severity and pulmonary edema, respectively, for UP360-treated rats. The aloe-based composition UP360 effectively improved the survival rate of septic animals and mitigated the severity of LPS-induced ALI in vivo. These data warrant further investigation of the composition for a potential application in human as an adjunct supplement in respiratory distress and sepsis.

PMID:37192488 | DOI:10.1089/jmf.2022.0136

Sud Med Ekspert. 2023;66(3):24-28. doi: 10.17116/sudmed20236603124.

ABSTRACT

The aim of this study is to estimate the variability limits of craniometric skull parameters, revealed in Kazakhstan, and find out significant criteria for forensic medical identification of the local population. The investigation included 25 standard craniometric skull parameters, revealed in Kazakhstan. Standard antropometric tests and tools were used. Current study confirm that the craniometrics indicators of Kazakhstan population have specific regional features. The skulls, revealed in Kazakhstan, are well craniometrically differentiated. Statistically significant differences were found out in 6 craniometric parameters in men (width of skull base, frontal chord, full face height, condylar and bigonial width, mandibular height) and in 4 parameters in women (transverse diameter, width of skull base, mastoid width, width of occipital foramen). The usage of updated data according to the regional features of the craniometrics parameters allow to significantly improve the forensic identification accuracy, study more completely the biological regularities of population formation and assess the comparative efficacy of individual features in the population reconstructions.

PMID:37192455 | DOI:10.17116/sudmed20236603124