Category: Nevin Manimala

Eur J Oncol Nurs. 2021 Oct 21;55:102060. doi: 10.1016/j.ejon.2021.102060. Online ahead of print.

ABSTRACT

PURPOSE: This study aims to explore the level of stress perceived and quality of life (QOL) by gynaecologic cancer (GC) patients and family caregivers’ dyads.

METHODS: In this cross-sectional study, 86 dyads were recruited from the gynaecological oncology department of a general hospital in Taichung City, Taiwan. The patients and family caregivers completed a sociodemographic information sheet, the Perceived Stress Scale, and the Taiwanese version of World Health Organization Quality of Life-BREF questionnaire. Data were analysed using descriptive statistics and Pearson’s correlations. This study used the actor-partner interdependence model (APIM) with distinguishable dyads to examine the effect of patients’ and caregivers’ perceived stress on QOL in patient-caregiver dyads.

RESULTS: GC patients’ and caregivers’ level of QOL was influenced by their own stress level (actor effect). Caregivers’ stress was statistically negatively associated with the patients’ QOL (partner effect); however, there were no partner effect from GC patients to caregivers. Both patients and family caregivers with higher perceived stress had poorer QOL. Therefore, we identified that stress has some level of actor and partner effects on QOL in GC patient-family caregiver dyads.

CONCLUSIONS: Family caregivers’ stress displayed both actor and partner effects within the first year of the cancer diagnosis; therefore, patient-and caregiver-based interventions, such as stress reduction strategies, should be developed to enhance patients’ and caregivers’ QOL and stress management ability.

PMID:34763206 | DOI:10.1016/j.ejon.2021.102060

Comp Immunol Microbiol Infect Dis. 2021 Oct 28;79:101717. doi: 10.1016/j.cimid.2021.101717. Online ahead of print.

ABSTRACT

The present study was conducted to compare the S. aureus isolates from different sources in the basis of resistance phenotypic and genotypic features and phylogenetic differences. Total of 70 S. aureus isolates (including 25 human, 25 raw milk and 20 pet animal isolates) were subjected to the antimicrobial susceptibility testing, polymerase chain reaction (PCR) detection of the resistance genes and DNA fingerprinting using random amplification of polymorphic DNA-PCR (RAPD-PCR) to survey the variability of the isolates. Among 70 S. aureus, 55 (78.5%) isolates were MRSA. The isolates showed the highest antibiotic resistance to methicillin, ampicillin and penicillin (78.5%) and showed the lowest resistance to ciprofloxacin (12.8%). ErmB and tetM resistance genes were present in all isolates and the vanA gene was not detected in any of the isolates. Thirteen distinct clusters were identified in RAPD-PCR fingerprinting. Statistical analysis showed that the isolates without resistance to antibiotics were significantly in associated with raw milk origin (P < 0.05). According to the results of the study, S. aureus strains with pets and raw milk origin are significant sources of antibiotic-resistant isolates such as MRSA. They are also carriers of resistance genes that can be transmit to human isolates and cause drug resistance in human infections. Identifying the source of these infections is possible with a reliable genotyping method such as RAPD-PCR.

PMID:34763201 | DOI:10.1016/j.cimid.2021.101717

J Psychosom Res. 2021 Oct 28;151:110659. doi: 10.1016/j.jpsychores.2021.110659. Online ahead of print.

ABSTRACT

INTRODUCTION: A hyper-coagulant state is a biological mechanism that triggers cardiac events in patients with coronary artery disease (CAD). Depressive symptoms and anxiety predict an unfavourable course of CAD. The SPIRR-CAD-RCT examined the effects of a psychological intervention and provided the opportunity to explore cross-sectional associations between indices of psychological strain and coagulation parameters, as well as prospective changes in depression scores and coagulation parameters.

METHODS: In this secondary analysis, we investigated 253 CAD patients (194 male; age m 58.9, SD 8.3 yrs.) with mild to moderate depression (≥8 on the HADS-D) at baseline and at follow-up 18 months later: TF, fibrinogen, D-dimer, VWF, FVII and PAI-1 and the course of depression (HAM-D), vital exhaustion (VE) and anxiety scores (HADS-A) were examined by ANOVA in the total and younger age groups (≤ 60).

RESULTS: HAM-D at baseline was correlated with TF (corr. R² = 0.27; F = 9.31, p = 0.001). HADS anxiety was associated with fibrinogen (corr. R².20; F = 7.27, p = 0.001). There was no detectable therapeutic effect on coagulation. Fibrinogen and VWF decreased within 18 months (time effect; p = 0.02; p = 0.04), as did HADS-D in both treatment groups (p < 0.001). Fibrinogen decreased more in patients ≤60 years with high VE compared to low VE (interaction time x group, p = 0.01).

CONCLUSIONS: This is the first study to show an association between TF and depression. Coagulation parameters as potential mediators of CAD progression correlated cross-sectionally with depression and anxiety and prospectively with VE. Further studies should replicate these correlations in depressed and non-depressed CAD patients.

ISRCTN: 76240576; clinicaltrials.gov.

PMID:34763203 | DOI:10.1016/j.jpsychores.2021.110659

Anaesth Crit Care Pain Med. 2021 Nov 8:100980. doi: 10.1016/j.accpm.2021.100980. Online ahead of print.

NO ABSTRACT

PMID:34763142 | DOI:10.1016/j.accpm.2021.100980

Comput Med Imaging Graph. 2021 Oct 23;94:102008. doi: 10.1016/j.compmedimag.2021.102008. Online ahead of print.

ABSTRACT

The global pandemic of coronavirus disease 2019 (COVID-19) is continuing to have a significant effect on the well-being of the global population, thus increasing the demand for rapid testing, diagnosis, and treatment. As COVID-19 can cause severe pneumonia, early diagnosis is essential for correct treatment, as well as to reduce the stress on the healthcare system. Along with COVID-19, other etiologies of pneumonia and Tuberculosis (TB) constitute additional challenges to the medical system. Pneumonia (viral as well as bacterial) kills about 2 million infants every year and is consistently estimated as one of the most important factor of childhood mortality (according to the World Health Organization). Chest X-ray (CXR) and computed tomography (CT) scans are the primary imaging modalities for diagnosing respiratory diseases. Although CT scans are the gold standard, they are more expensive, time consuming, and are associated with a small but significant dose of radiation. Hence, CXR have become more widespread as a first line investigation. In this regard, the objective of this work is to develop a new deep transfer learning pipeline, named DenResCov-19, to diagnose patients with COVID-19, pneumonia, TB or healthy based on CXR images. The pipeline consists of the existing DenseNet-121 and the ResNet-50 networks. Since the DenseNet and ResNet have orthogonal performances in some instances, in the proposed model we have created an extra layer with convolutional neural network (CNN) blocks to join these two models together to establish superior performance as compared to the two individual networks. This strategy can be applied universally in cases where two competing networks are observed. We have tested the performance of our proposed network on two-class (pneumonia and healthy), three-class (COVID-19 positive, healthy, and pneumonia), as well as four-class (COVID-19 positive, healthy, TB, and pneumonia) classification problems. We have validated that our proposed network has been able to successfully classify these lung-diseases on our four datasets and this is one of our novel findings. In particular, the AUC-ROC are 99.60, 96.51, 93.70, 96.40% and the F1 values are 98.21, 87.29, 76.09, 83.17% on our Dataset X-Ray 1, 2, 3, and 4 (DXR1, DXR2, DXR3, DXR4), respectively.

PMID:34763146 | DOI:10.1016/j.compmedimag.2021.102008

J Int AIDS Soc. 2021 Nov;24(11):e25833. doi: 10.1002/jia2.25833.

ABSTRACT

INTRODUCTION: A potential concern with the use of dapivirine (DPV) for HIV prevention is the selection of a drug-resistant virus that could spread and reduce the effectiveness of non-nucleoside reverse transcriptase (NNRTI)-based first-line antiretroviral therapy. We evaluated HIV-1 seroconversions in MTN-020/ASPIRE for selection of drug resistance and evaluated the genetic basis for observed reductions in susceptibility to DPV.

METHODS: MTN-020/ASPIRE was a placebo-controlled, Phase III safety and effectiveness study of DPV ring for HIV-1 prevention conducted at 15 sites in South Africa, Zimbabwe, Malawi and Uganda between 2012 and 2015. Plasma from individuals who seroconverted in ASPIRE was analysed for HIV-1 drug resistance using both population Sanger sequencing and next-generation sequencing (NGS) with unique molecular identifiers to report mutations at ≥1% frequency. DPV susceptibility of plasma-derived recombinant HIV-1 containing bulk-cloned full-length reverse transcriptase sequences from MTN-020/ASPIRE seroconversions was determined in TZM-bl cells. Statistical significance was calculated using the Fisher’s exact test.

RESULTS: Plasma from all 168 HIV seroconversions were successfully tested by Sanger sequencing; 57 of 71 DPV arm and 82 of 97 placebo (PLB) arm participants had NGS results at 1% sensitivity. Overall, 18/168 (11%) had NNRTI mutations including K101E, K103N/S, V106M, V108I, E138A/G, V179D/I/T and H221Y. Five samples from both arms had low-frequency NNRTI mutations that were not detected by Sanger sequencing. The frequency of NNRTI mutations from the DPV arm (11%) was not different from the PLB arm (10%; p = 0.80). The E138A mutation was detected in both the DPV (3 of 71 [4.2%]) and PLB arm (5 of 97 [5.2%]) and conferred modest reductions in DPV susceptibility in some reverse transcriptase backgrounds but not others.

CONCLUSIONS: HIV-1 drug resistance including NNRTI resistance did not differ between the DPV and placebo arms of the MTN-020/ASPIRE study, indicating that drug resistance was not preferentially acquired or selected by the DPV ring and that the preventive benefit of DPV ring outweighs resistance risk.

PMID:34762770 | DOI:10.1002/jia2.25833

Int J Health Plann Manage. 2021 Nov 11. doi: 10.1002/hpm.3373. Online ahead of print.

ABSTRACT

This study aims to investigate the determinants of the quality MRI in the Turkish healthcare system. The analysis is done by analysing the referred cases to a major university radiology department in Turkey, and matching the hospital and MRI use characteristics of the source institutions, where the original MRI was taken. Quality of MRI was measured by specialist radiologists. The resulting quality was analysed by gender and imaging area characteristics, source institutional quality, MRI use statistics in source institution and MRI machine use inclination of the source institution. Chi-square and logistic regression were conducted, with regional fixed effects. In the largest dataset, the highest quality institutions have significantly higher average expected MRI quality compared to one level beneath them (0.74 vs. 0.63) (P = 0.02), there is also a significant MRI quality difference between the second highest level of institution, and the third and the fourth (0.63-0.54). Smaller (<0.1) but significant quality difference (P = 0.05) exists for institutions with the lowest two quality levels. In the smaller dataset, with data only from the lowest two institutional quality groups, with a finer institutional quality grading, differences in institutional quality is again found to be a significant driver of MRI quality (P = 0.035).

PMID:34762751 | DOI:10.1002/hpm.3373

J Viral Hepat. 2021 Nov 11. doi: 10.1111/jvh.13631. Online ahead of print.

ABSTRACT

Many patients with chronic hepatitis B do not receive adequate follow-up. This study aimed to develop a risk score to predict clinical events in patients with chronic hepatitis B virus (HBV) infection at the population level for identifying patients at high-risk to warrant regular follow-up. This study analyzed population-based data from the nationwide claims database of South Korea obtained between 2005 and 2015. We identified 507,239 non-cirrhotic patients with chronic HBV infection who are not under antiviral treatment. A risk score for predicting clinical events (hepatocellular carcinoma, death, or liver transplantation) was developed based on multivariable Cox proportional hazard model in a development cohort (n = 401,745) and validated in a validation cohort (n = 105,494). The cumulative incidence rates of clinical events at 5 years were 2.56% and 2.44% in the development and validation cohorts, respectively. Clinical events in Asymptomatic Patients with chronic HBV infection (CAP-B) score ranging from 0 to 7.5 points based on age, sex, socioeconomic status, chronic hepatitis C co-infection, diabetes mellitus, statin or antiplatelet exposure, smoking, alcohol consumption, alanine aminotransferase, and gamma-glutamyltransferase had good discriminatory accuracy in both the development and validation cohorts (c-indices for 3-, 5-, 10-year risk prediction: all 0.786). The predicted and observed probabilities of clinical events were calibrated in both cohorts. A score of >3.5 points identified subjects at distinctly high risk. The CAP-B score using easily accessible variables can predict clinical events and may allow selection of patients with chronic HBV infection for priority of regular follow-up.

PMID:34762757 | DOI:10.1111/jvh.13631

Int J Health Plann Manage. 2021 Nov 11. doi: 10.1002/hpm.3383. Online ahead of print.

ABSTRACT

BACKGROUND: At the biological level, ageing results from a plodding decline in physical and mental capability, an emergent menace of malady, and eventually, fatality. Even though a few of the geriatric’s health changes are hereditary, to a great extent is due to individual’s physical and societal surroundings and their residence, locality, societies, gender, ethnicity or socio-economic status. The current debate is well popular by the relationship between increasing diversity and the ageing population with healthcare expenditure in the United States. Higher diversity in society and increasing ageing population have various socio-economic consequences. A good policy in this regard helpful to managed and get fruitful outcomes.

OBJECTIVE: This study aims to examine the direct effects of diversity and ageing population on healthcare spending. The assortment observed in geriatrics is not arbitrary. A huge portion emerges from individual’s physical and social settings and the influence of these environs on their prospect and well-being demeanour.

METHOD: This study used the Bayesian-vector autoregressive model, impulse response analysis, and variance decomposition and data over the period 1990-2018 for empirical analysis of the United States.

RESULTS: The empirical findings indicate that diversity and ageing population are more persistent with health expenditure in the United States. This study concludes that an increase in diversity and ageing population will rely on the long-term healthcare facility.

CONCLUSION: The study suggests that cohesive society and effective health intervention might aid in curtailing expenditure pressure linked with elderly population. Furthermore, a recommendation of this study is a good opportunity for healthcare policymakers and further researches.

PMID:34762749 | DOI:10.1002/hpm.3383

Med Anthropol Q. 2021 Nov 11. doi: 10.1111/maq.12675. Online ahead of print.

ABSTRACT

Since the early 2000s, Turkey has been going through a dynamic period of health reforms where the global push toward health statistics has converged with the state’s pronatalist concerns over declining birth rates. Reproductive behaviors are now monitored via health information technologies such as centralized databases. The World Health Organization and the Turkish Ministry of Health celebrate these technologies as essential steps toward evidence-based health care delivery. The everyday realities of these technologies, however, are more complicated, especially for nurses and their patients. Drawing on ethnographic fieldwork in state-run health clinics in Istanbul, this article demonstrates how these data-driven health technologies build on nurses’ gendered care labor and increase surveillance on urban poor and/or ethnoracially minoritized communities. In doing so, I argue that the datafication of reproduction operates as a particular mode of “reproductive governance” (Morgan and Roberts 2012) that reflects and reproduces existing social hierarchies and inequalities.

PMID:34762750 | DOI:10.1111/maq.12675