Category: Nevin Manimala

J Interprof Care. 2021 Aug 6:1-8. doi: 10.1080/13561820.2021.1951188. Online ahead of print.

ABSTRACT

This study aimed to develop a Japanese version of the Self-assessment Scale of Interprofessional Competency (JASSIC), which consists of six domains: Patient-/Client-/Family-/Community-Centered, Interprofessional Communication, Role Contribution, Facilitation Relationship, Reflection, and Understanding of Others. Validity of JASSIC was confirmed through a four-step process consisting of expert discussion, cognitive debriefing, feasibility, and statistical analysis. Confirmatory factor analysis (CFA) was performed by testing the correlation between the sum scores of JASSIC and the Assessment of Interprofessional Team Collaboration Scale-II(AITCS-II). First, 24 items were created through discussions among physicians, a nurse, a medical educator, and an information sociologist. Second, the items were modified by cognitive debriefing of a physician, nurse, pharmacist, occupational therapist, and social worker. Third, we provided the developed JASSIC for professionals at Hospital X (n = 139) and revised the wording and composition of the items. Finally, CFA among professionals at Hospital Y (n = 153) identified a 6-domain structure (GFI: 0.847, AGFI: 0.782, RMSEA: 0.088). Cronbach’s alpha was 0.92, and the correlation coefficient with AITCS-II was 0.72. Ongoing research into JASSIC will promote effective interprofessional collaborative practice not only in Japan but also other countries which share a similar culture and system.

PMID:34355655 | DOI:10.1080/13561820.2021.1951188

Subst Use Misuse. 2021 Aug 6:1-9. doi: 10.1080/10826084.2021.1958866. Online ahead of print.

ABSTRACT

Physicians trained in opioid use disorder (OUD) harm reduction can mitigate opioid overdose deaths by prescribing naloxone and educating patients about its use. Unfortunately, many physicians possess OUD stigma. Training during medical school presents an opportunity to reduce OUD stigma and improve opioid overdose reversal knowledge. This study assessed the efficacy of Opioid Overdose Awareness and Reversal Training (OOART) and evaluated the equivalency of the online and in-person OOART. Methods: Voluntary training was delivered to first-year medical (M1) students at one medical school. In 2018 and 2019, 29 and 68 M1 students, respectively, received in-person OOART training and completed pre- and post-training surveys. In 2020, 62 students participated in online OOART training, of which 53 completed both pre- and post-training surveys. Results: All three opioid overdose Knowledge questions showed significant improvements between pre- and post-training survey responses. For Attitude questions, six of eleven questions in 2019 and 2020 and four of eleven questions in 2018 had statistically significant improvements between pre- and post-training survey responses. There were no statistical differences between in-person and online post-training survey results for two out of the three Knowledge questions and all 11 Attitude questions. Conclusions: This study demonstrates that our OOART was effective in increasing opioid overdose reversal knowledge and reducing OUD stigma. There was no meaningful difference in outcomes between the training modalities. These results support the future expansion of online and in-person OOART to a larger population of medical students.

PMID:34355637 | DOI:10.1080/10826084.2021.1958866

Leuk Lymphoma. 2021 Aug 6:1-10. doi: 10.1080/10428194.2021.1961237. Online ahead of print.

ABSTRACT

We performed a retrospective analysis of 1415 acute lymphoblastic leukemia children diagnosed between January 2000 and December 2016 at Children Welfare Teaching Hospital, Baghdad, Iraq. Patients were divided into three cohorts according to treatment period (2000-2005; 2006-2011; 2012-2016). Treatments were based on modified-UKALL protocols; a steroid-pre-phase was introduced from September 2008. The overall complete remission was 86%, increased from 80% to 91% in the last period. Early deaths occurred in 10%, decreasing to 6%, overtime. Relapses were 23%; toxic deaths and abandonment 8% and 13%, respectively. At a median follow-up of 65.3 months, with abandonment considered as an event, the 5-year overall survival (OS) and event-free survival were 62.2% and 46.3%, statistically influenced by treatment period (5-year OS 62.6%, 59.1%, 66.3%; p=.057, respectively). Though pediatric ALL survival in Iraq is still below that observed in high income countries, survival rates progressively improved. Toxic deaths remain an important cause of failure.

PMID:34355644 | DOI:10.1080/10428194.2021.1961237

SAR QSAR Environ Res. 2021 Aug;32(8):655-687. doi: 10.1080/1062936X.2021.1955414.

ABSTRACT

Gelatinases [gelatinase A – matrix metalloproteinase-2 (MMP-2), gelatinase B – matrix metalloproteinase-9 (MMP-9)] play key roles in many disease conditions including cancer. Despite some research work on gelatinases inhibitors both jointly and individually had been reported, challenges still exist in achieving potency as well as selectivity. Here in part I of a series of work, we have reported the structural requirement of some arylsulfonamides. In particular, regression-based 2D-QSARs, topomer CoMFA (comparative molecular field analysis) and Bayesian classification models were constructed to refine structural features for attaining better gelatinase inhibitory activity. The 2D-QSAR models exhibited good statistical significance. The descriptors nsssN, SHBint6, SHBint7, PubchemFP629 were directly correlated with the MMP-2 binding affinities whereas nsssN, SHBint10 and AATS2i were directly proportional to MMP-9 binding affinities. The topomer CoMFA results indicated that the steric and electrostatic fields play key roles in gelatinase inhibition. The established Naïve Bayes prediction models were evaluated by fivefold cross validation and an external test set. Furthermore, important molecular descriptors related to MMP-2 and MMP-9 binding affinities and some active/inactive fragments were identified. Thus, these observations may be helpful for further work of aryl sulphonamide based gelatinase inhibitors in future.

PMID:34355614 | DOI:10.1080/1062936X.2021.1955414

Hemoglobin. 2021 Aug 6:1-8. doi: 10.1080/03630269.2021.1954943. Online ahead of print.

ABSTRACT

Sickle cell disease is a genetic disease with a predisposition to infections caused by encapsulated organisms, especially Streptococcus pneumoniae. Pneumococcal vaccines and prophylactic penicillin have reduced the rate of this infection and mortality in sickle cell disease. However, implementation of these interventions is limited in Africa. The objectives of the study were to assess health care providers’ behaviors with the implementation of pneumococcal vaccination and penicillin prophylaxis and to identify barriers to their use. A 25-item online questionnaire was administered through SickleinAfrica: a network of researchers, and healthcare providers, in Ghana, Nigeria, and Tanzania, working to improve health outcomes of sickle cell disease in Africa. Data was collected and managed using the Research Electronic Data Capture (REDCap), tools and data analysis was done using STATA version 13 and R statistical software. Eighty-two medical practitioners responded to the questionnaire. Only 54.0 and 48.7% of respondents indicated the availability of published guidelines on sickle cell disease management and pneumococcal vaccine use, respectively, at their facilities. The majority (54.0%) perceived that the vaccines are effective but over 20.0% were uncertain of their usefulness. All respondents from Ghana and Tanzania affirmed the availability of guidelines for penicillin prophylaxis in contrast to 44.1% in Nigeria. Eighty-five percent of respondents affirmed the need for penicillin prophylaxis but 15.0% had a contrary opinion for reasons including the rarity of isolation of Streptococcus pneumoniae in African studies, and therefore, the uncertainty of its benefit. Lack of published guidelines on the management of sickle cell disease and doubts about the necessity of prophylactic measures are potential barriers to the implementation of effective interventions.

PMID:34355623 | DOI:10.1080/03630269.2021.1954943

Technol Cancer Res Treat. 2021 Jan-Dec;20:15330338211033050. doi: 10.1177/15330338211033050.

ABSTRACT

PURPOSE: This study aimed to evaluate (1) the performance of the Auto-Planning module embedded in the Pinnacle treatment planning system (TPS) with 30 left-side breast cancer plans and (2) the dose-distance correlations between dose-based patients and overlap volume histogram-based (OVH) patients.

METHOD: A total of 30 patients with left-side breast cancer after breast-conserving surgery were enrolled in this study. The clinical manual-planning (MP) and the Auto-Planning (AP) plans were generated by Monaco and by the Auto-Planning module in Pinnacle respectively. The geometric information between organ at risk (OAR) and planning target volume (PTV) of each patient was described by the OVH. The AP and MP plans were ranked to compare with the geometry-based patients from OVH. The Pearson product-moment correlation coefficient (R) was used to describe the correlations between dose-based patients (APs and MPs) and geometry-based patients (OVH). Dosimetric differences between MP and AP plans were evaluated with statistical analysis.

RESULT: The correlation coefficient (mean R = 0.71) indicated that the AP plans have a high correlation with geometry-based patients from OVH, whereas the correlation coefficient (mean R = 0.48) shows a weak correlation between MP plans and geometry-based patients. The dosimetric comparison revealed a statistically significant improvement in the ipsilateral lung V_5Gy and V_10Gy, and in the heart V_5Gy of AP plans compared to MP plans, while statistical reduction was seen in PTV V_107% for MP plans compared to AP plans.

CONCLUSION: The overall results of AP plans were superior to MP plans. The dose distribution in AP plans was more consistent with the distance-dose relationship described by OVH. After eliminating the interference of human factors, the AP was able to provide more stable and objective plans for radiotherapy patients.

PMID:34355592 | DOI:10.1177/15330338211033050

Clin Rehabil. 2021 Aug 6:2692155211037148. doi: 10.1177/02692155211037148. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the one-year postoperative outcomes of anti-gravity treadmill rehabilitation with those of standard rehabilitation in patients with ankle or tibial plateau fractures.

DESIGN: An open-label prospective randomised study.

SETTING: Three trauma centres.

SUBJECTS: Patients were randomised into the intervention (anti-gravity treadmill) or control (standard protocol) rehabilitation group.

MAIN MEASURES: The primary endpoint was changes in the Foot and Ankle Outcome Score for ankle fractures and Knee Injury and Osteoarthritis Outcome Score for tibial plateau fractures from baseline to 12 months after operation. Secondary endpoints were the subscores of these scores, muscle atrophy (leg circumference at 20 cm above and 10 cm below the knee joint) and the Dynamic Gait Index.

RESULTS: Initially, 73 patients (37 vs 36) underwent randomisation. After 12 months, 29 patients in the intervention group and 24 patients in the control group could be analysed. No significant difference was noted in the Foot and Ankle Outcome Score (80.8 ± 18.4 and 78.4 ± 21.1) and Knee Injury and Osteoarthritis Outcome Score (84.8 ± 15.2 and 81.7 ± 17.0). The change in the Dynamic Gait Index from 12 weeks to 12 months differed significantly between the groups (P = 0.04). Patients with tibial plateau fractures had a 3 cm wider thigh circumference in the intervention group than those in the control group (95% confidence interval: -0.2 to 6.3 cm, P = 0.08).

CONCLUSION: One year after surgery, patients who had undergone anti-gravity treadmill rehabilitation showed better gait than patients in the control group, and those with tibial plateau fractures had less muscle atrophy.

PMID:34355605 | DOI:10.1177/02692155211037148

Hisp Health Care Int. 2021 Aug 6:15404153211036985. doi: 10.1177/15404153211036985. Online ahead of print.

ABSTRACT

INTRODUCTION: To inform efforts to provide healthcare to uninsurable, immigrant youth, we describe The Access Partnership (TAP) hospital-based charity care program and compare healthcare utilization and diagnoses among TAP and Medicaid patients.

METHODS: We use propensity scores to match each TAP patient to three Medicaid patients receiving care at a pediatric clinic from October 2010 to June 2015 on demographic characteristics. We use descriptive statistics to compare healthcare visits and diagnoses.

RESULTS: TAP (n = 78) and Medicaid patients (n = 234) had similar healthcare utilization, though Medicaid patients had more outpatient visits (10.8 vs. 7.7, p = .002), and TAP patients were more likely to have ever received subspecialty care (38.5% vs. 22.2%, p = .005). Diagnoses were similar between groups, with some exceptions: TAP patients more likely to present with genital and reproductive disease (33.3% vs. 19.7%, p = .013); Medicaid patients more likely to present with endocrine, metabolic, and nutritional disease (52.1% vs. 28.2%, p < .001), psychiatric, behavioral disease, and substance abuse (41.0, 26.9%, p = .026).

CONCLUSIONS: TAP patients had similar healthcare utilization and diagnoses to matched sample of Medicaid patients. Findings indicate policy proposals that extend public health insurance to all children would likely benefit immigrant children and not incur higher costs than those of low-income U.S. citizen children.

PMID:34355584 | DOI:10.1177/15404153211036985

Sci Rep. 2021 Aug 5;11(1):15907. doi: 10.1038/s41598-021-95372-1.

ABSTRACT

Programmed cell death ligend-1 (PD-L1) expression by immunohistochemistry (IHC) assays is a predictive marker of anti-PD-1/PD-L1 therapy response. With the popularity of anti-PD-1/PD-L1 inhibitor drugs, quantitative assessment of PD-L1 expression becomes a new labor for pathologists. Manually counting the PD-L1 positive stained tumor cells is an obviously subjective and time-consuming process. In this paper, we developed a new computer aided Automated Tumor Proportion Scoring System (ATPSS) to determine the comparability of image analysis with pathologist scores. A three-stage process was performed using both image processing and deep learning techniques to mimic the actual diagnostic flow of the pathologists. We conducted a multi-reader multi-case study to evaluate the agreement between pathologists and ATPSS. Fifty-one surgically resected lung squamous cell carcinoma were prepared and stained using the Dako PD-L1 (22C3) assay, and six pathologists with different experience levels were involved in this study. The TPS predicted by the proposed model had high and statistically significant correlation with sub-specialty pathologists’ scores with Mean Absolute Error (MAE) of 8.65 (95% confidence interval (CI): 6.42-10.90) and Pearson Correlation Coefficient (PCC) of 0.9436 ([Formula: see text]), and the performance on PD-L1 positive cases achieved by our method surpassed that of non-subspecialty and trainee pathologists. Those experimental results indicate that the proposed automated system can be a powerful tool to improve the PD-L1 TPS assessment of pathologists.

PMID:34354151 | DOI:10.1038/s41598-021-95372-1

Sci Rep. 2021 Aug 5;11(1):15939. doi: 10.1038/s41598-021-95318-7.

ABSTRACT

To assess the safety of cosmetic contact lenses and to identify other factors of contact lens (CL)-related complications for Japanese females. A web-based, cross-sectional, observational survey of complications related to CL use was performed. The frequencies of complications were compared between transparent and cosmetic CLs. Besides lens pigmentation, age, replacement schedule, total experience, daily wear time, location of purchase, stacking of CLs, CL exchange with friends, compliance to hygiene procedure, replacement of CLs at intervals longer than recommended, and CL wear overnight were considered as risk factors. Logistic regression analyses were performed to calculate the odds ratios. A total of 3803 Japanese females were analyzed. The frequency of adverse events was 33.4% (95%CI 31.3-35.4%) and 35.7% (95%CI 33.5-38.0%) for transparent and cosmetic CLs, respectively. In a multivariate model, statistically significant factors associated with complications included the following: quarterly schedule lenses, replacement at intervals longer than recommended, compliance to hygiene procedure, overnight wearing, purchase at physical shops and on the internet, and longer daily wearing time. Most of the risk-increasing behaviors are preventable. The role of public health ophthalmology is to increase awareness and to improve CL use behaviors.

PMID:34354150 | DOI:10.1038/s41598-021-95318-7