Nevin Manimala

J Med Internet Res. 2022 Sep 30;24(9):e37848. doi: 10.2196/37848.

ABSTRACT

BACKGROUND: Patients diagnosed with cervical cancer in the last 2 decades were mainly young females. Human papillomavirus (HPV) vaccination is the most radical way to prevent HPV infection and cervical cancer. However, most female college students in mainland China have not yet been vaccinated, and their relevant knowledge is limited. Theory-based education delivered via the internet is a potentially accessible and useful way to promote HPV vaccination among this population.

OBJECTIVE: This 3-month follow-up study intended to identify the feasibility and efficacy of an information-motivation-behavioral skills (IMB) model-based online intervention for promoting awareness and willingness regarding HPV vaccination among female college students.

METHODS: A 7-day online HPV education program for female college students in mainland China was developed using a cluster randomized trial design. Recruitment and questionnaire surveys were performed online without face-to-face contact. SPSS 23.0 was used for statistical analysis. The chi-square test and t test were used to compare differences in qualitative and continuous variables between intervention and control groups. The generalized estimating equation was used to test the effectiveness of the intervention with a consideration of the time factor.

RESULTS: Among 3867 participants, 102 had been vaccinated against HPV before the study (vaccination rate of 2.6%). A total of 3484 participants were followed up after the baseline survey, with no statistical difference in the loss rate between the intervention and control groups during the intervention and follow-up periods. At different follow-up time points, HPV-related knowledge, and the motivation, behavioral skills, and willingness regarding HPV vaccination were higher in the intervention group than in the control group. HPV-related knowledge was statistically different between the 2 groups, while the motivation, behavioral skills, and willingness regarding HPV vaccination only showed statistical differences right after the intervention, reaching a peak right after the intervention and then gradually reducing over time. Furthermore, there was no statistical difference in the HPV vaccination rate between the 2 groups.

CONCLUSIONS: IMB model-based online education could be a promising way to increase the HPV vaccination rate and reduce the burden of HPV infection and cervical cancer among high-risk female college students in China.

TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1900025476; http://www.chictr.org.cn/showprojen.aspx? proj=42672.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-DOI:10.1186/s12889-019-7903-x.

PMID:36178723 | DOI:10.2196/37848

JMIR Med Educ. 2022 Sep 30;8(3):e35637. doi: 10.2196/35637.

ABSTRACT

BACKGROUND: There are gaps in knowledge translation (KT) of current evidence-based practices regarding stroke assessment and rehabilitation delivered through teletherapy. A lack of this knowledge can prevent occupational therapy (OT) students and practitioners from implementing current research findings.

OBJECTIVE: The aim of this pilot study was to create an educational program to translate knowledge into practice regarding the remote delivery of stroke assessment and rehabilitation to OT students and practitioners. Four areas of focus were addressed in the educational program, including KT, task-oriented training, stroke assessments, and telerehabilitation.

METHODS: Two pilot studies were conducted to assess the knowledge gained via pretests and posttests of knowledge, followed by a System Usability Scale and general feedback questionnaire. Participants in study 1 were 5 OT practitioners and 1 OT assistant. Participants in study 2 were 9 current OT students. Four 1-hour modules were emailed weekly to participants over the course of 4 weeks, with each module covering a different topic (KT, task-oriented training, stroke assessments, and telerehabilitation). Preliminary results were reviewed using descriptive statistics.

RESULTS: Statistically significant results were found with increased scores of knowledge for both students and practitioners. Most of the educational modules had an above-average score regarding value and positive feedback for the educational program as a whole from the participants.

CONCLUSIONS: Overall, the results of this pilot study indicate that a web-based educational program is a valuable, informational method of increasing the translation of knowledge in the remote delivery of stroke assessment and rehabilitation. OT students and practitioners found the information presented to be valuable and relevant to their future profession and current practice.

PMID:36178717 | DOI:10.2196/35637

JMIR Res Protoc. 2022 Sep 30;11(9):e39843. doi: 10.2196/39843.

ABSTRACT

BACKGROUND: Informed consent is a legal and ethical prerequisite for psychotherapy. However, in clinical practice, consistent strategies to obtain informed consent are scarce. Inconsistencies exist regarding the overall validity of informed consent for psychotherapy as well as the disclosure of potential mechanisms and negative effects, the latter posing a moral dilemma between patient autonomy and nonmaleficence.

OBJECTIVE: This protocol describes a randomized controlled web-based trial aiming to investigate the efficacy of a one-session optimized informed consent consultation.

METHODS: The optimized informed consent consultation was developed to provide information on the setting, efficacy, mechanisms, and negative effects via expectation management and shared decision-making techniques. A total of 122 participants with an indication for psychotherapy will be recruited. Participants will take part in a baseline assessment, including a structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders-fifth edition (DSM-5) disorders. Eligible participants will be randomly assigned either to a control group receiving an information brochure about psychotherapy as treatment as usual (n=61) or to an intervention group receiving treatment as usual and the optimized informed consent consultation (n=61). Potential treatment effects will be measured after the treatment via interview and patient self-report and at 2 weeks and 3 months follow-up via web-based questionnaires. Treatment expectation is the primary outcome. Secondary outcomes include the capacity to consent, decisional conflict, autonomous treatment motivation, adherence intention, and side-effect expectations.

RESULTS: This trial received a positive ethics vote by the local ethics committee of the Center for Psychosocial Medicine, University-Medical Center Hamburg-Eppendorf, Hamburg, Germany on April 1, 2021, and was prospectively registered on June 17, 2021. The first participant was enrolled in the study on August 5, 2021. We expect to complete data collection in December 2022. After data analysis within the first quarter of 2023, the results will be submitted for publication in peer-reviewed journals in summer 2023.

CONCLUSIONS: If effective, the optimized informed consent consultation might not only constitute an innovative clinical tool to meet the ethical and legal obligations of informed consent but also strengthen the contributing factors of psychotherapy outcome, while minimizing nocebo effects and fostering shared decision-making.

TRIAL REGISTRATION: PsychArchives; http://dx.doi.org/10.23668/psycharchives.4929.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/39843.

PMID:36178713 | DOI:10.2196/39843

JMIR Form Res. 2022 Sep 30;6(9):e30113. doi: 10.2196/30113.

ABSTRACT

BACKGROUND: Millions of workers experience work-related ill health every year. The loss of working days often accounts for poor well-being because of discomfort and stress caused by the workplace. The ongoing pandemic and postpandemic shift in socioeconomic and work culture can continue to contribute to adverse work-related sentiments. Critically investigating state-of-the-art technologies, this study identifies the research gaps in recognizing workers’ need for well-being support, and we aspire to understand how such evidence can be collected to transform the workforce and workplace.

OBJECTIVE: Building on recent advances in sentiment analysis, this study aims to closely examine the potential of social media as a tool to assess workers’ emotions toward the workplace.

METHODS: This study collected a large Twitter data set comprising both pandemic and prepandemic tweets facilitated through a human-in-the-loop approach in combination with unsupervised learning and meta-heuristic optimization algorithms. The raw data preprocessed through natural language processing techniques were assessed using a generative statistical model and a lexicon-assisted rule-based model, mapping lexical features to emotion intensities. This study also assigned human annotations and performed work-related sentiment analysis.

RESULTS: A mixed methods approach, including topic modeling using latent Dirichlet allocation, identified the top topics from the corpus to understand how Twitter users engage with discussions on work-related sentiments. The sorted aspects were portrayed through overlapped clusters and low intertopic distances. However, further analysis comprising the Valence Aware Dictionary for Sentiment Reasoner suggested a smaller number of negative polarities among diverse subjects. By contrast, the human-annotated data set created for this study contained more negative sentiments. In this study, sentimental juxtaposition revealed through the labeled data set was supported by the n-gram analysis as well.

CONCLUSIONS: The developed data set demonstrates that work-related sentiments are projected onto social media, which offers an opportunity to better support workers. The infrastructure of the workplace, the nature of the work, the culture within the industry and the particular organization, employers, colleagues, person-specific habits, and upbringing all play a part in the health and well-being of any working adult who contributes to the productivity of the organization. Therefore, understanding the origin and influence of the complex underlying factors both qualitatively and quantitatively can inform the next generation of workplaces to drive positive change by relying on empirically grounded evidence. Therefore, this study outlines a comprehensive approach to capture deeper insights into work-related health.

PMID:36178712 | DOI:10.2196/30113

Int J Occup Saf Ergon. 2022 Sep 30:1-27. doi: 10.1080/10803548.2022.2131274. Online ahead of print.

ABSTRACT

PURPOSE: -This paper aims to prompt the first-line workers to go beyond the regular job roles and engage in more discretionary safety behavior-safety participation in the Chinese construction industry. The construction industry is a high-risk industry, and the first-line workers are more likely to expose to workplace hazards. Once the accidents happen, the negative consequences would come out. Therefore, employee voluntary safety behavior is focused on in this research.

DESIGN/METHODOLOGY/APPROACH-: The present research framework examines the roles of safety leadership and safety management practices from the group and organizational perspectives in predicting the voluntary safety behavior (safety participation) of the first-line workers in the Chinese construction industry through casual-chain mediators (safety climate and job satisfaction). In this study, Partial Least Squares Structural Equation Modeling (PLS-SEM) is adopted for the data analysis and hypotheses testing.

FINDINGS-: After data analysis, the results show that safety leadership and safety management practices are significantly and positively associated with the safety participation of the first-line workers through safety climate and job satisfaction. Moreover, safety management practices have a more statistical effect on safety climate compared to safety leadership.

PMID:36178706 | DOI:10.1080/10803548.2022.2131274

Pediatr Crit Care Med. 2022 Sep 30. doi: 10.1097/PCC.0000000000003074. Online ahead of print.

ABSTRACT

OBJECTIVES: Interest in using bedside C-reactive protein (CRP) and ferritin levels to identify patients with hyperinflammatory sepsis who might benefit from anti-inflammatory therapies has piqued with the COVID-19 pandemic experience. Our first objective was to identify patterns in CRP and ferritin trajectory among critically ill pediatric sepsis patients. We then examined the association between these different groups of patients in their inflammatory cytokine responses, systemic inflammation, and mortality risks.

DATA SOURCES: A prospective, observational cohort study.

STUDY SELECTION: Children with sepsis and organ failure in nine pediatric intensive care units in the United States.

DATA EXTRACTION: Two hundred and fifty-five children were enrolled. Five distinct clinical multi-trajectory groups were identified. Plasma CRP (mg/dL), ferritin (ng/mL), and 31 cytokine levels were measured at two timepoints during sepsis (median Day 2 and Day 5). Group-based multi-trajectory models (GBMTM) identified groups of children with distinct patterns of CRP and ferritin.

DATA SYNTHESIS: Group 1 had normal CRP and ferritin levels (n = 8; 0% mortality); Group 2 had high CRP levels that became normal, with normal ferritin levels throughout (n = 80; 5% mortality); Group 3 had high ferritin levels alone (n = 16; 6% mortality); Group 4 had very high CRP levels, and high ferritin levels (n = 121; 11% mortality); and Group 5 had very high CRP and very high ferritin levels (n = 30; 40% mortality). Cytokine responses differed across the five groups, with ferritin levels correlated with macrophage inflammatory protein 1α levels and CRP levels reflective of many cytokines.

CONCLUSIONS: Bedside CRP and ferritin levels can be used together to distinguish groups of children with sepsis who have different systemic inflammation cytokine responses and mortality risks. These data suggest future potential value in personalized clinical trials with specific targets for anti-inflammatory therapies.

PMID:36178701 | DOI:10.1097/PCC.0000000000003074

JAMA Netw Open. 2022 Sep 1;5(9):e2234200. doi: 10.1001/jamanetworkopen.2022.34200.

ABSTRACT

IMPORTANCE: Observational comparative effectiveness studies can inform the positioning of biologic therapies for older patients with inflammatory bowel disease (IBD) who are underrepresented in clinical trials.

OBJECTIVE: To compare the effectiveness and safety of vedolizumab vs tumor necrosis factor (TNF) for older patients with IBD.

DESIGN, SETTING, AND PARTICIPANTS: This active comparator, new-user design, comparative effectiveness study was conducted between January 1, 2005, and December 31, 2018, among 754 older patients (aged ≥50 years) with IBD from the Danish National Patient Register. The mean follow-up after treatment initiation took place at 32 to 40 weeks. Statistical analysis was performed from February 1 to April 27, 2022.

INTERVENTIONS: Treatment with vedolizumab or TNF antagonists.

MAIN OUTCOMES AND MEASURES: The primary effectiveness outcome was treatment failure, defined as the composite risk of IBD-related hospitalization, IBD-related surgery, or a new corticosteroid prescription more than 6 weeks after initiation of treatment with biologic therapy. Secondary effectiveness outcomes were time to each individual component of the composite effectiveness outcome. The primary safety outcome was the risk of serious infections, defined as infections requiring hospitalization. A 1:1 propensity score-matched analysis was conducted, accounting for patient-, disease-, and treatment-associated factors.

RESULTS: The study compared 377 older patients with IBD with incident use of vedolizumab (202 women [53.6%]; mean [SD] age, 61.2 [8.3] years; 177 [46.9%] with Crohn disease) vs 377 patients with incident use of TNF antagonists (206 women [54.6%]; mean [SD] age, 61.3 [8.1] years; 182 [48.3%] with Crohn disease). Overall, vedolizumab was associated with an increased risk of treatment failure compared with TNF antagonists (1-year risk, 45.4% vs 34.7%; adjusted hazard ratio [HR], 1.31; 95% CI, 1.02-1.69), including higher risk of IBD-related hospitalization (1-year risk, 27.8% vs 16.3%; adjusted HR, 1.48; 95% CI, 1.03-2.15) and IBD-related major abdominal surgery (1-year risk, 21.3% vs 8.0%; adjusted HR, 2.39; 95% CI, 1.45-3.94). In subgroup analysis by IBD phenotype, among patients with Crohn disease, vedolizumab was associated with a 77% higher risk of treatment failure (adjusted HR, 1.77; 95% CI, 1.21-2.58), while no difference in risk of treatment failure was seen among patients with ulcerative colitis (adjusted HR, 1.04; 95% CI, 0.75-1.43; P = .03 for interaction). There was no significant difference in the risk of serious infections, overall (1-year risk, 8.2% vs 8.7%; adjusted HR, 1.04; 95% CI, 0.58-1.85) and by IBD phenotype.

CONCLUSIONS AND RELEVANCE: In this comparative effectiveness study of older patients with IBD, vedolizumab was associated with a higher risk of treatment failure compared with TNF antagonists, particularly among patients with Crohn disease, without offering a significant safety advantage.

PMID:36178685 | DOI:10.1001/jamanetworkopen.2022.34200

Transfusion. 2022 Sep 30. doi: 10.1111/trf.17128. Online ahead of print.

ABSTRACT

BACKGROUND: Transfusion of cold-stored platelet concentrates (CS-PCs) appears effective in massively bleeding patients. However, few studies have evaluated their in vivo hemostatic function in severe thrombocytopenia.

STUDY DESIGN AND METHODS: The in vivo function of plasma-depleted human PCs was evaluated in rabbits with a blocked reticuloendothelial system and busulfan-induced thrombocytopenia. On day 1, a human apheresis PC was processed in a platelet additive solution (PAS-PC) and split evenly for cold or room temperature storage (RTS). On days 3, 6, or 9, RTS- or CS-PAS-PCs were transfused (4.0 × 10⁹ platelets/kg) after plasma depletion into two to four rabbits that developed adequate thrombocytopenia (<25 × 10⁹ /L). Ear bleeding time was measured by two incisions in small veins. The hemostatic rate was defined as the percentage of rabbits achieving bleeding cessation within 600 s at either incision. The experiment was repeated using five different PCs on each storage day.

RESULTS: The mean pre-transfusion rabbit platelet count was 8.6 ± 5.2 × 10⁹ /L. The hemostatic rates with RTS- and CS-PAS-PCs were both 100% on day 3, 93 ± 15% and 73 ± 15% on day 6 (p = .07), and 65 ± 36% and 73 ± 37% on day 9 (p = .27), respectively, with no statistical differences. Total platelet counts were significantly lower after CS-PAS-PC than RTS-PAS-PC transfusion on all days (e.g., 58.7 ± 5.7 vs. 42.4 ± 14.7 × 10⁹ /L, p = .0007, day 9), and did not reach 50 × 10⁹ /L in several experiments. Platelet count increments correlated significantly with hemostatic efficacy for CS-PAS-PC transfusion only.

DISCUSSION: CS-PAS-PCs might achieve similar hemostasis as RTS-PAS-PCs in thrombocytopenic patients with mild bleeding. Hemostatic efficacy could be improved by transfusing more CS-PAS-PCs.

PMID:36178666 | DOI:10.1111/trf.17128

Environ Sci Pollut Res Int. 2022 Sep 30. doi: 10.1007/s11356-022-23211-5. Online ahead of print.

ABSTRACT

Rapid changes in land use and land cover (LULC) have ecological and environmental effects in metropolitan areas. Since the 1990s, Saudi Arabia’s cities have undergone tremendous urban growth, causing urban heat islands, groundwater depletion, air pollution, loss of ecosystem services, etc. This study evaluates the variance and heterogeneity in land surface temperature (LST) because of LULC changes in Abha-Khamis Mushyet, Saudi Arabia, from 1990 to 2020. The research aims to determine the impact of urban biophysical parameters on the High-High (H-H) LST cluster using geospatial, statistical, and machine learning techniques. The support vector machine (SVM) was used to map LULC. The land surface temperature (LST) has been derived using the mono-window algorithm (MWA). The local indicator of spatial associations (LISA) model was implemented on the spatiotemporal LST maps to identify LST clusters. Also, the parallel coordinate plot (PCP) approach was employed to examine the relationship between LST clusters and urban biophysical variables as a proxy of LULC. LULC maps show that urban areas rose by > 330% between 1990 and 2020. Built-up areas had an 83.6% transitional probability between 1990 and 2020. In addition, vegetation and agricultural land have been transformed into built-up areas by 17.9% and 21.8% respectively between 1990 and 2020. Uneven LULC changes in terms of built-up areas lead to increased LST hotspots. High normalized difference built-up index (NDBI) was linked to LST hotspots but not normalized difference water index (NDWI) or normalized difference vegetation index (NDVI). This research could help policymakers develop mitigation strategies for urban heat islands.

PMID:36178650 | DOI:10.1007/s11356-022-23211-5

Methods Mol Biol. 2023;2554:91-106. doi: 10.1007/978-1-0716-2624-5_7.

ABSTRACT

Proteome Integral Solubility Alteration (PISA) is a recently developed mass spectrometry-based, deep proteomics method for unbiased, proteome-wide target deconvolution of ligands, requiring no chemical ligand modification. PISA can be applied to living cells for studying target engagement in vivo or alternatively to protein extracts to identify in vitro ligand-interacting proteins. Here we describe the PISA workflow optimized in our lab. PISA improves the target discovery throughput 10-100 folds compared to the previously used proteomics methods and provides higher statistical significance for target candidates by enabling several biological replicates. Sample multiplexing makes all-in-one analysis of multiple ligands simultaneously possible. PISA dramatically reduces analysis costs, allowing many research questions in need of target deconvolution to be addressed, and unlocks the potential of miniaturizing biological models, including primary cells.

PMID:36178622 | DOI:10.1007/978-1-0716-2624-5_7