Nevin Manimala

J Med Syst. 2021 Jun 7;45(7):74. doi: 10.1007/s10916-021-01749-0.

ABSTRACT

Extant research on the relationship between portal use and office visits is mixed. Some researchers have stated that there is no correlation between the two events, others have found a positive correlation, and still others have found a negative correlation between portal use and office visits. Through the use of system-generated data from two different portal systems, we demonstrate the correlation between portal visits and office visits. We also demonstrate how this correlation differs between two institutions and across three demographic attributes. We performed a retrospective bivariate correlation analysis between portal visits and office visits. The correlation analysis was followed by an application of Fisher’s z transformation of the correlation coefficients to determine significant differences in correlation across ethnicity, gender, and age. We found a positive and statistically significant correlation between portal visits and office visits among both hospital patients (n = 2,594, r = .239, p < .000) and university health service patients (n = 1,233, r = .596, p < .000). This correlation varies significantly across the dimensions of ethnicity, gender, and age. Our findings support the importance of portal use in the care continuum. Future research should aim to better understand the nuance of personal characteristics on the relationship between portal visits and office visits. Knowing these nuances can assist practitioners with further promoting patient self-engagement through portal use.

PMID:34097149 | DOI:10.1007/s10916-021-01749-0

Sci Eng Ethics. 2021 Jun 7;27(3):37. doi: 10.1007/s11948-021-00315-8.

ABSTRACT

Increasingly, policymakers within biomedicine argue that “non-financial” interests should be given equal scrutiny to individuals’ financial relationships with industry. Problematized as “non-financial conflicts of interest,” interests, ranging from intellectual commitments to personal beliefs, are managed through disclosure, restrictions on participation, and recusal where necessary. “Non-financial” interests, though vaguely and variably defined, are characterized as important influences on judgment and thus, are considered risks to scientific objectivity. This article explores the ways that “non-financial interests” have been constructed as an ethical problem and the implications for research integrity. I conducted an interpretive, qualitative study, which triangulated two data sources: documents (including published accounts of identifying and managing “non-financial” interests and conflict of interest policies) and in-depth interviews with 16 leaders within evidence-based medicine, responsible for contributing to, directing, or overseeing conflict of interest policy development and implementation. This article outlines how evolutions in the definition of conflict of interest have opened the door to include myriad “non-financial” interests, resulting in the generalisation of a statistical concept-risk of bias-to social contexts. Consequently, biases appear equally pervasive among participants while in reality, a politics of objectivity is at play, with allegations of conflict of interest used as a means to undermine others’ credibility, or even participation. Iterations of the concept of conflict of interest within biomedicine have thus consistently failed to articulate or address questions of accountability including whose interests are able to dominate or distort evidence-led processes and why. Consequently, current policy solutions meant to mitigate bias may instead serve exclusionary purposes under the guise of impartiality while remaining vulnerable to interference from powerful stakeholders.

PMID:34097141 | DOI:10.1007/s11948-021-00315-8

Langenbecks Arch Surg. 2021 Jun 7. doi: 10.1007/s00423-021-02216-7. Online ahead of print.

ABSTRACT

PURPOSE: Lateral neck nodal metastases are common in patients with differentiated thyroid cancer (DTC) and usually have an indolent nature. They may be detected via neck palpation or preoperative ultrasound (US) of the neck. We hypothesized that preoperative neck metastases detected with US did not affect regional recurrence or long-term survival.

METHODS: A retrospective analysis of patients’ records treated for DTC at our institution between January 2006 and December 2016 was performed. Information about preoperative US of the neck, treatment, demographics, staging, and histopathology was obtained. The endpoints for the study were nodal recurrence and survival. Differences in survival were analyzed between three groups of patients divided by presence or lack of preoperative US and/or palpable cervical lymph nodes (PLN). Furthermore, the prognostic value of multiple variables was tested by univariate and multivariate analysis.

RESULTS: There were 1108 patients with DTC, 221 males and 887 females. The median age was 48.3 years (range 3 to 86), the median time of observation was 68 months (range 0 to 142). Eight hundred sixty-two patients without PLN or preoperative US represented group 1, 112 patients with PLN were in group 2, and 134 patients without PLN and with preoperative US were in group 3. Only five patients had a regional recurrence, one died due to distant metastases. There was no statistically significant difference in survival between the groups (p = 0.841) and neck US was not significantly associated with overall survival neither in univariate nor in multivariate analysis.

CONCLUSION: In patients with DTC, the benefits of preoperative US of cervical lymph nodes are probably limited and “less is more” approach is advised.

PMID:34097134 | DOI:10.1007/s00423-021-02216-7

BMJ Open Sci. 2020 Jul 20;4(1):e100115. doi: 10.1136/bmjos-2020-100115. eCollection 2020 Jul 20.

ABSTRACT

Reproducible science requires transparent reporting. The ARRIVE guidelines (Animal Research: Reporting of In Vivo Experiments) were originally developed in 2010 to improve the reporting of animal research. They consist of a checklist of information to include in publications describing in vivo experiments to enable others to scrutinise the work adequately, evaluate its methodological rigour and reproduce the methods and results. Despite considerable levels of endorsement by funders and journals over the years, adherence to the guidelines has been inconsistent, and the anticipated improvements in the quality of reporting in animal research publications have not been achieved. Here, we introduce ARRIVE 2.0. The guidelines have been updated and information reorganised to facilitate their use in practice. We used a Delphi exercise to prioritise and divide the items of the guidelines into two sets, the ‘ARRIVE Essential 10’, which constitutes the minimum requirement, and the ‘Recommended Set’, which describes the research context. This division facilitates improved reporting of animal research by supporting a stepwise approach to implementation. This helps journal editors and reviewers verify that the most important items are being reported in manuscripts. We have also developed the accompanying Explanation and Elaboration document, which serves (1) to explain the rationale behind each item in the guidelines, (2) to clarify key concepts and (3) to provide illustrative examples. We aim, through these changes, to help ensure that researchers, reviewers and journal editors are better equipped to improve the rigour and transparency of the scientific process and thus reproducibility.

PMID:34095516 | PMC:PMC7610906 | DOI:10.1136/bmjos-2020-100115

Wellcome Open Res. 2021 May 21;6:125. doi: 10.12688/wellcomeopenres.16913.1. eCollection 2021.

ABSTRACT

The Tree of Life Gateway uses Genome Note publications to announce the completion of genomes assembled by the Tree of Life programme, based at the Wellcome Sanger Institute and involving numerous partner organisations and institutes. Tree of Life participates in the Darwin Tree of Life Project, which aims to sequence the genomes of all 70,000+ eukaryotic species in the Atlantic archipelago of Britain and Ireland, the Aquatic Symbiosis Genomics Project, which will sequence 1000 species involved in 500 symbioses between eukaryotic hosts and their microbial ‘cobionts’, and other initiatives, such as the Vertebrate Genome Project. These Genome Notes report the origins of ethically sourced samples used for sequencing, give the methods used to generate the sequence and use statistics and interactive figures to demonstrate the quality of the genome sequences. In addition to describing the production of these sequences, each Genome Note gives citeable credit to those who participated in producing the genome assembly and announces the availability of the data for reuse by all. It is through the use and reuse of this openly and publicly released data that we hope effective and lasting solutions to the ongoing biodiversity crisis can be found.

PMID:34095514 | PMC:PMC8142598 | DOI:10.12688/wellcomeopenres.16913.1

SAGE Open Nurs. 2021 May 21;7:23779608211017798. doi: 10.1177/23779608211017798. eCollection 2021 Jan-Dec.

ABSTRACT

INTRODUCTION: Moral resilience has recently been proposed as one strategy to address moral distress in nurses and nursing students. Central to nursing students’ capacity for moral resilience is how they understood and enact resilience with an element of realism, suggesting an ethical, ideological influence. Resilience is shown to differ significantly across students, and possibly because of a disconnect between a students’ perceived resilience and their ethical ideology. Yet, resilience seldom has been explored in relation to ethical ideology.

OBJECTIVE: This study aims to explore self-reported resilience in relation to ethical ideology in undergraduate nursing students, compare differences in scores, and explore relationships between study variables and selected demographic characteristics.

METHODS: A descriptive cross-sectional research design was followed. An online encrypted survey was conducted among a convenient sample of nursing undergraduates who met the eligibility criteria and provided implied informed consent. This study complied with ethical principles outlined in the Canadian Tri-Council Policy Statement for research with human subjects. Ethical approval was secured from the University’s Research Ethics Board. Data were analyzed using mean scores, standard deviations, independent sample t-test, variance analysis with post hoc-testing, and Pearson correlation to explore differences in perceptions and associations between study and selected demographic variables.

RESULTS: Undergraduate students have a high level of self-reported resilience. Statistically significant differences in self-reported resilience across selected demographic variables were observed. The association between resilience and ethical ideology was not significant. Ethical relativism was significantly correlated with age and year of study.

CONCLUSION: Findings suggest that faculty cultivating resilience in nursing students pays attention to gender’s influence discourses in students’ perceptions of resilience and ethical ideology and provides students with opportunities for ethical self-reflection and dialogue to critically examine their ethical ideological perspectives and the influence these may have on moral resilience development. Implications for future research are discussed.

PMID:34095499 | PMC:PMC8141986 | DOI:10.1177/23779608211017798

Energy Ecol Environ. 2021 May 29:1-12. doi: 10.1007/s40974-021-00215-4. Online ahead of print.

ABSTRACT

Pollution-free rivers give indication of a healthy ecosystem. The stretch of Tawi river particularly in the Jammu city is experiencing pollution load and the quality is degraded. The present study highlights the impact of COVID-19 lockdown on the water quality of Tawi river in Jammu, J&K Union Territory. Water quality data based upon the real-time water monitoring for four locations (Below Tawi Bridge, Bhagwati Nagar, Belicharana and Surajpur) have been obtained from the web link of Jammu and Kashmir Pollution Control Board. The important parameters used in the present study include pH, alkalinity, hardness, conductivity, BOD and COD. The river was designated fit for bathing in all the monitoring locations except Bhagwati Nagar which recorded a BOD value >5 mg/L because of domestic sewage and municipal waste dumping. The overall water quality in the river during lockdown was good and falls in Class B with pH (7.0-8.5), alkalinity (23.25-185.0 mg/L), hardness (84.25-177.5 mg/L), conductivity (117-268 ms/cm). The improved water quality obtained during lockdown is never long-lasting as evident from the BOD and COD values observed during Unlock 1.0 due to accelerated anthropogenic activities in response to overcoming the economic loss, bringing the river water quality back to the degraded state. The statistical analysis known as cluster analysis has also been performed to evaluate the homogeneity of various monitoring sites based on the physicochemical variables. The need of the hour is to address the gaps of rejuvenation strategies and work over them for effective river resiliency and for sustainable river basin management.

PMID:34095454 | PMC:PMC8164404 | DOI:10.1007/s40974-021-00215-4

Alzheimers Dement (N Y). 2021 May 31;7(1):e12136. doi: 10.1002/trc2.12136. eCollection 2021.

ABSTRACT

INTRODUCTION: A previous phase 2b study supported the use of the 5-HT6 receptor antagonist intepirdine as adjunctive therapy to donepezil for Alzheimer’s disease (AD) dementia. A phase 3 study, MINDSET, was performed to test this hypothesis.

METHODS: MINDSET was a global, double-blind, randomized, placebo-controlled trial in 1315 mild-to-moderate AD dementia patients on stable donepezil. Patients received 35 mg/day intepirdine or placebo for 24 weeks. The co-primary endpoints were change from baseline to week 24 on the Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) and Alzheimer’s Disease Cooperative Study-Activities of Daily Living (ADCS-ADL).

RESULTS: There were no statistically significant differences between intepirdine and placebo groups (adjusted mean [95% confidence interval]) on the co-primary endpoints ADAS-Cog (-0.36 [-0.95, 0.22], P = 0.2249) and ADCS-ADL (-0.09 [-0.90, 0.72], P = 0.8260). Intepirdine demonstrated a favorable safety profile similar to placebo.

DISCUSSION: Intepirdine as adjunctive therapy to donepezil did not produce statistical improvement over placebo on cognition or activities of daily living in mild-to-moderate AD dementia patients.

PMID:34095437 | PMC:PMC8165732 | DOI:10.1002/trc2.12136

SSM Popul Health. 2021 May 19;15:100823. doi: 10.1016/j.ssmph.2021.100823. eCollection 2021 Sep.

ABSTRACT

There is a rise in attention to residential history in cancer epidemiology aimed at more effective estimation of social and physical environmental exposures and the influence of place of residence on cancer outcomes. However, in the United States, as in many other countries, residential history data are not readily available. In this paper we explore the feasibility of using the annual Medicare billing ZIP code history available in the SEER-Medicare database to study residential mobility among older cancer survivors in the U.S. In a cohort of women diagnosed with breast cancer between 2007 and 2015, we examine the completeness of the data along with the overall characteristics of residential moves based on race and stage at diagnosis. Findings indicate that residential mobility among older women with breast cancer in the U.S. is limited, but differences by race/ethnicity, stage at diagnosis and before/after diagnosis are statistically significant. And breast cancer survivors from minority groups move more frequently than their non-Hispanic White counterparts. The results also show that move rate slightly, but statistically significantly, increases after diagnosis. We conclude that SEER-Medicare can be utilized to study residential mobility among older cancer survivors. We recommend the creation of sub-cohorts based on specific research questions to account for variability in residential mobility due to very short survival times or a diagnosis shortly after Medicare enrollment. Studying residential history provides the opportunity for assigning socioecological and exposure metrics for future survival studies.

PMID:34095430 | PMC:PMC8167195 | DOI:10.1016/j.ssmph.2021.100823

Gynecol Oncol Rep. 2021 May 13;37:100784. doi: 10.1016/j.gore.2021.100784. eCollection 2021 Aug.

ABSTRACT

Expedited diagnostic processes for all suspected cervical cancer cases remain essential in the effort to improve clinical outcomes of the disease. However, in some developing countries like Zambia, there is paucity of data that assesses factors influencing diagnostic and treatment turnaround time (TAT) and other metrics vital for quality cancer care. We conducted a retrospective hospital-based study at the Cancer Diseases Hospital (CDH) for cervical cancer cases presenting to the facility between January 2014 and December 2018. Descriptive statistics were used to summarize demographic characteristics while a generalized linear model of the negative binomial was used to assess determinants of overall TAT. Our study included 2121 patient case files. The median age was 49 years (IQR: ±17) and most patients (n = 634, 31%) were aged between 41 and 50 years. The International Federation of Gynaecology and Obstetrics (FIGO) Cancer stage II (n = 941, 48%) was the most prevalent while stage IV (n = 103, 5.2%) was the least. The average diagnostic TAT in public laboratories was 1.48 (95%CI: 1.21-1.81) times longer than in private laboratories. Furthermore, referral delay was 55 days (IQR: 24-152) and the overall TAT (oTAT) was 110 days (IQR: 62-204). The age of the patient, HIV status, stage of cancer and histological subtype did not influence oTAT while marital status influenced oTAT. The observed longer oTAT may increase irreversible adverse health outcomes among cervical cancer patients. There is a need to improve cancer care in Zambia through improved health expenditure especially in public health facilities.

PMID:34095422 | PMC:PMC8165546 | DOI:10.1016/j.gore.2021.100784