Lancet Child Adolesc Health. 2023 Sep 29:S2352-4642(23)00224-9. doi: 10.1016/S2352-4642(23)00224-9. Online ahead of print.
NO ABSTRACT
PMID:37783222 | DOI:10.1016/S2352-4642(23)00224-9
Am J Audiol. 2023 Oct 2:1-11. doi: 10.1044/2023_AJA-23-00027. Online ahead of print.
ABSTRACT
PURPOSE: The primary purpose of this study was to determine which scope of practice roles and responsibilities are attributed to the profession of audiology (AUD) relative to other health care disciplines by a group of health and human services faculty and students.
METHOD: An online survey inquiring about participant knowledge of different health professions’ scopes of practice, and experience with and attitude toward the profession of AUD, was sent to faculty and students in the Western Michigan University College of Health and Human Services. Students also completed two subscales of the Interprofessional Attitudes Scale. Descriptive statistics and chi-square and Kruskal-Wallis analyses evaluating response differences between groups are presented.
RESULTS: Thirty-six faculty and 118 students (48 graduate and 70 undergraduate) completed the survey. AUD was the profession most often associated with all hearing-related scope of practice activities. Speech-language pathology was often associated with hearing-related scope of practice activities. Audiologists were less commonly associated with vestibular, balance, and mobility scope of practice activities. Group was significant for four scope of practice activities. About half of respondents indicated they knew nothing or a little about AUD, and a majority had no or rare interactions with audiologists in class or clinic. Only about half of participants responded they were likely or very likely to refer patients to an audiologist.
CONCLUSION: Increased knowledge of the scope of practice and exposure to the profession of AUD may benefit other health care professionals and patients, possibly leading to increased interprofessional practice and an increased number of appropriate referrals.
PMID:37783210 | DOI:10.1044/2023_AJA-23-00027
Ann Med. 2023;55(2):2263869. doi: 10.1080/07853890.2023.2263869. Epub 2023 Oct 2.
ABSTRACT
OBJECTIVES: To improve diagnostic accuracy of pulmonary mucoepidermoid carcinoma (PMEC) through multi-detector computed tomography (MSCT) findings.
METHODS: MSCT findings of 27 histopathologically confirmed PMEC cases were retrospectively analyzed, including the location, size, margin, density, enhancement of the lesion and accompanying signs.
RESULTS: Among the 27 PMEC cases, 6 (6/27, 22.2%) were the large airway pattern, 14 were (14/27, 51.9%) the pulmonary hilum pattern, and 7 (7/27, 26.9%) were the peripheral pattern. Among those 20 cases with central pattern(6 large airway and 14 pulmonary hilum patterns), 6 presented mild enhancement, 4 moderate enhancement, 5 severe enhancement, 5 heterogeneous enhancement, and 3 with calcification. 7 cases with peripheral patterns were presented as solid pulmonary nodules and masses, 3 with severe enhancement, 1 with moderate enhancement and 3 with mild enhancement. Four cases accompanied by lymph nodal metastasis, and 7 cases with distant organ metastasis. Age(t = -3.132, p = 0.005), enlarged lymph node (x2 = 9.281, p = 0.005), and distant metastasis(x2 = 7.816, p = 0.008) were statistically significant in the low-grade group and high-grade group.
CONCLUSIONS: MSCT images of PMEC patients demonstrated some characteristic findings, which would help improve the diagnostic accuracy of the disease.
PMID:37783202 | DOI:10.1080/07853890.2023.2263869
J Health Popul Nutr. 2023 Oct 2;42(1):105. doi: 10.1186/s41043-023-00429-8.
ABSTRACT
BACKGROUND: A virus infection may lead the body to produce more immune cells of particular types or stimulate the production of new ones, both of which may have anti-leukemic effects. There has been no research on whether immune cells stimulated by varicella-zoster virus (VZV) infection have anti-leukemic effects. The objective of this investigation is to assess the impact of VZV infection on patients’ long-term survival following allogeneic hematopoietic stem cell transplantation (allo-HSCT).
METHODS: This retrospective study investigated the association between varicella-zoster virus (VZV) reactivation and outcomes in 219 individuals who received allogeneic hematopoietic stem cell transplantation (allo-HSCT) at the Sun Yat-sen University’s First Affiliated Hospital. According to being diagnosed with VZV infection or not, these patients were grouped into two groups. The comparison of cumulative incidence of relapse, non-recurrent mortality, and overall survival (OS) was conducted between the two groups.
RESULTS: Analyzing multivariate data, VZV reactivation was linked to lower relapse incidence in the group containing all individuals (hazard ratio [HR] = 0.27; 95% confidence interval [CI], 0.12-0.64), patients suffering from acute myeloid leukaemia (HR = 0.10; 95% CI, 0.01-0.83), and patients suffering from acute lymphoblastic leukaemia (HR = 0.25; 95% CI, 0.08-0.77). Moreover, VZV reactivation was linked with decreased non-relapse mortality in all individuals (HR = 0.20; 95% CI, 0.05-0.79), but no statistical significance was found for any disease subgroup. Further, VZV reactivation was an independent predictor for improved OS in the group containing all individuals (HR = 0.10; 95% CI, 0.03-0.29), patients suffering from acute myeloid leukaemia (HR = 0.09; 95% CI, 0.01-0.66), and patients suffering from acute lymphoblastic leukaemia (HR = 0.16; 95% CI, 0.04-0.68).
CONCLUSION: This is the first study to show that VZV reactivation following allo-HSCT is an independent predictor for lower relapse rates and improved OS, providing novel therapeutic approaches to improve patients’ long-term survival following allo-HSCT.
PMID:37784192 | DOI:10.1186/s41043-023-00429-8
Acta Psychol (Amst). 2023 Sep 30;240:104042. doi: 10.1016/j.actpsy.2023.104042. Online ahead of print.
ABSTRACT
Given that there is limited evidence concerning the psychometric properties of DASS-21 when applied to primary school students, the present study undertook a comprehensive exploration of the psychometric evidence supporting the use of the DASS-21 within this demographic. The research comprised three studies. In Study 1, the basic psychometric properties of internal consistency and construct validity were examined. A total of 3138 primary school students from three provinces in mainland China participated. The internal reliability of the overall scale was 0.93, and for all the subscales, it was higher than 0.80. Construct validity was partially supported. Both exploratory and confirmatory factor analyses upheld the factorial validity of the original three-factor structure. While convergent validity was established, the results showed unsatisfactory discriminant validity. The bifactor model showed that DASS-21 raw scores predominantly indicated the general factor, evidenced by the high explained common variance and omega-hierarchical values. However, the contributions from the three specific factors were minimal, with their omega hierarchical values all below 0.15. In Study 2, a longitudinal design was adopted, tracking 1366 primary school students from Southwest China over a three-month interval. The results further confirmed that the DASS-21 exhibited scalar time-invariance. The latent mean analysis showed that there were no statistically significant differences in the latent means of depression, anxiety, and stress between Time 1 and Time 2. In Study 3, which included 364 college students and 483 enterprise workers, the results demonstrated that the DASS-21 had measurement invariance across different populations. The latent mean analysis further confirmed that, in terms of the latent mean of all three subscales, both college students and enterprise workers had significantly higher scores than primary school students. Overall, the findings indicated that the DASS-21 is a suitable tool for screening schoolchildren for general psychological distress, but it is not suitable for discerning distinct negative mood state disorders.
PMID:37783184 | DOI:10.1016/j.actpsy.2023.104042
Intensive Crit Care Nurs. 2023 Sep 30;80:103551. doi: 10.1016/j.iccn.2023.103551. Online ahead of print.
ABSTRACT
OBJECTIVE: This meta-analysis aimed to assess the predictive value of the rapid shallow breathing index for extubation outcomes.
METHODOLOGY: We conducted a systematic review of literature (inception to March 2023) and a meta-analysis. Statistical analysis was performed using Meta-Disc 1.4 software, RevMan 5.4 software and Stata 14.0 software to evaluate the predictive value of RSBI for extubation outcomes.
RESULTS: A total of 1,987 studies were retrieved, and after applying the inclusion criteria, 79 studies were included in the final analysis, involving 13,170 patients undergoing mechanical ventilation. The random-effects model was employed for statistical analysis. The summary receiver operating characteristic curves (SROC) area under the curve (AUC) was 0.8144. The pooled sensitivity was 0.60 (95% CI: 0.59, 0.61), the pooled specificity was 0.68 (95% CI: 0.66, 0.70).
CONCLUSIONS: The Rapid Shallow Breathing Index demonstrated moderate accuracy, poor pooled sensitivity and specificity in predicting successful extubation, however the study does not present adequate data to support or reject the use of this tool as a single parameter that predicts extubation outcome. Future studies should explore the combination of The Rapid Shallow Breathing Index with other indicators and clinical experience to improve the success rate of extubation and reduce the risk of extubation failure.
IMPLICATIONS FOR CLINICAL PRACTICE: Premature and delayed extubation in mechanically ventilated patients can have a negative impact on prognosis and prolong hospital stay. The Rapid Shallow Breathing Index is a simple, cost-effective, and easily monitored objective evaluation index, which can be used to predict the outcome of extubation, especially in primary hospitals. Our study comprehensively evaluated the value of this tool in predicting extubation outcomes, which can help clinicians combine subjective experience with objective indicators to improve the accuracy of extubation time decisions.
PMID:37783181 | DOI:10.1016/j.iccn.2023.103551
Clinics (Sao Paulo). 2023 Sep 30;78:100283. doi: 10.1016/j.clinsp.2023.100283. Online ahead of print.
ABSTRACT
OBJECTIVES: The aim of this study was to evaluate the effect of STS resection in the thigh on MS and the HRQoL.
METHODS: Fourteen adults patients with STS in the thigh who underwent wide resection and limb preservation were evaluated. The patients were submitted to the Mini-Mental State Examination (MMSE). A hand-held dynamometer was used to measure the MS the flexors, adductors, abductors, and extensors muscles of the operated and non-operated thighs and between the dominant and non-dominant operated sides. The Musculoskeletal Tumor Society (MSTS) and Short Form Health Survey-36 (SF-36) questionnaires were applied to quantify the psychometric properties of the HRQoL. The data were submitted to statistical analysis using the Wilcoxon test (MS), and Mann-Whitney and Spearman correlation (MSTS and SF-36) (α = 0.05).
RESULTS: There was no significant difference in MS between the operated side and the non-operated side, and between the dominant and non-dominant operated side (ρ > 0.05). The MSTS presented a significant difference in the emotional acceptance for patients submitted to radiotherapy (ρ = 0.029). The SF-36 showed significant differences in the emotional aspect for patients submitted to chemotherapy (ρ = 0.027) and in the social aspect between the dominant and non-dominant operated side (ρ = 0.024).
CONCLUSIONS: The HRQoL of adult patients is hampered after the treatment of STS even when MS is maintained.
PMID:37783169 | DOI:10.1016/j.clinsp.2023.100283
Accid Anal Prev. 2023 Sep 30;193:107331. doi: 10.1016/j.aap.2023.107331. Online ahead of print.
ABSTRACT
Interaction effects constitute crucial crash attributes that can be classified into two distinct categories: spatiotemporal interactions and factor interactions. These interactions are rarely addressed systematically in modeling the severity of single-vehicle (SV) crashes. This study focuses on uncovering these crash attributes by designing a full Bayesian spatiotemporal interaction multilevel logit (STIML-logit) approach with heterogeneity in means and variances (HMV). Meanwhile, a nested Gaussian conditional autoregressive (CAR) structure is proposed to fit the spatiotemporal interaction component and its effectiveness is verified by calibrating four different interaction patterns. A standard multilevel logit (with and without HMV), a multilevel logit with HMV, and a spatiotemporal multilevel logit with HMV are constructed for comparison. Risk factors are decomposed into traffic environment factors (group level) and individual crash factors (case level) to construct a multilevel structure and to capture possible interactions between risk factors from different levels (cross-level factor interactions). We perform regression modeling utilizing SV crash cases covering 96 major urban roads in Shandong, China. The modeling results underscore several significant findings: (1) the STIML-logit with HMV demonstrates the best regression performance, suggesting that systematically dealing with the interaction effects and the HMV is a trustworthy modeling perspective; (2) crash models with the nested CAR outperform those with the traditional CAR and the result is supported by all the spatiotemporal statistical functions, highlighting the potential advantages of the nested structure; (3) all the environment factors maintain significant interactions with the case factors, highlighting that the contribution of the environment factors to crash injuries is not constant but is rather influenced by the specific case-related crash factors. The study introduces a promising regression architecture for modeling crash injuries and revealing subtle crash attributes.
PMID:37783161 | DOI:10.1016/j.aap.2023.107331
Accid Anal Prev. 2023 Sep 30;193:107307. doi: 10.1016/j.aap.2023.107307. Online ahead of print.
ABSTRACT
Identifying critical safety management drivers with high driver-level risks is essential for traffic safety improvement. Previous studies commonly evaluated driver-level risks based upon aggregated statistical characteristics (e.g., driving exposure and driving behavior), which were obtained from long-period driving monitoring data. However, given the great advancements of the connected vehicle and in-vehicle data instrumentation technologies, there has been a notable increase in the collection of short-period driving data, which has emerged as a prominent data source for analysis. In this data environment, traditionally employed aggregated behavior characteristics are unstable due to the time-varying feature of driving behavior coupled with insufficient data sampling periods. Thus, traditional modeling methods based upon aggregated statistical characteristics are no longer feasible. Instead of utilizing such unreliable statistical information to represent driver-level risks, this study employed temporal variation characteristics of driving behavior to identify critical safety management drivers in the short-period driving data environment. Specifically, the relationships between driving behavior temporal variation characteristics and individual crash occurrence probability were developed. To eliminate the impacts of drivers’ driving behavior heterogeneity on model performance, “traffic entropy” index that could quantify the abnormal degrees of driving behavior was proposed. Deep learning models including convolutional neural network (CNN) and long short-term memory (LSTM) were employed to conduct the temporal variation feature mining. Empirical analyses were conducted using data obtained from online ride-hailing services. Experiment results showed that temporal variation characteristics based models outperformed traditional aggregated statistical characteristics based models. The area under the curve (AUC) index was improved by 4.1%. And the proposed traffic entropy index further enhanced the model performance by 5.3%. The best model achieved an AUC of 0.754, comparable to existing approaches utilizing long-period driving data. Finally, applications of the proposed method in driver management program development and its further investigations have been discussed.
PMID:37783160 | DOI:10.1016/j.aap.2023.107307
Ann Diagn Pathol. 2023 Sep 28;67:152214. doi: 10.1016/j.anndiagpath.2023.152214. Online ahead of print.
ABSTRACT
There are immunohistochemistry (IHC) and immunofluorescence (IF) panels described in the literature and established by personal and institutional experiences that are in common use by pathologists in their daily practice. Stewardship is a difficult discussion because IHC utilization is influenced by many factors including the pathologist’s experience, background, practice setting, personal bias, and medicolegal culture. We developed the methodology to audit the IHC/IF utilization in our academic subspecialty practice. We aim to share this methodology and to provide our data that can be used for consideration by other subspecialized academic practices. This analysis included a total of 63,157 specimens that were accessioned during 2022, representing 38,612 cases. The likelihood of ordering IHC/IF ranged from 1 % (in genitourinary pathology) to 59 % (in renal pathology). The average percentage of specimens with IHC/IF was 21 % for the entire practice. In cases where IHC/IF was ordered, the number of stained slides averaged 4.9 per specimen for the entire practice. The number of IHC/IF slides per specimen ranged from 1.9 (in gastrointestinal pathology) to 12.2 (in renal pathology). The highest number of antibodies ordered for a single specimen by subspecialty ranged from 11 (in cardiac pathology) to 63 (in dermatopathology). Renal pathology was the only subspecialty that had an average number of IHC/IF slides that was statistically significantly different from all other subspecialties. We described the various patterns of utilization by subspecialty and rationalized their subtle differences. We also analyzed the types of cases that exceeded the reimbursement limits set by the Centers for Medicare and Medicaid Services (CMS).
PMID:37783147 | DOI:10.1016/j.anndiagpath.2023.152214