Tag: nevin manimala

Cureus. 2024 Oct 6;16(10):e70929. doi: 10.7759/cureus.70929. eCollection 2024 Oct.

ABSTRACT

INTRODUCTION: A persistent systemic hyperglycemia as observed in patients with type 2 diabetes mellitus (DM) has been associated with periodontal inflammation. Therefore, the primary objective of the present study was to assess the levels of thromboxane B2 (TXB2) and prostaglandin E2 (PGE2) in the gingival crevicular fluid (GCF) of type 2 DM and non-diabetic patients with chronic periodontitis. The secondary objectives were to correlate these levels with various parameters such as age, gender, glycated hemoglobin (HbA1c) levels, probing depth (PD), and fasting blood sugar levels and to determine the significant predictors for PGE2 and TXB2 levels. Materials and methods: This case-control, cross-sectional study was conducted on 60 patients who were divided into three groups: group 1 (n=20) comprising type 2 DM patients with chronic periodontitis, group 2 (n=20) composed of non-diabetic patients with chronic periodontitis, and group 3 (n=20) as controls comprising of periodontally and systemically healthy individuals. HbA1c, fasting blood glucose levels, PD, and PGE2 and TXB2 levels were checked in GCF for all the patients. The data was subjected to statistical analysis.

RESULTS: The two-way analysis of variance test results revealed statistically significant differences across groups for all parameters. The levels of both biomarkers showed a positive correlation with HbA1c, PD, fasting blood sugar levels, and duration of type 2 DM. Furthermore, PD and fasting blood sugar levels showed the strongest influence on both PGE2 and TXB2 levels. For PGE2, fasting blood sugar levels (p=0.006) and PD (p<0.001) were significant predictors. For TXB2, significant predictors included HbA1c (p=0.003), fasting blood sugar levels (p=0.015), and PD (p<0.001).

CONCLUSION: PGE2 and TXB2 levels were significantly increased in type 2 DM with chronic periodontitis, compared with non-diabetic patients with chronic periodontitis and periodontally healthy patients.

PMID:39502985 | PMC:PMC11537775 | DOI:10.7759/cureus.70929

Cureus. 2024 Oct 6;16(10):e70921. doi: 10.7759/cureus.70921. eCollection 2024 Oct.

ABSTRACT

Introduction Optimisation of patients with type 2 diabetes mellitus (T2DM) prior to metabolic surgery aims to achieve tight glycaemic control by the time of surgery. Little is known about the influence of altering preoperative glycated haemoglobin (HbA1c) on postoperative weight loss and glycaemic control. The aim of this study was to determine whether a change in HbA1c during the preoperative period correlated with long-term weight maintenance and HbA1c in patients undergoing metabolic surgery. The quantity of glucose-lowering medication used prior to and following surgery was also examined. Methods A retrospective analysis was conducted on patients with T2DM who underwent metabolic surgery between 2013 and 2017. Preoperative HbA1c change was measured as a change in glycaemic control during the one-year pre-surgery. The primary outcomes were % excess weight loss (EWL) and HbA1c at five-year post-surgery. Secondary outcomes were % EWL and HbA1c at one-year post-surgery and the use of glucose-lowering medications post-surgery. The Pearson correlation coefficient (r) was used to determine the relationship between the pre-surgery HbA1c change and postoperative % EWL and HbA1c. A chi-squared test was used to calculate the statistical impact of changes in medication use post-surgery. Results Sixty-nine patients with complete data were included in the study. The mean change in HbA1cin the one-year pre-surgery, the one-year post-surgery and five-year post-surgery was -0.9% (1.5), -0.7% (1.2) and 0% (0 1.8), respectively. A change in HbA1cin the one-year pre-surgery did not correlate with % EWL at one-year and five-year post-surgery or with HbA1cat one-year and five-year post-surgery. At one-year and five-year post-surgery, there was a significant decrease in the proportion of patients requiring glucose-lowering medications compared to patient use prior to surgery (p < 0.001). Conclusion This study demonstrated a significant reduction in the proportion of glucose-lowering medication required long-term following metabolic surgery. Altering preoperative glycaemic control was not associated with long-term weight maintenance or glycaemic control.

PMID:39502975 | PMC:PMC11537774 | DOI:10.7759/cureus.70921

Cureus. 2024 Oct 5;16(10):e70911. doi: 10.7759/cureus.70911. eCollection 2024 Oct.

ABSTRACT

INTRODUCTION: This study examines trends in executive compensation at non-profit hospitals across the United States from 2018 to 2022. The research aims to address gaps in the current literature by providing an up-to-date analysis of compensation practices and their relationship to hospital financial metrics.

METHODS: A descriptive longitudinal study was conducted using data from Form 990 filings of 20 randomly selected non-profit hospitals across four U.S. regions. Executive compensation data, along with hospital financial metrics, were extracted and analyzed. Statistical analyses included descriptive statistics, non-parametric tests for trend analysis, and correlation studies using Kendall’s Tau B.

RESULTS: The median increase in executive compensation over the five-year period was 23.4%, with a median annual increase of 6.2%. Significant positive correlations were found between executive compensation and hospital revenue (τ = 0.676, p < 0.001), net assets (τ = 0.600, p < 0.001), and net income (τ = 0.273, p < 0.001). However, percentage changes in these variables over time were not significantly correlated.

CONCLUSION: The study reveals significant growth in executive compensation at non-profit hospitals, with notable regional variations. While compensation correlates strongly with hospital financial metrics, the lack of correlation in their respective changes over time suggests a complex relationship. These findings raise important questions about resource allocation and compensation practices in non-profit healthcare institutions, highlighting the need for further research and policy discussions.

PMID:39502965 | PMC:PMC11535135 | DOI:10.7759/cureus.70911

Child Adolesc Psychiatry Ment Health. 2024 Nov 5;18(1):139. doi: 10.1186/s13034-024-00832-x.

ABSTRACT

BACKGROUND: Non-suicidal self-injury (NSSI) behaviors among adolescents with mood disorders represent a significant global public health concern. This study aimed to assess the prevalence and identify key predictors of NSSI behaviors in Chinese adolescents diagnosed with depressive or bipolar disorders, addressing a critical gap in the literature.

METHOD: Data from 2343 participants in the Chinese Adolescent Depression Cohort (CADC) were analyzed. The study employed a comprehensive approach, utilizing medical records, clinical assessments, and validated psychometric instruments. Statistical analyses included chi-square tests, logistic regression, and ROC curve analyses, culminating in the development of a predictive nomogram.

RESULTS: The prevalence of NSSI behaviors was strikingly high at 73.32%. Significant predictors included female gender (AOR = 2.14, 95% CI [1.70, 2.68]), presence of hallucinations (AOR = 1.52, 95% CI [1.18, 1.97]), borderline personality features (AOR = 1.03, 95% CI [1.01, 1.08]), and childhood trauma (AOR = 1.02, 95% CI [1.01, 1.03]). The study’s key contribution is a predictive nomogram with an AUC of 0.74, demonstrating good efficacy in predicting NSSI behaviors.

CONCLUSION: This research reveals an alarmingly high prevalence of NSSI behaviors in Chinese adolescents with mood disorders and identifies critical predictors spanning demographic, clinical, and psychometric domains. The developed nomogram offers a novel approach for risk assessment, highlighting the importance of comprehensive evaluations in adolescent mental healthcare. These findings have significant implications for developing targeted interventions and improving risk assessment strategies in clinical practice.

PMID:39501322 | DOI:10.1186/s13034-024-00832-x

BMC Psychol. 2024 Nov 5;12(1):623. doi: 10.1186/s40359-024-02122-9.

ABSTRACT

BACKGROUND: In past decades, the Chinese government has enacted a series of ecological policies to encourage organizations, the pivotal institutional agents implementing national policies, and employees, the crucial micro-actors engaging in ecological construction, to bring about employee pro-environmental behavior (EPEB) which is the foundation to realize nation’s ecological strategies. Yet, the effectiveness of a widely adopted organizational-level green management practice “organizational green compensation” (OGC) and a typical individual-level green personality trait “employee green conscientiousness” (EGC) have been explored alone, ignoring the prevalence of various OGC-EGC combinations and failing to clarify the potential influences of OGC-EGC (in)congruence on EPEB. Our research endeavors to address this limitation by resolving the following two problems: What are the (in)congruence effects of OGC and EGC on EPEB in the Chinese context? And what is the underlying mechanism?

METHODS: Study 1 surveyed EGC, OGC, and EPEB among 778 subordinate-supervisor dyads and sought to test two single effects and three sets of comparisons between and within the congruence and incongruence effects using the methodology of polynomial regression and response surface analysis. Study 2 measured EGC, OGC, employee environmental commitment (EEC), and EPEB among 713 subordinate-supervisor dyads and attempted to verify the mediating role of EEC employing the block variable approach.

RESULTS: Study 1 found that OGC and EGC independently, positively promote EPEB (ß = 0.39, p < 0.001; ß = 0.24, p < 0.001), the OGC-EGC congruence relates to higher EPEB compared to the OGC-EGC incongruence (p₁₁ = 3.77, 95% CI = [0.71, 23.04]; p₁₀ = – 0.65, 95% CI = [- 25.80, 0.42]; [α₃ -α₄ +α₅] = – 0.24, 95% CI = [- 0.41, – 0.07]), the EPEB level is higher when the OGC-EGC congruence is at a high rather than low level ([α₁ +α₂] = 0.51, 95% CI = [0.39, 0.62]), and the EPEB level under the high-low combination is lower than that under the low-high combination ([α₁-α₂] = – 0.20, 95% CI = [- 0.38, – 0.02]). Study 2 further confirmed that EEC plays a mediating role during the OGC-EGC-EPEB relationships (the indirect effect = 0.14, 95% CI = [0.08, 0.20]).

CONCLUSION: This research substantiates the value of OGC-EGC (in)congruence to fully understand EPEB variations such that, EPEB will be boosted (hampered) when OGC is (in)congruent with EGC; a higher congruence between OGC and EGC leads to higher EPEB, the high-low combination of OGC and EGC results in lower EPEB compared to the low-high combination, and EEC plays a mediating role in the above relationships, offering the Chinese evidence and providing theoretical and practical implications for the optimization of the OGC-EGC combinations to strengthen EPEB.

PMID:39501311 | DOI:10.1186/s40359-024-02122-9

BMC Surg. 2024 Nov 5;24(1):347. doi: 10.1186/s12893-024-02603-z.

ABSTRACT

INTRODUCTION: There are a growing number of surgical approaches for laparoscopic radical resection of right-sided colon cancer, while there are relatively few comparative analyses of the different surgical approaches.

OBJECTIVE: To evaluate the safety and efficacy of different surgical approaches (intermediate approach, caudolateral approach, caudolateral combined with intermediate approach) for laparoscopic radical resection of right-sided colon cancer by conducting a network meta-analysis (NMA).

METHOD: We searched PubMed, Web of science and China National Knowledge Infrastructure (CNKI) databases. We reviewed the Chinese and English literature on controlled studies of laparoscopic radical resection of right-sided colon cancer including intermediate approach, caudolateral approach and caudolateral combined with intermediate approach, reported from the establishment of the database to September 2023. The inclusion and exclusion criteria were independently conducted by two researchers and relevant data was extracted from the qualifying literature and analyzed using Stata15 software.

RESULTS: Nine controlled studies of relevance including 715 patients were screened with right-sided colon cancer. Net meta-analysis showed that compared with the intermediate approach, the caudolateral approach was superior to the intermediate approach in terms of operation time (SMD = 0.75, 95% CI = 0.38 ~ 1.12, P = 0.0001), and bleeding volume (SMD = 1.15, 95% CI = 0.18 ~ 2.13, P = 0.002), while the difference was not statistically significant among the caudolateral approach compared with the intermediate approach in terms of the number of lymph node dissection, postoperative complication rate, time to first postoperative flatus and postoperative hospitalization. Compared with the intermediate approach, the combined approach was superior to the intermediate approach in terms of operation time (SMD = -0.87, 95% CI = -1.22 ~ -1.52, P < 0.05), bleeding volume (SMD = -1.09, 95% CI = -1.98 ~ -0.19, P < 0.05), the number of lymph node dissection (SMD = 0.21, 95% CI = 0.01 ~ 0.41, P < 0.05), and postoperative complication rate (RR = 2.24, 95% CI = 1.21 ~ 4.13, P < 0.05), while the difference was no statistically significant among the combined approach compared with the intermediate approach in terms of time to first postoperative flatus and postoperative hospitalization. Compared with the caudolateral approach, there was no statistically significant difference between the caudolateral approach and the combined approach in terms of operation time, bleeding volume, the number of lymph node dissection, postoperative complication rate, time to first postoperative flatus and postoperative hospitalization. According to the results of the surface under the cumulative ranking curve (SUCRA), the caudolateral approach and the combined approach were superior to the intermediate approach in terms of operation time (SUCRA: 65.1%, 84.9%, 0), bleeding volume (SUCRA: 77%, 71.9%, 1%), the number of lymph node dissection (SUCRA: 49.6%, 90.8%, 9.7%), postoperative complication rate (SUCRA: 46.6%, 97.5%, 5.9%), time to first postoperative flatus (SUCRA: 67%, 77.8%, 5.2%), postoperative hospitalization (SUCRA: 30.8%, 96.4%, 22.8%).

CONCLUSION: The caudolateral combined with intermediate approach and the caudolateral approach are safer and more effective than the intermediate approach. According to the results of SUCRA, the combined approach is superior to the caudolateral approach in terms of operation time, the number of lymph node dissection, postoperative complication rate, time to first postoperative flatus and postoperative hospitalization, the caudolateral approach is superior to the combined approach in term of bleeding volume.

PMID:39501308 | DOI:10.1186/s12893-024-02603-z

BMC Med Educ. 2024 Nov 5;24(1):1265. doi: 10.1186/s12909-024-06244-x.

ABSTRACT

BACKGROUND: Decades of medical data show worse patient outcomes among racial and gender minorities due to implicit, explicit, and structural biases. Increasing representation of marginalized groups among care providers is imperative to help address this. Limited literature exists on bias awareness strategies for interviewers during the selection of applicants to General Internal Medicine (GIM) programs in Canada. This study examines the trial of bias reduction tools to increase interviewers’ awareness of implicit biases.

METHODS: The Model of Improvement framework guided the trail of an instructional video, the adapted implicit association test (IAT), and a paper awareness tool (PAT) to increase interviewers’ awareness of implicit biases during the University of Alberta’s GIM applicant selection. An anonymous online survey was disseminated to physician interviewers. Descriptive statistics (percentages) and a modified sentiment analysis was completed.

RESULTS: 10 of 14 interviewers completed the survey. Respondents reported an increased awareness of using bias reduction tools (IAT, 25%; video, 71%; PAT, 67%) to inform them on their implicit biases. The future use of IAT, video, and PAT was supported by 50%, 71%, and 67% of interviewers, respectively.

CONCLUSIONS: Interviewers prefer the instructional video and PAT over the IAT. Textual responses suggest existing concerns for biases inherent to the interview process yet 70% (7/10) of respondents believe that interviews should have a weighting of 50% towards final ranking of candidates. As many institutions continue to rely on interviews to evaluate candidates, our findings indicate the need for a national study to develop a framework to mitigate inherent biases during interviewing of candidates.

PMID:39501300 | DOI:10.1186/s12909-024-06244-x

Int J Equity Health. 2024 Nov 5;23(1):227. doi: 10.1186/s12939-024-02278-1.

ABSTRACT

BACKGROUND: Community-based participatory research (CBPR) is a collaborative research approach that engages academic researchers and community stakeholders as equal partners in all research steps to address community concerns and achieve health equity. The CBPR approach has been widely used in vaccination promotion programmes. However, the elements and steps of CBPR-based programmes varied among studies. The purpose of this scoping review was to synthesize the elements and steps, and establish an implementation framework to guide the utilisation of CBPR approaches in vaccination promotion.

METHODS: This scoping review was performed in accordance with Arksey and O’Malley’s five-stage framework. A systematic search was conducted on a set of electronic databases and grey literature sources. The retrieved articles were screened according to the criteria of CBPR and vaccination promotion, and data were extracted and recorded on a calibrated and predefined form in terms of study characteristics and CBPR components. Two authors worked independently to complete literature search, study selection, and data extraction. A narrative summary was used in categorising characteristics, and the contents of the included studies were summarised through qualitative analysis.

RESULTS: A total of 8557 publications were initially screened, and 23 articles were finally included. According to the CBPR conceptual model, the elements in each CBPR component specifically for vaccination promotion included (1) the establishment of community-academic partnership (CAP)s, (2) community capacity building by partner training vaccination knowledge, research literacy, and service abilities and skills, (3) development and implementation of community-based intervention and (4) Outcome evaluation. A CAP was established between academic researchers or institutes and eight types of partners, including community service organisation-related non-government organisations (NGOs), health service institution-related NGOs, religious organisations, government agencies, educational institutions, media agencies, business agencies, and community representatives. The maintenance of CAP was achieved with four key strategies, namely, strengthening communication, forming management groups, sharing resources and information, and providing incentives. Twelve studies provided comprehensive insights into the strategies employed for intervention development, utilising either quantitative surveys, qualitative methods or a combination of both approaches. The contents of interventions included health service supports, health education activities, social marketing campaigns, community mobilisation, interactive discussions, vaccination reminders and incentives. As for outcome evaluation, vaccination rate and the effectiveness of interventions were assessed. A considerable increase was observed in 95.7% of the included studies (22/23), and the highest increase (92.9%) was attained after the intervention. An implementation framework was generated to summarise the elements and steps of CBPR approaches for vaccination promotion.

CONCLUSIONS: This review summarised current evidence and generated an implementation framework to elucidate the elements and steps in the development and application of CBPR approaches in vaccination promotion. CBPR approaches are recommended for future vaccination promotion programmes, involving community stakeholders and research professionals, to ensure equitable access to vaccinations across diverse populations.

PMID:39501299 | DOI:10.1186/s12939-024-02278-1

Child Adolesc Psychiatry Ment Health. 2024 Nov 5;18(1):140. doi: 10.1186/s13034-024-00811-2.

ABSTRACT

AIM: Our aim was to assess the burden of children and adolescents’ mental health problems on the Slovenian outpatient healthcare system before, during and after the pandemic.

METHODS: In a retrospective analysis of healthcare indicators from 2008 to 2023, we analysed data from the National Institute of Public Health. Key domains included initial visits for mental and behavioural disorders (MBDs) to primary care for the population aged 0-19; the number of referrals to an initial assessment with a child and adolescent psychiatrist (CAP) at the secondary level for the population aged 0-17 along with the corresponding waiting times; and the number of urgent referrals for the population aged 0-17 to emergency mental health centres at the tertiary level. The calculations included rates per 1000 people. Descriptive statistics and diagrams were used to compare the data. Segmented linear regression analysis (SLR) was conducted on the primary healthcare data to identify the distinct temporal point indicating an increase.

RESULTS: Comparing the average rates of the 2020-2022 period to those of the 2018-2019 period, there was a 20% increase in initial visits to primary care, a 23% increase in the referral rate to a CAP at the secondary level, and a 41% increase to the tertiary level of care. In secondary care, a four- to sevenfold increase in waiting times for the initial CAP assessment was observed between 2019 and 2023. The incidence of initial visits to primary healthcare services for MBD increased from 2008 to 2019 (average annual growth rate of 4.5%). The average annual growth rate for the 2020-2022 period tripled to 13.9%. The SLR showed that the trend of accelerating growth could have begun in 2017 for the 0-5 age group and possibly for the 15-19 age group as well.

CONCLUSIONS: After the initial decline in 2020, all levels of the Slovenian healthcare system faced an increased burden of MBD in children and adolescents from 2021 to 2022 compared to pre-pandemic levels. Nevertheless, a portion of this increase aligns with longitudinal growing trends from 2008 onwards. Tackling the crisis requires urgent national action, significant improvement in organization, and investments in mental health.

PMID:39501287 | DOI:10.1186/s13034-024-00811-2

Acta Vet Scand. 2024 Nov 5;66(1):58. doi: 10.1186/s13028-024-00781-7.

ABSTRACT

BACKGROUND: Bovine respiratory disease (BRD) is common in intensively raised cattle and is often treated with antibiotics. For practitioners, knowledge of the bacteria involved in an outbreak and their antibiotic susceptibility is warranted. To this end, samples from the upper or lower respiratory tract of calves can be submitted for bacteriological culture and susceptibility testing of relevant isolates. However, it is debated whether isolates from the upper respiratory tract are representative of bacteria causing infections in the lower respiratory tract. In this study, we used MALDI-TOF MS, multilocus sequence typing (MLST) and core-genome multilocus sequence typing (cgMLST) to compare culture results of 219 paired samples (sample pairs) of deep nasal swabs (DNS) and tracheobronchial lavage (TBL). The sample pairs came from 171 calves in 30 calf groups across 25 farms with 48 calves sampled twice.

RESULTS: The predominant bacterial pathogen was Pasteurella multocida, which was isolated from 37.4% of DNS and 22.4% of TBL. There was no statistically significant difference in isolation frequency of P. multocida between calves considered healthy and those suspected for BRD for DNS (P = 0.778) or TBL (P = 0.410). Among the 49 sample pairs where P. multocida was isolated from TBL, the same species was isolated from DNS in 29 sample pairs (59.2%). Isolates from 28 of these sample pairs were evaluated by MLST, and in 24 pairs (86.0%) P. multocida from DNS and TBL were of the same sequence type (ST). Moreover, cgMLST showed that the genetic distance between isolates within 21 of the 28 sample pairs (75.0%), was less than two alleles, and DNS and TBL isolates were considered identical. In seven sample pairs (25%), the genetic distance was greater, and DNS and TBL isolates were considered nonidentical.

CONCLUSIONS: Pasteurella multocida was readily isolated from DNS and in calves where this species was isolated also from TBL, DNS and TBL isolates were identical in 75% of the sample pairs. This suggests that during an outbreak of BRD, submission of DNS samples from 4 to 6 calves could be a convenient approach for practitioners seeking guidance on P. multocida present in the lower respiratory tract and their antibiotic susceptibility.

PMID:39501282 | DOI:10.1186/s13028-024-00781-7