Tag: nevin manimala

BMC Pregnancy Childbirth. 2024 Nov 26;24(1):788. doi: 10.1186/s12884-024-06997-9.

ABSTRACT

BACKGROUND: Placental accreta spectrum (PAS) disorder with bladder involvement is found to be associated with severe maternal and neonatal morbidity.When planning surgery or other treatments, a diagnosis and assessment of the invasiveness of placenta accreta spectrum disorder with bladder involvement are crucial.The detection of the depth of villi invasion can be accomplished with both MRI and US.The advent of three-dimensional Crystal Vue provides details additional information for scanning abnorma issue.

PURPOSE: Our goal was to compare and assess the diagnostic accuracy of 2D US combined with the 3D Crystal Vue and MRI in case of placenta accreta spectrum (PAS) involving the bladder.

MATERIALS AND METHODS: 111 pregnancy patients between May 2019 and November 2023 at the First Affiliated Hospital of Anhui Medical University whether or not they had placenta previa were included in the study if they were diagnosed of having placenta increta (PI) or placenta percreta (PP).Both US and MRI were used to evaluate the pregnant women.Total 53 pregnant women were ultimately included in our analysis.53 patients were split into groups with and without bladder involvement. They underwent 2D US,3D Crystal Vue, and MRI.The visual features of every subject were noted. Next, we analyzed the fundamental information, associated medical history, pregnancy outcomes, and different US and MRI signals between the two groups. To determine the potential contributing factors of PAS complicated with bladder involvement, a univariate analysis was performed. A multivariable logistic regression analysis was performed to identify US and MRI findings predictive of bladder involvement in placenta accreta spectrum.

RESULTS: Multiple logistic regression analysis found that the bridging vessels (OR, 31.76,95% CI, 1.64-614.31,p = 0.022) and the tramline sign “fully” obliterated on Crystal Vue feature (OR, 68.92;95%CI,6.76-702.35,p < 0.001) were independently associated with an increased likelihood of bladder involvement. These findings when combined allowed for the prediction of bladder involvement with an 88.2% sensitivity, a 94.4% specificity, and an AUC of 0.933 (95% CI,0.829-0.983, p = 0.001). The results of the MRI logistic regression analysis were as follows: the three independent risk factors for bladder involvement were: Placental bulge (OR,57.99,95%CI,3.89-835.80,p = 0.003),Bladder wall interruption (OR,11.93, 95%CI, 1.60-88.85, p = 0.016), and Bladder vessel sign (OR, 9.75,95%CI, 1.43-66.21, p = 0.020).The joint diagnosis showed a sensitivity of 94.1% and specificity of 83.3%.The area under the curve was 0.942(95%CI,0.841-0.988). Regarding projected bladder involvement, there were no statistically significant differences between MRI and 2D integrated 3D Crystal Vue imaging.

CONCLUSION: Both 2D coupled 3D Crystal Vue imaging and MRI are highly effective for predicting bladder invasion.Ultrasound is preferred over MRI because it is more convenient and more affordable.Among them, the tramline sign “fully” obliterated on 3D Crystal Vue was a new and reliable US sign for detecting bladder involvement.

PMID:39593009 | DOI:10.1186/s12884-024-06997-9

BMC Health Serv Res. 2024 Nov 27;24(1):1478. doi: 10.1186/s12913-024-11996-9.

ABSTRACT

BACKGROUND: Patient satisfaction is a crucial indicator of healthcare quality, influencing outcomes and providing insights for improvement. This study aims to assess patient satisfaction levels, and associated factors, and identify areas for enhancement at Remera Rukoma District Hospital (RRDH) in Rwanda, where such data was previously lacking.

METHODS: A cross-sectional study using a mixed approach of data collection was conducted, involving 384 participants (164 inpatients, 220 outpatients). Quantitative surveys and qualitative interviews were employed. Patient satisfaction was categorized as Very Satisfied (> 70%), Satisfied (50-69.9%), or Not Satisfied (≤ 49.9%). Data analysis included descriptive statistics, bivariate logistic regression, and thematic analysis of qualitative data.

RESULTS: The study comprised 37.8% male and 62.2% female participants. Overall, 52.6% were highly satisfied, 29% satisfied, and 18% not satisfied. Among outpatients, 35.9% were dissatisfied with cashier services, and 46.9% with pharmacy wait times. Inpatients showed 74.4% satisfaction with the admission process, but 69.5% reported delayed test result feedback. Educational level significantly influenced satisfaction, with uneducated participants showing lower odds of satisfaction compared to university-educated ones (cOR = 0.409, 95% CI: 0.186-0.897, p = 0.026). Qualitative findings highlighted issues with wait times, communication, and service consistency.

CONCLUSIONS: While overall satisfaction at RRDH was positive, the study identified areas needing improvement, particularly in communication, wait times, and service delays. Education level was significantly associated with satisfaction level. Addressing these factors, beyond operational efficiency, may significantly impact patient satisfaction. Enhancing communication, managing expectations, and optimizing service delivery are crucial for maintaining satisfaction and improving service quality.

PMID:39593008 | DOI:10.1186/s12913-024-11996-9

BMC Infect Dis. 2024 Nov 26;24(1):1349. doi: 10.1186/s12879-024-10251-0.

ABSTRACT

BACKGROUND: Despite global efforts, HIV/AIDS remains a significant public health challenge, with Türkiye witnessing a consistent rise in annual diagnoses. Patient satisfaction with antiretroviral therapy (ART) is crucial for treatment adherence and effectiveness. This study examines treatment satisfaction levels among people living with HIV (PLWH) in Türkiye and identifies associated factors.

MATERIALS AND METHODS: A cross-sectional prospective cohort study was conducted at Tepecik Training and Research Hospital, Izmir, Türkiye, involving 238-PLWH receiving ART. Data were collected through face-to-face interviews using the HIV Treatment Satisfaction Questionnaire (HIVTSQ-12) and demographic/clinical forms. Confirmatory Factor Analysis and descriptive statistics were employed for data analysis.

RESULTS: Participants exhibited high overall treatment satisfaction, with significant associations between satisfaction levels and socio-demographic/clinical factors. Individuals with lower education levels, no substance use, minimal alcohol consumption, and suppressed viral loads reported higher satisfaction scores.

CONCLUSION: This study highlights the potential for personalizing HIV treatment strategies based on socio-demographic and clinical factors. Findings emphasize the need to promote healthy lifestyles, enhance health literacy, and implement anti-addiction programs to improve treatment adherence and satisfaction among PLWH. Based on the findings, there is a need to develop strategies aimed at improving treatment satisfaction and outcomes in HIV management.

PMID:39592993 | DOI:10.1186/s12879-024-10251-0

BMC Pregnancy Childbirth. 2024 Nov 26;24(1):789. doi: 10.1186/s12884-024-06964-4.

ABSTRACT

BACKGROUND: Forming an emotional bond towards the infant is an important developmental aspect of the mother-child relationship. Two questionnaires frequently used for the assessment of mother-infant bonding, namely the Maternal Postnatal Attachment Scale (MPAS) and the Postpartum Bonding Questionnaire (PBQ), have shown inconclusive psychometric properties. To ensure comparability of results across studies, it is crucial to examine the replicability of psychometric properties and previously proposed factor structures of measurements when adapted to other languages.

AIM: The study aim was to investigate the psychometric properties of the German versions of both MPAS and PBQ, across three different German-speaking study samples.

METHODS: Maternal data from three longitudinal studies from Hamburg, Germany (PAULINE-PRINCE study, N = 229), and Dresden, Germany (MARI study, N = 286; DREAM study, N = 1,968), were used to investigate the psychometric properties (descriptive statistics, item difficulty, inter-item correlations) and the factorial structure (confirmatory factor analysis, CFA; principal axis factoring, PAF) of both MPAS and PBQ. Correlations with maternal-fetal bonding, adult romantic attachment style, attachment style to one’s own mother, postpartum depressive symptoms, and education level were investigated.

RESULTS: Across the three samples, both MPAS and PBQ showed convincing results regarding the psychometric properties for their total scores, with satisfying to excellent internal consistencies. A strong correlation between the MPAS and PBQ total scores was observed (r=-.71, p < .001). In PAF, for both questionnaires, factor structures on subscale level differed across samples and assessment points. For MPAS and PBQ total scores, significant small to medium-sized associations in the expected directions with maternal-fetal bonding and depressive symptoms, as well as for MPAS with adult romantic attachment style, and for PBQ with attachment towards one’s own mother were found. In two samples, higher educated participants reported less optimal MIB.

CONCLUSION: The results across the three included samples provide evidence for the validity of the construct assessed with the German adaptations of both MPAS and PBQ. However, the factor analytical results on subscale level highlight the need to further investigate the concept of mother-infant bonding in the first year after birth as well as to develop instruments applicable for use in clinical and community samples with satisfying psychometric properties.

PMID:39592992 | DOI:10.1186/s12884-024-06964-4

BMC Public Health. 2024 Nov 26;24(1):3283. doi: 10.1186/s12889-024-20838-6.

ABSTRACT

OBJECTIVES: In the context of musculoskeletal health, the emergence of pre-sarcopenia as a precursor to sarcopenia has garnered attention for its potential insights into early muscle loss. We explored the association between different metabolic phenotypes of obesity, and the incidence of pre-sarcopenia over a 3-year follow-up in a cohort from the Tehran Lipid and Glucose Study (TLGS).

METHODS: In this 3-year longitudinal study, 2257 participants were categorized into four groups based on their BMI and metabolic status: metabolically healthy normal weight (MHNW), metabolically healthy overweight/obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy overweight/obese (MUO). The participants were assessed for various anthropometric and body composition indices including muscle mass determined by bioelectrical impedance analysis (BIA). Blood samples were collected for metabolic indices, and participants underwent measurements for blood pressure. Pre-sarcopenia was defined based on low muscle mass. Statistical analyses included logistic regression and chi-squared tests.

RESULTS: The MUNW group exhibited the highest prevalence of pre-sarcopenia (33.5%), while the MHO group had the lowest (2.8%). Adjusted models revealed that the odds ratio for pre-sarcopenia was higher in the MUNW group (OR = 2.23, P < 0.001), whereas the MHO and MUO groups showed lower odds (OR = 0.11 and 0.13, both P < 0.001). Notably, the association was gender-dependent, with MUNW females having a higher risk even after adjustments (OR = 2.37, P = 0.042).

CONCLUSION: Our findings suggest that metabolic health may play a pivotal role in pre-sarcopenia, emphasizing the need for targeted interventions based on both metabolic and obesity phenotypes.

PMID:39592987 | DOI:10.1186/s12889-024-20838-6

BMC Infect Dis. 2024 Nov 27;24(1):1352. doi: 10.1186/s12879-024-10225-2.

ABSTRACT

BACKGROUND: Human Immune Deficiency Virus (HIV) remains the leading cause of morbidity and mortality globally. It can lead to Acquired Immunodeficiency Syndrome (AIDS), which results in gradual deterioration and failure of the immune system. As the immune system becomes compromised, the patient becomes highly susceptible to life-threatening infection which ends with early death. Even though Antiretroviral Therapy (ART) significantly decreases mortality as a whole, the rate of death is still the highest, especially in the first and second years of ART initiation. The study aims to assess the survival and predictors of mortality among HIV-infected adults after initiation of antiretroviral therapy in Jigjiga City Governmental Hospitals, Eastern Ethiopia.

METHOD: Institution-based Retrospective follow-up study was employed among ART patients from January 1, 2015, to December 31, 2021. Data were cleaned and entered in Epi-data version 3.1 and exported to STATA 14 for further analysis. Kaplan-Meier and Log-Rank tests were applied to compare survival differences among categories of different variables. In bi-variable analysis, P-values < 0.20 were included in a multivariable analysis. A multivariable Cox regression model was used to measure the risk of death identify the and significant predictors of death. Variables that a P-value < 0.05 were considered statistically significant predictors of mortality.

RESULT: In this study 466(53.34%) participants were male and 552(65.56%) were urban residents about 91(10.81%) have died with an overall incidence rate of 3.92 (95% CI (2.43-5.41)) per 100-person year of observation. The overall survival probability of the study group was 83.97%. In the multivariable Cox regression analysis, baseline World Health Organization (WHO) stage III/IV (AHR = 2.42(1.43-4.09)) have no caregiver (AHR = 2.23; 95% CI (1.16-4.29)), being bedridden functional status (AHR = 2.18; 95% CI (1.01-4.72)), and poor last known adherence level (AHR = 4.23; 95%CI (2.39-7.47)) were found to be significant predictors of mortality.

CONCLUSION: The incidence of death was relatively high, especially in the second year of ART. Baseline clinical WHO stage III/IV, bedridden functional status at enrolment, and absence of caregiver, poor level of recent adherence were found to be independent predictors of mortality. Patients with these risk factors need special attention and are crucial to reducing the rate of mortality.

PMID:39592986 | DOI:10.1186/s12879-024-10225-2

BMC Public Health. 2024 Nov 26;24(1):3275. doi: 10.1186/s12889-024-20770-9.

ABSTRACT

BACKGROUND: Consumption of sugary drinks (SD) among children and adolescents is a prevalent public health issue both within Canada and worldwide. This problem is exacerbated by the powerful marketing of such beverages to youth, which is known to influence a wide range of dietary behaviours.

METHODS: A cross-sectional, secondary analysis of the International Food Policy Survey Youth Wave 2019 was conducted to assess the relationship between self-reported exposure to SD marketing within the past 30 days or SD brand advertisements and brand preference and brand recall among youth aged 10-17 from Australia, Canada, Chile, Mexico, the United Kingdom, and the United States. Ordinal, multinomial, and binary logistic regression were used as appropriate to examine these associations.

RESULTS: Youth brand preference and recall was positively associated with self-reported exposure to general and brand-specific SD marketing across all countries. No statistical interaction was observed between youth age and SD marketing overall or within countries. Soft drinks, sports drinks, and fruit juice brands were most commonly recalled by all youth.

CONCLUSION: Similar results were observed among children and adolescents within all countries. Global marketing policies should consider older children and adolescents to adequately protect and support child health.

PMID:39592972 | DOI:10.1186/s12889-024-20770-9

Comput Biol Med. 2024 Nov 25;184:109466. doi: 10.1016/j.compbiomed.2024.109466. Online ahead of print.

ABSTRACT

Convolutional neural networks are continually evolving; with some efforts aimed at improving accuracy, others at increasing speed, and some at enhancing accessibility. Improving accessibility broadens the application of neural networks across a wider range of tasks, including the detection of eye diseases. Early diagnosis of eye diseases and consulting an ophthalmologist can prevent many vision disorders. Given the importance of this issue, various datasets have been collected from the cornea to facilitate the process of making neural network models. However, most of the methods introduced in the past are computationally complex. In this study, we tried to increase the accessibility of deep neural network models. We did this at the most fundamental level-specifically, by redesigning and optimizing the convolutional layers. By doing so, we created a new general model that incorporates our novel convolutional layer named ArConv layers. Thanks to the efficient performance of this new layer, the model has suitable complexity for use in mobile phones and perform the task of diagnosing the presence of disease with high accuracy. The final model we present contains only 1.3 million parameters. In comparison to the MobileNetV2 model, which has 2.2 million parameters, our model demonstrated better accuracy when trained and evaluated on the RfMiD dataset under identical conditions, achieving an accuracy of 0.9328 versus 0.9266 on the RfMiD test set.

PMID:39591671 | DOI:10.1016/j.compbiomed.2024.109466

Comput Biol Med. 2024 Nov 25;184:109368. doi: 10.1016/j.compbiomed.2024.109368. Online ahead of print.

ABSTRACT

This study addresses the characterization of normal gait and pathological deviations caused by neurological diseases. We focus on the angular knee kinematics in the sagittal plane and we propose to exploit Hidden Markov Models to build a statistical model of normal gait. Such model provides a log-likelihood score that quantifies gait quality. Hence allowing to assess deviations of pathological cycles from normal gait. Our approach allows a refined characterization of motor impairments of three different patients’ groups. In particular, it detects the affected lower limb in Hemiparetic patients. Comparatively to the Gait Variable Score and a Dynamic Time Warping-based metric, our results show that our statistical method is more effective for finely quantifying pathological deviations. Finally, we show the potential use of our methodology to assess therapeutic impacts during gait rehabilitation, which represents a promising avenue for improving patient care.

PMID:39591667 | DOI:10.1016/j.compbiomed.2024.109368

Rep Prog Phys. 2024 Nov 26. doi: 10.1088/1361-6633/ad9756. Online ahead of print.

ABSTRACT

Statistical mechanics provides a framework for describing the physics of large, complex many-body systems using only a few macroscopic parameters to determine the state of the system. For isolated quantum many-body systems, such a description is achieved via the eigenstate thermalization hypothesis (ETH), which links thermalization, ergodicity and quantum chaotic behavior. However, tendency towards thermalization is not observed at finite system sizes and evolution times in a robust many-body localization (MBL) regime found numerically and experimentally in the dynamics of interacting many-body systems at strong disorder. Although the phenomenology of the MBL regime is well-established, the central question remains unanswered: under what conditions does the MBL regime give rise to an MBL phase in which the thermalization does not occur even in the asymptotic limit of infinite system size and evolution time?&#xD;&#xD;This review focuses on recent numerical investigations aiming to clarify the status of the MBL phase, and it establishes the critical open questions about the dynamics of disordered many-body systems. Persistent finite size drifts towards ergodicity consistently emerge in spectral properties of disordered many-body systems, excluding naive single-parameter scaling hypothesis and preventing comprehension of the status of the MBL phase. The drifts are related to tendencies towards thermalization and non-vanishing transport observed in the dynamics of many-body systems, even at strong disorder. These phenomena impede understanding of microscopic processes at the ETH-MBL crossover. Nevertheless, the abrupt slowdown of dynamics with increasing disorder strength suggests the proximity of the MBL phase. This review concludes that the questions about thermalization and its failure in disordered many-body systems remain a captivating area open for further explorations.

PMID:39591655 | DOI:10.1088/1361-6633/ad9756