Tag: nevin manimala

BMC Med Inform Decis Mak. 2022 Jun 21;22(1):165. doi: 10.1186/s12911-022-01900-y.

ABSTRACT

BACKGROUND: Almost eight children per 1000 live births are expected to have a congenital heart defect globally. The seven most critical congenital heart conditions that cause severe compromise on the patient’s quality and duration of life are collectively referred to as the Critical Congenital Heart Diseases (CCHD). CCHD is a critical condition that requires prompt detection and intervention as a life-saving measure. Pulse oximetry is a non-invasive, highly specific, and moderately sensitive method that can be used for screening new-borns for CCHD. The Emirates Health Services (EHS), UAE, adopted a strategy of developing a stringent program for newborn screening of Critical Congenital Heart disease, which would help in the early diagnosis and treatment of CCHD patients. An automated EMR (Wareed) driven solution was introduced to enhance this program as part of the routine workflow for the nurse care providers.

METHODS: Our study is a retrospective observational study that aims to understand: the prevalence of CCHD in our target population and to study the impact of an automated program on screening compliance and its implications for early diagnosis of CCHD.

RESULTS: We found that an EMR-driven automated screening program was highly effective in achieving high compliance (98.9%). It created a (statistically significant) improvement in the disease identification for CCHD in live births at EHS facilities.

CONCLUSION: We conclude that implementing an automated protocol through the EMR can effectively improve new-born screening coverage. It reduces the days to CCHD diagnosis, which would improve health outcomes in neonates.

PMID:35729549 | DOI:10.1186/s12911-022-01900-y

BMC Urol. 2022 Jun 21;22(1):88. doi: 10.1186/s12894-022-01043-2.

ABSTRACT

AIM: The effects of the COVID-19 pandemic on healthcare in Australia have yet to be fully determined. There are well documented decreases in the rates of screening and diagnostic testing for many cancers in 2020, with commensurate stage migration of cancers when they are eventually detected. We aimed to determine whether there was a decrease in the rate of prostate cancer (PC) screening and testing in Australia in 2020.

METHOD: Data was extracted from the Department of Human Services (DHS) website for Medicare Benefits Schedule (MBS) item numbers for tests pertinent to detection of Prostate Cancer. This data is de-identified and publicly available. Data was analysed at both a national, and a state level.

RESULTS: For 2020 nationwide the percentage change for prostate cancer testing was minor with 97% as many PSA tests, 99% as many prostate MRIs, and 105% as many prostate biopsies as the average for the preceding years. The differences were not significant (PSA tests p = 0.059 and prostate biopsies p = 0.109). The predicted values are fairly similar to both the average values for the preceding 5 years and the actual number of tests done in 2020. With exception of PSA tests in Victoria the actual number of tests performed was within the 95% Prediction Interval (performed: 167,426; predicted 171,194-196,699; p = 0.015).

CONCLUSION: The current pandemic has had a widespread reach across Australia, with varying impact across each state and territory. Contrary to the trends across the world, our data suggest that during 2020 in Australia most areas remained unaffected in terms of prostate cancer testing excluding Victoria, which had statistically significant decrease in the number of PSA tests correlating with the extended lockdown that occurred in the state.

PMID:35729543 | DOI:10.1186/s12894-022-01043-2

BMC Neurol. 2022 Jun 21;22(1):229. doi: 10.1186/s12883-022-02732-z.

ABSTRACT

Freezing of gait is a common gait disorder among patients with advanced Parkinson’s disease and is associated with falls. This paper designed the relevant experimental procedures to obtain FoG signals from PD patients. Accelerometers, gyroscopes, and force sensing resistor sensors were placed on the lower body of patients. On this basis, the research on the optimal feature extraction method, sensor configuration, and feature quantity selection in the FoG detection process is carried out. Thirteen typical features consisting of time domain, frequency domain and statistical features were extracted from the sensor signals. Firstly, we used the analysis of variance (ANOVA) to select features through comparing the effectiveness of two feature selection methods. Secondly, we evaluated the detection effects with different combinations of sensors to get the best sensors configuration. Finally, we selected the optimal features to construct FoG recognition model based on random forest. After comprehensive consideration of factors such as detection performance, cost, and actual deployment requirements, the 35 features obtained from the left shank gyro and accelerometer, and 78.39% sensitivity, 91.66% specificity, 88.09% accuracy, 77.58% precision and 77.98% f-score were achieved. This objective FoG recognition method has high recognition accuracy, which will be helpful for early FoG symptoms screening and treatment.

PMID:35729546 | DOI:10.1186/s12883-022-02732-z

BMC Pediatr. 2022 Jun 22;22(1):356. doi: 10.1186/s12887-022-03412-0.

ABSTRACT

BACKGROUND: Neonatal phototherapy (NNPT) has long been used as an effective and relatively safe method of treating neonatal hyperbilirubinemia. Considering the subsequent evidence of long-term impacts of NNPT such as malignancies, this study was conducted to evaluate the relationship between NNPT and childhood cancers.

METHODS: This case-control study assessed 116 children up to 4 years old with every kind of cancer referred to the Oncology department of Afzalipour hospital, Kerman, Iran, from 2011 to 18. Moreover, 116 pediatric patients without cancer hospitalized at the same Center were included after sex and age matching as the control group. The history of phototherapy and its duration were evaluated in these two groups.

RESULTS: We found no association between the NNPT and malignancies in children. However, high intensive phototherapy was higher historically among affected cancerous patients than in non-cancerous cases without any statistically significant difference (25% vs 19%; P = 0.26). Maternal educational level and history of maternal infection during pregnancy, which initially appeared to be two factors associated with malignancy in single variable regression analyses, were not significant based on the adjusted models.

CONCLUSIONS: The results did not show a positive correlation between NNPT and childhood cancers, which may partly be due to the relatively small sample size of the study. However, some other evidence is worrisome enough that NNPT should not be considered risk-free. Additional multi-centric studies should be undertaken to specify that phototherapy is really safe.

PMID:35729528 | DOI:10.1186/s12887-022-03412-0

BMC Ophthalmol. 2022 Jun 21;22(1):273. doi: 10.1186/s12886-022-02497-6.

ABSTRACT

BACKGROUND: This study aimed to investigate the clinical effectiveness of posterior scleral reinforcement(PSR) for the treatment of myopic traction maculopathy (MTM).

METHODS: This was a prospective study of 32 eyes from 20 patients with MTM treated with PSR using genipin-cross-linked donor sclera. The length of the scleral strip used for the surgery was designed to be 1.5-times the axial length of the eye, whereas its width was 0.4-times the axial length of the eye. The optical coherence tomography images, spherical equivalent of refractive error, axial length, best corrected visual acuity, electroretinogram findings, and intraocular pressure of the patients were assessed postoperatively.

RESULTS: The mean duration of follow-up was 17.80 ± 8.74 months. The differences between the spherical equivalent of refractive error, best corrected visual acuity, axial length, and electroretinogram findings recorded preoperatively and those measured postoperatively were statistically significant (p < 0.05). The final reduction in axial length was 1.64 ± 0.85 mm. At the end of the follow-up, optical coherence tomography showed essential foveal reattachment in 30 eyes (93.75%), partial reattachment in two eyes (6.25%), and closure of macular holes in seven eyes (77.78%). No retinal detachment, vitreous haemorrhage, or other serious complications occurred following the surgery.

CONCLUSIONS: Posterior scleral reinforcement with genipin-cross-linked sclera showed safe and effective outcomes for the treatment of MTM during a follow-up period of at least one year.

TRIAL REGISTRATION: 11122018, ChiCTR1800020012 .

PMID:35729520 | DOI:10.1186/s12886-022-02497-6

BMC Bioinformatics. 2022 Jun 21;23(1):243. doi: 10.1186/s12859-022-04786-9.

ABSTRACT

BACKGROUND: Microbial communities in the human body, also known as human microbiota, impact human health, such as colorectal cancer (CRC). However, the different roles that microbial communities play in healthy and disease hosts remain largely unknown. The microbial communities are typically recorded through the taxa counts of operational taxonomic units (OTUs). The sparsity and high correlations among OTUs pose major challenges for understanding the microbiota-disease relation. Furthermore, the taxa data are structured in the sense that OTUs are related evolutionarily by a hierarchical structure.

RESULTS: In this study, we borrow the idea of super-variant from statistical genetics, and propose a new concept called super-taxon to exploit hierarchical structure of taxa for microbiome studies, which is essentially a combination of taxonomic units. Specifically, we model a genus which consists of a set of OTUs at low hierarchy and is designed to reflect both marginal and joint effects of OTUs associated with the risk of CRC to address these issues. We first demonstrate the power of super-taxon in detecting highly correlated OTUs. Then, we identify CRC-associated OTUs in two publicly available datasets via a discovery-validation procedure. Specifically, four species of two genera are found to be associated with CRC: Parvimonas micra, Parvimonas sp., Peptostreptococcus stomatis, and Peptostreptococcus anaerobius. More importantly, for the first time, we report the joint effect of Parvimonas micra and Parvimonas sp. (p = 0.0084) as well as that of Peptostrepto-coccus stomatis and Peptostreptococcus anaerobius (p = 8.21e-06) on CRC. The proposed approach provides a novel and useful tool for identifying disease-related microbes by taking the hierarchical structure of taxa into account and further sheds new lights on their potential joint effects as a community in disease development.

CONCLUSIONS: Our work shows that proposed approaches are effective to study the microbiota-disease relation taking into account for the sparsity, hierarchical and correlated structure among microbes.

PMID:35729515 | DOI:10.1186/s12859-022-04786-9

J Am Coll Health. 2022 Jun 21:1-7. doi: 10.1080/07448481.2022.2089852. Online ahead of print.

ABSTRACT

Objective COVID-19 forced third-level students to transition to online learning (OL). Many students encountered issues with OL, such as accessibility. However, the relationship between OL issues and mental health during this time remains poorly understood. Participants: Third-level students in Ireland (N = 268) completed an online questionnaire examining experiences with OL and mental health during COVID-19. Methods: OL social, lecturer, accessibility, individual skills, and environment issues, were entered into logistic regression analyses to examine whether these variables predicted mental health outcomes and/or preference to keep OL. Results: Students reporting more individual skills issues were more likely to attain a probable diagnosis of posttraumatic stress disorder, complex posttraumatic stress disorder, and depression (p < 0.0083); students who reported more environment issues were less likely to report preference to keep OL (p < 0.0005). Conclusions: Given individual skills issues associated with worse mental health, future research should examine improving student perceptions of their own OL skills.

PMID:35728258 | DOI:10.1080/07448481.2022.2089852

N Z Med J. 2022 Apr 14;135(1553):19-26.

ABSTRACT

AIMS: The ‘Impact on Life’ (IoL) questionnaire is a patient reported quality-of-life assessment tool used to prioritise cataract surgery in New Zealand (NZ). This study evaluated the association between ethnicity and IoL questionnaire responses.

METHODS: This is a retrospective cohort study of patients prioritised for public-funded cataract surgery between November 2014 and March 2019 in New Zealand. Data were extracted from the New Zealand Ministry of Health National Prioritisation Web Service database. Ethnic, demographic and IoL data for all patients who were prioritised for surgery were analysed after controlling for age, gender, visual acuity and cataract type.

RESULTS: Of the 58,648 prioritisation events, over the four-and-a-half-year period, 46,352 prioritisation events had documented scores for the IoL questionnaire. The study population had a mean age of 74.4 years and had a female preponderance (74%). The average IoL score was 22.5/36 (SD 7.8). After controlling for age, gender, visual acuity (VA) and cataract type, there was only a marginal difference between Māori and non-Māori IoL scores (22.8/36 vs 22.4/36) despite statistical significance for the difference (p=0.001). Māori and Pacific people presented at a younger age (68.5 years and 66.7 years, respectively) with worse visual acuity than other ethnic groups (mean range 70.1-76.7 years). Mean IoL scores were 23.0/36 for Māori and Pacific people and 22.4/36 for other ethnic groups.

CONCLUSIONS: Māori and Pacific people present younger with worse VA and more advanced cataracts at time of surgical prioritisation when compared with other ethnic groups. Despite these differences, after controlling for confounding factors, the mean IoL score did not differ to a level that was clinically significant between different ethnic groups in New Zealand at time of prioritisation for cataract surgery. These results suggest that there are no meaningful ethnic specific differences in patient reported quality of life for patients with cataract in New Zealand after controlling for other factors. Alternatively, the IoL tool may lack the sensitivity to detect meaningful ethnic disparities that may exist for quality of life in this cohort of patients.

PMID:35728201

N Z Med J. 2022 Apr 1;135:77-81.

ABSTRACT

AIMS: The global COVID-19 pandemic and lockdowns have affected the patterns of hospital presentations for non-COVID related illnesses. Apprehension and perceived risk of hospitalisation has been postulated to be a significant deterrent to presentation. This study aims to explore pandemic- and- lockdown-related concerns with regards to hospital admission from a patient’s perspective.

METHODS: A cross-sectional study was undertaken in the form of an inpatient questionnaire for patients admitted to a coronary care unit and the cardiology ward during the Level 4 lockdown. The questionnaire included six questions designed to gather patient perception of the impact of lockdown on their hospital presentation.

RESULTS: Out of 91 patients who completed the questionnaire, 41 (45%) were >70 years old. Twenty (22%) patients answered that lockdown delayed or affected their decision to present to hospital. Within this cohort, there was a statistical difference between those aged 70 years and younger, and those over 70 years old (16/50 (32%) versus 4/41 (10%), p=0.011).

CONCLUSIONS: Apprehension and concerns regarding the risk of COVID-19 was prevalent in a significant proportion of patients and affected/delayed their decision to present to hospital. This may partly explain lower rates of presentation during the pandemic.

PMID:35728186

N Z Med J. 2022 Apr 14;135(1553):10-18.

ABSTRACT

AIM: Our aim was to examine rate of recurrence of toxoplasmosis retinochoroiditis and risk factors for recurrence. No New Zealand epidemiological data on recurrence rates of toxoplasmosis retinochoroiditis have been previously published.

METHODS: Retrospective chart review of all patients with toxoplasmosis retinochoroiditis presented to Auckland District Health Board Department of Ophthalmology between 2006-2019.

RESULTS: One hundred and twenty-six eyes of 115 patients were included with a median age at initial diagnosis of 36.7 years (IQR 23.7-53.8). Fifty-nine patients were female (51.3%), and 16 patients (13.9%) were immunosuppressed. Twenty-six of the 86 patients tested (30.2%) were IgM positive at presentation. Mean follow-up was 6.1 years and 73 recurrences occurred during the follow-up period in 36 patients (31.3%). Treatment was initiated in 87.4% of cases, with oral cotrimoxazole or clindamycin the most common options. Recurrence occurred in 14.8% in the first year (95% CI 10.3%-21.0%), and the risk of recurrence was increased 2x for every previously documented recurrence (HR 2.00; p<0.001). There was no statistically significant increased risk of recurrence with age, IgM positivity, immunosuppression or macular involvement.

CONCLUSIONS: Toxoplasmosis retinochoroiditis had a 14.8% risk of recurrence in the first year, with each previous recurrence increasing the risk by two-times.

PMID:35728200