Tag: nevin manimala

Eur J Prev Cardiol. 2023 Apr 11:zwad111. doi: 10.1093/eurjpc/zwad111. Online ahead of print.

ABSTRACT

AIMS: LDL cholesterol (LDL-C) is a well-established risk factor for coronary artery disease (CAD). However, the optimal LDL-C level with regard to efficacy and safety remains unclear. We aimed to investigate the causal relationships between LDL-C and efficacy and safety outcomes.

METHODS: We analyzed 353,232 British from the UK Biobank and 41,271 Chinese from the China-PAR project. Linear and non-linear Mendelian randomization (MR) analyses were performed to evaluate the causal relation between genetically proxied LDL-C and CAD, all-cause mortality, and safety outcomes (including hemorrhagic stroke, diabetes mellitus, overall cancer, non-cardiovascular death, and dementia).

RESULTS: No significant non-linear associations were observed for CAD, all-cause mortality, and safety outcomes (Cochran Q P > 0.25 in British and Chinese) with LDL-C levels above the minimum values of 50 mg/dL and 20 mg/dL in British and Chinese, respectively. Linear MR analyses demonstrated a positive association of LDL-C with CAD (British: odds ratio [OR] per unit mmol/L increase, 1.75, P = 7.57 × 10-52; Chinese: OR, 2.06, P = 9.10 × 10-3). Furthermore, stratified analyses restricted to individuals with LDL-C levels less than the guidelines-recommended 70 mg/dL demonstrated lower LDL-C levels were associated with a higher risk of adverse events, including hemorrhagic stroke (British: OR, 0.72, P = 0.03) and dementia (British: OR, 0.75, P = 0.03).

CONCLUSION: In British and Chinese populations, we confirmed a linear dose-response relationship of LDL-C with CAD and found potential safety concerns at low LDL-C levels, providing recommendations for monitoring adverse events in people with low LDL-C in the prevention of cardiovascular disease.

PMID:37040432 | DOI:10.1093/eurjpc/zwad111

Int J Qual Health Care. 2023 Apr 11:mzad018. doi: 10.1093/intqhc/mzad018. Online ahead of print.

ABSTRACT

BACKGROUND: The increase in bacterial drug resistance has become a serious public health problem worldwide. The application of antibiotics involves various clinical departments, and the rational application of antibiotics is the key to improve the efficacy. In order to provide a basis for further improving the etiological submission rate and standardizing the rational use of antibiotics, this article discussed the intervention effect of multi department cooperation on improving the etiological submission rate before antibiotic treatment.

METHODS: A total of 87607 patients were involved in this study and divided into the control group (45890) and the intervention group (41717) according to whether multi-sector cooperation management was implemented. The intervention group involves the etiology examination rate before antimicrobial therapy of hospitalized patients from August to December 2021, and the control group involves it from August to December 2020. The submission rates of the two groups, and before antibiotic treatment at the unrestricted use level, the restricted use level and the special use level in departments and the timing of submission were compared and analyzed.

RESULTS: The overall differences in etiological submission rate before antibiotic treatment at the unrestricted use level (20.70% vs 55.98%), the restricted use level (38.23% vs 66.58%) and the special use level (84.92% vs 93.14%) were statistically significant before and after the intervention (P <0.05). At the more specific level, the etiological submission rates of different departments before antibiotic treatment at the unrestricted use level, the restricted use level and the special use level have all been improved, but the special activities of multi-sector cooperation management did not improve the submission timing significantly.

CONCLUSION: Multi-department cooperation can effectively improve the pathogen detection rate before antimicrobial treatment, but it is necessary to improve measures for specific departments to improve the long-term management and incentive and restraint mechanism.

PMID:37040384 | DOI:10.1093/intqhc/mzad018

PLoS One. 2023 Apr 11;18(4):e0284351. doi: 10.1371/journal.pone.0284351. eCollection 2023.

ABSTRACT

Over the past 20 years, the construct of perceived value has been the subject of much research, most of it applied to the service sector. The intangible nature of this sector requires an in-depth analysis of customer perceptions of what they give and what they receive. In this research, perceived value is applied in the context of higher education, where perceived quality faces several challenges and has a tangible component that is related to their experience when receiving the educational service, and an intangible component that is related to the image and reputation of the university. One of these challenges is the increasingly competitive environment of universities, so it is important to understand what factors influence students’ perception of value. For this purpose, several scales of perceived value were reviewed and one was selected and its psychometric properties were evaluated. For this evaluation, cultural adaptation techniques, exploratory factor analysis and confirmatory factor analysis were used. The statistical results showed the validity and reliability of the scale applied to universities in the Colombian context.

PMID:37040381 | DOI:10.1371/journal.pone.0284351

PLoS One. 2023 Apr 11;18(4):e0284270. doi: 10.1371/journal.pone.0284270. eCollection 2023.

ABSTRACT

Childhood undernutrition is a major public health challenge in sub-Saharan Africa, particularly Nigeria. Determinants of child malnutrition may have substantial spatial heterogeneity. Failure to account for these small area spatial variations may cause child malnutrition intervention programs and policies to exclude some sub-populations and reduce the effectiveness of such interventions. This study uses the Composite Index of Anthropometric Failure (CIAF) and a geo-additive regression model to investigate Nigeria’s prevalence and risk factors of childhood undernutrition. The geo-additive model permits a flexible, joint estimation of linear, non-linear, and spatial effects of some risk factors on the nutritional status of under-five children in Nigeria. We draw on data from the most recent Nigeria Demographic and Health Survey (2018). While the socioeconomic and environmental determinants generally support literature findings, distinct spatial patterns were observed. In particular, we found CIAF hotspots in the northwestern and northeastern districts. Some child-related factors (Male gender: OR = 1.315; 95% Credible Interval (CrI): 1.205, 1.437) and having diarrhoea: OR = 1.256; 95% CrI: 1.098, 1.431) were associated with higher odds of CIAF. Regarding household and maternal characteristics, media exposure was associated with lower odds of CIAF (OR = 0.858; 95% CrI: 0.777, 0.946). Obese maternal BMI was associated with lower odds of CIAF (OR = 0.691; 95% CrI: 0.621, 0.772), whereas, mothers classified as thin were associated with higher odds of CIAF (OR = 1.216; 95% CrI: 1.055, 1.411). Anthropometric failure is highly prevalent in Nigeria and spatially distributed. Therefore, localised interventions that aim to improve the nutritional status of under-five children should be considered to avoid the under-coverage of the regions that deserve more attention.

PMID:37040379 | DOI:10.1371/journal.pone.0284270

J Hosp Palliat Nurs. 2023 Apr 11. doi: 10.1097/NJH.0000000000000947. Online ahead of print.

ABSTRACT

Spiritual care can improve patients’ physical and emotional well-being, but patients at the end of life often experience their spiritual needs are not being sufficiently met by the health care professionals. This is caused by barriers among health care professionals that stem from inadequate education on spiritual care and lack of self-reflection on spiritual topics. By participating in spiritual care training, health care professionals seem to gain the knowledge, confidence, and skills they need to care spiritually for patients. The aim of this study was to evaluate the effect and experiences of a training course in spiritual care for 30 nurses working at a Danish hospice. This was done by means of both a before-and-after questionnaire and focus group interviews. The course focused primarily on the nurses and their personal and collegial reflections on spiritual care, whereas increased spiritual care for patients seemed to be a secondary outcome of the course. There was a significant statistical correlation between the nurses’ values and spirituality, and their confidence in being able to exercise spiritual care for patients. The training course facilitated spiritual empowerment, collegial spiritual care, and spiritual language among the nurses, which led to increased spiritual care for patients.

PMID:37040374 | DOI:10.1097/NJH.0000000000000947

PLoS One. 2023 Apr 11;18(4):e0277725. doi: 10.1371/journal.pone.0277725. eCollection 2023.

ABSTRACT

Avocado sunblotch viroid (ASBVd) is a subcellular pathogen of avocado that reduces yield from a tree, diminishes the appearance of the fruit by causing unsightly scarring and impedes trade because of quarantine conditions that are imposed to prevent spread of the pathogen via seed-borne inoculum. For countries where ASBVd is officially reported, permission to export fruit to another country may only be granted if an orchard can be demonstrated to be a pest free production site. The survey requirements to demonstrate pest freedom are usually defined in export protocols that have been mutually agreed upon by the trading partners. In this paper, we introduce a flexible statistical protocol for use in optimizing sampling strategies to establish pest free status from ASBVd in avocado orchards. The protocol, which is supported by an interactive app, integrates statistical considerations of multistage sampling of trees in orchards with a RT-qPCR assay allowing for detection of infection in pooled samples of leaves taken from multiple trees. While this study was motivated by a need to design a survey protocol for ASBVd, the theoretical framework and the accompanying app have broader applicability to a range of plant pathogens in which hierarchical sampling of a target population is coupled with pooling of material prior to diagnosis.

PMID:37040350 | DOI:10.1371/journal.pone.0277725

PLoS One. 2023 Apr 11;18(4):e0283963. doi: 10.1371/journal.pone.0283963. eCollection 2023.

ABSTRACT

BACKGROUND: The factors influencing tourist loyalty are widely highlighted in the literature. However, we find that the relationship between some influencing factors and loyalty is still inconsistent, and we don’t yet know the strength and magnitude of the relationships. To address this issue, this study examined a meta-analysis of the five factors (satisfaction, motivation, perceived value, perceived quality, and experience quality) influencing tourist loyalty and its sub-dimensions.

METHODS: The samples included articles from major academic databases, including Web of Science, Wiley Online, EBSCO, SAGE, Taylor and Francis, and Elsevier. Studies written in Chinese were retrieved from CNKI.com. We used the following keywords for retrieval: loyalty, behavioral intention, recommendation intention, word-of-mouth, revisit intentions, intention to revisit, willingness to recommend, and similar related terms. Conceptual and empirical studies published between January 1989 and September 2021 were extracted. To test whether there was publication bias, we used Fail-Safe-Number (FSN) to verify the stability of the results. The homogeneity test of the selected statistical model was based on the Q test and I2. The results were obtained by combining multiple single effect values into the combined effect value.

RESULTS: We developed 21 hypotheses and proposed a theoretical framework and analyzed 114650 accumulated sample sizes from 242 independent empirical studies. Among the 21 hypotheses proposed in this paper, the remaining 20 hypotheses have been proved except for hypothesis H6.

CONCLUSIONS: The findings showed that the five factors had varying degrees of positive and significant relationships with tourist loyalty and its sub-dimensions. In the descending order of effects, the five factors are degree of satisfaction, quality of experience, perceived value, perceived quality and motivation. We discussed the significance of the meta-analysis, theoretical and practical implications for destination marketing.

PMID:37040349 | DOI:10.1371/journal.pone.0283963

Am J Audiol. 2023 Apr 11:1-5. doi: 10.1044/2023_AJA-22-00195. Online ahead of print.

ABSTRACT

PURPOSE: When a bilateral evaluation is conducted with the integrated speech protocol described in Punch and Rakerd (2019), testing for the first ear concludes with a measurement of the uncomfortable loudness level for speech (UCL). The purpose of this study was to assess the possibility that exposure to the high speech intensities required for that UCL test might bias the subsequent measurement of a listener’s most comfortable loudness level for speech (MCL) in the opposite ear.

METHOD: Across 32 test runs, the left and right ear MCLs were established for 16 young adult listeners with normal hearing (five women, 11 men). The MCL assessed on each test run was measured twice. The first measurement was made at the start of the run and before a full integrated speech evaluation was conducted in the opposite ear (pretest); the second was made after that evaluation (posttest).

RESULTS: The difference between the MCL means measured on the pretest (37.7 dB) and the posttest (38.5 dB) was less than 1 dB, and it did not approach statistical significance, t(15) = 0.69, p = .50.

CONCLUSIONS: There was no evidence that UCL testing done in one ear on a bilateral speech test will have carryover effects that bias the subsequent measurement of a listener’s MCL in the other ear. The results, therefore, support the potential clinical use of an integrated protocol when conducting bilateral speech audiometric evaluations.

PMID:37040328 | DOI:10.1044/2023_AJA-22-00195

J Speech Lang Hear Res. 2023 Apr 11:1-14. doi: 10.1044/2023_JSLHR-22-00201. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to investigate the acoustic changes in vowel production with different forms of auditory feedback via cochlear implant (CI), hearing aid (HA), and bimodal hearing (CI + HA).

METHOD: Ten post-lingually deaf adult bimodal CI users (aged 50-78 years) produced English vowels /i/, /ɛ/, /æ/, /ɑ/, /ʊ/, and /u/ in the context of /hVd/ during short-term use of no device (ND), HA, CI, and CI + HA. Segmental features (first formant frequency [F ₁], second formant frequency [F ₂], and vowel space area) and suprasegmental features (duration, intensity, and fundamental frequency [f _o]) of vowel production were analyzed. Participants also categorized a vowel continuum synthesized from their own productions of /ɛ/ and /æ/ using HA, CI, and CI + HA.

RESULTS: F ₁s of all vowels decreased; F ₂s of front vowels but not back vowels increased; vowel space areas increased; and vowel durations, intensities, and f _os decreased with statistical significance in the HA, CI, and CI + HA conditions relative to the ND condition. Only f _os were lower, and vowel space areas were larger with CI and CI + HA than with HA. Average changes in f _o, intensity, and F ₁ from the ND condition to the HA, CI, and CI + HA conditions were positively correlated. Most participants did not show a typical psychometric function for vowel categorization, and thus, the relationship between vowel categorization and production was not tested.

CONCLUSIONS: The results suggest that acoustic, electric, and bimodal hearing have a measurable impact on vowel acoustics of post-lingually deaf adults when their hearing devices are turned on and off temporarily. Also, changes in f _o and F ₁ with the use of hearing devices may be largely driven by changes in intensity.

PMID:37040323 | DOI:10.1044/2023_JSLHR-22-00201

Lang Speech Hear Serv Sch. 2023 Apr 11:1-15. doi: 10.1044/2023_LSHSS-22-00116. Online ahead of print.

ABSTRACT

PURPOSE: Developmental language disorder (DLD) is a relatively new, internationally promoted term to describe individuals with language impairments not secondary to a biomedical condition. This study aimed to better understand speech-language pathologists’ (SLPs’) current level of comfort using DLD terminology and knowledge of DLD in the United States to help SLPs better understand how and why they should consider adopting DLD terminology in their clinical practice.

METHOD: After completing an online presurvey to evaluate current comfort levels in using DLD terminology and current knowledge of DLD, currently practicing SLPs viewed a 45-min prerecorded educational video on DLD. Following this viewing, participants completed a postsurvey nearly identical to the presurvey to measure change in their comfort levels with DLD terminology use and in DLD knowledge.

RESULTS: After filtering to remove likely fraudulent responders, we included 77 participants in all analyses. Presurvey Likert scale responses indicated at least some comfort in using DLD terminology. Additionally, presurvey results of true/false DLD knowledge questions revealed high variability in respondents’ knowledge of DLD. A McNemar chi-square test indicated statistically significant changes in participants’ comfort levels in using DLD terminology from pre- to postsurvey for each question. A paired t test indicated statistically significant changes in DLD knowledge from pre- to postsurvey.

CONCLUSION: Despite some limitations, it was concluded that diffusion efforts, such as educational presentations, are likely to increase SLPs’ comfort levels in using DLD terminology and SLPs’ knowledge of DLD.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.22344349.

PMID:37040315 | DOI:10.1044/2023_LSHSS-22-00116