Tag: nevin manimala

Pediatr Infect Dis J. 2023 Mar 29. doi: 10.1097/INF.0000000000003919. Online ahead of print.

ABSTRACT

BACKGROUND: To construct a predictive model for intravenous immunoglobulin (IVIG) resistant Kawasaki disease (KD) based on the gradient boosting decision tree (GBDT), so as to early identify children with IVIG resistance and actively take additional treatment to prevent adverse events.

METHODS: The case data of KD children hospitalized in the Pediatric Department of Lanzhou University Second Hospital from October 2015 to July 2020 were collected. All KD patients were divided into IVIG responsive group and IVIG resistant group. GBDT was used to explore the influencing factors of IVIG-resistant KD and to construct a prediction model. Then compared with previous models, the optimal model was selected.

RESULTS: In the process of GBDT model construction, 80% of the data were used as the test set, and 20% of the data were used as the validation set. Among them, the verification set was used to adjust the hyperparameters in GDBT learning. The model performed best with a hyperparameter tree depth of 5. The area under the curve of the GBDT model constructed based on the best parameters was 0.87 (95% CI: 0.85-0.90), the sensitivity was 72.62%, the specificity was 89.04%, and the accuracy was 61.65%. The contribution degree of each feature value to the model was total bilirubin, albumin, C-reactive protein, fever time, and Na in order.

CONCLUSION: The GBDT model is more suitable for the prediction of IVIG-resistant KD in this study area.

PMID:37053575 | DOI:10.1097/INF.0000000000003919

J Contin Educ Health Prof. 2023 Apr 12. doi: 10.1097/CEH.0000000000000508. Online ahead of print.

ABSTRACT

INTRODUCTION: Comprehending scientific information have been reported as a barrier in evidence-based practice (EBP) adoption. This survey research aimed to verify the preferred sources of information for acquiring knowledge about physiotherapy and the association between types of information source and barriers in EBP implementation.

METHODS: A total of 610 physiotherapists were included and answered an online questionnaire about the preferred sources for searching physiotherapy-related information and possible barriers in EBP implementation.

DISCUSSION: Physiotherapists reported scientific resources as the preferred source of information, scientific databases (31%), followed by scientific articles (25%). The main barrier cited in EBP implementation was the difficulty in obtaining full-text articles (34%), followed by lack of statistical knowledge (30%). The use of peer-reviewed resources as the most preferred source of information is associated with the presence of issues in comprehending scientific information.

CONCLUSIONS: Although the positive attitude toward the use of scientific information, the findings raised question regarding the proper translation of scientific information to clinical practice. The importance of scientific information seems to be a well-established attitude among physiotherapists. However, there is a clear need for strategies aiming to improve the understanding of scientific information and consequently facilitate EBP implementation.

PMID:37053570 | DOI:10.1097/CEH.0000000000000508

Nurs Educ Perspect. 2023 Apr 14. doi: 10.1097/01.NEP.0000000000001118. Online ahead of print.

ABSTRACT

Sense of belongingness in the academic environment has been associated with positive student outcomes and increased student success. To cultivate belongingness, graduate nursing students were invited to participate in a virtual fitness challenge. Sense of belongingness was measured through pre- (n = 103) and post-intervention (n = 64) surveys with three subscales: other students, faculty, and the university. Students reported improved sense of belongingness following the intervention for all subscales, with statistically significant improvements related to other students (p = .007) and the university (p = .023). A virtual fitness challenge may improve sense of belongingness among graduate nursing students.

PMID:37053558 | DOI:10.1097/01.NEP.0000000000001118

Am J Public Health. 2023 Apr 13:e1-e9. doi: 10.2105/AJPH.2023.307274. Online ahead of print.

ABSTRACT

Objectives. To analyze rural-urban differences in COVID-19 vaccination uptake, hesitancy, and trust in information sources in the United States. Methods. We used data from a large survey of Facebook users. We computed the vaccination, hesitancy, and decline rates and the trust proportions among individuals hesitant toward COVID-19 information sources for rural and urban regions in each state from May 2021 to April 2022. Results. In 48 states with adequate data, on average, two thirds of states showed statistically significant differences in monthly vaccination rates between rural and urban regions, with rural regions having a lower vaccination rate at all times. Far fewer states showed statistically significant differences when comparing monthly hesitancy and decline rates for urban versus rural regions. Doctors and health professionals received the highest level of trust. Friends and family were also among the most trusted sources in rural areas where the vaccination uptake was low. Conclusions. Rural-urban difference in hesitancy rates among those still unvaccinated was much smaller than the rural-urban difference in vaccination rates, suggesting that access to vaccines may be another contributor to the lower vaccination rates in rural areas. (Am J Public Health. Published online ahead of print April 13, 2023:e1-e9. https://doi.org/10.2105/AJPH.2023.307274).

PMID:37053528 | DOI:10.2105/AJPH.2023.307274

Diabetes Technol Ther. 2023 Apr 13. doi: 10.1089/dia.2023.0085. Online ahead of print.

ABSTRACT

Continuous glucose monitoring (CGM) systems are used in therapeutic decisions for diabetes management, however the impact of body composition on CGM accuracy is not known. Body composition variables (body mass index BMI, mid arm circumference, percentage fat and impedance) were collected in an observational study designed to determine the accuracy of an investigational Medtronic Guardian<TM>sensor 3. Seven days of sensor glucose data were analysed from 112 participants >7 years of age with mean BMI Z score 0.48 (< 18 years) and BMI 26.7 (≥18 years). The outcome was the weighted absolute relative difference (ARD). Data were analysed using generalised estimating equations to account for correlation between repeated measures. No statistically significant associations between measures of body composition and device accuracy were found. Body composition does not have a meaningful impact on the accuracy of CGM systems.

PMID:37053526 | DOI:10.1089/dia.2023.0085

Anesth Analg. 2023 Apr 12. doi: 10.1213/ANE.0000000000006483. Online ahead of print.

ABSTRACT

Factor V Leiden is the commonest hereditary prothrombotic allele, affecting 1% to 5% of the world’s population. The objective of this study was to characterize the perioperative and postoperative outcomes of patients with Factor V Leiden compared to patients without a diagnosis of hereditary thrombophilia. This was a focused systematic review of studies including adult (>18 years) patients with Factor V Leiden (heterozygous or homozygous) undergoing noncardiac surgery. Included studies were either randomized controlled trials or observational. The primary clinical outcomes of interest were thromboembolic events occurring from the perioperative period up to 1 year postoperatively, defined as deep venous thrombosis, pulmonary embolism, or other clinically significant thrombosis occurring during or after a surgical procedure. Secondary outcomes included cerebrovascular events, cardiac events, death, transplant-related outcomes, and surgery-specific morbidity. Pediatric and obstetrical patients were excluded, as were case reports and case series. Databases searched included MEDLINE and EMBASE from inception until August 2021. Study bias was assessed through the CLARITY (Collaboration of McMaster University researchers) Risk of Bias tools, and heterogeneity through analysis of study design and end points, as well as the I2 statistic with its confidence interval and the Q statistic. A total of 5275 potentially relevant studies were identified, with 115 having full text assessed for eligibility and 32 included in the systematic review. On the whole, the literature suggests that patients with Factor V Leiden have an increased risk of perioperative and postoperative thromboembolic events compared to patients without the diagnosis. Increased risk was also seen in relation to surgery-specific morbidity and transplant-related outcomes, particularly arterial thrombotic events. The literature did not support an increased risk for mortality, cerebrovascular, or cardiac complications. Limitations of the data include predisposition toward bias due in many study designs and small sample sizes across the majority of published studies. Variable outcome definitions and durations of patient follow-up across different surgical procedures resulted in high study heterogeneity precluding the effective use of meta-analysis. Factor V Leiden status may confer additional risk for surgery-related adverse outcomes. Large, adequately powered studies are required to accurately estimate the degree of this risk by zygosity.

PMID:37053508 | DOI:10.1213/ANE.0000000000006483

Plast Reconstr Surg. 2023 Apr 13. doi: 10.1097/PRS.0000000000010529. Online ahead of print.

ABSTRACT

BACKGROUND: To evaluate the long-term outcomes of mandibular reconstruction with vascularized free fibula flap in pediatric patients.

METHODS: Consecutive cases of mandibular reconstruction with vascularized free fibula flaps in pediatric patients at Peking University School and Hospital of Stomatology between 1999 and 2019 were reviewed. Postoperative computed tomography (CT) data of all patients were collected at each postoperative follow-up point, and after the age of 18 years. The length and height of the grafted fibula and the length of the remaining mandible were evaluated by measuring the three-dimensional CT data using ProPlan CMF 3.0 software. Lower limb function was evaluated using the Enneking evaluation scale. Facial symmetry was self-evaluated and scored. Statistical analysis was performed on the data obtained.

RESULTS: Fourteen patients were included in this study. All flaps were successful. The CT measurement results showed growth in the length of the grafted fibula which reconstructed the mandibular ramus and the residual mandible (P < 0.05). The height of the grafted fibula remained stable (P > 0.05). Eight patients were followed-up until > 18 years of age, and the CT measurement results after 18 years showed an essentially symmetrical mandible profile (P > 0.05). All patients were satisfied with their postoperative facial symmetry. Enneking evaluation scores showed good recovery of lower limb functions.

CONCLUSION: Vascularized free fibula flap for mandibular reconstruction in pediatric patients is safe and reliable while also providing good cosmetic and functional outcomes as it demonstrated positive growth.

PMID:37053458 | DOI:10.1097/PRS.0000000000010529

Health Psychol. 2023 Apr 13. doi: 10.1037/hea0001278. Online ahead of print.

ABSTRACT

OBJECTIVE: There is a tremendous opportunity for electronic health services (eHealth) to reach adults with low income who want to participate in weight loss interventions, but face barriers in access. This review (a) synthesizes and presents results from all studies evaluating the effectiveness of eHealth weight loss interventions for adults with low income and (b) describes the strategies used to tailor them to these groups.

METHOD: Electronic databases were searched for studies examining the effectiveness of eHealth weight loss interventions designed for adults with low income and screened for eligibility by two independent reviewers. All experimental study designs were included. Data were extracted, results were qualitatively synthesized, and studies were assessed for quality.

RESULTS: Nine studies met the inclusion criteria (N = 1,606 total participants). Four studies reported significant reductions in weight of small to moderate magnitude among participants in eHealth interventions (M weight loss = -2.2 kg; SD = 1.6). Many studies did not describe how they tailored the intervention for adults with low income; however, studies that achieved significant results tended to use more tailoring strategies. Most studies reported high retention rates. Three studies were rated as strong quality, four as moderate, and two as weak.

CONCLUSIONS: Evidence is limited that eHealth weight loss interventions for this population are effective in achieving clinically and statistically significant weight reductions. While interventions that used more tailoring strategies tended to be more effective, studies that use the rigorous methodology and describe interventions in more depth could better elucidate whether eHealth interventions are an effective approach in this population. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37053431 | DOI:10.1037/hea0001278

J Exp Psychol Learn Mem Cogn. 2023 Apr 13. doi: 10.1037/xlm0001240. Online ahead of print.

ABSTRACT

Previous masked translation priming studies, especially those with different-script bilinguals, have shown that cognates provide more priming than noncognates, a difference attributed to cognates’ phonological similarity. In our experiments employing a word naming task, we examined this issue for Chinese-Japanese bilinguals in a slightly different way, using same-script cognates as primes and targets. In Experiment 1, significant cognate priming effects were observed. The sizes of the priming effects were, however, statistically not different for phonologically similar (e.g., /xin4lai4/-/shiNrai/) and dissimilar cognate pairs (e.g., /bao3zheng4/- /hoshoR/), suggesting no impact of phonological similarity. In Experiment 2, using exclusively Chinese stimuli, we demonstrated a significant homophone priming effect using two-character logographic primes and targets, indicating that phonological priming is possible for two-character Chinese targets. However, priming only emerged for pairs that had the same tone pattern (e.g., /shou3wei4/-/shou3wei4/), suggesting that a match in lexical tone is crucial for observing phonologically based priming in that situation. Therefore, Experiment 3 involved phonologically similar Chinese-Japanese cognate pairs in which the similarity of their suprasegmental phonological features (i.e., lexical tone and pitch-accent information) was varied. Priming effects were statistically not different for tone/accent similar pairs (e.g., /guan1xin1/-/kaNsiN/) and dissimilar pairs (e.g., /man3zu2/-/maNzoku/). Our results indicate that phonological facilitation is not involved in producing cognate priming effects for Chinese-Japanese bilinguals. Possible explanations, based on underlying representations of logographic cognates, are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37053424 | DOI:10.1037/xlm0001240

Psychol Methods. 2023 Apr 13. doi: 10.1037/met0000565. Online ahead of print.

ABSTRACT

artially nested designs (PNDs) are common in intervention studies in psychology and other social sciences. With this design, participants are assigned to treatment and control groups on an individual basis, but clustering occurs in some but not all groups (e.g., the treatment group). In recent years, there has been substantial development of methods for analyzing data from PNDs. However, little research has been done on causal inference for PNDs, especially for PNDs with nonrandomized treatment assignments. To reduce the research gap, in the current study, we used the expanded potential outcomes framework to define and identify the average causal treatment effects in PNDs. Based on the identification results, we formulated the outcome models that could produce treatment effect estimates with causal interpretation and evaluated how alternative model specifications affect the causal interpretation. We also developed an inverse propensity weighted (IPW) estimation approach and proposed a sandwich-type standard error estimator for the IPW-based estimate. Our simulation studies demonstrated that both the outcome modeling and the IPW methods specified following the identification results can yield satisfactory estimates and inferences of the average causal treatment effects. We applied the proposed approaches to data from a real-life pilot study of the Pregnant Moms’ Empowerment Program for illustration. The current study provides guidance and insights on causal inference for PNDs and adds to researchers’ toolbox of treatment effect estimation with PNDs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37053414 | DOI:10.1037/met0000565