Tag: nevin manimala

Blood Coagul Fibrinolysis. 2021 Jun 1;32(4):248-252. doi: 10.1097/MBC.0000000000001025.

ABSTRACT

Early diagnosis of disseminated intravascular coagulation (DIC) before its progression to an overt stage is beneficial for its treatment and prognosis.This retrospective study aimed to evaluate the diagnostic performance of D-dimer and fibrin monomer in the early stage of DIC.A total of 707 patients suspected of having DIC, 302 healthy people were enrolled and divided into four groups: overt DIC, nonovert DIC, non-DIC based on the International Society of Thrombosis and Hemostasis scoring for overt DIC and the modified nonovert DIC criteria, healthy people as control group. Quantitative determination was done by immunoturbidimetry for D-dimer and fibrin monomer.The median of fibrin monomer in overt, nonovert and non-DIC was 41.65, 26.89 and 8.68 μg/ml, respectively. The median of D-dimer in overt, nonovert and non-DIC was 9.69, 3.98 and 3.08 μg/ml, respectively. D-dimer and fibrin monomer values were higher in overt DIC than other groups, but there was no difference between nonovert DIC and non-DIC in D-dimer. Unlike D-dimer, statistically significant differences were found in fibrin monomer between nonovert and non-DIC. At receiver operator characteristic curve-generated cutoff values, fibrin monomer had much excellent predictive performance compared with D-dimer for distinguishing nonovert DIC from non-DIC. D-dimer and fibrin monomer had same diagnostic performance in distinguishing overt DIC from non-DIC.Fibrin monomer is a better indicator compared with D-dimer in distinguishing patients with nonovert DIC from non-DIC. Hence, it might serve as an excellent negative exclusion marker to provide a reference for early clinical diagnosis and intervention through more studies.

PMID:33955858 | DOI:10.1097/MBC.0000000000001025

JMIR Mhealth Uhealth. 2021 May 6;9(5):e25895. doi: 10.2196/25895.

ABSTRACT

BACKGROUND: Melanoma is attributable to predisposing phenotypical factors, such as skin that easily sunburns and unprotected exposure to carcinogenic UV radiation. Reducing the proportion of young adults who get sunburned may reduce the incidence of melanoma, a deadly form of skin cancer. Advances in technology have enabled the delivery of real-time UV light exposure and content-relevant health interventions.

OBJECTIVE: This study aims to examine the feasibility of young adults performing the following tasks daily: wearing a UV dosimeter, receiving text messages and real-time UV-B doses on their smartphone, and responding to daily web-based surveys about sunburn and sun protection.

METHODS: Young adults aged 18-39 years (n=42) were recruited in the United States in June 2020 via social media. Participants received the UV Guard sun protection system, which consisted of a UV dosimeter and a smartphone app. During 3 consecutive periods, intervention intensity increased as follows: real-time UV-B dose; UV-B dose and daily behavioral facilitation text messages; and UV-B dose, goal setting, and daily text messages to support self-efficacy and self-regulation. Data were self-reported through daily web-based surveys for 28 days, and UV-B doses were transmitted to cloud-based storage.

RESULTS: Patients’ median age was 22 years (IQR 20, 29), and all patients had sun-sensitive skin. Sunburns were experienced during the study by fewer subjects (n=18) than those in the preceding 28 days (n=30). In July and August, the face was the most commonly sunburned area among 13 body locations; 52% (22/42) of sunburns occurred before the study and 45% (19/42) occurred during the study. The mean daily UV-B dose decreased during the 3 periods; however, this was not statistically significant. Young adults were most often exercising outdoors from 2 to 6 PM, walking from 10 AM to 6 PM, and relaxing from noon to 2 PM. Sunburn was most often experienced during exercise (odds ratio [OR] 5.65, 95% CI 1.60-6.10) and relaxation (OR 3.69, 95% CI 1.03-4.67) relative to those that did not exercise or relax in each category. The self-reported exit survey indicated that participants felt that they spent less time outdoors this summer compared to the last summer because of the COVID-19 pandemic and work. In addition, 38% (16/42) of the participants changed their use of sun protection based on their app-reported UV exposure, and 48% (20/42) shifted the time they went outside to periods with less-intense UV exposure. A total of 79% (33/42) of the participants were willing to continue using the UV Guard system outside of a research setting.

CONCLUSIONS: In this proof-of-concept research, young adults demonstrated that they used the UV Guard system; however, optimization was needed. Although some sun protection behaviors changed, sunburn was not prevented in all participants, especially during outdoor exercise.

TRIAL REGISTRATION: ClinicalTrials.gov NCT03344796; http://clinicaltrials.gov/ct2/show/NCT03344796.

PMID:33955844 | DOI:10.2196/25895

Subst Abus. 2021 May 6:1-2. doi: 10.1080/08897077.2021.1915919. Online ahead of print.

ABSTRACT

Lebanon, a small middle-income nation in western Asia, has been crippled by decades of political turmoil and armed conflict. A “quadruple crisis” hit the country over the past years, starting with the protracted humanitarian Syrian refugee crisis, followed by a severe socioeconomic collapse, the global COVID-19 pandemic, and lastly the Beirut port catastrophic blast. With the exposure to repetitive traumatic events and associated organic brain injury, the Lebanese population has become at a higher risk of addiction, among other psychiatric comorbidities. With the scarce statistics about the topic and limited addiction services in the country, collaborative local efforts and international help are urgently needed to fight the upcoming substance use epidemic. Raising awareness, providing adequate training, and securing resources for the management of both addiction and trauma are of utmost importance.

PMID:33955819 | DOI:10.1080/08897077.2021.1915919

JMIR Med Inform. 2021 May 6;9(5):e28413. doi: 10.2196/28413.

ABSTRACT

BACKGROUND: Improving the understandability of health information can significantly increase the cost-effectiveness and efficiency of health education programs for vulnerable populations. There is a pressing need to develop clinically informed computerized tools to enable rapid, reliable assessment of the linguistic understandability of specialized health and medical education resources. This paper fills a critical gap in current patient-oriented health resource development, which requires reliable and accurate evaluation instruments to increase the efficiency and cost-effectiveness of health education resource evaluation.

OBJECTIVE: We aimed to translate internationally endorsed clinical guidelines to machine learning algorithms to facilitate the evaluation of the understandability of health resources for international students at Australian universities.

METHODS: Based on international patient health resource assessment guidelines, we developed machine learning algorithms to predict the linguistic understandability of health texts for Australian college students (aged 25-30 years) from non-English speaking backgrounds. We compared extreme gradient boosting, random forest, neural networks, and C5.0 decision tree for automated health information understandability evaluation. The 5 machine learning models achieved statistically better results compared to the baseline logistic regression model. We also evaluated the impact of each linguistic feature on the performance of each of the 5 models.

RESULTS: We found that information evidentness, relevance to educational purposes, and logical sequence were consistently more important than numeracy skills and medical knowledge when assessing the linguistic understandability of health education resources for international tertiary students with adequate English skills (International English Language Testing System mean score 6.5) and high health literacy (mean 16.5 in the Short Assessment of Health Literacy-English test). Our results challenge the traditional views that lack of medical knowledge and numerical skills constituted the barriers to the understanding of health educational materials.

CONCLUSIONS: Machine learning algorithms were developed to predict health information understandability for international college students aged 25-30 years. Thirteen natural language features and 5 evaluation dimensions were identified and compared in terms of their impact on the performance of the models. Health information understandability varies according to the demographic profiles of the target readers, and for international tertiary students, improving health information evidentness, relevance, and logic is critical.

PMID:33955834 | DOI:10.2196/28413

West J Nurs Res. 2021 May 6:1939459211013580. doi: 10.1177/01939459211013580. Online ahead of print.

ABSTRACT

The purpose of this study was to examine individuals’ knowledge of cardiovascular risk-related biometric numbers and to compare self-reported and investigator-measured numbers in a convenience sample of adults in the Midwest region. Sociodemographic data and personal knowledge of cardiovascular risk-related biometric numbers were assessed using self-reported questionnaires. Investigators conducted health assessments to obtain biometric numbers. Among the 224 participants, participants’ reported knowledge about their cardiovascular risk-related biometric numbers was low, especially for high-density lipoprotein and fasting blood glucose levels. Participants’ knowledge was associated with education level and the recency of their last healthcare visit for health assessment. We found statistically significant mean differences between self-reported and investigator-measured blood pressure, and weight. This study found that there were discrepancies between self-reported and investigator-measured cardiovascular risk-related numbers. Future research is needed to develop educational interventions to improve personal knowledge of cardiovascular risks.

PMID:33955791 | DOI:10.1177/01939459211013580

Psychother Res. 2021 May 6:1-15. doi: 10.1080/10503307.2021.1921303. Online ahead of print.

ABSTRACT

Objective: The purpose of this paper is to describe an approach to dynamical systems (DS) using a set of differential equations, and how an application of these equations can be used to address a critical element of the therapeutic relationship. Using APA’s Three Approaches to Psychotherapy with a Female Client: The Next Generation and Three Approaches to Psychotherapy with a Male Client: The Next Generation videos, DS models were created for each of the six sessions with expert clinicians (Judith Beck, Leslie Greenberg, and Nancy McWilliams) from the three theoretical approaches. Method: A second-by-second observational coding system of the emotional exchanges of the therapists and clients was used as the data for the equations. Results: DS modeling allowed for a side-by-side comparison between the three approaches as well as between the two clients. Examining the graphs created by plotting the results of the DS equations (in particular, phase-space portraits) revealed that there were similarities among the three theoretical approaches, and there were notable differences between the two clients. Conclusions: DS modelling can provide researchers and clinicians with a powerful tool to investigate the complex phenomenon that is psychotherapy.

PMID:33955816 | DOI:10.1080/10503307.2021.1921303

J Environ Sci Health C Toxicol Carcinog. 2021 May 6:1-24. doi: 10.1080/26896583.2021.1883964. Online ahead of print.

ABSTRACT

Cancer is a main concern for human health and there is a need of alternative methodologies to rapidly screen large quantitative of compounds that may represent a toxicological risk. Here a statistical analyses is performed on a benchmark database of experimental Ames data to identify chemical descriptors discriminating mutagens and non-mutagens. A total of 53 activating and deactivating modulators are identified, that flagged respectively a percentage of mutagen and non-mutagen up to 87%. Modulators are further combined to form synergistic cross-terms, accounting for the effect that combined properties may have on the final toxicity. Exclusion rules are defined as exception to the modulators. Synergistic cross-terms and exclusion rules improve the enrichment of mutagens/non-mutagens with respect of the original abundance in the dataset to values higher than 95%. The external predictivity of modulators and cross-terms reach balanced accuracy up to 0.775 that is analogous to other mutagenicity models from the literature, confirming the suitability of the rules to real-life screening of chemicals. Modulators are discussed for their mechanistic link to mutagenicity. This analysis confirms the key role of some properties (polarizability, shape, mass, presence of reactive functional groups or unsaturated planar systems) as driving elements for the initiation of the mutagenicity.

PMID:33955817 | DOI:10.1080/26896583.2021.1883964

J Occup Health. 2021 Jan;63(1):e12224. doi: 10.1002/1348-9585.12224.

ABSTRACT

OBJECTIVES: Little is known about workplace measures against coronavirus disease 2019 (COVID-19) in Japan during the winter of 2020, especially in micro-, small-, and medium-sized enterprises (MSMEs). This study aimed to provide an overview of the current situation of anti-COVID-19 measures in Japanese enterprises during the winter, considering company size.

METHODS: This study was an Internet-based nationwide cross-sectional study. Individuals who were registered as full-time workers were invited to participate in the survey. Data were collected using an online self-administered questionnaire in December 2020. The chi-squared test for trend was performed to calculate the P-value for trend for each workplace measure across company sizes.

RESULTS: For the 27 036 participants, across company sizes, the most prevalent workplace measure was encouraging mask wearing at work, followed by requesting that employees refrain from going to work when ill and restricting work-related social gatherings and entertainment. These measures were implemented by approximately 90% of large-scale enterprises and by more than 40% of micro- and small-scale enterprises. In contrast, encouraging remote working was implemented by less than half of large-scale enterprises and by around 20% of micro- and small-scale enterprises. There were statistically significant differences in all workplace measures by company size (all P < .001).

CONCLUSIONS: We found that various responses to COVID-19 had been taken in workplaces. However, some measures, including remote working, were still not well-implemented, especially in smaller enterprises. The findings suggest that occupational health support for MSMEs is urgently needed to mitigate the current wave of COVID-19.

PMID:33955633 | DOI:10.1002/1348-9585.12224

J Agric Food Chem. 2021 May 6. doi: 10.1021/acs.jafc.0c07942. Online ahead of print.

ABSTRACT

An intelligent surgical knife (iKnife) coupled with rapid evaporative ionization mass spectrometry (REIMS) was employed for the lipidomic profiling of fresh and frozen-thawed beef muscle. The data were obtained by REIMS and then processed using multivariate statistical analysis methods including principal component analysis-linear discriminant analysis (PCA-LDA) and orthogonal partial least-squares discriminant analysis (OPLS-DA). The discrimination of fresh and frozen-thawed meat has been achieved, and the real-time identification accuracy was 92-100%. Changes in the composition and content of fatty acids and phospholipids were statistically analyzed by OPLS-DA, and the ions of m/z 279.2317, m/z 681.4830, and m/z 697.4882 were selected as differential compounds/metabolites. The developed method was also successfully applied in the discrimination of fresh and frozen-thawed meat samples. These results showed that REIMS as a high-throughput, rapid, and real-time mass spectrometry detection technology can be used for the identification of fresh and frozen-thawed meat samples.

PMID:33955749 | DOI:10.1021/acs.jafc.0c07942

J Urol. 2021 May 6:101097JU0000000000001869. doi: 10.1097/JU.0000000000001869. Online ahead of print.

ABSTRACT

PURPOSE: We assessed the long-term surgical, functional urinary and sexual outcome of adolescent and young adult men who underwent childhood hypospadias repair.

MATERIALS AND METHODS: Men born with non-syndromic hypospadias and healthy male controls, aged 16-21 years old, were recruited and their surgical, urinary, sexual functional and aesthetic outcomes assessed. Good outcome was defined as a patent and orthotopic meatus without fistulae and straight erections (<30° curvature) without erectile or ejaculatory problems. Statistics included regression analyses, Chi²/Fisher Exact tests and Student’s t/Mann-Whitney U and Kruskal Wallis tests.

RESULTS: 193 cases and 50 controls participated, 16.4 [8.2-21.2] years after initial repair. At least one re-intervention was performed in 39.2%. The highest re-intervention rate was found in those younger than 12 months at initial repair, even when excluding proximal hypospadias cases. A disturbed urinary and/or suboptimal sexual functional outcome was seen in 52.9% of cases. Suboptimal voiding was found in 22.1%, although few had relevant residual urine. More re-interventions and proximal hypospadias were associated with suboptimal urinary outcome and the latter also with impaired sexual function. Poor inter-observer agreements were found between physician’s and patient’s genital appraisal.

CONCLUSIONS: In 52.9% of cases, at least one concern was identified that required long-term follow-up. Hypospadias repair below twelve months was associated with more re-interventions. Adopting a restrictive attitude towards aesthetic refinement unless on the patient’s own request, could improve urinary outcomes.

PMID:33955779 | DOI:10.1097/JU.0000000000001869