Tag: pubmed

Am J Trop Med Hyg. 2025 Feb 11:tpmd240653. doi: 10.4269/ajtmh.24-0653. Online ahead of print.

ABSTRACT

There is uncertainty regarding the usefulness of predictive models for dengue prognosis. We performed a systematic review to identify and evaluate prognostic models in patients with dengue. We conducted a literature search in PubMed, Embase, and Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) up to May 24, 2023. We included case-control and cohort studies that developed or validated multivariable prognostic models related to severity, hospitalization, intensive care unit (ICU) admission, or mortality in patients of any age with a laboratory-based diagnosis of dengue. A narrative synthesis of the performance measures of the prognostic models evaluated in each study was performed. Of the 4,211 articles, a total of 35 studies reporting information on 43 prognostic models were included. Among these, 35 were developmental and 8 were for external validation. Most models were designed to predict severity (n = 30), followed by mortality (n = 10), hospitalization (n = 2), and ICU admission (n = 1). The reported C-statistic in the models ranged from 0.70 to 0.95 for severity, 0.83 to 0.99 for mortality, 0.87 for hospitalization, and 0.92 for ICU admission. Calibration measures were poorly reported in the vast majority of models. According to the Prediction Study Risk of Bias Assessment Tool, the risk of bias was considered high for all included models, and applicability was of low concern for most models. Our study identified multiple prognostic models, particularly for predicting severity and mortality in patients with dengue. Although most models demonstrated acceptable discriminative ability, calibration measures were poorly reported, and the overall methodological design was poor.

PMID:39933179 | DOI:10.4269/ajtmh.24-0653

JMIR Serious Games. 2025 Feb 11;13:e56269. doi: 10.2196/56269.

ABSTRACT

BACKGROUND: During keyhole surgery, the surgeon is required to perform highly demanding tasks while only being able to see part of the patient’s anatomy. This limited field of view is widely cited as a key limitation of the procedure, and many computational methods have been proposed to overcome it. However, the precise effects of a limited field of view on task performance remain unknown due to the lack of tools to study these effects effectively.

OBJECTIVE: This paper describes our work on developing a serious game with 2 objectives: (1) to create an engaging game that communicates some of the challenges of keyhole surgery, and (2) to test the effect of a limited field of view on task performance. The development of a serious game that can be played by a wide range of participants will enable us to gather quantitative data on the effects of the reduced field of view on task performance. These data can inform the future development of technologies to help surgeons reduce the impact of a limited field of view on clinical outcomes for patients. The game is open source and may be adapted and used by other researchers to study related problems.

METHODS: We implemented an open-source serious game in JavaScript, inspired by the surgical task of selectively cauterizing blood vessels during twin-to-twin transfusion surgery. During the game, the player is required to identify and cut the correct blood vessel under different fields of view and varying levels of vascular complexity. We conducted a quantitative analysis of task performance time under different conditions and a formative analysis of the game using participant questionnaires.

RESULTS: We recruited 25 players to test the game and recorded their task performance time, accuracy, and qualitative metrics. Reducing the field of view resulted in participants taking significantly longer (P<.001) to perform otherwise identical tasks (mean 6.4 seconds, 95% CI 5.0-7.8 seconds vs mean 13.6 seconds, 95% CI 10.3-16.9 seconds). Participants found the game engaging and agreed that it enhanced their understanding of the limited field of view during keyhole surgery.

CONCLUSIONS: We recruited 25 players to test the game and recorded their task performance time, accuracy, and qualitative metrics. Reducing the field of view resulted in participants taking statistically significantly longer (16.4 vs 9.8 seconds; P=.05) to perform otherwise identical tasks. Participants found the game engaging and agreed that it enhanced their understanding of the limited field of view during keyhole surgery.

PMID:39933172 | DOI:10.2196/56269

JMIR Med Educ. 2025 Feb 11;11:e64780. doi: 10.2196/64780.

ABSTRACT

BACKGROUND: Virtual reality simulation (VRS) teaching offers nursing students a safe, immersive learning environment with immediate feedback, enhancing learning outcomes. Before the COVID-19 pandemic, nursing students had limited training and opportunities to care for patients in isolation units with infectious diseases. However, the pandemic highlighted the ongoing global priority of providing care for patients with infectious diseases.

OBJECTIVE: This study aims to (1) examine the effectiveness of VRS in preparing nursing students to care for patients with infectious diseases by assessing its impact on their theoretical knowledge, learning motivation, and attitudes; and (2) evaluate their experiences with VRS.

METHODS: This 2-phased mixed methods study recruited third-year undergraduate nursing students enrolled in the Integrated Emergency and Critical Care course at a university in Taiwan. Phase 1 used a quasi-experimental design to address objective 1 by comparing the learning outcomes of students in the VRS teaching program (experimental group) with those in the traditional teaching program (control group). Tools included an infection control written test, the Instructional Materials Motivation Survey, and a learning attitude questionnaire. The experimental group participated in a VRS lesson titled “Caring for a Patient with COVID-19 in the Negative Pressure Unit” as part of the infection control unit. In phase 2, semistructured interviews were conducted to address objective 2, exploring students’ learning experiences.

RESULTS: A total of 107 students participated in phase 1, and 18 students participated in phase 2. Both the VRS and control groups showed significant improvements in theoretical knowledge scores (for the VRS group t₄₆=-7.47; P<.001, for the control group t₅₉=-4.04; P<.001). However, compared with the control group, the VRS group achieved significantly higher theoretical knowledge scores (t_98.13=2.70; P=.008) and greater learning attention (t₁₀₅=2.30; P=.02) at T1. Additionally, the VRS group demonstrated a statistically significant higher regression coefficient for learning confidence compared with the control group (β=.29; P=.03). The students’ learning experiences in the VRS group were categorized into 4 themes: Applying Professional Knowledge to Patient Care, Enhancing Infection Control Skills, Demonstrating Patient Care Confidence, and Engaging in Real Clinical Cases. The core theme identified was Strengthening Clinical Patient Care Competencies.

CONCLUSIONS: The findings suggest that VRS teaching significantly enhanced undergraduate nursing students’ infection control knowledge, learning attention, and confidence. Qualitative insights reinforced the quantitative results, highlighting the holistic benefits of VRS teaching in nursing education, including improved learning outcomes. The positive impact on student motivation and attitudes indicates a potentially transformative approach to nursing education, particularly in the post-COVID-19 era, where digital and remote learning tools play an increasingly vital role.

PMID:39933166 | DOI:10.2196/64780

JMIR Mhealth Uhealth. 2025 Feb 11;13:e52887. doi: 10.2196/52887.

ABSTRACT

BACKGROUND: Adolescence through emerging adulthood represents a critical period associated with changes in lifestyle behaviors. Understanding the dynamic relationships between cognitive, social, and environmental contexts is informative for the development of interventions aiming to help youth sustain physical activity and limit sedentary time during this life stage. Ecological momentary assessment (EMA) is an innovative method involving real-time assessment of individuals’ experiences and behaviors in their naturalistic or everyday environments; however, EMA compliance can be problematic due to high participant burdens.

OBJECTIVE: This systematic review synthesized existing evidence pertaining to compliance in EMA studies that investigated wake-time movement behaviors among adolescent and emerging adult populations. Differences in EMA delivery scheme or protocol, EMA platforms, prompting schedules, and compensation methods-all of which can affect participant compliance and overall study quality-were examined.

METHODS: An electronic literature search was conducted in PubMed, PsycINFO, and Web of Science databases to select relevant papers that assessed movement behaviors among the population using EMA and reported compliance information for inclusion (n=52) in October 2022. Study quality was assessed using a modified version of the Checklist for Reporting of EMA Studies (CREMAS).

RESULTS: Synthesizing the existing evidence revealed several factors that influence compliance. The platform used for EMA studies could affect compliance and data quality in that studies using smartphones or apps might lessen additional burdens associated with delivering EMAs, yet most studies used web-based formats (n=18, 35%). Study length was not found to affect EMA compliance rates, but the timing and frequency of prompts may be critical factors associated with missingness. For example, studies that only prompted participants once per day had higher compliance (91% vs 77%), but more frequent prompts provided more comprehensive data for researchers at the expense of increased participant burden. Similarly, studies with frequent prompting within the day may provide more representative data but may also be perceived as more burdensome and result in lower compliance. Compensation type did not significantly affect compliance, but additional motivational strategies could be applied to encourage participant response.

CONCLUSIONS: Ultimately, researchers should consider the best strategies to limit burdens, balanced against requirements to answer the research question or phenomena being studied. Findings also highlight the need for greater consistency in reporting and more specificity when explaining procedures to understand how EMA compliance could be optimized in studies examining physical activity and sedentary time among youth.

TRIAL REGISTRATION: PROSPERO CRD42021282093; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=282093.

PMID:39933165 | DOI:10.2196/52887

J Med Internet Res. 2025 Feb 11;27:e68881. doi: 10.2196/68881.

ABSTRACT

BACKGROUND: Despite the reinstatement of proactive human papillomavirus (HPV) vaccine recommendations in 2022, Japan continues to face persistently low HPV vaccination rates, which pose significant public health challenges. Misinformation, complacency, and accessibility issues have been identified as key factors undermining vaccine uptake.

OBJECTIVE: This study aims to examine the evolution of public attitudes toward HPV vaccination in Japan by analyzing social media content. Specifically, we investigate the role of misinformation, public health events, and cross-vaccine attitudes (eg, COVID-19 vaccines) in shaping vaccine hesitancy over time.

METHODS: We collected tweets related to the HPV vaccine from 2011 to 2021. Natural language processing techniques and large language models (LLMs) were used for stance analysis of the collected data. Time series analysis and latent Dirichlet allocation topic modeling were used to identify shifts in public sentiment and topic trends over the decade. Misinformation within opposed-stance tweets was detected using LLMs. Furthermore, we analyzed the relationship between attitudes toward HPV and COVID-19 vaccines through logic analysis.

RESULTS: Among the tested models, Gemini 1.0 pro (Google) achieved the highest accuracy (0.902) for stance analysis, improving to 0.968 with hyperparameter tuning. Time series analysis identified significant shifts in public stance in 2013, 2016, and 2020, corresponding to key public health events and policy changes. Topic modeling revealed that discussions around vaccine safety peaked in 2015 before declining, while topics concerning vaccine effectiveness exhibited an opposite trend. Misinformation in topic “Scientific Warnings and Public Health Risk” in the sopposed-stance tweets reached a peak of 2.84% (47/1656) in 2012 and stabilized at approximately 0.5% from 2014 onward. The volume of tweets using HPV vaccine experiences to argue stances on COVID-19 vaccines was significantly higher than the reverse.

CONCLUSIONS: Based on observation on the public attitudes toward HPV vaccination from social media contents over 10 years, our findings highlight the need for targeted public health interventions to address vaccine hesitancy in Japan. Although vaccine confidence has increased slowly, sustained efforts are necessary to ensure long-term improvements. Addressing misinformation, reducing complacency, and enhancing vaccine accessibility are key strategies for improving vaccine uptake. Some evidence suggests that confidence in one vaccine may positively influence perceptions of other vaccines. This study also demonstrated the use of LLMs in providing a comprehensive understanding of public health attitudes. Future public health strategies can benefit from these insights by designing effective interventions to boost vaccine confidence and uptake.

PMID:39933163 | DOI:10.2196/68881

Retina. 2025 Feb 6. doi: 10.1097/IAE.0000000000004426. Online ahead of print.

ABSTRACT

PURPOSE: To investigate any difference in the rate of serotonin reuptake inhibitor (SRI) use in patients with retinal vein occlusions (RVO), compared to an age matched control group.

METHODS: Retrospective data collection of risk factors and prescribed drugs from consecutive electronic patient records of all patients diagnosed with RVO over 5 years. Routine, age matched patients were identified for a control group. The two groups were compared with Chi2 test and multiple Logistic regression. Odds ratios (OR) were calculated.

RESULTS: In total, 775 patients were included in this study. 283 patients were in the RVO group and 492 in the control group. The rate of SRI and Statin use was significantly different in both groups for all ages (p<0.001). Logistic regression confirmed a significant reduction in RVO associated with SRI use (OR 0.39), Statins (OR 0.51) and combined drugs (OR 0.22) with all groups reaching statistical significance (p<0.001).

CONCLUSION: This study has found lower rates of RVO in patients receiving an SRI or a Statin compared to controls. This data suggests that individuals taking an SRI are less likely to suffer a RVO and SRIs may have an additive effect when combined with Statins.

PMID:39933153 | DOI:10.1097/IAE.0000000000004426

J Cataract Refract Surg. 2025 Feb 11. doi: 10.1097/j.jcrs.0000000000001630. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate a novel software program (SpikeFinder) that improves quality of measurements obtained by optical low coherence reflectometry (OLCR) biometry (Lenstar).

SETTING: Tertiary care academic center.

DESIGN: Retrospective case series.

METHOD: ology: After applying inclusion criteria, 12,988 eyes scanned with OLCR biometry and swept-source OCT (SS-OCT) biometry (IOLMaster700) were analyzed. Measurements, including axial length (AL), anterior chamber depth (ACD), and lens thickness (LT), were compared. SpikeFinder was applied to eyes with the most prominent ACD and LT measurement differences. Statistical testing was performed using Wilcoxon (two variables) and Kruskal-Wallis ANOVA tests (multiple variables) with Tukey post-hoc adjustments. Heteroscedastic testing (WHWK Statistics Package) was used to assess differences after software application.

RESULTS: 99.1% of AL measurements were within 0.01 mm between the two biometers. SS-OCT LT was significantly longer than the OLCR LT: 33% differed by ≥ 0.50 mm (p<0.001). Correspondingly, SS-OCT ACD was significantly shorter than OLCR ACD: 14% differed by ≥ 0.50 mm (p<0.001). SS-OCT biometer – OLCR biometer values for ACD and LT before applying SpikeFinder were -0.64 ± 0.31 mm and 1.15 ± 0.38 mm, respectively (p<0.001). After applying SpikeFinder to a subgroup of 337 eyes, these differences were -0.02 ± 0.03 mm and 0.01 ± 0.11 mm, respectively. SpikeFinder ACD and LT values were similar to SS-OCT biometer-measured ACD (p=0.872) and LT (p=0.987) values.

CONCLUSION: The SpikeFinder program can help improve the accuracy of ACD and LT measurements obtained by the OLCR biometer, which may enhance the performance of formulas that utilize these measurements.

PMID:39933143 | DOI:10.1097/j.jcrs.0000000000001630

Neurol Neuroimmunol Neuroinflamm. 2025 Mar;12(2):e200371. doi: 10.1212/NXI.0000000000200371. Epub 2025 Feb 11.

ABSTRACT

BACKGROUND AND OBJECTIVES: Older studies reported an increased risk of relapse after in vitro fertilization (IVF) in women with multiple sclerosis (MS), which has not been confirmed by more recent works. All these studies had several limitations, such as small sample sizes, absence of a control population, or lack of neurologic validation of the relapses. The aim of this study was to determine the risk of relapse after IVF in women with MS.

METHODS: This retrospective cohort study included all women with MS who underwent IVF between 2009 and 2019 and a control group of women with MS who did not undergo IVF matched on age, MS duration, number of relapses, and MS-specific treatments in the previous year. Data on MS (disease duration, treatments, and relapses) were from the French MS Registry (OFSEP), whereas data on IVF (number of procedures, stimulation protocol type, and outcomes) were from the French national health insurance database. For this, the 2 databases were linked by indirect matching.

RESULTS: In total, 115 women with MS underwent 199 IVF procedures (mean age at first IVF: 33.9 ± 4.0 years; 45.2% had ≥2 IVF procedures), and 175 IVFs (88.0%) could be matched to specific patients. The risk of relapse in the 3 months after index date was the same in both IVF group and control group (0.06 relapse per patient-year), as confirmed also by the before-after analysis in the IVF group (0.06 vs 0.08).

DISCUSSION: This study, using a 10-year clinical and administrative dataset, did not find any increased risk of relapse after IVF. The maintenance of disease-modifying therapies until IVF was a determining factor in reducing the risk of relapse.

PMID:39933125 | DOI:10.1212/NXI.0000000000200371

JCO Oncol Pract. 2025 Feb 11:OP2400898. doi: 10.1200/OP-24-00898. Online ahead of print.

ABSTRACT

PURPOSE: Treatment of limited-stage small cell lung cancer (LS-SCLC) with twice-a-day radiation therapy (RT) has remained the standard of care for many decades. Growing evidence suggests that outcomes with dose escalated twice-a-day RT may further improve outcomes. However, once-daily treatment remains common. The purpose of this study was to evaluate individual treatment facilities for utilization of twice-a-day RT.

METHODS: Patients with LS-SCLC treated with definitive chemoradiation from 2004 to 2019 were identified in the National Cancer Database. RT was classified as twice-a-day (45 Gy in 30 fractions) or once-daily (59.4-70.2 Gy in 30-39 fractions). Patients were excluded if surgery was performed. All patients received doublet chemotherapy. Unique treatment facilities delivering at least one twice-a-day treatment course during the study period were classified as BID-treating. Facilities not delivering any twice-a-day RT were classified as QD-only. The proportion of QD-only facilities was identified. Facility-level characteristics associated with QD-only classification were analyzed.

RESULTS: A total of 22,362 patients with LS-SCLC were treated at 1,222 unique facilities. A slight majority of facilities (n = 644, 52.7%) were BID-treating, whereas fewer (n = 578, 47.3%) were QD-only. A total of 73.9% of academic facilities were BID-treating versus 48.3% of nonacademic facility types (P < .001). Only 20.7% of low volume treatment facilities (lowest quartile of patients with LS-SCLC treated) used twice-a-day fractionation versus 78.2% of the highest quartile volume facilities (P < .001). On multivariable analysis, academic and high-volume facilities were statistically significantly associated with BID-treating classification (adjusted odds ratio, 2.5 [P < .001] and 4.2 [P < .001], respectively).

CONCLUSION: Nearly half of facilities treating LS-SCLC with definitive chemoradiation do not use twice-a-day fractionation schedules despite ongoing and growing evidence of superiority to once-daily fractionation. High-volume, academic facilities were more likely to offer twice-a-day fractionation.

PMID:39933118 | DOI:10.1200/OP-24-00898

Oncol Nurs Forum. 2024 Dec 12;52(1):61-69. doi: 10.1188/25.ONF.61-69.

ABSTRACT

OBJECTIVES: To retrospectively evaluate the incidence of palliative care (PC) consultations for older adults with lung cancer who died in the past five years, as well as the impact of social determinants of health (SDOHs) on PC consultations.

SAMPLE &AMP; SETTING: 63 participants aged 65 years or older with a lung cancer diagnosis who died in the past five years. Electronic health records were used to extract data.

METHODS &AMP; VARIABLES: A medical record extraction form was used to collect the following data: (a) lung cancer diagnosis, (b) PC consultations, (c) patient demographic information, and (d) SDOHs factors. All data were entered into a secure research electronic data capture management site.

RESULTS: Older adults who were married, White, and female and lived in a below-average rural or suburban area were more often benefactors of a PC consultation.

IMPLICATIONS FOR NURSING: It is imperative for nurses to support patients from diagnosis to end of life by facilitating PC consultations. This study highlights the importance of collecting SDOHs for all patients admitted to the hospital in the electronic health record. Awareness of SDOHs can help nurses facilitate end-of-life care plans.

PMID:39933111 | DOI:10.1188/25.ONF.61-69