Tag: pubmed

Cureus. 2024 Dec 2;16(12):e74990. doi: 10.7759/cureus.74990. eCollection 2024 Dec.

ABSTRACT

Background The use of automatic external defibrillators (AEDs) by lay rescuers can reduce the time to defibrillation and improve survival in out-of-hospital cardiac arrest (OHCA). AEDs use voice prompts to guide users through the defibrillation process, creating a potential barrier for deaf and hard-of-hearing (HoH) individuals. The objective of this study is to assess familiarity with and concerns regarding AED use among members of these communities. Methods A 19-question Qualtrics survey was distributed to adults in the United States who self-identified as deaf or HoH. The questions included seven demographics, eight yes/no/unsure, three Likert scales, and one multiple-response question. Quantitative analysis was performed using 95% confidence intervals to compare familiarity with and concerns about AED use among deaf, HoH, and combined groups of respondents. Results Of the responses, 500 met the inclusion criteria; 130 (26%) self-identified as deaf, and 370 (74%) self-identified as HoH. Around 460 (92%) were in the 18-40 age group. AED recognition was high among both deaf (90.77%) and HoH (84.59%) respondents, though deaf respondents were less likely than HoH respondents to have seen an AED in a public place (p=0.03) or know how to safely use one (p=0.001). In both the deaf and HoH groups, the top concern regarding AED use was that AEDs were too technical or complicated (61.86% and 56.8%). Of all respondents, 36.4% reported that AEDs were not user-friendly (p=0.034). All participants identified some concerns regarding AED use in emergencies. In addition, 56.15% of deaf and 39.19% of HoH respondents were concerned that AED use is potentially dangerous (p<0.001). There was no statistically significant difference between the two groups in knowing when to use an AED or where to find more information about AEDs. Conclusion Deaf and HoH people have specific concerns about AEDs, including the safety and complexity of operating an AED and the accessibility (user-friendliness). In this study, the deaf population is less familiar with using an AED than the HoH population. Possible interventions to address concerns of the deaf and HoH communities include AED training given in American Sign Language (ASL) and updating AED designs with improved visual and non-verbal directions.

PMID:39624811 | PMC:PMC11611321 | DOI:10.7759/cureus.74990

Pharmacoepidemiol Drug Saf. 2024 Dec;33(12):e70066. doi: 10.1002/pds.70066.

ABSTRACT

PURPOSE: The largest rural outbreak of human immunodeficiency virus (HIV) in the US was centered in Scott County, Indiana, and linked to injection practices involving the opioid Opana ER (oxymorphone extended release [ER] reformulated). We examined supply trends using pharmacy transactions of Opana ER in Scott and all US counties from January 2007 to December 2019.

METHODS: We calculated the monthly morphine milligram equivalents (MME) of Opana ER (and its competitor OxyContin) in pharmacies using the Automation of Reports and Consolidated Orders System (ARCOS) database from the Washington Post. We modeled the MME rate per capita in Scott County and five geographic comparators in seven distinct time periods including the market introduction of abuse deterrent formulations of both drugs and the HIV outbreak period (circa 2014).

RESULTS: After Opana ER introduction, transaction rates surged in Scott County, where annual OxyContin MMEs were already seven-fold higher than Indiana overall (CY2009: 46.8 vs. 6.8 MME/pop., respectively). Immediately after OxyContin’s reformulation, the Opana ER growth rate in Scott County surpassed all geographic comparators modeled (~27 times faster than the US, 1.28 vs. 0.047 MME/pop/month, respectively). By 2012, prior to the outbreak, MMEs from Opana ER almost perfectly replaced the diminishing OxyContin supply. When Opana ER with INTAC was subsequently introduced, pharmacy transactions declined precipitously by nearly 50%, persisting through the HIV outbreak period and market withdrawal.

CONCLUSIONS: Opana ER rapidly supplanted OxyContin in a vulnerable population that was at heightened risk for HIV who subsequently faced an immediate supply shock after its reformulation. Pharmacy transactions are critical for suspicious order monitoring and pharmacovigilance by US and international agencies especially during deleterious supply shocks in legal and illicit drug markets.

PMID:39623517 | DOI:10.1002/pds.70066

Health Qual Life Outcomes. 2024 Dec 2;22(1):104. doi: 10.1186/s12955-024-02316-0.

ABSTRACT

BACKGROUND: To assess fatigue in cancer patients, several patient-reported outcome measures (PROMs) are available that differ in content. To support the selection of suitable measures for specific applications and to evaluate possibilities of quantitative linking, the present study provides a content comparison of common fatigue measures, scales, and item banks. We included the EORTC CAT Core, EORTC QLQ-FA12, EORTC QLQ-C30, FACIT-F, PROMIS Fatigue (Cancer item bank v1.0), Brief Fatigue Inventory (BFI), Multidimensional Fatigue Inventory (MFI-20), Piper Fatigue Scale (PFS-12), and PRO-CTCAE.

METHODS: All items of the included measures were linked to the International Classification of Functioning, Disability and Health (ICF). Additionally, they were categorized as assessing general, physical, emotional, or cognitive fatigue. Descriptive statistics were used to display the contents covered in each measure and to allow for a qualitative comparison.

RESULTS: The measures consist of 160 items in total and covered primarily contents of the ICF components ‘Body functions’, ‘Activities and participation’, and ‘Environmental Factors’. Most ICF codings refer to ‘b1300 Energy level’ (9-67% of the codings per instrument; 47% of all coded content). Within the broad categorization of types of fatigue, most items were classified as general fatigue (33-100% of the codings per instrument; 49% of the overall item pool). While the EORTC CAT Core focuses exclusively on physical and general fatigue, FACIT and BFI additionally assess emotional fatigue. The EORTC QLQ-FA12, PROMIS, MFI-20, and PFS-12 cover all fatigue components, including cognitive fatigue.

DISCUSSION: The review provides an in-depth content comparison of PROMs assessing cancer-related fatigue. This can inform the selection of suitable measures in different clinical contexts. Furthermore, it will inform quantitative analyses to facilitate comparison of scores obtained with different PROMs.

PMID:39623483 | DOI:10.1186/s12955-024-02316-0

Scand J Trauma Resusc Emerg Med. 2024 Dec 2;32(1):122. doi: 10.1186/s13049-024-01297-9.

ABSTRACT

BACKGROUND: Helicopter hoist operations (HHO) are an important option for rescue operations in rugged and challenging terrain. German mid-range mountains are characterized by the versatility of ground conditions, few urban structures, and frequent use for local leisure activities, including the practice of more or less high-risk outdoor sports. This retrospective analysis aims to investigate the incidence of rescue missions in German mid-range mountains requiring HHO. The contributing air rescue bases’ operational tactics and the underlying medical characteristics, such as injury patterns and the provided medical care, are also reported.

METHODS: This study is a retrospective analysis of the documentation of HHO missions carried out at the air rescue bases in Freiburg, Nuremberg, and Bautzen staffed by emergency physicians between 01/2020 and 07/2022. Data was extracted from the German Air Rescue database. To assess the topics of interest, we conducted basic descriptive statistics.

RESULTS: Data selection retrieved 410 HHO-associated rescue missions. A total of 304 datasets, including HHO, were suitable for further statistical processing. Air rescue base Freiburg contributed 152, Nuremberg 63, and Bautzen 89 missions. HHO missions showed an increased frequency in the summer season and from Friday to Sunday. In this collective, 75% of the underlying diagnoses were trauma-associated; in 33% of all patients, traumatic injury of the pelvis or lower limb occurred. 28% of the patients were in a potential or actual life-threatening condition and were scored NACA 4 or higher. The rates of invasive medical treatment, such as endotracheal intubation (5%) or venous access (79%), were considerably higher than in overall emergency missions. In terms of mission tactics and cooperation with mountain rescue services, different approaches of the three air bases resulted in differences regarding first-on-scene rates and time spans.

CONCLUSION: The results show a relevant year-round need to deploy emergency medical expertise to inaccessible terrain in the three regions examined. Detailed analysis showed relevant differences in operational tactics between the three bases and potential for optimization. Simultaneous alerting of the hoist helicopter and reliable and precise coordination with other rescue organizations involved, especially the local mountain rescue service and the rescue coordination center, can help to shorten both the treatment-free interval and the prehospital time for patients in inaccessible terrain.

TRIAL REGISTRATION: The study is registered at DRKS (DRKS00033493).

PMID:39623469 | DOI:10.1186/s13049-024-01297-9

Retrovirology. 2024 Dec 3;21(1):20. doi: 10.1186/s12977-024-00653-y.

ABSTRACT

BACKGROUND: The role of viruses in the development of breast cancer has been a subject of debate and extensive research over the past few decades. Several studies have examined the association between Bovine leukemia virus (BLV) infection and the risk of developing breast cancer; however, their findings have yielded inconsistent results. To address this uncertainty, the purpose of the present study was to conduct a systematic review and meta-analysis to determine any potential association between BLV and breast cancer.

METHODS: The literature search was performed by finding related articles from PubMed, Web of Science, Scopus, EMBASE, and ScienceDirect databases. Statistical analysis was conducted using the meta package in R Studio and Review Manager 5.1. The I² test was used to assess between-study heterogeneity. The Mantel-Haenszel method calculated the pooled odds ratio and its 95% confidence interval. Studies were divided into subgroups for comparison.

RESULTS: The literature search identified a total of 17 studies that were deemed suitable for inclusion in the systematic review. Out of these 17 studies, 12 were used in the subsequent meta-analysis. Combining the data from these eligible studies, we calculated the pooled multi-factor adjusted odds ratio (OR) and a 95% confidence interval (CI). Considering the heterogeneity observed across the studies, the result obtained using the fixed effects model was 2.12 (1.77, 2.54). However, upon removing the six studies that contributed significantly to the heterogeneity, the pooled OR with a 95% CI was recalculated to be 3.92 (2.98, 5.16).

CONCLUSION: The result of this study suggests that BLV infection is statistically associated with Breast cancer.

PMID:39623467 | DOI:10.1186/s12977-024-00653-y

Health Res Policy Syst. 2024 Dec 2;22(1):157. doi: 10.1186/s12961-024-01250-3.

ABSTRACT

BACKGROUND: The phenomenon of growth in drug consumption within the framework of national volume-based procurement (VBP) policy raises speculations about demand release and policy inducing. This study aims to explore the reasons and mechanisms of drug consumption increases following VBP policy from two perspectives.

METHODS: We collected data from the China Drug Supply Information Platform, National Bureau of Statistics and the Joint Procurement Office. Twenty cardiovascular international non-proprietary names (INNs) in the first three VBP batches and 28 observation regions were included, constructing 418 valid INN-region combinations as the unit for analysis. The average monthly consumption volume of VBP cardiovascular drug was assigned as the explained variable. The generalized difference-in-difference method was conducted using the price reduction level and the size of policy assessment task as the policy intensity indicator. Moderating effect model was employed to examine the role of resident’s income level.

RESULTS: Increased cardiovascular drug consumption was observed in 285 (68.18%) INN-region combinations after policy implementation. Under VBP policy, the price reduction level was significantly correlated with drug consumption in total (β = 0.144, p < 0.001), as well as in tertiary hospitals, secondary hospitals and primary healthcare centers (PHCs) (all p-values < 0.05). Resident’s income level negatively moderated the impact of price reduction level on drug consumption in total (β = -0.089, p < 0.001) and in secondary hospitals (β = 0.154, p < 0.001) and PHCs (β = -0.2.9, p < 0.001), rather than in tertiary hospitals (β = -0.079, p > 0.05). The size of policy assessment task was positively associated with drug consumption in total (β = 0.052, p < 0.001), as well as in tertiary hospitals, secondary hospitals and PHCs (all p-values < 0.05).

CONCLUSIONS: Two mechanisms codrive drug consumption increases under VBP policy: first is the improvement of cardiovascular medication access and consumption toward lower-income groups following price reduction, pointing to the fulfillment of unmet needs, and second is policy pressure from supporting assessment measures on hospital drug use, indicating potential overprescribing.

PMID:39623462 | DOI:10.1186/s12961-024-01250-3

BMC Med. 2024 Dec 2;22(1):570. doi: 10.1186/s12916-024-03767-4.

ABSTRACT

BACKGROUND: Understanding the prevalence of diseases and where it is detected and recorded in healthcare settings is important for planning effective prevention and care provision. We examined inequalities in the prevalence of 205 chronic conditions and in the care setting where the related diagnoses were recorded in the English National Health Service.

METHODS: We used data from the Clinical Practice Research Datalink Aurum linked with Hospital Episode Statistics for 12.8 million patients registered with 1406 general practices in 2018. We mapped diagnoses recorded in primary and secondary care in the previous 12 years. We used linear regressions to assess associations of ethnicity, deprivation, and general practice with a diagnosis being recorded in primary care only, secondary care only, or both settings.

RESULTS: 72.65% of patients had at least one diagnosis recorded in any care setting. Most diagnoses were reported only in primary care (62.56%) and a minority only in secondary care (15.24%) or in both settings (22.18%). Black (- 0.08 percentage points (pp)), Asian (- 0.08 pp), mixed (- 0.13 pp), and other ethnicity patients (- 0.31 pp) were less likely than White patients to have a condition recorded. Patients in most deprived areas were 0.27 pp more likely to have a condition recorded (+ 0.07 pp in secondary care only, + 0.10 pp in both primary and secondary care, and + 0.10 pp in primary care only). Differences in prevalence by ethnicity were driven by diagnostic recording in primary care. Higher recording of diagnoses in more deprived areas was consistent across care settings. There were large differences in prevalence and diagnostic recording between general practices after adjusting for patient characteristics.

CONCLUSIONS: Linked primary and secondary care records support the identification of disease prevalence more comprehensively. There are inequalities in the prevalence and setting of diagnostic recording by ethnicity, deprivation, and providers on average across conditions. Further research should examine inequalities for each specific condition and whether they reflect also differences in access or recording as well as disease burden. Improving recording where needed and making national linked records accessible for research are key to understanding and reducing inequalities in disease prevention and management.

PMID:39623457 | DOI:10.1186/s12916-024-03767-4

Eur J Med Res. 2024 Dec 3;29(1):575. doi: 10.1186/s40001-024-02174-y.

ABSTRACT

BACKGROUND: The risks of obesity and epigenetic age acceleration (EAA) have drawn widespread attention. Lipid accumulation product (LAP) is a simple and reliable indicator of obesity; however, the relationship between LAP and EAA remains unclear.

METHODS: Data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2002 were used. The EAA was assessed using a self-administered questionnaire in the database. LAP was calculated based on triglycerides and waist circumference. The association between LAP and EAA was analyzed using logistic regression models, subgroup analysis, and smooth curve fitting.

RESULTS: A total of 1796 participants were included in the study, of whom 1055 had EAA. After adjusting for relevant covariates, participants with EAA generally had higher LAP levels than those without EAA (258.1 vs. 244.6). Logistic regression analysis showed that individuals in the highest LAP quartile (Q4) were more likely to have EAA than those in the lowest quartile (Q1) (OR = 1.77; 95% CI 1.31-2.39; P < 0.001). The area under the curve of the adjusted logistic regression analysis was 0.706.

CONCLUSION: This research indicates that elevated LAP levels are independently linked to an increased risk of EAA, and early intervention to reduce high LAP levels is necessary to mitigate the progression of EAA.

PMID:39623450 | DOI:10.1186/s40001-024-02174-y

BMC Psychol. 2024 Dec 3;12(1):716. doi: 10.1186/s40359-024-02185-8.

ABSTRACT

Frontline medical workers (FMWs) faced high stress levels in frontline clinics during the COVID-19 pandemic. This study aims to alleviate FMWs’ psychological stress by enhancing protection measures, which includes refining the selection process, improving protective measures for their work in frontline clinics, and determining the appropriate time for evacuation. A Chinese-language-version stress questionnaire, covering stress-related issues and sociodemographic characteristics, was administered to FMWs in Shanghai during the COVID-19 pandemic in 2022, yielding 107 valid responses. The questionnaire’s reliability and validity were subsequently confirmed. Exploratory factor analysis (EFA) was applied to the stress-related questions, with the KMO and Bartlett’s test values of 0.886, 877.8522 (df = 120, p < 0.0001), respectively. Structure equation modeling (SEM) was used to confirm the factors and measure the relationships among the stress-related questions, factors and sociodemographic characteristics. The parameters of SEM named SOFAIDC were significant with SRMSR, RMSEA, AGFI, NFI, and PNFI being 0.0422, 0.0507, 0.9946, 0.9958, and 0.7615, respectively. Paired sample t-tests revealed the significant decrease in FMWs’ stress score of the current week and the previous week, with all t-values being negative and significant (p < 0.01). A latent growth model (LGM) named LGM30 verified the overall decreasing stress trend over the weeks, with high R-squares (> 0.80), significant positive linear and negative quadratic time parameters. Based on the trajectory analysis, a stress scorecard with an AUC of 0.856 was developed. This study found that there are four factors for FMWs’ psychological stress (anxiety about infection, exhaustion, lack of cognition for infection, and hesitant feeling), and improving targeted hospital protection could alleviate FMWs’ psychological stress through SOFAIDC, as all the total effect of factors or items from the feeling of being protected by hospital were negative. Meanwhile, although overall FMWs’ stress trend has decreased, 22.43% of FMWs have maintained or experienced a high stress trend, and the stress might increase over weeks in frontline clinics. To perfect hospital protection to alleviate FMWs’ psychological stress, the scorecard could be used to select FMWs with low-stress trends, LGM30 could be used to determine the withdrawal time (such as week 8), and targeted hospital protections could be designed based on the relationships between feeling of being protected by the hospital and factors in SOFAIDC, such as providing adequate protective equipment, improving the rationality of FMWs’ work schedules, recruiting personnel with higher education levels, and paying adequate monetary compensation.

PMID:39623436 | DOI:10.1186/s40359-024-02185-8

Nutr J. 2024 Dec 2;23(1):153. doi: 10.1186/s12937-024-01058-5.

ABSTRACT

AIMS: This study aims to ascertain whether abdominal fat accumulation evaluated by waist circumference increases the risk of hypertension using the nationwide population.

METHODS: We enrolled 47,037 participants from the China Health and Nutrition Survey (CHNS), China Health and Retirement Longitudinal Study (CHARLS), and National Health, and Nutrition Examination Survey (NHANES). The adjusted logistic regression model was used to examine the relationship between waist circumference and prevalent hypertension. 9445 participants without baseline hypertension from the CHNS and CHARLS were followed up to investigate the association between waist circumference and onset hypertension. The association was evaluated using a Cox regression model and restricted cubic spline. Furthermore, Mendelian randomization was employed to explore causal inferences.

RESULTS: In the baseline survey, waist circumference demonstrated a notable correlation with hypertension, presenting an odds ratio (with 95% confidence intervals) of 1.34 (1.28 ~ 1.40). After a mean follow-up of 3.8 years for participants without baseline hypertension, 2,592 (27.5%) developed hypertension. In the pooled analysis, the Cox regression showed that every 10 cm increase in waist circumference was associated with 20% (95% CI: 13% ~ 27%) elevated risk of new-onset hypertension. Restricted cubic splines indicated a pronounced linear dose-response relationship. A subgroup analysis affirmed the persisting association between waist circumference and hypertension onset even in those with normal BMI. The Mendelian randomization method revealed a significant causative association between waist circumference and hypertension.

CONCLUSION: Elevated waist circumference stands as an independent risk factor for hypertension, even in those with normal BMI. Our results provide evidence supporting the routine measure for waist circumference.

PMID:39623430 | DOI:10.1186/s12937-024-01058-5