Tag: pubmed

J Saudi Heart Assoc. 2024 Nov 15;36(4):316-334. doi: 10.37616/2212-5043.1399. eCollection 2024.

ABSTRACT

OBJECTIVES: Mitral valve surgery is the reference treatment for severe symptomatic mitral regurgitation (MR). Percutaneous mitral valve interventions, such as the MitraClip procedure, offer an alternative, particularly for high-risk patients. The aim of this systematic review and meta-analysis was to analyze the safety and effectiveness of transcatheter mitral valve repair (TMVR) compared to surgical mitral valve repair or replacement (SMVR) in elderly patients with mitral regurgitation.

METHODS: We searched PubMed, Scopus, Ovid, EBSCO, and ProQuest through July 2024. Eligible studies were randomized controlled trials and observational comparative studies of TMVR versus SMVR for patients with MR, reporting outcomes such as all-cause mortality, MR recurrence, stroke, myocardial infarction, and length of stay (LOS). Statistical analyses were performed using RevMan.

RESULTS: Our search identified 3166 records, with 2756 screened and 21 studies included after review. The studies, comprising 20 retrospective cohorts and 1 randomized controlled trial with 20,900 patients, compared TMVR to SMVR. TMVR patients were significantly older than SMVR patients (MD 3.44 years; P < 0.00001). Mortality rates were similar at 30 days (relative risk (RR) 1.08; P = 0.79) and one year (RR 1.27; P = 0.18), but SMVR showed lower mortality at three years (RR 1.82; P = 0.006). SMVR also significantly reduced MR ≥ 3+ recurrence at 30 days (RR 6.95; P < 0.00001), one year (RR 3.31; P = 0.0001), and three years (RR 4.37; P < 0.00001). TMVR was associated with higher myocardial infarction rates (RR 1.58; P = 0.02) but reduced LOS (MD -4.88 days; P < 0.00001). Sensitivity analysis showed consistent results for recurrence of MR ≥ 3+ and variable outcomes for other metrics. Evidence of publication bias was noted for mortality at 30 days and LOS.

CONCLUSION: While TMVR with the MitraClip offers shorter hospital stays and is less invasive, SMVR provides better long-term survival and lower MR recurrence rates, emphasizing the need for a tailored approach based on patient risk profiles.

PMID:39606773 | PMC:PMC11590862 | DOI:10.37616/2212-5043.1399

Rev Bras Med Trab. 2024 Nov 14;22(3):e20231180. doi: 10.47626/1679-4435-2023-1180. eCollection 2024 Jul-Sep.

ABSTRACT

INTRODUCTION: The military police officer is exposed to several risk factors that could lead to physical and psychiatric disorders. However, there is a paucity of scientific literature on the health of special operations police officers.

OBJECTIVES: To identify the main causes and associated factors of forensic medical examinations among members of a Battalion of Special Police Operations.

METHODS: This cross-sectional study analyzed data from 210 forensic medical examinations performed between January 2019 and June 2021. The dependent variable was the reason for the appointment, and the independent variables were gender, age, military rank, and length of career. Bivariate analyses were performed using the chi-squared test or Fisher’s exact test.

RESULTS: Most police officers were men (98.1%), military (41.8%), with a mean age of 36.6 years and a mean length of service of 12.9 years. The most common reason for an examination was to obtain a physical fitness report (44.3%), followed by routine examination of healthy police officers (17.6%) and trauma (14.3%). There were no statistically significant associations between the independent variables and trauma appointments. However, there was a statistical association between appointments for physical fitness reports and being under 35 years of age.

CONCLUSIONS: Most common reasons for forensic medical examinations were physical fitness reports, routine examinations, and trauma. Examinations for physical fitness reports were statistically associated with younger age.

PMID:39606772 | PMC:PMC11595399 | DOI:10.47626/1679-4435-2023-1180

Rev Bras Med Trab. 2024 Nov 14;22(3):e20231131. doi: 10.47626/1679-4435-2023-1131. eCollection 2024 Jul-Sep.

ABSTRACT

INTRODUCTION: The demands and conditions of work can lead to development of a range of health conditions, including repetitive stress injuries and work-related musculoskeletal disorders.

OBJECTIVES: To assess the prevalence of musculoskeletal symptoms and the working conditions of primary school teachers working for the public municipal education system in Cuiabá, Mato Grosso, Brazil.

METHODS: A cross-sectional study was conducted with teachers working for the public municipal education system in the capital of Mato Grosso state. The sample comprised 326 teachers. Data were collected using the Vocal Production Condition – Teacher instrument and the Nordic Musculoskeletal Questionnaire.

RESULTS: The mean age of the sample was 43.01 years and teachers were predominantly female (87.12%), were married or in a stable relationship (62.70%), had postgraduate qualifications (73.93%), worked at one school only (58.95%), and stated that the pace of their working routine was sometimes stressful (59.01%), that they always took work home with them (57.45%), and that there was sometimes stress at work (54.92%), and reported presence of musculoskeletal symptoms during the last 12 months (76.74%).

CONCLUSIONS: The highest prevalence rates of musculoskeletal symptoms were observed among married women, those with postgraduate qualifications, those who worked at one school only, and those who had a stressful working routine. It was therefore concluded that mapping working conditions could provide a foundation for reducing the occurrence of musculoskeletal symptoms and improving the health of this population.

PMID:39606762 | PMC:PMC11595378 | DOI:10.47626/1679-4435-2023-1131

Rev Bras Med Trab. 2024 Nov 14;22(3):e20231215. doi: 10.47626/1679-4435-2023-1215. eCollection 2024 Jul-Sep.

ABSTRACT

INTRODUCTION: More than 500,000 work accidents were registered each year in Brazil from 2016 to 2018, representing more than BRL 300 million in expenditures.

OBJECTIVES: To analyze the prevalence of work accidents in Brazil between 2016 and 2020 according to geographic region, age group, and sex and analyze the prevalence according to the cause and economic activity type.

METHODS: Descriptive, cross-sectional study based on data from the Social Security Statistics Yearbook.

RESULTS: The work accident rate between 2016 and 2019 was lower than in previous years. The Southern and Southeastern regions had the highest prevalence of work accidents (11.7/1,000 workers and 9.10/1,000 workers, respectively), while the Northeastern region had the lowest rate (6.22/1,000 workers). There was a greater reduction in work accidents among men than women. The most prevalent types of work accidents involved injuries, poisoning, and other external causes, in addition to diseases of the musculoskeletal system and connective tissue.

CONCLUSIONS: Record keeping about work accidents must be improved, given that informal workers are not considered in social security data. More accurate data can also help increase prevention efforts, and can lead to more effective occupational health and safety policies to further reduce the work accident rate.

PMID:39606761 | PMC:PMC11595383 | DOI:10.47626/1679-4435-2023-1215

Rev Bras Med Trab. 2024 Nov 14;22(3):e20241227. doi: 10.47626/1679-4435-2024-1227. eCollection 2024 Jul-Sep.

ABSTRACT

INTRODUCTION: Healthcare workers in both the public and private systems were on the front line of the fight against the COVID-19 pandemic. As a consequence, they faced uncertainty, heavy demand, excessive working hours, and the fear of contracting the virus.

OBJECTIVES: To investigate the occurrence of psychological distress among public and private healthcare workers at the start of the COVID-19 pandemic.

METHODS: An observational, quantitative study was conducted from April to June of 2020, enrolling workers who had cared for suspected and confirmed cases of covid-19 in Brazil. Psychological distress was assessed using the Self-Reporting Questionnaire-20. Associations between the outcome and independent variables were analyzed using the chi-square test.

RESULTS: Majorities of the 400 healthcare workers studied were nursing professionals (69.8%), worked in the Southeast region of Brazil (69.5%), were affiliated to a public healthcare institution (71.8%), and had a mean working week of 45.81 hours. The rate of psychological distress in the sample was 56.8%. There was no statistically significant association between the outcome and the type of organization (public/private). There were associations between psychological distress and professional category and between psychological distress and prior comorbidities.

CONCLUSIONS: There was evidence of impact on mental wellbeing irrespective of care level or setting. Psychological distress was one of the greatest challenges faced by the healthcare workers during the pandemic, irrespective of the type of institution, and was a phenomenon of relevance to occupational health in general during the pandemic.

PMID:39606756 | PMC:PMC11595382 | DOI:10.47626/1679-4435-2024-1227

Rev Bras Med Trab. 2024 Nov 14;22(3):e20241175. doi: 10.47626/1679-4435-2024-1175. eCollection 2024 Jul-Sep.

ABSTRACT

INTRODUCTION: Burnout syndrome is a condition resulting from chronic exposure to interpersonal stressors in the workplace. Faculty in the health field are particularly susceptible to burnout syndrome due to frequent emotional stress.

OBJECTIVES: To identify an association between the dimensions of burnout syndrome and the coping strategies these faculty have adopted.

METHODS: An observational, analytical and cross-sectional study was conducted in 2021 with 164 faculty from a public university. The Maslach Burnout Inventory and the Brief-Coping Orientation to Problems Experienced were used. The analysis included descriptive statistics and Spearman correlation, using SPSS 16.0.

RESULTS: Emotional exhaustion was high for 54.88% of the sample. Depersonalization scored high for 97.57% of the participants, whereas personal accomplishment was high for 100%. These results are no indication of burnout syndrome, which requires high scores for emotional exhaustion and depersonalization and low scores for personal accomplishment. Active coping, planning, and positive reframing were the most used strategies, which are aimed at solving problems and are considered protective against this condition. Denial, behavioral disengagement, and substance use, which are focused on avoidance and emotion, with potentially negative effects, were the least used. The correlations between the dimensions of burnout syndrome and the coping factors were weak or very weak.

CONCLUSIONS: Although burnout syndrome was not identified, the sample was at a high risk of becoming ill due to emotional exhaustion. The correlations between the dimensions of burnout syndrome and the coping factors were weak.

PMID:39606754 | PMC:PMC11595380 | DOI:10.47626/1679-4435-2024-1175

Ann Oper Res. 2024;342(3):1819-1835. doi: 10.1007/s10479-023-05491-3. Epub 2023 Jul 10.

ABSTRACT

Every day, hundreds of mosquito surveys are carried out around the world to inform policy and management decisions on how best to reduce or prevent the burden of mosquito-borne disease or mosquito nuisance. These surveys are usually time consuming and expensive. Mosquito surveillance is the essential component of vector management and control. However, surveillance is often carried out with a limited if not without a quantitative assessment of the sampling effort which can results in underpowered or overpowered studies, or certainly in overpowered studies when power analyses are carried out assuming independence in the measurements obtained from longitudinal and geographically proximal mosquito surveys. Many free, open-source and user-friendly tools to calculate statistical power are available, such as G*Power, glimmpse, powerandsamplesize.com website or R-cran packages (pwr and WebPower to name few of them). However, these tools may not be sufficient for powering mosquito surveys due to the additional properties of seasonal and spatially clustered repeated measurements required to reflect mosquito population dynamics. To facilitate power analysis for mosquito surveillance, we have developed TIMESS, a deployable browser-based Shiny app that estimates the number of repeated measurements and locations of mosquito surveys for a given effect size, power, significance level, seasonality and level of expected between-location clustering. In this article we describe TIMESS, its usage, strengths and limitations.

PMID:39606738 | PMC:PMC11588820 | DOI:10.1007/s10479-023-05491-3

ArXiv [Preprint]. 2024 Nov 19:arXiv:2411.12853v1.

ABSTRACT

Protein structures represent the key to deciphering biological functions. The more detailed form of similarity among these proteins is sometimes overlooked by the conventional structural comparison methods. In contrast, further advanced methods, such as Triangular Spatial Relationship (TSR), have been demonstrated to make finer differentiations. Still, the classical implementation of TSR does not provide for the integration of secondary structure information, which is important for a more detailed understanding of the folding pattern of a protein. To overcome these limitations, we developed the SSE-TSR approach. The proposed method integrates secondary structure elements (SSEs) into TSR-based protein representations. This allows an enriched representation of protein structures by considering 18 different combinations of helix, strand, and coil arrangements. Our results show that using SSEs improves the accuracy and reliability of protein classification to varying degrees. We worked with two large protein datasets of 9.2K and 7.8K samples, respectively. We applied the SSE-TSR approach and used a neural network model for classification. Interestingly, introducing SSEs improved performance statistics for Dataset 1, with accuracy moving from 96.0% to 98.3%. For Dataset 2, where the performance statistics were already good, further small improvements were found with the introduction of SSE, giving an accuracy of 99.5% compared to 99.4%. These results show that SSE integration can dramatically improve TSR key discrimination, with significant benefits in datasets with low initial accuracies and only incremental gains in those with high baseline performance. Thus, SSE-TSR is a powerful bioinformatics tool that improves protein classification and understanding of protein function and interaction.

PMID:39606719 | PMC:PMC11601798

Proc IEEE Comput Soc Conf Comput Vis Pattern Recognit. 2024 Jun;2024:11226-11237. doi: 10.1109/cvpr52733.2024.01067. Epub 2024 Sep 16.

ABSTRACT

Introducing interpretability and reasoning into Multiple Instance Learning (MIL) methods for Whole Slide Image (WSI) analysis is challenging, given the complexity of gigapixel slides. Traditionally, MIL interpretability is limited to identifying salient regions deemed pertinent for downstream tasks, offering little insight to the end-user (pathologist) regarding the rationale behind these selections. To address this, we propose Self-Interpretable MIL (SI-MIL), a method intrinsically designed for interpretability from the very outset. SI-MIL employs a deep MIL framework to guide an interpretable branch grounded on handcrafted pathological features, facilitating linear predictions. Beyond identifying salient regions, SI-MIL uniquely provides feature-level interpretations rooted in pathological insights for WSIs. Notably, SI-MIL, with its linear prediction constraints, challenges the prevalent myth of an inevitable trade-off between model interpretability and performance, demonstrating competitive results compared to state-of-the-art methods on WSI-level prediction tasks across three cancer types. In addition, we thoroughly benchmark the local-and global-interpretability of SI-MIL in terms of statistical analysis, a domain expert study, and desiderata of interpretability, namely, user-friendliness and faithfulness.

PMID:39606709 | PMC:PMC11601081 | DOI:10.1109/cvpr52733.2024.01067

Front Neurol. 2024 Nov 13;15:1479245. doi: 10.3389/fneur.2024.1479245. eCollection 2024.

ABSTRACT

BACKGROUND: According to recent research, there is a considerable correlation between the severity of coronary artery disease and the platelet-to-high-density lipoprotein cholesterol ratio (PHR), which suggests that PHR is a potentially valuable inflammatory biomarker. However, the body of current research offers insufficiently strong evidence to clarify the connection between PHR and the incidence of stroke. Therefore, this study aims to elucidate any potential associations between PHR and stroke risk.

METHODS: This study employed data from the China Health and Retirement Longitudinal Study (CHARLS) covering the period from 2011 to 2018. It included 5,872 participants who did not have a history of stroke in 2011. These patients were separated into four groups according to their baseline PHR quartiles. The main goal of the study was to focus on stroke outcomes. Stroke was defined as an occurrence of a cerebrovascular accident confirmed by a physician. We employed Cox proportional hazards regression models to investigate the association between PHR and the likelihood of experiencing a stroke. Furthermore, we conducted restricted cubic spline regression analysis and subgroup analysis.

RESULTS: The average follow-up period was 77.5 months, during which 390 participants experienced a stroke. In comparison to the lowest quartile group, participants in the highest quartile of PHR had a 49% increased risk of stroke (HR 1.49, 95% CI 1.13-1.96, p = 0.004). The adjusted multivariable Cox regression analysis maintained the statistical significance of this association (aHR 1.42, 95% CI 1.06-1.90, p = 0.019). After adjustment, a positive linear relationship between stroke risk and PHR was identified through restricted cubic spline regression analysis (nonlinear p > 0.05). Additionally, the impact of stroke was consistent across a variety of subgroups, as evidenced by subgroup analysis.

CONCLUSION: Our study indicates that higher PHR levels are significantly associated with an increased risk of stroke and that these levels can be used to identify groups that are at high risk of stroke.

PMID:39606701 | PMC:PMC11599229 | DOI:10.3389/fneur.2024.1479245