Tag: pubmed

Sci Rep. 2024 Dec 30;14(1):31563. doi: 10.1038/s41598-024-73147-8.

ABSTRACT

Cardiac implantable electronic devices infections (CIEDI) are associated with poor survival despite the improvement in transvenous lead extraction (TLE). Aetiology and systemic involvement are driving factors of clinical outcomes. The aim of this study was to explore their contribute on overall mortality. A prospective study was performed between 2011 and 2021, including all TLE candidates at our regional referral University hospital for CIEDI with microbiological confirmed aetiology. Considering significant predictors of mortality at multivariate Cox regression analyses, a 5-point BOP₂D score was developed, and it was validated with a prospective cohort from the Padua University. 157 patients were enrolled (mean age 71.3 ± 12.3 years, 81.5% male). S. aureus was isolated in 32.5% of patients, and it was more associated with valvular heart disease, systemic infection, and chronic kidney disease. CIEDI pattern was associated with 1-year mortality, with a significantly worse outcome in patients with “cold closed pocket” (CCP). The developed BOP₂D score presented a 0.807 AUC (95%CI 0.703-0.910, p < 0.001) and a good predictive value (OR 2.355, 95%CI 1.754-3.162; p < 0.001), and was associated with a progressive increase in mortality with a score > 2. The score validation with the registry from the Padua University (135 patients) retrieved a C-statistic of 0.746 (95%CI 0.613-0.879; p = 0.002). Both CCP and S. aureus were confirmed as risk factors for mortality in CIEDI patients. This study supports the hypothesis that the infectious process may occur through different mechanisms associated with different infection patterns, and high-risk patients should be considered for specific and aggressive approaches.

PMID:39738145 | DOI:10.1038/s41598-024-73147-8

Sci Rep. 2024 Dec 30;14(1):31712. doi: 10.1038/s41598-024-81090-x.

ABSTRACT

INTRODUCTION: Insecticide-treated bed nets are often used as a physical barrier to prevent infection of malaria. In Sub-Saharan Africa, one of the most important ways of reducing the malaria burden is the utilization of insecticide-treated bed nets. However, there is no sufficient information on the utilization of insecticide-treated bed nets and their associated factors in Ethiopia.

OBJECTIVES: This study aimed to assess the utilization of insecticide-treated bed nets and associated factors among households in Pawie District, Benshangul Gumuz, North West Ethiopia.

METHODS: A community-based cross-sectional study was conducted in the Pawie district to identify factors influencing the use of insecticide-treated nets (ITNs). Diverse household groups were engaged, and data were collected using a structured questionnaire and observational checklists by trained interviewers. The data were entered into Epi-Data version 3.1 and analyzed using SPSS version 23. Advanced statistical methods, including binary and multi-variable logistic regression, were employed to examine the factors associated with ITN utilization.

RESULTS: From the total of 633 respondents, more than two third, 438 (69.2% with 95% CI: 65.2%, 72.5%) had utilized insecticide-treated bed nets during the early morning of the interview. Approximately 297 respondents (67.8%) successfully hung their insecticide-treated nets (ITNs) properly during the early morning of observation. In this study, 406 respondents (64.1%, 95% CI: 60.5, 68.1) showed a solid understanding of insecticide-treated nets (ITNs) utilization. Key predictors for the utilization of insecticide-treated bed nets (ITNs) included age (AOR = 1.86, 95% CI: 1.11, 3.13, p = 0.019), educational status (AOR = 0.45, 95% CI: 0.26, 0.77, p = 0.008), knowledge level (AOR = 2.64, 95% CI: 1.89, 3.81, p < 0.001), and family size (AOR = 1.89, 95% CI: 1.31, 2.74, p = 0.001). All of these variables were found to be statistically significant for the utilization of insecticide-treated bed net.

CONCLUSIONS: Utilization of the insecticide-treated bed nets (ITNs) remains low in the study area. To address this, it is crucial to raise public awareness and improve utilization of the insecticide-treated bed nets (ITNs) to decrease malaria transmission in the district. Ongoing health education initiatives, including demonstrations on the proper way to hang bed nets, will be essential in fostering better practices and improving community health outcomes.

PMID:39738138 | DOI:10.1038/s41598-024-81090-x

Sci Rep. 2024 Dec 30;14(1):31612. doi: 10.1038/s41598-024-77379-6.

ABSTRACT

To investigate the population distribution characteristics of elderly osteoporosis fracture patients in Hebei Province and analyze the effects of air pollutants on elderly osteoporosis fractures, We retrospectively collected 18,933 cases of elderly osteoporosis fractures from January 1, 2019, to December 31, 2022, from four hospitals in Hebei Province. The average age was 76.44 ± 7.58 years, predominantly female (13,189 patients, 69.66%). The number of hospitalized patients increased progressively from 2019 to 2022. The Distribution Lag Nonlinear Model (DLNM) showed that the cumulative lagged effects of PM2.5 and PM10 on the number of hospitalized elderly osteoporosis fracture patients exhibited a bimodal distribution, with the Relative Risk (RR) reaching its peak at a 1-day lag (PM2.5: RR = 1.032, 95% CI: 1.019, 1.045; PM10: RR = 1.022, 95% CI: 1.014, 1.029). Similarly, the cumulative lagged effect of NO₂ displayed a bimodal pattern, with the RR peaking at a 12-day lag (RR = 1.138, 95% CI: 1.101, 1.187). The single-day lag effect of SO₂ was statistically significant from day 9 to day 12, reaching its maximum at day 11 (RR = 1.054, 95% CI: 1.032, 1.71). PM2.5, PM10, NO₂, and SO₂ increase the risk of osteoporosis fractures in the elderly, including single-day and cumulative lag effects. Further studies are needed to explore the molecular mechanisms behind this relationship.

PMID:39738137 | DOI:10.1038/s41598-024-77379-6

Sci Rep. 2024 Dec 30;14(1):31585. doi: 10.1038/s41598-024-77111-4.

ABSTRACT

BAY 2413555 is a novel selective and reversible positive allosteric modulator of the type 2 muscarinic acetylcholine (M2) receptor, aimed at enhancing parasympathetic signaling and restoring cardiac autonomic balance for the treatment of heart failure (HF). This study tested the safety, tolerability and pharmacokinetics of this novel therapeutic option. REMOTE-HF was a multicenter, double-blind, randomized, placebo-controlled, phase Ib dose-titration study with two active arms. Study participants had an established diagnosis of HF with NYHA Class I-III and LVEF ≤ 45%. Patients were required to have an implanted cardiac defibrillator (ICD) or cardiac resynchronization therapy (CRT) device because of the potential for bradycardia or AV conduction delay, which may be induced by BAY 2413555. The study period included a screening and run-in period, followed by a treatment period of over 28 days, consisting of two parts, A and B, comprising 14 days each. Participants were randomized into 1 of 3 arms: a placebo arm and two BAY 2413555 arms-one receiving 1.25 mg in both Part A and Part B (BAY 1.25 mg-1.25 mg) and the other receiving 1.25 mg in Part A followed by 5 mg in Part B (BAY 1.25 mg-5 mg). The primary safety endpoint was the number of participants with treatment-emergent adverse events (TEAEs). Secondary endpoints included number of participants with high degree AV block or symptomatic pauses/ bradycardia and changes from baseline in resting heart rate after 2 and 4 weeks of dosing with BAY 2413555. Changes from baseline in heart rate recovery (HRR) at 1 and 2 min after exercise testing and chronotropic reserve (CR) were also assessed. Of the anticipated 129 participants, 22 participants were randomized: 7 to placebo, 8 to BAY 1.25 mg-1.25 mg, and 7 to BAY 1.25 mg-5 mg. The study was terminated early based on new and unexpected preclinical findings from a chronic animal toxicology study in monkeys in which evidence of increased vascular inflammation was observed, leading to a no longer favorable risk-benefit balance for the intended long-term (i.e., life-long) treatment of heart failure patients. Comparable adverse events were not encountered in REMOTE-HF. Overall, until the termination of the study, BAY 2413555 was safe and well tolerated, with no deaths or TEAEs leading to discontinuation, and no symptomatic bradycardia or AV blocks observed. There was a larger change in the mean HRR at 60 s in the pooled BAY 2413555 treatment arms in Part A (1.25 mg) compared to the placebo (+ 7.3 vs. -6.7 bpm), indicating enhanced cardiac parasympathetic activity. Administration of 1.25 mg and 5 mg BAY 2413555 was safe and well tolerated in both active treatment arms, with no concerning safety findings observed. However, due to the limited number of subjects resulting from early termination, the results should be considered with caution and viewed as exploratory. There were promising signs of target engagement, providing grounds for further exploration of the mechanism.

PMID:39738130 | DOI:10.1038/s41598-024-77111-4

Nat Commun. 2024 Dec 30;15(1):10849. doi: 10.1038/s41467-024-55146-5.

ABSTRACT

Recently, RNA velocity has driven a paradigmatic change in single-cell RNA sequencing (scRNA-seq) studies, allowing the reconstruction and prediction of directed trajectories in cell differentiation and state transitions. Most existing methods of dynamic modeling use ordinary differential equations (ODE) for individual genes without applying multivariate approaches. However, this modeling strategy inadequately captures the intrinsically stochastic nature of transcriptional dynamics governed by a cell-specific latent time across multiple genes, potentially leading to erroneous results. Here, we present SDEvelo, a generative approach to inferring RNA velocity by modeling the dynamics of unspliced and spliced RNAs via multivariate stochastic differential equations (SDE). Uniquely, SDEvelo explicitly models inherent uncertainty in transcriptional dynamics while estimating a cell-specific latent time across genes. Using both simulated and four scRNA-seq and spatial transcriptomics datasets, we show that SDEvelo can model the random dynamic patterns of mature-state cells while accurately detecting carcinogenesis. Additionally, the estimated gene-shared latent time can facilitate many downstream analyses for biological discovery. We demonstrate that SDEvelo is computationally scalable and applicable to both scRNA-seq and sequencing-based spatial transcriptomics data.

PMID:39738101 | DOI:10.1038/s41467-024-55146-5

Sci Rep. 2024 Dec 30;14(1):31617. doi: 10.1038/s41598-024-80218-3.

ABSTRACT

In this article, a nonlinear fractional bi-susceptible [Formula: see text] model is developed to mathematically study the deadly Coronavirus disease (Covid-19), employing the Atangana-Baleanu derivative in Caputo sense (ABC). A more profound comprehension of the system’s intricate dynamics using fractional-order derivative is explored as the primary focus of constructing this model. The fundamental properties such as positivity and boundedness, of an epidemic model have been proven, ensuring that the model accurately reflects the realistic behavior of disease spread within a population. The asymptotic stabilities of the dynamical system at its two main equilibrium states are determined by the essential conditions imposed on the threshold parameter. The analytical results acquired are validated and the significance of the ABC fractional derivative is highlighted by employing a recently proposed Toufik-Atangana numerical technique. A quantitative analysis of the model is conducted by adjusting vaccination and hospitalization rates using constant control techniques. It is suggested by numerical experiments that the Covid-19 pandemic elimination can be expedited by adopting both control measures with appropriate awareness. The model parameters with the highest sensitivity are identified by performing a sensitivity analysis. An optimal control problem is formulated, accompanied by the corresponding Pontryagin-type optimality conditions, aiming to ascertain the most efficient time-dependent controls for susceptible and infected individuals. The effectiveness and efficiency of optimally designed control strategies are showcased through numerical simulations conducted before and after the optimization process. These simulations illustrate the effectiveness of these control strategies in mitigating both financial expenses and infection rates. The novelty of the current study is attributed to the application of the structure-preserving Toufik-Atangana numerical scheme, utilized in a backward-in-time manner, to comprehensively analyze the optimally designed model. Overall, the study’s merit is found in its comprehensive approach to modeling, analysis, and control of the Covid-19 pandemic, incorporating advanced mathematical techniques and practical implications for disease management.

PMID:39738098 | DOI:10.1038/s41598-024-80218-3

World J Surg Oncol. 2024 Dec 30;22(1):353. doi: 10.1186/s12957-024-03647-4.

ABSTRACT

AIM: The aim of this study was to introduce the Esophagus-Sparing Anastomotic Narrowing Revision (ESANR) technique for the intraoperative management of anastomotic narrowing and to conduct a literature review to provide an algorithm for the management of narrowing and strictures that may develop secondary to esophagojejunostomy.

METHODS: Three patients with anastomotic narrowing during esophagojejunostomy were analyzed between September 2019 and June 2024. The anastomotic narrowing was detected by intraoperative gastroscopy after reconstruction. The ESANR technique was performed for the management of anastomotic narrowing. We conducted a systematic search of PubMed, Embase, and Web of Science databases for studies published up to June 2024 related to the treatment of anastomotic stricture. Data on the number of patients, sex, age, type of anastomosis, treatment, and outcomes were collected.

RESULTS: The ESANR technique proved effective for the management of anastomotic narrowing in patients who underwent esophagojejunostomy during gastric cancer surgery. No anastomotic stricture or leakage was found following ESANR, and all three patients recovered without complications. 12 studies with a total of 174 patients were analyzed. The management of anastomotic stricture, which included Balloon Dilation (BD), Endoscopic Incision Therapy (EIT), stent placement, Endoscopic combination therapy (Needle-Knife stricturotomy NKS, Balloon Dilation with Triamcinolone Injection TAC), and re-do laparoscopic esophagojejunostomy.

CONCLUSIONS: In conclusion, the ESANR technique demonstrates potential advantages in addressing anastomotic narrowing in esophagojejunostomy. However, further clinical data and analyses are necessary to verify its effectiveness and establish robust statistical support.

PMID:39736755 | DOI:10.1186/s12957-024-03647-4

BMC Vet Res. 2024 Dec 31;20(1):590. doi: 10.1186/s12917-024-04432-x.

ABSTRACT

BACKGROUND: In developing countries such as Uganda, domestic dogs suffer high burdens of infectious diseases often with high mortalities. Surveillance data on the common diseases and associated mortalities is however scanty. We thus, present results of a retrospective study of common clinical conditions and mortalities of dogs brought for treatment at the small animal clinic, Makerere University, Kampala, Uganda.

METHODS: We analysed data from the case records register of the clinic from January 2021-December, 2022. Descriptive statistics were generated using the frequency functions of R (R-4.3.3 for Windows^®). Records were reviewed for all 650 cases presented at the clinic except those presented for routine care services like vaccination and grooming.

RESULTS: Up to 51% of the dogs were female, mostly (56%) under two years old. The Alsatian (30.7%) and mongrel (22.7%) were the commonest breeds. Cases were recorded as: elective surgeries (29.2%), parvovirus infection (13.9%), skin infections (09.7%), canine babesiosis (6.9%), fractures (6.0%) and neoplasms (6%); mainly transmissible venereal tumour (TVT). Some (3.4%) dogs developed post-operative complications, while 4.8% were euthanized and 12% died during treatment. Of the dogs that died, 50% were parvovirus infection cases while other conditions included babesiosis (13%), poisoning (7.8%), pyometra (7.8%) and liver dysfunction (5.1%).

CONCLUSION: We impute that parvovirus infection and other preventable diseases were the most frequent reasons for morbidity and mortality of especially puppies in Uganda. This points to the need for epidemiologic surveillance of dog diseases and community sensitisation for improved control of dog diseases.

PMID:39736747 | DOI:10.1186/s12917-024-04432-x

J Eat Disord. 2024 Dec 30;12(1):216. doi: 10.1186/s40337-024-01174-x.

ABSTRACT

BACKGROUND: Training gaps regarding the diagnosis and management of eating disorders in diverse populations, including racial, ethnic, sexual, and gender minoritized groups, have not been thoroughly examined.

OBJECTIVE: This study aimed to examine resident physicians’ knowledge and attitudes regarding eating disorders in diverse populations, with a focus on areas for improved training and intervention.

METHODS: Ninety-two resident physicians in internal medicine, emergency medicine, obstetrics/gynecology, psychiatry, and surgery at an academic center completed an online survey from 12/1/2020-3/1/2021, which comprised multiple choice and vignette-style open-ended questions to assess knowledge and attitudes toward the management and clinical presentations of eating disorders. Overall, the survey response rate was 25.7%. Descriptive statistics were reported. Vignette-style questions were analyzed using inductive coding and the frequency of responses was reported.

RESULTS: A minority of resident physicians self-reported confidence in their knowledge of the medical complications (n = 42, 45%), risk factors (n = 38, 41%), and clinical presentations (n = 32, 35%) associated with eating disorders. Responses to vignette-style questions correctly identified relevant management methods (such as electrolyte monitoring and referral to specialty care), but demonstrated limited knowledge of the clinical presentation of eating disorders. Furthermore, most respondents reported a lack of knowledge regarding eating disorders in sexual and gender minoritized patients (n = 68, 73.9%) as well as racial and ethnic minoritized patients (n = 64, 69.6%).

CONCLUSIONS: Our findings suggest concerning gaps in knowledge and confidence among resident physicians with regard to the diagnosis and treatment of eating disorders, particularly in racial, ethnic, sexual, and gender minoritized patients. Moreover, responses to vignette-like questions indicate significant homogeneity in respondents’ perceptions of the clinical presentation of eating disorders, reflecting cultural biases which associate eating disorders with underweight, young, female patients. The majority did not feel competent in treating eating disorders in diverse populations and expressed desire for additional training in this area. More research is needed to better understand and address these gaps in eating disorder training, with the goal of increasing equity in patient outcomes.

PMID:39736744 | DOI:10.1186/s40337-024-01174-x

BMC Health Serv Res. 2024 Dec 31;24(1):1665. doi: 10.1186/s12913-024-12184-5.

ABSTRACT

BACKGROUND: The demand for quality healthcare is rising worldwide, and nurses in South Africa are under pressure to provide care with limited resources. This demanding work environment leads to burnout and exhaustion among nurses. Understanding the specific factors leading to these issues is critical for adequately supporting nurses and informing policymakers. Currently, little is known about the unique factors associated with burnout and emotional exhaustion among nurses in South Africa. Furthermore, whether these factors can be predicted using demographic data alone is unclear. Machine learning has recently been proven to solve complex problems and accurately predict outcomes in medical settings. In this study, supervised machine learning models were developed to identify the factors that most strongly predict nurses reporting feelings of burnout and experiencing emotional exhaustion.

METHODS: The PyCaret 3.3 package was used to develop classification machine learning models on 1165 collected survey responses from nurses across South Africa in medical-surgical units. The models were evaluated on their accuracy score, Area Under the Curve (AUC) score and confusion matrix performance. Additionally, the accuracy score of models using demographic data alone was compared to the full survey data models. The features with the highest predictive power were extracted from both the full survey data and demographic data models for comparison. Descriptive statistical analysis was used to analyse survey data according to the highest predictive factors.

RESULTS: The gradient booster classifier (GBC) model had the highest accuracy score for predicting both self-reported feelings of burnout (75.8%) and emotional exhaustion (76.8%) from full survey data. For demographic data alone, the accuracy score was 60.4% and 68.5%, respectively, for predicting self-reported feelings of burnout and emotional exhaustion. Fatigue was the factor with the highest predictive power for self-reported feelings of burnout and emotional exhaustion. Nursing staff’s confidence in management was the second highest predictor for feelings of burnout whereas management who listens to employees was the second highest predictor for emotional exhaustion.

CONCLUSIONS: Supervised machine learning models can accurately predict self-reported feelings of burnout or emotional exhaustion among nurses in South Africa from full survey data but not from demographic data alone. The models identified fatigue rating, confidence in management and management who listens to employees as the most important factors to address to prevent these issues among nurses in South Africa.

PMID:39736726 | DOI:10.1186/s12913-024-12184-5