Tag: pubmed

Nurs Ethics. 2024 Aug 12:9697330241268901. doi: 10.1177/09697330241268901. Online ahead of print.

ABSTRACT

BACKGROUND: Belonging to the clinical environment and the professional values of the performers play a role in forming a professional identity. Therefore, it is necessary to understand the degree of connection among these concepts.

AIM: This study aimed to examine the mediating effects of professional values on the relationship between nurses’ clinical environment belongingness and professional identity.

DESIGN: In the present study, a descriptive cross-sectional multicenter design was used.

PARTICIPANTS AND RESEARCH CONTEXT: A convenient sample of 635 nurses recruited from three hospitals in Fars Province, Southern Iran, from September 2023 to January 2024. Nurses Professional Values Scale-Revised, Clinical Environment Belongingness Scale, and Professional Identity Scale were used to collect the data. The mediation model was analyzed using SPSS v27 and the Process Macro 4.0.

ETHICAL CONSIDERATIONS: The protocol of this study was approved by the Research Ethics Committee of Fasa University of Medical Sciences, and informed consent was obtained from all nurses. The study conforms to the principles outlined in the Declaration of Helsinki.

RESULTS: Based on the results of regression analysis, clinical environment belongingness had a positive and significant impact on professional identity (β = 0.366, p < 0.001) and professional value (β = 0.676, p < 0.001). Professional value significantly predicted professional identity (β = 0.170, p < 0.001). The indirect effect of clinical environment belongingness on professional identity via professional values was statistically significant (β = 0.115, SE = 0.024, 95% CI = [0.068, 0.162]), and this effect was directly (β = 0.336, SE = 0.034, 95% CI = [0.297, 0.434]) significant.

CONCLUSIONS: The new theoretical framework for nurses developed in this study can contribute to professional development. It is further recommended that the promotion of professional value and clinical environment belongingness may be effective in enhancing the professional identity of the nursing staff, as indicated by the results.

PMID:39133934 | DOI:10.1177/09697330241268901

J Med Internet Res. 2024 Aug 12;26:e50275. doi: 10.2196/50275.

ABSTRACT

BACKGROUND: Ecological momentary assessment (EMA) is a measurement methodology that involves the repeated collection of real-time data on participants’ behavior and experience in their natural environment. While EMA allows researchers to gain valuable insights into dynamic behavioral processes, the need for frequent self-reporting can be burdensome and disruptive. Compliance with EMA protocols is important for accurate, unbiased sampling; yet, there is no “gold standard” for EMA study design to promote compliance.

OBJECTIVE: The purpose of this study was to use a factorial design to identify optimal study design factors, or combinations of factors, for achieving the highest completion rates for smartphone-based EMAs.

METHODS: Participants recruited from across the United States were randomized to 1 of 2 levels on each of 5 design factors in a 2×2×2×2×2 design (32 conditions): factor 1-number of questions per EMA survey (15 vs 25); factor 2-number of EMAs per day (2 vs 4); factor 3-EMA prompting schedule (random vs fixed times); factor 4-payment type (US $1 paid per EMA vs payment based on the percentage of EMAs completed); and factor 5-EMA response scale type (ie, slider-type response scale vs Likert-type response scale; this is the only within-person factor; each participant was randomized to complete slider- or Likert-type questions for the first 14 days or second 14 days of the study period). All participants were asked to complete prompted EMAs for 28 days. The effect of each factor on EMA completion was examined, as well as the effects of factor interactions on EMA completion. Finally, relations between demographic and socioenvironmental factors and EMA completion were examined.

RESULTS: Participants (N=411) were aged 48.4 (SD 12.1) years; 75.7% (311/411) were female, 72.5% (298/411) were White, 18.0% (74/411) were Black or African American, 2.7% (11/411) were Asian, 1.5% (6/411) were American Indian or Alaska Native, 5.4% (22/411) belonged to more than one race, and 9.6% (38/396) were Hispanic/Latino. On average, participants completed 83.8% (28,948/34,552) of scheduled EMAs, and 96.6% (397/411) of participants completed the follow-up survey. Results indicated that there were no significant main effects of the design factors on compliance and no significant interactions. Analyses also indicated that older adults, those without a history of substance use problems, and those without current depression tended to complete more EMAs than their counterparts. No other demographic or socioenvironmental factors were related to EMA completion rates. Finally, the app was well liked (ie, system usability scale score=82.7), and there was a statistically significant positive association between liking the app and EMA compliance.

CONCLUSIONS: Study results have broad implications for developing best practices guidelines for future studies that use EMA methodologies.

TRIAL REGISTRATION: ClinicalTrials.gov number NCT05194228; https://clinicaltrials.gov/study/NCT05194228.

PMID:39133915 | DOI:10.2196/50275

JMIR Form Res. 2024 Aug 12;8:e55339. doi: 10.2196/55339.

ABSTRACT

BACKGROUND: Cross-neurotype differences in social communication patterns contribute to high unemployment rates among adults with autism. Adults with autism can be unsuccessful in job searches or terminated from employment due to mismatches between their social attention behaviors and society’s expectations on workplace communication.

OBJECTIVE: We propose a behavioral intervention concerning distribution of attention in triadic (three-way) conversations. Specifically, the objective is to determine whether providing personalized feedback to each individual with autism based on an analysis of their attention distribution behavior during an initial conversation session would cause them to modify their orientation behavior in a subsequent conversation session.

METHODS: Our system uses an unobtrusive head orientation estimation model to track the focus of attention of each individual. Head orientation sequences from a conversation session are analyzed based on five statistical domains (eg, maximum exclusion duration and average contact duration) representing different types of attention distribution behavior. An intervention is provided to a participant if they exceeded the nonautistic average for that behavior by at least 2 SDs. The intervention uses data analysis and video modeling along with a constructive discussion about the targeted behaviors. Twenty-four individuals with autism with no intellectual disabilities participated in the study. The participants were divided into test and control groups of 12 participants each.

RESULTS: Based on their attention distribution behavior in the initial conversation session, 11 of the 12 participants in the test group received an intervention in at least one domain. Of the 11 participants who received the intervention, 10 showed improvement in at least one domain on which they received feedback. Independent t tests for larger test groups (df>15) confirmed that the group improvements are statistically significant compared with the corresponding controls (P<.05). Crawford-Howell t tests confirmed that 78% of the interventions resulted in significant improvements when compared individually against corresponding controls (P<.05). Additional t tests comparing the first conversation sessions of the test and control groups and comparing the first and second conversation sessions of the control group resulted in nonsignificant differences, pointing to the intervention being the main effect behind the behavioral changes displayed by the test group, as opposed to confounding effects or group differences.

CONCLUSIONS: Our proposed behavioral intervention offers a useful framework for practicing social attention behavior in multiparty conversations that are common in social and professional settings.

PMID:39133914 | DOI:10.2196/55339

Interact J Med Res. 2024 Aug 12;13:e58635. doi: 10.2196/58635.

ABSTRACT

BACKGROUND: Previous research and safety advocacy groups have proposed various behaviors for older adults to actively engage in medication safety. However, little is known about how older adults perceive the importance and reasonableness of these behaviors in ambulatory settings.

OBJECTIVE: This study aimed to assess older adults’ perceptions of the importance and reasonableness of 8 medication safety behaviors in ambulatory settings and compare their responses with those of younger adults.

METHODS: We conducted a survey of 1222 adults in the United States using crowdsourcing to evaluate patient behaviors that may enhance medication safety in community settings. A total of 8 safety behaviors were identified based on the literature, such as bringing medications to office visits, confirming medications at home, managing medication refills, using patient portals, organizing medications, checking medications, getting help, and knowing medications. Respondents were asked about their perception of the importance and reasonableness of these behaviors on a 5-point Likert rating scale in the context of collaboration with primary care providers. We assessed the relative ranking of behaviors in terms of importance and reasonableness and examined the association between these dimensions across age groups using statistical tests.

RESULTS: Of 1222 adult participants, 125 (10.2%) were aged 65 years or older. Most participants were White, college-educated, and had chronic conditions. Older adults rated all 8 behaviors significantly higher in both importance and reasonableness than did younger adults (P<.001 for combined behaviors). Confirming medications ranked highest in importance (mean score=3.78) for both age groups while knowing medications ranked highest in reasonableness (mean score=3.68). Using patient portals was ranked lowest in importance (mean score=3.53) and reasonableness (mean score=3.49). There was a significant correlation between the perceived importance and reasonableness of the identified behaviors, with coefficients ranging from 0.436 to 0.543 (all P<.001).

CONCLUSIONS: Older adults perceived the identified safety behaviors as more important and reasonable than younger adults. However, both age groups considered a behavior highly recommended by professionals as the least important and reasonable. Patient engagement strategies, common and specific to age groups, should be considered to improve medication safety in ambulatory settings.

PMID:39133905 | DOI:10.2196/58635

J Bras Nefrol. 2024 Oct-Dec;46(4):e20230135. doi: 10.1590/2175-8239-JBN-2023-0135en.

ABSTRACT

INTRODUCTION: Chronic kidney disease (CKD) and metabolic syndrome (MS) are recognized as public health problems which are related to overweight and cardiometabolic factors. The aim of this study was to develop a model to predict MS in people with CKD.

METHODS: This was a prospective cross-sectional study of patients from a reference center in São Luís, MA, Brazil. The sample included adult volunteers classified according to the presence of mild or severe CKD. For MS tracking, the k-nearest neighbors (KNN) classifier algorithm was used with the following inputs: gender, smoking, neck circumference, and waist-to-hip ratio. Results were considered significant at p < 0.05.

RESULTS: A total of 196 adult patients were evaluated with a mean age of 44.73 years, 71.9% female, 69.4% overweight, and 12.24% with CKD. Of the latter, 45.8% had MS, the majority had up to 3 altered metabolic components, and the group with CKD showed statistical significance in: waist circumference, systolic blood pressure, diastolic blood pressure, and fasting blood glucose. The KNN algorithm proved to be a good predictor for MS screening with 79% accuracy and sensitivity and 80% specificity (area under the ROC curve – AUC = 0.79).

CONCLUSION: The KNN algorithm can be used as a low-cost screening method to evaluate the presence of MS in people with CKD.

PMID:39133895 | DOI:10.1590/2175-8239-JBN-2023-0135en

Neurology. 2024 Sep 10;103(5):e209763. doi: 10.1212/WNL.0000000000209763. Epub 2024 Aug 12.

ABSTRACT

BACKGROUND AND OBJECTIVES: Charcot-Marie-Tooth disease type 4J (CMT4J) is caused by autosomal recessive variants in the Factor-Induced Gene 4 (FIG4) gene. Recent preclinical work has demonstrated the feasibility of adeno-associated virus serotype 9-FIG4 gene therapy. This study aimed to further characterize the CMT4J phenotype and evaluate feasibility of validated CMT-related outcome measures for future clinical trials.

METHODS: This cross-sectional study enrolled children and adults with genetically confirmed CMT4J, with 2 documented disease-causing variants in the FIG4 gene. Patients were recruited through the Inherited Neuropathy Consortium network. Disease severity was assessed using standardized CMT-specific outcome measures and exploratory biomarkers including muscle MRI fat fraction, electrophysiology, and neurofilament light chain levels. Descriptive statistics and correlation analyses were conducted to explore relationships between variables.

RESULTS: We recruited a total of 19 patients, including 14 pediatric patients (mean age 10.9 ± 3.9 years) and 5 adults (mean age 40.0 ± 13.9 years). The most frequent symptoms were gross motor delay and distal more than proximal muscle weakness, which were observed in 14 of 19 patients. The most common non-neuromuscular symptoms were cognitive and respiratory deficits, each seen in 8 of 19 patients. We denoted asymmetric weakness in 2 patients and nonuniform slowing of conduction velocities in 6 patients. Charcot-Marie-Tooth Disease Pediatric Scale (CMTPedS), Pediatric Quality of Life Inventory, and Vineland Adaptive Behavior Scale scores were affected in most patients. We observed a significant positive correlation between neurofilament light chain levels and CMTPedS, but the study was underpowered to observe a correlation between CMTPedS and MRI fat fraction.

DISCUSSION: We obtained baseline clinical and biomarker data in a broad cohort with CMT4J in pediatric and adult patients. Motor delay, muscle weakness, and respiratory and cognitive difficulties were the most common clinical manifestations of CMT4J. Many patients had nerve conduction studies with nonuniform slowing, and 2 had an asymmetric pattern of muscle weakness. We observed that the neurofilament light chain levels correlated with the CMTPedS in the pediatric population. This study showed feasibility of clinical outcomes including CMTPedS in assessment of disease severity in the pediatric patient population and provided baseline characteristics of exploratory biomarkers, neurofilament light chain levels, and muscle MRI fat fraction. The coronavirus disease 2019 pandemic affected some of the visits, resulting in a reduced number of some of the assessments.

PMID:39133880 | DOI:10.1212/WNL.0000000000209763

Proc Natl Acad Sci U S A. 2024 Aug 20;121(34):e2317725121. doi: 10.1073/pnas.2317725121. Epub 2024 Aug 12.

ABSTRACT

Using global data for around 180 countries and territories and 170 food/feed types primarily derived from FAOSTAT, we have systematically analyzed the changes in greenhouse gas (GHG) emission intensity (GHG_i) (kg CO_2eq per kg protein production) over the past six decades. We found that, with large spatial heterogeneity, emission intensity decreased by nearly two-thirds from 1961 to 2019, predominantly in the earlier years due to agronomic improvement in productivity. However, in the most recent decade, emission intensity has become stagnant, and in a few countries even showed an increase, due to the rapid increase in livestock production and land use changes. The trade of final produced protein between countries has potentially reduced the global GHG_i, especially for countries that are net importers with high GHG_i, such as many in Africa and South Asia. Overall, a continuous decline of emission intensity in the future relies on countries with higher emission intensity to increase agricultural productivity and minimize land use changes. Countries with lower emission intensity should reduce livestock production and increase the free trade of agricultural products and improve the trade optimality.

PMID:39133857 | DOI:10.1073/pnas.2317725121

Proc Natl Acad Sci U S A. 2024 Aug 20;121(34):e2315000121. doi: 10.1073/pnas.2315000121. Epub 2024 Aug 12.

ABSTRACT

How did specific useful protein sequences arise from simpler molecules at the origin of life? This seemingly needle-in-a-haystack problem has remarkably close resemblance to the old Protein Folding Problem, for which the solution is now known from statistical physics. Based on the logic that Origins must have come only after there was an operative evolution mechanism-which selects on phenotype, not genotype-we give a perspective that proteins and their folding processes are likely to have been the primary driver of the early stages of the origin of life.

PMID:39133848 | DOI:10.1073/pnas.2315000121

Int Braz J Urol. 2024 Aug 12;50. doi: 10.1590/S1677-5538.IBJU.2024.0308. Online ahead of print.

ABSTRACT

PURPOSE: Vacuum-assisted mini-percutaneous nephrolithotomy (vmPCNL) is being increasingly adopted due to its faster operating times and lower incidence of postoperative infectious complications (IC), however, studies have been limited by small sample sizes. We hypothesize that vmPCNL is an efficacious treatment for renal stone disease with acceptable stone-free rates (SFR) and low incidence of IC. The objectives of this study were to measure SFR three months after surgery, determine the factors influencing SFR, and determine the rates of postoperative IC after vmPCNL.

MATERIALS AND METHODS: Seven hundred and sixty seven patients underwent vmPCNL for the treatment of renal stones > 20 mm at a single institution. Patients underwent postoperative computed tomography at three months to assess SFR. Postoperative fever and SIRS/Sepsis were recorded for individual patients. Multivariate logistics regression was performed to assess predictors of SFR.

RESULTS: The SFR was found to be 73.7% at three months. Stone burden (OR 0.39, 95% CI [0.33-0.46]) and age (OR 1.03, 95% CI [1.01-1.04]) emerged as statistically significant predictors of SFR on multivariate analysis. 5.5% of patients experienced postoperative fever, while 2.9% experienced SIRS/Sepsis.

CONCLUSIONS: This is the largest continuous cohort of patients to undergo vmPCNL for stone disease and demonstrates that vmPCNL is safe and efficacious, with an SFR of 74% at three months. The incidence of postoperative fever and SIRS/Sepsis is 5.5% and 2.9% respectively. Further randomized studies with large sample sizes are required to ascertain the rates of these complications in comparison to conventional approaches.

PMID:39133794 | DOI:10.1590/S1677-5538.IBJU.2024.0308

J Vet Intern Med. 2024 Aug 12. doi: 10.1111/jvim.17153. Online ahead of print.

ABSTRACT

BACKGROUND: Electroencephalography (EEG) recording protocols have been standardized for humans. Although the utilization of techniques in veterinary medicine is increasing, a standard protocol has not yet been established.

HYPOTHESIS: Assessment of a sedation-awakening EEG protocol in dogs.

ANIMALS: Electroencephalography examination was performed in a research colony of 6 nonepileptic dogs (control [C]) and 12 dogs with epilepsy admitted to the clinic because of the epileptic seizures.

METHODS: It was a prospective study with retrospective control. Dogs with epilepsy were divided into 2 equal groups, wherein EEG acquisition was performed using a “sedation” protocol (IE-S, n = 6) and a “sedation-awakening” protocol (IE-SA, n = 6). All animals were sedated using medetomidine. In IE-SA group, sedation was reversed 5 minutes after commencing the EEG recording by injecting atipamezole IM. Type of background activity (BGA) and presence of EEG-defined epileptiform discharges (EDs) were evaluated blindly. Statistical significance was set at P > 0.05.

RESULTS: Epileptiform discharges were found in 1 of 6 of the dogs in group C, 4 of 6 of the dogs in IE-S group, and 5 of 6 of the dogs in IE-SA group. A significantly greater number of EDs (spikes, P = .0109; polyspikes, P = .0109; sharp waves, P = .01) were detected in Phase 2 in animals subjected to the “sedation-awakening” protocol, whereas there was no statistically significant greater number of discharges in sedated animals.

CONCLUSIONS AND CLINICAL IMPORTANCE: A “sedation-awakening” EEG protocol could be of value for ambulatory use if repeated EEG recordings and monitoring of epilepsy in dogs is needed.

PMID:39133769 | DOI:10.1111/jvim.17153