Tag: pubmed

Elife. 2024 Dec 24;13:RP96312. doi: 10.7554/eLife.96312.

ABSTRACT

Chronic back pain (CBP) is a global health concern with significant societal and economic burden. While various predictors of back pain chronicity have been proposed, including demographic and psychosocial factors, neuroimaging studies have pointed to brain characteristics as predictors of CBP. However, large-scale, multisite validation of these predictors is currently lacking. In two independent longitudinal studies, we examined white matter diffusion imaging data and pain characteristics in patients with subacute back pain (SBP) over 6- and 12-month periods. Diffusion data from individuals with CBP and healthy controls (HC) were analyzed for comparison. Whole-brain tract-based spatial statistics analyses revealed that a cluster in the right superior longitudinal fasciculus (SLF) tract had larger fractional anisotropy (FA) values in patients who recovered (SBPr) compared to those with persistent pain (SBPp), and predicted changes in pain severity. The SLF FA values accurately classified patients at baseline and follow-up in a third publicly available dataset (Area under the Receiver Operating Curve ~0.70). Notably, patients who recovered had FA values larger than those of HC suggesting a potential role of SLF integrity in resilience to CBP. Structural connectivity-based models also classified SBPp and SBPr patients from the three data sets (validation accuracy 67%). Our results validate the right SLF as a robust predictor of CBP development, with potential for clinical translation. Cognitive and behavioral processes dependent on the right SLF, such as proprioception and visuospatial attention, should be analyzed in subacute stages as they could prove important for back pain chronicity.

PMID:39718010 | DOI:10.7554/eLife.96312

Endocrinol Diabetes Metab. 2025 Jan;8(1):e70020. doi: 10.1002/edm2.70020.

ABSTRACT

PURPOSE: To investigate the impact of clinical and socio-economic factors on glycaemic control and construct statistical models to predict optimal glycaemic control (OGC) after implementing intermittently scanned continuous glucose monitoring (isCGM) systems.

METHODS: This retrospective study included 1072 type 1 diabetes patients (49.0% female) from three centres using isCGM systems. Clinical data and net income from the census tract were collected for each individual. OGC was defined as time in range > 70%, with time below 70 mg/dL < 4%. The sample was randomly split in two equal parts. Logistic regression models to predict OGC were developed in one of the samples, and the best model was selected using the Akaike information criterion and adjusted for Pearson’s and Hosmer-Lemeshow’s statistics. Model reliability was assessed via external validation in the second sample and internal validation using bootstrap resampling.

RESULTS: Out of 2314 models explored, the most effective predictor model included annual net income per person, sex, age, diabetes duration, pre-isCGM HbA1c, insulin dose/kg, and the interaction between sex and HbA1c. When applied to the validation cohort, this model demonstrated 72.6% specificity, 67.3% sensitivity, and an area under the curve (AUC) of 0.736. The AUC through bootstrap resampling was 0.756. Overall, the model’s validity in the external cohort was 80.4%.

CONCLUSIONS: Clinical and socio-economic factors significantly influence OGC in type 1 diabetes. The application of statistical models offers a reliable means of predicting the likelihood of achieving OGC following isCGM system implementation.

PMID:39718005 | DOI:10.1002/edm2.70020

Philos Trans A Math Phys Eng Sci. 2024 Dec 30;382(2287):20230331. doi: 10.1098/rsta.2023.0331. Epub 2024 Dec 24.

ABSTRACT

The quantum interference effects of mixing the most non-classical states of light, number states, with the most classical-like of pure field states, the coherent state, are investigated. We demonstrate how the non-classicality of a single photon when mixed with a coherent field can transform the statistical properties of the output and further demonstrate that the entanglement of the output is independent of the coherent state amplitude.This article is part of the theme issue ‘The quantum theory of light’.

PMID:39717975 | DOI:10.1098/rsta.2023.0331

Eur J Ophthalmol. 2024 Dec 24:11206721241306142. doi: 10.1177/11206721241306142. Online ahead of print.

ABSTRACT

INTRODUCTION: Keratoconus patients turn to the internet for answers to their disease expectations. Webpages are not filtered or submitted to evaluation before getting published. We aim to evaluate the quality and readability of the online information regarding keratoconus in Portugal and Brazil.

METHODS: Two independent ophthalmologists and one ophthalmologist supervisor evaluated 30 Portuguese and 30 Brazilian websites by order of appearance in Google with the word “Queratocone” and “Ceratocone”, respectively. Two quality scores were used: a quality index of consumer health information (DISCERN) and the Journal of the American Medical Association (JAMA) benchmark. Readability was evaluated with 3 scores: FleschKincaid Reading Ease (FRE), FleschKincaid Grade (FKG) and Automated Readability Index (ARI).

RESULTS: Sites from private hospitals or clinics were the most prevalent in both countries, followed by health platform sites. Final JAMA benchmark was 1.13 ± 1.18 in Portugal and 1.07 ± 1.00 in Brazil. Final DISCERN was 34.07 ± 11.71 in Portugal and 38.17 ± 10.51 in Brazil. FRE and FKG scores denoted “difficult to read” and “college school level” in both countries; ARI denoted “professor” level in Portugal and “college student” level in Brazil needed to understand the text, a statistically significant difference. There was no correlation between Google ranking and quality and readability scores.

DISCUSSION AND CONCLUSIONS: The information on keratoconus available online to Portuguese-speaking patients is of poor quality and difficult to interpret. Ophthalmologists have a shared responsibility to tackle this challenge through multifold efforts. Educating our patients on how to find reputable websites can help them navigate their life with keratoconus.

PMID:39717969 | DOI:10.1177/11206721241306142

Med Decis Making. 2024 Dec 24:272989X241305142. doi: 10.1177/0272989X241305142. Online ahead of print.

ABSTRACT

BACKGROUND: In the United States, human papillomavirus (HPV) vaccination among 27- to 45-y-olds (mid-adults) is recommended based on shared clinical decision making with a health care provider. We developed a patient decision aid tool to support the implementation of this mid-adult HPV vaccination guideline. The purpose of this study was to evaluate the effect of a patient decision aid tool for HPV vaccination, HPV DECIDE, compared with an information fact sheet among mid-adults who have not received the HPV vaccine.

METHOD: Participants were recruited between December 2023 and January 2024. We used a randomized Solomon, 4-group, pretest/posttest design with mid-adults aged 27 to 45 y who were unvaccinated for HPV and balanced based on sex (n = 612). The primary outcome was decisional conflict. Intermediate outcomes included knowledge, behavioral expectancies, self-efficacy, and perceived risk. Variables were measured using validated scales. Pretest sensitization was not present; intervention and control groups were compared. Fixed-effects inverse-variance weighting was used to pool effect estimates and determine meta-analytic statistical significance across tests with and without pretest controls.

RESULTS: Participants in the intervention group had significantly lower total decisional conflict scores (B = -3.58, P = 0.007) compared with the control group. Compared with the control group, participants in the intervention group showed higher knowledge (B = 0.48, P = 0.020), greater intention to receive (B = 0.196, P = 0.049) and discuss the HPV vaccine (B = 0.324, P ≤ 0.001), and greater self-efficacy about HPV vaccine decision making (B = 3.28, P = 0.043). There were no statistically significant results for perceived risks of HPV infection.

CONCLUSIONS: The HPV DECIDE tool for mid-adult HPV vaccination shows promise for immediate reductions in decisional conflict and improvement in knowledge, intentions, and self-efficacy about the HPV vaccine. Future studies are warranted to evaluate the effectiveness of this patient decision aid tool in real-world settings.

HIGHLIGHTS: Shared clinical decision making is recommended for HPV vaccination with mid-adults.A patient decision aid for HPV vaccination reduced decisional conflict for mid-adults.The HPV vaccine patient decision aid was acceptable to mid-adults.

PMID:39717960 | DOI:10.1177/0272989X241305142

An Sist Sanit Navar. 2024 Dec 24;47(3):e1093. doi: 10.23938/ASSN.1093.

ABSTRACT

BACKGROUND: This study examines the relationship between unmet healthcare needs and employment status, with a focus on how this relationship was influenced by the Spanish economic recession of 2008-2012.

METHODS: Data were obtained from the Spanish National Health Survey for 2006 and 2011-2012. The outcome variable was the presence of unmet healthcare needs, describing its reasons. The analysis included the period (pre-crisis/crisis), demographic variables (sex, age, Spanish citizenship), employment status, social factors (level of education, marital status, social-class), and health indicators (self-assessed health, chronic conditions, and limitations). Logistic regression was used to predict unmet health needs based on the period, employment status, and control variables.

RESULTS: The frequency of unmet healthcare needs was low and decreased further during the crisis (5% pre-crisis vs 3% during the crisis). Unmet healthcare needs were more strongly associated with health status than with employment status. However, among the unemployed, unmet healthcare needs increased during the crisis compared to the pre-crisis.

CONCLUSIONS: The most vulnerable groups, characterized by higher unmet healthcare needs, included women, individuals with lower levels of education, and those in poorer health. These groups may require more targeted attention. These findings should be interpreted in the context of the Spanish National Health System, which is fully decentralized and provides healthcare and protection to all residents.

PMID:39717952 | DOI:10.23938/ASSN.1093

Pacing Clin Electrophysiol. 2024 Dec 24. doi: 10.1111/pace.15128. Online ahead of print.

ABSTRACT

BACKGROUND: Pulmonary vein isolation (PVI) has been established as an effective management option for symptomatic paroxysmal atrial fibrillation (PAF). We aimed to explore the role of P-wave parameters in a 12-lead electrocardiogram (ECG) in predicting the success of repeat PAF ablation.

METHODS: We enrolled consecutive patients who underwent a second AF ablation procedure for PAF in a UK tertiary center after an index ablation conducted between 2018 and 2019 and a repeat ablation up to 2021. A digital 12-lead ECG was recorded with a 1-50-Hz bandpass filter applied. P-wave duration (PWD), P-wave voltage (PWV), P-wave dispersion (PWDisp), and P-wave terminal force in V1 (PTFV1) were measured before and after the procedure. Changes were correlated with the 12-month clinical outcome. Procedural success was freedom from ECG-documented AF up to 12 months following ablation.

RESULTS: Study criteria were satisfied by 72 patients, of which 43 (60%) had successful repeat PVI at 12 months. The mean age is 65, and 47 (65%) were males. The demographics were comparable between both study arms. PWD decreased after successful repeat ablations (136.7 to 124.6 ms, p = 0.01) and failed repeat ablations (135.4 to 125.3 ms, p = 0.009) without a significant change between both arms. PMV and PWDisp did not change significantly after both study arms. PTFV1 significantly decreased after successful repeat ablations (-3.1 to -4.4 mm.s, p = 0.005) without a significant change after failed ablations (-2.9 to -2.7 mm.s, p = 0.42). Changes were statistically significant between both arms (p = 0.004).

CONCLUSION: PTFV1 reduction following the second AF ablation was correlated with successful repeat AF ablation at 12 months.

PMID:39717950 | DOI:10.1111/pace.15128

Pacing Clin Electrophysiol. 2024 Dec 24. doi: 10.1111/pace.15127. Online ahead of print.

ABSTRACT

BACKGROUND: Pacemaker recipients demonstrate a higher prevalence of atrial fibrillation (AF), yet the regular ventricular activation in pacemaker-dependent patients with AF presents a substantial diagnostic challenge.

METHODS: A total of 310 medical practitioners completed a brief, validated survey consisting of three electrocardiograms displaying AF with ventricular pacing. Participants were instructed to identify the underlying rhythm.

RESULTS: Cardiologists outperformed all other groups with 69% correct responses, followed by emergency physicians (33%) and internists (24%). The poorest performance was observed among primary care physicians (14%) and medical interns (12%) (p < 0.0001). The comparison between groups revealed a statistically significant difference between cardiologists and non-cardiologists (p < 0.001).

CONCLUSION: The detection of AF in patients with ventricular-paced rhythm remains a significant diagnostic challenge, with notable gaps even among cardiologists. It is imperative to educate physicians that AF in this context may not present with the typical irregular rhythm. Routine interrogation of cardiac devices in cases where the rhythm is unclear can facilitate a timely and accurate diagnosis of this concealed arrhythmia.

PMID:39717948 | DOI:10.1111/pace.15127

Biotechnol Bioeng. 2024 Dec 24. doi: 10.1002/bit.28906. Online ahead of print.

ABSTRACT

An open-source modeling platform, called Anaerobic Digestion Model No. 1 Fast (ADM1F), is introduced to achieve fast and numerically stable simulations of anaerobic digestion processes. ADM1F is compatible with an iPython interface to facilitate model configuration, simulation, data analysis, and visualization. Faster simulations and more stable results are accomplished by implementing an advanced open-source library of numerical methods called Portable Extensive Toolkit for Scientific Computation (PETSc) to solve the ADM1 system of equations. Leveraging PETSc, ADM1F can consistently complete a steady-state simulation under 0.2 s, over 99% faster than a benchmark ADM1 model implemented with MATLAB while achieving agreement of model outputs within 1% of those obtained with the benchmark model. For dynamic simulations, however, ADM1F has a computational speed advantage only when the influent characteristics update more frequently than every 4 h. The ability of ADM1F to be useful as a tool to study anaerobic digestion systems is demonstrated through two example implementations of ADM1F: (1) a two-phase co-digestion scenario evaluating the impact of the organic loading rate and the substrate composition on reactor performance and stability, and (2) a conventional digester scenario assessing the effectiveness of recovery strategies after disruptions that led to instability. These examples demonstrate how the high simulation speed and the convenience of the iPython interface allow ADM1F to complete complex analyses within minutes, much faster than computational strategies currently reported in the literature.

PMID:39717912 | DOI:10.1002/bit.28906

IJID Reg. 2024 Nov 20;14:100495. doi: 10.1016/j.ijregi.2024.100495. eCollection 2025 Mar.

ABSTRACT

OBJECTIVES: We examined shifts in labor productivity and their economic ramifications among adult patients with long COVID in Japan.

METHODS: A total of 396 patients were categorized into three groups based on symptom progression: non-long COVID, long COVID recovered, and long COVID persistent. Patient-reported outcomes were assessed at three time intervals: 3, 6, and 12 months after COVID-19 diagnosis. Labor productivity was gauged through presenteeism and absenteeism, measured using the World Health Organization Health and Work Performance Questionnaire.

RESULTS: Long COVID was observed in 52.7% of patients, and 29.3% of all the patients continued to experience long COVID symptoms 1 year after diagnosis. At all three time points (3, 6, and 12 months after diagnosis), the long COVID persistent group showed a statistically significant difference in absolute presenteeism compared with the non-long COVID and long COVID recovered groups (P <0.01). Economic loss owing to decrease in labor productivity was calculated as $21,659 per year in the long COVID persistent group and $9008 per year in the long COVID recovered group (P <0.01).

CONCLUSION: The study’s results revealed a notable decline in labor productivity over time, underscoring the importance of early detection and intervention to mitigate the socio-economic repercussions of long COVID, in addition to its health implications.

PMID:39717862 | PMC:PMC11664411 | DOI:10.1016/j.ijregi.2024.100495