Tag: pubmed

Pol Merkur Lekarski. 2024;52(6):691-697. doi: 10.36740/Merkur202406111.

ABSTRACT

OBJECTIVE: Aim: To identify the opportunities, approaches, challenges, and needs of professionals at disease control and prevention centers in the process of using data for developing public health policy..

PATIENTS AND METHODS: Materials and Methods: The program provides for sociological surveys of professionals from disease control and prevention centers regarding the opportunities, needs, and challenges in using data to develop public health policy. The research materials included scientific publications, national-level regulatory legal acts, WHO program documents and sociological research questionnaires. The study utilized bibliosemantic, sociological, medical-statistical methods, and content analysis.

RESULTS: Results: A range of issues was identified regarding the use of data for substantiating and developing public health policy. A survey of professionals from disease control and prevention centers indicated that they encounter a lack of data on social and mental health ([rate ± standard error] 19,7±3,5 per 100 respondents); work with at-risk populations (15,0±3,2); socioeconomic determinants (14,2±3,1); occupational diseases and labor protection (13,4±3,0); and non-communicable diseases and behavioral risk factors (11,0±2,8). Every sixth to tenth respondent reported challenges in obtaining and analyzing data. A high need (74,8±3,8 per 100 respondents) was identified for professional development in data usage for policy substantiation, along with preferred formats.Priority measures for improving data use in public health policy development were identified.

CONCLUSION: Conclusions: The identified issues in data usage for public health policy development, as well as the needs of professionals at disease control and prevention centers concerning data collection and analysis, and the priority measures for improvement, should be considered.

PMID:39951636 | DOI:10.36740/Merkur202406111

Pol Merkur Lekarski. 2024;52(6):679-684. doi: 10.36740/Merkur202406109.

ABSTRACT

OBJECTIVE: Aim: To investigate the relationships between age, smoking status, inflammatory markers, and endotoxicosis in patients with chronic pancreatitis, focusing on C-reactive protein (CRP) and middle molecular peptides, specifically MMP254 and MMP280..

PATIENTS AND METHODS: Materials and Methods: The study involved the examination of 108 patients diagnosed with chronic pancreatitis. These patients were categorized by age according to the World Health Organization (WHO) guidelines. Additionally, patients were stratified based on smoking status. Key biochemical markers were assessed, including fecal α-elastase, medium molecular weight peptides, and C-reactive protein levels. This approach allows for a comprehensive evaluation of how age and smoking may influence the course of chronic pancreatitis, while also considering the diagnostic value of these specific biomarkers in monitoring pancreatic function and inflammatory responses in these patients.

RESULTS: Results: A statistically significant impact of age on fecal α-elastase, C-reactive protein, and medium molecular peptides levels has been identified. Additionally, smoking has been shown to exacerbate pathological changes in these markers.

CONCLUSION: Conclusions: these findings underscore the necessity for individualized treatment approaches that consider age and smoking history, particularly in older patients. Future research should further explore the underlying mechanisms linking these variables to chronic pancreatitis, with an emphasis on the long-term effects of smoking cessation and interventions targeting inflammatory markers and endotoxicosis. This understanding is crucial for enhancing management strategies and improving the quality of life for patients suffering from chronic pancreatitis.

PMID:39951634 | DOI:10.36740/Merkur202406109

Pol Merkur Lekarski. 2024;52(6):654-659. doi: 10.36740/Merkur202406106.

ABSTRACT

OBJECTIVE: Aim: The aim is to study the impact of prolonged quarantine related to COVID-19 and martial law on the health and physical fitness of students in Ukrainian higher educational institutions..

PATIENTS AND METHODS: Materials and Methods: Research methods: literature analysis, surveys, testing of students’ health and physical fitness, methods of mathematical statistics. The research was conducted in 2019-2023. The survey involved 462 (143 males and 319 females) students. Health assessments and physical fitness tests were conducted with second-year students (before quarantine (2019): males – n = 63; females – n = 78; after quarantine (2023): males – n = 51; females – n = 67).

RESULTS: Results: The negative attitude of the majority of students (66.4 % of men and 76.5 % of women) to distance learning in physical education was revealed. A significant deterioration of all studied indicators of students’ health and physical fitness during the quarantine period related to COVID-19 and martial law in Ukraine was revealed.

CONCLUSION: Conclusions: Since the state of health and level of physical fitness of students is the main criterion for the effectiveness of physical education in higher educational institutions of Ukraine, physical education departments should focus their work on modernizing traditional and developing new forms and methods of physical education, shaping students’ civic consciousness and behavior, their readiness to serve society and protect the state with dignity.

PMID:39951631 | DOI:10.36740/Merkur202406106

Pol Merkur Lekarski. 2024;52(6):647-653. doi: 10.36740/Merkur202406105.

ABSTRACT

OBJECTIVE: Aim: To determine modern strategies of quality assurance in medical care and to meet educational needs of health care professionals regarding the quality of medical care..

PATIENTS AND METHODS: Materials and Methods: The study programme included sociological surveys of healthcare professionals on their educational needs in terms of quality assurance of medical care. The study used bibliosemantic, sociological, medical and statistical methods, and content analysis. The study materials included scientific publications, the WHO program documents, national-level regulations and questionnaires on their educational needs in terms of quality of care and patient safety.

RESULTS: Results: Data show that, there are still a lot of problems in quality assurance and safety of health care services. The respondents highly appreciated the results of implemented JCI requirements at the healthcare facility ([mean ± standard error] 4,3±0,07 points on a five-point scale), the level of information about current operational processes, changes, plans etc. (4,4±0,06), the clarity and comprehensibility of the quality assurance tasks (4,5±0,04), the control method (4,6±0,05), and the attitude of the management (4,6±0,05). The need to improve knowledge and acquire more competencies in health care quality was identified ([rate ± standard error] 88,4±2,30 respondents per 100 respondents).

CONCLUSION: Conclusions: The assessments by health care providers of the quality of medical care, level of knowledge on these issues and the need to improve them, with prioritization of topics and forms of training, found in the course of the study, form the basis for the programs of continuous improvement of medical care quality.

PMID:39951630 | DOI:10.36740/Merkur202406105

Pol Merkur Lekarski. 2024;52(6):638-646. doi: 10.36740/Merkur202406104.

ABSTRACT

OBJECTIVE: . Aim: The aim of this study was to design, validate, and assess the effectiveness of the MiNa scale in measuring mindfulness and its impact on young students’ mental health and holistic development, with a focus on diverse educational needs.

PATIENTS AND METHODS: Materials and Methods: This study utilized a mixed-methods approach to validate the MiNa Questionnaire. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were conducted on a sample of 224 students from Greece and Cyprus, who completed the questionnaire. Psychometric properties, including reliability and validity, were also assessed using standard statistical methods.

RESULTS: Results: EFA revealed a three-factor structure explaining 53% of the variance, with strong factor loadings and reliability (Cronbach’s α > 0.7). CFA further confirmed the model fit, with RMSEA = 0.03, CFI = 0.97, and SRMR = 0.08. The results indicated significant improvements in students that attended mindfulness interventional programs, especially on their emotional regulation, and cognitive focus. It is important to note that positive results were predominantly observed among the sample of students characterized by vulnerability.

CONCLUSION: Conclusions: The MiNa Questionnaire has proven to be a reliable and valid tool for assessing mindfulness in students from diverse educational backgrounds. Its adaptability for students with disabilities, combined with its cultural inclusivity, makes it a valuable resource for educators seeking to implement mindfulness programs in varied educational contexts.

PMID:39951629 | DOI:10.36740/Merkur202406104

Optom Vis Sci. 2025 Feb 14. doi: 10.1097/OPX.0000000000002237. Online ahead of print.

ABSTRACT

SIGNIFICANCE: Intervention strategies for post-mild traumatic brain injury (mTBI) ocular motor disorders vary across disciplines and include watchful waiting, vestibular rehabilitation, vision rehabilitation/vision therapy, and optical intervention. However, evidence supporting their effectiveness is limited, highlighting the need for high-quality randomized controlled trials with standardized testing, diagnostic criteria, and reassessment of ocular motor function after intervention.

BACKGROUND: Ocular motor disorders occur frequently after mTBI.

OBJECTIVES: This study aimed to conduct a scoping review of interventions for mTBI-related ocular motor disorders in children and adults.

DATA SOURCES: The following electronic bibliographic databases were searched: PubMed, Embase, PEDro, OVID, Clinical Key, Google Scholar, and REHABDATA.

STUDY SELECTION: Intervention studies published in English between 2003 and 2024 involving mTBI participants who had an ocular motor assessment prior to intervention were included in this study.

DATA EXTRACTION AND SYNTHESIS: Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines were followed for reporting. Study population, intervention, and outcomes were extracted and synthesized in tabular and graphical formats.

RESULTS: Sixty-seven eligible studies were included, with only three (4%) judged as low risk of bias. Intervention strategies included watchful waiting (n = 31, 46%), vestibular rehabilitation (n = 13, 19%), vision rehabilitation/vision therapy (n = 10, 15%), optical intervention (n = 4, 6%), and alternative interventions or multifaceted interventions (n = 9, 14%). Among the studies providing statistically supported results, improvements in one or more ocular motor outcome domains were reported in nearly 80% of the studies on watchful waiting (19/24) and 100% of the studies on vestibular rehabilitation (4/4), vision rehabilitation/vision therapy (7/7), or optical intervention (1/1).

CONCLUSIONS AND IMPLICATIONS: Although post-mTBI ocular motor deficits improved with watchful waiting strategy, vestibular rehabilitation, vision rehabilitation/vision therapy, and optical interventions, most studies had significant risk of bias. This review emphasizes the necessity for high-quality randomized controlled trials with standardized testing protocols and diagnostic criteria and reassessment of ocular motor functions after intervention to evaluate the effectiveness of these interventions in different age groups and recovery stages.

PMID:39951336 | DOI:10.1097/OPX.0000000000002237

J Chem Inf Model. 2025 Feb 14. doi: 10.1021/acs.jcim.4c02163. Online ahead of print.

ABSTRACT

Metal-embedded complexes (MECs), including transition metal complexes (TMCs) and metal-organic frameworks (MOFs), are important in catalysis, materials science, and molecular devices due to their unique metal atom centrality and complex coordination environments. However, modeling and predicting their properties accurately is challenging. A new metal attention (MA) framework for graph neural networks (GNNs) was proposed to address the limitations of traditional methods, which fail to differentiate core coordination structures from ordinary covalent bonds. This MA framework converts heterogeneous graphs of complexes into homogeneous ones with distinct metal features by highlighting key metal-feature coordination through hierarchical pooling and a metal cross-attention. To assess its performance, 11 widely used GNN algorithms, three of which are heterogeneous, were compared. Experimental results indicate significant improvements in accuracy: an average of 32.07% for predicting TMC properties and up to 23.01% for MOF CO₂ absorption. Moreover, tests on the framework’s robustness regarding data set size variation and comparison with a larger non-MA model show that the enhanced performance stems from the architecture, not merely increasing model capacity. The MA framework’s potential in predicting metal complex properties offers a potent statistical tool for optimizing and designing new materials like catalysts and gas storage systems.

PMID:39951325 | DOI:10.1021/acs.jcim.4c02163

Environ Toxicol Chem. 2025 Feb 14:vgaf047. doi: 10.1093/etojnl/vgaf047. Online ahead of print.

ABSTRACT

Excess metal accumulation in organisms can result in adverse impacts at the levels of the individual, population, and community. A detectable increase of metal concentrations in organisms does not necessarily imply that there are such impacts, but to our knowledge no field study has directly tested this hypothesis. To test this hypothesis, we investigated the accumulation of six elements (Cu, Zn, Cd, Pb, As, and Se) in masu salmon (Oncorhynchus masou, Salmonidae) at a total of nine study sites in a metal-contaminated river receiving mine discharge and in a nearby reference river. Multiple fish community surveys in 2018 and 2019 consistently indicated that the abundances and condition factors of the four dominant fish species, including masu salmon, were comparable in the two rivers. In contrast, despite sample sizes of only five individuals per site, statistically significant increases in the concentrations of Cu, Cd, Pb, As, and Se in the muscle of masu salmon were observed at multiple sites in the metal-contaminated river, where no detectable impacts on the abundance or condition factor of the fish were observed. The muscle concentrations of Cu, Zn, Cd, Pb, As, and Se at these sites were 1.4-2.5, 1.5-1.9, 188-520, 4.6-68.0, 1.1-3.9, and 2.8-3.5 times, respectively, the mean concentrations at the reference sites, although the increase of the Zn concentration in muscle at these metal-contaminated river sites was not significant. These results provide clear empirical evidence that a detectable increase in metal accumulation does not necessarily imply that population and community-level impacts are simultaneously occurring in the environment.

PMID:39951317 | DOI:10.1093/etojnl/vgaf047

JAMA Health Forum. 2025 Feb 7;6(2):e245220. doi: 10.1001/jamahealthforum.2024.5220.

ABSTRACT

IMPORTANCE: Understanding the drivers of health care spending across US counties is important for developing policies and assessing the allocation of health care services.

OBJECTIVE: To estimate the amount of cross-county health care spending variation explained by (1) population age, (2) health condition prevalence, (3) service utilization, and (4) service price and intensity.

DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, data for 4 key drivers of per capita spending were extracted for 3110 US counties, 148 health conditions, 38 age-sex groups, 4 payers, and 7 types of care for 2019. Service utilization was measured as service volume per prevalent case, while price and intensity was measured as spending per visit, admission, or prescription. Das Gupta and Shapley decomposition methods and linear regression were used to estimate the contribution of each factor. The data analysis was conducted between March 2024 and July 2024.

EXPOSURES: Age, disease prevalence, service utilization, or service price and intensity.

MAIN OUTCOMES AND MEASURES: Variation in health care spending across US counties.

RESULTS: In 2019, 76.6% of personal health care spending was included in this study. Overall, 64.8% of cross-county health care spending variation among 3110 US counties was explained by service utilization, while population age, disease prevalence, and price and intensity of services explained 4.1%, 7.0%, and 24.1%, respectively. The rate at which these factors contributed to variation in spending differed by payer, type of care, and health condition. Service utilization was associated with insurance coverage, median income, and education. An increase in each of these from the median to the 75th percentile was associated with a 7.8%, 4.4%, and 3.8% increase in ambulatory care utilization, respectively. The fraction of Medicare beneficiaries with Medicare Advantage was associated with less utilization. An increase in Medicare Advantage coverage from the median to the 75th percentile was associated with a 1.9% decrease in ambulatory care utilization. Differences in cross-state spending levels were also attributed to different factors. For Utah, the state with the least health care spending per capita, spending rates were lower for all types of care due principally to the young age profile. For New York, the state with the highest spending, spending rates were relatively high for hospital inpatient and prescribed pharmaceutical spending. For both types of care, high service price and intensity contributed to the above-average spending.

CONCLUSIONS AND RELEVANCE: In this cross-sectional study, variation in health care spending among US counties was largely related to variation in service utilization. Understanding the drivers of spending variation in the US may help policymakers assess the allocation of health care resources.

PMID:39951314 | DOI:10.1001/jamahealthforum.2024.5220

JAMA Health Forum. 2025 Feb 7;6(2):e245376. doi: 10.1001/jamahealthforum.2024.5376.

ABSTRACT

IMPORTANCE: Private equity (PE) acquisition of physician practices is increasing, with owners targeting sales, or exits, in 3 to 7 years. Little is known about the association of exit with physician retention and subsequent employment.

OBJECTIVE: To examine whether PE exit of physician practices is associated with changes in physician retention and subsequent choice of practice size.

DESIGN, SETTING, AND PARTICIPANTS: Using data from the Centers for Medicare & Medicaid Services Doctors and Clinicians National Downloadable File from December 31, 2014, to December 31, 2020, this case-control study compared employment changes for physicians at PE-exiting practices sold between January 1, 2016, and December 31, 2018 (treatment group), with employment changes for matched control physicians in practices not sold by PE owners but with the same specialty, hospital referral region, practice size, and time period. Physicians billing fee-for-service Medicare during the study period were eligible for inclusion. A difference-in-differences design was used to compare retention between the treatment and control groups in the 2 years before and after exit using a multinomial logit model that adjusted for physician decade of graduation. Data were analyzed from August 1, 2023, to November 9, 2024.

EXPOSURE: Exit of a PE-owned physician practice.

MAIN OUTCOMES AND MEASURES: Physician employment outcomes included staying (continuing to bill through the initial practice), working elsewhere (only billing through other practices), and retirement (no longer billing). Whether a physician left to a join large (>120-physician) practice was also evaluated.

RESULTS: Of the 1215 physicians included in the analysis (405 at 70 PE-exiting practices and 810 matched controls; 814 [67.0%] male and 401 (33.0%) were female. Physicians in all PE-exiting practices were typically in practices of more than 20 physicians (471 [65.2%]) and often in the South (373 [51.7%]). Dermatology was the leading specialty (216 [29.9%]), followed by family medicine (94 [13.0%]). Physicians employed in PE-exiting practices were 16.5 (95% CI, 10.6-22.3) percentage points less likely to continue working in that practice 2 years after exit compared with matched controls. There was no significant change in the probability of retirement (0 percentage points; 95% CI, -4.1 to 4.0). Physicians in PE-exiting practices were 10.1 (95% CI, 6.5 to 13.7) percentage points likelier than matched controls to join a large practice of more than 120 physicians.

CONCLUSIONS AND RELEVANCE: In this case-control study, PE exit was followed by an increase in physician turnover and subsequent employment at a large (>120-physician) practice relative to matched controls, notwithstanding similar turnover rates between these physicians and matched controls prior to exit. The increase in physician turnover and consolidation following PE exits has important implications for patients, physicians, investors, and physician markets.

PMID:39951313 | DOI:10.1001/jamahealthforum.2024.5376