Tag: pubmed

Quant Imaging Med Surg. 2024 Dec 5;14(12):8467-8478. doi: 10.21037/qims-24-389. Epub 2024 Nov 6.

ABSTRACT

BACKGROUND: Non-neoplastic ground-glass nodules (GGNs) generally decrease in size or density during follow-up; however, some exhibit the opposite effect (and show progressive changes), which can lead to unnecessary resection. This study sought to determine the progressive changes in non-neoplastic GGNs using follow-up computed tomography (CT).

METHODS: This cross-sectional study included 70 patients diagnosed with pathologically confirmed non-neoplastic GGNs from January 2017 to March 2023. Of the patients, 35 showed progressive changes and 35 showed no significant changes. The initial and preoperative chest CT images were reviewed to evaluate their changes. The progressive changes in the GGNs were classified into the following five types: type I: increasing density; type II: increasing size; type III: increasing density and solid component; type IV: increasing size and density/solid component; and type V: increasing size, density, and solid component. The T-test, Pearson chi-square test, Wilkinson sign test and Mann-Whitney U-test were used for the data analysis. A two-sided P value <0.05 was considered statistically significant.

RESULTS: Among the 35 GGNs with progressive changes, type II (14, 40.0%) was the most common, followed by types IV (9, 25.7%), I (5, 14.3%), V (5, 14.3%), and III (2, 5.3%). The number of lesions that changed in <6, ≥6 and <12, ≥12 and ≤24, >24 months was 22 (62.9%), 4 (11.4%), 5 (14.3%), and 4 (11.4%), respectively. Among the 28 GGNs with an increasing volume, the number of lesions with a volume doubling time (VDT) of <344 and >441 days was 20 (71.4%) and 8 (28.6%), respectively. Except for these progressive changes, the other features did not exhibit significant changes, especially the ill-defined boundary (74.3% vs. 71.4%, P>0.99).

CONCLUSIONS: GGNs with progressive changes are more likely to be non-neoplastic if the changes occur in a short period or the lesions maintain an ill-defined boundary.

PMID:39698674 | PMC:PMC11652038 | DOI:10.21037/qims-24-389

Quant Imaging Med Surg. 2024 Dec 5;14(12):9157-9168. doi: 10.21037/qims-24-1014. Epub 2024 Nov 29.

ABSTRACT

BACKGROUND: The detection of prostate cancer (PCa) via conventional magnetic resonance imaging (MRI) in patients with prostate-specific antigen (PSA) levels within the grey zone remains challenging. Whether synthetic MRI can provide supplementary benefits for the accurate diagnosis of PCa in this specific population is still unknown. This study aims to investigate the diagnostic performance of synthetic MRI for differentiating PCa lesions from noncancerous lesions in patients with PSA levels within the grey zone (4-10 ng/mL).

METHODS: Clinical and MRI data, including synthetic MRI data of patients suspected of having PCa between August 2020 and August 2022, were retrospectively collected from The First Affiliated Hospital of Sun Yat-sen University and Sun Yat-sen University Cancer Center. Patients with PSA levels ranging from 4-10 ng/mL were enrolled. Pathology was obtained either from transrectal ultrasound-guided biopsy or radical prostatectomy. Regions of interest were manually drawn by two independent radiologists, and the values of quantitative parameters, including longitudinal relaxation time (T1), transverse relaxation time (T2), proton density (PD), and apparent diffusion coefficient (ADC), were separately measured. Interobserver agreement was evaluated using the interclass correlation coefficient (ICC). The differences in quantitative parameter values between PCa and noncancerous lesions were assessed using an independent sample t-test or the Mann-Whitney U test. Receiver operating characteristic curve analysis was performed to evaluate the diagnostic performance of each parameter (T1, T2, PD, and ADC values), as well as their combination. P<0.05 indicated statistical significance.

RESULTS: A total of 130 patients were enrolled in this study, with a mean age of 67.32±8.87 years. The interobserver agreement of all the T1, T2, PD, and ADC values was classified as good or above (ICC =0.60-1.00). The means of the T1, T2, PD, and ADC values were significantly different between PCa and noncancerous lesions (P=0.022, P<0.001, P=0.035, P<0.001, respectively). Notably, the ADC value demonstrated superior diagnostic performance compared to that of the other parameters, with an area under the curve (AUC) of 0.854 [95% confidence interval (CI): 0.781-0.909]. The combination of T1, T2, PD, and ADC values had a greater diagnostic performance (AUC =0.853, 95% CI: 0.781-0.909) than the T1 (AUC =0.622), T2 (AUC =0.721), or PD (AUC =0.608) values for differentiating PCa lesions from non-cancerous lesions. However, compared to the difference in the ADC value, no significant difference was found (P=0.982).

CONCLUSIONS: Quantitative parameters, including T1, T2, and PD, derived from synthetic MRI can be applied to differentiate PCa lesions from noncancerous lesions in patients with PSA levels within the grey zone. However, when these parameters were combined with the ADC, the diagnostic performance did not improve compared to that with the ADC value alone.

PMID:39698673 | PMC:PMC11651948 | DOI:10.21037/qims-24-1014

BMC Med Educ. 2024 Dec 18;24(1):1491. doi: 10.1186/s12909-024-06481-0.

ABSTRACT

BACKGROUND: Microaggressions, subtle and often unintentional acts of hostility, have been recognized as a significant issue in healthcare, adversely affecting learners’ emotional and physical well-being. Current strategies for addressing microaggressions are broad frameworks without empirical substantiation that leave learners without a clear direction for intervention. This study introduces a novel scripted, succinct, bystander intervention tool to combat microaggressions. The intervention tool developed by the research team, named I-RANT, follows the script of introduction, role naming, affirming the target, negating the microaggression, and transitioning within patient encounters. The study goal was to assess the ability of a training session to impact learners’ recognition of microaggressions, confidence in intervening, and competency in applying the I-RANT tool.

METHODS: A pre-experimental study was conducted with 97 second-year medical students at a large academic center in the Southeast United States. The I-RANT tool was taught through a 90-minute training session. The session included an introduction lecture, small group discussions, and role-play scenarios. Pre- and post-intervention surveys assessed microaggression recognition via a multiple-choice questionnaire (MCQ) and self-reported confidence in intervening on a Likert scale. Differences were compared via paired T-test. Role-play scenarios were observed by trained faculty and graded for competence using a rubric.

RESULTS: Participants showed significant improvement in microaggression identification with increase in MCQ score from 4.17 (SD 0.75) pre-intervention to 4.74 (SD 0.42) post-intervention (p < .001) and increased self-reported confidence from 3.2 (SD 1.0) to 4.2 (SD 0.63) (p < .001). Trained faculty evaluated a random sampling of students’ role-play scenarios (n = 30) revealing that 97% of sampled students demonstrated competence in utilizing the I-RANT tool.

DISCUSSION: The I-RANT training session empowered learners to address microaggressions. Learners demonstrated a statistically significant improvement in recognition of microaggressions and confidence in intervening. The majority of learners demonstrated competency in utilizing the I-RANT tool by the end of the training session.

CONCLUSIONS: This study supports the effectiveness of our training session in enhancing medical students’ ability to recognize and address microaggressions. I-RANT empowers learners with a tool to intervene against microaggressions within patient encounters.

PMID:39695515 | DOI:10.1186/s12909-024-06481-0

BMC Public Health. 2024 Dec 18;24(1):3527. doi: 10.1186/s12889-024-20974-z.

ABSTRACT

BACKGROUND: Metabolically unhealthy non-obese (MUNO) individuals are at higher risk of cardiovascular diseases, while not receiving sufficient attention. This study was conducted to explore the association between BMI-adjusted CC and MUNO in non-obese US adults using the NHANES database.

METHODS: A total of 9,628 non-obese US adults (48.01% female and 51.99% male) were included in this cross-sectional study. The metabolically unhealthy phenotype was defined as ≥ 2 components of metabolic abnormalities. BMI-adjusted CC and BMI-adjusted skeletal muscle mass (SMM) were divided into quartiles. Weighted multiple logistic regression model was used to evaluate the study aims. The relation between BMI-adjusted CC and BMI-adjusted SMM was tested by Spearman correlation.

RESULTS: In the multivariate analysis, compared with the lowest quartile of BMI-adjusted CC and BMI-adjusted SMM, OR (95%CI) of the highest quartile was 0.30 (0.25, 0.35) (P < 0.001, P for trend < 0.001) and 0.39 (0.29, 0.53) (P < 0.001, P for trend < 0.001), respectively. BMI-adjusted CC was positively correlated with BMI-adjusted SMM for all participants (r = 0.48). A weak non-linear association was observed in BMI-adjusted CC and MUNO (P = 0.047). Similar results were observed in sex- and BMI-specific subgroup and sensitivity analysis.

CONCLUSION: BMI-adjusted CC was inversely associated with MUNO, suggesting more attention should be paid to monitoring BMI-adjusted CC for the public to ease the disease burden, especially for people without obesity.

PMID:39695513 | DOI:10.1186/s12889-024-20974-z

BMC Psychiatry. 2024 Dec 18;24(1):924. doi: 10.1186/s12888-024-06371-1.

ABSTRACT

INTRODUCTION: Depression is a common and debilitating mental health issue among refugees in East Africa, who face numerous challenges. However, there is a lack of systematic reviews and meta-analyses that have explored the pooled prevalence and associated factors of depression among refugees in East Africa. This study aims to investigate the pooled prevalence of depression and its associated factors among refugees living in East Africa.

METHODS: A systematic search was conducted across several databases, including PubMed/MEDLINE, CINAHL, ScienceDirect, African Journals of Online (AJOL), and Google Scholar. The quality of the included studies was assessed using a Joanna Briggs Institute (JBI) quality appraisal tool. Statistical analysis was carried out using STATA-17 software packages, and a meta-analysis was conducted using a random-effects model. Heterogeneity among the studies was assessed using the I² statistic. Publication bias was evaluated using the DOI plot, Luis Furuya Kanamori (LFK) index, and Egger’s test. For associated factors of depression, effect sizes (odds ratio) with 95% confidence intervals were analyzed.

RESULT: A total of eight studies involving 6,388 participants were included in this systematic review and meta-analysis, all of which were assessed to have a low risk of bias. The pooled prevalence of depression was 50.60%, with a 95% CI (35.49%, 65.71). Regarding factors associated with depression; being female [(OR = 2.01; 95% CI (1.06, 3.82)], having poor social support [OR 5.88; 95% CI (2.53, 13.67)], and experienced eight or more traumatic events [OR = 3.31;95% CI (1.74, 6.31) were positively associated factors with depression.

CONCLUSION: The pooled prevalence of depression among refugees in East Africa was found to be significantly high. Female participants, poor social support, and experienced eight or more traumatic events were factors affecting depression among refugees in East Africa. Therefore, policymakers and health personnel in East Africa should prioritize addressing the needs of female participants, individuals with poor social support, and those who have experienced eight or more traumatic events.

PMID:39695510 | DOI:10.1186/s12888-024-06371-1

BMC Public Health. 2024 Dec 18;24(1):3454. doi: 10.1186/s12889-024-20938-3.

ABSTRACT

This study examined the influence of socio-economic factors on the adoption of improved cookstoves (ICSs) and identified barriers to their dissemination in Wereta district, Amhara, Ethiopia. A structured cross-sectional approach was employed, surveying 308 households through questionnaires and interviews. Key socio-economic factors such as income level, family size, education, and age were found to significantly affect ICS adoption (p < 0.05), whereas cooking location, household decision-making, and involvement of societal stakeholders did not show a statistically significant impact (p > 0.05). The primary barriers to ICS adoption included limited awareness, high costs, and age-related factors. Addressing these challenges by targeting the significant socio-economic determinants is crucial for facilitating the transition from traditional to improved cookstoves. The findings offer valuable insights for policymakers, NGOs, research organizations, and manufacturers, highlighting potential areas for targeted intervention to enhance ICS adoption in the community.

PMID:39695509 | DOI:10.1186/s12889-024-20938-3

BMC Ophthalmol. 2024 Dec 18;24(1):536. doi: 10.1186/s12886-024-03807-w.

ABSTRACT

BACKGROUND: To compare the effectiveness of a brief binocular vision screening protocol to a comprehensive examination for detecting binocular vision anomalies before and after cataract surgery.

METHODS: A comprehensive binocular vision test battery as a gold standard were administered on recruited patients before the first surgery and at the third visit after surgery on the second eye. A receiver operating characteristic (ROC) curve was plotted to illustrate the diagnostic ability of each test. In addition, a univariate logistic regression analysis was performed to further determine the contribution of each preoperative test to the prediction of pre- and post-surgical binocular vision anomalies.

RESULTS: Significant differences were shown for the difference in phoria from distance to near measured by the cover test (Area Under Curve [AUC] = 0.96, P < 0.01), step vergence testing of positive fusional vergence at distance (AUC = 0.71, P < 0.01) and near (AUC = 0.77, P < 0.01). The other tests did not show statistically significant differences. The ROC curve generated by combining the difference in distance and near phoria with positive fusional vergence at both distance and near demonstrated a more robust measure of diagnostic accuracy. (AUC = 0.98, P < 0.01).

CONCLUSION: Distance and near phoria difference measured by cover test has similar effectiveness as a comprehensive binocular vision testing protocol for the diagnosis of binocular vision anomalies. Distance and near positive fusional vergence measured by step vergence testing also have significant predictive value. A combination of the two tests is an outstanding screening protocol for binocular vision anomalies before cataract surgery.

TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov (NCT03592615, Date of registration: July 19, 2018).

PMID:39695508 | DOI:10.1186/s12886-024-03807-w

BMC Public Health. 2024 Dec 18;24(1):3468. doi: 10.1186/s12889-024-21054-y.

ABSTRACT

INTRODUCTION: Globally, there has been a decline in the age of menarche; the decline is higher in poorer countries than in richer ones. The measurement of the decline was based on the reported mean age at menarche (MAM) across the countries. There is a significant knowledge gap in investigating the generational decline in MAM in low- and median-income countries (LMC). In Nigeria, different studies have reported MAM, but none have attempted to investigate the generational shift in the reported MAM in girls residing in rural and urban areas. This review sought to understand if there is a rural-urban disparity in the MAM.

METHODS: Documents were searched in the relevant bibliometric database and Population intervention, comparison(s) and outcome (PICO) framework were used as eligibility criteria for extracting data from the documents based on some inclusion and exclusion criteria. The population are adolescent schoolgirls in rural and urban settlements in Nigeria. The comparator is the age of menarche of urban versus rural adolescent schoolgirls in Nigeria, while the mean age at menarche (MAM) is the outcome. Data quality assessment was done to critically appraise the included studies and enhance. Data were synthesized using narrative review, descriptive and inferential statistics.

RESULTS: Ten articles were included in the study, following the PRISMA framework. The overall mean evaluation of the risk of bias in the individual studies included in the review was computed to be 88%. Generally, there seems to be a decline in the age at menarche from 1976 to 2023. The rural MAM is higher than the urban MAM, and the gap between the two appears to be narrowing. The t-test showed no statistically significant mean differences between the rural and urban mean age at menarche (T = 2.1009, p value = 0.4679). The mean menarcheal age for girls in rural and urban areas is 13.44 and 13.04, respectively. There is a strong positive correlation between the rural and urban MAMs (Pearson = 0.93, p < 0.001). The Gaussian kernel estimated a bimodal distribution for rural girls, where they are most likely to experience menarche at 11 and 13 years, respectively, while urban girls are most likely to experience menarche at 13 years. In both locations, the incidence of menarche decreases just after the peak at 13 years.

CONCLUSION: Although rural girls have delayed menarche, there is no statistically significant mean difference between the age at menarche reported for rural and urban areas in Nigeria. Interventions in the form of counseling and reproductive education are recommended. The review provides a strong foundation for further research and policy development aimed at improving the health and well-being of adolescent girls in Nigeria and other similar settings.

PROSPERO REGISTRATION: CRD42024529497.

PMID:39695506 | DOI:10.1186/s12889-024-21054-y

BMC Ophthalmol. 2024 Dec 18;24(1):539. doi: 10.1186/s12886-024-03808-9.

ABSTRACT

BACKGROUND: Dry eye syndrome (DES) is common but lack of data in quality of life (QoL) of DES patients in Thailand. The primary outcome of this study was to determine QoL and health utility in patients of DES by EuroQol 5-domain (EQ-5D) of the 5-level version (5 L) instrument. The secondary outcome was comparison of the utility in the patients of DES classified by severity and causes including the autoimmune and non-autoimmune diseases.

METHOD: The study was a cross-sectional study at a hospital in the northern part of Thailand. The inclusions DES patients were followed by Tear Film and Ocular surface Society the Dry Eye WorkShop II definition. The EQ-5D-5 L (Thai version) descriptive system and the EQ visual analogue scale (VAS) was instrument for QoL evaluation.

RESULT: Total patients of DES were fifty-six. The most patients were female. The mean age was 57.7(± 13.9) years. The mean of EQ-5D-utility and EQ-VAS were 0.76 (± 0.18) and 72.56 (± 15.19), respectively. The mean of EQ-5D-utility in these patients who were classified by severity including mild, moderate and severe were 0.84 (± 0.16), 0.78 (± 0.14) and 0.71 (± 0.22), respectively. There is no statistic significant in the EQ-5D-utility and EQ-VAS among severity and the causes of these patients.

CONCLUSIONS: This study demonstrated the importance of assessing QoL in DES. The EQ-5D-utility was accorded with the severity of DES. However, no statistic significant was showed in the mean of EQ-5D-utility and EQ-VAS between the severity and between the causes including the autoimmune and non-autoimmune diseases of these patients.

PMID:39695504 | DOI:10.1186/s12886-024-03808-9

BMC Med Educ. 2024 Dec 18;24(1):1487. doi: 10.1186/s12909-024-06440-9.

ABSTRACT

BACKGROUND: A Bachelor’s degree in nursing is one of the most challenging programs in the field of medical sciences. As a result, maintaining students’ academic motivation at the desired level is a constant concern for policymakers and educational administrators. Furthermore, tackling complex ethical dilemmas is inherent in nursing, making the educational period an important moment to instill moral sensitivity and reinforce professional ethics in students. This study aimed to investigate the association between academic motivation and moral sensitivity among undergraduate nursing students.

METHODS: In this descriptive-correlational study, 265 undergraduate nursing students from the Abhar School of Nursing at Zanjan University of Medical Sciences in Iran were chosen using a census approach in 2024. The data collection tools included demographic surveys, the Academic Motivation Scale (AMS), and the Moral Sensitivity Questionnaire (MSQ), all completed online. The data were analyzed with SPSS version 16 software, which used descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (independent t-test, ANOVA, Pearson correlation, and multiple regression) with a significance level of 0.05.

RESULTS: Nursing students had average academic motivation and moral sensitivity ratings of 79.24 ± 14.05 and 121.12 ± 16.33, respectively. Furthermore, a significant relationship was found between the overall scores and all dimensions of academic motivation and moral sensitivity (p < 0.001). Additionally, 29.1% of the variance in moral sensitivity was explained by the dimensions of the student’s academic motivation.

CONCLUSION: This study’s findings revealed a link between academic motivation and moral sensitivity among nursing students. As a result, it is advised that levels of academic motivation be continually checked during the program. This will assist in identifying students at danger of losing motivation and allow for the development and execution of effective initiatives to improve their academic engagement.

PMID:39695501 | DOI:10.1186/s12909-024-06440-9