Tag: pubmed

JMIR Form Res. 2024 Jun 17;8:e56687. doi: 10.2196/56687.

ABSTRACT

BACKGROUND: Internet medical treatment, also known as telemedicine, represents a paradigm shift in health care delivery. This contactless model allows patients to seek medical advice remotely, often before they physically visit a doctor’s clinic. Herein, physicians are in a relatively passive position, as patients browse and choose their health care providers. Although a wealth of experience is undoubtedly a draw for many patients, it remains unclear which specific facets of a doctor’s credentials and accomplishments patients prioritize during their selection process.

OBJECTIVE: Our primary aim is to delve deeper into the correlation between physicians’ static characteristics-such as their qualifications, experiences, and profiles on the internet-and the number of patient visits they receive. We seek to achieve this by analyzing comprehensive internet hospital data from public hospitals. Furthermore, we aim to offer insights into how doctors can present themselves more effectively on web-based platforms, thereby attracting more patients and improving overall patient satisfaction.

METHODS: We retrospectively gathered web-based diagnosis and treatment data from the First Affiliated Hospital of Guangxi Medical University in 2023. These data underwent rigorous analysis, encompassing basic descriptive statistics, correlation analyses between key factors in doctors’ internet-based introductions, and the number of patient consultation visits. Additionally, we conducted subgroup analyses to ascertain the independence of these vital factors. To further distill the essence from these data, we used nonnegative matrix factorization to identify crucial demographic characteristics that significantly impact patient choice.

RESULTS: The statistical results suggested that there were significant differences in the distribution of consultation volume (P<.001), and the correlation analysis results suggested that there was a strong correlation between the two groups of data (ρ=0.93; P<.001). There was a correlation between the richness of a profile and popularity (P<.001). Patients were more interested in physicians with advanced titles, doctoral degrees, social activities, and scientific achievements (P<.001) as well as other institutional visit experiences (P=.003). More prosperous social activities, scientific achievements, experiences of other institutional visits, and awards were more common among people with advanced professional titles. Doctoral degrees remained attractive to patients when data were limited to senior physicians (P<.001). Patients trusted the medical staff with advanced titles, social activities, scientific achievements, and doctoral degrees (P<.001).

CONCLUSIONS: Patient preferences for choosing a health care provider differed significantly between free and paid consultations. Notably, patients tended to trust doctors with advanced professional titles more and were more likely to seek out those with doctoral qualifications over other professional ranks. Additionally, physicians who actively participated in social events and scientific endeavors often had an advantage in attracting new patients. Given these insights, doctors who invest in enhancing their personal and professional experiences within these domains are likely to see increased popularity and patient satisfaction.

PMID:38885498 | DOI:10.2196/56687

Lupus. 2024 Jun 17:9612033241260334. doi: 10.1177/09612033241260334. Online ahead of print.

ABSTRACT

OBJECTIVE: In this pilot study, we used untargeted metabolomics to identify biochemical mechanisms or biomarkers potentially underlying SLE-related fatigue.

METHODS: Metabolon conducted untargeted metabolomic plasma profiling using ultrahigh performance liquid chromatography/tandem mass spectrometry on plasma samples of 23 Black females with systemic lupus erythematosus (SLE) and 21 no SLE controls. Fatigue phenotypes of general fatigue, physical fatigue, mental fatigue, reduced activity, and reduced motivation were measured with the reliable and valid Multidimensional Fatigue Inventory (MFI).

RESULTS: A total of 290 metabolites were significantly different between the SLE and no SLE groups, encompassing metabolites related to glycolysis, TCA cycle activity, heme catabolism, branched chain amino acids, fatty acid metabolism, and steroids. Within the SLE group, controlling for age and co-morbidities, TCA cycle metabolites of alpha-ketoglutarate (AKG) and succinate were statistically significantly associated (p < .05) with physical and general fatigue.

CONCLUSION: While pervasive perturbations in the entire TCA cycle have been implicated as a potential mechanism for fatigue, our results suggest individual metabolites of AKG and succinate may be potential biomarkers or targets of intervention for fatigue symptom management in SLE. Additionally, perturbations in heme metabolism in the SLE group provide additional insights into mechanisms that promote systemic inflammation.

PMID:38885489 | DOI:10.1177/09612033241260334

Anesth Analg. 2024 Jul 1;139(1):211-219. doi: 10.1213/ANE.0000000000006967. Epub 2024 Jun 17.

ABSTRACT

BACKGROUND: Postoperative acute kidney injury (PO-AKI) is a frequent complication after surgery. Various tools have been proposed to identify patients at high risk for AKI, including preoperative serum creatinine or estimated glomerular filtration rate (eGFR), urinary cell cycle arrest, and tubular damage biomarkers; however, none of these can appropriately assess AKI risk before surgery. Renal functional reserve (RFR) screened by the Doppler-derived intraparenchymal renal resistive index variation (IRRIV) test has been proposed to identify patients at risk for AKI before a kidney insult. IRRIV test has been developed in healthy individuals and previously investigated in cardiac surgery patients. This study aims to evaluate the value of the IRRIV test in identifying PO-AKI among patients undergoing robotic abdominal surgery in the Trendelenburg position for pelvic oncological disease.

METHODS: We performed a prospective, double-blinded, observational study. Preoperative baseline renal function and RFR were assessed in 53 patients with baseline eGFR >60 mL/min/1.73 m2, undergoing robotic surgery in the Trendelenburg position for pelvic oncological disease. The capability of Doppler-derived RFR in predicting PO-AKI was investigated with the area under the receiver operating characteristic curve (ROC-AUC).

RESULTS: Approximately 15.1% of patients developed AKI within the first 3 postoperative days. Thirty-one (58.5%) patients had a physiologic delta-RRI (ie, ≥0.05), while 22 (41.5%) patients did not. The ROC-AUC for PO-AKI was 0.85 (95% confidence interval [CI], 0.74-0.97; P = .007) for serum creatinine, 0.84 (95% CI, 0.71-0.96; P = .006) for eGFR, and 0.84 (95% CI, 0.78-0.91; P = .017) for delta-RRI. When combined with eGFR, the ROC-AUC for delta-RRI was 0.95 (95% CI, 0.9-1).

CONCLUSIONS: Our findings show that the preoperative assessment of Doppler-derived RFR combined with baseline renal function improves the capability of identifying patients at high risk for PO-AKI with eGFR >60 mL/min/1.73 m2 after robotic abdominal surgery in Trendelenburg position for pelvic oncological disease.

PMID:38885478 | DOI:10.1213/ANE.0000000000006967

JCO Oncol Pract. 2024 Jun 17:OP2400016. doi: 10.1200/OP.24.00016. Online ahead of print.

ABSTRACT

PURPOSE: This study used willingness-to-pay (WTP) exercises to explore the relationships between race, financial toxicity, and treatment decision making among people with cancer.

METHODS: A convenience sample of people with multiple myeloma who attended an academic medical center in 2022 was surveyed. Financial toxicity was assessed by the Comprehensive Score for financial Toxicity, with scores <26 indicating financial toxicity. WTP was assessed with (1) a discrete choice experiment (DCE), (2) fixed-choice tasks, and (3) a bidding game.

RESULTS: In total, 156 people were approached, and 130 completed the survey. The majority of the sample was White (n = 99), whereas 24% (n = 31) was African American or Black. Forty-six percent (n = 60) of the sample were experiencing financial toxicity. In the DCE, the relative importance of cost was twice as high for those with financial toxicity (30% compared with 14%; P < .001). In the fixed-choice tasks, they were twice as likely to accept a treatment with shorter progression-free survival but lower costs (adjusted odds ratio [aOR], 2.47; P = .049). In the bidding game, the median monthly WTP of those with financial toxicity was half that of those without ($100 in US dollars [USD] compared with $200 USD; P < .001). Only in the bidding game was race statistically associated with WTP; after controlling for financial toxicity, African American or Black participants were three times as likely (aOR, 3.06; P = .007) to report a lower WTP.

CONCLUSION: Across all three exercises, participants with financial toxicity reported lower WTP than those without. As financial toxicity disproportionally affects some segments of patients, it is possible that financial toxicity contributes to cancer disparities.

PMID:38885465 | DOI:10.1200/OP.24.00016

J Chem Theory Comput. 2024 Jun 17. doi: 10.1021/acs.jctc.4c00510. Online ahead of print.

ABSTRACT

We present a reduction of the Milestoning (ReM) algorithm to analyze the high-dimensional Milestoning kinetic network. The algorithm reduces the Milestoning network to low dimensions but preserves essential kinetic information, such as local residence time, exit time, and mean first passage time between any two states. This is achieved in three steps. First, nodes (milestones) in the high-dimensional Milestoning network are grouped into clusters based on the metastability identified by an auxiliary continuous-time Markov chain. Our clustering method is applicable not only to time-reversible networks but also to nonreversible networks generated from practical simulations with statistical fluctuations. Second, a reduced network is established via network transformation, containing only the core sets of clusters as nodes. Finally, transition pathways are analyzed in the reduced network based on the transition path theory. The algorithm is illustrated using a toy model and a solvated alanine dipeptide in two and four dihedral angles.

PMID:38885437 | DOI:10.1021/acs.jctc.4c00510

Psychol Trauma. 2023 Sep;15(Suppl 2):S352-S356. doi: 10.1037/tra0001483.

ABSTRACT

OBJECTIVE: Moral COVID-19 pandemic. This study aims to explore the relationship between moral injury (MI), posttraumatic stress disorder (PTSD), and suicidal behaviors approximately 1 year after the pandemic peaked in mainland China.

METHODS: An online survey was conducted from March 27 to April 26, 2021, across mainland China. A total of 3,465 health professionals completed the Chinese version of the MI Symptoms Scale-Health Professional, Suicidal Behaviors Questionnaire-Revised, and PTSD Checklist for DSM-5 (PCL-5).

RESULTS: The prevalence of PTSD and suicidal behavior among health professionals were 26.9% and 24.2%, respectively. MI is associated with a higher risk of PTSD (OR =3.52, 95% CI [3.01, 4.13]), and a higher risk of suicidal behaviors (OR= 2.13, 95% CI [1.81, 2.50]) under the controlling of sociodemographic variables. And the interaction of PTSD and MI was associated with a significantly increased risk of suicidal behaviors (ORinteraction = 1.61, 95% CI [1.29, 2.02]).

CONCLUSIONS: The MI symptoms are associated with a higher risk of PTSD, and suicidal behaviors among health professionals 1 year after the peak of the COVID-19 pandemic in China. The findings underscore the importance of identifying and treating MI as one way to manage PTSD and suicidal behaviors among health professionals during the postpandemic period. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:38885427 | DOI:10.1037/tra0001483

Psychol Trauma. 2023 Sep;15(Suppl 2):S297-S304. doi: 10.1037/tra0001497.

ABSTRACT

OBJECTIVE: The current study evaluates the psychometric properties of the Protective and Compensatory Experiences Survey (PACES; Morris et al., 2018) within a military population. The study’s aims are to evaluate if the PACES is a reliable measure to use with military samples and to examine the validity of the PACES measure when exploring protective experiences in relation to adverse childhood experiences (ACEs) and adult traumatic stress (ATS) in an active duty military sample.

METHOD: Active duty Service members were recruited to complete an online survey that included measures pertaining to ACEs, PACES, and ATS.

RESULTS: The reliability and validity of PACES indicate that Service members who are involved in protective and compensatory experiences as youth are less likely to have experiences of stress both as children and as adults.

CONCLUSIONS: Given the need for mission readiness of Service members and their higher likelihood to experience ACEs than civilians, the role of protective and compensatory factors is vital to their livelihood and career. PACES psychometrics offer a reliable and valid measure to use when exploring the risk and resilience experiences of Service members across the lifespan. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:38885426 | DOI:10.1037/tra0001497

Bioinformatics. 2024 Jun 17:btae373. doi: 10.1093/bioinformatics/btae373. Online ahead of print.

ABSTRACT

MOTIVATION: Metabolomics, as an essential tool in systems biology, is now widely accessible to researchers of all levels. Yet challenges remain in data analysis and result interpretation. To address these challenges, we introduced MetaboReport, a versatile and interactive web app that simplifies metabolomics experiment design, data preprocessing, exploration, statistical analysis, visualization, and reporting.

RESULTS: MetaboReport produces a comprehensive HTML report, including project details, an introduction, interactive plots and tables, statistical results and an in-depth explanations and interpretation of the results. MetaboReport is particularly tailored for research labs and metabolomics core facilities that provide metabolomics services, allowing them to efficiently manage and document different metabolomics projects, and effectively report the metabolomics results to users.

AVAILABILITY: MetaboReport is freely accessible on https://metaboreport.com,with source code available on GitHub (https://github.com/YonghuiDong/MetReport). Alternatively, users can install MetaboReport as a standalone desktop app (https://metaboreport.sourceforge.io).

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:38885410 | DOI:10.1093/bioinformatics/btae373

Bioinformatics. 2024 Jun 17:btae344. doi: 10.1093/bioinformatics/btae344. Online ahead of print.

ABSTRACT

MOTIVATION: Multi-strain infection is a common yet under-investigated phenomenon of many pathogens. Currently, biologists analyzing SNP information sometimes have to discard mixed infection samples as many downstream analyses require monogenomic inputs. Such a protocol impedes our understanding of the underlying genetic diversity, co-infection patterns, and genomic relatedness of pathogens. A scalable tool to learn and resolve the SNP-haplotypes from polygenomic data is an urgent need in molecular epidemiology.

RESULTS: We develop a slice sampling Markov Chain Monte Carlo algorithm, named SNP-Slice, to learn not only the SNP-haplotypes of all strains in the populations but also which strains infect which hosts. Our method reconstructs SNP-haplotypes and individual heterozygosities accurately without reference panels and outperforms the state-of-the-art methods at estimating the multiplicity of infections and allele frequencies. Thus, SNP-Slice introduces a novel approach to address polygenomic data and opens a new avenue for resolving complex infection patterns in molecular surveillance. We illustrate the performance of SNP-Slice on empirical malaria and HIV datasets and provide recommendations for using our method on empirical datasets.

AVAILABILITY AND IMPLEMENTATION: The implementation of the SNP-Slice algorithm, as well as scripts to analyze SNP-Slice outputs, are available at https://github.com/nianqiaoju/snp-slice.

PMID:38885409 | DOI:10.1093/bioinformatics/btae344

Adv Physiol Educ. 2024 Sep 1;48(3):465-473. doi: 10.1152/advan.00036.2024.

ABSTRACT

Student-faculty interaction (SFI) is an important indicator of student engagement that positively associates with academic achievement and retention. Quantitative information regarding the impact of emergency remote teaching (ERT) during COVID-19 on SFI is limited. This retrospective, observational cohort study tests the hypothesis that COVID-19 ERT negatively affected SFI in a gender-dependent manner. Electronic records of office hour (OH) appointments, used to measure SFI, for first-year medical students across three time periods, before, during and after COVID, were obtained and analyzed. A concerning, marked decline in SFI during and after the COVID-19 pandemic is noted. Before COVID, significantly more women (75.20%) made at least one OH appointment compared with men (40.54%). During COVID, the proportion of women making an OH appointment (69.71%) was statistically indistinguishable from women before COVID-19. In contrast, significantly fewer men during COVID (10.34%) than before COVID made an OH appointment. On return to face-to-face teaching, no rebound effect was observed. Compared with before COVID gender-matched peers, fewer men and women after COVID made OH appointments. Discipline-based analyses show that for all three time periods physiology emerged as the content area in which students made most OH appointments. The reduction in SFI observed, combined with the consistency with which the participants in our study indicated a need for assistance with the physiology discipline, emphasizes the importance of active promotion of faculty support and deliberate efforts to reconnect with students in the post-COVID context.NEW & NOTEWORTHY Applying readily available data, we quantify a persistent, negative impact of the shift to emergency remote teaching (ERT) on a measure of student-faculty interaction (SFI) among first-year medical students. A gender-based component to these effects is also discussed. Before, during, and after COVID, physiology emerged as the most engaged-with discipline as measured by office hour (OH) appointment volume.

PMID:38885323 | DOI:10.1152/advan.00036.2024