Tag: pubmed

PLoS One. 2023 Oct 5;18(10):e0292218. doi: 10.1371/journal.pone.0292218. eCollection 2023.

ABSTRACT

INTRODUCTION: The success rate of pulmonary tuberculosis in developing countries is different than expected despite effective treatment. We evaluated treatment outcomes and associated factors of pulmonary tuberculosis patients.

METHODS: A retrospective cross-sectional study was employed among randomly selected health centers in Addis Ababa, Ethiopia. Patient records of adult pulmonary tuberculosis patients treated between January 1st, 2017, and December 31st, 2019 were reviewed. Convenient sampling technique was used to select the study participants. Statistical package for social sciences (SPSS), version 24-computer software was used for analysis. Participants’ characteristics were descriptively described, and Bivariate, and multivariate logistic regression analysis were used to determine independent variables related to clinical outcomes. The significance level was determined at p-value < 0.05 and a 95% confidence level.

RESULTS: Six hundred thirty-six patient records with a mean age of 37.49± 2.99 were reviewed. The overall treatment success rate was 84.9%. Absence of comorbid illness [AOR = 0.444; 95% CI:0.219-0.900], non-smoking [AOR = 0.35; 95% CI:0.194-0.645], and being HIV negative [AOR = 0.22; 95% CI: 0.106-0.460] were associated with successful treatment outcomes, whereas, not having treatment supporter [AOR = 15.68; 95% CI: 8.11-30.33] was associated with unsuccessful treatment outcome.

CONCLUSIONS: Treatment success in this study was below the average target set by WHO. HIV positivity, co-morbidities, and smoking increased risk of treatment failure. Patient education about cessation may improve treatment success.

PMID:37796955 | DOI:10.1371/journal.pone.0292218

PLoS One. 2023 Oct 5;18(10):e0292303. doi: 10.1371/journal.pone.0292303. eCollection 2023.

ABSTRACT

INTRODUCTION: Despite the evidence that calcium supplementation in pregnancy improves maternofoetal outcomes, many women still do not take calcium supplements during pregnancy in Cameroon. This study identifies factors that influence calcium supplementation during pregnancy in a low resource setting.

METHODS: We conducted a cross-sectional hospital-based study (from November 2020 to September 2021) targeting 1074 healthy women in late pregnancy at the maternities of four major health facilities in the Nkongsamba Health District, Cameroon. Data were collected using an interview-administered semi-structured questionnaire and analysed using Epi Info version 7.2.4.0, and the statistical threshold for significance set at p-value = 0.05.

RESULTS: The mean age of the participants was 28.20±6.08 years, with a range of 15-47 years. The proportion of women who reported taking any calcium supplements in pregnancy was 72.62 [69.85-75.22]%. Only 12% of calcium-supplemented women took calcium supplements throughout pregnancy, while a majority (50%) took calcium supplements just for 4-5 months. Women believe that taking calcium supplements is more for foetal growth and development (37.12%) and prevention of cramps (38.86%), than for the prevention of hypertensive diseases in pregnancy (2.84%). About all pregnant women (97.65%) took iron and folic acid supplements during pregnancy, and 99.24% took these supplements at least once every two days. Upon control for multiple confounders, the onset of antenatal care before 4 months of pregnancy (AOR = 2.64 [1.84-3.78], p-value = 0.000), having had more than 3 antenatal care visits (AOR = 6.01 [3.84-9.34], p-value = 0.000) and support/reminder from a partner on the necessity to take supplements in pregnancy (AOR = 2.00 [1.34-2.99], p-value = 0.001) were significantly associated with higher odds of taking any calcium supplements in pregnancy.

CONCLUSION: Calcium supplementation practices in pregnancy remain poor in this population and far from WHO recommendations. Early initiation of antenatal care, a high number of antenatal visits and reminders or support from the partner on supplement intake significantly increase the odds of taking any calcium supplements in pregnancy. In line with WHO recommendations, women of childbearing age should be sensitised to initiate antenatal care earlier and attain as many visits as possible. Male involvement in prenatal care might also boost the likelihood of these women taking calcium supplements.

PMID:37796953 | DOI:10.1371/journal.pone.0292303

Personal Disord. 2023 Oct 5. doi: 10.1037/per0000638. Online ahead of print.

ABSTRACT

Narrative identity, as an integral element of personality, has gained increased attention for understanding personality pathology. In this study, associations between narrative identity characteristics (i.e., event valence, theme, contextual coherence, thematic coherence, self-event connection valence, agency, and communion) and personality pathology were examined. Personality pathology was conceptualized as (a) levels of personality (dys)functioning and maladaptive personality traits, (b) six trait facet profiles, and (c) categorical DSM-5 (fifth edition of the Diagnostic Statistical Manual of Mental Disorders) diagnoses. Data of 242 youth (M_age = 18.79; SD_age = 2.65) were collected as part of a longitudinal study on personality development. Narratives were assessed with turning point interviews, and trait and functioning levels with self-report questionnaires. The narrative identity characteristics of a negative valence, a negative self-event connection valence, low agency, and low communion were associated with higher levels of personality dysfunctioning, negative affectivity, detachment, and psychoticism. These characteristics were also associated with the borderline, avoidant, obsessive-compulsive, and schizotypal trait facet profiles. No associations were found when considering personality pathology from a categorical perspective. Findings may inspire researchers and clinicians to give personal stories a more central role in their work. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37796600 | DOI:10.1037/per0000638

JMIR Res Protoc. 2023 Oct 5;12:e51096. doi: 10.2196/51096.

ABSTRACT

BACKGROUND: Children’s mental health is a public health priority, with 1 in 5 European children younger than 12 years having a behavioral, developmental, or psychological disorder. Mental health literacy (MHL) is a modifiable determinant of mental health, promoting psychological well-being and reducing mental health problems. Despite its significance, no interventions or scales currently exist for increasing and measuring MHL in this population.

OBJECTIVE: This study has dual objectives: (1) cocreating and evaluating an intervention on children’s MHL, and (2) developing and validating a scale that measures children’s MHL.

METHODS: Our study focuses on children aged 9-11 years attending primary school classes in various settings, including urban and rural areas, and priority education zones within a French department. Using a participatory research approach, we will conduct workshops involving children, parents, teachers, and 1 artist to cocreate an intervention comprising multiple tools (eg, a pedagogical kit and videos). This intervention will undergo initial evaluation in 4 classes through observations, interviews, and satisfaction questionnaires to assess its viability. Concurrently, the artist will collaborate with children to create the initial version of the CHILD-MHL scale, which will then be administered to 300 children. Psychometric analyses will validate the scale. Subsequently, we will conduct a cluster randomized controlled trial involving a minimum of 20 classes, using the CHILD-MHL scale scores as the primary end point to evaluate the intervention’s efficacy. Additional interviews will complement this mixed methods evaluation. Both the intervention and the scale are grounded in the Child-Focused MHL model.

RESULTS: The first tool of the intervention is the pedagogical kit Le Jardin du Dedans, supported by the public organization Psycom Santé Mentale Info and endorsed by UNICEF (United Nations Children’s Fund) France. The second tool is a handbook by the Pan American Health Organization and the World Health Organization, which is addressed to teachers to sensitize them to children’s mental health problems. The third is a 5-page supplementary leaflet produced by the nongovernmental organization The Ink Link, which teaches children the notion of MHL. Finally, we produced 56 items of the MHL Scale and listed existing education policies for children’s mental health.

CONCLUSIONS: After its robust evaluation, the intervention could be extended to several schools in France. The scale will be the first in the world to measure children’s MHL. It will be used not only to evaluate interventions but also to provide data for decision makers to include MHL in all educational policies. Both the intervention and the scale could be translated into other languages.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/51096.

PMID:37796588 | DOI:10.2196/51096

JMIR Med Inform. 2023 Oct 5;11:e44892. doi: 10.2196/44892.

ABSTRACT

BACKGROUND: Given the threat posed by cancer to human health, there is a rapid growth in the volume of data in the cancer field and interdisciplinary and collaborative research is becoming increasingly important for fine-grained classification. The low-resolution classifier of reported studies at the journal level fails to satisfy advanced searching demands, and a single label does not adequately characterize the literature originated from interdisciplinary research results. There is thus a need to establish a multilabel classifier with higher resolution to support literature retrieval for cancer research and reduce the burden of screening papers for clinical relevance.

OBJECTIVE: The primary objective of this research was to address the low-resolution issue of cancer literature classification due to the ambiguity of the existing journal-level classifier in order to support gaining high-relevance evidence for clinical consideration and all-sided results for literature retrieval.

METHODS: We trained a multilabel classifier with scalability for classifying the literature on cancer research directly at the publication level to assign proper content-derived labels based on the “Bidirectional Encoder Representation from Transformers (BERT) + X” model and obtain the best option for X. First, a corpus of 70,599 cancer publications retrieved from the Dimensions database was divided into a training and a testing set in a ratio of 7:3. Second, using the classification terminology of International Cancer Research Partnership cancer types, we compared the performance of classifiers developed using BERT and 5 classical deep learning models, such as the text recurrent neural network (TextRNN) and FastText, followed by metrics analysis.

RESULTS: After comparing various combined deep learning models, we obtained a classifier based on the optimal combination “BERT + TextRNN,” with a precision of 93.09%, a recall of 87.75%, and an F₁-score of 90.34%. Moreover, we quantified the distinctive characteristics in the text structure and multilabel distribution in order to generalize the model to other fields with similar characteristics.

CONCLUSIONS: The “BERT + TextRNN” model was trained for high-resolution classification of cancer literature at the publication level to support accurate retrieval and academic statistics. The model automatically assigns 1 or more labels to each cancer paper, as required. Quantitative comparison verified that the “BERT + TextRNN” model is the best fit for multilabel classification of cancer literature compared to other models. More data from diverse fields will be collected to testify the scalability and extensibility of the proposed model in the future.

PMID:37796584 | DOI:10.2196/44892

J Exp Psychol Hum Percept Perform. 2023 Oct 5. doi: 10.1037/xhp0001152. Online ahead of print.

ABSTRACT

The visual system continuously adapts to the statistical properties of the environment. In this study, we demonstrated that training significantly enhanced subjects’ perceptual sensitivity to co-occurrence statistics in naturalistic textures. The learning effect was specific to the statistical component and spatial location. By examining the time course of learning, we found that learning was accelerated at an untrained location. Our findings establish a link between statistical learning and visual perception, indicating multistage plasticity beyond V1 in the visual hierarchy. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37796580 | DOI:10.1037/xhp0001152

JMIR Aging. 2023 Oct 5;6:e49154. doi: 10.2196/49154.

ABSTRACT

BACKGROUND: Harm from medications is a major patient safety challenge among older persons. Adverse drug events tend to arise when prescribing or evaluating medications; therefore, interventions targeting these may promote patient safety. Guidelines highlight the value of a joint plan for continued treatment. If such a plan includes medications, a medication plan promoting patient safety is advised. There is growing evidence for the benefits of including patients and health care professionals in initiatives for improving health care products and services through co-design.

OBJECTIVE: This study aimed to identify participants’ needs and requirements for a medication plan and explore their reasoning for different design choices.

METHODS: Using a case study design, we collected and analyzed qualitative and quantitative data and compared them side by side. We explored the needs and requirements for a medication plan expressed by 14 participants (older persons, nurses, and physicians) during a co-design initiative in a regional health system in Sweden. We performed a directed content analysis of qualitative data gathered from co-design sessions and interviews. Descriptive statistics were used to analyze the quantitative data from survey answers.

RESULTS: A medication plan must provide an added everyday value related to safety, effort, and engagement. The physicians addressed challenges in setting aside time to apply a medication plan, whereas the older persons raised the potential for increased patient involvement. According to the participants, a medication plan needs to support communication, continuity, and interaction. The nurses specifically addressed the need for a plan that was easy to gain an overview of. Important function requirements included providing instant access, automation, and attention. Content requirements included providing detailed information about the medication treatment. Having the plan linked to the medication list and instantly obtainable information was also requested.

CONCLUSIONS: After discussing the needs and requirements for a medication plan, the participants agreed on an iteratively developed medication plan prototype linked to the medication list within the existing electronic health record. According to the participants, the medication plan prototype may promote patient safety and enable patient engagement, but concerns were raised about its use in daily clinical practice. The last step in the co-design framework is testing the intervention to explore how it works and connects with users. Therefore, testing the medication plan prototype in clinical practice would be a future step.

PMID:37796569 | DOI:10.2196/49154

JAMA Otolaryngol Head Neck Surg. 2023 Oct 5. doi: 10.1001/jamaoto.2023.3028. Online ahead of print.

ABSTRACT

IMPORTANCE: Because microvascular free flap reconstruction is increasingly used to restore function in patients with head and neck cancer, there is a growing need for evidence-based perioperative care.

OBJECTIVE: To assess the association of different team-based surgical approaches with intraoperative and postoperative outcomes for patients undergoing head and neck free flap reconstruction.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study of 733 patients was conducted at an academic tertiary care medical center. Head and neck oncologic procedures involving microvascular free flap reconstruction with available intraoperative data collected from January 1, 2000, to December 31, 2021, were included.

MAIN OUTCOMES AND MEASURES: Patient characteristics including demographic characteristics and comorbid conditions, operative variables, length of stay, and postoperative outcomes were measured. Descriptive statistics and effect size measures were performed to compare the 3 intraoperative surgical team approaches, specifically single surgeon, separate 2-team approach, and integrated 2-team approach; 1:1 nearest neighbor matching without caliper was performed to compare single- vs 2-team and separate and integrated 2-team approaches. Effect size measures including Cramer V for dichotomous variables, the Kendall W coefficient of concordance for ordinal variables, and η2 for continuous variables were reported with 95% CIs to describe precision.

RESULTS: Among 733 cases, there were no clinically significant differences in patient demographic characteristics, clinicopathologic characteristics, and choice of free flap reconstruction based on intraoperative surgical team approach. The mean (SD) age was 58.7 (12.4) years, and 514 were male (70.1%). In terms of operative and postoperative variables, there was a difference in operative times and intraoperative fluid requirements among the 3 different techniques, with the integrated 2-team approach demonstrating a mean reduction in operative time of approximately 2 hours (η2 = 0.871; 95% CI, 0.852-0.887; mean [SD] operative time = 541 [191] minutes for the single-surgeon approach, 399 [175] minutes for the integrated 2-team approach, and 537 [200] minutes for the separate 2-team approach) and lower fluid requirements of greater than 1 L (η2 = 0.790; 95% CI, 0.762-0.817). In both unadjusted analyses and propensity score matching, there were no clinically significant differences in terms of ischemia time, use of pressors, postoperative complications (including free flap failure, number of return trips to the operating room, length of stay, or 30-day readmission) based on intraoperative team approach.

CONCLUSIONS AND RELEVANCE: Findings suggest that the integrated 2-team surgical approach for complex head and neck microvascular reconstruction can be used to safely decrease operative time, with no difference in postoperative outcomes.

PMID:37796525 | DOI:10.1001/jamaoto.2023.3028

Transl Vis Sci Technol. 2023 Oct 3;12(10):4. doi: 10.1167/tvst.12.10.4.

ABSTRACT

PURPOSE: To investigate the relationship between limited English proficiency (LEP) and diabetic retinopathy (DR) in patients presenting for cataract surgery.

METHODS: This is a retrospective observational study of patients who underwent cataract surgery between January 2014 and February 2020. Patients who self-identified as needing or preferring an interpreter were defined as having LEP. Differences in demographics, characteristics, and outcomes including history of type 2 diabetes (T2DM), DR, preoperative best corrected visual acuity (BCVA), macular edema, and anti-vascular endothelial growth factor injections were analyzed. Statistical comparisons were assessed using logistic regression with generalized estimating equations.

RESULTS: We included 13,590 eyes. Of these, 868 (6.4%) were from LEP patients. Patients with LEP were more likely to be Hispanic (P < 0.001), female sex (P = 0.008), or older age (P = 0.003) and have worse mean BCVA at presentation (P < 0.001). Patients with LEP had a significantly higher rate of T2DM (P < 0.001), macular edema (P = 0.033), and DR (18.1% vs. 5.8%, P < 0.001). Findings remained significant when controlling for age, sex, race/ethnicity, and type of health insurance. Patients with LEP and DR were more likely to have had later stages of DR (P = 0.023).

CONCLUSIONS: Patients with LEP presenting for cataract surgery had a higher rate of DR and associated complications compared to patients with English proficiency. Further studies are needed to understand how language disparities influence health and what measures could be taken to improve healthcare in this vulnerable population.

TRANSLATIONAL RELEVANCE: Our study highlights healthcare disparities within ophthalmology and emphasizes the importance of advocating for improved healthcare delivery for patients with LEP.

PMID:37796496 | DOI:10.1167/tvst.12.10.4

JAMA Oncol. 2023 Oct 5. doi: 10.1001/jamaoncol.2023.3859. Online ahead of print.

NO ABSTRACT

PMID:37796491 | DOI:10.1001/jamaoncol.2023.3859