Tag: pubmed

Rhinology. 2023 Sep 13. doi: 10.4193/Rhin23.204. Online ahead of print.

ABSTRACT

This meta-analysis aims to investigate the outcome of sinonasal adenoid cystic carcinoma (snAdCC). We followed PRISMA guidelines and included studies reporting 5-year overall survival (OS) rates for snAdCC. Eligible studies were identified through a literature search and assessed using JBI critical appraisal checklist. A total of 17 studies were included comprising 2259 patients (mean age: 58.1 years, 52.7% female, 47.3% male). The meta-analysis demonstrated that the 5-year OS, 10-year OS, and 5-year disease-free survival (DFS) were 68%, 40%, and 47.2%, respectively. Descriptive statistics on study level showed high rates of locally advanced tumor stages at diagnosis: 23% cT3, 53% cT4, 3.4% N+, and 4.2% M+. 29.7% of the tumors were in the nasal cavity, 67.6% in the paranasal sinuses. The maxillary, ethmoid, sphenoid, and frontal sinus were affected in 50.9%, 7.2%, 4%, and 0.5%, of cases. A combination of surgery and radiotherapy was used in 45.4% of the patients and 19.3% of patients received surgery only. In conclusion, these findings emphasize the significance of thorough surveillance for individuals with snAdCC to identify any potential recurrence or progression of the disease.

PMID:37703531 | DOI:10.4193/Rhin23.204

Am J Hosp Palliat Care. 2023 Sep 13:10499091231200639. doi: 10.1177/10499091231200639. Online ahead of print.

ABSTRACT

Objective: Palliative care often plays a pivotal role in supporting informal caregivers of persons living with dementia who experience a lack of continuity in care. Dementia caregiver activation, the caregiver’s willingness and ability to navigate care needs, requires communication skills for developing relationships with healthcare providers. Communication activation is important because caregivers facilitate physician and patient information exchange. This study aimed to explore changes in communication outcomes (attitude, knowledge, and skills) and impact on caregiver communication activation (confidence, self-report) following completion of a brief communication module. Methods: A 15-minute asynchronous online module was developed to provide caregivers with communication skills for working with doctors and nurses. Caregivers completed pre/post module measures of communication outcomes, a vignette for applying communication strategies and were interviewed within a week of module completion to assess self-reported communication activation. Module acceptability was also evaluated. Results: Communication knowledge (P < .01) significantly increased and nearly all participants (99%) demonstrated use of module-specific communication skills after completing the module. While not statistically significant, caregiver attitudes were in the expected direction. Caregiver self-reported communication confidence (P < .001) significantly increased and 84% of caregivers described communication activation at post-module. Caregivers (83%) were likely to recommend the module. Conclusions: The brief communication module for dementia caregivers in this project offers an online resource with low time-burden that results in caregiver communication activation. Future testing in the clinical setting will increase understanding of its efficacy and integration and could be a viable resource for palliative care providers.

PMID:37703530 | DOI:10.1177/10499091231200639

Fam Community Health. 2023 Oct-Dec 01;46(4):242-249. doi: 10.1097/FCH.0000000000000377.

ABSTRACT

Existing research has established the detrimental effects of food insecurity on health. However, understanding of the social conditions that may moderate this relationship remains limited. To address this gap, the study investigates two questions: First, does marital status moderate the association between food insecurity and self-rated health? Second, if such moderation exists, does its impact vary based on gender? Data from the 2017-2018 Canadian Community Health Survey, a nationally representative survey conducted by Statistics Canada (n =101 647), were utilized for this investigation. The findings demonstrated that individuals living in food-insecure households reported poorer self-rated mental and general health. However, the negative impact of food insecurity on both health outcomes was less pronounced among married individuals than among their unmarried counterparts. Furthermore, the stress-buffering role of marriage was found to be more substantial among men than among women. In light of the significant stress-buffering role of marriage revealed in this study, it is crucial for policies to aim at providing comparable coping resources to unmarried individuals, particularly women.

PMID:37703512 | DOI:10.1097/FCH.0000000000000377

J Am Coll Surg. 2023 Sep 13. doi: 10.1097/XCS.0000000000000863. Online ahead of print.

ABSTRACT

BACKGROUND: High-quality computed tomography (CT) can exclude HVI in patients with an A-SBS but performs poorly at identifying HVI. Delay in diagnosis of HVI has significant consequences necessitating timely identification.

STUDY DESIGN: This multicenter, prospective observational study conducted at nine trauma centers between August 2020-October 2021 included adult trauma patients with A-SBS who underwent abdominal CT prior to surgery. HVI was determined intra-operatively and physiologic, examination, laboratory, and imaging findings were collected. Lasso and probit regression selected predictor variables and coefficients were used to assign integer points for the HVI Score. Validation was performed by comparing area under receiver operating curves (AUROC).

RESULTS: Analysis included 473 in the development set and 203 in the validation set. The HVI Score includes initial systolic blood pressure < 110mmHg, abdominal tenderness, guarding, and select abdominal CT findings. The derivation set has an AUROC of 0.96 and the validation set has an AUROC of 0.91. The HVI Score ranges from 0-17 with score 0-5 having a HVI risk of 0.03-5.36%, 6-9 having a risk of 10.65-44.1%, and 10-17 having a risk of 58.59-99.72%.

CONCLUSIONS: This multicenter study developed and validated a novel HVI Score incorporating readily available physiologic, examination, and CT findings to risk stratify patients with an abdominal SBS. The HVI Score can be used to guide decisions regarding management of a patient with an abdominal SBS and suspected HVI.

PMID:37703489 | DOI:10.1097/XCS.0000000000000863

Chaos. 2023 Sep 1;33(9):093117. doi: 10.1063/5.0156025.

ABSTRACT

Synchronization of chaotic systems is usually investigated for structurally equivalent systems typically coupled through linear diffusive functions. Here, we focus on a particular type of coupling borrowed from a nonlinear control theory and based on the optimal placement of a sensor-a device measuring the chosen variable-and an actuator-a device applying the actuating (control) signal to a variable’s derivative-in the response system, leading to the so-called flat control law. We aim to investigate the dynamics produced by a response system that is flat coupled to a drive system and to determine the degree of generalized synchronization between them using statistical and topological arguments. The general use of a flat control law for getting generalized synchronization is discussed.

PMID:37703476 | DOI:10.1063/5.0156025

Rev Esc Enferm USP. 2023 Aug 28;57:e20230047. doi: 10.1590/1980-220X-REEUSP-2023-0047en. eCollection 2023.

ABSTRACT

OBJECTIVE: To compare nursing staff workload and dimensioning measured by two patient classification systems.

METHOD: Cross-sectional study, developed in a clinical inpatient unit of a large hospital in southern Brazil, between June and August 2022. Included patients (n = 260) were assessed through two different patient classification systems. The dimensioning calculation provided by the standard and descriptive statistics were applied.

RESULTS: Of the total number of patients, 1,248 classifications were performed with each of the classification systems. One of the instruments showed a concentration of demand for minimal care (54.5%) and the other for intermediate care (63.4%). The anticipation of required nursing hours was discrepant (235.58 and 298.16 hours), as well as the projected nursing staff, which was of 53 and 67 workers, respectively.

CONCLUSION: Measurement of workload and dimensioning were different when using two patient classification systems in the same sample. Additional accuracy studies shall be carried out.

PMID:37703470 | DOI:10.1590/1980-220X-REEUSP-2023-0047en

Inorg Chem. 2023 Sep 13. doi: 10.1021/acs.inorgchem.3c00008. Online ahead of print.

ABSTRACT

We introduce Na₂[Fe₃S₄], comprising anionic layers, synthesized by a simple and straightforward solid-state method based on the fusion of binary sulfides of abundant sodium and iron. The structure crystallizes in a trigonal lattice with honeycomb cavities, as well as 25% of statistical iron vacancies in the crystal structure. The compound depicts high dielectric constants from 998 to 1850 at a frequency of 1 kHz depending on the sintering temperature, comparable with benchmark dielectric materials. According to the complex electrochemical impedance results, the compound depicts an electrical conductivity at ambient temperature. Optical investigations reveal a band gap of 1.64 eV, which is in agreement with an electronic band gap of 1.63 eV computed by density functional theory calculations. Magnetometry results reveal an antiferromagnetic behavior with a transition at 120 K. These findings introduce Na₂[Fe₃S₄] as a sustainable multifunctional material with potential for a variety of electronic and magnetic applications.

PMID:37703452 | DOI:10.1021/acs.inorgchem.3c00008

Pain. 2023 Sep 13. doi: 10.1097/j.pain.0000000000003051. Online ahead of print.

ABSTRACT

Neonatal pain is a critical issue in clinical practice. The oral administration of glucose-based solutions is currently one of the most common and effective nonpharmacologic strategies for neonatal pain relief in daily minor procedures. However, a varying degree of analgesic efficacy has been reported for this treatment. Environmental, maternal, and genetic factors may explain this variability and potentially allow for a personalized analgesic approach, maximizing therapeutic efficacy and preventing side effects. We investigated the exposome (ie, the set of clinical and anthropometric variables potentially affecting the response to the therapy) and the genetic variability of the noradrenaline transporter gene (solute carrier family 6 member 2 [SLC6A2]) and 2 glucose transporter genes (solute carrier family 2 member 1 [SLC2A1] and 2 [SLC2A2]) in relation to the neonatal analgesic efficacy of a 33% glucose solution. The study population consisted in a homogeneous sample of more than 1400 healthy term newborns. No association for the exposome was observed, whereas a statistically significant association between the G allele of SLC2A1-rs1105297 and a fourfold decreased probability of responding to the therapy was identified after multiple-testing correction (odds ratio of 3.98, 95% confidence interval 1.95-9.17; P = 4.05 × 10-4). This allele decreases the expression of SLC2A1-AS1, causing the upregulation of SLC2A1 in the dorsal striatum, which has been suggested to be involved in reward-related processes through the binding of opioids to the striatal mu-opioid receptors. Altogether, these results suggest the involvement of SLC2A1 in the analgesic process and highlight the importance of host genetics for defining personalized analgesic treatments.

PMID:37703430 | DOI:10.1097/j.pain.0000000000003051

Health Promot Int. 2023 Oct 1;38(5):daad109. doi: 10.1093/heapro/daad109.

ABSTRACT

Adolescents’ general health status and health behaviors have been closely monitored in recent years. It is estimated that adolescents comprise one-sixth of the world’s population. This study examined whether eHealth literacy was predicted via health promotion activities and preventive health practices among Turkish adolescents. This cross-sectional study was conducted between March and May 2022 with 706 adolescents in Çorum, Turkey. A face-to-face questionnaire form was used, including socio-demographic characteristics, preventive health practices, eHealth literacy scale and Adolescent Health Promotion Scale. The data of the research were analyzed with the SPSS 22.0 program. Percentage, mean, Pearson Correlation analysis, and multiple regression analysis were used in the analyzes. The p < 0.05 value was considered statistically significant in the evaluations. In the study, 55.8% were female, and the mean age of the whole group was 16.09 ± 2.63 years. The mean score on the eHealth literacy scale was 29.40 ± 6.29. The mean of the total scores obtained from the Adolescent Health Promotion Scale was 137.97 ± 21.87. There was a significant positive correlation between eHealth literacy and the Adolescent Health Promotion Scale (p < 0.001). Multiple linear regression analysis was performed to predict eHealth literacy using the variables of Adolescent Health Promotion and preventive health practices. eHealth literacy positively and significantly predicts health promotion activities (β = 0.27, t (695) = 7.54, p < 0.001). eHealth literacy increased annual weight measurement by more than 0.13 (β = 0.13), annual blood iron measurement by more than 0.16 (β = 0.16) and annual dental examination by more than 0.11 (β = 0.11). Developing eHealth literacy interventions will be necessary for environments with a high concentration of adolescents (schools and courses). Also, primary health care services should be integrated with the school environment.

PMID:37703395 | DOI:10.1093/heapro/daad109

Sleep. 2023 Sep 13:zsad242. doi: 10.1093/sleep/zsad242. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: Polysomnography (PSG) scoring is labor intensive, subjective, and often ambiguous. Recently several deep learning (DL) models for automated sleep scoring have been developed, they are tied to a fixed amount of input channels and resolution. In this study, we constructed a standardized image-based PSG dataset in order to overcome the heterogeneity of raw signal data obtained from various PSG devices and various sleep laboratory environments.

METHODS: All individually exported European data format files containing raw signals were converted into images with an annotation file, which contained the demographics, diagnoses, and sleep statistics. An image-based DL model for automatic sleep staging was developed, compared with a signal-based model and validated in an external dataset.

RESULTS: We constructed 10,253 image-based PSG datasets using a standardized format. Among these, 7,745 diagnostic PSG data were used to develop our DL model. The DL model using the image dataset showed similar performance to the signal-based dataset for the same subject. The overall DL accuracy was greater than 80%, even with severe obstructive sleep apnea. Moreover, for the first time, we showed explainable DL in the field of sleep medicine as visualized key inference regions using Eigen-class activation maps. Furthermore, when a DL model for sleep scoring performs external validation, we achieved a relatively good performance.

CONCLUSION: Our main contribution demonstrates the availability of a standardized image-based dataset, and highlights that changing the data sampling rate or number of sensors may not require retraining, although performance decreases slightly as the number of sensors decreases.

PMID:37703391 | DOI:10.1093/sleep/zsad242