Tag: pubmed

PLoS Comput Biol. 2023 Nov 13;19(11):e1011580. doi: 10.1371/journal.pcbi.1011580. Online ahead of print.

ABSTRACT

In the early phases of growth, resurgent epidemic waves of SARS-CoV-2 incidence have been characterised by localised outbreaks. Therefore, understanding the geographic dispersion of emerging variants at the start of an outbreak is key for situational public health awareness. Using telecoms data, we derived mobility networks describing the movement patterns between local authorities in England, which we have used to inform the spatial structure of a Bayesian BYM2 model. Surge testing interventions can result in spatio-temporal sampling bias, and we account for this by extending the BYM2 model to include a random effect for each timepoint in a given area. Simulated-scenario modelling and real-world analyses of each variant that became dominant in England were conducted using our BYM2 model at local authority level in England. Simulated datasets were created using a stochastic metapopulation model, with the transmission rates between different areas parameterised using telecoms mobility data. Different scenarios were constructed to reproduce real-world spatial dispersion patterns that could prove challenging to inference, and we used these scenarios to understand the performance characteristics of the BYM2 model. The model performed better than unadjusted test positivity in all the simulation-scenarios, and in particular when sample sizes were small, or data was missing for geographical areas. Through the analyses of emerging variant transmission across England, we found a reduction in the early growth phase geographic clustering of later dominant variants as England became more interconnected from early 2022 and public health interventions were reduced. We have also shown the recent increased geographic spread and dominance of variants with similar mutations in the receptor binding domain, which may be indicative of convergent evolution of SARS-CoV-2 variants.

PMID:37956206 | DOI:10.1371/journal.pcbi.1011580

PLoS One. 2023 Nov 13;18(11):e0294152. doi: 10.1371/journal.pone.0294152. eCollection 2023.

ABSTRACT

INTRODUCTION: Perineal extramammary paget’s disease (EMPD) is characterized with high recurrence rate. Although numerous therapeutic measures for this disease have been reported so far, it is unknown whether there is significant difference in their recurrence-preventing efficiency. This study aims to compare the recurrence outcomes of reported perineal EMPD treatments.

METHODS: We searched public databases of for published studies concerning perineal EMPD treatments. After screening by inclusion and exclusion criteria, we extracted the data relevant to recurrence rate, and conducted network meta-analysis (NMA) by using Bayesian random-effects approach.

RESULTS: Our analysis included 29 previous studies (involving both male and female patients) and 11 treatment designs which are wide local excision (WLE), local excision (LE), Mohs micrographic surgery (MMS), radiotherapy (RT), radical vulvectomy (RV), photodynamic therapy (PDT), lasers (LS), imiquimod, and WLE+RT, WLE+PDT, WLE+LS. Comparing with WLE, the MMS showed significant advantage in reducing recurrence [OR: 0.18 (0.03-0.87)], while none of the rest treatments has statistically significant results. After removing outlier studies, MMS still has the significant advantages [OR: 0.35 (0.11-0.82)], and LE turned to be the treatment with worst performance [OR: 13 (2.50-110)]. Covariance analysis of follow-up length, gender differences, and lesion locations indicated only short follow-up time could affect the recurrence statistics, which tend to conceal the real differences. Funnel plot demonstrated there is no significant small study effect.

CONCLUSION: MMS has the best performance on reducing perineal EMPD recurrence, while LE exhibits the worst capability in such regard. Recurrence-preventing abilities of other treatments have no significant difference between each other.

PMID:37956192 | DOI:10.1371/journal.pone.0294152

J Med Internet Res. 2023 Nov 13;25:e47573. doi: 10.2196/47573.

ABSTRACT

BACKGROUND: Although many surveys have been conducted on patients accessing their own health records in recent years, there is a limited amount of nationwide cross-country data available on patients’ views and preferences. To address this gap, an international survey of patient users was conducted in the Nordic eHealth project, NORDeHEALTH.

OBJECTIVE: We aimed to investigate the sociodemographic characteristics and experiences of patients who accessed their electronic health records (EHRs) through national patient portals in Norway, Sweden, Finland, and Estonia.

METHODS: A cross-sectional web-based survey was distributed using the national online health portals. The target participants were patients who accessed the national patient portals at the start of 2022 and who were aged ≥15 years. The survey included a mixture of close-ended and free-text questions about participant sociodemographics, usability experience, experiences with health care and the EHR, reasons for reading health records online, experience with errors, omissions and offense, opinions about security and privacy, and the usefulness of portal functions. In this paper, we summarized the data on participant demographics, past experience with health care, and the patient portal through descriptive statistics.

RESULTS: In total, 29,334 users completed the survey, of which 9503 (32.40%) were from Norway, 13,008 (44.35%) from Sweden, 4713 (16.07%) from Finland, and 2104 (7.17%) from Estonia. National samples were comparable according to reported gender, with about two-thirds identifying as women (19,904/29,302, 67.93%). Age distributions were similar across the countries, but Finland had older users while Estonia had younger users. The highest attained education and presence of health care education varied among the national samples. In all 4 countries, patients most commonly rated their health as “fair” (11,279/29,302, 38.48%). In Estonia, participants were more often inclined to rate their health positively, whereas Norway and Sweden had the highest proportion of negative health ratings. Across the whole sample, most patients received some care in the last 2 years (25,318/29,254, 86.55%). Mental health care was more common (6214/29,254, 21.24%) than oncological care (3664/29,254, 12.52%). Overall, most patients had accessed their health record “2 to 9 times” (11,546/29,306, 39.4%), with the most frequent users residing in Sweden, where about one-third of patients accessed it “more than 20 times” (4571/13,008, 35.14%).

CONCLUSIONS: This is the first large-scale international survey to compare patient users’ sociodemographics and experiences with accessing their EHRs. Although the countries are in close geographic proximity and demonstrate similar advancements in giving their residents online records access, patient users in this survey differed. We will continue to investigate patients’ experiences and opinions about national patient-accessible EHRs through focused analyses of the national and combined data sets from the NORDeHEALTH 2022 Patient Survey.

PMID:37955963 | DOI:10.2196/47573

JMIR Res Protoc. 2023 Nov 13;12:e50626. doi: 10.2196/50626.

ABSTRACT

BACKGROUND: Globally, health care systems are challenged with the shortage of health care professionals, particularly nurses. The decline in the nursing workforce is primarily attributed to an aging population, increased demand for health care services, and a shortage of qualified nurses. Stressful working conditions have also increased the physical and emotional demands and perceptions of burnout, leading to attrition among nurses. Robotics has the potential to alleviate some of the workforce challenges by augmenting and supporting nurses in their roles; however, the impact of robotics on nurses is an understudied topic, and limited literature exists.

OBJECTIVE: We aim to understand the extent and type of evidence in relation to robotics integration in nursing practice.

METHODS: The Joanna Briggs Institute methodology and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist will guide the scoping review. The MEDLINE (Ovid), Embase (Ovid), CINAHL Plus with Full Text (EBSCOhost), Scopus, Cochrane Library, and IEEE Xplore electronic bibliographic databases will be searched to retrieve papers. In addition, gray literature sources, including Google Scholar, dissertations, theses, registries, blogs, and relevant organizational websites will be searched. Furthermore, the reference lists of included studies retrieved from the databases and the gray literature will be hand-searched to ensure relevant papers are not missed. In total, 2 reviewers will independently screen retrieve papers at each stage of the screening process and independently extract data from the included studies. A third reviewer will be consulted to help decision-making if conflicts arise. Data analysis will be completed using both descriptive statistics and content analysis. The results will be presented using tabular and narrative formats.

RESULTS: The review is expected to describe the current evidence on the integration and impact of robots and robotics into nursing clinical practice, provide insights into the current state and knowledge gaps, identify a direction for future research, and inform policy and practice. The authors expect to begin the data searches in late January 2024.

CONCLUSIONS: The robotics industry is evolving rapidly, providing different solutions that promise to revamp health care delivery with possible improvements to nursing practice. This review protocol outlines the steps proposed to systematically investigate this topic and provides an opportunity for more insights from scholars and researchers working in the field.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/50626.

PMID:37955956 | DOI:10.2196/50626

JMIR Form Res. 2023 Nov 13;7:e47977. doi: 10.2196/47977.

ABSTRACT

BACKGROUND: Peer-assisted learning (PAL) using peer-led web-based platforms (PWPs), including social media, can be a highly effective method of supporting medical trainees. PWPs, such as mobile apps for sharing anesthesia resources and social media groups or discussion forums pertaining to anesthesia training, may play a role in facilitating anesthesia trainee-led web-based education. However, there have been many challenges facing anesthesia trainees when it comes to incorporating PWPs, especially social media and mobile apps for PAL.

OBJECTIVE: The primary objective of this survey was to assess the proportion of trainees that use social media and mobile apps. The secondary objective was to identify the trainees’ perceptions on the use of social media and mobile apps for educational purposes, including PAL.

METHODS: This cross-sectional study was conducted through a survey administered via email at a single large academic center. The survey tool collected data between 2016 and 2017 on the following: demographic data (year of study, field of specialty), use of technology and web-based resources for medicine, use of social media platforms for anesthesia or training, benefits and barriers to future uses of social media for training, and ideas for trainee-led websites. Descriptive statistics were reported.

RESULTS: In total, 80 anesthesia trainees (51 residents and 29 fellows) responded to the survey (response rate of 33% of out 240 trainees contacted). All trainees reported having a mobile device that most (n=61, 76%) reported using multiple times a day to access medical resources. The highest perceived benefits of PWPs according to residents were that the most valuable information was available on-demand (n=27, 53%), they saved time (n=27, 53%), and they improved their overall learning experience within anesthesia (n=24, 47%). In comparison, fellows thought that PWPs were beneficial because they provided multiple perspectives of a single topic (n=13, 45%) and served as an additional platform to discuss ideas with peers (n=13, 45%). The most popular platforms used by both residents and fellows were Facebook (residents: n=44, 86%; fellows: n=26, 90%) followed by LinkedIn (residents: n=21, 42%; fellows: n=9, 29%). Even though most anesthesia trainees used social media for personal reasons, only 26% (n=21) reported having used resident- or fellow-driven PWP resources. Examples of PWPs that trainees used included anesthesia groups and a resident Dropbox resource folder.

CONCLUSIONS: There was generally an acceptance for using PWPs for PAL as they provided various benefits for trainees at all levels of learning. PWPs have the potential to garner an increased sense of community and sharing within learning experiences throughout all levels of training. The information gained from this survey will help inform the basis for developing an anesthesia trainee-led e-learning platform.

PMID:37955954 | DOI:10.2196/47977

J Med Internet Res. 2023 Nov 13;25:e43368. doi: 10.2196/43368.

ABSTRACT

BACKGROUND: The mobile Agnew Relationship Measure (mARM) is a self-report questionnaire for the evaluation of digital mental health interventions and their interactions with users. With the global increase in digital mental health intervention research, translated measures are required to conduct research with local populations.

OBJECTIVE: The aim of this study was to translate and validate the original English version of the mARM into a German version (mARM-G).

METHODS: A total of 2 native German speakers who spoke English as their second language conducted forward translation of the original items. This version was then back translated by 2 native German speakers with a fluent knowledge of English. An independent bilingual reviewer then compared these drafts and created a final German version. The mARM-G was validated by 15 experts in the field of mobile app development and 15 nonexperts for content validity and face validity; 144 participants were recruited to conduct reliability testing as well as confirmatory factor analysis.

RESULTS: The content validity index of the mARM-G was 0.90 (expert ratings) and 0.79 (nonexperts). The face validity index was 0.89 (experts) and 0.86 (nonexperts). Internal consistency for the entire scale was Cronbach α=.91. Confirmatory factor analysis results were as follows: the chi-square statistic to df ratio was 1.66. Comparative Fit Index was 0.87 and the Tucker-Lewis Index was 0.86. The root mean square error of approximation was 0.07.

CONCLUSIONS: The mARM-G is a valid and reliable tool that can be used for future studies in German-speaking countries.

PMID:37955952 | DOI:10.2196/43368

J Med Internet Res. 2023 Nov 13;25:e48634. doi: 10.2196/48634.

ABSTRACT

BACKGROUND: Impairments in cognition and motivation are core features of psychosis and strong predictors of social and occupational functioning. Accumulating evidence indicates that cognitive deficits in psychosis can be improved by computer-based cognitive training programs; however, barriers include access and adherence to cognitive training exercises. Limited evidence-based methods have been established to enhance motivated behavior. In this study, we tested the effects of web-based targeted cognitive and social cognitive training (TCT) delivered in conjunction with an innovative digital smartphone app called Personalized Real-Time Intervention for Motivational Enhancement (PRIME). The PRIME app provides users with a motivational coach to set personalized goals and secure social networking for peer support.

OBJECTIVE: This study investigated whether deficits in cognition and motivation in people with a psychosis spectrum disorder (N=100) can be successfully addressed with 30 hours of TCT+PRIME as compared with 30 hours of a computer games control condition (CG) plus PRIME (CG+PRIME). Here, we describe our study procedures, the feasibility and acceptability of the intervention, and the results on all primary outcomes.

METHODS: In this double-blind randomized controlled trial, English-speaking participants completed all cognitive training, PRIME activities, and assessments remotely. Participants completed a diagnostic interview and remote cognitive, clinical, and self-report measures at baseline, posttraining, and at a 6-month follow-up.

RESULTS: This study included participants from 27 states across the United States and 8 countries worldwide. The study population was 58% (58/100) female, with a mean age of 33.77 (SD 10.70) years. On average, participants completed more than half of the cognitive training regimen (mean 18.58, SD 12.47 hours of training), and logged into the PRIME app 4.71 (SD 1.58) times per week. The attrition rate of 22% (22/100) was lower than that reported in our previous studies on remote cognitive training. The total sample showed significant gains in global cognition (P=.03) and attention (P<.001). The TCT+PRIME participants showed significantly greater gains in emotion recognition (P<.001) and global cognition at the trend level (P=.09), although this was not statistically significant, relative to the CG+PRIME participants. The total sample also showed significant improvements on multiple indices of motivation (P=.02-0.05), in depression (P=.04), in positive symptoms (P=.04), and in negative symptoms at a trend level (P=.09), although this was not statistically significant. Satisfaction with the PRIME app was rated at 7.74 (SD 2.05) on a scale of 1 to 10, with higher values indicating more satisfaction.

CONCLUSIONS: These results demonstrate the feasibility and acceptability of remote cognitive training combined with the PRIME app and that this intervention can improve cognition, motivation, and symptoms in individuals with psychosis. TCT+PRIME appeared more effective in improving emotion recognition and global cognition than CG+PRIME. Future analyses will test the relationship between hours of cognitive training completed; PRIME use; and changes in cognition, motivation, symptoms, and functioning.

TRIAL REGISTRATION: ClinicalTrials.gov NCT02782442; https://clinicaltrials.gov/study/NCT02782442.

PMID:37955951 | DOI:10.2196/48634

J Sports Med Phys Fitness. 2023 Nov 13. doi: 10.23736/S0022-4707.23.15426-0. Online ahead of print.

ABSTRACT

BACKGROUND: Physical performance measures such as horizontal power, acceleration, and change-of-direction ability are related to performance in soccer, and may aid in talent selection, coaching decisions and the prescription of training programs. The purpose of this study was to describe the normative values of three performance tests in amateur female youth soccer players.

METHODS: A cross-sectional descriptive study design was employed with 151 amateur female youth soccer players (age 14.20±1.13 years). Physical performance measures included the standing broad jump, 10-meter sprint, and Pro-Agility Test. Time since peak height velocity (PHV) was calculated to represent physical maturity status. Descriptive statistics were sought, and Pearson’s correlation coefficients were used to identify correlations between variables. One-Way Analysis of Variance with a Tukey post-hoc test was used to calculate the relationship between categorical groups of chronological ages and years since PHV. Significance was set at P<0.05.

RESULTS: Normative data for each physical performance measure are presented based on chronological age and physical maturity status for amateur female youth soccer players. Chronological age was significantly associated with improved performance in standing broad jump (R=0.558; 95% CI: 0.436, 0.658; P<0.01), 10-meter sprint time (R=-0.375; 95% CI: -0.495, -0.217; P<0.01), and Pro-Agility Test time (R=-0.424; 95% CI: -0.546, -0.284; P<0.01). Physical maturity status was also significantly associated with improved performance in standing broad jump (R=0.650; 95% CI: 0.426, 0.711; P<0.01), 10-meter sprint time (R=-0.430; 95% CI: -0.507, -0.232; P<0.01), and Pro-Agility Test time (R=-0.453; 95% CI: -0.554, -0.293; P<0.01).

CONCLUSIONS: The normative data from this study demonstrates differences in physical performances across chronological ages and physical maturity status. Physical maturity status had a slightly stronger association for all performance measures than chronological age. The variance and range tended to increase across performance measures with increasing age.

PMID:37955932 | DOI:10.23736/S0022-4707.23.15426-0

JAMA Intern Med. 2023 Nov 13. doi: 10.1001/jamainternmed.2023.6041. Online ahead of print.

NO ABSTRACT

PMID:37955927 | DOI:10.1001/jamainternmed.2023.6041

JAMA Pediatr. 2023 Nov 13. doi: 10.1001/jamapediatrics.2023.4907. Online ahead of print.

ABSTRACT

IMPORTANCE: Preterm birth is a major contributor to neonatal morbidity and mortality, and considerable differences exist in rates of preterm birth among maternal racial and ethnic groups. Emerging evidence suggests pregnant individuals born outside the US have fewer obstetric complications than those born in the US, but the intersection of maternal nativity with race and ethnicity for preterm birth is not well studied.

OBJECTIVE: To determine if there is an association between maternal nativity and preterm birth rates among nulliparous individuals, and whether that association differs by self-reported race and ethnicity of the pregnant individual.

DESIGN, SETTING, AND PARTICIPANTS: This was a nationwide, cross-sectional study conducted using National Center for Health Statistics birth registration records for 8 590 988 nulliparous individuals aged 15 to 44 years with singleton live births in the US from 2014 to 2019. Data were analyzed from March to May 2022.

EXPOSURES: Maternal nativity (non-US-born compared with US-born individuals as the reference, wherein US-born was defined as born within 1 of the 50 US states or Washington, DC) in the overall sample and stratified by self-reported ethnicity and race, including non-Hispanic Asian and disaggregated Asian subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Pacific Islander, Vietnamese, and other Asian), non-Hispanic Black, Hispanic and disaggregated Hispanic subgroups (Cuban, Mexican, Puerto Rican, and other Hispanic), and non-Hispanic White.

MAIN OUTCOMES AND MEASURES: The primary outcome was preterm birth (<37 weeks of gestation) and the secondary outcome was very preterm birth (<32 weeks of gestation).

RESULTS: Of 8 590 988 pregnant individuals included (mean [SD] age at delivery, 28.3 [5.8] years in non-US-born individuals and 26.2 [5.7] years in US-born individuals; 159 497 [2.3%] US-born and 552 938 [31.2%] non-US-born individuals self-identified as Asian or Pacific Islander, 1 050 367 [15.4%] US-born and 178 898 [10.1%] non-US-born individuals were non-Hispanic Black, 1 100 337 [16.1%] US-born and 711 699 [40.2%] non-US-born individuals were of Hispanic origin, and 4 512 294 [66.1%] US-born and 328 205 [18.5%] non-US-born individuals were non-Hispanic White), age-standardized rates of preterm birth were lower among non-US-born individuals compared with US-born individuals (10.2%; 95% CI, 10.2-10.3 vs 10.9%; 95% CI, 10.9-11.0) with an adjusted odds ratio (aOR) of 0.90 (95% CI, 0.89-0.90). The greatest relative difference was observed among Japanese individuals (aOR, 0.69; 95% CI, 0.60-0.79) and non-Hispanic Black individuals (aOR, 0.74; 0.73-0.76) individuals. Non-US-born Pacific Islander individuals experienced higher preterm birth rates compared with US-born Pacific Islander individuals (aOR, 1.15; 95% CI, 1.04-1.27). Puerto Rican individuals born in Puerto Rico compared with those born in US states or Washington, DC, also had higher preterm birth rates (aOR, 1.07; 95% CI, 1.03-1.12).

CONCLUSIONS AND RELEVANCE: Overall preterm birth rates were lower among non-US-born individuals compared with US-born individuals. However, there was substantial heterogeneity in preterm birth rates across maternal racial and ethnic groups, particularly among disaggregated Asian and Hispanic subgroups.

PMID:37955913 | DOI:10.1001/jamapediatrics.2023.4907