Tag: pubmed

PLoS One. 2023 Jul 10;18(7):e0288339. doi: 10.1371/journal.pone.0288339. eCollection 2023.

ABSTRACT

Researchers have begun studying the impact of human opioid and cannabinoid use on dog populations. These studies have used data from an animal poison control center (APCC) and there are concerns that due to the illicit nature and social stigma concerning the use of these drugs, owners may not always be forthcoming with veterinarians or APCC staff regarding pet exposures to these toxicants. As a result, models derived from APCC data that examine the predictability of opioid and cannabinoid dog poisonings using pet demographic and health disorder information may help veterinarians or APCC staff more reliably identify these toxicants when examining or responding to a call concerning a dog poisoned by an unknown toxicant. The fitting of epidemiologically informed statistical models has been useful for identifying factors associated with various health conditions and as predictive tools. However, machine learning, including lasso regression, has many useful features as predictive tools, including the ability to incorporate large numbers of independent variables. Consequently, the objectives of our study were: 1) identify pet demographic and health disorders associated with opioid and cannabinoid dog poisonings using ordinary and mixed logistic regression models; and 2) compare the predictive performance of these models to analogous lasso logistic regression models. Data were obtained from reports of dog poisoning events collected by the American Society for the Prevention of Cruelty to Animals’ (ASPCA) Animal Poisoning Control Center, from 2005-2014. We used ordinary and mixed logistic regression models as well as lasso logistic regression models with and without controlling for autocorrelation at the state level to train our models on half the dataset and test their predictive performance on the remainder. Although epidemiologically informed logistic regression models may require substantial knowledge of the disease systems being investigated, they had the same predictive abilities as lasso logistic regression models. All models had relatively high predictive parameters except for positive predictive values, due to the rare nature of calls concerning opioid and cannabinoid poisonings. Ordinary and mixed logistic regression models were also substantially more parsimonious than their lasso equivalents while still allowing for the epidemiological interpretation of model coefficients. Controlling for autocorrelation had little effect on the predictive performance of all models, but it did reduce the number of variables included in lasso models. Several disorder variables were associated with opioid and cannabinoid calls that were consistent with the acute effects of these toxicants. These models may help build diagnostic evidence concerning dog exposure to opioids and cannabinoids, saving time and resources when investigating these cases.

PMID:37428780 | DOI:10.1371/journal.pone.0288339

PLoS One. 2023 Jul 10;18(7):e0288262. doi: 10.1371/journal.pone.0288262. eCollection 2023.

ABSTRACT

Establishing links between breeding, stopover, and wintering sites for migratory species is important for their effective conservation and management. Isotopic assignment methods used to create these connections rely on the use of predictable, established relationships between the isotopic composition of environmental hydrogen and that of the non-exchangeable hydrogen in animal tissues, often in the form of a calibration equation relating feather (δ2Hf) values derived from known-origin individuals and amount-weighted long-term precipitation (δ2Hp) data. The efficacy of assigning waterfowl to moult origin using stable isotopes depends on the accuracy of these relationships and their statistical uncertainty. Most current calibrations for terrestrial species in North America are done using amount-weighted mean growing-season δ2Hp values, but the calibration relationship is less clear for aquatic and semi-aquatic species. Our objective was to critically evaluate current methods used to calibrate δ2Hp isoscapes to predicted δ2Hf values for waterfowl. Specifically, we evaluated the strength of the relationships between δ2Hp values from three commonly used isoscapes and known-origin δ2Hf values three published datasets and one collected as part of this study, also grouping these data into foraging guilds (dabbling vs diving ducks). We then evaluated the performance of assignments using these calibrations by applying a cross-validation procedure. It remains unclear if any of the tested δ2Hp isoscapes better predict surface water inputs into food webs for foraging waterfowl. We found only marginal differences in the performance of the tested known-origin datasets, where the combined foraging-guild-specific datasets showed lower assignment precision and model fit compared to data for individual species. We recommend the use of the more conservative combined foraging-guild-specific datasets to assign geographic origin for all dabbling duck species. Refining these relationships is important for improved waterfowl management and contributes to a better understanding of the limitations of assignment methods when using the isotope approach.

PMID:37428774 | DOI:10.1371/journal.pone.0288262

J Couns Psychol. 2023 Jul;70(4):340. doi: 10.1037/cou0000666.

ABSTRACT

Reports an error in “Do psychotherapists improve with time and experience? A longitudinal analysis of outcomes in a clinical setting” by Simon B. Goldberg, Tony Rousmaniere, Scott D. Miller, Jason Whipple, Stevan Lars Nielsen, William T. Hoyt and Bruce E. Wampold (Journal of Counseling Psychology, 2016[Jan], Vol 63[1], 1-11). The article (https://doi.org/10.1037/cou0000131), had an error in the Method section in the Early termination section under the Variables heading. The coding was reversed in the sentence “Patients received a code of 0 (early termination) or 1 (nonearly termination) on this dichotomous variable” and should have read “Patients received a code of 1 (early termination) or 0 (nonearly termination) on this dichotomous variable.” The online version of this article has been corrected. (The following abstract of the original article appeared in record 2015-58774-001.) Objective: Psychotherapy researchers have long questioned whether increased therapist experience is linked to improved outcomes. Despite numerous cross-sectional studies examining this question, no large-scale longitudinal study has assessed within-therapist changes in outcomes over time.

METHOD: The present study examined changes in psychotherapists’ outcomes over time using a large, longitudinal, naturalistic psychotherapy data set. The sample included 6,591 patients seen in individual psychotherapy by 170 therapists who had on average 4.73 years of data in the data set (range = 0.44 to 17.93 years). Patient-level outcomes were examined using the Outcome Questionnaire-45 and a standardized metric of change (prepost d). Two-level multilevel models (patients nested within therapist) were used to examine the relationship between therapist experience and patient prepost d and early termination. Experience was examined both as chronological time and cumulative patients seen.

RESULTS: Therapists achieved outcomes comparable with benchmarks from clinical trials. However, a very small but statistically significant change in outcome was detected indicating that on the whole, therapists’ patient prepost d tended to diminish as experience (time or cases) increases. This small reduction remained when controlling for several patient-level, caseload-level, and therapist-level characteristics, as well as when excluding several types of outliers. Further, therapists were shown to vary significantly across time, with some therapists showing improvement despite the overall tendency for outcomes to decline. In contrast, therapists showed lower rates of early termination as experience increased.

CONCLUSIONS: Implications of these findings for the development of expertise in psychotherapy are explored. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37428762 | DOI:10.1037/cou0000666

PLoS One. 2023 Jul 10;18(7):e0274439. doi: 10.1371/journal.pone.0274439. eCollection 2023.

ABSTRACT

The relationship of food comminution and individual age in Tupaia belangeri is investigated. It is hypothesized that with increasing age the performance of the molar dentition decreases due to progressive tooth wear. While this relationship is well-documented for herbivores, age-related test series are largely lacking for insectivorous mammals. 15 individuals of Tupaia belangeri were fed exclusively with mealworms, and their faeces were analyzed for the number and size of chitin particles. The exoskeleton of a mealworm is resistant to digestive fluids in the gastrointestinal tract, and the size of individual chitin particles indicates the effectiveness of mechanical comminution that occurs in the oral cavity during mastication. It is hypothesized that a more precise occlusion of the dentition results in smaller particle size. Although individuals of all ages (juvenile, adult, and senile) were able to effectively process mealworms with their dentition prior to digestion, a larger area of very large chitin particles (98% quantile of all particles in senile animals as compared to in the same quantile in adults) in the feces of senile animals was detected. Even though the particle size of indigestible material is irrelevant for the digestive process, these findings either document somatic senescence in the functionality of the teeth, or alternatively a change in chewing behaviour with age.

PMID:37428732 | DOI:10.1371/journal.pone.0274439

PLoS One. 2023 Jul 10;18(7):e0283412. doi: 10.1371/journal.pone.0283412. eCollection 2023.

ABSTRACT

This study investigates the association between individuals’ concern about contracting COVID-19 and their compliance with recommended preventive and mitigation measures, namely wearing face masks, maintaining social distancing and handwashing, in the context of the Middle East and North Africa (MENA) region. The empirical analysis is based on a panel dataset from the Combined COVID-19 MENA Monitor Household Survey, which was carried out in Jordan, Morocco, Sudan, Tunisia and Egypt. Applying a probit estimation technique, a positive and statistically significant association was found between the level of COVID-19 worries and individuals’ compliance with the mitigation measures. Notably, the results revealed that this association followed a “first-up-then-down” trend, showing that compliance with the three mitigation measures rose as individuals’ worries about contracting the virus increased, and then markedly decreased after they had been infected. Socio-demographic characteristics contributing to lower levels of compliance included being male, being over 60, having lower levels of education and having a lower household income. A cross-country analysis revealed remarkable differences between the five countries, with the strongest association between COVID-19 concerns and adherence to mitigation measures observed in Tunisia and Sudan, and the weakest association seen in Jordan and Morocco. Policy implications are outlined for effective risk communication and management during disease outbreaks and public health emergencies to encourage appropriate public health behaviours.

PMID:37428731 | DOI:10.1371/journal.pone.0283412

BJS Open. 2023 Jul 10;7(4):zrad051. doi: 10.1093/bjsopen/zrad051.

ABSTRACT

BACKGROUND: Intraoperative neuromonitoring is widely used in thyroid and parathyroid surgery to prevent unilateral and especially bilateral recurrent nerve paresis. Reference values for amplitude and latency for the recurrent laryngeal nerve and vagus nerve have been published. However, data quality measures that exclude errors of the underlying intraoperative neuromonitoring (IONM) data (immanent software errors, false data labelling) before statistical analysis have not yet been implemented.

METHODS: The authors developed an easy-to-use application (the Mainz IONM Quality Assurance and Analysis tool) using the programming language R. This tool allows visualization, automated and manual correction, and statistical analysis of complete raw data sets (electromyogram signals of all stimulations) from intermittent and continuous neuromonitoring in thyroid and parathyroid surgery. The Mainz IONM Quality Assurance and Analysis tool was used to evaluate IONM data generated and exported from ‘C2’ and ‘C2 Xplore’ neuromonitoring devices (inomed Medizintechnik GmbH) after surgery. For the first time, reference values for latency and amplitude were calculated based on ‘cleaned’ IONM data.

RESULTS: Intraoperative neuromonitoring data files of 1935 patients consecutively operated on from June 2014 to May 2020 were included. Of 1921 readable files, 34 were excluded for missing data labelling. Automated plausibility checks revealed: less than 3 per cent device errors for electromyogram signal detection; 1138 files (approximately 60 per cent) contained potential labelling errors or inconsistencies necessitating manual review; and 915 files (48.5 per cent) were indeed erroneous. Mean(s.d.) reference onset latencies for the left vagus nerve, right vagus nerve, recurrent laryngeal nerve, and external branch of the superior laryngeal nerve were 6.8(1.1), 4.2(0.8), 2.5(1.1), and 2.1(0.5) ms, respectively.

CONCLUSION: Due to high error frequencies, IONM data should undergo in-depth review and multi-step cleaning processes before analysis to standardize scientific reporting. Device software calculates latencies differently; therefore reference values are device-specific (latency) and/or set-up-specific (amplitude). Novel C2-specific reference values for latency and amplitude deviate considerably from published values.

PMID:37428557 | DOI:10.1093/bjsopen/zrad051

Games Health J. 2023 Jul 10. doi: 10.1089/g4h.2023.0004. Online ahead of print.

ABSTRACT

Introduction: Early mobilization after surgery is crucial for reducing postoperative complications and restoring patients’ fitness and ability to care for themselves. Immersive, activity-promoting fitness games in virtual reality (VR) can be used as a low-cost motivational adjunct to standard physiotherapy to promote recovery after surgery. In addition, they have potentially positive effects on mood and well-being, which are often compromised after colorectal surgery. The purpose of this pilot study was to evaluate the feasibility and clinical outcomes of a VR-based intervention that provides additional mobilization. Methods: Patients undergoing curative surgery for colorectal cancer were randomly assigned to an intervention group or a control group. Participants in the intervention group (VR group) received daily bedside fitness exercises using immersive, activity-promoting, virtual reality fitness games in addition to standard care during their postoperative hospital stay. Results: A total of 62 patients were randomized. The feasibility outcomes were in line with the predefined goals. In the VR group, an improvement in overall mood (+0.76 points; 95% confidence interval [CI] 0.39 to 1.12; P < 0.001) and a shift toward positive feelings were observed. The median length of hospital stay was 7.0 days in the VR group compared with 9.0 days in the control group, but the difference (2.0 days) did not reach statistical significance (95% CI -0.0001 to 3.00; P = 0.076). Surgical outcomes, health status, and measures of distress did not differ between groups. Conclusions: The study demonstrated the feasibility of a VR intervention that improved overall mood and showed a desirable effect on feelings and length of hospital stay after colorectal surgery. The results should stimulate further research investigating the potential of VR as an adjunct to physiotherapy to enhance mobilization after surgery.

PMID:37428543 | DOI:10.1089/g4h.2023.0004

JMIR Res Protoc. 2023 Jul 10;12:e46649. doi: 10.2196/46649.

ABSTRACT

BACKGROUND: Health care services are being challenged by an increasing number of patients and limited resources. Hence, research investigating options to reduce costs and increase effectiveness is warranted. Digital outpatient services can provide flexible and tailored follow-up, improve patients’ health literacy, and facilitate the identification of adverse courses of disease. However, previous research largely focused on disease-specific contexts and outcomes. Therefore, research on digital services investigating generic outcomes such as health literacy is warranted.

OBJECTIVE: This article aims to describe the “digital outpatient service” intervention and present the protocol for an ongoing multicenter, nonrandomized trial evaluating this intervention.

METHODS: Based on previous experiences and evidence-based knowledge, we developed this intervention through patient-journey maps in collaboration with each clinical specialty. The patients gain access to a mobile app for self-monitoring and patient-reported outcomes and a chat for contact between the patients and health care workers. The health care workers’ dashboard includes a traffic light system to draw attention to the most urgent patient reports. In this multicenter, non-randomized controlled trial, patients are allocated to the control group receiving standard care or the 6-month intervention. Eligible patients are aged 18 years or older who receive outpatient care at the neurology, lung, pain, or cancer departments at 2 university hospitals in Norway. Our evaluation will include patient-reported outcomes, qualitative interviews, and clinical measures. The primary outcome will be health literacy using the Health Literacy Questionnaire. A sample size of 165 participants is split into a 1:2 ratio in favor of the intervention. We will analyze quantitative data in SPSS (IBM Corp) using descriptive statistics and logistic regression, and qualitative data using thematic analysis.

RESULTS: This trial started in September 2021, and the intervention started in January 2022. Recruitment has ended, with 55 patients in the control group and 107 patients in the intervention group. Follow-up is expected to end in July 2023, with results expected to be obtained in December 2023.

CONCLUSIONS: This study will evaluate an intervention facilitated by an already certified digital multicomponent solution, with intervention content based on patient-reported outcomes, health literacy, and self-monitoring. The intervention is specifically tailored to each participating center and the needs of their patients using patient journey maps. The comprehensive and generic evaluation of this digital outpatient service intervention is a strength as it targets a heterogeneous sample of patients. Thus, this study will provide important knowledge about the applicability and effects of digital health care services. As a result, patients and health care workers will gain a new, evidence-based understanding of whether and how digital tools may be used in clinical care.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05068869; https://clinicaltrials.gov/ct2/show/NCT05068869.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/46649.

PMID:37428533 | DOI:10.2196/46649

J Med Internet Res. 2023 Jul 10;25:e45922. doi: 10.2196/45922.

ABSTRACT

BACKGROUND: Oral anticoagulation is the cornerstone treatment of several diseases. Its management is often challenging, and different telemedicine strategies have been implemented to support it.

OBJECTIVE: The aim of the study is to systematically review the evidence on the impact of telemedicine-based oral anticoagulation management compared to usual care on thromboembolic and bleeding events.

METHODS: Randomized controlled trials were searched in 5 databases from inception to September 2021. Two independent reviewers performed study selection and data extraction. Total thromboembolic events, major bleeding, mortality, and time in therapeutic range were assessed. Results were pooled using random effect models.

RESULTS: In total, 25 randomized controlled trials were included (n=25,746 patients) and classified as moderate to high risk of bias by the Cochrane tool. Telemedicine resulted in lower rates of thromboembolic events, though not statistically significant (n=13 studies, relative risk [RR] 0.75, 95% CI 0.53-1.07; I²=42%), comparable rates of major bleeding (n=11 studies, RR 0.94, 95% CI 0.82-1.07; I²=0%) and mortality (n=12 studies, RR 0.96, 95% CI 0.78-1.20; I²=11%), and an improved time in therapeutic range (n=16 studies, mean difference 3.38, 95% CI 1.12-5.65; I²=90%). In the subgroup of the multitasking intervention, telemedicine resulted in an important reduction of thromboembolic events (RR 0.20, 95% CI 0.08-0.48).

CONCLUSIONS: Telemedicine-based oral anticoagulation management resulted in similar rates of major bleeding and mortality, a trend for fewer thromboembolic events, and better anticoagulation quality compared to standard care. Given the potential benefits of telemedicine-based care, such as greater access to remote populations or people with ambulatory restrictions, these findings may encourage further implementation of eHealth strategies for anticoagulation management, particularly as part of multifaceted interventions for integrated care of chronic diseases. Meanwhile, researchers should develop higher-quality evidence focusing on hard clinical outcomes, cost-effectiveness, and quality of life.

TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42020159208; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=159208.

PMID:37428532 | DOI:10.2196/45922

Breastfeed Med. 2023 Jul 10. doi: 10.1089/bfm.2022.0239. Online ahead of print.

ABSTRACT

Objective: To determine the prevalence of ankyloglossia in diamniotic monochorionic and diamniotic dichorionic twins, as well as to verify the relationship between gender and type of pregnancy. Study Design: A cross-sectional observational study, carried out with 52 pairs of dichorionic/diamniotic twins and 49 monochorionic/diamniotic pairs. The data collection was carried out through the analysis of medical records and the results of the Neonatal Screening of the Tongue Frenulum Assessment Protocol in Babies, and corresponded to the period of 2 years (2020-2022). Statistical analysis of data was performed, considering the significance value of 5%. The study was approved by the Human Research Ethics Committee of the institution. Results: The statistical analysis of multiple logistic regression between the two groups of twins (Mono/Di and Di/Di) according to the socioeconomic, demographic, and clinical-epidemiological profile was statistically significant for some variables. The prevalence of ankyloglossia, according to the type of twin pregnancy, showed a statistically significant difference. There was no statistical difference in relation to sex and ankyloglossia, or between couples diagnosed with ankyloglossia according to the type of pregnancy. Conclusion: Monochorionic/diamniotic twins had a higher prevalence of ankyloglossia, regardless of gender.

PMID:37428528 | DOI:10.1089/bfm.2022.0239