Tag: pubmed

Eur J Heart Fail. 2023 Jul 5. doi: 10.1002/ejhf.2970. Online ahead of print.

ABSTRACT

AIMS: Multivariable prediction models can be used to estimate risk of incident heart failure (HF) in the general population. A systematic review and meta-analysis was performed to determine the performance of models.

METHODS AND RESULTS: From inception to 3rd November 2022 MEDLINE and EMBASE databases were searched for studies of multivariable models derived, validated and/or augmented for HF prediction in community-based cohorts. Discrimination measures for models with cstatistic data from ≥3 cohorts were pooled by Bayesian meta-analysis, with Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation heterogeneity assessed through a 95% prediction interval (PI). Risk of bias was assessed using PROBAST. We included 36 studies with 59 prediction models. In meta-analysis, the Atherosclerosis Risk in Communities (ARIC) Risk Score (summary c-statistic 0.802, 95% CI 0.707-0.883), graph-based attention model (GRAM; 0.791, 95% CI 0.677-0.885), Pooled Cohort equations to Prevent Heart Failure (PCP-HF) white men model (0.820, 95% CI 0.792-0.843), PCP-HF white women model (0.852, 95% CI 0.804-0.895), and REverse Time AttentIoN Model (RETAIN; 0.839, 95% CI 0.748-0.916) had a statistically significant 95% PI and excellent discrimination performance. The ARIC Risk Score and PCP-HF models had significant summary discrimination among cohorts with a uniform prediction window. 77% of model results were at high risk of bias, certainty of evidence was low, and no model had a clinical impact study.

CONCLUSIONS: Prediction models for estimating risk of incident HF in the community demonstrate excellent discrimination performance. Their usefulness remains uncertain due to high risk of bias, low certainty of evidence, and absence of clinical effectiveness research. This article is protected by copyright. All rights reserved.

PMID:37403669 | DOI:10.1002/ejhf.2970

Curationis. 2023 Jun 29;46(1):e1-e8. doi: 10.4102/curationis.v46i1.2350.

ABSTRACT

BACKGROUND: Acute psychiatric units are found to be stressful working environments because of the nature of illness patients present with.

OBJECTIVES: This study aimed to determine self-reported incidents of physical and verbal violence towards nurses working in acute psychiatric units in Western Cape, South Africa.

METHOD: A questionnaire was used to collect data. Chi-square test was performed to determine association between gender, category and experience of violence. Mann-Whitney U test was carried out to determine associations between years of employment and the likelihood of experiencing physical violence and verbal abuse.

RESULTS: Overall physical violence 35 (34.3%) and verbal abuse 83 (83%) incidents. Most female respondents reported both physical violence (74.2%, n = 26) and verbal abuse (72.2%, n = 60), with (56.2%, n = 18) professional nurses reporting physical violence. Years of employment was statistically significantly associated with the likelihood of nurses experiencing physical violence (p = 0.007).

CONCLUSION: Most respondents (74.2%, n = 26) were females and they mostly experienced physical violence and verbal abuse while 28.2% (n = 29) were males. Years of service were associated with the likelihood of experiencing physical violence.Contribution: The knowledge gained will add on existing knowledge about the challenge of violence experienced by nurses in the workplace and might have an influence on policymakers.

PMID:37403668 | DOI:10.4102/curationis.v46i1.2350

Curationis. 2023 Jun 23;46(1):e1-e6. doi: 10.4102/curationis.v46i1.2364.

ABSTRACT

BACKGROUND: The attribute of empathy leads to more desired patient outcomes. A patient who experiences empathy from student nurses will feel important and cared for. It is vital to know how student nurses perceive themselves in terms of empathy in caring. Thus, self-reflection is a requirement on the part of student nurses in a caring relationship.

OBJECTIVES: This study aimed to determine student nurses’ self-perceptions of empathy in caring and compare the third- and fourth-year student nurses’ self-perceptions of empathy in caring.

METHOD: A quantitative, descriptive and comparative approach was employed in the study. The population was undergraduate student nurses in their third- and fourth-year level of study (n = 77), while 56 respondents participated in the study. Ethical approval was obtained prior to commencing with the study. Data were collected by way of the Consultation and Relational Empathy measure questionnaire that consisted of 10 items responded to by using the 5-point Likert scale. Data were analysed by means of descriptive statistics, inferential statistics and t-tests.

RESULTS: All the student nurses perceived themselves to have empathy in caring. There was no significant difference in perceptions of empathy in caring by the nurses in their third- and fourth-year level of study.

CONCLUSION: The results of the study provide insights for nursing education and training to shape and mould the empathy perceived by the student nurses. Future research could focus on the patients’ perspective coupled with the student nurses’ perspective to prevent bias.Contribution: This paper contributes by adding self perceptions of empathy by student nurses to support best practice in nursing.

PMID:37403667 | DOI:10.4102/curationis.v46i1.2364

Curationis. 2023 Jun 15;46(1):e1-e11. doi: 10.4102/curationis.v46i1.2353.

ABSTRACT

BACKGROUND: Prevention of mother-to-child transmission (PMTCT) of HIV services has become an integral part of antenatal services. Prevention of mother-to-child transmission was introduced in all the regions of Ghana, but mother-to-child transmission (MTCT) continued to increase.

OBJECTIVES: To explore and describe midwives’ perceptions and attitudes towards PMTCT of HIV services.

METHOD: Quantitative research approach and descriptive cross-sectional design were used. The population includes all midwives between the ages of 21 and 60 years who work in antenatal care (ANC) clinics in 11 district hospitals in the Central Region of Ghana where the study was conducted. Forty-eight midwives were interviewed using a census sample process. Data were analysed using the Statistical Package for the Social Sciences version 21. Correlation analysis was performed to find the relationships between the attitudes and the perceptions of the midwives on PMTCT of HIV services.

RESULTS: Seventy percent of midwives had positive perceptions of PMTCT of HIV services and 85% had positive attitudes towards the provision of PMTCT of HIV services. Midwives were screening all pregnant women who visited the ANCs and referring those who tested positive to other institutions where they can be monitored. Some of the concerns considered were views on retesting HIV-infected pregnant women throughout their pregnancy. There was a positive correlation between attitudes and perceptions of midwives on PMTCT of HIV services.

CONCLUSION: Midwives had positive perceptions and positive attitudes towards the PMTCT of HIV services that they were providing to antenatal attendees. Also, as the attitudes of the midwives towards PMTCT of HIV services improved, their perceptions of PMTCT services also improved.Contribution: Decentralisation of PMTCT of HIV services to community-based health facilities is appropriate to enable sub-district health facilities to test for HIV and provide counselling services to pregnant women.

PMID:37403663 | DOI:10.4102/curationis.v46i1.2353

Eur J Heart Fail. 2023 Jul 5. doi: 10.1002/ejhf.2968. Online ahead of print.

ABSTRACT

Both acetazolamide and sodium-glucose cotransporter 2 (SGLT2) inhibitors block sodium reabsorption in the proximal renal tubule primarily through inhibition of sodium hydrogen exchanger isoform 3 (NHE3), but neither SGLT2 inhibitors nor acetazolamide produce a sustained natriuresis due to compensatory upregulation of sodium reabsorption at distal nephron sites. Nevertheless, acetazolamide and SGLT2 inhibitors have been used as adjunctive therapy to loop diuretics in states where NHE3 is upregulated, e.g., acute heart failure. Two randomized controlled trials have been carried out with acetazolamide in acute heart failure (DIURESIS-CHF and ADVOR). In ADVOR, acetazolamide improved physical signs of fluid retention, but this finding could not be explained by the modest observed diuretic effect. Acetazolamide did not produce a natriuresis in the DIURESIS-CHF trial, and in ADVOR, immediate effects on symptoms and body weight were not reported, and the drug had no effect on morbidity or mortality after 90 days. Three randomized controlled trials have been carried out with empagliflozin (EMPAG-HF, EMPA-RESPONSE-AHF and EMPULSE in acute heart failure. The EMPULSE trial did not report effects on diuresis or in changes in physical signs of congestion during the first week of treatment, but in EMPAG-HF and EMPA-RESPONSE-AHF, empagliflozin had no effect of dyspnea, urinary sodium excretion or body weight during the first 4 days. In the EMPULSE trial, empagliflozin improved health status at 15 days and reduced the risk of worsening heart failure events at 90 days, but these effects are similar in magnitude and time course to the early statistical significance on the risk of heart failure hospitalizations achieved within 14-30 days in the major trials of SGLT2 inhibitors in patients with chronic heart failure. Neurohormonal inhibitors produce this early effect in the absence of a diuresis. Additionally, in numerous randomized controlled trials, in-hospital diuretic intensification has not reduced the risk of major heart failure events, even when treatment is sustained. These findings, taken collectively, suggest that any immediate diuretic effects of acetazolamide and SGLT2 inhibitors in acute heart failure are not likely to influence the short- or long-term clinical course of patients This article is protected by copyright. All rights reserved.

PMID:37403655 | DOI:10.1002/ejhf.2968

Orthop Surg. 2023 Jul 5. doi: 10.1111/os.13804. Online ahead of print.

ABSTRACT

OBJECTIVE: Despite rapid advances in minimally invasive surgery, en bloc laminectomy remains the most common surgical approach for treating thoracic ossification of the ligamentum flavum (TOLF). However, the learning curve of this risky operation is rarely reported. Therefore, we aimed to describe and analyze the learning curve of ultrasonic osteotome-based en bloc laminectomy for TOLF.

METHODS: Among 151 consecutive patients with TOLF who underwent en bloc laminectomy performed by one surgeon between January 2012 and December 2017, we retrospectively analyzed their demographic data, surgical parameters, and neurological function. Neurological outcome was evaluated with the modified Japanese Orthopaedic Association (mJOA) scale, and the Hirabayashi method was used to calculate the neurological recovery rate. The learning curve was assessed with logarithmic curve-fitting regression analysis. Univariate analysis methods were used for statistical analysis, including t-test, rank sum test, and chi-square test.

RESULTS: A total of 50% of learning milestones could be reached in approximately 14 cases, and the asymptote in 76 cases. Therefore, 76 of the 151 enrolled patients were defined as the “early group,” and the remaining 75 were delimitated as the “late group” for comparison. There was a significant intergroup difference in the corrected operative time (94.80 ± 27.77 vs 65.93 ± 15.67 min, P < 0.001) and the estimated blood loss (median 240 vs 400 mL, P < 0.001). The overall follow-up was 83.1 ± 18.5 months. The mJOA significantly increased from a median of 5 (IQR: 4-5) before the surgery to 10 (IQR: 9-10) at the last follow-up (P < 0.001). The overall complication rate was 37.1%, and no significant intergroup difference was found, except for the incidence of dural tears (31.6% vs 17.3%, p = 0.042).

CONCLUSION: Initially, mastering the en bloc laminectomy technique using ultrasonic osteotome for TOLF treatment can be challenging, but the surgeon’s experience improves as the operative time and blood loss decrease. Improved surgical experience reduced the risk of dural tears but was not associated with the overall complication rate or long-term neurological function. Despite the relatively long learning curve, en bloc laminectomy is a secure and valid technique for TOLF treatment.

PMID:37403615 | DOI:10.1111/os.13804

Schweiz Arch Tierheilkd. 2023 Jul;165(7):524-528. doi: 10.17236/sat00400.

ABSTRACT

Determination of somatic cell counts (SCC) becomes more and more important also for ewe’s milk. SCC can be a useful indicator of milk quality for milk processors while it can be a mastitis indicator for sheep keepers and an important selection criterion for breeders. The objective of our study was to acquire basic information about factors influencing SCC variability in lambing ewes of the Tsigai (T) and Improved Valachian (IV) breeds. Somatic cell counts (SCC) were determined in 866 milk samples in 2017 and 2018, during lamb sucking and during milking period. An instrument Fossomatic 90 (Foss Electric, Hillerød, Denmark) was used for analysis. Average SCC varied from 270 to 1897 × 103 cells/ml during lamb sucking and from 268 to 2139 × 103 cells/ml during milking period. Differences between the sampling periods were statistically significant in 2017. An increase in SCC was observed at the end of both sucking and milking periods. An overall evaluation of lactation brought about the average SCC at 364 × 103 cells/ml in 2017 (log(10) SCC – 2,25) and at 1,091 × 103 cells/ml in 2018 (log(10) SCC – 2,68). The indicator log(10) was significantly influenced by breed in 2017 (T – 2,61; IV – 2,75). The effect of lactation number and number of sucking lambs did not have any significant influence on SCC.

PMID:37403592 | DOI:10.17236/sat00400

Med Phys. 2023 Jul 5. doi: 10.1002/mp.16584. Online ahead of print.

ABSTRACT

BACKGROUND: Colonic polyps are the most prevalent neoplastic lesions detected during colorectal cancer screening, and timely detection and excision of these precursor lesions is crucial for preventing multiple malignancies and reducing mortality rates.

PURPOSE: The pressing need for intelligent polyp detection has led to the development of a high-precision intelligent polyp segmentation network designed to improve polyp screening rates during colonoscopies.

METHODS: In this study, we employed ResNet50 as the backbone network and embedded a multi-channel grouping fusion encoding module in the third to fifth stages to extract high-level semantic features of polyps. Receptive field modules were utilized to capture multi-scale features, and grouping fusion modules were employed to capture salient features in different group channels, guiding the decoder to generate an initial global mapping with improved accuracy. To refine the segmentation of the initial global mapping, we introduced an enhanced boundary weight attention module that adaptively thresholds the initial global mapping using learnable parameters. A self-attention mechanism was then utilized to calculate the long-distance dependency relationship of the polyp boundary area, resulting in an output feature map with enhanced boundaries that effectively refines the boundary of the target area.

RESULTS: We carried out contrast experiments of MGF-Net with mainstream polyp segmentation networks on five public datasets of ColonDB, CVC-ColonDB, CVC-612, Kvasir, and ETIS. The results demonstrate that the segmentation accuracy of MGF-Net is significantly improved on the datasets. Furthermore, a hypothesis test was conducted to assess the statistical significance of the computed results.

CONCLUSIONS: Our proposed MGF-Net outperforms existing mainstream baseline networks and presents a promising solution to the pressing need for intelligent polyp detection. The proposed model is available at https://github.com/xiefanghhh/MGF-NET.

PMID:37403578 | DOI:10.1002/mp.16584

Phys Chem Chem Phys. 2023 Jul 5. doi: 10.1039/d3cp01374j. Online ahead of print.

ABSTRACT

Diffusion-driven rotation in cholesteric liquid crystals has been studied using molecular dynamics simulation. Then a chemical potential gradient parallel to the cholesteric axis induces a torque that rotates the director at a constant rate around this axis, besides driving a mass current. An equimolar mixture of Gay-Berne ellipsoids and Lennard-Jones spheres was used as the molecular model. In order to keep the system homogeneous, the color conductivity algorithm was used to apply a color field instead of a chemical potential gradient to drive a mass current. Then the particles are given a color charge that interacts with a color field in the same way as with an electric field, but these charges do not interact with each other. This algorithm is often used to calculate the mutual diffusion coefficient. In the above liquid crystal model, it was found that the color field induces a torque that rotates the director at a constant rate around the cholesteric axis in addition to driving a mass current. The phenomenon was quantified by calculating the cross-coupling coefficient between the color field and the director angular velocity. The results were cross-checked by using a director rotation algorithm to exert a torque to rotate the director at a constant rate. Besides rotation of the director, this resulted in a mass current parallel to the cholesteric axis. The cross-coupling coefficient between the torque and the mass current was equal to the cross-coupling coefficient between the color field and the director rotation rate within a statistical uncertainty of 10 percent, thus fulfilling the Onsager reciprocity relations. As a further cross-check, these cross-coupling coupling coefficients, the color conductivity, and the twist viscosity were calculated by evaluating the corresponding Green-Kubo relations. Finally, it was noted that the orientation of the cholesteric axis parallel to the color field is the one that minimizes the irreversible energy dissipation rate. This is in accordance with a theorem stating that this quantity is minimal in the linear regime of a nonequilibrium steady state.

PMID:37403565 | DOI:10.1039/d3cp01374j

Eur J Pain. 2023 Jul 5. doi: 10.1002/ejp.2156. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Anti-osteoporosis (OP) drugs have been suggested to contribute to pain reduction during OP management. This scoping review aimed at mapping the literature on pain relief with anti-OP drugs in OP treatment.

DATABASES AND DATA TREATMENT: Medline, Pubmed and Cochrane databases were searched by two reviewers with keywords combinations. Randomized controlled and real-life English studies, pain as an endpoint, antiosteoporosis drugs were inclusion criteria. Case reports, surveys, comment letters, conference abstracts, animal studies and grey literature were excluded. Predetermined data were extracted by two reviewers and disagreement solved through discussion.

RESULTS: A total of 130 articles were identified, 31 publications were included, 12 randomized clinical trials and 19 observational studies. Pain reduction was assessed by different tools: Visual Analogue Scale, Verbal Rating Scale, Facial Scale or as a domain of quality of life questionnaires including Short form 8, 36, mini-OP, Japanese OP, Qualeffo, Roland Morris Disability questionnaires. Collective data show that anti-OP drugs may display an analgesic effect that may be linked to the local mode of action of drugs on bone and consecutive modulation of pain sensitization. The methodology of the studies showed a heterogeneity of endpoints, comparators, statistical approaches and follow-up duration.

CONCLUSION: Considering the limitations of the literature, there is a need for more rigorous trials and larger real-life studies taking into account the recommendations published for research in rheumatology and in pain medicine. The identification of responders, patient subtypes, and of analgesic-effect doses would allow optimization and individualization for pain relief in patients with OP.

SIGNIFICANCE STATEMENT: This scoping review shows that anti-OP drugs may improve pain and quality of life of patients with OP. The heterogeneity in design, choice of endpoints, methodology, comparators and follow-up duration of included randomized clinical trials and real-life studies does not allow so far to identify a predominant antiosteoporosis drug or an optimal dosage for pain relief. These gaps need to be addressed and warrant further research in the future for optimizing pain improvement in the course of OP drug treatment.

PMID:37403555 | DOI:10.1002/ejp.2156