Tag: pubmed

Viruses. 2023 Nov 10;15(11):2242. doi: 10.3390/v15112242.

ABSTRACT

South Africa has a dual high burden of HIV and drug-resistant TB (DR-TB). We sought to understand the association of HIV and antiretroviral therapy status with TB treatment outcomes. This was a retrospective chart review of 246 patients who began treatment at two DR-TB hospitals in Eastern Cape, South Africa between 2017 and 2020. A categorical outcome with three levels was considered: unfavorable, transferred out, and successful. Descriptive statistics and logistic regression were used to compare the individuals without HIV, with HIV and on antiretroviral therapy (ART), and with HIV but not on ART. Sixty-four percent of patients were co-infected with HIV, with eighty-seven percent of these individuals on ART at treatment initiation. The majority (59%) of patients had a successful treatment outcome. Twenty-one percent of patients transferred out, and an additional twenty-one percent did not have a successful outcome. Individuals without HIV had more than three and a half times the odds of success compared to individuals with HIV on ART and more than ten times the odds of a successful outcome compared to individuals with HIV not on ART (OR 3.64, 95% CI 1.11, 11.95; OR 10.24, 95% CI 2.79, 37.61). HIV co-infection, especially when untreated, significantly decreased the odds of treatment success compared to individuals without HIV co-infection.

PMID:38005919 | DOI:10.3390/v15112242

Viruses. 2023 Nov 10;15(11):2238. doi: 10.3390/v15112238.

ABSTRACT

Hantavirus pulmonary syndrome (HPS) is a rodent-borne zoonotic disease that is endemic throughout the Americas. Agricultural activities increase exposure to wild rodents, especially for sugarcane cutters. We carried out a survey of the epidemiological aspects of HPS and investigated the prevalence of hantavirus infection in the sugarcane cutter population from different localities in the Brazilian Midwest region. We conducted a retrospective study of all confirmed HPS cases in the state of Goiás reported to the National HPS surveillance system between 2007 and 2017, along with a seroepidemiological study in a population of sugarcane cutters working in Goiás state in 2016, using the anti-hantavirus (Andes) ELISA IgG. A total of 634 serum samples from cane cutters were tested for hantavirus antibodies, with 44 (6.9%) being IgG-reactive according to ELISA. The destination of garbage was the only statistically significant variable (p = 0.03) related to the detection of hantavirus IgG (p < 0.05). We described the epidemiological profile of reported hantavirus cases in Goiás-a highly endemic area for HPS, and where the seroepidemiological study was conducted. Our results increase our knowledge about hantavirus infections in Brazil and highlight the vulnerability of sugarcane cutters to a highly lethal disease that, to date, has no specific treatment or vaccination.

PMID:38005915 | DOI:10.3390/v15112238

Breast. 2023 Nov 15;73:103603. doi: 10.1016/j.breast.2023.103603. Online ahead of print.

ABSTRACT

BACKGROUND: Breast cancer is the most common cancer and the leading cause of cancer-related death among women. However, evidence concerning hematological and biochemical markers influencing the natural history of breast cancer from in situ breast cancer to mortality is limited.

METHODS: In the UK Biobank cohort, 260,079 women were enrolled during 2006-2010 and were followed up until 2019 to test the 59 hematological and biochemical markers associated with breast cancer risk and mortality. The strengths of these associations were evaluated using the multivariable Cox regression models. To understand the natural history of breast cancer, multi-state survival models were further applied to examine the effects of biomarkers on transitions between different states of breast cancer.

RESULTS: Eleven biomarkers were found to be significantly associated with the risk of invasive breast cancer, including mainly inflammatory-related biomarkers and endogenous hormones, while serum testosterone was also associated with the risk of in-situ breast cancer. Among them, C-reactive protein (CRP) was more likely to be associated with invasive breast cancer and its transition to death from breast cancer (HR for the highest quartile = 1.46, 95 % CI = 1.07-1.97), while testosterone and insulin-like growth factor-1 (IGF-1) were more likely to impact the early state of breast cancer development (Testosterone: HR for the highest quartile = 1.31, 95 % CI = 1.12-1.53; IGF-1: HR for the highest quartile = 1.17, 95 % CI = 1.00-1.38).

CONCLUSION: Serum CRP, testosterone, and IGF-1 have different impacts on the transitions of different breast cancer states, confirming the role of chronic inflammation and endogenous hormones in breast cancer progression. This study further highlights the need of closer surveillance for these biomarkers during the breast cancer development course.

PMID:38000092 | DOI:10.1016/j.breast.2023.103603

Int J Surg. 2023 Nov 23. doi: 10.1097/JS9.0000000000000924. Online ahead of print.

ABSTRACT

BACKGROUND: This study employs a meta-analytic approach to investigate the impact of robotic-assisted partial nephrectomy, with and without near-infrared fluorescence imaging (NIRF-RAPN vs S-RAPN), on patients’ perioperative outcomes and postoperative changes in renal function.

MATERIALS AND METHODS: We conducted a comprehensive and rigorous systematic review and cumulative meta-analysis of primary outcomes following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), AMSTAR (Assessing the Methodological Quality of Systematic Reviews) Guidelines, and Risk-of-Bias Tool (RoB2). To ensure a thorough search, we systematically searched five major databases, including Medline, PubMed, Cochrane Library, Scopus, and Web of Science, from databases’ inception to April 2023.

RESULTS: No significant differences were found between the two groups in terms of age (P=0.19), right side (P=0.54), BMI (P=0.39), complexity score (P=0.89), tumor size (P = 0.88), operating time (P = 0.39), estimated blood loss (P = 0.47), length of stay (P = 0.87), complications (P = 0.20), transfusion (P = 0.36), and positive margins (P = 0.38). However, it is noteworthy that the NIRF-RAPN group exhibited significant reductions in warm ischemia time (P=0.001), the percentage change in estimated glomerular filtration rate at discharge (P=0.01) compared to the S-RAPN group.

CONCLUSION: This meta-analysis provides evidence that the group undergoing NIRF-RAPN showed a statistically significant protective effect on the estimated glomerular filtration rate (eGFR).

PMID:38000056 | DOI:10.1097/JS9.0000000000000924

Int J Surg. 2023 Nov 23. doi: 10.1097/JS9.0000000000000879. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to compare the differences in quality of life (QOL) and overall survival (OS) between DPPHR and PD during long-term follow-up. Duodenum-preserving pancreatic head resection (DPPHR) and pancreatoduodenectomy (PD) have been shown to be effective in alleviating symptoms and controlling malignancies, but there is ongoing debate over whether DPPHR has an advantage over PD in terms of long-term benefits.

METHOD: We searched the PubMed, Cochrane, Embase, and Web of Science databases for relevant studies comparing DPPHR and PD published before 1 May 2023. This study was registered with PROSPERO. Randomised controlled trials and non-randomised studies were included. The Mantel-Haenszel model and inverse variance method were used as statistical approaches for data synthesis. Subgroup analyses were conducted to evaluate the heterogeneity of the results. The primary outcome was the global QOL score, measured using the QLQ-C30 system.

RESULTS: We analysed ten studies involving 976 patients (456 DPPHR and 520 PD). The global QOL score did not differ significantly between the DPPHR and PD groups (standard mean difference [SMD] 0.21, 95% confidence interval [CI] [-0.05, 0.46], P=0.109, I2=70%); however, the OS time of patients with DPPHR was significantly improved (HR 0.59, 95% CI [0.44, 0.77], P<0.001, I2=0%). The follow-up length may be an important source of heterogeneity. Studies with follow-up length between two to seven years showed better global QOL for DPPHR than for PD (SMD 0.43, 95% CI [0.23, 0.64], P<0.001, I2=0%). There were no significant differences between the two groups in any of the functional scales of the QLQ-C30 system (all P>0.05). On the symptom scale, patients in the DPPHR group had lower scores for fatigue, nausea and vomiting, loss of appetite, insomnia, and diarrhoea than those in the PD group (all P<0.05).

CONCLUSION: There were no significant differences in global QOL scores between the two surgeries; however, DPPHR had advantages over PD in terms of safer perioperative outcomes, lower long-term symptom scores, and longer OS times. Therefore, DPPHR should be recommended over PD for the treatment of benign pancreatic diseases and low-grade malignant tumours.

PMID:38000055 | DOI:10.1097/JS9.0000000000000879

Int J Biostat. 2023 Nov 27. doi: 10.1515/ijb-2023-0052. Online ahead of print.

ABSTRACT

Model-based component-wise gradient boosting is a popular tool for data-driven variable selection. In order to improve its prediction and selection qualities even further, several modifications of the original algorithm have been developed, that mainly focus on different stopping criteria, leaving the actual variable selection mechanism untouched. We investigate different prediction-based mechanisms for the variable selection step in model-based component-wise gradient boosting. These approaches include Akaikes Information Criterion (AIC) as well as a selection rule relying on the component-wise test error computed via cross-validation. We implemented the AIC and cross-validation routines for Generalized Linear Models and evaluated them regarding their variable selection properties and predictive performance. An extensive simulation study revealed improved selection properties whereas the prediction error could be lowered in a real world application with age-standardized COVID-19 incidence rates.

PMID:38000054 | DOI:10.1515/ijb-2023-0052

Int J Nurs Educ Scholarsh. 2023 Nov 24;20(1). doi: 10.1515/ijnes-2023-0017. eCollection 2023 Jan 1.

ABSTRACT

OBJECTIVES: This study aimed to investigate the level of perceived competence and explore the predictors of competence in nursing students at graduation.

METHODS: This cross-sectional study was conducted with students at the point of graduation (n=239). A sociodemographic form and three different scales assessing students’ competence, self-efficacy, and self-reflection and insight were used to collect data. Visual Analog Scale (VAS) was used to assess students’ satisfaction (i.e., the role as nursing students in the nursing program), job-related stress (i.e., perceived stress related to nursing program), and coping behaviors. The data were analyzed using descriptive statistics and hierarchical linear regression.

RESULTS: The mean scores of perceived competence, self-reflection, insight, and self-efficacy were 5.25 ± 0.96 (range: 1-7), 54.51 ± 7.83 (range: 12-96), 33.36 ± 5.40 (range: 8-48), 84.13 ± 12.27 (range: 0-100), respectively. Self-efficacy was the most significant associated factor of the entire group of variables in competence.

CONCLUSIONS: Scores of perceived competence of students were optimistic. Self-efficacy was the most important factor affecting competence; that is, the greater the self-efficacy, the better the perceived competence.

PMID:38000005 | DOI:10.1515/ijnes-2023-0017

J Asthma. 2023 Nov 24:1-19. doi: 10.1080/02770903.2023.2288317. Online ahead of print.

ABSTRACT

Objective: We aim to assess the risk factors of uncontrolled asthma in children and adolescents. Method: A systemic search was conducted from electronic databases (PubMed/Medline, Cochrane Library, and Google Scholar) from inception to July 17, 2023. All statistical analyses were conducted in Review Manager 5.4.1. Studies meeting inclusion criteria were selected. A random-effect model was used when heterogeneity was seen to pool the studies, and the result was reported in the Odds Ratio (OR) and the corresponding 95% confidence interval (CI). We also used a narrative approach where it was not feasible to quantitatively assess the outcome. Results: Ten observational studies were used to conduct this systematic review and meta-analysis. A quantitative analysis of five factors was done. Pooled analysis showed a statistically significant risk of uncontrolled asthma in association with past hypersensitivity reactions (SMD = 1.51 (1.16, 1.98); p = 0.002; I2 = 84%) and incomplete controller adherence (SMD = 3.15 (1.83, 5.41); p < 0.0001; I2 = 94%). While non-significant relation was seen in parental asthma (SMD = 1.23 (0.98, 1.55); p = 0.07; I2 = 15%), oral corticosteroid use (SMD = 0.99 (0.72, 1.36); p = 0.96; I2 = 81%) and education of caregivers (SMD = 0.99 (0.72, 1.36); p = 0.96; I2 = 81%). Some other factors were also discussed qualitatively. Conclusion: Our study shows that some significant risk factors might cause uncontrolled asthma in children and adolescents like past hypersensitivity reactions and incomplete controller adherence.

PMID:37999990 | DOI:10.1080/02770903.2023.2288317

J Asthma. 2023 Nov 24:1-21. doi: 10.1080/02770903.2023.2288325. Online ahead of print.

ABSTRACT

INTRODUCTION: Asthma is the most common chronic disease among children. The management of asthma in children requires ongoing effort and is heavily dependent on the effectiveness of family management. This study aimed to evaluate the validity and reliability of the Family Management Scale for Children with Asthma (FMSCA) by adapting it to Turkish.

METHODS: This methodological research comprised 293 parents between December 2020 and May 2021. Inclusion criteria were having a child with a diagnosis of asthma for more than 6 months, being literate, and not having problems in communication. FMSCA was examined for language, content and construct validity. Internal consistency was calculated using Cronbach’s α coefficient, item-total correlation, and test-retest equivalence. Ethical principles were adhered to.

RESULTS: The content validity index scores of the items in the FMSCA ranged from 0.90 to 1.0. The Kaiser-Meyer-Olkin value was determined to be 0.965 and the Bartlett’s Test of Sphericity value was χ² = 18296.335 (p ≤ 0.001). Many indices were used to examine the fit of the FMSCA model. Of these, the χ^2/SD value was determined to be 1.61. The total FMSCA Cronbach α coefficient was 0.981. The relationship between the test-retest results was statistically significant, high, and positive (p <0.05).

CONCLUSION: FMSCA is a valid and reliable tool that can be used to objectively evaluate family management in families with children with asthma and to determine the effectiveness of interventions.

PMID:37999987 | DOI:10.1080/02770903.2023.2288325

JMIR Med Educ. 2023 Nov 24;9:e49013. doi: 10.2196/49013.

ABSTRACT

BACKGROUND: UK medical graduates can apply for specialty training after completing a 2-year internship (foundation training). Postfoundation training application requirements vary depending on specialty but fundamentally require key skills such as teaching, research, and leadership.

OBJECTIVE: This study investigated whether medical student demographics impact their self-reported familiarity with the Post-Foundation Training Pathways (PFTPs) and Post-Foundation Application Process (PFAP).

METHODS: This was a cross-sectional study using a Bristol Online Survey. We invited all UK medical students to answer a range of questions about their demographics. Students were then asked to rank their familiarity with PFTPs and PFAP on a scale of 1 to 5 (1=least familiar and 5=most familiar). The responses were collected between March 2022 and April 2022 and exported for further analysis. Statistical analysis was conducted in Stata (version 17.1; StataCorp) using chi-square tests.

RESULTS: A total of 850 students from 31 UK medical schools took part. There was a significant difference between gender and self-reported familiarity with PFTPs (P<.001) and PFAP (P<.001), with male students expressing higher familiarity. Similarly, there was a difference between ethnicity and self-reported familiarity with PFTPs (P=.02) and PFAP (P<.001), with White students more likely to express higher familiarity than their Black, Asian, or Mixed Ethnic counterparts. Lastly, there was an overall difference between medical background and age and self-reported familiarity with PFTPs and PFAP (all P<.001), with students from medical backgrounds and older students being more likely to express higher familiarity.

CONCLUSIONS: The impact of gender, ethnicity, age, and medical background on students’ self-reported familiarity with PFTPs and PFAP is significant. Further studies are required to evaluate the impact of these factors on tested knowledge of PFTPs and PFAP and whether this impacts the success rate of postfoundation applications.

PMID:37999951 | DOI:10.2196/49013