Tag: pubmed

Stud Health Technol Inform. 2022 Aug 31;298:127-131. doi: 10.3233/SHTI220921.

ABSTRACT

Interoperability and portability of healthcare data to enable research in the healthcare sector is an important factor towards precision medicine and a learning health system. With many safety-nets put in place like the European General Data Protection Regulation, and local standards like the broad consent set up by the German Medical Informatics Initiative, management and compliance to these standards across all systems and clinical data repositories becomes a daunting task. An appropriate process needs to be established especially when patient data is transferred to and from different systems and standards. On extraction and transforming, an appropriate method of loading the modified data to a destination where it can be read and accessed needs to be established besides functional compliance by the repository systems. This paper makes recommendations in relation to data load strategies while working with FHIR server-based data marts.

PMID:36073470 | DOI:10.3233/SHTI220921

Stud Health Technol Inform. 2022 Aug 31;298:51-55. doi: 10.3233/SHTI220906.

ABSTRACT

Health data science is an emerging discipline that bridges computer science, statistics and health domain knowledge. This consists of taking advantage of the large volume of data, often complex, to extract information to improve decision-making. We have created a Master’s degree in Health Data Science to meet the growing need for data scientists in companies and institutions. The training offers, over two years, courses covering computer science, mathematics and statistics, health and biology. With more than 60 professors and lecturers, a total of 835 hours of classes (not including the mandatory 5 months of internship per year), this curriculum has enrolled a total of 53 students today. The feedback from the students and alumni allowed us identifying new needs in terms of training, which may help us to adapt the program for the coming academic years. In particular, we will offer an additional module covering data management, from the edition of the clinical report form to the implementation of a data warehouse with an ETL process. Git and application lifecycle management will be included in programming courses or multidisciplinary projects.

PMID:36073455 | DOI:10.3233/SHTI220906

Stud Health Technol Inform. 2022 Sep 2;297:525-532. doi: 10.3233/SHTI220883.

ABSTRACT

The Norwegian building code give an apparently clear framework for the implementation of universal design (UD) in public buildings. However, it seems that neither increased awareness of UD, nor compliance with building regulations can so far guarantee equal use. Statistics and inspections reveal that there still are shortcomings as regards accessibility for many groups. Children with reduced mobility or impaired vision are better cared for than students whose needs are less documented. There is still a necessity for understanding the needs of other groups, such as children with hearing impairments, or other sensory challenges, children with social anxieties and those within the autism spectrum. A key part of achieving UD should be a design process where users’ needs are in focus. Based on recent research carried out by SINTEF Building and Infrastructure and funded by the Directorate for Children, Youth and Families, this paper presents 1) Examples of practices where primary and lower secondary schools have been designed within a framework of UD, and 2) Important drivers for universal design during the design process. Recommendations will be proposed for further development of standardized tools. Findings indicate that opportunities to challenge the minimum requirements for UD within a conventional design process are few without having a supportive and competent client. The regulations and standards do not necessarily ensure inclusion and equal use. Low understanding about what UD entails in terms of user knowledge and involvement may be one reason. Norwegian standards for UD do not appear to be in significant use. Tools for UD often appear as checklists, based on the building regulations. The examples show that effective collaboration between the client and the architect plays a central role in the UD of schools. Architects not only need tools to think about usability at all design levels, but the ability to collaborate with the client and users in every phase.

PMID:36073434 | DOI:10.3233/SHTI220883

Stud Health Technol Inform. 2022 Sep 2;297:135-142. doi: 10.3233/SHTI220831.

ABSTRACT

The Norwegian mapping authority has developed a standard method and an easy and flexible tool for mapping accessibility mostly for people with limited or no walking abilities in urban and recreational areas. We choose an object-orientated approach where points, lines and polygons represent objects in the environment. All data are stored in a geospatial database and are presented as web map and can be downloaded and analysed using GIS software. By the end of 2021, more than 250 out of 356 municipalities are mapped using that method. The aim of this project is to establish a national standard for mapping of accessibility and to provide a geodatabase that shows the status of accessibility throughout Norway. The data provide a useful tool for national statistics, local planning authorities and private users. The results show that accessibility is still low and Norway and faces many challenges to meet the goals for Universal Design.

PMID:36073388 | DOI:10.3233/SHTI220831

J Biomol Struct Dyn. 2022 Sep 8:1-13. doi: 10.1080/07391102.2022.2119278. Online ahead of print.

ABSTRACT

In S. aureus, lipophilic membrane (LLM) protein is a methicillin resistance factor and is an essential role in peptidoglycan metabolism. The virtual screening of antibacterial molecules against the model of LLM was performed to identify the potent antibacterial molecules. Molecular docking results of pharmacokinetic filtered molecules illustrated that five molecules had higher binding affinities than tunicamycin (TUM) and were stabled via non-covalent interactions (hydrogen bond and hydrophobic interactions) at the active site of LLM. Further, molecular dynamics results revealed that binding of identified antibacterial molecules with LLM resulted in stable LLM-inhibitor(s) complexes. Molecular Mechanics/Position-Boltzmann Surface Area (MMPBSA) analysis showed that LLM-inhibitor(s) complexes had high binding affinities in the range of -213.49 ± 2.24 to -227.42 ± 3.05 kJ/mol. The amino acid residues decomposition analysis confirmed that identified antibacterial molecules bound at the active site (Asn148, Leu149, Asp151, Asp208, His269, His271, and His272) of LLM. Noticeably, the current study found five antibacterial molecules (BDE 27575101, BDE 33638168, BDE 33672484, LAS 51502073, and BDE 25098678) were highly potent than TUM and even than earlier reported molecules. Therefore, here reported antibacterial molecules may be used directly or developed to inhibit LLM of S. aureus.Communicated by Ramaswamy H. Sarma.

PMID:36073371 | DOI:10.1080/07391102.2022.2119278

J Cell Mol Med. 2022 Sep 8. doi: 10.1111/jcmm.17492. Online ahead of print.

ABSTRACT

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is the novel coronavirus responsible for worldwide coronavirus disease (COVID-19). We previously observed that Angiotensin-converting enzyme 2 (ACE2) and Dipeptidyl peptidase-4 (DPP4) are significantly overexpressed in naso-oropharyngeal swabs (NPS) of COVID-19 patients, suggesting their putative functional role in the disease progression. ACE2 and DPP4 overexpression in COVID-19 patients may be associated to epigenetic mechanism, such as miRNA differential expression. We investigated if hsa-let7b-5p, reported to target both ACE2 and DPP4 transcripts, could be involved in the regulation of these genes. We verified that the inhibition and overexpression of hsa-let7b-5p matched to a modulation of both ACE2 and DPP4 levels. Then, we observed a statistically significant downregulation (FC = -1.5; p < 0.05) of hsa-let7b-5p in the same COVID-19 and control samples of our previous study. This is the first study that shows hsa-let7b-5p low expression in naso-oropharyngeal swabs of COVID-19 patients and demonstrates a functional role of this miR in regulating ACE2 and DPP4 levels. These data suggest the involvement of hsa-let7b-5p in the regulation of genes necessary for SARS-CoV-2 infections and its putative role as a therapeutic target for COVID-19.

PMID:36073344 | DOI:10.1111/jcmm.17492

Rev Port Cardiol. 2022 Aug;41(8):681-688. doi: 10.1016/j.repc.2021.05.017. Epub 2022 May 28.

ABSTRACT

INTRODUCTION AND OBJECTIVES: Lifestyle changes are frequently insufficient to reduce cardiovascular (CV) risk in patients with dyslipidemia. This study aims to characterize the long-term evolution of lipid profile and CV risk of patients under primary prevention.

METHODS: A retrospective study was performed of outpatients at a Portuguese cardiovascular risk clinic with ≥2 CV risk factors, followed for ≥2 years between 1995 and 2015. Statin therapy had been initiated early, in accordance with the clinic’s practice. After written informed consent was obtained, sociodemographic and clinical characteristics were collected from medical charts, at baseline and last visit. Changes in lipid profile and CV risk scores were estimated. Associations between HDL-C or LDL-C changes and gender, age, observation time and treatments were assessed through bivariate analysis and multiple linear regression models.

RESULTS: Out of 516 participants with mean follow-up of 11.4±4.3 years, 56.6% were female and 91.5% received statins. Lipid profile showed statistically significant improvement, including median changes in LDL-C and HDL-C of -77.0 mg/dl and +19 mg/dl, respectively. CV risk also showed statistically significant improvements according to all scores. Statin therapy resulted in a mean HDL-C increase of 7.4 mg/dl (independently of gender and other treatments) and a mean LDL-C reduction of 51.8 mg/dl (irrespective of age and other treatments).

CONCLUSION: Results from this long-term real-life study indicate that primary prevention, specifically early and continuous therapy with intermediate-intensity statins as an add-on to lifestyle interventions, was important in obtaining consistent and adequate metabolic correction in patients with additional risk factors.

PMID:36073267 | DOI:10.1016/j.repc.2021.05.017

Epilepsia. 2022 Sep 8. doi: 10.1111/epi.17407. Online ahead of print.

ABSTRACT

OBJECTIVE: Thyroid hormone abnormalities have been linked to antiseizure medications (ASMs). Oxcarbazepine is considered safer than carbamazepine because it induces the hepatic P-450 metabolic enzymes less than the carbamazepine. However, limited data exist for the influence of oxcarbazepine on thyroid function in children and adolescents. The objective of this study was to determine the effect of oxcarbazepine on thyroid function in these patients.

METHODS: A total of 162 pediatric patients with epilepsy who started oxcarbazepine for the first time between April 2003 and May 2020 were enrolled. The longitudinal effects of oxcarbazepine for thyroid functions were confirmed using general estimating equations.

RESULTS: Serum triiodothyronine (T3), thyroxine (T4), and free thyroxine (fT4) levels significantly decreased during 5 years of follow-up (all P < 0.001). In particular, T3 and fT4 levels were steeply reduced in the first 2 years of oxcarbazepine treatment. There was no significant change in thyroid-stimulating hormone during oxcarbazepine treatment.

SIGNIFICANCE: Serum T3, T4, and fT4 levels significantly decreased during oxcarbazepine use, and this change was maintained during the treatment period. In patients receiving oxcarbazepine, it is recommended that periodic thyroid function testing should be performed, especially within the first two years after starting this ASM. Our results indicate that oxcarbazepine-induced hypothyroidism does not appear to be accompanied by a significant increase in TSH, and consequently might be missed if TSH alone is monitored as a measure of thyroid dysfunction.

PMID:36073252 | DOI:10.1111/epi.17407

Expert Opin Drug Metab Toxicol. 2022 Sep 8. doi: 10.1080/17425255.2022.2122813. Online ahead of print.

ABSTRACT

INTRODUCTION: Three psychotropic drug classes, benzodiazepines, antiepileptic drugs (AEDs) and antidepressants (ADs), whether used in treatment or overdose, may be associated with respiratory aspiration. Polypharmacy was defined by counting suspected drugs from these classes or two others, antipsychotics and opioids. The confounding effects of polypharmacy were considered in this study.

AREAS COVERED: VigiBase records of respiratory aspiration associated with benzodiazepines, AEDs, and/or ADs from inception until September 5, 2021, were reviewed. VigiBase, the World Health Organization’s global pharmacovigilance database, uses a statistical signal for associations called the information component (IC).

EXPERT OPINION: The ICs (and IC₀₂₅) were benzodiazepines 2.8 (and 2.6), AEDs 1.6 (and 1.5), and ADs 1.4 (and 1.3). The cases of respiratory aspiration associated with at least one drug from these 3 classes included: 1) 553 cases absent any known overdose (2.8±1.7 drugs) and 2) 347 overdose cases (2.9±1.8 drugs). Little support for the association of respiratory aspiration and benzodiazepine, AED or AD monotherapy in therapeutic dosages was found. Studies of the association between benzodiazepine monotherapy and respiration aspiration are needed in geriatric patients. ADs added to other medications increased lethality in all cases of respiratory aspiration including those associated with overdose, polypharmacy and/or major medical problems.

PMID:36073179 | DOI:10.1080/17425255.2022.2122813

Nan Fang Yi Ke Da Xue Xue Bao. 2022 Aug 20;42(8):1250-1255. doi: 10.12122/j.issn.1673-4254.2022.08.19.

ABSTRACT

OBJECTIVE: To investigate the value of HBV RNA for predicting the therapeutic effect of long-term entecavir (ETV) antiviral therapy in patients with chronic hepatitis B (CHB).

METHODS: Serum samples were collected from 59 CHB patients treated with ETV for 96 or 108 months. HBV RNA levels, HBV DNA levels, and serological marker (HBeAg) levels were measured at baseline and 3, 6, 9, 12, 36, 72, and 96 (or 108) months during the therapy.

RESULTS: Although HBV RNA level decreased after 12 and 36 months of ETV antiviral therapy, no significance changes occurred in HBV RNA negative conversion rate (P>0.05). After 72 months of treatment or longer, 33 patients had HBV RNA levels lower than 100 copies/mL, and among them 29 patients had HBV RNA levels lower than the detection limit, and HBV RNA negative conversion rate was statistically significant (P < 0.05). A lower HBV RNA level was associated with a higher HBeAg negative conversion rate (P < 0.05). Age and HBV RNA level were positively correlated with HBeAg negative conversion rate (P < 0.05).

CONCLUSION: Prolonged ETV antiviral therapy results in better clearance of HBV RNA and a higher negative conversion rate in CHB patients. The length of antiviral therapy and age are positively correlated with the negative conversion rate of HBV RNA, and earlier administration of the antiviral treatment achieves better therapeutic effect. Serum HBV RNA level can be used as an indicator for predicting conversion to negative HBeAg in CHB patients receiving ETV therapy.

PMID:36073226 | DOI:10.12122/j.issn.1673-4254.2022.08.19