Tag: pubmed

Virol J. 2022 Aug 8;19(1):132. doi: 10.1186/s12985-022-01858-3.

ABSTRACT

BACKGROUND: Immunocompromised (IC) patients are at higher risk of more severe COVID-19 infections than the general population. Special considerations should be dedicated to such patients. We aimed to investigate the efficacy of COVID-19 vaccines based on the vaccine type and etiology as well as the necessity of booster dose in this high-risk population.

MATERIALS AND METHODS: We searched PubMed, Web of Science, and Scopus databases for observational studies published between June 1st, 2020, and September 1st, 2021, which investigated the seroconversion after COVID-19 vaccine administration in adult patients with IC conditions. For investigation of sources of heterogeneity, subgroup analysis and sensitivity analysis were conducted. Statistical analysis was performed using R software.

RESULTS: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we included 81 articles in the meta-analysis. The overall crude prevalence of seroconversion after the first (n: 7460), second (n: 13,181), and third (n: 909, all population were transplant patients with mRNA vaccine administration) dose administration was 26.17% (95% CI 19.01%, 33.99%, I² = 97.1%), 57.11% (95% CI: 49.22%, 64.83%, I² = 98.4%), and 48.65% (95% CI: 34.63%, 62.79%, I² = 94.4%). Despite the relatively same immunogenicity of mRNA and vector-based vaccines after the first dose, the mRNA vaccines induced higher immunity after the second dose. Regarding the etiologic factor, transplant patients were less likely to develop immunity after both first and second dose rather than patients with malignancy (17.0% vs 37.0% after first dose, P = 0.02; 38.3% vs 72.1% after second dose, P < 0.001) or autoimmune disease (17.0% vs 36.4%, P = 0.04; 38.3% vs 80.2%, P < 0.001). To evaluate the efficacy of the third dose, we observed an increasing trend in transplant patients after the first (17.0%), second (38.3%), and third (48.6%) dose.

CONCLUSION: The rising pattern of seroconversion after boosting tends to be promising. In this case, more attention should be devoted to transplant patients who possess the lowest response rate.

PMID:35941646 | DOI:10.1186/s12985-022-01858-3

BMC Med Inform Decis Mak. 2022 Aug 8;22(1):210. doi: 10.1186/s12911-022-01959-7.

ABSTRACT

BACKGROUND: While various quantitative studies based on the Unified Theory of Acceptance and Use of Technology (UTAUT) and Technology Acceptance Models (TAM) exist in the general medical sectors, just a few have been conducted in the behavioral sector; they have all been qualitative interview-based studies.

OBJECTIVE: The purpose of this study is to assess the adoption dimensions of a behavioral electronic health record (EHR) system for behavioral clinical professionals using a modified clinical adoption (CA) research model that incorporates a variety of micro, meso, and macro level factors.

METHODS: A questionnaire survey with quantitative analysis approach was used via purposive sampling method. We modified the existing CA framework to be suitable for evaluating the adoption of an EHR system by behavioral clinical professionals. We designed and verified questionnaires that fit into the dimensions of the CA framework. The survey was performed in five US behavioral hospitals, and the adoption factors were analyzed using a structural equation analysis.

RESULTS: We derived a total of seven dimensions, omitting those determined to be unsuitable for behavioral clinical specialists to respond to. We polled 409 behavioral clinical experts from five hospitals. As a result, the ease of use and organizational support had a substantial impact on the use of the behavioral EHR system. Although the findings were not statistically significant, information and service quality did appear to have an effect on the system’s ease of use. The primary reported benefit of behavioral EHR system adoption was the capacity to swiftly locate information, work efficiently, and access patient information via a mobile app, which resulted in more time for better care. The primary downside, on the other hand, was an unhealthy reliance on the EHR system.

CONCLUSIONS: We demonstrated in this study that the CA framework can be a useful tool for evaluating organizational and social elements in addition to the EHR system’s system features. Not only the EHR system’s simplicity of use, but also organizational support, should be considered for the effective implementation of the behavioral EHR system.

TRIAL REGISTRATION: The study was approved by the Institutional Review Board of Seoul National University Bundang Hospital (IRB No.: B-1904-534-301).

PMID:35941636 | DOI:10.1186/s12911-022-01959-7

Global Health. 2022 Aug 8;18(1):76. doi: 10.1186/s12992-022-00864-y.

ABSTRACT

BACKGROUND: SARS-CoV-2, a new coronavirus first reported by China on December 31st, 2019, has led to a global health crisis that continues to challenge governments and public health organizations. Understanding COVID-19 knowledge, attitudes, and practices (KAP) is key for informing messaging strategies to contain the pandemic. Cross-national studies (e.g.: comparing China to the U.S.) are needed to better understand how trans-cultural differences may drive differences in pandemic response and behaviors. The goal of the study is to compare knowledge and perceptions of COVID-19 between adults in China and the U.S. These data will provide insight into challenges these nations may face in coordinating pandemic response.

METHODS: This is a convergent mixed methods study comparing responses from China and the U.S. to a multinational COVID-19 KAP online survey. The survey included five quantitative constructs and five open-ended questions. Chinese respondents (n = 56) were matched for gender, age, education, perceived social standing, and time of survey completion with a U.S. cohort (n = 57) drawn from 10,620 U.S.

RESPONDENTS: Quantitative responses were compared using T-test & Fisher-Exact tests. Inductive thematic analysis was applied to open-ended questions.

RESULTS: Both U.S. and Chinese samples had relatively high intention to follow preventive behaviors overall. Differences in intended compliance with a specific recommendation appear to be driven by the different cultural norms in U.S. and China. Both groups expressed trepidation about the speed of COVID-19 vaccine development, driven by concern for safety among Chinese respondents, and concern for efficacy among U.S.

RESPONDENTS: The Chinese cohort expressed worries about other countries’ passive handling of the pandemic while the U.S. cohort focused on domestic responses from individuals and government. U.S. participants appeared more knowledgeable on some aspects of COVID-19. Different perspectives regarding COVID-19 origins were identified among the two groups. Participants from both samples reported high trust in health professionals and international health organizations.

CONCLUSIONS: Mixed methods data from this cross-national analysis suggests sociocultural differences likely influence perceptions and knowledge of COVID-19 and its related public health policies. Discovering and addressing these culturally-based differences and perceptions are essential to coordinate a global pandemic response.

PMID:35941625 | DOI:10.1186/s12992-022-00864-y

BMC Infect Dis. 2022 Aug 8;22(1):677. doi: 10.1186/s12879-022-07665-z.

ABSTRACT

BACKGROUND: The most appropriate alternative to induction therapy for HIV-associated cryptococcal meningitis (CM) remains unclear when standard treatment is unavailable, inaccessible, intolerable, or ineffective.

METHODS: A prospective, multi-centre cohort study was conducted to analyze the data of 156 HIV-infected patients with CM who were treated with amphotericin B deoxycholate (AmB-D) + flucytosine (5FC), voriconazole (VCZ) + 5FC, or AmB-D + Fluconazole (Flu) as induction regimens. Clinical efficacy, cumulative mortality, and adverse effects were compared among the three treatment groups.

RESULTS: Fewer deaths occurred by week 4 and week 10 among patients receiving AmB-D + 5FC than among those receiving AmB-D + Flu [4 (5.1%) vs. 8 (16.0%) deaths by week 4; hazard ratio, 1.8; 95% confidence interval [CI], 1.0 to 3.3; p = 0.039; and 8 (10.3%) vs. 14 (28.0%) deaths by week 10; hazard ratio, 1.8; 95% CI, 1.1 to 2.7; p = 0.008, respectively]. AmB-D plus 5FC was found to result in significantly higher rates of cerebrospinal fluid (CSF) culture sterility (57.6% vs. 34% by week 2; 87.9% vs. 70% by week 10; p < 0.05 for both comparisons). However, the differences in CSF culture sterility and mortality between the VCZ + 5FC group and the AmB-D + 5FC group were not statistically significant. VCZ plus 5FC had a significantly advantageous effect on the incidence of new AIDS-defining illness and length of hospital stay, compared with AmB-D plus 5FC. Laboratory adverse events (grade 3 or 4), such as severe anemia, were less frequent with VCZ + 5FC use than with AmB-D combined with 5FC or Flu use.

CONCLUSION: Our results suggest that AmB-D combined with 5FC remains the more efficacious induction regimen compared to AmB-D plus Flu, and that VCZ + 5FC might be a potential alternative when the standard regimen is not readily available, accessible, tolerated, or effective.

CLINICAL TRIALS: Registration number, ChiCTR1900021195. Registered 1 February 2019, http://www.chictr.org.cn/showproj.aspx?proj=35362 .

PMID:35941618 | DOI:10.1186/s12879-022-07665-z

Arch Public Health. 2022 Aug 9;80(1):184. doi: 10.1186/s13690-022-00938-8.

ABSTRACT

BACKGROUND: Abortion is one of the top five causes of maternal mortality in low and middle-income countries. It is associated with a complication related to pregnancy and childbirth. Despite this, there was limited evidence on the prevalence and associated factors of abortion in East African countries. Therefore, this study aimed to investigate the prevalence and associated factors of abortion among reproductive-aged women in East African countries.

METHODS: The Demographic and Health Surveys (DHS) data of 12 East African countries was used. A total weighted sample of 431,518 reproductive-age women was included in the analysis. Due to the hierarchical nature of the DHS data, a multilevel binary logistic regression model was applied. Both crude and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was calculated for potential associated factors of abortion in East Africa. In the final model, variables with a p value < 0.05 were declared as statistically significant factors of abortion.

RESULTS: Around 5.96% (95%CI: 4.69, 7.22) of reproductive-aged women in East Africa had a history of abortion. Alcohol use, tobacco or cigarette smoking, being single, poorer wealth index, currently working, traditional family planning methods, and media exposure were associated with a higher risk of abortion. However, higher parity, having optimum birth intervals, and modern contraceptive uses were associated with lower odds of abortion.

CONCLUSIONS: The prevalence of abortion among reproductive-aged women in East Africa was high. Abortion was affected by various socio-economic and obstetrical factors. Therefore, it is better to consider the high-risk groups during the intervention to prevent the burdens associated with abortion.

PMID:35941615 | DOI:10.1186/s13690-022-00938-8

Int J Behav Nutr Phys Act. 2022 Aug 8;19(1):102. doi: 10.1186/s12966-022-01322-z.

ABSTRACT

BACKGROUND: Physical activity (PA) is a proven strategy to prevent chronic diseases and reduce falls. Furthermore, it improves or at least maintains performance of activities of daily living, and thus fosters an independent lifestyle in older adults. However, evidence on the association of PA with relevant subgroups, such as older adults with utilization of long-term care (LTC), is sparse. This knowledge would be essential for establishing effective, need-based strategies to minimize the burden on healthcare systems due to the increasing need for LTC in old age.

METHODS: Data originate from the 2011/12 (t₁) baseline assessment and 2016 (t₂) follow-up of the population-based Cooperative Health Research in the Region of Augsburg (KORA-)Age study in southern Germany. In 4812 observations of individuals ≥65 years, the association between various types of PA (walking, exercise (i. e., subcategory of PA with the objective to improve or maintain one or more components of physical fitness), walking+exercise) and utilization of LTC (yes/no) was analyzed using generalized estimating equation logistic models. Corresponding models stratified by sex (females: 2499 observations; males: 2313 observations) examined sex-specific associations. Descriptive analyses assessed the proportion of individuals meeting the suggested minimum values in the German National Physical Activity Recommendations for older adults (GNPAR).

RESULTS: All types of PA showed a statistically significant association with non-utilization of LTC in the entire cohort. “Walking+exercise” had the strongest association with non-utilization of LTC in the entire cohort (odds ratio (OR): 0.52, 95% confidence interval (CI): 0.39-0.70) and in males (OR: 0.41, CI: 0.26-0.65), whereas in females it was “exercise” (OR: 0.58; CI: 0.35-0.94). The proportion of individuals meeting the GNPAR was higher among those without utilization of LTC (32.7%) than among those with LTC (11.7%) and group differences were statistically significant (p ≤ 0.05).

CONCLUSIONS: The GNPAR are rarely met by older adults. However, doing any type of PA is associated with non-utilization of LTC in community-dwelling older adults. Therefore, older adults should be encouraged to walk or exercise regularly. Furthermore, future PA programs should consider target-groups’ particularities to reach individuals with the highest needs for support.

PMID:35941614 | DOI:10.1186/s12966-022-01322-z

BMC Womens Health. 2022 Aug 8;22(1):338. doi: 10.1186/s12905-022-01919-3.

ABSTRACT

BACKGROUND: Most women undergoing screening examinations in the U.S. do not receive immediate results and for many this results in increased stress, inconvenience, delayed diagnosis, and potential loss to follow-up.

OBJECTIVE: To study the impact of same appointment mammogram results on breast cancer screening experience and patient satisfaction.

MATERIALS AND METHODS: A 6-question survey with questions focused on breast cancer screening experience with our new service of same appointment mammogram results was distributed to 200 patients, with 185 patients returning their responses. Patients evaluated their current experience on receiving their screening results during the same appointment with their prior breast cancer screening experience. Patients who did not respond to their satisfaction score either before or after same appointment results were excluded from the patient cohort analyzing satisfaction score. Remaining questions were analyzed separately as additional satisfaction assessment tools.

RESULTS: About 48% of the patients indicated an improvement in their screening experience with same appointment mammography results service, while 47% of the patients reported no significant difference in their experience.

CONCLUSION: Although not statistically significant, same appointment mammogram results were able to make a positive impact on breast cancer screening experience among 48% of the patients. Further research elucidating barriers to screening and other ways to improve patient satisfaction will be required to increase breast cancer screening compliance.

PMID:35941606 | DOI:10.1186/s12905-022-01919-3

BMC Oral Health. 2022 Aug 8;22(1):330. doi: 10.1186/s12903-022-02365-1.

ABSTRACT

BACKGROUND: To evaluate condylar morphology, ramus height, and asymmetry indexes in patients with different vertical skeletal patterns and to determine the association between condylar and ramal measurements with the mandibular plane angle.

METHODS: Dental panoramic radiographs of 60 patients with different skeletal patterns were evaluated. According to the cranial base (Sella-Nasion)-mandibular plane (SN-MP) angle, the patients were divided into three groups: normal angle (NA), low angle (LA), and high angle (HA). The condylar area, condylar perimeter, condylar heights, and ramus height were measured, and the asymmetry index value of each measurement was calculated. A one-way analysis of variance as well as a post hoc Tukey and Kruskall-Wallis tests were used to determine intergroup differences. Pearson’s correlation coefficient was used to determine the relationship between all measurements and SN-MP.

RESULTS: The intergroup comparison of condylar area, condylar perimeter, condylar heights, and ramus height measurements showed that the patients in the LA group have statistically significantly greater values compared to those in the HA group. A statistically significant difference was detected between the NA and LA groups only in the condylar area measurements. There was no statistical difference only in the ramus height measurements between the NA and HA groups. Asymmetry index values of the groups were similar. The negative correlations were found between all measurements and the SN-MP angle.

CONCLUSION: HA individuals have lower ramus heights and smaller condylar morphologies than NA and LA individuals. In addition, as the SN-MP angle increases, the condyle dimensions and ramus height decrease, and this is a clinically important finding.

PMID:35941596 | DOI:10.1186/s12903-022-02365-1

Cardiovasc Diabetol. 2022 Aug 8;21(1):151. doi: 10.1186/s12933-022-01589-3.

ABSTRACT

BACKGROUND: Insulin resistance and hyperinsulinemia in patients with type 2 diabetes (T2D) are adversely associated with the development and worsening of heart failure (HF). Herein, we sought to investigate the effect of canagliflozin on insulin concentrations and the associations of changes in insulin concentrations with HF-related clinical parameters in patients with T2D and HF.

METHODS: This was a post-hoc analysis of the investigator-initiated, multicenter, open-label, randomized, controlled CANDLE trial for patients with T2D and chronic HF (UMIN000017669). The endpoints were the effects of 24 weeks of canagliflozin treatment, relative to glimepiride treatment, on insulin concentrations and the relationship between changes in insulin concentrations and clinical parameters of interest, including New York Heart Association (NYHA) classification. The effects of canagliflozin on those parameters were also analyzed by baseline insulin level.

RESULTS: Among the participants in the CANDLE trial, a total of 129 patients (canagliflozin, n = 64; glimepiride, n = 65) who were non-insulin users with available serum insulin data both at baseline and week 24 were included in this analysis. Overall, the mean age was 69.0 ± 9.4 years; 75% were male; the mean HbA1c was 6.8 ± 0.7%; and the mean left ventricular ejection fraction was 59.0 ± 14.1%, with parameters roughly balanced between treatment groups. Canagliflozin treatment significantly reduced insulin concentrations at week 24 (p < 0.001), and the between-group difference (canagliflozin minus glimepiride) in those changes was – 3.52 mU/L (95% confidence interval, – 4.85 to – 2.19; p < 0.001). Decreases in insulin concentrations, irrespective of baseline insulin level, were significantly associated with improvement in NYHA class in patients treated with canagliflozin.

CONCLUSION: Our findings suggest that canagliflozin treatment in patients with T2D and HF ameliorated excess insulin overload, contributing to the improvement of clinical HF status.

TRIAL REGISTRATION: University Medical Information Network Clinical Trial Registry, number 000017669, Registered on May 25, 2015.

PMID:35941584 | DOI:10.1186/s12933-022-01589-3

BMC Pregnancy Childbirth. 2022 Aug 8;22(1):626. doi: 10.1186/s12884-022-04907-5.

ABSTRACT

BACKGROUND: Ending preventable maternal, and neonatal morbidity and mortality cannot be achieved without quality care interventions during the intrapartum and postpartum period. Poor quality care during the intrapartum and postpartum period contributes high burden of maternal and neonatal morbidity. Therefore, the current study aimed to assess the quality of intrapartum care and its associated factors in public health facilities in North Achefer District, North West Ethiopia.

METHOD: A mixed-type institution-based cross-sectional study design was conducted from November 7 to December 6, 2019. Simple random sampling and purposive sampling were used to select study participants for quantitative and qualitative studies respectively. Data were coded and entered into Epi data version 4.4.2 software and exported to SPSS version 25 for analysis. Variables with a p-value of less than and equal to 0.25 were entered into multivariable regression analysis and variables with p values < 0.05 were considered statistically significant factors of the quality of intrapartum care. The qualitative data were analyzed by using thematic content analysis. Finally, qualitative findings were used to supplement the quantitative result.

RESULT: The finding showed that, 27.3% (95% CI: 26.6-28) of mothers received good quality intrapartum care. Presence of long-distance (AOR = 0.19; 95% CI = 0.06, 0.66), health care facility (AOR = 0.07; 95% CI = 0.02, 0.20), and partograph utilization (AOR = 4.9; 95% CI = 1.82, 13.14) were factors associated with the quality of intrapartum care.

CONCLUSION: The proportion of intrapartum quality care was low. Distance, partograph utilization, and type of health facility were factors associated with quality of intrapartum care. The district, zonal health offices, and regional health bureau should provide capacity building and follow up on partograph utilization, and increase the accessibility of ambulances.

PMID:35941583 | DOI:10.1186/s12884-022-04907-5