Tag: pubmed

Clin Neurol Neurosurg. 2021 Mar 20;205:106605. doi: 10.1016/j.clineuro.2021.106605. Online ahead of print.

ABSTRACT

BACKGROUND: The benefits of telemedicine in neurosurgery have been widely studied, especially as its implementation into clinical practice boomed at the start of the COVID-19 pandemic. However, few studies have investigated telemedicine from the perspective of the patient experience.

OBJECTIVE: To evaluate patient satisfaction scores of telemedicine outpatient clinic visits in neurosurgery in comparison with in-person visits.

METHODS: After obtaining Institutional Review Board approval, Press Ganey surveys from 3/1/2019 to 9/15/2020 were evaluated retrospectively from single-institution, academic neurosurgical clinics. Due to the non-normality of our data, stratified Wilcoxon tests were performed with correction for care provider differences. Domain score probability values were corrected for multiple comparisons. Average scores (range 20-100) are documented as mean ± standard deviation.

RESULTS: The response rates were 20% (97 responders) for telemedicine visits and 19% (589 responders) for in-person visits. Patient overall satisfaction score was slightly higher with telemedicine visits compared to in-person corrected for care provider differences (94.2 ± 12.2 vs 93.1 ± 13.4, p = 0.085). The care provider domain demonstrated no statistically significant difference in telemedicine compared to in-person (94.7 ± 14.4 vs 92.4 ± 16.5, p = 0.096). The access domain (93.7 ± 12.3 vs 93.4 ± 12.4, p = 0.999) and overall domains (94.1 ± 12.1 vs 94.4 ± 13.4, p = 1.000) were not found to be different between visit types.

CONCLUSION: Telemedicine appears to be a valuable option for neurosurgical patients and is not significantly different to in-person visits in all domains. This study demonstrates that telemedicine visits result in comparable satisfaction scores by neurosurgical patients, and providers should continue offering this option to their patients as we approach the post-COVID era.

PMID:33894681 | DOI:10.1016/j.clineuro.2021.106605

Nurse Educ Today. 2021 Apr 17;102:104911. doi: 10.1016/j.nedt.2021.104911. Online ahead of print.

ABSTRACT

BACKGROUND: According to recent statistics from the Korean Ministry of Education, the number of students who have dropped out of college has increased.

OBJECTIVES: To assess the relationship between creativity, social support, voice behaviour, and college life adjustment among first-year nursing students and to identify the factors influencing college life adjustment.

DESIGN: This study used a cross-sectional correlational design.

SAMPLE: Non-random convenience sampling.

PARTICIPANTS: Participants were first-year Korean nursing students (n = 153).

METHOD: Data were collected using structured questionnaires and analysed using a multiple regression analysis.

RESULTS: Adjustment to college life was significantly correlated with creativity (r = 0.26, p < .001), social support (r = 0.37, p < .001), and voice behaviour (r = 0.40, p < .001). A stepwise regression model showed subjective interpersonal degree (β = 0.32, p < .001), satisfaction with major (β = 0.31, p < .001), voice behaviour (β = 0.25, p < .001), and academic confidence (β = 0.15, p = .015) were significant predictors of college life adjustment (R² = 0.56, p < .001).

CONCLUSION: To improve the college life adjustment of new students in nursing schools, nursing education programmes should include strategies to enhance interpersonal-relationship levels, satisfaction with nursing major, voice behaviour, and academic confidence.

PMID:33894593 | DOI:10.1016/j.nedt.2021.104911

Nurse Educ Today. 2021 Apr 17;102:104908. doi: 10.1016/j.nedt.2021.104908. Online ahead of print.

ABSTRACT

BACKGROUND: Unfinished Nursing Care (UNC) indicates required interventions that are delayed or omitted. Nursing students are also exposed to UNC during their clinical rotations. However, no tools have been validated to date to collect UNC as perceived by them.

OBJECTIVES: To validate a tool measuring UNC as perceived by nursing students.

DESIGN: A validation study in 2018 by following the COnsensus-based Standards for the selection of health Measurement INstruments guideline.

SETTING: Three nursing programmes in Northern Italy.

PARTICIPANTS: All 1190 students who were attending their clinical rotation in hospital or community settings, were eligible. To assess the criterion validity, 30 clinical nurse supervisors in a random sample of units were involved.

METHODS: Content and face validity of the Unfinished Nursing Care Survey tool (UNCS) were assessed; then the tool, divided into part A (unfinished interventions) and B (reasons) was administered via Google and paper-pencil. Acceptability, construct validity (Mokken Scale Analysis, Exploratory and Confirmatory Factor Analyses), hypothesis testing, and criterion validity were assessed.

RESULTS: 737 students (61.9%) and 30 (100%) clinical nurse supervisors participated. On the Mokken Scale, with regard to part A, nursing interventions were ordered in higher and lower priority, reflecting different degrees of difficulty in terms of leaving the interventions unfinished. In the Confirmatory Factor Analyses, reasons for UNC were categorised into ‘Communication’, ‘Priority setting’, ‘Nurses’ aides’ supervision’, ‘Material resources’, ‘Human resources’, and ‘Workload unpredictability’. Students in the second year perceived higher UNC occurrence; only some individual and nursing programme variables were significantly correlated with the UNC. No statistical differences emerged between the UNC perceptions of students and that of their clinical supervisors.

CONCLUSION: The Unfinished Nursing Care Survey for Students is composed of part A (22 items) and part B (18 items) seems to be valid in terms of acceptability, construct validity, hypothesis testing, and criterion validity.

PMID:33894594 | DOI:10.1016/j.nedt.2021.104908

Ann Diagn Pathol. 2021 Mar 15;52:151731. doi: 10.1016/j.anndiagpath.2021.151731. Online ahead of print.

ABSTRACT

In this study we evaluated the expression of SATB2 protein in colorectal cancer (CRC) and its association with microsatellite instability (MSI) status, inflammation and hypoxia. Immunohistochemical SATB2 expression was observed in 111 CRC samples. We assessed the correlation between SATB2 expression and clinico-morphological parameters, MSI, COX-2 and HIF-1α expression. SATB2 was noticed in 92.8% CRC. We observed nuclear staining with predominantly strong immunoreaction intensity (67.6%) and percentage of SATB-2 positive cells in more than 50% of cells (87.4%). The statistically significant associations were recorded between high SATB2 expression and low grade, negative lymph nodes and negative vascular invasion. Statistical analysis confirmed a significant correlation between SATB2 expression and microsatellite stability, tendency to correlate with COX-2 and no significant correlation with HIF-1α. SATB2 is overexpressed in CRC and its high expression is a marker of good prognosis. Moreover, SATB2 expression is significantly associated with microsatellite stability, there is tendency to correlate with pro-inflammatory COX-2 and there is no association with hypoxia.

PMID:33894556 | DOI:10.1016/j.anndiagpath.2021.151731

Complement Ther Clin Pract. 2021 Apr 14;43:101393. doi: 10.1016/j.ctcp.2021.101393. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to determine the effect of acupressure on stress, fasting blood glucose (FBG) and glycosylated hemoglobin (HBA1C) in patients with type 2 diabetes.

METHODS: In this randomized controlled clinical trial, sixty-six diabetic patients who met the inclusion criteria were randomly divided into intervention and sham groups. The intervention group applied self-acupressure to the desired points for a month. The sham group were asked to slightly touch the same points. The DASS-21 and FBG were measured before intervention, 24 h after the intervention for both groups. In addition, HBA1C was measured for both groups before intervention and three months after the beginning of the intervention. Data were analyzed with SPSS 15.

RESULTS: Statistical data analysis of 60 patients showed that the mean FBG and the mean stress score of the intervention group reduced significantly after the intervention (p < 0.001) but the mean rate of HBA1C in the intervention group did not differ significantly after the intervention (p = 0.21).

CONCLUSION: Acupressure should be considered for diabetic patients to reduce their stress and FBG.

PMID:33894577 | DOI:10.1016/j.ctcp.2021.101393

Phys Med. 2021 Apr 21;84:141-148. doi: 10.1016/j.ejmp.2021.03.040. Online ahead of print.

ABSTRACT

PURPOSE: Whole-body bone scintigraphy is the most widely used method for detecting bone metastases in advanced cancer. However, its interpretation depends on the experience of the radiologist. Some automatic interpretation systems have been developed in order to improve diagnostic accuracy. These systems are pixel-based and do not use spatial or textural information of groups of pixels, which could be very important for classifying images with better accuracy. This paper presents a fast method of object-oriented classification that facilitates easier interpretation of bone scintigraphy images.

METHODS: Nine whole-body images from patients suspected with bone metastases were analyzed in this preliminary study. First, an edge-based segmentation algorithm together with the full lambda-schedule algorithm were used to identify the object in the bone scintigraphy and the textural and spatial attributes of these objects were calculated. Then, a set of objects (224 objects, ~ 46% of the total objects) were selected as training data based on visual examination of the image, and were assigned to various levels of radionuclide accumulation before performing the data classification using both k-nearest-neighbor and support vector machine classifiers. The performance of the proposed method was evaluated using as metric the statistical parameters calculated from error matrix.

RESULTS: The results revealed that the proposed object-oriented classification approach using either k-nearest-neighbor or support vector machine as classification methods performed well in detecting bone metastasis in terms of overall accuracy (86.62 ± 2.163% and 86.81 ± 2.137% respectively) and kappa coefficient (0.6395 ± 0.0143 and 0.6481 ± 0.0218 respectively).

CONCLUSIONS: In conclusion, the described method provided encouraging results in mapping bone metastases in whole-body bone scintigraphy.

PMID:33894584 | DOI:10.1016/j.ejmp.2021.03.040

Chemosphere. 2021 Apr 17;279:130591. doi: 10.1016/j.chemosphere.2021.130591. Online ahead of print.

ABSTRACT

The presence of antimicrobials, antimicrobial-resistant bacteria (ARB), and the associated antimicrobial resistance genes (ARGs) in the environment is a global health concern. In this study, the concentrations of 25 antimicrobials, the resistance of Escherichia coli (E. coli) strains in response to the selection pressure imposed by 15 antimicrobials, and enrichment of 20 ARGs in E. coli isolated from hospital wastewaters and surface waters were investigated from 2016 to 2018. In hospital wastewaters, clarithromycin was detected at the highest concentration followed by sulfamethoxazole and sulfapyridine. Approximately 80% of the E. coli isolates were resistant, while 14% of the isolates exhibited intermediate resistance against the tested antimicrobial agents. Approximately 61% of the examined isolates were categorized as multidrug-resistant bacteria. The overall abundance of phenotypes that were resistant toward drugs was in the following order: β-lactams, tetracycline, quinolones, sulfamethoxazole/trimethoprim, aminoglycosides, and chloramphenicol. The data showed that the E. coli isolates frequently harbored bla_TEM, bla_CTX-M, tetA, qnrS, and sul2. These results indicated that personal care products were significantly associated with the presence of several resistant phenotypes and resistance genes, implying their role in co-association with multidrug resistance. Statistical analysis also indicated a disparity specific to the site, treatment, and year in the data describing the prevalence of ARB and ARGs and their release into downstream waters. This study provides novel insights into the abundance of antimicrobial, ARB and ARGs in Sri Lanka, and could further offer invaluable information that can be integrated into global antimicrobial resistance databases.

PMID:33894511 | DOI:10.1016/j.chemosphere.2021.130591

J Mech Behav Biomed Mater. 2021 Apr 16;119:104531. doi: 10.1016/j.jmbbm.2021.104531. Online ahead of print.

ABSTRACT

PURPOSE: To measure the pressure distribution on the oral mucosa in vitro by comparing the pressure distributions under a complete denture and that of an implant overdenture.

MATERIALS AND METHOD: Anatomically accurate models and conventional Class I complete denture (CD) were produced and subjected to cyclic loading using a 100 N vertical centric and unilateral masticatory load with the universal testing machine (Instron 3369). Four miniature pressure sensors were positioned at four different locations in the intaglio surface of the denture and recorded pressure at 100 Hz frequency measured during a 10-cycle load at 1 Hz. Testing was repeated in different clinical combinations; CD vs. single implant overdentures (1-IOD), CD vs. two, three and four implant overdentures (2-IOD, 3-IOD vs. 4-IOD). The pressure profile (kPa) of complete dentures were measured and compared to the implant overdenture combinations. Collected data was statically analysed using SPSS and one-way analysis of variance.

RESULTS: The highest mean pressure was observed in CD group, with the mean mandible buccal ridge pressure value of 212.82 kPa ± 136.9 due to its surface area. There were no statistically significant differences between the group combinations (p = 0.146) but between various locations in the mean pressure recorded across the five denture/overdenture combinations.

CONCLUSION: CD experienced large pressure values on mandibular denture. 1-IOD demonstrated the most pressure in comparison to CD where with an increase in the number of implants used, it transformed the denture from being pure-borne mucosa to an implant overdenture, providing support and distributing the pressure amongst the implants.

PMID:33894527 | DOI:10.1016/j.jmbbm.2021.104531

Environ Pollut. 2021 Apr 15;284:117164. doi: 10.1016/j.envpol.2021.117164. Online ahead of print.

ABSTRACT

Microplastics (MPs) are becoming a major concern due to their great potential to sorb and transport pollutants in the aquatic environment; hexabromocyclododecane (HBCD) is a common chemical additive in polystyrene (PS) MPs. However, the underlying mechanisms for the interaction of tetracycline (TC) onto HBCD-PS composites MPs (HBCD-PS MPs) are still not well documented. Our findings showed that the addition of HBCD resulted in a relatively higher hydrophobicity of PS MPs, and significantly enhanced the sorption ability of HBCD-PS MPs for TC. The kinetic models suggested that the sorption of TC onto PS and HBCD-PS MPs were mainly controlled by film diffusion and intra-particle diffusion, respectively. The statistical physics models were used to elucidate the sorption of TC onto PS and HBCD-PS MPs was associated with the formation of the monolayer, and the results indicated the TC was sorbed onto the two MPs by both multi-molecular and non-parallel processes. The TC sorption was solution pH-dependent while the effect of NaCl content on TC sorption was negligible. The presence of Cu(Ⅱ), Pb(Ⅱ), Cd(Ⅱ), and Zn(Ⅱ) ions had different influences on the TC sorption onto both the MPs. Overall, various mechanisms including π-π and hydrophobic interactions jointly regulated the sorption of TC onto both the MPs. Our results provided new insights into the sorption behavior and interaction mechanisms of TC onto both the MPs and highlighted that the addition of HBCD likely increased the enrichment capacity of MPs for pollutants in the environment.

PMID:33894538 | DOI:10.1016/j.envpol.2021.117164

Lung Cancer. 2021 Apr 18;156:68-71. doi: 10.1016/j.lungcan.2021.04.016. Online ahead of print.

ABSTRACT

INTRODUCTION: The CALGB 30610/RTOG 0538 randomized trial was designed to test whether high-dose thoracic radiotherapy (TRT) would improve survival compared with 45 Gy twice-daily (BID) TRT in limited stage small cell lung cancer (LSCLC). Two piloted experimental TRT regimens were of interest to study, 70 Gy daily (QD) and 61.2 Gy concomitant boost (CB). Driven by concerns about adequate patient accrual, a study design was employed that eliminated one experimental TRT arm based on early interim toxicity and tolerability, with the study then continuing as a traditional 2-arm phase III study.

METHODS: Patients with LSCLC were assigned to receive four cycles of cisplatin and etoposide chemotherapy with one of 3 TRT regimens starting with either the first or second cycle of chemotherapy. The interim endpoint was the cumulative highest toxicity calculated from a scoring system based on treatment-related grade 3 and higher toxicity and the ability to complete therapy in the experimental arms.

RESULTS: The final interim analysis was performed after 70 patients accrued to each experimental cohort, and a difference in treatment related toxicity scoring was not found (p = 0.739). Severe esophageal toxicity was comparable in both cohorts. Pulmonary toxicity was low overall, though 4 patients (5.7 %) on the 61.2 Gy arm developed grade 4 dyspnea, which was not observed in the 70 Gy arm. A protocol mandated decision was made to discontinue the 61.2 Gy arm following review of toxicity with the Data and Safety Monitoring Board.

CONCLUSION: A randomized trial design using a planned early interim toxicity analysis to discriminate between experimental treatment arms is feasible in a phase III setting. Refinement of the design could increase the likelihood of detecting clinically meaningful differences in toxicity in future studies.

PMID:33894496 | DOI:10.1016/j.lungcan.2021.04.016