Tag: pubmed

Altern Ther Health Med. 2022 Jun 10:AT7430. Online ahead of print.

ABSTRACT

CONTEXT: Correct and effective handovers of patients’ information during shift changes can ensure patients’ safety and can help an incoming shift of nurses to continuously monitor patients’ psychological problems and avoid unnecessary physical restraints. Development of a standard procedure for handover of patients who have been physically restrained has important clinical significance related to the smooth continuation of nursing work and assurance of the quality of care.

OBJECTIVE: The study intended to investigate the clinical effects of the situation-background-assessment-recommendation (SBAR) communication mode on the quality of the information passed during shift changes about patients in intensive care units (ICUs) who had been physically restrained and to compare it to the clinical effects obtained using traditional methods of communication.

DESIGN: The study was a retrospective analysis of the process used by nurses who were passing patient’s information during shift changes when caring for patients who had been physically restrained.

SETTING: The study took place in an ICU at the Second Hospital of Hebei Medical University in Shijiazhuang, Hebei, China.

PARTICIPANTS: Participants were 21 nurses caring for 239 ICU patients under physical restraint at the Second Hospital.

INTERVENTION: Of the 239 patients, 118 had been hospitalized between March 1 and March 15, 2018 and were assigned to the control group, and 121 had been hospitalized between June 1 and June 15, 2018 and were assigned to the intervention group. An ICU Physical Restraint Handover Order was established according to the SBAR communication mode. The intervention group used the SBAR communication mode and the control group used the hospital’s routine communication mode for the physical restraint of a patient during a nursing shift.

OUTCOME MEASURES: The study measured the differences between the groups in the nurses’ passing rates based on standards for the use of physical restraints, the quality of handover of information during shift changes about patients under physical restraint, the quality of the documentation written by nurses about the physical restraint, and the nurses’ satisfaction with the handover of information during a shift change.

RESULTS: Among the patient, 112 in the intervention group (92.56%) and 92 in the control group (77.97%) were qualified for physical restraint. A statistically significant difference existed between the two groups in the passing rate for the use of physical restraints (P = .001). The quality score for the handovers during shift changes of patients under physical restraint in the intervention group was 95.46 ± 2.50 and for the control group was 91.08 ± 3.57, with the difference being statistically significant (P = .030). The quality score for the nursing documentation for the intervention group, at 97.21 ± 1.49, was higher than that of the control group, at 90.78 ± 3.42, and the difference was statistically significant (P < .001). The nurses’ satisfaction score for the intervention group, at 98.14 ± 1.01 was higher than that of the control group, at 92.57 ± 1.86, and the difference was statistically significant (P = .006).

CONCLUSIONS: The use of the SBAR communication mode to improve the information passed to nurses about patients under physical restraint during a shift change can improve the quality of the physical restraint and nurses’ satisfaction and has a better clinical-application effect than the traditional methods used during shift changes.

PMID:35687709

Altern Ther Health Med. 2022 Jun 10:AT7423. Online ahead of print.

ABSTRACT

OBJECTIVES: Our study aimed to investigate the clinical features, management, and maternal-infant prognosis in patients with complete uterine rupture in the second and third trimester of pregnancy.

METHODS: A total of 15 patients with complete uterine rupture in their second and third trimester of pregnancy who were admitted to our hospital between January 2012 and December 2020 were included in our study. The patients enrolled were divided into the scar group (11 patients) and the non-scar group (4 patients) according to the existence or absence of a uterine scar. The general data, clinical characteristics and follow-up results in the 2 groups were compared.

RESULTS: There was no significant difference in age, pregnancy duration or delivery cycle between the 2 groups (P > .05). The incidence of original scar rupture in the scar group was significantly higher than in the non-scar group (P > .05). No significant difference was found in clinical characteristics between the scar and the non-scar groups (P > .05). The most common clinical features included abdominal pain, inability to lie flat, hemorrhagic shock, prenatal vaginal bleeding and uterine rupture, mostly occurring in the lower segments of the uterus and cervix. A total of 3 patients were misdiagnosed as having surgical disease. After completing relevant examinations, the uterine rupture was repaired surgically; the patients were discharged after blood transfusion, and their condition resolved. In all, 3 patients in the non-scar group and 1 patient in the scar group were transferred to the intensive care unit (ICU). All 15 patients were discharged after treatment. Follow-up was completed by all patients for 12 to 36 months, with an average follow-up time of 23.09 ± 2.19 months. Of the 15 patients, 2 underwent induced abortion after 24 months due to unplanned pregnancy. A 5-minute Apgar score of ≤7 in the scar group was higher than that in the non-scar group, but the difference was not statistically significant (P > .05). Perinatal mortality in the 15 patients was 40.00% (6/15).

CONCLUSION: The most common clinical features in patients with complete uterine rupture in the second and third trimester of pregnancy included abdominal pain, inability to lie flat, hemorrhagic shock, prenatal vaginal bleeding and uterine rupture, mostly occurring in the lower segments of the uterus and cervix. In addition, a remarkably worse maternal-infant prognosis was seen in patients with complete uterine rupture in the second and third trimester of scarless pregnancy compared with patients with complete uterine rupture in the second and third trimester of scarred pregnancy.

PMID:35687703

J Proteome Res. 2022 Jun 10. doi: 10.1021/acs.jproteome.2c00161. Online ahead of print.

ABSTRACT

In their recent review ( J. Proteome Res. 2022, 21 (4), 849-864), Crook et al. diligently discuss the basics (and less basics) of Bayesian modeling, survey its various applications to proteomics, and highlight its potential for the improvement of computational proteomic tools. Despite its interest and comprehensiveness on these aspects, the pitfalls and risks of Bayesian approaches are hardly introduced to proteomic investigators. Among them, one is sufficiently important to be brought to attention: namely, the possibility that priors introduced at an early stage of the computational investigations detrimentally influence the final statistical significance.

PMID:35687673 | DOI:10.1021/acs.jproteome.2c00161

Expert Rev Gastroenterol Hepatol. 2022 Jun 10. doi: 10.1080/17474124.2022.2088508. Online ahead of print.

ABSTRACT

BACKGROUND: Endoscopic mucosal resection of duodenal polyps (EMR) is a challenging intervention. The aim of this study was to review the patient characteristics, techniques, procedure outcomes, adverse events, and recurrence of duodenal polyps.

RESEARCH DESIGN AND METHODS: Patients were included if they had pathologically confirmed non-ampullary duodenal polyps that were either sporadic or familial adenomatous polyposis syndrome-related and had received EMR with at least one follow-up EGD for surveillance. Descriptive statistics were employed to report findings.

RESULTS: A total of 65 patients underwent a total of 90 EMRs for duodenal polyps. The mean age was 65.4 years and 29 of the patients were female. Complete resection of the visible mass was achieved in 96.9% of cases. Endoscopic hemostasis was required in 18.5% of patients. Delayed bleeding occurred in 9%, and delayed perforations requiring surgical intervention in 2.2% of patients with no mortality. Surgery after EMR was needed in 12.7% of cases. Eleven (16.9%) patients had recurrent duodenal adenoma on follow-up EGD.

CONCLUSION: Duodenal polyps can be safely resected and have a notable recurrence rate. This is particularly true for adenomas, warranting post-resection endoscopic surveillance. The appropriate interval for post-resection surveillance for duodenal adenomas should be a focus of future study.

PMID:35687675 | DOI:10.1080/17474124.2022.2088508

IEEE Trans Cybern. 2022 Jun 10;PP. doi: 10.1109/TCYB.2022.3165879. Online ahead of print.

ABSTRACT

Fuzzy membership is an effective approach used in twin support vector machines (SVMs) to reduce the effect of noise and outliers in classification problems. Fuzzy twin SVMs (TWSVMs) assign membership weights to reduce the effect of outliers, however, it ignores the positioning of the input data samples and hence fails to distinguish between support vectors and noise. To overcome this issue, intuitionistic fuzzy TWSVM combined the concept of intuitionistic fuzzy number with TWSVMs to reduce the effect of outliers and distinguish support vectors from noise. Despite these benefits, TWSVMs and intuitionistic fuzzy TWSVMs still suffer from some drawbacks as: 1) the local neighborhood information is ignored among the data points and 2) they solve quadratic programming problems (QPPs), which is computationally inefficient. To overcome these issues, we propose a novel intuitionistic fuzzy weighted least squares TWSVMs for classification problems. The proposed approach uses local neighborhood information among the data points and also uses both membership and nonmembership weights to reduce the effect of noise and outliers. The proposed approach solves a system of linear equations instead of solving the QPPs which makes the model more efficient. We evaluated the proposed intuitionistic fuzzy weighted least squares TWSVMs on several benchmark datasets to show the efficiency of the proposed model. Statistical analysis is done to quantify the results statistically. As an application, we used the proposed model for the diagnosis of Schizophrenia disease.

PMID:35687632 | DOI:10.1109/TCYB.2022.3165879

PLoS One. 2022 Jun 10;17(6):e0269727. doi: 10.1371/journal.pone.0269727. eCollection 2022.

ABSTRACT

As a member state of the European Union, where vaccines against COVID-19 are available and affordable, Bulgaria reports the lowest immunization coverage and the most pronounced vaccine distrust. The present study aimed to assess the self-reported adverse reactions following COVID-19 vaccination as a possible tool to increase the trust in vaccines. A cross-sectional survey-based study, covering 761 vaccinated respondents, was conducted in Plovdiv (469 with an mRNA vaccine and 292 with an adenoviral vector vaccine). Descriptive statistics parametric and non-parametric methods were applied. Statistical significance was set at p<0.05. The median age of the respondents was 42 years, females (72.5%). At least one adverse reaction was reported in 89.9% of those immunized with mRNA vaccine and 93.8% in the adenoviral vector vaccine group (p>0.05). They were mild to moderate and resolved within several days. The levels of local reactions were comparable: 91.7% in those who received mRNA and 89.7% in those who received an adenoviral vector vaccine (p = 0.366). The most common types of systemic reactions were fatigue, headache, and muscle pains. An association was found between the systemic reactions and the type of vaccine administered: 59.7% in mRNA recipients and 89.4% in adenoviral vector vaccinees (p<0.001). None of the registered systemic reactions required medical attention. There were 3 reports of generalized urticaria after an mRNA and 2 after an adenoviral vector vaccine. The reported reactions are relatively high but expected and no adverse events have been reported that are not listed in the official Summary of Product Characteristics.

PMID:35687609 | DOI:10.1371/journal.pone.0269727

PLoS One. 2022 Jun 10;17(6):e0269802. doi: 10.1371/journal.pone.0269802. eCollection 2022.

ABSTRACT

OBJECTIVE: Stigma towards people with mental health problems is a growing issue across the world, to which healthcare providers might contribute. The aim of the present study was to explore psychiatrists’ attitudes towards their patients and link them to psychosocial and professional factors.

METHODS: An online questionnaire was used to approach the in- and outpatient psychiatric services across Hungary. A total of 211 trainees and specialists in adult and child psychiatry participated in our study. Their overall stigmatizing attitudes were measured, with focus on attitude, disclosure and help-seeking, and social distance dimensions by using the self-report Opening Minds Stigma Scale for Health Care Providers (OMS-HC). Multiple linear regression analyses were performed to elucidate the dimensions of stigma and its association with sociodemographic, professional and personal traits.

RESULTS: Stigmatizing attitudes of close colleagues towards patients were statistically significant predictors of higher scores on the attitude [B = 0.235 (0.168-0.858), p = 0.004], the disclosure and help-seeking subscales [B = 0.169 (0.038-0.908), p = 0.033], and the total score of the OMS-HC [B = 0.191 (0.188-1.843), p = 0.016]. Psychiatrists who had already sought help for their own problems had lower scores on the disclosure and help-seeking subscale [B = 0.202 (0.248-1.925), p = 0.011]. The overall stigmatizing attitude was predicted by the openness to participate in case discussion, supervision or Balint groups [B = 0.166 (0.178-5.886), p = 0.037] besides the more favorable attitudes of their psychiatrist colleagues [B = 0.191 (0.188-1.843), p = 0.016].

CONCLUSIONS: The favorable attitudes of psychiatrists are associated with their own experiences with any kind of psychiatric condition, previous help-seeking behavior and the opportunity to work together with fellow psychiatrists, whose attitudes are less stigmatizing. The perception of fellow colleagues’ attitudes towards patients and the openness to case discussion, supervision and Balint groups were the main two factors that affected the overall attitudes towards patients; therefore, these should be considered when tailoring anti-stigma interventions for psychiatrists.

PMID:35687584 | DOI:10.1371/journal.pone.0269802

PLoS Negl Trop Dis. 2022 Jun 10;16(6):e0010469. doi: 10.1371/journal.pntd.0010469. Online ahead of print.

ABSTRACT

Domestic dogs (Canis lupus familiaris) can transmit a variety of pathogens due to their ubiquitousness in urban, rural and natural environments, and their close interactions with wildlife and humans. In this study, we used a mixed-methods approach to assess the role of domestic dogs as potential intermediaries of disease transmission from wildlife to humans among indigenous Waiwai in the Konashen Community Owned Conservation Area, Guyana. To address these objectives we 1) performed physical examinations and collected biological samples to assess Waiwai domestic dog health, and 2) administered questionnaires to characterize the role of dogs in the community and identify potential transmission pathways between wildlife, dogs, and humans. We observed ectoparasites on all dogs (n = 20), including: fleas (100%), ticks (15%), botflies (30%), and jigger flea lesions (Tunga penetrans) (80%). Ten percent of dogs were seropositive for Ehrlichia canis/ewingii, 10% were positive for Dirofilaria immitis, and one dog was seropositive for Leishmania infantum. All dogs (n = 20) were seronegative for: canine distemper virus, Brucella canis, Leptospira serovars, Trypanosoma cruzi, Anaplasma phagocytophilum/platys and Borrelia burgdorferi. Our questionnaire data revealed that the Waiwai remove ectoparasites from their dogs, clean up dog feces, and administer traditional and/or Western medicine to their dogs. White blood cell, strongyle-type ova, and eosinophil counts were lower in dogs that were not frequently used for hunting, dogs that did receive traditional and/or western medicine, and dogs that were frequently kept in elevated dog houses, although differences were not statistically significant. While our results suggest that the Waiwai have developed cultural practices that may promote dog health and/or prevent zoonotic disease transmission, more research is necessary to determine the efficacy of these practices. Our study provides important data on the health of dogs and the potential for disease transmission to humans in a zoonotic hotspot.

PMID:35687596 | DOI:10.1371/journal.pntd.0010469

PLoS One. 2022 Jun 10;17(6):e0268600. doi: 10.1371/journal.pone.0268600. eCollection 2022.

ABSTRACT

BACKGROUND: Levels of child undernutrition and its correlates exhibit considerable spatial variation at different levels of granularity. In India, such variations and their interrelation have not been studied at the sub-district level primarily due to the non-availability of good quality granular data. Given the sheer regional diversity in India, it is essential to develop a region-specific evidence base at the micro-level.

DATA AND OBJECTIVES: The current study utilised, for the first time, a sub-district level survey data (Concurrent Child Monitoring Survey-II, 2014-15) to investigate the statistically significant clusters and spatial patterns of burden of undernutrition among children. The emergence of distinct patterns at the level of natural geographical regions of the state-coastal, southern and northern regions, lead to a region-specific analysis to measure the impact of various demographic, socio-economic and maternal factors on the prevalence of undernutrition specific to the three regions, using the National Family Health Survey-IV unit-level data.

METHODS: The spatial dependence and clustering of child undernourishment across sub-districts in Odisha were studied using various spatial statistical techniques, including spatial econometric models. Binary logistic regression was applied in the region-specific analysis.

RESULTS: Findings indicated statistically significant spatial clustering of undernutrition among children in specific geographic pockets with poor sanitation, low institutional and skilled deliveries, poor maternal health reinforcing the need for inter-sectoral coordination. Disparities across the three natural-regions, suggest that the parameters requiring priority for intervention may differ across levels of overall development.

CONCLUSION: The spatial clustering of different socio-demographic indicators in specific geographic pockets highlights the differential impact of these determinants on child undernutrition thereby reinforcing a strong need for targeted intervention in these areas. Present analysis and the evidence-based micro-level analysis can be utilised as a model for other Indian states and low-resource countries, making interventions more effective through multiple, synergistic and a multi-sectoral approach.

PMID:35687570 | DOI:10.1371/journal.pone.0268600

PLoS One. 2022 Jun 10;17(6):e0268586. doi: 10.1371/journal.pone.0268586. eCollection 2022.

ABSTRACT

Contact tracing is a key component of successful management of COVID-19. Contacts of infected individuals are asked to quarantine, which can significantly slow down (or prevent) community spread. Contact tracing is particularly effective when infections are detected quickly, when contacts are traced with high probability, when the initial number of cases is low, and when social distancing and border restrictions are in place. However, the magnitude of the individual contribution of these factors in reducing epidemic spread and the impact of population immunity (due to either previous infection or vaccination), in determining contact tracing outputs is not fully understood. We present a delayed differential equation model to investigate how the immunity status and the relaxation of social distancing requirements affect contact tracing practices. We investigate how the minimal contact tracing efficiency required to keep an outbreak under control depends on the contact rate and on the proportion of immune individuals. Additionally, we consider how delays in outbreak detection and increased case importation rates affect the number of contacts to be traced daily. We show that in communities that have reached a certain immunity status, a lower contact tracing efficiency is required to avoid a major outbreak, and delayed outbreak detection and relaxation of border restrictions do not lead to a significantly higher risk of overwhelming contact tracing. We find that investing in testing programs, rather than increasing the contact tracing capacity, has a larger impact in determining whether an outbreak will be controllable. This is because early detection activates contact tracing, which will slow, and eventually reverse exponential growth, while the contact tracing capacity is a threshold that will easily become overwhelmed if exponential growth is not curbed. Finally, we evaluate quarantine effectiveness in relation to the immunity status of the population and for different viral variants. We show that quarantine effectiveness decreases with increasing proportion of immune individuals, and increases in the presence of more transmissible variants. These results suggest that a cost-effective approach is to establish different quarantine rules for immune and nonimmune individuals, where rules should depend on viral transmissibility after vaccination or infection. Altogether, our study provides quantitative information for contact tracing downsizing in vaccinated populations or in populations that have already experienced large community outbreaks, to guide COVID-19 exit strategies.

PMID:35687566 | DOI:10.1371/journal.pone.0268586