Tag: pubmed

Korean J Fam Med. 2021 Sep;42(5):369-375. doi: 10.4082/kjfm.20.0212. Epub 2021 Sep 20.

ABSTRACT

BACKGROUND: Smoking is a preventable cause of chronic morbidity. Patient empowerment is a process through which people establish greater control over their health-related decisions and actions. To assess the effect of patient empowerment versus health education on the nicotine dependence score and progress of patients under different stages of smoking cessation.

METHODS: This was a single-blinded randomized controlled clinical trial that included 76 smokers attending family medicine clinics. Participants were divided into two groups: empowerment and health education groups. Their nicotine-dependence score and smoking cessation stage were identified. All study participants were subjected to five health education sessions with a 3-month follow-up period.

RESULTS: The mean nicotine-dependence score decreased significantly in both groups after the intervention. This decrease was slightly higher in the empowerment group; however, the difference was not statistically significant. After the intervention, 16.7% of the health education and 30.0% of the empowerment group transitioned from stage 1 to stages 2-4 of smoking cessation, with the change being statistically significant only in the empowerment group. There was no statistically significant difference in the number of study participants who stopped smoking between the health education and empowerment groups.

CONCLUSION: Both the empowerment model and traditional health education have similar positive effects on decreasing the nicotine-dependence level. There was a significant improvement in the stage of change for patients under the empowerment model, although there was no statistically significant difference between the groups regarding the number of participants who stopped smoking.

PMID:34607412 | DOI:10.4082/kjfm.20.0212

Drug Res (Stuttg). 2021 Oct 4. doi: 10.1055/a-1647-2222. Online ahead of print.

ABSTRACT

Acute poisoning is commonly seen with pharmaceutical substance or pesticides. Understanding pattern of acute poisoning due to different agents can enable better emergency management. The aim of this study is to present and evaluate the fatality-related data of acute poisoning due to aluminum phosphide (rice pills) and methadone. This descriptive-analytical study was performed on patients Shahid Rahimi Hospital due to poisoning with rice tablets (aluminum phosphide) and methadone from 2015-2020. The data collection tool was a questionnaire using with demographic data, type and dose of poison and clinical presentation, duration of hospitalization was obtained and statistically analyzed. Out of 19 238 patients with poisoning referred to this center, 412 people referred to the hospital due to rice pill poisoning, of which 56 (13.59%) died and among 2157 patients due to methadone poisoning, 22 of them (1.09%) died. In both the groups, rice pill and methadone, there were more male patients 53.57 and 81.81%, respectively. In aluminum phosphide poisoning, the greatest population was in the age group (15-35). However, no specific age group was seen in methadone poisoning. The duration of hospitalization and the time of referral to the emergency department to the death of the patient was significantly correlated with mortality in both the groups. The prevalence of intentional rice kill poising was greatest, effecting young population, we recommend that health care awareness program and training should be provided in this regard. Furthermore, psychiatric care should be made easily available in the region.

PMID:34607375 | DOI:10.1055/a-1647-2222

Epidemiol Health. 2021 Sep 16:e2021069. doi: 10.4178/epih.e2021069. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to validate a simple risk assessment tool for estimating the advanced colorectal neoplasia (ACN) risk at colonoscopy screening; and the potential factors for cooperating with this tool in Korean population.

METHOD: Our study analyzed data of the Cancer screenee cohort – National Cancer Center, Korea. The risk level was assessed by the Asia Pacific Colorectal Screening Score (APCS) developed by the Asia-Pacific Working Group on Colorectal Cancer. The logistic regression models were recruited to assess the association between colorectal-related outcomes and the risk level by APCS. The discriminatory performance of the APCS score for various colorectal related outcomes was assessed by the C-statistics.

RESULTS: A total of 12,520 individuals was included in our analysis, in which 317 ACN cases and 4,528 adenoma cases were founded. Our results revealed that the APCS had successfully classified our population into different risk groups, where significant differences in ACN rate and other outcomes were observed. The score performed acceptable discrimination capability with AUC value ranged from 0.62 to 0.65 for different outcomes. The result of the multivariate logistic regression model revealed that the high-risk group had 3.1 folds higher risk of having ACN (95% CI: 2.08- 4.67). Besides, BMI was reported as the significant predictor for ACN in both multivariate and subgroup analysis.

CONCLUSION: Our study highlighted significant differences in colorectal related outcomes detection between colorectal risk levels by APCS score and the potential cooperation with BMI for improving the discriminatory capability of APCS.

PMID:34607403 | DOI:10.4178/epih.e2021069

Am J Trop Med Hyg. 2021 Oct 4:tpmd210584. doi: 10.4269/ajtmh.21-0584. Online ahead of print.

ABSTRACT

Dengue virus (DENV), chikungunya virus (CHIKV), and Zika virus (ZIKV) are arboviruses that can affect maternal and fetal outcome if acquired during pregnancy. This study was done to estimate the positivity of DENV, CHIKV, and ZIKV in febrile pregnant women attending a tertiary care hospital in north India. Symptomatic pregnant women were tested for these viruses by IgM ELISA and/or by Trioplex real-time polymerase chain reaction. Their symptoms and laboratory parameters were recorded and were followed up till delivery to know their immediate delivery outcome. Of 104 women tested, 50 (48.1%) were positive for viral markers. Of these, evidence of infection by DENV, CHIKV, and both was found in 34 (32.7%), 10 (9.6%), and 6 (5.8%), respectively. ZIKV was not detected in any woman. Maximum DENV positivity occurred in the third trimester of pregnancy and in women residing in urban than rural areas. Chills and rigors, arthralgia, retro-orbital pain, anemia, and vaginal bleeding were more commonly associated with DENV positivity. Backache, arthralgia, jaundice, and vaginal bleeding were more common in CHIKV positives but the difference between positives and nonpositives regarding these symptoms was not statistically significant. Dengue infections were associated with more frequent hospitalizations (OR = 8.38, 95% confidence intervals [CI] = 3.29-21.30) and mortality (OR = 19.0, 95% CI = 1.01-357.10). Hence, to conclude, in India wherever possible, all symptomatic pregnant women should be screened for DENV, CHIKV, and ZIKV as part of sentinel surveillance for ZIKV.

PMID:34607306 | DOI:10.4269/ajtmh.21-0584

Cereb Cortex. 2021 Oct 5:bhab356. doi: 10.1093/cercor/bhab356. Online ahead of print.

ABSTRACT

Neuroimaging evidence implicates structural network-level abnormalities in bipolar disorder (BD); however, there remain conflicting results in the current literature hampered by sample size limitations and clinical heterogeneity. Here, we set out to perform a multisite graph theory analysis to assess the extent of neuroanatomical dysconnectivity in a large representative study of individuals with BD. This cross-sectional multicenter international study assessed structural and diffusion-weighted magnetic resonance imaging data obtained from 109 subjects with BD type 1 and 103 psychiatrically healthy volunteers. Whole-brain metrics, permutation-based statistics, and connectivity of highly connected nodes were used to compare network-level connectivity patterns in individuals with BD compared with controls. The BD group displayed longer characteristic path length, a weakly connected left frontotemporal network, and increased rich-club dysconnectivity compared with healthy controls. Our multisite findings implicate emotion and reward networks dysconnectivity in bipolar illness and may guide larger scale global efforts in understanding how human brain architecture impacts mood regulation in BD.

PMID:34607352 | DOI:10.1093/cercor/bhab356

Nurse Educ Today. 2021 Sep 29;107:105160. doi: 10.1016/j.nedt.2021.105160. Online ahead of print.

ABSTRACT

BACKGROUND: Students use social media for sharing information and connecting with their friends, also for peer support, peer learning and student engagement. Research indicates that approximately twice the number of students were using social media for educational purposes compared to academic staff and almost all students discuss academic issues on social media. However, little is known about how diverse cohorts of student nurses use social media for specific purposes at different stages of their learning.

OBJECTIVES: Identify how student nurses in each country of study use social media for learning. Identify how each generation of student nurses use social media for learning. Identify how student nurses use social media as their education progresses.

DESIGN: A cross-sectional survey.

SETTINGS: The study was undertaken across three countries Jamaica, Trinidad and Tobago and the UK.

PARTICIPANTS: Student nurses from each of the countries that consented to participate met the inclusion criteria.

METHODS: 1050 student nurses across the three countries self-completed the cross-sectional survey between March and September 2019. Data was analysed using descriptive and inferential statistics.

RESULTS: WhatsApp® was the most used platform for learning amongst participants. Watching videos and downloading articles represented two-thirds of social media usage for learning. Smart phones were the most used device to access social media. Kruskal-Wallis tests were significant (≤0.001) for checking social media and messaging in lecture, use of social media for studies and classroom activities by country, generation (except classroom activities) and year of education. Use of social media for classroom activities had no significance by generation.

CONCLUSION: Country, generation and year of education are factors that influence the use of social media in student nurses’ learning. These should be considered by Universities in curriculum development and in teaching and learning delivery. From a pragmatic approach, social media is available and used by a majority of student nurses and can be widely assimilated into the nursing curriculum.

PMID:34607295 | DOI:10.1016/j.nedt.2021.105160

Am J Trop Med Hyg. 2021 Oct 4:tpmd210785. doi: 10.4269/ajtmh.21-0785. Online ahead of print.

ABSTRACT

Occult Hepatitis B Infection (OBI) is a critical risk factor for triggering post-transfusion hepatitis (PTH), cirrhosis, hepatocellular carcinoma, and hepatitis B virus (HBV) reactivation, which β-thalassemia major (BTM) patients are at risk of it due to multiple blood transfusions. This study was aimed at determining the prevalence of OBI among BTM patients from Khuzestan Province, Iran. In this cross-sectional study, 90 thalassemia patients, who have received blood 36 to 552 times, participated referred to the Shafa hospital of Ahvaz city from January 2018 to April 2019. ELISA for determining serological markers (HBsAg, anti-HBc, anti-HBs, and anti-HCV) and real-time PCR for detecting HBV-DNA were performed; Nested PCR was conducted for DNA sequencing and determining the genotype of OBI case. Phylogenetic and statistical analyses were done by R package. Of 90 subjects enrolled in this study; 95.5% (86/90) were HBsAg negative, and the frequency of OBI among them was 1.16% (1/86). The anti-HBs, anti-HBc, and anti-HCV were detected in 80.00%, 7.78%, and 12.2% of patients, respectively. HBV-DNA was assessed at four HBsAg-positive subjects as well, and all of them were negative. The phylogenetic analysis showed that the detected HBV DNA in the OBI case belongs to the genotype D. This research, for the first time, demonstrated that OBI is present among β-thalassemia patients in Iran. Also, further studies are necessary to determine the actual prevalence of OBI among BTM patients in Iran to decisions concerning OBI screening, especially in transfusion centers.

PMID:34607305 | DOI:10.4269/ajtmh.21-0785

Int J Med Inform. 2021 Sep 21;156:104588. doi: 10.1016/j.ijmedinf.2021.104588. Online ahead of print.

ABSTRACT

BACKGROUND: Electronic health record (EHR) data is commonly used for secondary purposes such as research and clinical decision support. However, reuse of EHR data presents several challenges including but not limited to identifying all diagnoses associated with a patient’s clinical encounter. The purpose of this study was to assess the feasibility of developing a schema to identify and subclassify all structured diagnosis codes for a patient encounter.

METHODS: To develop a subclassification schema we used EHR data from an interhospital transport data repository that contained complete hospital encounter level data. Eight discrete data sources containing structured diagnosis codes were identified. Diagnosis codes were normalized using the Unified Medical Language System and additional EHR data were combined with standardized terminologies to create and validate the subcategories. We then employed random forest to assess the usefulness of the new subcategorized diagnoses to predict post-interhospital transfer mortality by building 2 models, one using standard diagnosis codes, and one using the new subcategorized diagnosis codes.

RESULTS: Six subcategories of diagnoses were identified and validated. The subcategories included: primary or admitting diagnoses (10%), past medical, surgical or social history (9%), problem list (20%), comorbidity (24%), discharge diagnoses (6%), and unmapped diagnoses (31%). The subcategorized model outperformed the standard model, achieving a training AUROC of 0.97 versus 0.95 and testing model AUROC of 0.81 versus 0.46.

DISCUSSION: Our work demonstrates that merging structured diagnosis codes with additional EHR data and secondary data sources provides additional information to understand the role of diagnosis throughout a clinical encounter and improves predictive model performance. Further work is necessary to assess if subcategorizing produces benefits in interpreting the results of prognostic models and/or operationalizing the results in clinical decision support applications.

PMID:34607290 | DOI:10.1016/j.ijmedinf.2021.104588

J Chromatogr A. 2021 Sep 22;1657:462570. doi: 10.1016/j.chroma.2021.462570. Online ahead of print.

ABSTRACT

The purpose of this paper is to propose a simple method for daily inspections of a gas chromatography-mass spectrometry (GC-MS) system with an instrumental detection limit (IDL) as an indicator. A definition of DLs by ISO is 3.3σ where σ denotes the standard deviation (SD) of blank measurements. Estimation of σ is carried out according to the function of mutual information (FUMI) theory and actually with commercial software (TOCO19). An IDL which is a combination of a signal area, width and noise level is concluded to be a good indicator for daily inspections compared with each of its constituents. Methyl stearate is used as a standard material for the daily inspection of a programmed-temperature GC-MS system. A short chromatogram of 1800 data points (1.5 min) containing a target signal and background noise is fit for the IDL prediction by TOCO19. The relative SDs (RSDs) based on the theoretically estimated σ are shown to coincide with statistical results from repeated measurements within 95% confidence intervals. Column temperature is observed to affect IDLs through background fluctuation and then temperature-IDL relationship is examined in a range from 170 to 270 °C. Actual daily inspections over a month are demonstrated.

PMID:34607291 | DOI:10.1016/j.chroma.2021.462570

ESMO Open. 2021 Oct 1;6(5):100279. doi: 10.1016/j.esmoop.2021.100279. Online ahead of print.

ABSTRACT

BACKGROUND: KRAS is mutated in ∼30% of non-small-cell lung cancer (NSCLC) but it has also been identified as one of the mechanisms underlying resistance to tyrosine kinase inhibitors (TKIs) in EGFR-positive NSCLC patients. Novel KRAS inhibitors targeting KRAS p.G12C mutation have been developed recently with promising results. The proportion of EGFR-positive NSCLC tumours harbouring the KRAS p.G12C mutation upon disease progression is completely unexplored.

MATERIALS AND METHODS: Plasma samples from 512 EGFR-positive advanced NSCLC patients progressing on a first first-line treatment with a TKI were collected. The presence of KRAS p.G12C mutation was assessed by digital PCR.

RESULTS: Overall, KRAS p.G12C mutation was detected in 1.17% of the samples (n = 6). In two of these cases, we could confirm that the KRAS p.G12C mutation was not present in the pre-treatment plasma samples, supporting its role as an acquired resistance mutation. According to our data, KRAS^G12C patients showed similar clinicopathological characteristics to those of the rest of the study cohort and no statistically significant associations between any clinical features and the presence of the mutation were found. However, two out of six KRAS^G12C tumours harboured less common EGFR driver mutations (p.G719X/p.L861Q). All KRAS^G12C patients tested negative for the presence of p.T790M resistance mutation.

CONCLUSIONS: The KRAS p.G12C mutation is detected in 1% of EGFR-positive NSCLC patients who progress on a first line with a TKI. All KRAS^G12C patients were negative for the presence of the p.T790M mutation and they did not show any distinctive clinical feature.

PMID:34607284 | DOI:10.1016/j.esmoop.2021.100279