Tag: pubmed

Int J Med Inform. 2021 May 10;152:104485. doi: 10.1016/j.ijmedinf.2021.104485. Online ahead of print.

ABSTRACT

BACKGROUND: Ownership has significant impact on website motivation. Consumers may heavily rely on the health website ownership cue when assessing credibility and making behavioral response toward health information on it. Health websites were primarily divided into four different ownership types (i.e., governmental, organizational, commercial, and personal) in China’s context. However, research on Chinese consumer behavior toward different ownership types of health websites is scarce.

OBJECTIVES: To investigate the most credible and most commonly used health website ownership type among Chinese consumers, and to identify the influencing factors on perceived credibility, and actual usage of health websites.

METHODS: A cross-sectional survey of 1653 participants was conducted in 3-tier hospitals in 3 cities with different income levels. Multinomial logistic regression analyses were used to identify factors influencing Chinese consumers’ perceived credibility and actual use of health websites.

RESULTS: The most credible health website was the organizational, followed by the governmental, commercial, and personal. The most commonly used health website was the commercial, followed by the organizational, governmental, and personal. Individuals in medium-income and low-income cities were more likely than those in high-income cities to trust and use non-governmental health websites. Compared to the governmental health website, consumers of high-level hospitals were less likely than those of primary hospitals to trust and use personal health websites. Compared to the governmental health website, high-income individuals were more likely than low-income individuals to trust the personal health website, and use the organizational and commercial health website.

CONCLUSIONS: Both Chinese consumers’ perceived credibility and actual use of health website varied by ownership, and there was a gap between perceived credibility and actual usage of health website. Most sociodemographic factors had no statistically significant correlations with perceived credibility and actual usage of health website. City income level, consumer type and consumer income level were significantly associated with perceived credibility, actual usage of health websites.

PMID:34004399 | DOI:10.1016/j.ijmedinf.2021.104485

J Affect Disord. 2021 Apr 25;290:197-201. doi: 10.1016/j.jad.2021.04.028. Online ahead of print.

ABSTRACT

BACKGROUND: Bipolar Affective Disorder (BPAD) accounts for 10-25% of all mood disorders in the geriatric population and 5% of all inpatient admissions to geropsychiatric units. Electroconvulsive therapy (ECT) is an effective treatment for all phases of BPAD, though only a few studies have focused on BPAD in the geriatric population. This study examines the safety and efficacy of ultra-brief right unilateral (UBRUL) ECT for patients with late-life bipolar depression (BD).

METHODS: A retrospective chart review was conducted of patients with late-life BD who received UBRUL ECT treatments. Symptomatic response was measured using pre- and post-ECT Quick Inventory of Depressive Symptomatology (QIDS-SR16) and Beck Depression Inventory (BDI-II) scores. Clinical improvement and cognitive change were measured using Clinical Global Impression-Improvement (CGI-I) and Electroconvulsive Cognitive Assessment (ECCA) scores.

RESULTS: Twenty-Seven elderly patients (mean age 69.1 ± 7.7 years) were included in the analysis. Baseline QIDS-SR16 was 17.3 ± 5.3 and BDI-II 30.0 ± 9.2. 80.0% (16/20) and 57.1% (4/7) of patients achieved response (50.0% decline) in their QIDS-SR16 and BDI-II scores, respectively. Remission rates in QIDS-SR16 (post-ECT scores ≤5) and BDI-II (post-ECT scores ≤12) were 65.0% (13/20) and 42.9% (3/7), respectively. Mean QIDS-SR16 and BDI-II scores were reduced by a statistically significant 68.2% and 50.5%, respectively (two-tailed, paired p-values <0.01) after ECT. CGI-I of ≤2 was attained by 85.2% (23/27) of patients. 85.7% (12/14) of patients saw no change or improvement in ECCA scores.

LIMITATIONS: Inherent complications of chart review regarding quality, availability, and homogeny of data.

CONCLUSIONS: UBRUL ECT is a safe and effective treatment for patients presenting with late-life BD.

PMID:34004401 | DOI:10.1016/j.jad.2021.04.028

World Neurosurg. 2021 May 15:S1878-8750(21)00712-9. doi: 10.1016/j.wneu.2021.05.017. Online ahead of print.

ABSTRACT

OBJECTIVE: In 1985, Takeshi Kawase published an anterior petrosal approach to expose the posterior cranial fossa and to minimize retraction of the temporal lobe. However, several neurosurgeons still have difficulty with removing tumors through an anterior petrosal approach, because a complete understanding of the Kawase pyramid has not been achieved. We hypothesized that if anterior petrosectomy is performed with three-dimensional understanding of the Kawase pyramid, it would have a positive effect on the extent of tumor resection.

METHODS: We performed a retrospective study of patients who underwent surgical treatment for meningioma through an anterior petrosal approach. Patients were divided into total resection and subtotal resection groups, and statistical differences between the two groups were analyzed. To identify factors predictive of complete tumor removal, univariable and multivariable logistic regression analyses were performed.

RESULTS: The width and height of the drilled internal acoustic canal (IAC) of the total resection group were significantly longer than those of the subtotal resection group (p=0.001, p=0.033). The operative angle of the total resection group was significantly larger than that of the subtotal resection group (p<0.001). Regression analyses showed only drilled IAC width to be predictive of complete tumor removal, increasing the likelihood thereof by 2.778-fold with an increase in drilled IAC width by 1 mm (p=0.023).

CONCLUSIONS: Insufficient petrosectomy during an anterior petrosal approach adversely affects the extent of tumor resection. Furthering three-dimensional understanding of the Kawase pyramid could help complete tumor resection and better outcomes without causing damage to the surrounding organs.

PMID:34004357 | DOI:10.1016/j.wneu.2021.05.017

J Diabetes Investig. 2021 May 18. doi: 10.1111/jdi.13579. Online ahead of print.

ABSTRACT

BACKGROUND: Body aging is a universal biological process. With aging, cells undergo a series of physiological changes. The main feature is cell proliferation decline, although the cell still have normal functions. Pancreatic β cells are no exception. However, the physiological senescence of β-cells and the resulting function and transcriptome changes have rarely attracted attention. The specific senescence phenotype of β-cells remains unknown.

MATERIALS AND METHODS: Pancreatic samples from three female C57BL/6 mice with aged 2.5 months (young) mice and 20 months (old) were digested to a single-cell suspension and analyzed, with 10×genomic single-cell RNA sequencing (scRNA-seq), β cells were determined by biosynthesis analysis, and differences between old and young mice were identified.

RESULTS: Forty-seven differential genes with significant and statistical significance were screened in β cells (fold change>1.5, P<0.05). In old mice, 27 genes were up-regulated and 20 genes were down-regulated. Genes Mt1, Mt2, Pyy, Gcg and Pnlip and mitochondrial genes mt-Nd1, mt-Nd3 , mt-Co1, mt-Co2, and mt-Co3 were found to be involved in cellular senescence. Transcription factors Jund and Fos were important regulators of senescence.

CONCLUSIONS: An overall difference was found between the pancreatic β cells of old and young mice. Transcription factors facilitate transitions between pancreatic β cells. These findings are worthy of deep exploration and provide new resources and directions for the research of pancreatic aging in mice.

PMID:34003589 | DOI:10.1111/jdi.13579

Diagn Cytopathol. 2021 May 18. doi: 10.1002/dc.24801. Online ahead of print.

ABSTRACT

BACKGROUND: The diagnosis of spindle cell neoplasms (SCN) of the upper gastrointestinal (GI) tract, hepatobiliary tract, and pancreas detected by fine needle aspiration (FNA) is challenging. We describe a single-center experience of these samples with follow-up data and characterization of the morphologic findings.

METHODS: We retrospectively reviewed pathology records for all FNAs diagnostic for or suggestive of SCN on esophagus, stomach, small bowel, liver, and pancreas in a 15 year period. All cases with at least 6 month follow-up were included. Surgical material (biopsy or resection) was the diagnostic gold standard. All FNAs with subsequent surgical specimens were reviewed and assessed for cellularity, architectural features, and nuclear features.

RESULTS: In 15 years, 5101 FNAs of the upper GI tract, hepatobiliary tract, and pancreas were performed. SCN was diagnosed in 98 (2%) patients. Seventy-two patients had definitive pathologic diagnoses: 68 were neoplastic and four were non-neoplastic. Cytomorphologic review in relationship to final diagnosis revealed three statistically significant features: low cellularity favors a benign process (P = .00544), epithelioid nuclear morphology favors malignancy (P = .00278), and identification of perinuclear vacuoles favors a diagnosis of GIST over non-GIST SCN (P = .04236).

CONCLUSIONS: Among cases with follow-up, final pathologic diagnoses were SCN in 94% of cases diagnosed as SCN on FNA of upper GI, hepatobiliary tract, and pancreas. Although some cytomorphologic criteria are more suggestive of malignancy, arriving at a specific diagnosis relies on collaboration of clinical, radiologic, cytomorphologic, and immunohistochemical data.

PMID:34003599 | DOI:10.1002/dc.24801

J Hum Nutr Diet. 2021 May 18. doi: 10.1111/jhn.12919. Online ahead of print.

ABSTRACT

PURPOSE: Head and neck cancers (HNC) are strongly associated with malnutrition. This systematic review aimed to investigate the optimal frequency of individualised nutrition counselling (INC) pre-, peri- and post-treatment for patients with HNC.

METHODS: Pubmed, EMBASE, Cinahl and Scopus were searched from inception through to April 2020 to identify randomised controlled trials (RCTs) that focused on the INC frequency for adult patients with HNC (Registration no. 178868). Outcomes assessed were nutritional status, dietary intake, weight change, treatment interruptions, unplanned hospital admissions, quality of life, complications and morbidity. Certainty of evidence was assessed using GRADE.

RESULTS: Four RCTs were identified with five manuscripts (n=500 total participants). The certainty of evidence was ‘high’ for nutritional status and quality of life, ‘moderate’ for treatment interruptions and unplanned hospital admissions and ‘low’ for % weight change, complications/morbidity and dietary intake. Compared to control groups, there were consistent improvements for nutritional status, quality of life, treatment interruptions, unplanned hospital admissions, dietary intake, % weight change and morbidity when weekly INC was provided peri-treatment and fortnightly INC was provided post-treatment. No statistical significance was found for treatment interruptions, dietary intake and weight change when INC was provided fortnightly peri-treatment only. There were no RCTs in the current review that offered INC pre-treatment.

CONCLUSION: This systematic review shows beneficial effects with weekly INC peri-treatment and fortnightly INC post-treatment for patients with HNC in all outcomes studied. Future research should focus on models of care to address the optimal frequency of pre-treatment INC as well as the duration of post-treatment INC.

PMID:34003532 | DOI:10.1111/jhn.12919

J Viral Hepat. 2021 May 18. doi: 10.1111/jvh.13545. Online ahead of print.

ABSTRACT

A goal of the WHO strategy on the elimination of hepatitis as a public threat is a 65% reduction in the attributable mortality. Deaths related to hepatitis B and C infections are mostly due to decompensated cirrhosis and hepatocellular carcinoma (HCC) but accurately measuring mortality is challenging as death certificates often do not capture the underlying disease. The aim of this collaborative study between European Centre for Disease Prevention and Control (ECDC) and the European Association for the Study of the Liver (EASL) was to assess a WHO-developed protocol to support countries in implementing studies to collect data on the fraction of cirrhosis and hepatocellular carcinoma attributable to hepatitis B and C. Three sentinel sites (in Bulgaria, Norway and Portugal) collected data for patients first admitted or seen in their centres during 2016. Patients with cirrhosis or HCC were identified through patient files or healthcare databases using ICD-10 codes. The proportion of patients with cirrhosis and HCC who tested positive for HBV and HCV were calculated to estimate the aetiological fractions. After the pilot study was completed, each site was asked about the feasibility and acceptability of the protocol. A total of 1249 patients presenting with cirrhosis and/or HCC were evaluated across the three sites. The prevalence of HBV and HCV among cases of cirrhosis showed that in Norway and Portugal, HCV was responsible for about one quarter of the cases, whereas in Bulgaria, HBV was more common. HCV was responsible for more than one-third of HCC cases in Norway and Portugal, while in Bulgaria HBV was more frequent as HCC underlying cause. Results obtained during the pilot study were comparable to published estimates obtained through statistical modelling or meta-analyses. Several challenges were reported from the sites involved in the pilot including the considerable time needed for reviewing the hospital records and extracting the patient’s data.The pilot demonstrated the feasibility of collecting data on the prevalence of HBV and HCV infection among patients with cirrhosis and HCC in sentinel sites. This method can be used to estimate mortality attributable to HBV and HCV for elimination monitoring. Where easily implementable, sentinel studies are the best way to empower countries, get up-to date data, and closely monitor the changes in the attributable fraction at a country level.

PMID:34003542 | DOI:10.1111/jvh.13545

J Viral Hepat. 2021 May 18. doi: 10.1111/jvh.13546. Online ahead of print.

ABSTRACT

Improvement of health-related quality of life (HRQoL) is frequently reported as a benefit when treating hepatitis C virus infection (HCV) with direct acting antivirals (DAA). As most of the available data were obtained from clinical trials, limited generalizability to the real-world population might exist. This study aimed to investigate the impact of DAA therapy on changes in HRQoL in a real-world setting. HRQoL of 1,180 participants of the German-Hepatitis C-Registry was assessed by short-Form 36 (SF-36) questionnaires. Scores at post treatment weeks 12-24 (FU12/24) were compared to baseline (BL). Changes of ≥2.5 in mental and physical component summary scores (MCS and PCS) were defined as a minimal clinical important difference (MCID). Potential predictors of HRQoL changes were analyzed. Overall, a statistically significant increase in HRQoL after DAA therapy was observed, that was robust among various subgroups. However, roughly half of all patients failed to achieve a clinically important improvement in MCS and PCS. Low MCS (p<0.001, OR=0.925) and PCS (p<0.001, OR=0.899) BL levels were identified as predictors for achieving a clinically important improvement. In contrast, presence of fatigue (p=0.023, OR=1.518), increased GPT levels (p=0.005, OR=0.626) and RBV-containing therapy regimens (p=0.001, OR=1.692) were associated with a clinically important decline in HRQoL after DAA therapy. In conclusion, DAA treatment is associated with an overall increase of HRQoL in HCV-infected patients. Nevertheless, roughly half of the patients fail to achieve a clinically important improvement. Especially patients with a low HRQoL seem to benefit most from the modern therapeutic options.

PMID:34003549 | DOI:10.1111/jvh.13546

J Adv Nurs. 2021 May 18. doi: 10.1111/jan.14855. Online ahead of print.

ABSTRACT

AIM: To develop a consensus paper on the central points of an international invitational think-tank on nursing and artificial intelligence (AI).

METHODS: We established the Nursing and Artificial Intelligence Leadership (NAIL) Collaborative, comprising interdisciplinary experts in AI development, biomedical ethics, AI in primary care, AI legal aspects, philosophy of AI in health, nursing practice, implementation science, leaders in health informatics practice and international health informatics groups, a representative of patients and the public, and the Chair of the ITU/WHO Focus Group on Artificial Intelligence for Health. The NAIL Collaborative convened at a 3-day invitational think tank in autumn 2019. Activities included a pre-event survey, expert presentations and working sessions to identify priority areas for action, opportunities and recommendations to address these. In this paper, we summarize the key discussion points and notes from the aforementioned activities.

IMPLICATIONS FOR NURSING: Nursing’s limited current engagement with discourses on AI and health posts a risk that the profession is not part of the conversations that have potentially significant impacts on nursing practice.

CONCLUSION: There are numerous gaps and a timely need for the nursing profession to be among the leaders and drivers of conversations around AI in health systems.

IMPACT: We outline crucial gaps where focused effort is required for nursing to take a leadership role in shaping AI use in health systems. Three priorities were identified that need to be addressed in the near future: (a) Nurses must understand the relationship between the data they collect and AI technologies they use; (b) Nurses need to be meaningfully involved in all stages of AI: from development to implementation; and (c) There is a substantial untapped and an unexplored potential for nursing to contribute to the development of AI technologies for global health and humanitarian efforts.

PMID:34003504 | DOI:10.1111/jan.14855

Environ Toxicol Chem. 2021 May 18. doi: 10.1002/etc.5119. Online ahead of print.

ABSTRACT

Benthic communities contain some of the most threatened organisms in aquatic habitats due to different anthropogenic pressures. The high abundance of microplastics (MPs) in sediments will continue to increase in the future, further increasing the probability of interactions between macroinvertebrates and MPs. In the present study, a benthic community in a relatively pristine shallow pond was exposed either to an environmentally relevant high concentration of an MP mixture of 80 g m^-2 in the sediment, or a control sediment, without the addition of MPs. The mixture of MPs contained irregular shaped polyethylene (PE), polyvinyl-chloride (PVC), and polyamide (PA) in a ratio of 50%: 25%: 25%, respectively. The in situ experiment lasted for 100 days. The total number of taxa that colonized the microcosms was 22 (17 in the control, 18 in the MP treatment), and the colonization was not affected by the treatment. The most dominant group within the macroinvertebrate community was the dipteran family Chironomidae, both in the control and the MP treatment. No significant differences in the abundance and biomass at a community level were recorded between the groups by PERMANOVA ((F=0.993; p=0.456 and F=0.344; p=0.797, respectively). The mixture of MPs did not influence the abundance or biomass of the functional feeding groups (F=1.810; p=0.137 and F=0.377; p=0.736, respectively). The species richness (S), species abundance (N), species biomass (B), Shannon’s diversity index (H) and Simpson’s index of diversity (D) showed no statistically significant differences between the control and treatment groups. Czekanowski’s quantitative similarity index indicated that 84% of the community remained unaffected after MPs exposure. This article is protected by copyright. All rights reserved.

PMID:34003520 | DOI:10.1002/etc.5119