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O'Toole GA. We have a community problem. J Bacteriol 2024:e0007324. [PMID: 38529952 DOI: 10.1128/jb.00073-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Affiliation(s)
- George A O'Toole
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
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2
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Serafim RS, Bispo LGM, da Silva JMN, da Silva JG. Dimensional assessment of self-reported musculoskeletal symptoms by workers: A multi-case study. Work 2024:WOR230480. [PMID: 38517834 DOI: 10.3233/wor-230480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2024] Open
Abstract
BACKGROUND Work-related musculoskeletal disorders (WMSD) encompass a range of conditions affecting muscles, tendons, and nerves. Visual diagrams are widely used to identify symptoms and to generate musculoskeletal discomfort metrics. However, there is no consensus on the number of discomfort dimensions that can originate from self-reported musculoskeletal symptoms by individuals. OBJECTIVE This study aimed to test the fit of WMSD symptom models from workers in two samples of different sizes. METHODS A combination of Full-Information Item Factor Analysis (FIFA) and Item Response Theory (IRT) was utilized to analyze and test the models. The study was conducted in two samples of workers (n1 = 6944 and n2 = 420) who had their symptoms identified with the aid of a human body diagram. An analysis was conducted considering each sample's unidimensional and three multidimensional models. RESULTS The unidimensional model (general musculoskeletal discomfort), bi-dimensional model (discomfort in upper and lower body), and tridimensional model (discomfort in the upper limbs, lower limbs, and trunk) showed good values of factor loading and communalities, along with satisfactory item discrimination ability. Regardless of sample size, parameter estimation for IRT and FIFA proceeded without issues, presenting suitable fit parameters. CONCLUSION Three models were valid and reliable for more extensive and smaller samples. However, the tridimensional model was best for generating discomfort scores in body regions. Companies and safety professionals can use these findings to devise strategies to mitigate musculoskeletal pains based on perceived symptom locations.
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Affiliation(s)
- Rômulo Silva Serafim
- Federal University of Alagoas - Campus do Sertão - Delmiro Gouveia, Alagoas, Brazil
| | - Lucas Gomes Miranda Bispo
- Postgraduate Program in Production Engineering, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil
| | | | - Joel Gomes da Silva
- Federal University of Alagoas - Campus do Sertão - Delmiro Gouveia, Alagoas, Brazil
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3
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Sakal C, Li T, Li J, Li X. Identifying Predictive Risk Factors for Future Cognitive Impairment Among Chinese Older Adults: Longitudinal Prediction Study. JMIR Aging 2024; 7:e53240. [PMID: 38534042 DOI: 10.2196/53240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 01/29/2024] [Accepted: 02/27/2024] [Indexed: 03/28/2024] Open
Abstract
Background The societal burden of cognitive impairment in China has prompted researchers to develop clinical prediction models aimed at making risk assessments that enable preventative interventions. However, it is unclear what types of risk factors best predict future cognitive impairment, if known risk factors make equally accurate predictions across different socioeconomic groups, and if existing prediction models are equally accurate across different subpopulations. Objective This paper aimed to identify which domain of health information best predicts future cognitive impairment among Chinese older adults and to examine if discrepancies exist in predictive ability across different population subsets. Methods Using data from the Chinese Longitudinal Healthy Longevity Survey, we quantified the ability of demographics, instrumental activities of daily living, activities of daily living, cognitive tests, social factors and hobbies, psychological factors, diet, exercise and sleep, chronic diseases, and 3 recently published logistic regression-based prediction models to predict 3-year risk of cognitive impairment in the general Chinese population and among male, female, rural-dwelling, urban-dwelling, educated, and not formally educated older adults. Predictive ability was quantified using the area under the receiver operating characteristic curve (AUC) and sensitivity-specificity curves through 20 repeats of 10-fold cross-validation. Results A total of 4047 participants were included in the study, of which 337 (8.3%) developed cognitive impairment 3 years after baseline data collection. The risk factor groups with the best predictive ability in the general population were demographics (AUC 0.78, 95% CI 0.77-0.78), cognitive tests (AUC 0.72, 95% CI 0.72-0.73), and instrumental activities of daily living (AUC 0.71, 95% CI 0.70-0.71). Demographics, cognitive tests, instrumental activities of daily living, and all 3 recreated prediction models had significantly higher AUCs when making predictions among female older adults compared to male older adults and among older adults with no formal education compared to those with some education. Conclusions This study suggests that demographics, cognitive tests, and instrumental activities of daily living are the most useful risk factors for predicting future cognitive impairment among Chinese older adults. However, the most predictive risk factors and existing models have lower predictive power among male, urban-dwelling, and educated older adults. More efforts are needed to ensure that equally accurate risk assessments can be conducted across different socioeconomic groups in China.
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Affiliation(s)
- Collin Sakal
- School of Data Science, City University of Hong Kong, Hong Kong, China
| | - Tingyou Li
- School of Data Science, City University of Hong Kong, Hong Kong, China
| | - Juan Li
- Center on Aging Psychology, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Xinyue Li
- School of Data Science, City University of Hong Kong, Hong Kong, China
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4
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Ridout B, Forsyth R, Amon KL, Navarro P, Campbell AJ. The Urgent Need for an Evidence-Based Digital Mental Health Practice Model of Care for Youth. JMIR Ment Health 2024; 11:e48441. [PMID: 38534006 DOI: 10.2196/48441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 01/07/2024] [Accepted: 01/25/2024] [Indexed: 03/28/2024] Open
Abstract
Abstract
Australian providers of mental health services and support for young people include private and public allied health providers, government initiatives (eg, headspace), nongovernment organizations (eg, Kids Helpline), general practitioners (GPs), and the hospital system. Over 20 years of research has established that many young people prefer to seek mental health support online; however, clear client pathways within and between online and offline mental health services are currently lacking. The authors propose a Digital Mental Health Practice model of care for youth to assist with digital mental health service mapping. The proposed model offers accessible pathways for a client to engage with digital mental health services, provides clear navigation to access support for individual needs, and facilitates a seamless connection with offline mental health services using a transferable electronic health records system. This future-looking model also includes emerging technologies, such as artificial intelligence and the metaverse, which must be accounted for as potential tools to be leveraged for digital therapies and support systems. The urgent need for a user-centered Digital Mental Health Practice model of care for youth in Australia is discussed, highlighting the shortcomings of traditional and existing online triage models evident during the COVID-19 pandemic, and the complex challenges that must be overcome, such as the integration of diverse mental health care providers and establishment of a robust electronic health records system. Potential benefits of such a model include reduced pressure on emergency rooms, improved identification of immediate needs, enhanced referral practices, and the establishment of a cost-efficient national digital mental health care model with global applicability. The authors conclude by stressing the consequences of inaction, warning that delays may lead to more complex challenges as new technologies emerge and exacerbate the long-term negative consequences of poor mental health management on the economic and biopsychosocial well-being of young Australians.
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Affiliation(s)
- Brad Ridout
- Cyberpsychology Research Group, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Rowena Forsyth
- Cyberpsychology Research Group, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Krestina L Amon
- Cyberpsychology Research Group, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | | | - Andrew J Campbell
- Cyberpsychology Research Group, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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5
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Schmitz KS, Rennick LJ, Tilston-Lunel NL, Comvalius AD, Laksono BM, Geers D, van Run P, de Vries RD, de Swart RL, Duprex WP. Rational attenuation of canine distemper virus (CDV) to develop a morbillivirus animal model that mimics measles in humans. J Virol 2024; 98:e0185023. [PMID: 38415596 PMCID: PMC10949419 DOI: 10.1128/jvi.01850-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/05/2024] [Indexed: 02/29/2024] Open
Abstract
Morbilliviruses are members of the family Paramyxoviridae and are known for their ability to cause systemic disease in a variety of mammalian hosts. The prototypic morbillivirus, measles virus (MeV), infects humans and still causes morbidity and mortality in unvaccinated children and young adults. Experimental infection studies in non-human primates have contributed to the understanding of measles pathogenesis. However, ethical restrictions call for the development of new animal models. Canine distemper virus (CDV) infects a wide range of animals, including ferrets, and its pathogenesis shares many features with measles. However, wild-type CDV infection is almost always lethal, while MeV infection is usually self-limiting. Here, we made five recombinant CDVs, predicted to be attenuated, and compared their pathogenesis to the non-attenuated recombinant CDV in a ferret model. Three viruses were insufficiently attenuated based on clinical signs, fatality, and systemic infection, while one virus was too attenuated. The last candidate virus caused a self-limiting infection associated with transient viremia and viral dissemination to all lymphoid tissues, was shed transiently from the upper respiratory tract, and did not result in acute neurological signs. Additionally, an in-depth phenotyping of the infected white blood cells showed lower infection percentages in all lymphocyte subsets when compared to the non-attenuated CDV. In conclusion, infection models using this candidate virus mimic measles and can be used to study pathogenesis-related questions and to test interventions for morbilliviruses in a natural host species.IMPORTANCEMorbilliviruses are transmitted via the respiratory route but cause systemic disease. The viruses use two cellular receptors to infect myeloid, lymphoid, and epithelial cells. Measles virus (MeV) remains an important cause of morbidity and mortality in humans, requiring animal models to study pathogenesis or intervention strategies. Experimental MeV infections in non-human primates are restricted by ethical and practical constraints, and animal morbillivirus infections in natural host species have been considered as alternatives. Inoculation of ferrets with wild-type canine distemper virus (CDV) has been used for this purpose, but in most cases, the virus overwhelms the immune system and causes highly lethal disease. Introduction of an additional transcription unit and an additional attenuating point mutation in the polymerase yielded a candidate virus that caused self-limiting disease with transient viremia and virus shedding. This rationally attenuated CDV strain can be used for experimental morbillivirus infections in ferrets that reflect measles in humans.
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Affiliation(s)
| | - Linda J. Rennick
- Center for Vaccine Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Natasha L. Tilston-Lunel
- Center for Vaccine Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | | | | | - Daryl Geers
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
| | - Peter van Run
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
| | - Rory D. de Vries
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
| | - Rik L. de Swart
- Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
| | - W. Paul Duprex
- Center for Vaccine Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Amery F. From laboratory to mountaintop: Creating an artificial aurora in the late nineteenth century. Hist Sci 2024:732753241229147. [PMID: 38494601 DOI: 10.1177/00732753241229147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
There existed a tradition of mimetic experimentation in the late nineteenth century, whereby morphologists sought to scale down sublime natural phenomena to tabletop devices in the laboratory. Experimenters constructed analogs of the aurora, attempting to replicate the colors and forms of the phenomenon with discharge tube experiments and electrical displays, which became popular spectacles at London's public galleries. This paper analyses a closely allied but different kind of imitation. Between 1872 and 1884, Professor Karl Selim Lemström (1838-1904) attempted to reproduce the aurora borealis in all of its complexity atop four mountains in northern Finland. Crucially, his "artificial aurora" was to materialize at the same scale as the original phenomenon and in its natural habitat in the polar atmosphere. With his experiment Lemström hoped to uncover the workings of the aurora and the electrical currents that he believed were always present within the atmosphere; his epistemological framework was one of learning by making. This paper sheds light on the broader problem of what it meant to authentically replicate a phenomenon that remained largely enigmatic, and, most importantly, how this replication could be verified. This prompts a discussion as to whether model experiments needed only to appear visually similar to the objects they purported to imitate, were required to preserve their form, or needed to be materially identical in order to the original to be identified as legitimate "reproductions" in the late nineteenth century.
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Affiliation(s)
- Fiona Amery
- Dr. Fiona Amery, Department of History and Philosophy of Science, University of Cambridge, UK
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Inayaturohmat F, Anggriani N, Supriatna AK, Biswas MHA. A Systematic Literature Review of Mathematical Models for Coinfections: Tuberculosis, Malaria, and HIV/AIDS. J Multidiscip Healthc 2024; 17:1091-1109. [PMID: 38510530 PMCID: PMC10951863 DOI: 10.2147/jmdh.s446508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/19/2024] [Indexed: 03/22/2024] Open
Abstract
Tuberculosis, malaria, and HIV are among the most lethal diseases, with AIDS (Acquired Immune Deficiency Syndrome) being a chronic and potentially life-threatening condition caused by the human immunodeficiency virus (HIV). Individually, each of these infections presents a significant health challenge. However, when tuberculosis, malaria, and HIV co-occur, the symptoms can worsen, leading to an increased mortality risk. Mathematical models have been created to study coinfections involving tuberculosis, malaria, and HIV. This systematic literature review explores the importance of coinfection models by examining articles from reputable databases such as Dimensions, ScienceDirect, Scopus, and PubMed. The primary emphasis is on investigating coinfection models related to tuberculosis, malaria, and HIV. The findings demonstrate that each article thoroughly covers various aspects, including model development, mathematical analysis, sensitivity analysis, optimal control strategies, and research discoveries. Based on our comprehensive evaluation, we offer valuable recommendations for future research efforts in this field.
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Affiliation(s)
- Fatuh Inayaturohmat
- Doctoral in Mathematics Study Programme, Department of Mathematics, Faculty of Mathematics and Natural Sciences, Universitas Padjadjaran, Sumedang, Indonesia
| | - Nursanti Anggriani
- Department of Mathematics, Faculty of Mathematics and Natural Sciences, Universitas Padjadjaran, Sumedang, Indonesia
| | - Asep K Supriatna
- Department of Mathematics, Faculty of Mathematics and Natural Sciences, Universitas Padjadjaran, Sumedang, Indonesia
| | - Md Haider Ali Biswas
- Mathematics Discipline, Science, Engineering and Technology School, Khulna University, Khulna 9208, Bangladesh
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8
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Charakida M, Gibbone E, Huluta I, Syngelaki A, Wright A, Nicolaides KH. First trimester screening identifies maternal cardiac maladaptation at mid-gestation. Ultrasound Obstet Gynecol 2024. [PMID: 38477164 DOI: 10.1002/uog.27640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/22/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND First, a logistic regression model, based on maternal demographic characteristics and medical history and blood pressure at 11-13 weeks' gestation, can identify about 70% of women who develop future chronic hypertension (CH) in the three years following pregnancy, at screen positive rate of 10%. Second, at mid-gestation women who subsequently develop hypertensive disorders of pregnancy (HDP) have increased peripheral vascular resistance and mild cardiac functional and morphological alterations and these cardiovascular abnormalities persist for at least 2 years after delivery. OBJECTIVE To examine whether the use of the first-trimester risk for subsequent development of CH can help to identify women at high risk for cardiovascular maladaptation at mid-gestation. METHODS Prospective observational study in 3812 women with singleton pregnancies women attending for a routine hospital visit at 11+0 to 13+6 weeks' gestation and again at 19+1 to 23+3 weeks at King's College Hospital, London, UK between August 2019 and August 2020. The first-trimester visit included recording of maternal demographic characteristics and medical history and measurement of systolic and diastolic blood pressure. At mid-gestation detailed maternal cardiovascular assessment was carried out. The association of risk for development of CH, determined from first-trimester assessment, and cardiovascular indices at mid-gestation was examined. RESULTS Women who are at high-risk for development of future CH, compared to those at low-risk, had a higher incidence of hypertensive disorders of pregnancy (HDP). In addition, high-risk women, had reduced systolic and diastolic function at mid-gestation. Among women with HDP, those who were high-risk for future CH, compared to those at low-risk, also had worse cardiac function at mid-gestation. CONCLUSION Use of a model for first-trimester prediction of subsequent development of CH can identify women who show evidence of cardiac maladaptation at mid-gestation. Further studies are needed to clarify whether women who screen as high-risk for future CH, compared to those at low-risk, have reduced cardiac function beyond pregnancy. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- M Charakida
- Harris Birthright Research Centre for Fetal Medicine, Fetal Medicine Research Institute, King's College Hospital, London, UK
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - E Gibbone
- Harris Birthright Research Centre for Fetal Medicine, Fetal Medicine Research Institute, King's College Hospital, London, UK
| | - I Huluta
- Harris Birthright Research Centre for Fetal Medicine, Fetal Medicine Research Institute, King's College Hospital, London, UK
| | - A Syngelaki
- Harris Birthright Research Centre for Fetal Medicine, Fetal Medicine Research Institute, King's College Hospital, London, UK
- Department of Women and Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - A Wright
- Department of Women and Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, Fetal Medicine Research Institute, King's College Hospital, London, UK
- Institute of Health Research, University of Exeter, Exeter, UK
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Otto SP, MacPherson A, Colijn C. Endemic does not mean constant as SARS-CoV-2 continues to evolve. Evolution 2024:qpae041. [PMID: 38459852 DOI: 10.1093/evolut/qpae041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Indexed: 03/11/2024]
Abstract
COVID-19 has become endemic, with dynamics that reflect the waning of immunity and re-exposure, by contrast to the epidemic phase driven by exposure in immunologically naïve populations. Endemic does not, however, mean constant. Further evolution of SARS-CoV-2, as well as changes in behaviour and public health policy, continue to play a major role in the endemic load of disease and mortality. In this paper, we analyse evolutionary models to explore the impact that a newly arising variant can have on the short-term and longer-term endemic load, characterizing how these impacts depend on the transmission and immunological properties of the variants. We describe how evolutionary changes in the virus will increase the endemic load most for a persistently immune-escape variant, by an intermediate amount for a more transmissible variant, and least for a transiently immune-escape variant. Balancing the tendency for evolution to favour variants that increase the endemic load, we explore the impact of vaccination strategies and non-pharmaceutical interventions (NPIs) that can counter these increases in the impact of disease. We end with some open questions about the future of COVID-19 as an endemic disease.
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Affiliation(s)
- Sarah P Otto
- Department of Zoology & Biodiversity Research Centre, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Ailene MacPherson
- Department of Mathematics, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Caroline Colijn
- Department of Mathematics, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
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Bresolin P, Steindal SA, Bingen HM, Zlamal J, Gue Martini J, Petersen EK, Nes AAG. Technology-Supported Guidance Models to Stimulate Nursing Students' Self-Efficacy in Clinical Practice: Scoping Review. JMIR Nurs 2024; 7:e54443. [PMID: 38457802 PMCID: PMC10960213 DOI: 10.2196/54443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/09/2024] [Accepted: 02/21/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND In nursing education, bridging the gap between theoretical knowledge and practical skills is crucial for developing competence in clinical practice. Nursing students encounter challenges in acquiring these essential skills, making self-efficacy a critical component in their professional development. Self-efficacy pertains to individual's belief in their ability to perform tasks and overcome challenges, with significant implications for clinical skills acquisition and academic success. Previous research has underscored the strong link between nursing students' self-efficacy and their clinical competence. Technology has emerged as a promising tool to enhance self-efficacy by enabling personalized learning experiences and in-depth discussions. However, there is a need for a comprehensive literature review to assess the existing body of knowledge and identify research gaps. OBJECTIVE The aim of this study is to systematically map and identify gaps in published studies on the use of technology-supported guidance models to stimulate nursing students' self-efficacy in clinical practice. METHODS This scoping review followed the framework of Arksey and O'Malley and was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR). A systematic, comprehensive literature search was conducted in ERIC, CINAHL, MEDLINE, Embase, PsycINFO, and Web of Science for studies published between January 2011 and April 2023. The reference lists of the included papers were manually searched to identify additional studies. Pairs of authors screened the papers, assessed eligibility, and extracted the data. The data were thematically organized. RESULTS A total of 8 studies were included and four thematic groups were identified: (1) technological solutions for learning support, (2) learning focus in clinical practice, (3) teaching strategies and theoretical approaches for self-efficacy, and (4) assessment of self-efficacy and complementary outcomes. CONCLUSIONS Various technological solutions were adopted in the guidance models to stimulate the self-efficacy of nursing students in clinical practice, leading to positive findings. A total of 7 out of 8 studies presented results that were not statistically significant, highlighting the need for further refinement of the applied interventions. Nurse educators play a pivotal role in applying learning strategies and theoretical approaches to enhance nursing students' self-efficacy, but the contributions of nurse preceptors and peers should not be overlooked. Future studies should consider involving users in the intervention process and using validated instruments tailored to the studies' intervention objectives, ensuring relevance and enabling comparisons across studies.
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Affiliation(s)
- Paula Bresolin
- Federal University of Santa Catarina, Santa Catarina, Brazil
| | - Simen A Steindal
- VID Specialized University, Oslo, Norway
- Lovisenberg Diacinal University College, Oslo, Norway
| | | | | | | | | | - Andréa Aparecida Gonçalves Nes
- Lovisenberg Diacinal University College, Oslo, Norway
- Ethics of Care, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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11
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Schroeder LF, Rebman P, Kasaie P, Kenu E, Zelner J, Dowdy DW. A Generalizable Decision-Making Framework for Selecting Onsite versus Send-out Clinical Laboratory Testing. Med Decis Making 2024:272989X241232666. [PMID: 38449385 DOI: 10.1177/0272989x241232666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
BACKGROUND Laboratory networks provide services through onsite testing or through specimen transport to higher-tier laboratories. This decision is based on the interplay of testing characteristics, treatment characteristics, and epidemiological characteristics. OBJECTIVES Our objective was to develop a generalizable model using the threshold approach to medical decision making to inform test placement decisions. METHODS We developed a decision model to compare the incremental utility of onsite versus send-out testing for clinical purposes. We then performed Monte Carlo simulations to identify the settings under which each strategy would be preferred. Tuberculosis was modeled as an exemplar. RESULTS The most important determinants of the decision to test onsite versus send-out were the clinical utility lost due to send-out testing delays and the accuracy decrement with onsite testing. When the sensitivity decrements of onsite testing were minimal, onsite testing tended to be preferred when send-out delays reduced clinical utility by >20%. By contrast, when onsite testing incurred large reductions in sensitivity, onsite testing tended to be preferred when utility lost due to delays was >50%. The relative cost of onsite versus send-out testing affected these thresholds, particularly when testing costs were >10% of treatment costs. CONCLUSIONS Decision makers can select onsite versus send-out testing in an evidence-based fashion using estimates of the percentage of clinical utility lost due to send-out delays and the relative accuracy of onsite versus send-out testing. This model is designed to be generalizable to a wide variety of use cases. HIGHLIGHTS The design of laboratory networks, including the decision to place diagnostic instruments at the point-of-care or at higher tiers as accessed through specimen transport, can be informed using the threshold approach to medical decision making.The most important determinants of the decision to test onsite versus send-out were the clinical utility lost due to send-out testing delays and the accuracy decrement with onsite testing.The threshold approach to medical decision making can be used to compare point-of-care testing accuracy decrements with the lost utility of treatment due to send-out testing delays.The relative cost of onsite versus send-out testing affected these thresholds, particularly when testing costs were >10% of treatment costs.
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Affiliation(s)
- Lee F Schroeder
- Department of Pathology, University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - Paul Rebman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Parastu Kasaie
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ernest Kenu
- School of Public Health, University of Ghana, Ghana
| | - Jon Zelner
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - David W Dowdy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Richards CJ, Steele JR, Spinks GM. Numerical model of pressure generated by elastic compression garments on a compressible human limb analogue. J Wound Care 2024; 33:171-179. [PMID: 38451791 DOI: 10.12968/jowc.2024.33.3.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
OBJECTIVE This study aimed to formulate a numerical approach (finite element modelling (FEM)) to calculate pressure values generated by compression garments on a compressible limb analogue, and to validate the numerical approach using experimental measurements. Existing models were also compared. METHOD Experimentally measured pressure values and deformation caused by compression bands on a compressible human limb analogue were compared with values predicted using the Young-Laplace equation, a previously formulated analytical model and the FEM. RESULTS The FEM provided greater accuracy in predicting the pressure generated by compression bands compared to existing models. The FEM also predicted deformation of the limb analogue with good agreement relative to experimental values. CONCLUSION It was concluded that modelling the non-uniform manner in which the way a limb analogue is compressed should be incorporated into future modelling of the pressures generated by compression garments on a compressible limb analogue. DECLARATION OF INTEREST The authors have no conflicts of interest to declare.
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Affiliation(s)
- Christopher J Richards
- Australian Institute for Innovative Materials, University of Wollongong, Wollongong, Australia
| | - Julie R Steele
- Biomechanics Research Laboratory, University of Wollongong, Wollongong, Australia
| | - Geoffrey M Spinks
- Australian Institute for Innovative Materials, University of Wollongong, Wollongong, Australia
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El Sawaf O, Effa F, Arz JP, Grimault N. Modeling alarm detection in noise for normal and hearing-impaired listeners: the effect of elevated thresholds and enlarged auditory filters. Int J Occup Saf Ergon 2024; 30:264-271. [PMID: 38124394 DOI: 10.1080/10803548.2023.2294624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
A model was developed to assess how elevated absolute thresholds and enlarged auditory filters can impede the ability to detect alarms in a noisy background, such alarms being of paramount importance to ensure the safety of workers. Based on previously measured masked thresholds of 80 listeners in five groups (normal hearing to strongly impaired), the model was derived from signal detection theory (SDT) applied to Glasberg and Moore's excitation pattern model. The model can describe the influence of absolute thresholds and enlarged auditory filters together or separately on the detection ability for normal hearing and hearing-impaired listeners with various hearing profiles. Furthermore, it suggests that enlarged auditory filters alone can explain all of the impairment in this specific alarm detection task. Finally, the possibility of further development of the model into an alarm detection model is discussed.
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Affiliation(s)
- Ossen El Sawaf
- French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), Work Equipment Engineering Division, France
- French National Centre for Scientific Research (CNRS) UMR5292, Centre Hospitalier Le Vinatier, France
- Mechanics and Acoustics Laboratory (LMA), Aix-Marseille University Centrale Méditerranée, France
| | - François Effa
- French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), Work Equipment Engineering Division, France
- French National Centre for Scientific Research (CNRS) UMR5292, Centre Hospitalier Le Vinatier, France
| | - Jean-Pierre Arz
- French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases (INRS), Work Equipment Engineering Division, France
| | - Nicolas Grimault
- French National Centre for Scientific Research (CNRS) UMR5292, Centre Hospitalier Le Vinatier, France
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Wang J, Rao X, Huang S, Wang Z, Niu X, Zhu M, Wang S, Shi L. Detection of a temporal salient object benefits from visual stimulus-specific adaptation in avian midbrain inhibitory nucleus. Integr Zool 2024; 19:288-306. [PMID: 36893724 DOI: 10.1111/1749-4877.12715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
Food and predators are the most noteworthy objects for the basic survival of wild animals, and both are often deviant in both spatial and temporal domains and quickly attract an animal's attention. Although stimulus-specific adaptation (SSA) is considered a potential neural basis of salient sound detection in the temporal domain, related research on visual SSA is limited and its relationship with temporal saliency is uncertain. The avian nucleus isthmi pars magnocellularis (Imc), which is central to midbrain selective attention network, is an ideal site to investigate the neural correlate of visual SSA and detection of a salient object in the time domain. Here, the constant order paradigm was applied to explore the visual SSA in the Imc of pigeons. The results showed that the firing rates of Imc neurons gradually decrease with repetitions of motion in the same direction, but recover when a motion in a deviant direction is presented, implying visual SSA to the direction of a moving object. Furthermore, enhanced response for an object moving in other directions that were not presented ever in the paradigm is also observed. To verify the neural mechanism underlying these phenomena, we introduced a neural computation model involving a recoverable synaptic change with a "center-surround" pattern to reproduce the visual SSA and temporal saliency for the moving object. These results suggest that the Imc produces visual SSA to motion direction, allowing temporal salient object detection, which may facilitate the detection of the sudden appearance of a predator.
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Affiliation(s)
- Jiangtao Wang
- Department of Automation, Zhengzhou University School of Electrical Engineering, Zhengzhou, China
| | - Xiaoping Rao
- State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Key Laboratory of Magnetic Resonance in Biological Systems, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan, China
| | - Shuman Huang
- Department of Automation, Zhengzhou University School of Electrical Engineering, Zhengzhou, China
| | - Zhizhong Wang
- Department of Automation, Zhengzhou University School of Electrical Engineering, Zhengzhou, China
| | - Xiaoke Niu
- Department of Automation, Zhengzhou University School of Electrical Engineering, Zhengzhou, China
| | - Minjie Zhu
- Department of Automation, Zhengzhou University School of Electrical Engineering, Zhengzhou, China
| | - Songwei Wang
- Department of Automation, Zhengzhou University School of Electrical Engineering, Zhengzhou, China
| | - Li Shi
- Department of Automation, Zhengzhou University School of Electrical Engineering, Zhengzhou, China
- Department of Automation, Tsinghua University, Beijing, China
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Bacsu JDR, Rahemi Z, Petrovsky D, Sefcik JS, Kwan ma KP, Baker ZG, Smith ML. Advancing Gerontology through Exceptional Scholarship (AGES): a Mentorship Initiative for Early Career Faculty. Can Geriatr J 2024; 27:80-84. [PMID: 38433883 PMCID: PMC10896206 DOI: 10.5770/cgj.27.700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
Mentorship is critical to supporting professional development and growth of new and emerging faculty members. Working with the Gerontological Society of America (GSA), we created the Advancing Gerontology through Exceptional Scholarship (AGES) Initiative as a mentorship model to promote productivity and peer support for new and early career faculty members. In this commentary, we highlight the AGES Program as a prototype to facilitate peer support, collective learning, and co-authorship opportunities to advance new and early career faculty members, especially in the field of aging. Moreover, we identify four crucial strategies that cultivated and refined our AGES Program including: i) ensuring flexibility to address mentee needs; ii) establishing check-ins and accountability to enhance productivity; iii) fostering peer support and collective learning; and iv) delivering motivational and educational activities. Drawing on our experience with the AGES Program, this commentary provides recommendations to support other groups looking to develop high-quality mentorship programs to support new and early career faculty members in academia.
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Affiliation(s)
| | - Zahra Rahemi
- School of Nursing, Clemson University, Greenville, SC, USA
| | - Darina Petrovsky
- Rutgers University School of Nursing Institutes for Health, Health Care Policy, and Aging Research, New Brunswick, NJ, USA
| | - Justine S. Sefcik
- College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Kris Pui Kwan ma
- Department of Family Medicine, University of Washington, Seattle WA, USA
| | - Zachary G. Baker
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Matthew Lee Smith
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
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16
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Hast M, Glatt V, Archdeacon M, Ledet E, Lewis G, Ahn J, Haller J. Biomechanics of fracture healing: how best to optimize your construct in the OR. OTA Int 2024; 7:e304. [PMID: 38487404 PMCID: PMC10936157 DOI: 10.1097/oi9.0000000000000304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
Orthopaedic surgeons routinely assess the biomechanical environment of a fracture to create a fixation construct that provides the appropriate amount of stability in efforts to optimize fracture healing. Emerging concepts and technologies including reverse dynamization, "smart plates" that measure construct strain, and FractSim software that models fracture strain represent recent developments in optimizing construct biomechanics to accelerate bone healing and minimize construct failure.
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Affiliation(s)
- Michael Hast
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA
| | - Vaida Glatt
- Department of Orthopaedic Surgery, University of Texas Health Science Center San Antonio, San Antonio, TX
| | - Michael Archdeacon
- Department of Orthopedic Surgery, University of Cincinnati, Cincinnati, OH
| | - Eric Ledet
- Department of Orthopedic Surgery, University of Cincinnati, Cincinnati, OH
| | - Gregory Lewis
- Department of Orthopaedics and Rehabilitation, Penn State College of Medicine, Hershey, PA
| | - Jaimo Ahn
- Department Orthopedics Surgery, University of Michigan, Ann Arbor, MI
| | - Justin Haller
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT
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Ye L, Jiang Z, Zheng M, Pan K, Lian J, Ju B, Liu X, Tang S, Guo G, Zhang S, Hong X, Lu W. Fatty acid metabolism-related lncRNA prognostic signature for serous ovarian carcinoma. Epigenomics 2024; 16:309-329. [PMID: 38356435 DOI: 10.2217/epi-2023-0388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Background: To explore the role of fatty acid metabolism (FAM)-related lncRNAs in the prognosis and antitumor immunity of serous ovarian cancer (SOC). Materials & methods: A SOC FAM-related lncRNA risk model was developed and evaluated by a series of analyses. Additional immune-related analyses were performed to further assess the associations between immune state, tumor microenvironment and the prognostic risk model. Results: Five lncRNAs associated with the FAM genes were found and used to create a predictive risk model. The patients with a low-risk profile exhibited favorable prognostic outcomes. Conclusion: The established prognostic risk model exhibits better predictive capabilities for the prognosis of patients with SOC and offers novel potential therapy targets for SOC.
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Affiliation(s)
- Lele Ye
- Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Zhuofeng Jiang
- Department of Biochemistry, School of Medicine, Southern University of Science & Technology, Shenzhen, 518055, Guangdong, China
| | - Mengxia Zheng
- Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Kan Pan
- First Clinical College, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
| | - Jingru Lian
- Department of Biochemistry, School of Medicine, Southern University of Science & Technology, Shenzhen, 518055, Guangdong, China
| | - Bing Ju
- Department of Biochemistry, School of Medicine, Southern University of Science & Technology, Shenzhen, 518055, Guangdong, China
| | - Xuefei Liu
- Department of Biochemistry, School of Medicine, Southern University of Science & Technology, Shenzhen, 518055, Guangdong, China
| | - Sangsang Tang
- Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Gangqiang Guo
- Wenzhou Collaborative Innovation Center of Gastrointestinal Cancer in Basic Research & Precision Medicine, Wenzhou Key Laboratory of Cancer-related Pathogens & Immunity, Department of Microbiology & Immunology, Institute of Molecular Virology & Immunology, Institute of Tropical Medicine, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China
| | - Songfa Zhang
- Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
| | - Xin Hong
- Department of Biochemistry, School of Medicine, Southern University of Science & Technology, Shenzhen, 518055, Guangdong, China
- Key University Laboratory of Metabolism & Health of Guangdong, Southern University of Science & Technology, Shenzhen, 518055, Guangdong, China
- Guangdong Provincial Key Laboratory of Cell Microenvironment & Disease Research, Southern University of Science & Technology, Shenzhen, 518055, Guangdong, China
| | - Weiguo Lu
- Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
- Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China
- Center of Uterine Cancer Diagnosis & Therapy of Zhejiang Province, Hangzhou, 310006, Zhejiang, China
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18
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Lai J, Wang H, Pan Z, Su F. Correction for: A novel six-microRNA-based model to improve prognosis prediction of breast cancer. Aging (Albany NY) 2024; 16:4074. [PMID: 38441535 DOI: 10.18632/aging.205643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 02/25/2024] [Indexed: 03/07/2024]
Affiliation(s)
- Jianguo Lai
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Hongli Wang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zihao Pan
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- Department of Thoracic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Fengxi Su
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
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Kaiser E, Von Gillhaussen P, Clarke J, Schurr U. Editorial: IPPS 2022 - plant phenotyping for a sustainable future. Front Plant Sci 2024; 15:1383766. [PMID: 38476688 PMCID: PMC10927961 DOI: 10.3389/fpls.2024.1383766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024]
Affiliation(s)
- Elias Kaiser
- Horticulture and Product Physiology, Plant Sciences Group, Wageningen University and Research, Wageningen, Netherlands
| | - Philipp Von Gillhaussen
- Forschungszentrum Jülich GmbH IBG-2: Plant Sciences, International Plant Phenotyping Network (IPPN), Juelich, Germany
| | - Jennifer Clarke
- Quantative Life Sciences Initiative (Complex Biosystems), University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Ulrich Schurr
- Plant Sciences (IBG-2), Institute of Bio- and Geosciences, Julich Research Center, Helmholtz Association of German Research Centres (HZ), Juelich, Germany
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20
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De Potter T, Tong C, Maccioni S, Velleca M, Galvain T. Cost-utility of VISITAG SURPOINT in catheter ablation of atrial fibrillation. Pacing Clin Electrophysiol 2024. [PMID: 38407315 DOI: 10.1111/pace.14931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/20/2023] [Accepted: 01/04/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Clinical studies have demonstrated the safety, efficacy, and efficiency of VISITAG SURPOINT® (VS), which provides important lesion markers during catheter ablation (CA) of atrial fibrillation (AF). The present study evaluated the cost-effectiveness of CA with VS compared to CA without VS in AF from the publicly-funded German and Belgium healthcare perspectives. METHODS We constructed a two-stage cost utility model that included a decision tree to simulate clinical events, costs, and utilities during the first year after the index procedure and a Markov model to simulate transitions between health states throughout a patient's lifetime. Model inputs included published literature, a meta-analysis of randomized controlled trials AF outcomes, and publicly available administrative data on costs. Deterministic and probabilistic sensitivity analyses were conducted to determine the robustness of the model. RESULTS CA with VS was associated with lower per patient costs vs CA without VS (Germany: €3295 vs. €3936, Belgium: €3194 vs. €3814) and similar quality-adjusted life-years (QALYs) per patient (Germany: 5.35 vs. 5.34, Belgium: 5.68 vs. 5.67). CA with VS was the dominant ablation strategy (incremental cost-effectiveness ratios: Germany: €-52,455/QALY, Belgium: €-50,676/QALY). The model results were robust and not highly sensitive to variation to individual parameters with regard to QALYs or costs. Freedom from AF and procedure time had the greatest impact on model results, highlighting the importance of these outcomes in ablation. CONCLUSIONS CA with VS resulted in cost savings and QALY gains compared to CA without VS, supporting the increased adoption of VS in CA in Germany and Belgium.
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Affiliation(s)
- Tom De Potter
- Cardiovascular Center, OLV Hospital, Moorselbaan, Aalst, Belgium
| | - Cindy Tong
- Johnson and Johnson Medical, New Brunswick, New Jersey, USA
| | - Sonia Maccioni
- Johnson and Johnson Medical, New Brunswick, New Jersey, USA
| | - Maria Velleca
- Johnson and Johnson Medical, New Brunswick, New Jersey, USA
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21
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Yu WG, He Q, Wang ZD, Tian CJ, Wang JK, Zheng Q, Ren F, Zhang C, Wang YM, Xu P, Wei ZW, Yun KM. Toxicokinetics of MDMA and Its Metabolite MDA in Rats. Fa Yi Xue Za Zhi 2024; 40:37-42. [PMID: 38500459 DOI: 10.12116/j.issn.1004-5619.2022.320201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
OBJECTIVES To investigate the toxicokinetic differences of 3,4-methylenedioxy-N-methylamphetamine (MDMA) and its metabolite 4,5-methylene dioxy amphetamine (MDA) in rats after single and continuous administration of MDMA, providing reference data for the forensic identification of MDMA. METHODS A total of 24 rats in the single administration group were randomly divided into 5, 10 and 20 mg/kg experimental groups and the control group, with 6 rats in each group. The experimental group was given intraperitoneal injection of MDMA, and the control group was given intraperitoneal injection of the same volume of normal saline as the experimental group. The amount of 0.5 mL blood was collected from the medial canthus 5 min, 30 min, 1 h, 1.5 h, 2 h, 4 h, 6 h, 8 h, 10 h, 12 h after administration. In the continuous administration group, 24 rats were randomly divided into the experimental group (18 rats) and the control group (6 rats). The experimental group was given MDMA 7 d by continuous intraperitoneal injection in increments of 5, 7, 9, 11, 13, 15, 17 mg/kg per day, respectively, while the control group was given the same volume of normal saline as the experimental group by intraperitoneal injection. On the eighth day, the experimental rats were randomly divided into 5, 10 and 20 mg/kg dose groups, with 6 rats in each group. MDMA was injected intraperitoneally, and the control group was injected intraperitoneally with the same volume of normal saline as the experimental group. On the eighth day, 0.5 mL of blood was taken from the medial canthus 5 min, 30 min, 1 h, 1.5 h, 2 h, 4 h, 6 h, 8 h, 10 h, 12 h after administration. Liquid chromatography-triple quadrupole tandem mass spectrometry was used to detect MDMA and MDA levels, and statistical software was employed for data analysis. RESULTS In the single-administration group, peak concentrations of MDMA and MDA were reached at 5 min and 1 h after administration, respectively, with the largest detection time limit of 12 h. In the continuous administration group, peak concentrations were reached at 30 min and 1.5 h after administration, respectively, with the largest detection time limit of 10 h. Nonlinear fitting equations for the concentration ratio of MDMA and MDA in plasma and administration time in the single-administration group and continuous administration group were as follows: T=10.362C-1.183, R2=0.974 6; T=7.397 3C-0.694, R2=0.961 5 (T: injection time; C: concentration ratio of MDMA to MDA in plasma). CONCLUSIONS The toxicokinetic data of MDMA and its metabolite MDA in rats, obtained through single and continuous administration, including peak concentration, peak time, detection time limit, and the relationship between concentration ratio and administration time, provide a theoretical and data foundation for relevant forensic identification.
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Affiliation(s)
- Wei-Guang Yu
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi Province, China
- Key Laboratory of the Ministry of Public Security for Toxicological Analysis of the Tribunal, Jinzhong 030600, Shanxi Province, China
| | - Qiang He
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi Province, China
- Key Laboratory of the Ministry of Public Security for Toxicological Analysis of the Tribunal, Jinzhong 030600, Shanxi Province, China
| | - Zheng-di Wang
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi Province, China
- Key Laboratory of the Ministry of Public Security for Toxicological Analysis of the Tribunal, Jinzhong 030600, Shanxi Province, China
| | - Cheng-Jun Tian
- Yuxian Public Security Bureau of Yangquan City, Yangquan 045000, Shanxi Province, China
| | - Jin-Kai Wang
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi Province, China
- Key Laboratory of the Ministry of Public Security for Toxicological Analysis of the Tribunal, Jinzhong 030600, Shanxi Province, China
| | - Qian Zheng
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi Province, China
- Key Laboratory of the Ministry of Public Security for Toxicological Analysis of the Tribunal, Jinzhong 030600, Shanxi Province, China
| | - Fei Ren
- Taiyuan Public Security Bureau, Taiyuan 030000, China
| | - Chao Zhang
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi Province, China
- Key Laboratory of the Ministry of Public Security for Toxicological Analysis of the Tribunal, Jinzhong 030600, Shanxi Province, China
| | - You-Mei Wang
- National Drug Laboratory, Centre for Counter-Narcotics Information Technology, Ministry of Public Security, Beijing 100193, China
| | - Peng Xu
- National Drug Laboratory, Centre for Counter-Narcotics Information Technology, Ministry of Public Security, Beijing 100193, China
| | - Zhi-Wen Wei
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi Province, China
- Key Laboratory of the Ministry of Public Security for Toxicological Analysis of the Tribunal, Jinzhong 030600, Shanxi Province, China
| | - Ke-Ming Yun
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi Province, China
- Key Laboratory of the Ministry of Public Security for Toxicological Analysis of the Tribunal, Jinzhong 030600, Shanxi Province, China
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Alamri A, Bin Abbas A, Al Hassan E, Almogbel Y. Development of a Prediction Model to Identify the Risk of Clostridioides difficile Infection in Hospitalized Patients Receiving at Least One Dose of Antibiotics. Pharmacy (Basel) 2024; 12:37. [PMID: 38392945 PMCID: PMC10892393 DOI: 10.3390/pharmacy12010037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/30/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
OBJECTIVE This study's objective was to develop a risk-prediction model to identify hospitalized patients at risk of Clostridioides difficile infection (CDI) who had received at least one dose of systemic antibiotics in a large tertiary hospital. PATIENTS AND METHODS This was a retrospective case-control study that included patients hospitalized for more than 2 days who received antibiotic therapy during hospitalization. The study included two groups: patients diagnosed with hospital CDI and controls without hospital CDI. Cases were matched 1:3 with assigned controls by age and sex. Descriptive statistics were used to identify the study population by comparing cases with controls. Continuous variables were stated as the means and standard deviations. A multivariate analysis was built to identify the significantly associated covariates between cases and controls for CDI. RESULTS A total of 364 patients were included and distributed between the two groups. The control group included 273 patients, and the case group included 91 patients. The risk factors for CDI were investigated, with only significant risks identified and included in the risk assessment model: age older than 70 years (p = 0.034), chronic kidney disease (p = 0.043), solid organ transplantation (p = 0.021), and lymphoma or leukemia (p = 0.019). A risk score of ≥2 showed the best sensitivity, specificity, and accuracy of 78.02%, 45.42%, and 78.02, respectively, with an area under the curve of 0.6172. CONCLUSION We identified four associated risk factors in the risk-prediction model. The tool showed good discrimination that might help predict, identify, and evaluate hospitalized patients at risk of developing CDI.
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Affiliation(s)
- Abdulrahman Alamri
- Pharmaceutical Care Services, Ministry of the National Guard Health Affairs, Riyadh 11426, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia
- Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia
| | - AlHanoof Bin Abbas
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah 51452, Saudi Arabia; (A.B.A.); (Y.A.)
| | - Ekram Al Hassan
- Department of Pathology and Laboratory Medicine, Ministry of the National Guard Health Affairs, Riyadh 11426, Saudi Arabia;
| | - Yasser Almogbel
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah 51452, Saudi Arabia; (A.B.A.); (Y.A.)
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Odrobina I. Clinical Predictive Modeling of Heart Failure: Domain Description, Models' Characteristics and Literature Review. Diagnostics (Basel) 2024; 14:443. [PMID: 38396482 PMCID: PMC10888082 DOI: 10.3390/diagnostics14040443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
This study attempts to identify and briefly describe the current directions in applied and theoretical clinical prediction research. Context-rich chronic heart failure syndrome (CHFS) telemedicine provides the medical foundation for this effort. In the chronic stage of heart failure, there are sudden exacerbations of syndromes with subsequent hospitalizations, which are called acute decompensation of heart failure (ADHF). These decompensations are the subject of diagnostic and prognostic predictions. The primary purpose of ADHF predictions is to clarify the current and future health status of patients and subsequently optimize therapeutic responses. We proposed a simplified discrete-state disease model as an attempt at a typical summarization of a medical subject before starting predictive modeling. The study tries also to structure the essential common characteristics of quantitative models in order to understand the issue in an application context. The last part provides an overview of prediction works in the field of CHFS. These three parts provide the reader with a comprehensive view of quantitative clinical predictive modeling in heart failure telemedicine with an emphasis on several key general aspects. The target community is medical researchers seeking to align their clinical studies with prognostic or diagnostic predictive modeling, as well as other predictive researchers. The study was written by a non-medical expert.
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Affiliation(s)
- Igor Odrobina
- Mathematical Institute, Slovak Academy of Science, Štefánikova 49, SK-841 73 Bratislava, Slovakia
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Chen F, Jiang S, Yao F, Huang Y, Cai J, Wei J, Li C, Wu Y, Yi X, Zhang Z. A nomogram based on clinicopathological and ultrasound characteristics to predict central neck lymph node metastases in papillary thyroid cancer. Front Endocrinol (Lausanne) 2024; 14:1267494. [PMID: 38410376 PMCID: PMC10895032 DOI: 10.3389/fendo.2023.1267494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/27/2023] [Indexed: 02/28/2024] Open
Abstract
Purpose Papillary thyroid cancer (PTC) has grown rapidly in prevalence over the past few decades, and central neck lymph node metastasis (CNLNM) is associated with poor prognoses. However, whether to carry out preventive central neck lymph node dissection (CNLND) is still controversial. We aimed to construct a prediction model of CNLNM to facilitate making clinical surgical regimens. Methods A total of 691 patients with PTC between November 2018 and December 2021 were included in our study. Univariate and multivariate analyses were performed on basic information and clinicopathological characteristics, as well as ultrasound characteristics (American College of Radiology (ACR) scores). The prediction model was constructed and performed using a nomogram, and then discriminability, calibrations, and clinical applicability were evaluated. Results Five variables, namely, male, age >55 years, clinical lymph node positivity, tumor size ≥1 cm, and ACR scores ≥6, were independent predictors of CNLNM in the multivariate analysis, which were eventually included to construct a nomogram model. The area under the curve (AUC) of the model was 0.717, demonstrating great discriminability. A calibration curve was developed to validate the calibration of the present model by bootstrap resampling, which indicated that the predicted and actual values were in good agreement and had no differentiation from the ideal model. The decision curve analysis (DCA) indicated that the prediction model has good clinical applicability. Conclusions Our non-invasive prediction model combines ACR scores with clinicopathological features presented through nomogram and has shown good performance and application prospects for the prediction of CNLNM in PTCs.
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Affiliation(s)
- Fei Chen
- General Surgery Center Department of Thyroid Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Shuiping Jiang
- Endocrinology Department, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Fan Yao
- General Surgery Center Department of Thyroid Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yixi Huang
- General Surgery Center Department of Thyroid Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiaxi Cai
- General Surgery Center Department of Thyroid Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jia Wei
- General Surgery Center Department of Thyroid Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Chengxu Li
- General Surgery Center Department of Thyroid Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yanxuan Wu
- General Surgery Center Department of Thyroid Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaolin Yi
- General Surgery Center Department of Thyroid Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhen Zhang
- Endocrinology Department, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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Fan M, Li P, Wang Y, Li Y, Zhao W, Wu R, Tian X, Zhang M, Cheng Z. Development of a novel predictive model for interstitial lung disease in ANCA-associated vasculitis prognostications within the Chinese population. Medicine (Baltimore) 2024; 103:e37048. [PMID: 38335439 PMCID: PMC10860988 DOI: 10.1097/md.0000000000037048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 12/22/2023] [Accepted: 01/03/2024] [Indexed: 02/12/2024] Open
Abstract
Antineutrophil cytoplasmic antibody vasculitis-associated interstitial lung disease (AAV-ILD) is a potentially life-threatening disease. However, very little research has been done on the condition's mortality risk. Hence, our objective is to find out the factors influencing the prognosis of AAV-ILD and employ these findings to create a nomogram model. Patients with AAV-ILD who received treatment at the First Affiliated Hospital of Zhengzhou University during the period from March 1, 2011, to April 1, 2022 were selected for this research. The development of nomogram entailed a synergistic integration of univariate, Lasso, and multivariate Cox regression analyses. Internal validation ensued through bootstrap techniques involving 1000 re-sampling iterations. Discrimination and calibration were assessed utilizing Harrell's C-index, receiver operating characteristic (ROC) curve, and calibration curve. Model performance was evaluated through integrated discrimination improvement (IDI), net reclassification improvement (NRI), and likelihood ratio test. The net benefit of the model was evaluated using decision curve analysis (DCA). A cohort comprising 192 patients was enrolled for analysis. Throughout observation period, 32.29% of the population died. Key factors such as cardiac involvement, albumin, smoking history, and age displayed substantial prognostic relevance in AAV-ILD. These factors were incorporated to craft a predictive nomogram. Impressively, the model exhibited robust performance, boasting a Harrell's C index of 0.826 and an AUC of 0.940 (95% CI 0.904-0.976). The calibration curves depicted a high degree of harmony between predicted outcomes and actual observations. Significantly enhancing discriminative ability compared to the ILD-GAP model, the nomogram was validated through the IDI, NRI, and likelihood ratio test. DCA underscored the superior predictive value of the predictive model over the ILD-GAP model. The internal validation further affirmed this efficacy, with a mean Harrell's C-index of 0.815 for the predictive model. The nomogram model can be employed to predict the prognosis of patients with AAV-ILD. Moreover, the model performance is satisfactory. In the future, external datasets could be utilized for external validation.
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Affiliation(s)
- Mingwei Fan
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Pengfei Li
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yu Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yue Li
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenjing Zhao
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruhao Wu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoying Tian
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengting Zhang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhe Cheng
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Inbar N, Doron II, Laufer Y. Physiotherapists' moral distress: Mixed-method study reveals new insights. Nurs Ethics 2024:9697330241230512. [PMID: 38337168 DOI: 10.1177/09697330241230512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
BACKGROUND Moral distress is a well-recognized term for emotional, cognitive, and physical reactions of professionals, when facing conflicts between perceived obligations and institutional constraints. Though studied across medical roles, limited research exists among physiotherapists. RESEARCH QUESTION What factors contribute to Moral distress among physiotherapists and how do they cope? OBJECTIVES To develop and test a multifaceted model of Moral distress and gain an in-depth understanding of the phenomena. RESEARCH DESIGN A 2017-2022 mixed-methods study: (1) Survey of 407 physiotherapists quantitatively testing a literature-based model analyzing relationships between Moral distress, Moral sensitivity, Locus of control, Self-efficacy, Ethical climate perceptions and demographics, analyzed by descriptive and inferential statistics, multiple comparisons and structural equation modelling (SPSS26, SAS, AMOS); (2) Semi-structured interviews with 21 physiotherapists examining Moral distress experiences using meticulous phenomenological analysis. PARTICIPANTS AND CONTEXT Israeli physiotherapists from various occupational settings recruited via professional networks. ETHICAL CONSIDERATIONS The Haifa University Ethics Committee authorized the study. Informed consent was obtained for the anonymous survey and before interviews regarding recording, and quote use. FINDINGS Quantitative results showed moderately high average Moral distress, significantly higher among women and paediatric physiotherapists, positively correlating with Moral sensitivity. Qualitative findings revealed intense emotions around Moral distress experiences, inner conflicts between care ideals and constraints, and coping strategies like reflective skills. Senior therapists, despite higher self-efficacy and moral sensitivity, still reported persistent high distress. DISCUSSION Moral distress has complex links with moral sensitivity, self-efficacy, perceived professional autonomy and organizational support. A renewed framework emerged explaining relations between moral distress and personal, professional and organizational factors. CONCLUSIONS Multidimensional insights help identify Moral distress causes and coping strategies among physiotherapists, advancing theory. Conclusions can shape ethics training programs and competencies.
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Li R, Zhou S, Yang C, Wang J. Investigation and Modeling of the Behavior of Temperature Characteristics of 0.3-1.1 GHz Complementary Metal Oxide Semiconductor Class-A Broadband Power Amplifiers. Micromachines (Basel) 2024; 15:246. [PMID: 38398973 PMCID: PMC10891772 DOI: 10.3390/mi15020246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/25/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024]
Abstract
A power amplifier (PA) stands as a central module within the electronic information system (EIS), and any variation in a PA's specifications has a direct impact on the EIS's performance, especially in the face of temperature fluctuations. In examining the influence of PA specification changes on the EIS, we employed support vector machine (SVM) to model the behavior of the temperature characteristics of 0.3-1.1 GHz complementary metal oxide semiconductor (CMOS) class-A broadband PAs. The results show that the parameters of S11, S12, S21, and S22 can be effectively modeled. SVM outperforms Elman and GRNN in terms of combined modeling time and modeling accuracy. This research can be extended to modeling the behavior of other types of power amplifiers or devices and circuits.
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Affiliation(s)
- Ruiliang Li
- Qingdao Institute for Marine Technology of Tianjin University, Qingdao 266200, China; (R.L.); (S.Z.)
| | - Shaohua Zhou
- Qingdao Institute for Marine Technology of Tianjin University, Qingdao 266200, China; (R.L.); (S.Z.)
- ZJU-Hangzhou Global Scientific and Technological Innovation Center, Zhejiang University, Hangzhou 310058, China
- School of Microelectronics, Tianjin University, Tianjin 300072, China
| | - Cheng Yang
- Qingdao Institute for Marine Technology of Tianjin University, Qingdao 266200, China; (R.L.); (S.Z.)
| | - Jian Wang
- School of Microelectronics, Tianjin University, Tianjin 300072, China
- Shandong Engineering Technology Research Center of Marine Information Perception and Transmission, Qingdao 266200, China
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Crozet G, Cliquet F, Robardet E. What would be the impact on the rabies risk of reducing the waiting period before dogs are imported? A modelling study based on the European Union legislation. Zoonoses Public Health 2024. [PMID: 38317287 DOI: 10.1111/zph.13113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 01/19/2024] [Accepted: 01/25/2024] [Indexed: 02/07/2024]
Abstract
AIMS Lyssavirus rabies (RABV) is responsible for a major zoonotic infection that is almost always lethal once clinical signs appear. Rabies can be (re)introduced into rabies-free areas through transboundary dog movements, thus compromising animal and human health. A number of measures have been implemented to prevent this happening, one of which is the waiting period (WP) after anti-rabies vaccination and serological testing. This WP ensures that antibodies assessed through the serological test are due to the vaccine, not to infection. Indeed, if antibodies are due to RABV infection, the dog should display clinical signs within this WP and would not therefore be imported. METHODS AND RESULTS Within a framework of quantitative risk assessment, we used modelling approaches to evaluate the impact of this WP and its duration on the risk of introducing rabies via the importation of dogs into the European Union. Two types of models were used, a classical stochastic scenario tree model and an individual-based model, both parameterised using scientific literature or data specifically applicable to the EU. Results showed that, assuming perfect compliance, the current 3-month waiting period was associated with a median annual number of 0.04 infected dogs imported into the EU. When the WP was reduced, the risk increased. For example, for a 1-month WP, the median annual number of infected dogs imported was 0.17 or 0.15 depending on the model, which corresponds to a four-fold increase. CONCLUSION This in silico study, particularly suitable for evaluating rare events such as rabies infections in rabies-free areas, provided results that can directly inform policymakers in order to adapt regulations linked to rabies and animal movements.
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Affiliation(s)
- Guillaume Crozet
- Laboratoire de Santé Animale USC EPIMAI, ANSES, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Florence Cliquet
- Nancy Laboratory for Rabies and Wildlife, ANSES, Malzéville, France
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Saadi S, Bakkali N, Martín-Blázquez R, Badih A, Bakkali M. The Multivariate Regression Models Suggested as Standardising Tools for Categorising Solitarious and Gregarious Groups of the Main Pest Locust, Schistocerca gregaria, Produce Reproducible Results. Insects 2024; 15:102. [PMID: 38392521 PMCID: PMC10889186 DOI: 10.3390/insects15020102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/15/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024]
Abstract
Outbreaks of the desert locust Schistocerca gregaria affect some of the poorest parts of Africa, with devastating outcomes. The key to understanding and dealing with this problematic adaptation to environmental changes is comparing gregarious and solitarious locusts, either in nature or in laboratories. Categorising locusts and detecting changes in their phase status is key to such comparisons, which have been hitherto based on applying mathematical models that use behavioural parameters and that each laboratory has to build anew for each experiment. All the models used thus far are different from one another. This implies differences in the tools used for the different experiments and by the different laboratories and, thus, potential noise in the results and interpretations. Standardising the way locusts are categorised is necessary if we want to reduce noise and errors. It is crucial if we seek to make the results and interpretations transferable and comparable between experiments and laboratories for such an important research area. To tackle this problem, we suggested two models as possible standardising tools. However, the problem of a lack of standardised tools re-emerged due to the doubts cast on the validity of those models. Here, we use samples from independent S. gregaria populations in order to test and validate those models. We discuss how successful the two models were at categorising solitarious, intermediate (transient), and gregarious nymph and adult S. gregaria samples. We highlight shortcomings and make more specific recommendations on the use of those models based on the precision differences they show when categorising solitarious and gregarious S. gregaria nymph and adult samples. Overall, both models have proven to be valid since their results were largely replicated and seem reproducible.
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Affiliation(s)
- Somia Saadi
- Departamento de Genética, Facultad de Ciencias, Universidad de Granada, Fuentenueva S/N, 18071 Granada, Spain
| | - Noureddine Bakkali
- Departamento de Genética, Facultad de Ciencias, Universidad de Granada, Fuentenueva S/N, 18071 Granada, Spain
| | - Rubén Martín-Blázquez
- Estación Biológica de Doñana, Consejo Superior de Investigaciones Científicas (CSIC), Avenida Américo Vespucio 26, Isla de la Cartuja, 41092 Sevilla, Spain
| | - Abdelmounim Badih
- Departamento de Ciencias Naturales, Agora Granada College International School, Urbanización Llanos de Silva S/N, 18230 Atarfe, Spain
| | - Mohammed Bakkali
- Departamento de Genética, Facultad de Ciencias, Universidad de Granada, Fuentenueva S/N, 18071 Granada, Spain
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Asadi F, Anvari M, Ghaderzadeh M, Ghorbani NR. Designing a model for implementing diagnosis-related groups in Iran: An action plan approach. Health Sci Rep 2024; 7:e1854. [PMID: 38332931 PMCID: PMC10850436 DOI: 10.1002/hsr2.1854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 10/18/2023] [Accepted: 11/27/2023] [Indexed: 02/10/2024] Open
Abstract
Background and Aims Implementing diagnosis-related groups (DRGs) in different countries increases the efficiency of healthcare services, improves treatment quality, and reduces treatment costs. Due to the lack of a coherent model for its implementation, the present study aimed to develop a DRGs-based implementation action plan Model for Iran. Methods The present study was an applied, descriptive cross-sectional study conducted in three stages. In the first stage, a review of studies conducted in different countries was carried out. In the second stage, a model was designed for an action plan to implement the DRGs in Iran. In the third stage, the model was validated based on the Delphi technique. Results The DRGs-based implementation action plan model in Iran was designed in three primary axes, including the strategic approach of the DRGs-based implementation action plan, technical dimensions, and executive institutions involved in the DRGs-based implementation action plan. Validation of the designed model showed the agreement of experts (94%) for the mentioned axes. Conclusion The significance of tailoring a DRGs-based implementation action plan to each country's unique context is well-established. Given the intricacies of the Iranian healthcare system, we recommend an initial pilot implementation of DRGs at the hospital level, followed by a gradual national rollout.
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Affiliation(s)
- Farkhondeh Asadi
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid BeheshtiUniversity of Medical SciencesTehranIran
| | - Mahrokh Anvari
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid BeheshtiUniversity of Medical SciencesTehranIran
| | - Mustafa Ghaderzadeh
- Department of Artificial Intelligence, School of Nursing and Health Sciences of BoukanUrmia University of Medical SciencesBoukanUrmiaIran
| | - Nahid Ramezan Ghorbani
- Department of Development & Coordination Scientific Information and Publications, Deputy of Research & TechnologyMinistry of Health & Medical EducationTehranIran
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Lee SH, Yoon H, Park J, Choi JM, Kim KM, Lee EK, Noh GJ, Moon JY, Cho BM. External validation of a pharmacokinetic model for target-controlled infusion of cefazolin as a prophylactic antibiotic. Br J Clin Pharmacol 2024; 90:582-587. [PMID: 37897050 DOI: 10.1111/bcp.15943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
AIMS This study aimed to evaluate the predictive performance of previously constructed cefazolin pharmacokinetic models and determine whether cefazolin administration via the target-controlled infusion (TCI) method may be possible in clinical practice. METHODS Twenty-five gastrectomy patients receiving cefazolin as a prophylactic antibiotic were enrolled. Two grams of cefazolin was dissolved in 50 mL of normal saline to give a concentration of 40 mg mL-1 . Before skin incision, cefazolin was administered using a TCI syringe pump, and its administration continued until the end of surgery. The target total plasma concentration was set to 100 μg mL-1 . Total and unbound plasma concentrations of cefazolin were measured in three arterial blood samples collected at 30, 60 and 120 min after the start of cefazolin administration. The predictive performance of the TCI system was evaluated using four measures: inaccuracy, divergence, bias and wobble. RESULTS Total (n = 75) and unbound (n = 75) plasma concentration measurements from 25 patients were included in the analysis. The pooled median (95% confidence interval) biases and inaccuracies were 6.3 (4.0-8.5) and 10.5 (8.6-12.4) for the total concentration model and -10.3 (-16.8 to -3.7) and 22.4 (18.2-26.7) for the unbound concentration model, respectively. All unbound concentrations were above 10 μg mL-1 . CONCLUSION Administration of cefazolin by the TCI method showed a clinically acceptable performance. Applying the TCI method by setting the total concentration as the target concentration rather than the unbound concentration is effective in maintaining a constant target concentration of cefazolin.
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Affiliation(s)
- Sou Hyun Lee
- Department of Anesthesiology and Pain Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, South Korea
| | - Hyeongseo Yoon
- University of Ulsan College of Medicine, Seoul, South Korea
| | - Junik Park
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jae Moon Choi
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Kyung Mi Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Eun-Kyung Lee
- Department of Statistics, Ewha Womans University, Seoul, South Korea
| | - Gyu-Jeong Noh
- Departments of Anesthesiology and Pain Medicine and Clinical Pharmacology and Therapeutics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ju-Yeon Moon
- Department of Pharmaceutical Analysis, International Scientific Standards, Inc, Chucheon-si, South Korea
| | - Byung-Moon Cho
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Nairn JJ, Forster WA. Importance of adjuvant formulation properties in predicting wetting on leaf surfaces. Pest Manag Sci 2024; 80:212-219. [PMID: 36495479 DOI: 10.1002/ps.7315] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/29/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Leaf wettability can be a barrier to retention of agrichemical sprays. Adjuvants are used to modify leaf wetting by sprays to enhance retention. A previous study developed a model that accurately predicted nonadjuvant formulation wetting (contact angle) on both synthetic and leaf surfaces. Model inputs were the surface properties, roughness and polarity, as measured by the wetting tension dielectric method, coupled with the formulation properties, surface tension and dielectric constant. Preliminary work has indicated that the wetting ability of adjuvant formulations on different surfaces could be modelled in a similar way if the effect of adjuvants on solution polarity could be accurately quantified. RESULTS The wetting of nine agrichemical adjuvants, at a range of concentrations, were measured on seven synthetic and 14 leaf surfaces. A novel method was developed to quantify the interfacial dielectric polarity (IDP) of adjuvant formulations. Adjuvant concentration did not change the IDP indicating the surface-active surfactant molecules migrate to the interface, loading until saturation. Formulation properties of surface tension and IDP were found to be strong predictors of wetting in conjunction with surface properties of the substrate. The previously developed unaltered comprehensive wetting model could predict the wetting of adjuvant formulations on synthetic and leaf surfaces (R2 = 0.9) using these inputs. CONCLUSIONS Wetting of adjuvant formulations can be modelled for a wide range of surfaces and this model is expected to advance the selection, and development, of adjuvants to target specific surfaces generating the desired wetting outcome. © 2022 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
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Yang G, Pu J, Zhu S, Shi Y, Yang Y, Mao J, Sun Y, Zhao B. Optimizing Levothyroxine Replacement: A Precision Dosage Model for Post-Thyroidectomy Patients. Int J Gen Med 2024; 17:377-386. [PMID: 38322508 PMCID: PMC10844101 DOI: 10.2147/ijgm.s438397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 01/11/2024] [Indexed: 02/08/2024] Open
Abstract
Background Thyroidectomy is commonly performed for benign or malignant thyroid tumors, often resulting in hypothyroidism. Levothyroxine (LT4) supplementation is crucial to maintain hormone levels within the normal range and suppress TSH for cancer control. However, determining the optimal dosage remains challenging, leading to uncertain outcomes and potential side effects. Methods We analyzed clinical examination data from 510 total thyroidectomy patients, including demographic information, blood tests, and thyroid function. Using R, we applied data preprocessing techniques and identified 274 samples with 98 variables. Principal Component Analysis, correlation analysis, and regression analysis were conducted to identify factors associated with optimal LT4 dosage. Results The analysis revealed that only eight variables significantly influenced the final satisfactory dosage of LT4 in tablets: Benign0/Malignant1 (benign or malignant), BQB (electrophoretic albumin ratio), TP (total protein), FDP (fibrin degradation products), TRAB_1 (thyroid-stimulating hormone receptor antibody), PT (prothrombin time), MONO# (monocyte count), and HCV0C (hepatitis C antibody). The resulting predictive model was: . Conclusion Parameters such as benign/malignant status, TRAB_1, and BQB ratio during medication can serve as observational indicators for postoperative LT4 dosage. The calculated linear model can predict the LT4 dosage for patients after thyroidectomy, leading to improved treatment effectiveness and conserving medical resources.
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Affiliation(s)
- Guanghua Yang
- Department of General Surgery, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, 200137, People’s Republic of China
| | - Jiaxi Pu
- Department of General Surgery, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, 200137, People’s Republic of China
| | - Sibo Zhu
- School of Life Sciences, Fudan University, Shanghai, 200438, People’s Republic of China
| | - Yong Shi
- Cinoasia Institute, Shanghai, 200438, People’s Republic of China
| | - Yi Yang
- Cinoasia Institute, Shanghai, 200438, People’s Republic of China
| | - Jiangnan Mao
- Cinoasia Institute, Shanghai, 200438, People’s Republic of China
| | - Yongkang Sun
- Department of General Surgery, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, 200137, People’s Republic of China
| | - Bin Zhao
- Department of General Surgery, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, 200137, People’s Republic of China
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Liu Y, Hu S, Teng M, Qing Y, Dong X, Chen L, Ai K. A novel anoikis-related prognostic signature associated with prognosis and immune infiltration landscape in lung adenocarcinoma. J Gene Med 2024; 26:e3610. [PMID: 37985130 DOI: 10.1002/jgm.3610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/06/2023] [Accepted: 09/23/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND One of the most prevalent malignancies in the world is lung adenocarcinoma (LUAD), with a large number of people dying from lung cancer each year. Anoikis has a crucial function in tumor metastasis, promoting cancer cell shedding and survival from the primary tumor site. However, the role of anoikis in LUAD is still unclear. METHODS The GeneCard database (https://www.genecards.org/) was utilized to obtain anoikis-related genes with correlation greater than 0.4. Differential analysis was employed to acquire differential genes. Univariate, multifactorial Cox analyses and the least absolute shrinkage and selection operator were then utilized to capture genes connected to overall survival time. These genes were used to build prognostic models. The predictive model was analyzed and visualized. Survival analysis was conducted on the model and risk scores were calculated. The TCGA samples were split into groups of low and high risk depending on risk scores. A Gene Expression Omnibus database sample was used for external verification. Immunization estimates were performed using ESTIMATE, CiberSort and single sample gene set enrichment analysis. The connection between the prognostic gene model and immune cells was analyzed. Drug susceptibility prediction analysis was performed. The clinical information for samples was extracted and analyzed. RESULTS We selected six genes related to anoikis in LUAD to construct a prognosis model (CDC25C, ITPRIP, SLCO1B3, CDX2, CSPG4 and PIK3CG). Compared with cases of high-risk scores, the overall survival of those with low risk was significantly elevated based on Kaplan-Meier survival analysis. Immune function analysis exhibited that different risk groups had different immune states. The results of ESTIMATE, CiberSort and single sample gene set enrichment analysis showed great gaps in immunization between patients in the two groups. The normogram of the risk score and the LUAD clinicopathological features was constructed. Principal component analysis showed that this model could effectively distinguish the two groups of LUAD patients. CONCLUSIONS We integrated multiple anoikis-related genes to build a prognostic model. This investigation demonstrates that anoikis-related genes can be used as a stratification element for fine therapy of individuals with LUAD.
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Affiliation(s)
- Yue Liu
- Department of Cardiothoracic Surgery, Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China
| | - Shiqi Hu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China
- Department of Thoracic Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Meixin Teng
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Yang Qing
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Xiao Dong
- Department of Cardiothoracic Surgery, Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China
| | - Linsong Chen
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China
| | - Kaixing Ai
- Department of Cardiothoracic Surgery, Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China
- Department of General Surgery, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China
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Viswalekshmi BR, Bendi D. A comprehensive model for quantifying construction waste in high-rise buildings in India. Waste Manag Res 2024; 42:111-125. [PMID: 37350242 DOI: 10.1177/0734242x231178227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
The construction industry plays a vital role in the economic development of any country. Concurrently, the sector also generates enormous quantities of construction and demolition waste (CDW) that damages the ecology causing environmental pollution and deteriorating human health. Recently, various governments and other organizations realized the importance of implementing construction waste management (CWM) practices to attain sustainability in construction. The current decade can be called a pathway for achieving the 2030 agenda for sustainable development goals in which CWM plays an inevitable role. However, accurately quantifying construction waste is necessary to successfully implement any CDW management plan. A detailed literature review for the current research revealed that limited information on the magnitude of construction waste is available in India. Therefore, the current paper proposes a practically viable model to estimate the waste generation index (construction waste generated per total floor area) of high-rise residential buildings in India. The waste quantification is being done based on the project documents and expert interviews. The methodology is later validated through a high-rise building with G + 18 stories located in Kerala, India. The study indicated that a high-rise concrete framed structure generates 122.3 kg m-2 of waste during construction. It was also noted that, concrete, aggregates and blocks constitute 92% of the total waste generated in the project. The developed model can also be used as a cornerstone for establishing a construction waste database at the regional level.
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Affiliation(s)
- B R Viswalekshmi
- Department of Architecture and Planning, National Institute of Technology Calicut, Calicut, Kerala, India
| | - Deepthi Bendi
- Department of Architecture and Planning, National Institute of Technology Calicut, Calicut, Kerala, India
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Daungsupawong H, Wiwanitkit V. Fruit and Vegetable Consumption Promotion Model and Prevention for Cholangiocarcinoma: A Direct Hit to the Target? Asian Pac J Cancer Prev 2024; 25:365. [PMID: 38415518 DOI: 10.31557/apjcp.2024.25.2.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Indexed: 02/29/2024] Open
Affiliation(s)
| | - Viroj Wiwanitkit
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences Saveetha University India
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Nairn JJ, Forster WA. Importance of leaf surface and formulation properties in predicting wetting outcomes. Pest Manag Sci 2024; 80:202-211. [PMID: 36441162 DOI: 10.1002/ps.7306] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/24/2022] [Accepted: 11/28/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Leaf wettability is a major hurdle for the retention of agrichemical sprays that is combated, in part, by using adjuvant modified formulations. Scientists must understand the properties of the leaf surface and the formulation that govern wetting to intelligently select or formulate products to target specific pests. RESULTS A comprehensive database comprising 11 synthetic surfaces and 54 leaf surfaces (species, adaxial and abaxial sides, cultivars, and plant age) using 35 formulations (neat solutions and adjuvants solutions at different concentrations) was compiled. Surface properties of the physical roughness and chemical polarity, as quantified by the wetting tension dielectric method, and formulation properties of surface tension and polarity, as quantified by dielectric constant, were found to govern wetting. A comprehensive wetting model was developed that employed these variables and was capable of accurately predicting the wetting outcome (R2 = 0.86) on all the leaf and synthetic surfaces investigated. This model adequately predicts adjuvant formulation wetting despite exact formulation polarity being unknown. CONCLUSIONS Wetting can be modelled for a wide range of surfaces and solutions. The comprehensive wetting model developed shows potential to better predict the wetting outcome of adjuvant formulations should a method to quantify the formulation dielectric constant be developed. This research provides a significant advancement in the understanding of the properties governing wetting, which may aid the selection and development of adjuvants to target specific surfaces. © 2022 Society of Chemical Industry.
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Sowan A, Chinman M. Model for Doctor of Nursing Practice Projects Based on Cross-Fertilization Between Improvement and Implementation Sciences: Protocol for Quality Improvement and Program Evaluation Studies. JMIR Res Protoc 2024; 13:e54213. [PMID: 38294860 PMCID: PMC10867758 DOI: 10.2196/54213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Hundreds of nursing professionals graduate each year from Doctor of Nursing Practice (DNP) programs, entrusted with roles as practice scholars and leaders. Graduates are tasked to lead multidisciplinary knowledge implementation projects to improve safety, quality, and key performance metrics. Nevertheless, there is a continued lack of agreement and faculty dissatisfaction with the format, focus, and results of the DNP graduation projects. The use of a wide range of models and methodologies from different sciences for knowledge implementation introduces challenges to DNP students; affects the scientific rigor of the projects; and results in the overuse, superficial use, or misuse of the models. Quality improvement (QI) and program evaluation studies are substantial investments that may lead to waste and even harm if not well conducted. Traditional QI methodologies, commonly used in DNP projects, were found to be uncertain in improving health care outcomes. The complexity of health care systems calls for cross-fertilization between improvement and implementation sciences to improve health care outcomes. OBJECTIVE This study describes the development, implementation, and evaluation of a hybrid model for QI and program evaluation studies to guide scholarship in the DNP program. METHODS The hybrid model was based on cross-fertilization between improvement and implementation sciences. The model adapted the Getting to Outcome (GTO) and Knowledge to Action (KTA) models as the overarching process models for knowledge implementation. Within each phase of the GTO and KTA models, expected barriers and facilitators for the implementation and adoption of innovation were identified based on the CFIR (Consolidated Framework for Implementation Research). Accordingly, strategies to facilitate the implementation and adoption of innovations were identified based on a refined list of implementation strategies and QI tools. The choice of these models was based on the top 5 criteria for selecting implementation science theories and frameworks. Seven DNP students used the hybrid model to conduct QI projects. Students evaluated their experiences by responding to a Qualtrics survey. RESULTS The hybrid model encouraged a comprehensive systematic way of thinking, provided tools essential to implementation success, emphasized the need for adaptability in implementation, maintained rigor in QI, and guided the sustainability of change initiatives. Some of the challenges faced by students included finding reliable and valid measures, attaining and maintaining staff buy-in, and competing organizational priorities. CONCLUSIONS Cross-fertilization between improvement and implementation sciences provided a roadmap and systematic thinking for successful QI projects in the DNP program. The integration of the CFIR with the GTO or KTA process models, enforced by the use of evidence-based implementation strategies and QI tools, reflected the complexity of health care systems and emphasized the need for adaptability in implementation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/54213.
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Affiliation(s)
- Azizeh Sowan
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Matthew Chinman
- RAND Corporation, Santa Monica, CA, United States
- VA Pittsburgh Healthcare System, Pittsburgh, PA, United States
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Pomkai N, Katewongsa P, Chamratrithirong A, Tharawan K, Sakulsri T, Samutachak B, Widyastari DA, Rasri N, Wijarn B, Wongsawat Y. Digital Group-Based Intervention for Physical Activity Promotion Among Thai Adults During the COVID-19 Lockdown: Randomized Controlled Trial. J Med Internet Res 2024; 26:e43366. [PMID: 38294853 PMCID: PMC10867743 DOI: 10.2196/43366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 05/17/2023] [Accepted: 11/24/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic significantly diminished the physical activity (PA) level of Thai adults belonging to Generation Y (Gen Y). As a response to the global crisis, many individuals worldwide have turned to social community platforms, recognizing their potential in promoting PA during the pandemic. Gen Y, in particular, demonstrates exceptional proficiency in using social media platforms, showcasing a remarkable aptitude for swiftly accessing new information and knowledge. However, their proclivity for reckless behavior exposes them to various health risks, potentially leading to enduring adverse health consequences. Consequently, there arises a pressing need to develop a comprehensive model aimed at elevating the PA levels among individuals belonging to Gen Y. OBJECTIVE This research aimed to examine the effectiveness of a digital group-based activity in promoting PA among Gen Y in Thailand. METHODS This was a parallel 2-arm randomized controlled trial with single-blind allocation to experimental and control groups and pre- and posttest measurements. Measurements were administered on the web and were designed for respondents to complete by themselves. The sample comprised 100 Gen Y individuals who met the inclusion criteria. Both groups were matched for background characteristics. The two 8-week intervention activities were (1) two weeks of education and (2) six weeks of motivation by target groups that set goals for PA together (using the Zoom meeting application), with a time limit and group consensus as to when the goal was to be achieved. The intervention activities were implemented one by one at specified intervals and delivered daily through health apps and the official LINE account. RESULTS The intervention starts from August 22 to October 16, 2021. Of the 100 participants, 20 (20%) left the study, and the remaining 80 (80%) participated in the study (40 individuals each in the experimental and control groups). After participating in the experiment, a statistically significant difference in PA was found between the 2 groups (moderate to vigorous PA; 25/40, 63%; P=.03). Participants in the intervention group collected a higher cumulative minute of moderate to vigorous PA weekly (283 minutes) than those in the control group (164 minutes), and this was statistically significant (P=.03). For the transition to the fourth stage of behavior (ie, action), the improvement in the experimental group, after participating in the trial, was statistically significant compared to that of the control group (P=.01). CONCLUSIONS Digital group-based activity showed its effectiveness in improving the PA of Gen Y individuals in the intervention group. It created a process-based intervention activity that corresponds to the stages of behavior changes, from contemplation to action. The digital community can also connect individuals to comparable groups locally and globally. TRIAL REGISTRATION Thai Clinical Trials Registry TCTR20211101005; https://www.thaiclinicaltrials.org/show/TCTR20211101005.
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Affiliation(s)
- Nanthawan Pomkai
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
| | - Piyawat Katewongsa
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
| | | | - Kanokwan Tharawan
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
| | - Teeranong Sakulsri
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
| | - Bhubate Samutachak
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
| | | | | | | | - Yodchanan Wongsawat
- Department of Biomedical Engineering, Faculty of Engineering, Mahidol University, Nakhon Pathom, Thailand
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Zhao H, Zhang W, Liu Y, Peng W. Risk factors and prediction model for thrombocytopenia following coronary artery bypass graft surgery in elderly Chinese population. J Thorac Dis 2024; 16:273-284. [PMID: 38410552 PMCID: PMC10894372 DOI: 10.21037/jtd-23-1396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/01/2023] [Indexed: 02/28/2024]
Abstract
Background Thrombocytopenia, a common complication of coronary artery bypass graft (CABG) surgery, is particularly prevalent among elderly individuals. This study developed a risk prediction model utilizing preoperative and intraoperative variables to identify high-risk elderly patients prone to developing thrombocytopenia. Methods The patients were retrospectively recruited from Beijing Anzhen Hospital between February 2019 and December 2020. Postoperative thrombocytopenia was defined as a postoperative platelet (PLT) count <100×109/L as measured within 7 days after surgery. The entire population was randomly split into derivation and validation sets in a 7:3 ratio. The derivation set underwent variable screen by the least absolute shrinkage and selection operator (LASSO) regression method. To evaluate the predictive ability of the model for thrombocytopenia, decision curve analysis (DCA) and receiver operating characteristic (ROC) curves were generated in the derivation and validation sets. Results A total of 1,773 patients were recruited in this study, with random assignment to either the derivation set (1,242 cases) or the validation set (531 cases). LASSO regression was utilized the risk factors associated with thrombocytopenia, resulting in selection of preoperative baseline variables: body mass index (BMI), estimated glomerular filtration rate (eGFR), B-type natriuretic peptide (BNP), preoperative PLT, and use of beta-blocker, and intraoperative variables: red blood cell (RBC) transfusion, plasma transfusion, use of intra-aortic balloon pump (IABP) and cardiopulmonary bypass (CPB), reoperation for bleeding, washed RBC transfusion volume, and use of epinephrine. The logistic regression was employed to establish the risk prediction. The area under the ROC curve (AUC) for the derivation set was 0.900 [95% confidence interval (CI): 0.880-0.920], while for the validation cohort, it was 0.897 (95% CI: 0.866-0.928). Conclusions The model incorporating significant preoperative and intraoperative variables exhibited good predictive performance for thrombocytopenia in elderly patients undergoing CABG surgery.
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Affiliation(s)
- Honglei Zhao
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Wei Zhang
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Yongmin Liu
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Wenxing Peng
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
- Department of Pharmacy, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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Jishi T. Estimation of time course in phytochrome photostationary state under artificial light for controlling plant growth. Front Plant Sci 2024; 14:1305182. [PMID: 38328619 PMCID: PMC10848169 DOI: 10.3389/fpls.2023.1305182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 12/07/2023] [Indexed: 02/09/2024]
Abstract
A model to estimate the time course of a phytochrome photostationary state (PSS) under an arbitrary light environment was developed. It is the solution of differential equations that use conversion rates between active and inactive forms of previously reported phytochromes. The model estimated that 90% of the PSS changes were completed using approximately 3.4 mmol m-2 of integrated end-of-day far-red light irradiation, and 99% of the changes were completed with approximately 6.9 mmol m-2 irradiation. Although these values were affected by the spectral photon flux density of the far-red light. They were consistent with previous results that examined dose requirements of far-red irradiation. The rate at which the PSS changes approached equilibrium was maximized under a red light, followed by far-red, green, and blue light. This estimation method could be used to control phytochrome responses for horticulture via artificial lighting.
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Affiliation(s)
- Tomohiro Jishi
- Grid Innovation Research Laboratory, Central Research Institute of Electric Power Industry, Chiba, Japan
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Byrne JF, Healy C, Föcking M, Susai SR, Mongan D, Wynne K, Kodosaki E, Heurich M, de Haan L, Hickie IB, Smesny S, Thompson A, Markulev C, Young AR, Schäfer MR, Riecher-Rössler A, Mossaheb N, Berger G, Schlögelhofer M, Nordentoft M, Chen EYH, Verma S, Nieman DH, Woods SW, Cornblatt BA, Stone WS, Mathalon DH, Bearden CE, Cadenhead KS, Addington J, Walker EF, Cannon TD, Cannon M, McGorry P, Amminger P, Cagney G, Nelson B, Jeffries C, Perkins D, Cotter DR. Proteomic Biomarkers for the Prediction of Transition to Psychosis in Individuals at Clinical High Risk: A Multi-cohort Model Development Study. Schizophr Bull 2024:sbad184. [PMID: 38243809 DOI: 10.1093/schbul/sbad184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
Psychosis risk prediction is one of the leading challenges in psychiatry. Previous investigations have suggested that plasma proteomic data may be useful in accurately predicting transition to psychosis in individuals at clinical high risk (CHR). We hypothesized that an a priori-specified proteomic prediction model would have strong predictive accuracy for psychosis risk and aimed to replicate longitudinal associations between plasma proteins and transition to psychosis. This study used plasma samples from participants in 3 CHR cohorts: the North American Prodrome Longitudinal Studies 2 and 3, and the NEURAPRO randomized control trial (total n = 754). Plasma proteomic data were quantified using mass spectrometry. The primary outcome was transition to psychosis over the study follow-up period. Logistic regression models were internally validated, and optimism-corrected performance metrics derived with a bootstrap procedure. In the overall sample of CHR participants (age: 18.5, SD: 3.9; 51.9% male), 20.4% (n = 154) developed psychosis within 4.4 years. The a priori-specified model showed poor risk-prediction accuracy for the development of psychosis (C-statistic: 0.51 [95% CI: 0.50, 0.59], calibration slope: 0.45). At a group level, Complement C8B, C4B, C5, and leucine-rich α-2 glycoprotein 1 (LRG1) were associated with transition to psychosis but did not surpass correction for multiple comparisons. This study did not confirm the findings from a previous proteomic prediction model of transition from CHR to psychosis. Certain complement proteins may be weakly associated with transition at a group level. Previous findings, derived from small samples, should be interpreted with caution.
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Affiliation(s)
- Jonah F Byrne
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Melanie Föcking
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Subash Raj Susai
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - David Mongan
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Kieran Wynne
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Eleftheria Kodosaki
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, UK
| | - Meike Heurich
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, UK
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Stefan Smesny
- Department of Psychiatry, Jena University Hospital, Jena, Germany
| | - Andrew Thompson
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Connie Markulev
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Alison Ruth Young
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC, Australia
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Miriam R Schäfer
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | | | - Nilufar Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Gregor Berger
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Monika Schlögelhofer
- BioPsyC-Biopsychosocial Corporation, Non-profit Association for Research Funding Ltd, Vienna, Austria
| | - Merete Nordentoft
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Eric Y H Chen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, 2/F New Clinical Building, Queen Mary Hospital, Pok Fu Lam, Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Swapna Verma
- Office of Education, Duke-NUS Graduate Medical School, Singapore, Singapore
- Department of Psychosis & East Region, Institute of Mental Health, Singapore, Singapore
| | - Dorien H Nieman
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Scott W Woods
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | | | - William S Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Daniel H Mathalon
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
- Mental Health Service 116d, Veterans Affairs San Francisco Health Care System, San Francisco, CA, USA
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences and Psychology, University of California, Los Angeles, CA, USA
| | | | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
- Department of Psychiatry, Emory University, Atlanta, GA, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin 9, Ireland
| | - Pat McGorry
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Paul Amminger
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Gerard Cagney
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Barnaby Nelson
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Clark Jeffries
- Renaissance Computing Institute, University of North Carolina, Chapel Hill, NC, USA
| | - Diana Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - David R Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin 9, Ireland
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Kauppi KJ, Roos ET, Borg PT, Cantell KS, Torkki PM. What is wellness? Investigating the importance of different domains of wellness among laypeople and experts: A survey study. Scand J Public Health 2024:14034948231217360. [PMID: 38217305 DOI: 10.1177/14034948231217360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2024]
Abstract
AIMS Lack of consensus on wellness has led to a vast number of different conceptualisations, which hinder international efforts to monitor individual-level wellness and social progress comparably. This study aimed to aid in the harmonisation of the concept by contributing to the scarce research on laypeople's views on wellness. The study investigates whether the importance of different areas of wellness varies depending on age, gender, education or socio-economic position. Furthermore, considering that wellness models are often constructed by expert panels, this study aimed to shed light on how experts' and laypeople's views on wellness vary. METHODS Altogether, 1152 laypeople and 23 Finnish experts rated the importance of 61 systematic review-based wellness domains. Each domain received an ordinal number, which, together with the Mann-Whitney U-test or Kruskal-Wallis test, was used to examine the differences between the groups. RESULTS Thirteen wellness domains were found at the top of the lists, regardless of whether the results were analysed based on gender, age, education or socio-economic position. When looking at the priority order of different domains, we were able to identify several differences between the expert panel and laypeople. CONCLUSIONS To ensure the relevance of wellness models, it is vital to understand the areas that laypeople consider to be important for their comprehensive wellness. This study offers 13 domains that could be combined with an expert view on wellness and used as a starting point for creating a more comprehensive, inclusive and better-suited wellness instrument.
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Affiliation(s)
- Krista J Kauppi
- Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
| | - Eira T Roos
- Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
- Aava Medical Centre, Finland
| | | | | | - Paulus M Torkki
- Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
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Wu Q, Zhou Z, Yan Z, Connel M, Garzo G, Yeo A, Zhang W, Su HI, Zhong S. A temporal extracellular transcriptome atlas of human pre-implantation development. Cell Genom 2024; 4:100464. [PMID: 38216281 PMCID: PMC10794780 DOI: 10.1016/j.xgen.2023.100464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/09/2023] [Accepted: 11/19/2023] [Indexed: 01/14/2024]
Abstract
Non-invasively evaluating gene expression products in human pre-implantation embryos remains a significant challenge. Here, we develop a non-invasive method for comprehensive characterization of the extracellular RNAs (exRNAs) in a single droplet of spent media that was used to culture human in vitro fertilization embryos. We generate the temporal extracellular transcriptome atlas (TETA) of human pre-implantation development. TETA consists of 245 exRNA sequencing datasets for five developmental stages. These data reveal approximately 4,000 exRNAs at each stage. The exRNAs of the developmentally arrested embryos are enriched with the genes involved in negative regulation of the cell cycle, revealing an exRNA signature of developmental arrest. Furthermore, a machine-learning model can approximate the morphology-based rating of embryo quality based on the exRNA levels. These data reveal the widespread presence of coding gene-derived exRNAs at every stage of human pre-implantation development, and these exRNAs provide rich information on the physiology of the embryo.
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Affiliation(s)
- Qiuyang Wu
- Shu Chien-Gene Ley Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA
| | - Zixu Zhou
- Genemo, Inc., San Diego, CA 92130, USA
| | - Zhangming Yan
- Shu Chien-Gene Ley Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA
| | - Megan Connel
- Reproductive Partners San Diego, La Jolla, CA 92037, USA
| | - Gabriel Garzo
- Reproductive Partners San Diego, La Jolla, CA 92037, USA
| | - Analisa Yeo
- Reproductive Partners San Diego, La Jolla, CA 92037, USA
| | - Wei Zhang
- Reproductive Partners San Diego, La Jolla, CA 92037, USA
| | - H Irene Su
- Reproductive Partners San Diego, La Jolla, CA 92037, USA; Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Diego, La Jolla, CA 92093, USA; Moores Cancer Center, University of California, San Diego, La Jolla, CA 92093, USA.
| | - Sheng Zhong
- Shu Chien-Gene Ley Department of Bioengineering, University of California, San Diego, La Jolla, CA 92093, USA; Genemo, Inc., San Diego, CA 92130, USA.
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Bentley KH, Madsen EM, Song E, Zhou Y, Castro V, Lee H, Lee YH, Smoller JW. Determining Distinct Suicide Attempts From Recurrent Electronic Health Record Codes: Classification Study. JMIR Form Res 2024; 8:e46364. [PMID: 38190236 PMCID: PMC10804255 DOI: 10.2196/46364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 09/15/2023] [Accepted: 09/27/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Prior suicide attempts are a relatively strong risk factor for future suicide attempts. There is growing interest in using longitudinal electronic health record (EHR) data to derive statistical risk prediction models for future suicide attempts and other suicidal behavior outcomes. However, model performance may be inflated by a largely unrecognized form of "data leakage" during model training: diagnostic codes for suicide attempt outcomes may refer to prior attempts that are also included in the model as predictors. OBJECTIVE We aimed to develop an automated rule for determining when documented suicide attempt diagnostic codes identify distinct suicide attempt events. METHODS From a large health care system's EHR, we randomly sampled suicide attempt codes for 300 patients with at least one pair of suicide attempt codes documented at least one but no more than 90 days apart. Supervised chart reviewers assigned the clinical settings (ie, emergency department [ED] versus non-ED), methods of suicide attempt, and intercode interval (number of days). The probability (or positive predictive value) that the second suicide attempt code in a given pair of codes referred to a distinct suicide attempt event from its preceding suicide attempt code was calculated by clinical setting, method, and intercode interval. RESULTS Of 1015 code pairs reviewed, 835 (82.3%) were nonindependent (ie, the 2 codes referred to the same suicide attempt event). When the second code in a pair was documented in a clinical setting other than the ED, it represented a distinct suicide attempt 3.3% of the time. The more time elapsed between codes, the more likely the second code in a pair referred to a distinct suicide attempt event from its preceding code. Code pairs in which the second suicide attempt code was assigned in an ED at least 5 days after its preceding suicide attempt code had a positive predictive value of 0.90. CONCLUSIONS EHR-based suicide risk prediction models that include International Classification of Diseases codes for prior suicide attempts as a predictor may be highly susceptible to bias due to data leakage in model training. We derived a simple rule to distinguish codes that reflect new, independent suicide attempts: suicide attempt codes documented in an ED setting at least 5 days after a preceding suicide attempt code can be confidently treated as new events in EHR-based suicide risk prediction models. This rule has the potential to minimize upward bias in model performance when prior suicide attempts are included as predictors in EHR-based suicide risk prediction models.
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Affiliation(s)
- Kate H Bentley
- Center for Precision Psychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Emily M Madsen
- Center for Precision Psychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Eugene Song
- Center for Precision Psychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Yu Zhou
- Center for Precision Psychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Victor Castro
- Mass General Brigham Research Information Science and Computing, Somerville, MA, United States
| | - Hyunjoon Lee
- Center for Precision Psychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Younga H Lee
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Jordan W Smoller
- Center for Precision Psychiatry, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
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Zhao X, Meng Q, Zhou M, Luo J, Hu L. Optimal treatment strategy and prognostic analysis for patients with non-metastatic pT4 colon adenocarcinoma. Front Oncol 2024; 13:1342289. [PMID: 38260849 PMCID: PMC10802841 DOI: 10.3389/fonc.2023.1342289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Objective This study endeavored to explore the optimal treatment strategy and conduct a prognostic analysis for patients diagnosed with pT4M0 (pathologic stage T4) colon adenocarcinoma (COAD). Methods and materials A total of 8,843 patients diagnosed with pT4M0 COAD between January 2010 and December 2015 were included in this study from the Surveillance, Epidemiology, and End Results (SEER) database. These patients were randomly divided into a training set and an internal validation set using a 7:3 ratio. Variables that demonstrated statistical significance (P<0.05) in univariate COX regression analysis or held clinical significance were incorporated into the multivariate COX regression model. Subsequently, this model was utilized to formulate a nomogram. The predictive accuracy and discriminability of the nomogram were assessed using the C-index, area under the curve (AUC), and calibration curves. Decision curve analysis (DCA) was conducted to confirm the clinical validity of the model. Results In the entire SEER cohort, the 3-year overall survival (OS) rate (74.22% vs. 63.20%, P<0.001) and the 3-year cancer-specific survival (CSS) rate (76.25% vs. 66.98%, P<0.001) in the surgery combined with postoperative adjuvant therapy (S+ADT) group surpassed those in the surgery (S) group. Multivariate COX regression analysis of the training set unveiled correlations between age, race, N stage, serum CEA (carcinoembryonic antigen), differentiation, number of resected lymph nodes, and treatment modalities with OS and CSS. Nomograms for OS and CSS were meticulously crafted based on these variables, achieving C-indexes of 0.692 and 0.690 in the training set, respectively. The robust predictive ability of the nomogram was further affirmed through receiver operating characteristic (ROC) and calibration curves in both the training and validation sets. Conclusion In individuals diagnosed with pT4M0 COAD, the integration of surgery with adjuvant chemoradiotherapy demonstrated a substantial extension of long-term survival. The nomogram, which incorporated key factors such as age, race, differentiation, N stage, serum CEA level, tumor size, and the number of resected lymph nodes, stood as a dependable tool for predicting OS and CSS rates. This predictive model held promise in aiding clinicians by identifying high-risk patients and facilitating the development of personalized treatment plans.
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Affiliation(s)
- Xinyue Zhao
- Graduate School of Dalian Medical University, Dalian, China
- Department of Radiation Oncology, Changzhou No. 2 People’s Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Qinghong Meng
- Department of Radiation Oncology, Changzhou No. 2 People’s Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Mengyun Zhou
- Department of Radiation Oncology, Changzhou No. 2 People’s Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Judong Luo
- Department of Radiation Oncology, Changzhou No. 2 People’s Hospital Affiliated to Nanjing Medical University, Changzhou, China
| | - Lijun Hu
- Department of Radiation Oncology, Changzhou No. 2 People’s Hospital Affiliated to Nanjing Medical University, Changzhou, China
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Keles MN, Eroğlu K. The use of theory or model in studies on postpartum care: A narrative review. Int J Nurs Knowl 2024; 35:21-31. [PMID: 36604707 DOI: 10.1111/2047-3095.12411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/09/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE It is aimed to raise awareness about the science of nursing for women's health and the use of nursing theories and models in research by reviewing the studies using theories or models in postpartum care. DATA SOURCES The data of the study were obtained by searching YÖK National Thesis Center, EBSCOhost, PubMed, Web of Science, Cochrane, and ScienceDirect databases. Reviewed studies were analyzed in terms of the type of research, sample characteristics, purpose, the field of use of theory and model in the research, and research results. CONCLUSIONS As a result of the review, it was noted that in the studies, Orem's Self-Care Deficit Nursing Theory/Model (n = 9), Roy's Adaptation Theory (n = 7), and Kolcaba's Theory of Comfort (n = 7) were the most used theories, theories and models were not used in a systematic structure at every stage of the research, and positive outcomes were obtained with the theory and model-based nursing interventions. IMPLICATIONS FOR NURSING PRACTICE The application of theory and model in postpartum care can be chosen by nurses as it improves patient outcomes. Furthermore, the use of theories and models in research to develop nursing knowledge will benefit nursing science while increasing professional autonomy.
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Affiliation(s)
- Maide Nur Keles
- Halic University Faculty of Health Sciences, Istanbul, Turkey
- Koc university Graduate School of Health Sciences, Istanbul, Turkey
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48
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Zhao Y, Guo J, Zhao S, Wang R, Wu D, Chang C. Incorporating mutations and bone marrow fibrosis into the revised international prognostic scoring system in myelodysplastic syndromes. Leuk Lymphoma 2024; 65:100-108. [PMID: 37865969 DOI: 10.1080/10428194.2023.2271593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023]
Abstract
The independent prognostic significance of bone marrow fibrosis (BMF) in myelodysplastic syndromes (MDS) is challenged under currently molecular prognostic models. In this study, the clinical and genetic data from 438 MDS patients were analyzed retrospectively. The patients were randomly divided into training (n = 306) and validation (n = 132) cohorts. The independent significant prognostic factors included age, IPSS-R, BMF, TP53 and U2AF1. Using their weighted coefficients, we developed a simplified prognostic system. Four risk groups were produced: low, intermediate, high and very high. The new model yielded more clearly separated survival curves than the IPSS-R. In addition, our model achieved higher C-indexes (0.61 in the training cohort and 0.63 in the validation cohort) than the IPSS-RM model (0.59 and 0.58) and IPSS-R (0.57 and 0.56). In conclusion, BMF was an independent significant prognostic factor for MDS, and adding BMF into the IPSS-R improved its predictive capability.
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Affiliation(s)
- Youshan Zhao
- Department of Hematology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Juan Guo
- Department of Hematology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Sida Zhao
- Department of Hematology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Roujia Wang
- Department of Hematology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Dong Wu
- Department of Hematology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Chunkang Chang
- Department of Hematology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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49
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Jovanović M. Bias in estimated short sprint profiles using timing gates due to the flying start: simulation study and proposed solutions. Comput Methods Biomech Biomed Engin 2024; 27:145-155. [PMID: 36708323 DOI: 10.1080/10255842.2023.2170713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/15/2023] [Indexed: 01/29/2023]
Abstract
Short sprints are most frequently evaluated and modeled using timing gates. Flying start distance is often recommended to avoid premature timing system triggering by lifting knees or swinging arms. This results in timing system initiation not being aligned with the initial force application, which yields bias in estimated short sprint parameters. This simulation study aims to explore the effects of the flying start distance on bias and sensitivity to detect changes in short sprint parameters using three models: the contemporary No Correction model and two proposed Estimated time correction (Estimated TC), and Estimated flying distance (Estimated FD) models. In conclusion, both the Estimated TC and Estimated FD models provided more precise parameter estimates, but surprisingly, the No correction model provided higher sensitivity for specific parameter changes. Besides standardizing the sprint starting technique for the short sprint performance monitoring, practitioners are recommended to utilize and track the results of all three models.
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Affiliation(s)
- Mladen Jovanović
- Faculty of Sport and Physical Education, University of Belgrade, Belgrade, Serbia
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50
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Gusarov MV, Tayts BM, Barinova AN. [The actual issues of improvement of organization of screening of skin neoplasms in out-patient conditions]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2024; 32:83-88. [PMID: 38349690 DOI: 10.32687/0869-866x-2024-32-1-83-88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/02/2023] [Indexed: 02/15/2024]
Abstract
The skin malignant neoplasms constitute one of significant problems of public health. The increasing of morbidity and mortality of melanoma and other types of skin cancers is registered. The early detection of disease assures mortality decreasing and increases survival of patients. The purpose of the study is to develop optimal model of organizational and preventive measures of early diagnostic of malignant skin tumors. The comprehensive study was carried out, which included assessment of survey of patients using questionnaire "Melanoma Diagnosis Day". Also it included identification of level of awareness of physicians about screening, medical records of patients during COVID-19 pandemic, risk groups identification and effectiveness of selecting patient for screening. The total number of observations is 21 581. The selective and continuous observation method was applied and parametric and non-parametric methods as well. The study determined that during COVID-19 pandemic in 2020, there was significant reliable uncompensated decrease in the number of patients with diagnosis of ICD D23, L82, C44 and decrease in the number of detected diseases. The melanoma, basalioma and other skin malignant neoplasms are reliably more common in patients of medium-high risk group, aged 60 years and older and in persons sunburned at the age of 18 years. The assignation of separate specialist to diagnose skin neoplasms allows statistically reliably increase rate of morphological confirmation of malignant neoplasms as compared to common reception by dermatologist. The sociological survey of physicians revealed statistically reliable difference in knowledge between dermatovenereologists, oncologists and physicians of other specialties concerning screening issues. The results of the study permitted to develop complex of organizational measures to improve screening. The model of organizational and preventive measures for early diagnostic of skin malignant tumors in outpatient conditions was proposed.
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Affiliation(s)
- M V Gusarov
- The Federal State Budget Educational Institution of Higher Education "The I. I. Mechnikov North-Western State medical University of Minzdrav of Russia", 191015, St. Petersburg, Russia
| | - B M Tayts
- The Federal State Budget Educational Institution of Higher Education "The I. I. Mechnikov North-Western State medical University of Minzdrav of Russia", 191015, St. Petersburg, Russia,
| | - A N Barinova
- The Federal State Budget Educational Institution of Higher Education "The I. I. Mechnikov North-Western State medical University of Minzdrav of Russia", 191015, St. Petersburg, Russia
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