Yoxas/statistical_literacy huggingface dataset:
Tuberculosis (TB), though preventable and curable, remains a global health problem, ranked one of the top causes of death worldwide, despite the World Health Organization's strategies. This may be due to the stigma surrounding the disease. This study assesses TB stigma in light of knowledge, attitudes, and preventive practices among individuals in an urban community. This was a descriptive, cross-sectional study among 317 residents of Surulere, Lagos, Nigeria, selected by multi-stage sampling. Data were collected using a pretested, semi-structured, interviewer-administered questionnaire and analyzed using Epi InfoTM version 7.2.2.6 2018 (Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA). Descriptive variables were summarized as frequencies, and the Chi-square test was used to test the associations. The level of significance was predetermined at P ≤0.05. Most participants were between the age group of 21 and 40 years. Approximately 9 out of every 10 respondents (91.8%) were aware of TB. Overall, only 2.4% of respondents had good knowledge of TB, more than half (59.1%) had positive attitudes toward TB, about one-third (37.1%) had good preventive practices and 22.7% of respondents expressed TB stigma, 63.6% would show no compassion or desire to help people with TB while 64.3% would rather people with TB were never employed. However, good knowledge translated into less stigma (P <0.001). Most participants were aware of TB, although knowledge, attitude, and practice levels were poor. Knowledge was found to reduce TB stigma, reinforcing the need for improved community literacy regrading TB. This has the potential to influence health-seeking behavior and promote better TB prevention, detection, and treatment outcomes.
Tuberculosis has been considered a global emergency since 1993, and controlling it has become even more challenging since 2020 due to the health and social crisis resulting from the COVID-19 pandemic. This study aimed to identify the impact of the COVID-19 pandemic on tuberculosis case detection activities within primary health Care in the largest city in Brazil. This is a cross-sectional and analytical study on the provision of tuberculosis detection actions in primary healthcare units during the pandemic period. A descriptive analysis was performed for characterization, and Generalized Mixed Models were used for evaluating associations, with a Bonferroni post hoc test applied. The study sample comprised 80 health units in the municipality. There was a moderate alteration level in the provision of consultations for individuals with signs and symptoms of tuberculosis in 2020 (13.8%) and in 2021 (15.1%). Statistical significance (p < 0.05) was found between the pandemic period and detection actions, with a lower alteration level in 2022. Tuberculosis detection activities underwent changes due to the COVID-19 pandemic, mainly in 2020, which was associated with alterations in consultation and case notification provision.
Tuberculosis is a common respiratory disease imposing significant health burden. Directly observed treatment short course strategy ensures patient compliance in tuberculosis treatment. The aim of this study was to assess pattern of tuberculosis, trend and outcome of patients registered at Directly observed treatment short course centre of Tribhuvan University Teaching Hospital. A retrospective observational study was conducted at Tribhuvan University Teaching Hospital. Tuberculosis patients of all age groups registered from July 2017 to June 2020 at Tribhuvan University Teaching Hospital Directly observed treatment short course centre were included. Data entry and analysis was done in SPSS version 20.0. Descriptive statistics was performed and results were interpreted in mean, frequency and percentage. A total of 2790 tuberculosis patients were included for final analysis. There were 1736 (62.2%) males. Mean age of patients was 37.94±20.28 years. Pulmonary tuberculosis was the most common type of tuberculosis seen in 948 (34%) patients. Fifty percent of total tuberculosis cases were confined to thorax. Tubercular pleural effusion and pleurisy (14.6%), central nervous system (13.2%), bone and joint (12.2%) were common forms of extrapulmonary tuberculosis. The mean incident tuberculosis cases registered annually was 697.5±95.63. Nearly half (49.1%) of the patients completed tuberculosis treatment regimen while 43.3% were referred to other Directly observed treatment short course centre as per their convenience. This study reflects the trend and pattern of tuberculosis epidemiology at tertiary care hospital of Nepal. There is a huge burden of both pulmonary and extrapulmonary tuberculosis at Tribhuvan University Teaching Hospital with slight annual variation in incident tuberculosis cases. Despite implementation of Directly observed treatment short course, the problem of non-compliance persists among the tuberculosis patients.
Tuberculosis is a major public health challenge in India and has been targeted for elimination. The National Tuberculosis Elimination Program (NTEP), in its all-previous forms has been one of the leading national health programs with the institutionalized engagement of medical colleges. This article outlines the mechanisms for medical college engagement in NTEP and discusses how the recent adoption of competency based medical education (CBME) for graduate medical education provides an opportunity for strengthening medical college participation in NTEP. The authors propose that for an accelerated progress towards 'End TB' in India, there is need for scaling up faculty development programs, focusing upon operational and implementation research, adopting a practical approach in designing curriculum for graduate medical teaching and creation of online repository of training material as well as the data bank of post-graduate theses, and other published and unpublished research work. Alongside, these efforts need to be supplemented by the professional associations of medical specialties and the governments through organizing annual national scientific and policy forum; and the capacity building of postgraduate students and faculty members in operational research, amongst others. The adoption of CBME has-arguably- created an opportunity for innovations at medical college level to support End TB. The learnings could also be utilized for enhanced engagement of medical colleges in other national health programs. India's experience on medical college engagement in tuberculosis elimination could serve as a 'good practice' for TB endemic countries in other parts of the world.
Tuberculosis is a principal public health issue. Reducing and controlling tuberculosis did not result in the expected success despite implementing effective preventive and therapeutic programs, one of the reasons for which is the delay in definitive diagnosis. Therefore, creating a diagnostic aid system for tuberculosis screening can help in the early diagnosis of this disease. This research aims to use machine learning techniques to identify economic, social, and environmental factors affecting tuberculosis. This case-control study included 80 individuals with TB and 172 participants as controls. During January-October 2021, information was collected from thirty-six health centers in Ahvaz, southwest Iran. Five different machine learning approaches were used to identify factors associated with TB, including BMI, sex, age , marital status, education, employment status, size of the family, monthly income, cigarette smoking, hookah smoking, history of chronic illness, history of imprisonment, history of hospital admission, first-class family, second-class family, third-class family, friend, co-worker, neighbor, market, store, hospital, health center, workplace, restaurant, park, mosque, Basij base, Hairdressers and school. The data was analyzed using the statistical programming R software version 4.1.1. According to the calculated evaluation criteria, the accuracy level of 5 SVM, RF, LSSVM, KNN, and NB models is 0.99, 0.72, 0.97,0.99, and 0.95, respectively, and except for RF, the other models had the highest accuracy. Among the 39 investigated variables, 16 factors including First-class family (20.83%), friend (17.01%), health center (41.67%), hospital (24.74%), store (18.49%), market (14.32%), workplace (9.46%), history of hospital admission (51.82%), BMI (43.75%), sex (40.36%), age (22.83%), educational status (60.59%), employment status (43.58%), monthly income (63.80%), addiction (44.10%), history of imprisonment (38.19%) were of the highest importance on tuberculosis. The obtained results demonstrated that machine-learning techniques are effective in identifying economic, social, and environmental factors associated with tuberculosis. Identifying these different factors plays a significant role in preventing and performing appropriate and timely interventions to control this disease.
Tuberculosis is one the leading causes of death from a single infectious disease, caused by the bacillus mycobacterium tuberculosis. In Ethiopia, even though several primary studies have been conducted on the incidence of tuberculosis among HIV-infected children, the pooled incidence rate of tuberculosis among HIV-infected children (aged 0-14 years) is unknown. Therefore, the main objectives of this systematic review and meta-analysis are to estimate the pooled incidence rate of tuberculosis among HIV-infected children and its predictors in Ethiopia. International electronic databases such as PubMed, HINARI, Science Direct, Google Scholar, and African Journals Online were searched using different search engines. Quality of primary studies was checked using the Joanna Briggs Institute checklist. The heterogeneity of studies was tested using I-square statistics. Publication bias was tested using a funnel plot and Egger's test. Forest plots and tables were used to present the results. The random effect model was used to estimate the pooled incidence of tuberculosis among children living with HIV. A total of 13 studies were included in this systematic review and meta-analysis. The pooled incidence of tuberculosis among HIV-infected children was 3.77 (95% CI: 2.83, 5.02) per 100-person-year observations. Advanced HIV disease (HR: 2.72, 95% CI: 1.9; 3.88), didn't receive complete vaccination (HR: 4.40, 95% CI: 2.16; 8.82), stunting (HR: 2.34, 95% CI: 1.64, 3.33), underweight (HR: 2.30, 95% CI: 1.61; 3.22), didn't receive Isoniazid preventive therapy (HR: 3.64, 95% CI: 2.22, 5.96), anemia (HR: 3.04, 95% CI: 2.34; 3.98), fair or poor antiretroviral therapy adherence (HR: 2.50, 95% CI: 1.84; 3.40) and didn't receive cotrimoxazole preventive therapy (HR: 3.20, 95% CI: 2.26; 4.40) were predictors of tuberculosis coinfection among HIV infected children. This systematic review and meta-analysis concluded that the overall pooled incidence rate of tuberculosis among HIV-infected children was high in Ethiopia as compared to the END TB strategy targets. Therefore, emphasis has to be given to drug adherence (ART and Isoniazid) and nutritional counseling. Moreover, early diagnosis and treatment of malnutrition and anemia are critical to reduce the risk of TB coinfection. Registered in PROSPERO with ID: CRD42023474956.
Tumor genomic profiling (TGP) examines genes and somatic mutations specific to a patient's tumor to identify targets for cancer treatments but can also uncover secondary hereditary (germline) mutations. Most patients are unprepared to make complex decisions related to this information. Black/African American (AA) cancer patients are especially at risk because of lower health literacy, higher levels of medical mistrust, and lower awareness and knowledge of genetic testing. But little is known about their TGP attitudes or preferences. Five in-person focus groups were conducted with Black/AA cancer patients (N = 33) from an NCI-designated cancer center and an affiliated oncology unit in an urban safety-net hospital located in Philadelphia. Focus groups explored participants' understanding of TGP, cultural beliefs about genetics, medical mistrust, and how these perceptions informed decision-making. Participants were mostly female (81.8%), and one-third had some college education; mean age was 57 with a SD of 11.35. Of patients, 33.3% reported never having heard of TGP, and 48.5% were not aware of having had TGP as part of their cancer treatment. Qualitative analysis was guided by the principles of applied thematic analysis and yielded five themes: (1) mistrust of medical institutions spurring independent health-information seeking; (2) genetic testing results as both empowering and overwhelming; (3) how provider-patient communication can obviate medical mistrust; (4) how unsupportive patient-family communication undermines interest in secondary-hereditary risk communication; and (5) importance of developing centralized patient support systems outside of treatment decisions. Results improve understanding of how Black/AA patients perceive of TGP and how interventions can be developed to assist with making informed decisions about secondary hereditary results.
Tumor genomic profiling (TGP) identifies targets for precision cancer treatments, but also secondary hereditary risks. Oncologists are poorly trained to communicate the results of TGP, especially among patients with lower health literacy, poorer genetics knowledge, and higher mistrust. African American (AA) patients are especially vulnerable to poor understanding due to significant cancer disparities and lower uptake of TGP. The goal of this research is to inform the development of an internet-based brief educational support for oncologists to prepare them to provide better decisional support related to TGP for their AA cancer patients. This mixed-methods study used semi-structured interviews of oncologists to inform development of an online survey with a convenience sample of US-based oncologists (n = 50) to assess perceptions of the challenges of TGP and communicating results to AA patients. Most interviewed oncologists felt it was important to consider racial/cultural differences when communicating about hereditary risks. Cost, family dynamics, discrimination concerns, and medical mistrust were identified as particularly salient. Survey respondents' views related to AAs and perceptions of TGP were strongly associated with years since completing training, with recent graduates expressing stronger agreement with statements identifying barriers/disadvantages to TGP for AA patients. Oncologists who had more recently completed training expressed more negative perceptions of TGP and more perceived challenges in communicating about TGP with their AA patients. Focused training for oncologists that addresses barriers specific to AAs may be helpful in supporting improved communication about TGP and improved decisional support for AA patients with cancer considering TGP to evaluate their tumors.
Tumor mutational burden (TMB) is a significant biomarker for predicting immune checkpoint inhibitor response, but the clinical performance of whole-exome sequencing (WES)-based TMB estimation has received less attention compared to panel-based methods. This study aimed to assess the reliability and comparability of WES-based TMB analysis among laboratories under routine testing conditions. A multicenter study was conducted involving 24 laboratories in China using in silico reference data sets. The accuracy and comparability of TMB estimation were evaluated using matched tumor-normal data sets. Factors such as accuracy of variant calls, limit of detection (LOD) of WES test, size of regions of interest (ROIs) used for TMB calculation, and TMB cutoff points were analyzed. The laboratories consistently underestimated the expected TMB scores in matched tumor-normal samples, with only 50% falling within the ±30% TMB interval. Samples with low TMB score (<2.5) received the consensus interpretation. Accuracy of variant calls, LOD of the WES test, ROI, and TMB cutoff points were important factors causing interlaboratory deviations. This study highlights real-world challenges in WES-based TMB analysis that need to be improved and optimized. This research will aid in the selection of more reasonable analytical procedures to minimize potential methodologic biases in estimating TMB in clinical exome sequencing tests. Harmonizing TMB estimation in clinical testing conditions is crucial for accurately evaluating patients' response to immunotherapy.
Tumour-infiltrating lymphocytes (TILs) are crucial for effective immune checkpoint blockade (ICB) therapy in solid tumours. However, ∼70% of these tumours exhibit poor lymphocyte infiltration, rendering ICB therapies less effective. We developed a bioinformatics pipeline integrating multiple previously unconsidered factors or datasets, including tumour cell immune-related pathways, copy number variation (CNV), and single tumour cell sequencing data, as well as tumour mRNA-seq data and patient survival data, to identify targets that can potentially improve T cell infiltration and enhance ICB efficacy. Furthermore, we conducted wet-lab experiments and successfully validated one of the top-identified genes. We applied this pipeline in solid tumours of the Cancer Genome Atlas (TCGA) and identified a set of genes in 18 cancer types that might potentially improve lymphocyte infiltration and ICB efficacy, providing a valuable drug target resource to be further explored. Importantly, we experimentally validated SUN1, which had not been linked to T cell infiltration and ICB therapy previously, but was one of the top-identified gene targets among 3 cancer types based on the pipeline, in a mouse colon cancer syngeneic model. We showed that Sun1 KO could significantly enhance antigen presentation, increase T-cell infiltration, and improve anti-PD1 treatment efficacy. Moreover, with a single-cell multiome analysis, we identified subgene regulatory networks (sub-GRNs) showing Stat proteins play important roles in enhancing the immune-related pathways in Sun1-KO cancer cells. This study not only established a computational pipeline for discovering new gene targets and signalling pathways in cancer cells that block T-cell infiltration, but also provided a gene target pool for further exploration in improving lymphocyte infiltration and ICB efficacy in solid tumours. A full list of funding bodies that contributed to this study can be found in the Acknowledgements section.
Tungiasis, a neglected tropical parasitosis, disproportionately affects children. Few empirical studies have reported neurocognitive and mental health outcomes of children with ectoparasitic skin diseases like tungiasis. Pathophysiology of tungiasis suggests it could detrimentally affect cognition and behaviour. This study pioneered the investigation of neurocognitive and mental health outcomes in children with tungiasis. This was a multi-site cross-sectional study including 454 quasi-randomly sampled school-children aged 8-14 from 48 randomly selected schools in two counties in Kenya and a district in Uganda. The participants were stratified into infected and uninfected based on the presence of tungiasis. The infected were further classified into mild and severe infection groups based on the intensity of the infection. Adapted, validated, and standardized measures of cognition and mental health such as Raven Matrices and Child Behaviour Checklist were used to collect data. Statistical tests including a multilevel, generalized mixed-effects linear models with family link set to identity were used to compare the scores of uninfected and infected children and to identify other potential risk factors for neurocognitive and behavioural outcomes. When adjusted for covariates, mild infection was associated with lower scores in literacy [adjusted β(aβ) = - 8.9; 95% confidence interval (CI) - 17.2, - 0.6], language (aβ = - 1.7; 95% CI - 3.2, - 0.3), cognitive flexibility (aβ = - 6.1; 95% CI - 10.4, - 1.7) and working memory (aβ = - 0.3; 95% CI - 0.6, - 0.1). Severe infection was associated with lower scores in literacy (aβ = - 11.0; 95% CI - 19.3, - 2.8), response inhibition, (aβ = - 2.2; 95% CI - 4.2, - 0.2), fine motor control (aβ = - 0.7; 95% CI - 1.1, - 0.4) and numeracy (aβ = - 3; 95% CI - 5.5, - 0.4). This study provides first evidence that tungiasis is associated with poor neurocognitive functioning in children. Since tungiasis is a chronic disease with frequent reinfections, such negative effects may potentially impair their development and life achievements.
Turnover intention is one of the common disturbances that affect the career development and management of university teachers. With an aim to solve this thorny issue, the study examined the associations between turnover intention and work stress among local undergraduate university teachers in China. A questionnaire survey was carried out on 7,565 local university teachers. Initially, confirmatory factor analysis was employed to validate the reliability and validity of the scale. Subsequently, descriptive statistics and correlation analyses were conducted. Following this, a latent moderated structural equation (LMS) was used to explore the relationship among work stress, job burnout, self-efficacy, and turnover intention. Moreover, the bias-corrected Bootstrap method was applied to further examine the mediating effects, moderating effects, and moderated mediating effects in the model. The hypothesized moderated mediation model was verified significant. Work stress directly and positively predicted job burnout and turnover intention, with job burnout serving a partial mediating role between work stress and turnover intention. Additionally, self-efficacy negatively moderated the direct impact of work stress on job burnout, as well as the mediating effect of job burnout. As the self-efficacy of university teachers increased, the direct effect of work stress on job burnout and the mediating effect of job burnout decreased. This study expanded the research on the antecedent variables of university teachers' turnover intention and revealed the individual contingency mechanism by which work stress affected turnover intention: the negative moderating effect of self-efficacy. Work stress induced university teachers' turnover intention, and this phenomenon was more obvious for faculties with low self-efficacy. Administrators of local undergraduate universities need to rationalize the allocation of teachers' job responsibilities and pay attention to the negative consequences of work stress in order to reduce turnover intentions. Particular attention should be paid to enhance teachers' self-efficacy. The findings of this study can provide in-depth recommendations for university faculty management and policy making, which can help shape a working atmosphere more conducive to teaching and research, thus enhancing the overall quality and competitiveness of faculty members within universities.
TUSDM's Comprehensive Care Department accomplished curriculum change and faculty development by following a process consistent with Tuckman's model of change. The FORMING of three ad-hoc committees was followed by STORMING stage, in which volunteers identified opportunities and needs of 11 courses. In the NORMING stage, committees' findings were categorized into four themes: curriculum restructuring, guideline development, outcomes assessment, and resource needs. The concluding PERFORMING stage involved addition and consolidation of courses, modules, workshops, and guidelines, establishing a faculty calibration plan, and revision of clinical outcomes assessment. A staged, bottom-up approach to implementing curriculum change can lead to outcomes enhancement, concomitant with faculty enrichment.