bluuebunny/crossref_metadata_2025 huggingface dataset:
Concurrent adjacent strabismus surgery with glaucoma drainage device placement in childhood glaucomas
Authors: Jacobson Adam , Bohnsack Brenda L.
Published: January 2024

Background

Determine outcomes of concurrent strabismus surgery with placement of a glaucoma drainage device (GDD) in children.

Methods

Retrospective review of pediatric patients who underwent simultaneous lateral rectus (LR) muscle surgery with superotemporal GDD placement. Strabismus and GDD success were defined as residual horizontal misalignment < 10 prism diopter (PD) and intraocular pressure (IOP) < 21 mmHg, no visually devastating complications, and no additional IOP-lowering surgeries.

Results

Fifteen eyes of 13 patients (69% male) underwent LR surgery (14 recessions, 1 resection) for exotropia or esotropia simultaneous with GDD placement (13 Baerveldt, 2 Ahmed) at 8.34 ± 5.26 years. Preoperative visual acuity (VA) in operative eye (0.89 ± 0.54) was worse than non-operative eye (0.23 ± 0.44, p = 0.0032). Preoperative horizontal deviation was 38.3 ± 9.4 PD and LR recession was 7.4 ± 1.1 mm. At final follow-up, VA in operative eye (0.87 ± 0.52) was unchanged from preoperative (p = 0.4062). Final IOP was significantly decreased (12.4 ± 4.7 mmHg vs. 31.1 ± 11.4 mmHg, p = 0.0001) as was number of glaucoma medications (2.7 ± 1.7 vs. 1.1 ± 1.3, p = 0.0037). Five (38%) and 9 patients (69%) met criteria for strabismus and GDD success, respectively. Two eyes required tube revision and endoscopic cyclophotocoagulation and 2 eyes had additional strabismus surgery.

Conclusions

Concurrent strabismus and GDD surgery decreased horizontal deviation and obtained IOP control. It is important to consider correction of strabismus at time of GDD placement to maximize visual development and improve cosmesis in children with glaucoma.
Experiences and satisfaction of video follow up of children with paediatric gastrointestinal conditions linking tertiary centre with guardians and clinicians at the local hospital: a cross-sectional study
Authors: Kassa Ann-Marie , Nyström Niklas , Waldenvik Kajsa , Engstrand Lilja Helene
Published: January 2024

Background

Children with complicated gastrointestinal conditions are dependent on follow up by tertiary care specialists throughout childhood to prevent and treat complications. In Sweden, paediatric surgical- and intestinal rehabilitation centres are centralised which means that many patients and guardians have to travel long distances to access tertiary referral centres. Our tertiary referral centre has developed a model of shared care with video conferences for follow up with our centre and the patient and guardians attending together with the responsible professionals at the local hospital. This study aimed to investigate the experiences and satisfaction with video follow-up visits (VFV) between a tertiary referral centre and guardians and clinicians at their local hospital.

Methods

Eligible participants were families with children with oesophageal atresia, intestinal failure and intestinal motility disorders and their local clinicians attending VFV with our tertiary referral centre from 2015 to 2020. Questionnaires included fixed-response alternatives, a 6-point Likert scale and open questions.

Results

Fifty-seven out of 102 families (56%) and 19 out of 27 local clinicians (70%) responded the questionnaires. In 68% of the VFV, two guardians attended compared to 35% in the physical visits. Of the guardians attending VFV, 82% lost ≤ half a working day and 91% attending physical visits lost ≥ one full working day. Median distance to the tertiary referral centre was 267 km and attending VFV avoided emissions of 7.2 metric tonnes of CO2. Of the guardians, 90% and of the clinicians 95% were satisfied with VFV. Advantages were avoidance of travelling and the participants shared the same information.

Conclusions

VFV is an appropriate alternative to physical visits with a high grade of satisfaction among the guardians and clinicians. VFV was time-saving for the families and reduced CO2 emissions.
Factors associated with death, hospitalization, resignation, and sick leave from work among patients with schizophrenia in Japan: a nested case–control study using a large claims database
Authors: Inada Ken , Saito Yoshitaka , Baba Kenji , Fukui Daisuke , Masuda Yuriko , Inoue Sachie , Masuda Takahiro
Published: January 2024

Background

Premature mortality, frequent relapse that easily leads to hospitalization, and discontinuous employment are key challenges for the treatment of schizophrenia. We evaluated risk factors for important clinical outcomes (death, hospitalization, resignation, and sick leave from work) in patients with schizophrenia in Japan.

Methods

A nested case–control study was conducted for patients with schizophrenia identified in a Japanese claims database. For each outcome, the case was matched with up to four controls of the same age, sex, index year, and enrollment status (employee or dependent family). Potential risk factors were defined by prescriptions or diagnoses within 3 months prior to or in the month of the event. The association among potential risk factors and each outcome was evaluated using multivariable conditional logistic regression analysis with stepwise variable selection.

Results

The number of cases and eligible patients for each outcome were 144 and 38,451 (death), 1,520 and 35,225 (hospitalization), 811 and 18,770 (resignation), and 4,590 and 18,770 (sick leave), respectively. Depression was a risk factor for death (odds ratio [OR]: 1.92; 95% confidence interval [CI]: 1.12, 3.29), hospitalization (OR: 1.22; 95% CI: 1.05, 1.42), and sick leave from work (OR: 1.46; 95% CI: 1.36, 1.57). Other risk factors for death were hospitalization history, Charlson Comorbidity Index (CCI) score, and prescription for laxatives. Prescriptions for hypnotics, laxatives, and anticholinergics were risk factors for hospitalization. Prescriptions for hypnotics and anticholinergics were risk factors for resignation. CCI score, prescription for hypnotics, laxatives, and antidiabetics were risk factors for sick leave from work.

Conclusions

Our findings suggest that depression and some physical symptoms, such as constipation and extrapyramidal symptoms, are risk factors for important clinical outcomes in patients with schizophrenia. Attention should be paid to both depression and physical symptoms for the treatment of schizophrenia.
Prevalence and associated factors of overweight and obesity among medical students from the Western Balkans (South-East Europe Region)
Authors: Ilić Miloš , Pang Huiwen , Vlaški Tomislav , Grujičić Maja , Novaković Budimka
Published: January 2024

Being overweight and obese is associated with an elevated risk of developing noncommunicable diseases, which are the leading causes of mortality worldwide. It is a warning that global prevalence of overweight among university students ranges from 20 to 40%, which presents a significant public health problem. To date, there was no research conducted on medical students regarding the prevalence and associated factors of overweight and obesity in the countries of the Western Balkans (Slovenia, Croatia, Bosnia and Herzegovina, North Macedonia, and Serbia). The aim of this study was to determine the prevalence and potential demographic, socioeconomic, and health-related behavioral factors associated with overweight and obesity of medical students from Western Balkans. A cross-sectional study was conducted, surveying 2452 students from 14 medical faculties from 5 countries in the region. The prevalence of overweight was 12% and obesity was 2.3% among medical students from Western Balkans. Male gender and smoking status are significant positive predictors of overweight and obesity. Daily level of physical activity up to 1 h per day, going to preventive check-ups once a year or as a part of annual dormitory check-ups are associated with lower odds of being overweight and obese. By creating adequate public health educational programs, students can be influenced to acquire proper health-related lifestyle habits, which would lead to reducing the prevalence of overweight and obesity among the student population, as well as risk of developing noncommunicable diseases and improving the overall health of the population.
Factors predicting the intention of drug abuse avoidance among adolescents in Pinlaung Township, Myanmar: predictive correlational design
Authors: Latt Nang Nwe Nwe , Putdivarnichapong Wimolnun , Phetrasuwan Supapak , Vongsirimas Nopporn
Published: January 2024

Background

Adolescence is a critical transition period and is at high risk for drug/substance abuse. In Myanmar, drug use is common among adolescents and is a public health concern. There are no studies of drug abuse prevention among Myanmar adolescents. Intentions to avoid drug abuse can be a protective factor for preventing drug abuse among adolescents. This study investigated the effects of sex, parental history of drug/alcohol abuse, self-efficacy, parental marital status, and family functioning on the intention of drug abuse avoidance among Myanmar adolescents.

Methods

This is a predictive correlational study. The Biopsychosocial model was used as the theoretical framework of this study. A convenient sampling method was used to collect data from 157 students aged 13–18 years in a government school, middle school level and high school level, Pinlaung Town, Southern Shan State, Myanmar during the COVID-19 pandemic and political protests. G* power software was used to calculate the sample size. Data was collected by four self-administered questionnaires: a socio-demographic questionnaire, Thai Family Functioning Scale (TFFS), General Self-Efficacy Scale (GSE), and Intention of Drug Avoidance Scale (IDAS). Multiple linear regression was employed to analyze the data.

Results

Five predictors, including biological sex, parental history without drug/alcohol abuse, self-efficacy, parental marital status, and family functioning, explained 24.4% of the variance in the intention of drug abuse avoidance among Myanmar adolescents (R2 = .244, F (5,151) = 9.738, p = .000). In addition, only three factors, family functioning (β = .31, p < .001), biological sex (β = -.25, p < .01), and self-efficacy (β = .16, p < .05) statistically and significantly predicted the intention of drug abuse avoidance among Myanmar adolescents.

Conclusions

Family functioning, female gender, and self-efficacy predicted the intention of drug abuse avoidance among Myanmar adolescents in Pinlaung Township, Southern Shan State, Myanmar.

Implications of this study

The results of this study have implications for all stakeholders through research, education, practice, and policymaking leading to improve the intentions of drug abuse avoidance among Myanmar adolescents. Furthermore, the results of this study specifically contribute to create psychoeducational intervention programs for increasing intention to avoid substance use by promoting family functioning and self-efficacy of adolescents. This is especially proper for male adolescents who have less intention to avoid substance use.
Assessing the relationship between nutrition literacy and eating behaviors among nursing students: a cross-sectional study
Authors: Mostafazadeh Pouya , Jafari Mohammad Javad , Mojebi Mohammad Reza , Nemati-Vakilabad Reza , Mirzaei Alireza
Published: January 2024

Background

Eating behavior is an essential aspect of life that can have long-term effects on health outcomes. Nutrition literacy is crucial for better health and well-being. It empowers individuals to make informed decisions about their nutrition and take control of their eating habits.

Objectives

This study aimed to assess the relationship between nutritional literacy and eating behavior among nursing students at the nursing faculties of Ardabil University of medical sciences.

Methods

A cross-sectional correlational study was conducted in Ardabil province, northwest Iran. The study collected data through simple random sampling at nursing schools in Ardabil province, with 224 nursing students participating. The study collected data from a demographic information form, the nutritional literacy self-assessment questionnaire for students (NL-SF12), and the adult eating behavior questionnaire (AEBQ). The data were analyzed using SPSS version 14.0 software.

Results

Based on the results, nutritional literacy explains 44% of the variance in eating behavior and shows significant explanatory power in two sub-scales of eating behavior. The adjusted R2 values for food approach and food avoidance scales were 0.33 and 0.27, respectively.

Conclusion

Given the significant relationship between nutritional literacy and eating behaviors among nursing students, nursing faculty managers and health policymakers should develop new public health strategies to increase nutritional literacy among nursing students.
Evaluation of the relationship between occupational-specific task performance and measures of physical fitness, cardiovascular and musculoskeletal health in firefighters
Authors: Ras Jaron , Soteriades Elpidoforos S. , Smith Denise L. , Kengne Andre P. , Leach Lloyd
Published: January 2024

Introduction

Firefighters are required to perform physically strenuous tasks such as hose drags, victim rescues, forcible entries and stair climbs to complete their public safety mission. Occupational-specific tasks are often used to evaluate the ability of firefighters to adequately/safely perform their duties. Depending on the regions, occupational-specific tasks include six to eight individual tasks, which emphasize distinct aspects of their physical fitness, while also requiring different levels of cardiovascular (CVH) and musculoskeletal health (MSH). Therefore, the aim of this study was to evaluate the relationship between specific occupational task performance and measures of physical fitness, cardiovascular and musculoskeletal health.

Methods

Using a cross-sectional design, 282 full-time male and female firefighters were recruited. A researcher-generated questionnaire and physical measures were used to collect data on sociodemographic characteristics, CVH, MSH and weekly physical activity habits. Physical measures were used to collect data on physical fitness and occupational-specific task performance.

Results

Absolute cardiorespiratory fitness (abV̇O2max), grip strength, leg strength, push-ups, sit-ups and lean body mass (allp < 0.001) had an inverse association with completion times on all occupational-specific tasks. Age was positively related to the performance of all tasks (allp < 0.05). Higher heart rate variability (HRV) was associated with better performance on all tasks (allp < 0.05). Bodyfat percentage (BF%) and diastolic blood pressure were positively associated with the step-up task (p < 0.05). Lower back musculoskeletal injury (LoBMSI), musculoskeletal discomfort (MSD), and lower limb MSD were associated with a decreased odds of passing the step-up. Upper body MSIs (UBMSI), LoBMSIs and Lower back MSD were associated with decreased odds of passing the rescue drag.

Conclusion

Firefighters that were taller, leaner, stronger and fitter with a more favourable CVH profile, higher HRV and less musculoskeletal discomfort performed best on all occupational-specific tasks.
A chemical accident cause text mining method based on improved accident triangle
Authors: Li Zheng , Yao Min , Luo Zhenmin , Wang Xinping , Liu Tongshuang , Huang Qianrui , Su Chang
Published: January 2024

Background

With the rapid development of China’s chemical industry, although researchers have developed many methods in the field of chemical safety, the situation of chemical safety in China is still not optimistic. How to prevent accidents has always been the focus of scholars’ attention.

Methods

Based on the characteristics of chemical enterprises and the Heinrich accident triangle, this paper developed the organizational-level accident triangle, which divides accidents into group-level, unit-level, and workshop-level accidents. Based on 484 accident records of a large chemical enterprise in China, the Spearman correlation coefficient was used to analyze the rationality of accident classification and the occurrence rules of accidents at different levels. In addition, this paper used TF-IDF and K-means algorithms to extract keywords and perform text clustering analysis for accidents at different levels based on accident classification. The risk factors of each accident cluster were further analyzed, and improvement measures were proposed for the sample enterprises.

Results

The results show that reducing unit-level accidents can prevent group-level accidents. The accidents of the sample enterprises are mainly personal injury accidents, production accidents, environmental pollution accidents, and quality accidents. The leading causes of personal injury accidents are employees’ unsafe behaviors, such as poor safety awareness, non-standard operation, illegal operation, untimely communication, etc. The leading causes of production accidents, environmental pollution accidents, and quality accidents include the unsafe state of materials, such as equipment damage, pipeline leakage, short-circuiting, excessive fluctuation of process parameters, etc.

Conclusion

Compared with the traditional accident classification method, the accident triangle proposed in this paper based on the organizational level dramatically reduces the differences between accidents, helps enterprises quickly identify risk factors, and prevents accidents. This method can effectively prevent accidents and provide helpful guidance for the safety management of chemical enterprises.
Modifiable lifestyle, mental health status and diabetic retinopathy in U.S. adults aged 18–64 years with diabetes: a population-based cross-sectional study from NHANES 1999–2018
Authors: Li Bo , Zhou Chuandi , Gu Chufeng , Cheng Xiaoyun , Wang Yujie , Li Chenxin , Ma Mingming , Fan Ying , Xu Xun , Chen Haibing , Zheng Zhi
Published: January 2024

Background

The relationship between integrated lifestyles, mental status and their impact on overall well-being has attracted considerable attention. This study aimed to evaluate the association between lifestyle factors, depression and diabetic retinopathy (DR) in adults aged 18–64 years.

Methods

A cohort of 3482 participants diagnosed with diabetes was drawn from the National Health and Nutrition Examination Survey (NHANES) spanning the years 1999–2018. DR was defined based on self-reported diabetic retinopathy diagnoses by professional physicians, relying on Diabetes Interview Questionnaires. Subgroup analysis was employed to assess lifestyle and psychological factors between participants with DR and those without, both overall and stratified by diabetic duration. Continuous variables were analyzed using the student’s t test, while weighted Rao-Scott χ2 test were employed for categorical variables to compare characteristics among the groups.

Results

Of the 3482 participants, 767 were diagnosed with diabetic retinopathy, yielding a weighted DR prevalence of 20.8%. Patients with DR exhibited a higher prevalence of heavy drinking, depression, sleep deprivation, and insufficient physical activity compared to those without DR. Furthermore, multivariable logistic regression analysis revealed that sleeping less than 5 h (OR = 3.18, 95%CI: 2.04–4.95, p < 0.001) and depression (OR = 1.35, 95%CI:1.06–1.64, p = 0.025) were associated with a higher risk of DR, while moderate drinking (OR = 0.49, 95%CI: 0.32–0.75, p = 0.001) and greater physical activity (OR = 0.64, 95%CI: 0.35–0.92, p = 0.044) were identified as protective factors.

Conclusions

Adults aged 18–64 years with DR exhibited a higher prevalence of lifestyle-related risk factors and poorer mental health. These findings underscore the need for concerted efforts to promote healthy lifestyles and positive emotional well-being in this population.
Continuity of primary care for type 2 diabetes and hypertension and its association with health outcomes and disease control: insights from Central Vietnam
Authors: Le Ho Thi Quynh-Anh , Pype Peter , Wens Johan , Nguyen Vu Quoc Huy , Derese Anselme , Peersman Wim , Bui Nhon , Nguyen Thi Thanh Huyen , Nguyen Minh Tam
Published: January 2024

Background

Vietnam is undergoing a rapid epidemiological transition with a considerable burden of non-communicable diseases (NCDs), especially hypertension and diabetes (T2DM). Continuity of care (COC) is widely acknowledged as a benchmark for an efficient health system. This study aimed to determine the COC level for hypertension and T2DM within and across care levels and to investigate its associations with health outcomes and disease control.

Methods

A cross-sectional study was conducted on 602 people with T2DM and/or hypertension managed in primary care settings. We utilized both the Nijmegen continuity of care questionnaire (NCQ) and the Bice - Boxerman continuity of care index (COCI) to comprehensively measure three domains of COC: interpersonal, informational, and management continuity. ANOVA, paired-sample t-test, and bivariate and multivariable logistic regression analysis were performed to examine the predictors of COC.

Results

Mean values of COC indices were: NCQ: 3.59 and COCI: 0.77. The proportion of people with low NCQ levels was 68.8%, and that with low COCI levels was 47.3%. Primary care offered higher informational continuity than specialists (p < 0.01); management continuity was higher within the primary care team than between primary and specialist care (p < 0.001). Gender, living areas, hospital admission and emergency department encounters, frequency of health visits, disease duration, blood pressure and blood glucose levels, and disease control were demonstrated to be statistically associated with higher levels of COC.

Conclusions

Continuity of primary care is not sufficiently achieved for hypertension and diabetes mellitus in Vietnam. Strengthening robust primary care services, improving the collaboration between healthcare providers through multidisciplinary team-based care and integrated care approach, and promoting patient education programs and shared decision-making interventions are priorities to improve COC for chronic care.
A comparison between antibiotic utilisation in public and private community healthcare in Malaysia
Authors: Lim Audrey Huili , Ab Rahman Norazida , Nasarudin Siti Nur Su’aidah , Velvanathan Tineshwaran , Fong Mary Chok Chiew , Mohamad Yahaya Abdul Haniff , Sivasampu Sheamini
Published: January 2024

Background

There are two parallel systems in Malaysian primary healthcare services: government funded public primary care and privately-owned practices. While there have been several studies evaluating antibiotic utilisation in Malaysian public healthcare, there is a lack of literature on the use of antibiotics in the private sector. There is a dire need to evaluate the more recent performance of public vs. private community healthcare in Malaysia. As such, this study aimed at measuring and comparing the utilisation of antibiotics in the public and private community healthcare sectors of Malaysia in 2018–2021.

Methods

This study was a retrospective analysis of antibiotic utilisation in Malaysian primary care for the period of 1 January 2018 until 31 December 2021 using the nationwide pharmaceutical procurement and sales data from public and private health sectors. Rates of antibiotic utilisation were reported as Defined Daily Doses per 1000 inhabitants per day (DID) and stratified by antibiotic classes. The secondary analysis included proportions of AWaRe antibiotic category use for each sector and proportion of antibiotic utilisation for both sectors.

Results

The overall national antibiotic utilisation for 2018 was 6.14 DID, increasing slightly to 6.56 DID in 2019, before decreasing to 4.54 DID in 2020 and 4.17 DID in 2021. Private primary care antibiotic utilisation was almost ten times higher than in public primary care in 2021. The public sector had fewer (four) antibiotic molecules constituting 90% of the total antibiotic utilisation as compared to the private sector (eight). Use of Access antibiotics in the public sector was consistently above 90%, while use of Access category antibiotics by the private sector ranged from 64.2 to 68.3%. Although use of Watch antibiotics in the private sector decreased over the years, the use of Reserve and ‘Not Recommended’ antibiotics increased slightly over the years.

Conclusion

Antibiotic consumption in the private community healthcare sector in Malaysia is much higher than in the public sector. These findings highlight the need for more rigorous interventions targeting both private prescribers and the public with improvement strategies focusing on reducing inappropriate and unnecessary prescribing.
Construction and evaluation of neonatal respiratory failure risk prediction model for neonatal respiratory distress syndrome
Authors: Lei Yupeng , Qiu Xia , Zhou Ruixi
Published: January 2024

Background

Neonatal respiratory distress syndrome (NRDS) is a common respiratory disease in preterm infants, often accompanied by respiratory failure. The aim of this study was to establish and validate a nomogram model for predicting the probability of respiratory failure in NRDS patients.

Methods

Patients diagnosed with NRDS were extracted from the MIMIC-iv database. The patients were randomly assigned to a training and a validation cohort. Univariate and stepwise Cox regression analyses were used to determine the prognostic factors of NRDS. A nomogram containing these factors was established to predict the incidence of respiratory failure in NRDS patients. The area under the receiver operating characteristic curve (AUC), receiver operating characteristic curve (ROC), calibration curves and decision curve analysis were used to determine the effectiveness of this model.

Results

The study included 2,705 patients with NRDS. Univariate and multivariate stepwise Cox regression analysis showed that the independent risk factors for respiratory failure in NRDS patients were gestational age, pH, partial pressure of oxygen (PO2), partial pressure of carbon dioxide (PCO2), hemoglobin, blood culture, infection, neonatal intracranial hemorrhage, Pulmonary surfactant (PS), parenteral nutrition and respiratory support. Then, the nomogram was constructed and verified.

Conclusions

This study identified the independent risk factors of respiratory failure in NRDS patients and used them to construct and evaluate respiratory failure risk prediction model for NRDS. The present findings provide clinicians with the judgment of patients with respiratory failure in NRDS and help clinicians to identify and intervene in the early stage.
Association of serum vitamin C levels with Asthma in adults: results of NHANES 2003–2006 and mendelian randomization study
Authors: Wang Kang , Zhao Lintao , Luo Hu , Deng Caixia , Gong Liang , Chen Zhujun
Published: January 2024

Background

The protective effect of vitamin C as an antioxidant against asthma in adults remains controversial. This study used an observational study and Mendelian randomization (MR) analysis to investigate the association between adult asthma and serum vitamin C levels.

Methods

Using information from the National Health and Nutrition Examination Survey (NHANES) 2003–2006, we carried out an observational study. A multivariate logistic regression model was employed to examine the connection between adult asthma and serum vitamin C levels. We used the inverse-variance weighted (IVW) method of MR analysis as the primary method to analyze the causal effect of serum vitamin C levels on asthma in adults.

Results

A total of 8,504 participants were included in the observational study, including 639 in the asthma group and 7,865 in the non-asthma group. Before sample weighting, serum vitamin C was associated with a reduced risk of asthma in adults (OR = 0.798, 95% CI: 0.673–0.945, P = 0.009). After sample weighting, serum vitamin C was not associated with adult asthma risk (OR = 0.829, 95% CI: 0.660 ~ 1.042, P = 0.104). MR analysis showed no causal relationship between serum vitamin C and adult asthma in either the UK Biobank (OR = 0.957, 95% CI: 0.871 ~ 1.053, P = 0.370) or FinnGen (OR = 0.973, 95% CI: 0.824 ~ 1.149, P = 0.750) cohorts.

Conclusion

Our study did not support a causal association between serum vitamin C levels and adult asthma risk. The relationship between serum vitamin C and adult asthma requires further research.
Understanding the effects of Haemophilus influenzae colonization on bronchiectasis: a retrospective cohort study
Authors: Yang Seo-Hee , Song Myung Jin , Kim Yeon Wook , Kwon Byoung Soo , Lim Sung Yoon , Lee Yeon-Joo , Park Jong Sun , Cho Young-Jae , Lee Jae Ho , Lee Choon-Taek , Kim Hyung-Jun
Published: January 2024

Background

Bacterial colonization is an essential aspect of bronchiectasis. Although Haemophilus influenzae is a frequent colonizer in some regions, its clinical impacts are poorly understood. This study aimed to elucidate the impact of H. influenzae colonization in patients with bronchiectasis.

Methods

This retrospective study screened adult patients diagnosed with bronchiectasis at a tertiary referral center between April 1, 2003, and May 16, 2021, in South Korea. Propensity score matching was used to match patients with and without H. influenzae colonization. We assessed the severity of bronchiectasis as per the bronchiectasis severity index, the incidence of exacerbation, differences in lung function, and all-cause mortality.

Results

Out of the 4,500 patients with bronchiectasis, 79 (1.8%) were colonized by H. influenzae. After 1:2 propensity score matching, 78 and 154 patients were selected from the H. influenzae colonizer and non-colonizer groups, respectively. Although there were no significant differences between the groups regarding baseline demographics, patients colonized with H. influenzae had a higher bronchiectasis severity index (median 6 [interquartile range 4–8] vs. 4 [2–7], p = 0.002), associated with extensive radiographic involvement (52.2% vs. 37.2%, p = 0.045) and mild exacerbation without hospitalization (adjusted incidence rate ratio 0.15; 95% confidence interval 0.12–0.24). Lung function and mortality rates did not reveal significant differences, regardless of H. influenzae colonization.

Conclusion

H. influenzae colonization in bronchiectasis was associated with more severe disease and greater incidence of mild exacerbation, but not lung function and mortality. Attention should be paid to patients with bronchiectasis with H. influenzae colonization.
Effectiveness and safety of awake prone positioning in COVID-19-related acute hypoxaemic respiratory failure: an overview of systematic reviews
Authors: Li Ya , Zhao Guixiang , Ma Yizhao , Wang Lu , Liu Ying , Zhang Hailong
Published: January 2024

Objective

To evaluate and summarize systematic reviews of the effects and safety of awake prone positioning for COVID-19-related acute hypoxaemic respiratory failure.

Methods

A comprehensive search was conducted on PubMed, Embase, the Cochrane Library, Web of Science, CNKI, CSPD, CCD and CBM from their inception to March 28, 2023. Systematic reviews (SRs) of awake prone positioning (APP) for COVID-19-related acute hypoxaemic respiratory failure in adults were included. Two reviewers screened the eligible articles, and four reviewers in pairs extracted data and assessed the methodological quality/certainty of the evidence of all included SRs by AMSTAR 2 and GRADE tools. The overlap of primary studies was measured by calculating corrected covered areas. Data from the included reviews were synthesized with a narrative description.

Results

A total of 11 SRs were included. The methodological quality of SRs included 1 “High”, 4 “Moderate”, 2 “Low” and 4 “Critically low” by AMSTAR 2. With the GRADE system, no high-quality evidence was found, and only 14 outcomes provided moderate-quality evidence. Data synthesis of the included SR outcomes showed that APP reduced the risk of requiring intubation (11 SRs) and improving oxygenation (3 SRs), whereas reduced significant mortality was not found in RCT-based SRs. No significant difference was observed in the incidence of adverse events between groups (8 SRs). The corrected covered area index was 27%, which shows very high overlap among studies.

Conclusion

The available SRs suggest that APP has benefits in terms of reducing intubation rates and improving oxygenation for COVID-19-related acute hypoxemic respiratory failure, without an increased risk of adverse events. The conclusion should be treated with caution because of the generally low quality of methodology and evidence.

Trial registration

The protocol for this review was registered with PROSPERO: CRD42023400986. Registered 15 April 2023.
Outcome of reverse shoulder arthroplasty secondary to rotator cuff arthropathy in a low-income population
Authors: Silva Christine M. M. , Teixeira Gisele Façanha Diógenes , de Brito Gabriella Cristina Coelho , Lacerda Marco A. A. , Rocha Francisco A. C.
Published: January 2024

Background

Reverse shoulder arthroplasty (RSA) is a valuable treatment for rotator cuff arthropathy (RCA) in developed regions. Socioeconomic issues impact access to specialized care and there is a lack of data on RSA outcomes in developing regions. We present our 24-month follow-up on RSA surgeries to treat RCA in our low-income population.

Methods

Prospective evaluation of 26 patients subjected to RSA at Hospital Geral de Fortaleza-CE, Brazil, between January 2018 and December 2020. Literacy [>/≤ 8 school years(SY)] and income were documented. Outcomes considered pain (visual analogue scale; VAS) as well as SSV, SPADI, ASES, and UCLA scoring, and range of motion [forward flexion (FF); external rotation (ER)].

Results

Patients were 68.5 ± 7.6 years-old with 16(61.5%) females; 65% had hypertension and 7 (26.9%) had diabetes. Over 90% declared < 900.00 US$ monthly family earnings and 10 (38.4%) patients declared ≤8 SY with > 80% exerting blue-collar jobs. Pain showed a significant reduction from baseline (8 ± 2) to 24 months (2.1 ± 2.3; p < 0.001). UCLA (10.3 ± 5.6 and 28.6 ± 7.2), ASES (16.7 ± 10.8 and 63.1 ± 28.4), SSV (326 ± 311 and 760 ± 234), and SPADI (98.3 ± 26.5) scores significantly improved from baseline to 24 months, achieving minimal clinically important difference. FF (89.2° ± 51.2° to 140.6 ± 38.3°) and ER (19.2° ± 22.5 to 33.4° ± 20.6°) significantly improved from baseline to 24 months (p = 0.004 and 0.027, respectively). There were 5 non-serious adverse events with one surgical revision. All patients returned to daily life activities.

Conclusion

This is the first outcome report 2 years following RSA in a low-income population. Data indicate this procedure is justifiable regardless of socioeconomic issues.
Lipid variability and risk of microvascular complications in patients with diabetes: a systematic review and meta-analysis
Authors: Karimi Mohammad Amin , Vaezi Ali , Ansari Akram , Archin Iman , Dadgar Kiarash , Rasouli Asma , Ghannadikhosh Parna , Alishiri Goharsharieh , Tizro Neda , Gharei Fatemeh , Imanparvar Saba , Salehi Sakineh , Mazhari Seyed Amirhossein , Etemadi Mohammad Hossein , Alipour Milad , Deravi Niloofar , Naziri Mahdyieh
Published: January 2024

Background and aims

The current systematic review aimed to elucidate the effects of lipid variability on microvascular complication risk in diabetic patients. The lipid components studied were as follows: High-density lipoprotein (HDL), High-density lipoprotein (LDL), Triglyceride (TG), Total Cholesterol (TC), and Remnant Cholesterol (RC).

Method

We carried out a systematic search in multiple databases, including PubMed, Web of Science, and SCOPUS, up to October 2nd, 2023. After omitting the duplicates, we screened the title and abstract of the studies. Next, we retrieved and reviewed the full text of the remaining articles and included the ones that met our inclusion criteria in the study.

Result

In this research, we examined seven studies, comprising six cohort studies and one cross-sectional study. This research was conducted in Hong Kong, China, Japan, Taiwan, Finland, and Italy. The publication years of these articles ranged from 2012 to 2022, and the duration of each study ranged from 5 to 14.3 years. The study group consisted of patients with type 2 diabetes aged between 45 and 84 years, with a diabetes history of 7 to 12 years. These studies have demonstrated that higher levels of LDL, HDL, and TG variability can have adverse effects on microvascular complications, especially nephropathy and neuropathic complications. TG and LDL variability were associated with the development of albuminuria and GFR decline.

Additionally, reducing HDL levels showed a protective effect against microalbuminuria. However, other studies did not reveal an apparent relationship between lipid variations and microvascular complications, such as retinopathy. Current research lacks geographic and demographic diversity. Increased HDL, TG, and RC variability have been associated with several microvascular difficulties. Still, the pathogenic mechanism is not entirely known, and understanding how lipid variability affects microvascular disorders may lead to novel treatments. Furthermore, the current body of this research is restricted in its coverage. This field's lack of thorough investigations required a more extensive study and comprehensive effort.

Conclusion

The relationship between lipid variation (LDL, HDL, and TG) (adverse effects) on microvascular complications, especially nephropathy and neuropathic (and maybe not retinopathy), is proven. Physicians and health policymakers should be highly vigilant to lipid variation in a general population.
Opinions of professors, dental students, and patients for publishing the patient images in the articles
Authors: Rowshani Ava , Hashemipour Maryam Alsadat
Published: January 2024

Introduction

The journals must have an instruction for writers to observe the essential ethical principles like privacy-preserving, secrecy, and keeping the patients’ identities hidden. Even though patient secrecy is an important ideology in medicine’s ethics, most journals have a little guide on this topic for the authors. According to the absence of such studies in dentistry and limited studies in medicine, our goal in this article is to review the opinions of professors, Kerman dentistry students, and patients for publishing the patient images in the articles.

Method

This research is an analytical, sectional, and descriptive study. The studied society includes the professors of the dentistry faculty (54 people), the 4th to 6th years dentistry students (122 people), and 129 patients who referred to the offices, the faculty, and other clinics in Kerman city base on simple random sampling method. A query including the personal questions, and questions related to the participants’ opinions about publishing the images was given to contributors. Abundance, average tables, chi-square (χ 2) test, T-test, and SPSS 21 software were used for data description.

Results

The contributors’ attitudes were different in three groups of participants: more than half of the patients (58.91%), 39.5% of students, and 31.38% of professors believed that no permission is needed. While, 64.34% of the patients, 89.34% of students, and 83.3% of professors believed that written permission is needed for publishing.

Conclusion

From the participants’ viewpoints, more strict forms are needed by increasing identity recognizability. The professors are more eager than the patients to receive patients’ permission for any kind of image. By reducing the level of identification, doctors and students are more eager than patients to receive approvals.
Quality of life and its predictors among patients with metastatic cancer in Bangladesh: the APPROACH survey
Authors: Rahman Rubayat , Mariam Lubna , Su Rebecca , Malhotra Chetna , Ozdemir Semra
Published: January 2024

Background

This study aimed to assess the health-related quality of life (HRQOL) (physical, functional, emotional, social, spiritual) and psychological (anxiety and depression) well-being and their associations with patient characteristics among patients with metastatic cancer in Bangladesh.

Methods

A convenience sample of 386 Bangladeshi patients with stage IV solid cancers was recruited from a palliative care outpatient department and an inpatient palliative center. Dependent variables included the physical, functional, emotional, social, and overall scores of the Functional Assessment of Cancer Therapy-General (FACT-G) scale, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-SP) scale, the anxiety, depression, and overall scores of the Hospital Anxiety and Depression (HADS) scale. Linear regressions examined the association between dependent variables and patient characteristics.

Results

A substantial proportion of Bangladeshi patients reported anxiety (59% of outpatients and 55% of inpatients) and depression (60% of outpatients and 73% of inpatients) symptoms. Generally, greater financial difficulty and symptom burden scores were associated with worse health outcomes. Older patients reported poorer functional and spiritual well-being but better anxiety scores. Females reported worse anxiety and depressive symptoms and physical well-being but better spiritual outcomes.

Conclusions

Additional efforts must be directed at improving the HRQOL of patients with metastatic cancer in Bangladesh. Furthermore, assistance should be made more accessible to vulnerable groups, including women, the elderly, and those with financial difficulty.
Factors influencing the uptake and utilization of cervical cancer screening services among women attending public health centers in Addis Ababa, Ethiopia: mixed methods study
Authors: Hussein Kemal , Kokwaro Gilbert , Wafula Francis , Kassie Getnet Mitike
Published: January 2024

Background

Cervical cancer is the second cause of cancer deaths among Ethiopian women. Despite multifaceted government efforts, the uptake and utilization of cervical cancer screening remain very low. This study aimed to assess factors influencing the uptake and utilization of cervical cancer screening at public health centers in Addis Ababa.

Methods

A convergent parallel mixed-method study was employed to collect data through eight focus group discussions with 66 women purposively recruited from outpatient clinics, and cross-sectional face-to-face exit interviews with 80 women attending cervical cancer clinics in four high-patient volume health centers. The group interviews were tape-recorded, transcribed in Amharic, translated into English, and a thematic analysis approach was used in the analysis. Exit interview data were collected using a structured questionnaire in the Open Data Kit tool on an android tablet. STATA version 17 was used for descriptive and inferential data analyses. Statistical significance was set at p < 0.05.

Results

The majority of focus group discussion participants had lack of knowledge of cervical cancer and its screening services. The major barriers to the uptake of screening were inadequate public awareness, fear of the procedure, embarrassment, provider’s gender, lack of male partner support, and childcare. Women aged 40 years and above were 13.9 times more likely to utilize cervical cancer screening than those under 30 years (AOR = 13.85; 95% CI: 1.40, 136.74). There was a strong preference for a female provider (AOR = 7.07; 95% CI: 1.53, 32.75) among women screened after attending antiretroviral therapy clinics and those screened due to abnormal vaginal bleeding than women referred from family planning clinics (AOR = 6.87; 95% CI: 1.02, 46.44). Safety of screening was negatively associated with women aged 30–39 (AOR = 0.045; 95% CI: 0.003, 0.696), and those who attended primary education, and secondary education and above, (AOR = 0.016; 95% CI: 0.001, 0.262), and (AOR = 0.054; 95% CI: 0.004, 0.724), respectively.

Conclusions

The study identified low public awareness, inadequate provider preference, safety concerns, and poor male partner support for cervical cancer screening. We recommend the decision-makers enhance public messages, maintain provider choices, ensure safety, and engage males to improve the uptake and utilization of cervical cancer screening.
Impact of the practice of touch-massage® by a nurse on the anxiety of patients with hematological disorders hospitalized in a sterile environment, a randomized, controlled study
Authors: Simon Armelle , Nizard Jean-Julien , Chevalier Patrice , Le Gouill Steven , Rulleau Thomas , Planche Lucie , Evin Adrien
Published: January 2024

Context

In addition to curative care, supportive care is beneficial in managing the anxiety symptoms common in patients in sterile hematology unit. We hypothesize that personal massage can help the patient, particularly in this isolated setting where physical contact is extremely limited. The main objective of this study was to show that anxiety could be reduced after a touch-massage® performed by a nurse trained in this therapy.

Methods

A single-center, randomized, unblinded controlled study in the sterile hematology unit of a French university hospital, validated by an ethics committee. The patients, aged between 18 and 65 years old, and suffering from a serious and progressive hematological pathology, were hospitalized in sterile hematology unit for a minimum of three weeks, patients were randomized into either a group receiving 15-minute touch-massage® sessions or a control group receiving an equivalent amount of quiet time once a week for three weeks. In the treated group, anxiety was assessed before and after each touch-massage® session, using the State-Trait Anxiety Inventory questionnaire with subscale state (STAI-State). In the control group, anxiety was assessed before and after a 15-minute quiet period. For each patient, the difference in the STAI-State score before and after each session (or period) was calculated, the primary endpoint was based on the average of these three differences. Each patient completed the Rosenberg Self-Esteem Questionnaire before the first session and after the last session.

Results

Sixty-two patients were randomized. Touch-massage® significantly decreased patient anxiety: a mean decrease in STAI-State scale score of 10.6 [7.65–13.54] was obtained for the massage group (p ≤ 0.001) compared with the control group. The improvement in self-esteem score was not significant.

Conclusion

This study provides convincing evidence for integrating touch-massage® in the treatment of patients in sterile hematology unit.

Trial registration

NCT02343965.