Collection Of Demographic Data Research Articles

Elaboración de una escala de puntuación predictiva de infección periamigdalina basada en signos y síntomas

BackgroundPeritonsillar infection (PTI) is a reason for urgent consultation due to intense throat discomfort. A delayed or inaccurate diagnosis can jeopardize the upper aerodigestive tract and be fatal in its evolution. Our objective was to develop a predictive model for the presence of IPA helping in its rapid detection. Patients and methodsA 66-month retrospective observational study from 2017 was carried out in a county and tertiary referral hospitals, registering data from all patients diagnosed with PTI and a proportional volume of subjects with pharyngeal symptoms without PTI. Collection of clinical, exploratory and demographic data among participants. Their higher relative risk of PTI presence allowed them to be considered as variables to be tested. Development of a scoring scale for the probability of suffering from it and logistic regression analysis, obtaining the ROC curve with the best diagnostic correlation. Internal validation and estimation of the predictive values of the model. ResultsOn 348 cases of PTI, the assessment scale scored the presence of six variables: trismus (3), unilateral dysphagia-odynophagia (2), velar bulging (2), reflex otalgia (1), pharyngolalia (1) and age between 16 and 46 years (1). With a range of 0-10, a cut-off ≥6 offered a sensitivity of 96.1%, a specificity of 93.9%, and an efficiency of 94.9%. The area under the ROC curve was 0.979. ConclusionsThe internal validation of this model based on signs and symptoms makes it a very useful tool for early detection of PTI in otorhinolaryngology and primary care.

Changes in Running Kinematics and Kinetics Following a 10 km Run.

Little is known about changes in kinetics or kinematics following a 10 km training run. This information has implications on risk of running-related injury. The purpose of this study was to examine the effect of a 10 km run on running kinematics and kinetics in a sample of experienced runners. Cross-Sectional Study. Nineteen runners ages 18-48 (7 female, 12 male) consented to participate including eight (3 female, 5 male) ultra-runners, and 11 (4 female, 7 male) recreational runners. Following collection of demographic data and completion of a short running survey, participants did a 6-minute run at their self-selected running speed to acclimate to the instrumented treadmill. Reflective markers were placed over designated anatomical landmarks on both sides of the pelvis as well as the left lower extremity and marked with a skin pen. Subjects then ran on the treadmill and 30 seconds of video data were recorded at 240 frames/sec using a high-speed camera for the sagittal plane and the frontal plane. Simultaneously, ground reaction forces (GRFs) were recorded at 1200 Hz through the treadmill's embedded force plates. Each runner then ran 10 km on a paved trail at their self-selected pace. Immediately following the run, reflective markers were reattached, guided by markings placed before the run, and a 30-second post-run trial of the video and GRF data were recorded. Video data were analyzed using Kinovea software to measure the kinematic variables of interest. Paired t-tests with Bonferroni corrections were used to find if significant differences existed between pre- and post-run data for all kinematic and kinetic variables. No significant or clinically relevant differences existed between the pre- and post-run measurements for the kinematic or kinetic variables. The only significant difference noted between the ultra-runners and recreational runners was that the ultra-runners had significantly higher cadence (p=0.045). A 10 km run at a self-selected pace did not result in change in the mean kinematic or kinetic variables in this group of experienced runners. Ultra-runners employ higher cadence than recreational runners, but their kinematics and kinetics are similar. Level 3.

Effects of the Family Empowerment Program on Medication Adherence and Treatment Success Among Adults with Pulmonary Tuberculosis: A Randomized Controlled Trial

Unsuccessful treatment of pulmonary tuberculosis results from medication non-adherence. Family is a significant source of support for adults with pulmonary tuberculosis but has limited ability to continuously support in the first six months of treatments. This randomized controlled trial, a two-arm post-test-only design was utilized to investigate the effects of the family empowerment program on medication adherence and treatment success among adults with pulmonary tuberculosis. The sample comprised 64 family members caring for newly diagnosed adults with pulmonary tuberculosis who visited a tuberculosis clinic of a university hospital in central Thailand. The participants were assigned randomly to either the experimental arm (n = 32) to receive the program or the control arm (n = 32) to receive only usual care. Data were collected using the Demographic and Pulmonary Tuberculosis-related Characteristic Data Collection Form, Family Member’s Demographic Characteristic Data Collection Form, Tuberculosis Medication Adherence Scale, and criteria to identify tuberculosis treatment success of the World Health Organization. Data were analyzed using descriptive statistics, Pearson’s chi-square, Fisher’s Exact, and McNemar tests. The results showed that the experimental arm had significantly higher medication adherence at the 3rd and 19th weeks after the program ended than the control arm. The experimental arm had a significantly higher treatment success rate at the 19th week thanthe control arm. The family empowerment program was effective in improving medication adherence and treatment success. Nurses need to be trained to empower family members in providing continuous support for adults with pulmonary tuberculosis. To fully assess the program’s effectiveness, additional research is required to investigate its performance in different contexts and with various samples.

Medial meniscal repair in stable knees: Survival rate and risk factors for failure at a minimum of 5 years

IntroductionThe menisci play a major role in the protection of the knee against osteoarthritis. A medial meniscus (MM) tear occurring in a stable knee is more at risk of repair failure than a suture concomitant with reconstruction of the anterior cruciate ligament. HypothesisThe survival of MM sutures in stable knees depends on the type of lesion. Materials and methodsThis retrospective study was carried out as part of the 2022 Francophone Arthroscopy Society's symposium, across 10 centers (Bordeaux-Mérignac, Caen, Lille, Lille Louvière, Lyon, Marseille, Toulouse, Saint-Étienne, Strasbourg and Versailles) including medial meniscus sutures in stable knees performed before the end of 2017 (minimum 5 years of follow-up) with a collection of demographic, imaging, suture and postoperative protocol data, and a functional evaluation using the Knee injury and Osteoarthritis Outcome score (KOOS). The aim of this study was to analyze the medial meniscus sutures in stable knees and to evaluate their survival and their risk factors for failure according to the type of lesion; failure being defined by the use of a meniscectomy. ResultsThree-hundred and sixty-seven MM sutures, including 122 bucket-handle tears, were included. The KOOS score was improved by the meniscal suture by an average of 22.2 points for each sub-score (p<0.05), with an improvement, which was more marked for the bucket-handle tears. The failure rate, defined by revision surgery by meniscectomy, was 33% on average (42% for bucket-handles tears, 26% for others). The probability of survival was reduced for bucket-handle tears (62% at 5 years versus 77% for the other types). For all lesions, the main risk factor identified for failure was immediate weight-bearing [OR=3.6 (1.62; 7.98), p=0.0016]. Smoking was a failure risk factor for bucket-handle tears [OR=5.76 (1.81; 18.35), p=0.003]. ConclusionMM sutures in stable knees improve knee function but present a different risk of failure depending on the type of lesion treated with a higher risk of failure for bucket-handle tears with the need for caution to be applied with regards to weight-bearing and smoking. Level of evidenceIV; retrospective series.

Psychometric Properties of the Turkish Validity and Reliability of the Parent Diabetes Distress Scale

The aim of this study was to evaluate the validity and reliability of the Turkish translation of the Parent Diabetes Distress Scale (PDDS). The PDDS is a 5-point Likert-type scale with 20 items. After obtaining permission from the scale developers, the study commenced. First, a systematic adaptation of the scale into the Turkish language was performed including translation, expert panel review, back translation, and pilot study. Test-retest was applied to 35 participants. After these procedures, data collection was undertaken using the adapted PDDS and a demographic data collection form. The collected data were analyzed for reliability, including stability of the scale with test-retest and internal consistency of the scale (Cronbach’s α), and validity including construct validity of the scale with confirmatory factor analysis (CFA). The parents of 210 teenagers, aged >11 and <18 years, who had been diagnosed with type 1 diabetes mellitus for at least one year were included. Of these parents, 71.9% (n=151) were mothers and 53.3% (n=112) of the children were girls. The Cronbach’s α value was 0.906. The results of the CFA were χ2/df=4.406, p<0.001, comparative fit test 0.704, and goodness of fit tests 0.749. The mean total PDDS score was 2.2±0.7. These results indicate that scores of 1.6 points or less was evaluated as “little or no distress” 1.7-2.4 as “moderate distress,” and >2.4 points as “high distress”. This showed that the majority of the parents in the study experienced moderate or severe diabetes-related distress. The Turkish version of the PDDS fulfilled the validity and reliability tests at an acceptable level.

Diversity data in oncology electronic data capture and database design: A global overview, gap analysis and recommendations for industry from the imCORE network, a worldwide research network designed to connect members in an open environment of shared information, expertise, and decisions.

101 Background: The importance of enrolling diverse and inclusive patient populations in clinical trials has never been more critical however the implementation of measures to ensure inclusive clinical trials remains inconsistent and challenging industry wide. One key mechanism for tracking diversity in clinical trials is the database design of patient demographic classifications. Methods: In this paper we utilize the global reach of the imCORE network to explore the current trends in clinical trial database design for demographic data. We collect and review data on the design of electronic database systems from a diversity of sources including Roche Genentech clinical trial database frameworks and databases at our imCORE sites. We then provide a global electronic database demographic data classification overview and gap analysis. Results: Findings related to electronic database design, demographic data collection process, barriers to capturing diversity and demographic data are presented. Conclusions: Based on our findings we make recommendations from the site and sponsor perspective for an improved future state of electronic demographic diversity data collection in clinical trials with the goal of ultimately leading to meaningful change toward fully inclusive and equitable clinical trials.

Factors influencing resilience in patients with advanced cancer: A cross-sectional study.

Advanced cancer and its treatments lead to various detrimental impacts on patients. Resilience is an important ability to adapt to such adversity, but there is limited information about its influencing factors, specifically in patients with advanced cancer. This study aimed to examine the influence of social support, depression, anxiety, hope, optimism, spiritual well-being, religious belief, and hardiness on resilience among adults with advanced cancer. This cross-sectional research used multi-stage sampling to select 288 participants from a university hospital and three tertiary hospitals in northern Thailand. Data were collected using a demographic data collection form, the Hospital Anxiety and Depression Scale (HADS), the Thai version of the Social Support Questionnaire (SSQ), the Herth Hope Index (HHI), Life Orientation Test-Revised (LOT-R), Buddhist Belief Questionnaire, Health-Related Hardiness Scale (HRHS), and Connor-Davidson Resilience Scale (CD-RISC), from February 2021 to February 2022. Data were analyzed using descriptive statistics, Pearson correlation, and regression analysis. Depression (r = -0.47, p <0.01) and anxiety (r = -0.39, p <0.01) had a significant negative relationship with resilience. Spiritual well-being (r = 0.74, p <0.01), hope (r = 0.67, p <0.01), religious belief (r = 0.53, p <0.01), optimism (r = 0.40, p <0.01), social support (r = 0.33, p <0.01), and hardiness (r = 0.21, p <0.01) had significant positive relationships with resilience. Only hope (β = 0.29, p <0.01) and spiritual well-being (β = 0.59, p <0.01) together influenced resilience by 64.70%. Spiritual well-being and hope are crucial to resilience in patients with advanced cancer. Nurses should provide spiritual support to strengthen patients' ability to adapt successfully to life with advanced cancer.

Maternal mortality in Greece: The evolution from traditional mammis to overmedicalized obstetric care during the 20th century

AbstractGreece has been absent from the literature on maternal mortality in historical Europe, as very little evidence is yet available regarding maternal mortality patterns before the 1950s. The discontinuity in the collection and publication of demographic data in Greece, as well as the nonavailability of continuous national published statistics are the most important reasons for the lack of studies on maternal mortality. Therefore, this study aims to address this gap by utilising annual published statistics at the aggregate level, focusing primarily on the first half of the 20th century, while also making a significant contribution to the postwar period. The results of the study indicate a high incidence of maternal deaths in Greece, particularly in the northern—mostly rural and later annexed—regions of the country until the late 1930s. An important reason may be the lack of obstetric care in these areas. Although major urban centres were primarily served by qualified midwives by the mid‐1920s, rural Greece had access only to untrained midwives due to the insufficient number of trained midwives that could cater the needs of the entire country. Other contributing factors may include the high prevalence of infectious diseases, such as tuberculosis and malaria in certain areas of the country, poor nutritional status throughout the country before the 1950s, low literacy rates, low living standards, and lack of public health infrastructures. Greece's case study is intriguing as it has transitioned from an almost absolute lack of obstetric care, with the exception of the mostly untrained rural midwives known asmammisbefore the 1950s, to becoming one of the most highly medicalised countries in Europe by the end of the 20th century, succeeding very low levels of maternal mortality.

Molecular Detection of Plasmid-Mediated Quinolone Resistance Genes (qnrA and aac(6′)-Ib-cr) in Drug Resistant Escherichia coli, Sudan

Background: The quinolone group, a synthetic antimicrobial, is widely used worldwide to treat many diseases, including those caused by Gram-negative bacteria. Escherichia coli and others are among the bacteria that produce quinolone resistance genes (qnr) such as qnrA and aac(6′)-Ib-cr. &#x0D; Objective: The present study aimed to the isolate Escherichia coli from patients attending some Hospitals in Wad Medani city, identification of drug resistance patterns and detection of the frequency of quinolones resistance genes; qnrA and aac(6′)-Ib-cr among isolated strains.&#x0D; Methods: A cross-sectional descriptive, hospital-based study included 119 Escherichia coli strains was conducted. A designed questionnaire used for demographic data collection and the attitude toward antimicrobials usage. Clinical specimens were processed for aerobic bacterial isolation and identification. Antimicrobial sensitivity performed by Kirby Bauer disc diffusion technique according to the CLSI guidelines. Presence of qnrA and aac(6′)-Ib-cr genes was assessed by multiplex PCR.&#x0D; Results: Most strains of Escherichia coli originated from urine 53.8% (64/119) and wounds 42.9% (51/119) specimens. Meropenem had the best effect against tested strains with susceptibility of 85% (101/119). Multiplex PCR assay, using specific primers, demonstrated that 41.2% (49/119) and 37.8% (45/119) of isolated Escherichia coli possessed qnrA and aac(6′)-Ib-cr genes respectively.&#x0D; Conclusion: The high rate of qnrA and aac (6)-Ib-cr genes among Escherichia coli necessitate the usage of molecular tools in detecting the genetic determinants of drug resistance microorganisms in countries such as Sudan.

The relationship between breastfeeding self-efficacy and gender roles in postpartum women

ABSTRACT Breastfeeding self-efficacy is important for the achievement and maintenance of breastfeeding. For this reason, it is important to investigate the physical, psychological, social, and cultural factors that may affect breastfeeding self-efficacy. This study sought to investigate how gender roles affect breastfeeding self-efficacy. The study had a descriptive, cross-sectional, and co-relational design and was conducted on 213 postpartum women. The data collection tools of the study were the “Demographic Data Collection Form,” “BEM Gender Roles Inventory” and “Breastfeeding Self-Efficacy Scale Short Form.” Percentages, means, and standard deviation served as the visual representation of descriptive statistics. The difference between the mean scores on the breastfeeding self-efficacy scale according to gender roles was investigated using one-way analysis of variance. In order to identify which measurement was the result of the difference, dependent groups underwent a t-test with Bonferroni correction. Among the women participating in the study, 39.9 percent had feminine, 35.2 percent androgynous, 14.1 percent masculine, and 10.8 percent ambiguous gender roles. It was concluded that women with androgynous gender roles have the highest level of breastfeeding self-efficacy in comparison other gender roles. Considering the inadequacy of education on breastfeeding or lack of counseling service providers for women’s gender roles, there emerged a need for supportive care initiatives for the improvement of breastfeeding self-efficacy.

731 Evaluation of PROMIS-10 Global Health Survey Implementation at a Regional Burn Center Clinic

Abstract Introduction Patient-Reported Outcomes Measure System-10 (PROMIS-10) is a brief survey consisting of 10 items that evaluates patients’ global physical and mental health. PROMIS-10 was introduced into our burn clinic as a screening tool and serial measure of recovery. We aimed to assess the implementation of PROMIS-10 to improve its equitable use in outpatient clinics. Methods The PROMIS-10 was implemented in 2014 as part of a packet of other screening tools. The staff were trained in its use. Patients completed English-language surveys via paper/pen upon arrival at each of their burn clinic appointments while waiting to be roomed. Survey results were reviewed by clinic providers and addressed as part of routine care. Survey answers were entered into REDCap and merged with demographic and burn injury information. Data were collected and analyzed using univariate and bivariable statistics to evaluate equitable implementation. Results A total of 1,963 surveys were collected from 1,606 patients from January 2014 to December 2020 (Figure 1). After excluding patients with missing collection of survey and/or demographic data, our analysis included 1,072 patients. The mean number of surveys completed per visit was 0.53 (SEM=0.007) and 88% of patients completed 1 or more surveys. Patients who required intensive care during their index hospitalization or had an operation had higher mean surveys completed per visit (Highest Level of Care ICU=0.611 ± 0.02; Required an operation = 0.608 ± 0.015), whereas patients requiring an interpreter had lower mean surveys completed per visit (Required an Interpreter = 0.468 ± 0.031). Conclusions Although the majority of patients completed the PROMIS-10 during at least one clinic visit, there is significant room for improvement given our intent to use it as a screening tool for every encounter and metric of recovery progress over time. Focus on equity in completion is needed (e.g., coordinating interpreter-assisted completion, availability of translated forms, person-assisted completion for limited English proficiency, medical record integration for telemedicine and progress tracking). We did note that patients with markers of high burn severity (ICU stay, requiring an operation) had higher rates of survey completion per visit. This is a patient population in which serial evaluation is particularly helpful in monitoring recovery. Applicability of Research to Practice Use of PROMIS-10 can successfully be used as a screening and recovery progress metric in the outpatient setting. Equitable implementation should be assessed, and efforts to integrate such screening tools into the medical record should be considered.

770 Outcome Results of the Prospective CEA Registry

Abstract Introduction Cultured epidermal autograft (CEA) is a permanent skin replacement indicated for use in adult and pediatric patients with deep dermal or full thickness burns comprising a total body surface area (TBSA) ≥ 30%. CEA may be used in conjunction with split-thickness autografts or alone, in patients for whom split-thickness autografts may not be an option due to the severity and extent of their burns. CEA was approved for use in adults in the United States in 2007 as a Humanitarian Use Device (HUD) under a Humanitarian Device Exemption (HDE) and was approved for pediatric use in 2016. Methods The objective of the CEA Registry is to allow prospective collection and analysis of demographic, treatment, and outcome data for the real-world use of CEA. Prior to initiation of the Registry, a central Institutional Review Board reviewed and approved written procedures and informed consent from each participating burn center. As of the date of this analysis, 5 centers were enrolling patients in the Registry. The data are collected and stored in a 21 Code of Federal Regulations (CFR) Part 11 and Health Insurance Portability and Accountability Act (HIPAA) compliant environment. First patient enrollment in the Registry was 13 June 2019 and data cutoff for this analysis was 28 July 2022. Results Sixtyeight patients (50 adults and 18 children) had completed data in the registry, up through hospital discharge, for this analysis. Except for age and revised Baux score, demographics and burn characteristics were similar between the adult and pediatric populations. The majority of patients were male in both the adult (76%) and pediatric (67%) groups, with burn caused by flame the most common etiology (86% and 78%, respectively). The total body surface area (TBSA) of burn was 58% in adults and 56% in pediatric patients (range 30% to 96%), and almost half had inhalation injury in each group. Approximately 74% of adults and 67% of pediatric patients had TBSA ≥50%. Median age in the adult group was 42 years, and in the pediatric group was 15 years. Since age is a component of the calculation of Baux score, pediatric patients had lower mean revised Baux scores (75) compared to adults (107.5). Overall, 59 of the 68 patients (87%) survived until hospital discharge. The mean % graft take (engraftment) in both adult (81%) and pediatric (84%) groups is notable when compared to mean final graft take in 453 Epiceltreated patients reported in the HDE database (67% in adults and 70% in pediatric). By age group, adults had 84% survival rate and pediatric patients had 94% survival. Conclusions Outcomes from this prospective collection of data in severely burned patients treated with CEA demonstrate favorable engraftment and survival rates and are in general agreement with recent literature. Applicability of Research to Practice Reported outcomes from the CEA Registry can be used as a benchmark by centers using CEA for treatment of burns.

Addressing health care inequities in Canadian critical care through inclusive science: a pilot tool for standardized data collection.

Sociodemographic risks contributing to health inequities are often inadequately captured and reported in critical care studies. To address the lack of standardized terms and definitions, we sought to develop a practical and convenient resource of questions and response options for collecting sociodemographic variables for critical care research. To identify domains and variables that impact health equity, we searched: 1) PubMed for critical care randomized trials (2010 to 2021); 2) high-impact critical care and general medicine journals for special issues relating to equity; and 3) governmental and nongovernmental resources. We identified 23 domains associated with health equity, including pronouns, age, sex, gender identity, sexual orientation, race and ethnicity, visible minorities, language, household income, marital/relationship status, education, disabilities, immigrant and refugee status, employment, primary care access, expanded health insurance, internet access, housing security, food security, dependents, religion, and postal code. For each domain we provided standardized questions and response options; for 13/23 domains, we included more than one version of the question and response categories. We developed a standardized, practical, and convenient demographic data collection tool for critical care research studies. Questions and response options can be adapted by researchers for inclusion in individual study questionnaires or case report forms.

Effectiveness of Nusinersen in Type 1, 2 and 3 Spinal Muscular Atrophy: Croatian Real-World Data.

(1) Background: To investigate the real-world effectiveness and safety profile of nusinersen in Croatian paediatric and adult spinal muscular atrophy (SMA) patients. (2) Methods: A retrospective and anonymous collection of relevant demographic and clinical data for all Croatian SMA patients treated with nusinersen and reimbursed by the Croatian Health Insurance Fund (CHIF) between April 2018 and February 2022 was performed through searching the CHIF database and studying the associated reimbursement documentation. All patients who received at least one dose of nusinersen were included in the baseline clinical-demographic overview and safety analysis, whereas only subjects who had completed six doses were included in the effectiveness analysis. (3) Results: Fifty-two patients [61.5% male; median age 13.4 (0.1-51.1) yr.] received nusinersen treatment. In SMA type 1 and type 3 paediatric patients, statistically significant motor function improvement (CHOP INTEND 10.8 ± 10.3 vs. 20.0 ± 15.8, p = 0.003; HFMSE 49.6 ± 7.9 vs. 53.1 ± 7.7, p = 0.008; respectively) was achieved immediately after 4 loading doses of nusinersen and remained statistically significant onwards. Average improvements in HFMSE motor performance in SMA type 2 patients after four, five, and six doses of nusinersen were +6.0, +10.5, and +11.0 points, respectively. In SMA type 3 adult patients, no significant improvement in RHS motor performance or the 6-Minute Walk Test (MWT) was demonstrated. During the study period, 437 doses were administered without any new safety concerns appearing. (4) Conclusions: Our RWD findings indicate that nusinersen is an effective and safe treatment in a heterogeneous group of paediatric patients with all types of SMA; however, no significant benefit (but only RHS and 6MWT maintenance) was demonstrated in SMA type 3 patients who started nusinersen after >18 years of age.

Characteristics of analytically confirmed gamma-hydroxybutyrate (GHB) positive patients in the emergency department: presentation, poly-drug use, disposition and impact on intensive care resource utilisation

Background Gamma-hydroxybutyrate is a potent central nervous system depressant with a narrow recreational dose window and analytical detection time. We describe data relating to intoxicated patients presenting to emergency departments across metropolitan Adelaide who tested positive for gamma-hydroxybutyrate. This work was part of the Emergency Department Admission Blood Psychoactive Testing study. Methods Over a 15-month period, patients presenting to four metropolitan emergency departments with symptoms of drug intoxication were enrolled in the study. The methodology involved the collection of demographic and clinical data and a de-identified blood sample which underwent comprehensive toxicological analysis. Gamma-hydroxybutyrate was determined using an acid-catalysed cyclisation followed by liquid-liquid extraction and gas chromatography-mass spectrometry. Data relating to samples positive for gamma-hydroxybutyrate were examined. Results and discussion A total of 1120 patients were enrolled between March 2019 and May 2020, 309 of whom were positive for gamma-hydroxybutyrate (27.6%). Of these, 256 (83%) were also positive for metamfetamine (methamphetamine). The most common clinical observation in gamma-hydroxybutyrate-positive patients was central nervous system depression (89%). There was a significant relationship between gamma-hydroxybutyrate status and sex; although males outnumbered females in absolute terms, a higher proportion of females (32%) tested positive for gamma-hydroxybutyrate than males (25%, P = 0.0155). Blood gamma-hydroxybutyrate concentrations ranged from 10 to 651 mg/L (0.096–6.2 mmol/L) and increasing gamma-hydroxybutyrate concentration correlated with severe toxicity. The presence of gamma-hydroxybutyrate had a significant impact on the patient discharge destination: the majority (69.2%) of gamma-hydroxybutyrate-positive patients were managed and discharged from the emergency department or their attached short stay wards. A significantly higher proportion of gamma-hydroxybutyrate-positive patients were admitted to the intensive care unit (28.2%) compared with gamma-hydroxybutyrate-negative patients (12.7%, chi-squared = 36.85, P <0 .001). Gamma-hydroxybutyrate positive cases accounted for 45.8% of all study-related intensive care unit admissions. Conclusions Gamma-hydroxybutyrate is commonly detected in illicit drug-related emergency department presentations and is detected disproportionately in the patient cohort who require intensive care unit level care.

Population dynamics and harvest management of eastern mallards

AbstractManaging sustainable harvest of wildlife populations requires regular collection of demographic data and robust estimates of demographic parameters. Estimates can then be used to develop a harvest strategy to guide decision‐making. Mallards (Anas platyrhynchos) are an important species in the Atlantic Flyway for many users and they exhibited exponential growth in the eastern United States between the 1970s and 1990s. Since then, estimates of mallard abundance have declined 16%, prompting the Atlantic Flyway Council and United States Fish and Wildlife Service to implement more restrictive hunting regulations and develop a new harvest strategy predicated on an updated population model. Our primary objective was to develop an integrated population model (IPM) for use in an eastern mallard harvest management strategy. We developed an IPM using annual estimates of breeding abundance, 2‐season banding and recovery data, and hunter‐harvest data from 1998 to 2018. When developing the model, we used novel model selection methods to test various forms of a sub‐model for survival including estimating the degree of harvest additivity and any age‐specific trends. The top survival sub‐model included a negative annual trend on juvenile survival. The IPM posterior estimates for population abundance tracked closely with the observed estimates and estimates of mean annual population growth rate ranged from 0.88 to 1.08. Our population model provided increased precision in abundance estimates compared to survey methods for use in an updated harvest strategy. The IPM posterior estimates of survival rates were relatively stable for adult cohorts, and annual growth rate was positively correlated with the female age ratio, a measure of reproduction. Either or both of those demographic parameters, juvenile survival or reproduction, could be a target for management efforts to address the population decline. The resulting demographic parameters provided information on the equilibrium population size and can be used in an adaptive harvest strategy for mallards in eastern North America.

Dry eye module - An application intelligence platform for diagnosing and monitoring dry eye disease.

Dry Eye Module (DEM), a software application, was developed to facilitate the streamlining of dry eye evaluation and documentation, to unify diagnostic jargon, and to analyze data input to generate a dry eye diagnostic report. This diagnostic report generated is based on the current understanding of dry eye diagnostic algorithms (Dry Eye Workshop 2 [DEWS2]/Asia Dry Eye Society [ADES]). Apart from its plausible role in aiding unprecedented multicentric dry eye demographic data collection, the application software can generate a customized referral letter to the rheumatologist, highlighting the salient ophthalmic features to be shared. DEM uses schematic illustrations to depict eyelid, conjunctival, and corneal parameters that impact the ocular surface in dry eyes that can be captured and compared during serial visits. Furthermore, DEM displays a symptom sign trend chart that graphically represents improvement/stability or worsening of the subjective and objective dry eye status. DEM can generate a curated prescription using preloaded advice templates. DEM includes facility for state-of-the-art advanced dry eye diagnostic reporting for super specialty use. The addition of DEM to the dry eye diagnostic armamentarium would help bridge the current unmet needs of dry eye evaluation. These are lack of uniform reporting, lack of multicentric data on a unified platform, the inability to ensure complete evaluation, inability to avoid lacunae during follow-up visits, and the lack of a simple patient-ophthalmologist and an ophthalmologist-rheumatologist interface.

Day and night camera trap videos are effective for identifying individual wild Asian elephants.

Regular monitoring of wild animal populations through the collection of behavioral and demographic data is critical for the conservation of endangered species. Identifying individual Asian elephants (Elephas maximus), for example, can contribute to our understanding of their social dynamics and foraging behavior, as well as to human-elephant conflict mitigation strategies that account for the behavior of specific individuals involved in the conflict. Wild elephants can be distinguished using a variety of different morphological traits-e.g., variations in ear and tail morphology, body scars and tumors, and tusk presence, shape, and length-with previous studies identifying elephants via direct observation or photographs taken from vehicles. When elephants live in dense forests like in Thailand, remote sensing photography can be a productive approach to capturing anatomical and behavioral information about local elephant populations. While camera trapping has been used previously to identify elephants, here we present a detailed methodology for systematic, experimenter differentiation of individual elephants using data captured from remote sensing video camera traps. In this study, we used day and night video footage collected remotely in the Salakpra Wildlife Sanctuary in Thailand and identified 24 morphological characteristics that can be used to recognize individual elephants. A total of 34 camera traps were installed within the sanctuary as well as crop fields along its periphery, and 107 Asian elephants were identified: 72 adults, 11 sub-adults, 20 juveniles, and four infants. We predicted that camera traps would provide enough information such that classified morphological traits would aid in reliably identifying the adult individuals with a low probability of misidentification. The results indicated that there were low probabilities of misidentification between adult elephants in the population using camera traps, similar to probabilities obtained by other researchers using handheld cameras. This study suggests that the use of day and night video camera trapping can be an important tool for the long-term monitoring of wild Asian elephant behavior, especially in habitats where direct observations may be difficult.

Factors affecting a patient's experience following the open Latarjet procedure to treat recurrent anterior shoulder instability.

The open Latarjet procedure is a widely used treatment for recurrent anterior instability of the shoulder. Although satisfactory outcomes are reported, factors which influence a patient's experience are poorly quantified. The aim of this study was to evaluate the effect of a range of demographic factors and measures of the severity of instability on patient-reported outcome measures in patients who underwent an open Latarjet procedure at a minimum follow-up of two years. A total of 350 patients with anterior instability of the shoulder who underwent an open Latarjet procedure between 2005 and 2018 were reviewed prospectively, with the collection of demographic and psychosocial data, preoperative CT, and complications during follow-up of two years. The primary outcome measure was the Western Ontario Shoulder Instability Index (WOSI), assessed preoperatively, at two years postoperatively, and at mid-term follow-up at a mean of 50.6 months (SD 24.8) postoperatively. The secondary outcome measure was the abbreviated version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) score. The influence of the demographic details of the patients, measurements of the severity of instability, and the complications of surgery were assessed in a multivariate analysis. The mean age of the patients was 25.5 years (22 to 32) and 27 (7.7%) were female. The median time to surgery after injury was 19 months (interquartile range (IQR) 13 to 39). Seven patients developed clinically significant complications requiring further intervention within two years of surgery. The median percentage WOSI deficiency was 8.0% (IQR 4 to 20) and median QuickDASH was 3.0 (IQR 0 to 9) at mid-term assessment. A minority of patients reported a poorer experience, and 22 (6.3%) had a > 50% deficiency in WOSI score. Multivariate analysis revealed that consumption of ≥ 20 units of alcohol/week, a pre-existing affective disorder or epilepsy, medicolegal litigation, increasing time to surgery, and residing in a more socioeconomically deprived area were independently predictive of a poorer WOSI score. Although most patients treated by an open Latarjet procedure have excellent outcomes at mid-term follow-up, a minority have poorer outcomes, which are mainly predictable from pre-existing demographic factors, rather than measures of the severity of instability.

Disparities, concerns, and recommendations for LGBTQ+ data collection within the biological sciences

The omission of lesbian, gay, bisexual, trans, queer, intersex, and expansive minoritized sexual and gender identities (hereafter, LGBTQ+) from demographic data collection in science is a critical issue. Ignoring these identities perpetuates practices that drive people out of science, erase experiences, and discount systemic barriers navigated by LGBTQ+ scientists (Freeman 2020). Adding gender diversity and sexual orientation to surveys is one step toward increasing inclusion of LGBTQ+ researchers. Recently, scientific societies have increased collecting demographic data; however, there is still a need for longitudinal studies (Rushworth et al. 2021). LGBTQ+ demographic data allow institutions, educators, and employers to identify systemic barriers, pinpoint key policy changes, and track efforts to improve equity (Freeman 2020, Rushworth et al. 2021, Guyan 2022). However, groups that collect demographic data, such as state and federal agencies, granting agencies (i.e., the National Science Foundation), and universities do not collect data on LGBTQ+ identities, prohibiting evidence-based efforts to increase inclusion and further limiting interpretation of professional society and small-scale surveys (Rushworth et al. 2021). Although there are inherent risks in collecting data on LGBTQ+ people, improvements in data collection are imperative if we are to understand and address diversity, equity, and inclusion issues within the sciences (Aramati Casper et al. 2022).