Descriptive Variables Research Articles

Health seeking behavior among adult patients with cataract attending eye clinic at Homa bay County Teaching and Referral Hospital

Cataract; is the clouding of the natural crystalline lens of the eye leading to preventable blindness. Globally, cataracts resulted in approximately 15.2 million cases of blindness in the population over the age of 50 years in 2020. Majority of patients with cataract seek treatment late when vision loss has deteriorated and some even have total blindness. Cataract is a highly treatable condition when detected early and results in good visual outcomes. The main objective of the study was being to determine the health seeking behavior among adult patients with cataract attending eye clinic at Homa Bay County referral hospital so as to reverse the trend of blindness. A descriptive cross-sectional study design was used. The study population were all patients attending the eye clinic during the period of data collecting and are estimated to be 85 patients. The census method of sampling was applied so as to include the whole population in the study. Some data were collected from the patient records while others were through personal interviews. Data were analyzed using SPSS version 27, and descriptive variables such as means and frequencies were calculated. The findings were presented in the form of graphs and tables. There were total of 59 respondents who participated on the study. Majority of the respondents 34 (59.3%) were aged between 68 years and above ,37 (62.7%)were females and 22 (37.3%) were males.40 (66.1%) presented to the clinic with VA of > 3/60. 36 (61.0%) reached primary level, only 1(1.7%) reached tertiary level, 31(52.54) have sought treatment at the chemist before reporting to the hospital. 42 (71.2%) reported from 6 months and above to the facility, 57 (96.6%) comes from Homa Bay. In the study we noticed that 52.5%( 31 out of 59) had sought treatment first from the chemist. In this study, 61.0% (36 out of 39) respondents had poor access to eye care service due to cost of transport, 62.7% (37 et of 59) participants was due to cost of treatment and 69.5% (41 out of 59) was due to distance. In this study 35.6% (21 out of 59) respondents had blood pressure and cataract 18 out of 21 had poor vision of >6/60. 35 respondents had no blood pressure and 32 had severe visual acuity to blindness and 27.3% had no blood pressure. Pressure and diabetes as a comorbidity, It was concluded that majority of participants seek treatment at the chemist, decreased eye sight was a sign of cataract, reached primary level, believed that decreased eye sight was a sign of cataract It was also observed that patient who had cataract majority had no high blood pressure. It was recommended that decentralization of eye screening and treatment at the sub-county levels where is easily accessible. Harmonizing on the cost of treatment and also invite donors to fund on free camp to help the vulnerable. Deployment and training of eye workers and setting of full equipped 8 sub-county eye unit center for easy accessibility.

Geometric, Variational, and Bracket Descriptions of Fluid Motion with Open Boundaries

Geometric, Variational, and Bracket Descriptions of Fluid Motion with Open Boundaries

Assessment of Knowledge, Attitude, and Practice of Standard Infection Control Precautions among Health-care Workers in Baghdad, Al-Rusafa, 2023

Abstract Background: Hospital stays, mortality, and expenditures rise with health-care-associated infections, especially in developing countries. Public health promotes infection control. Aim: The aim of this study was to assess health-care workers’ (HCWs) infection control knowledge, attitude, and practice and determine how sociodemographic and job descriptive variables affect them. Settings and Design: A cross-sectional study at four Baghdad/Al-Rusafa government hospitals (Shaikh Zayed Hospital, Al-Shaheed Al-Sader Hospital, Ibn Al-Balady Children and Maternity Hospital, and Fatima Al-Zahraa Children and Maternity Hospital). Subjects and Methods: All resident doctors, nurses, and laboratory personnel who were present during data collection and agreed to participate were included in this study. Statistical Analysis: Data were entered using Excel 2019 and then analyzed using SPSS 26. Frequency and percentage analyzed quantitative data, while Chi-square test analyzed categorical data. P <0.05 indicated statistical significance. Results: Knowledge level was higher among HCWs aged 30–39 years (79.4%), doctors (81.0%), individuals with more than 5 years of experience (75.0%), and those who received training (83.7%). Positive attitudes were most prevalent among HCWs aged 49 years and older (68.6%), laboratory workers (59.4%), individuals with more than 5 years of experience (55.5%), and those who received training (60.6%). A higher level of practice was observed in individuals aged 30–39 years (83.2%), laboratory personnel (80.4%), those with 5–14 years of experience (80.4%), and trainees (83.0%). Conclusions: Three-quarters of HCWs had good knowledge and practice regarding infection control precautions, and nearly half of them had a positive attitude. The knowledge, attitude, and practice of HCWs were increasing with progress in age, increasing work experience, and also with training.

Knowledge Acquisition and Audience Retention in Stroke Education: Results From a Global Study by the World Stroke Organization.

The World Stroke Academy (WSA), the educational platform of the WSO, provides high-quality stroke education to health care professionals worldwide. Understanding the learning needs and preferences of WSA members is crucial for effective knowledge translation. This study aims to (1) assess demographics and professional backgrounds of WSA members, (2) identify preferences in knowledge acquisition, and (3) evaluate audience retention during WSA webinars. A survey was developed using Qualtrics and distributed via email to all WSA members from May 8 to May 23, 2023. The survey included multiple-choice, rating scale, and ranking questions. Audience retention data were obtained from the latest 6 WSA webinars (May 2023-December 2023). Descriptive variables were reported, and χ2 analysis and multinomial regression models were used. A random sample of 1065 WSO members received the survey; 327 initiated it (participation rate, 30.7%), and 236 completed it (completion rate, 72.2%). The mean age (SD) of participants was 46.7 (±11.6) years; 57.2% identified as male. Most respondents were stroke specialist physicians (65.3%) and were based in Europe (35.2%). Online journal articles represented 41.6% of the total time allocated for stroke education, with 17% allocated to webinars. Social media usage patterns showed X (formerly Twitter) as the top choice (34.7%). Age, profession, and location significantly influenced social media platform use. Audience retention was at 50% at the 57-minute mark and 44.3% at the end of webinars. Tailoring WSA webinar content to meet health care professionals' needs and enhancing interactive components can improve audience retention. These insights will guide the future development of the WSA portfolio.

Where's the Remote? Failure to Report Clinical Workflows in Heart Failure Remote Monitoring Studies.

Remote patient monitoring (RPM) clinical trials have reported mixed results in improving outcomes for patients with chronic heart failure (HF). The impact of clinical workflows that could impact RPM effectiveness is often overlooked. We sought to characterize workflows and response protocols that could impact outcomes in studies of noninvasive RPM in HF. We reviewed studies (1999-2024) assessing noninvasive RPM interventions for adults with HF. We collected 24 aspects of workflows describing education, physiologic and symptomatic data collection, transmission and review, clinical escalation protocols, and response time. We attempted to perform a meta-analysis to identify associations between workflow components and outcomes of death and hospitalization. We identified 63 studies (57.1% randomized controlled, 23.8% pilot/feasibility, 19.1% other) comprising 16,699 subjects. Despite a large number of studies and subjects, workflow reporting was insufficient to perform our intended meta-analysis regarding key workflow components. RPM clinical workflows were diverse in configuration, with high variability in component description ranging from always reported to never reported. Specifics of monitoring devices and related training were well reported as expected based on most trial hypotheses. However, elements of clinical data response such as frequency of data review, clinical escalation criteria, and provider response time were often underreported or not reported at all (48%, 24%, and 97%, respectively), hindering study replication and evidence-based implementation. Clinical workflows are poorly described in noninvasive RPM studies, preventing systematic assessment, device comparison, and replication. A standardized approach to reporting HF RPM workflows is vital to evaluate effectiveness and guide evidence-based clinical implementation.

Cricket players’ perceptions of playing on artificial turf

ABSTRACT With the recent introduction of artificial turf outfield playing surfaces in community-level cricket, this paper presents the physical performance and injury-related perceptions of male, senior cricketers. Following validity and reliability testing, 43 cricketers from two clubs completed a questionnaire comprising three sections: demographic information; individual performance; and injury risk and severity. Descriptive variables were computed, and chi-square tests were conducted to identify differences in perceptions based on the field type that players were exposed to and their injury status. Most players preferred artificial turf for training (53.7%) and wet/rainy conditions (64.1%), but natural grass for competitive games (67.4%) and dry conditions (69.0%). There were significant differences in perceptions for game speed (p < 0.001), the need to be fitter (p = 0.015), and the overall physical performance quality based on injury status (p = 0.017) and field (p < 0.021). Skin injuries were the only injuries that were reported as more likely on artificial turf. In general, players did not feel that the technical and physical performance aspects of cricket were affected when playing on artificial turf compared to natural grass. However, the field type that players were exposed to significantly influenced their perceptions and highlights the importance of artificial turf composition for future adoption in cricket.

COVID-19 and pregnancy: a comprehensive study of comorbidities and outcomes

ObjectivesThis study aimed to investigate the impact of pregnancy and pre-existing comorbidities on COVID-19 infections and associated complications of hospitalisation and mortality in women of reproductive age (WRA). The study also compared the risk of severe COVID-19 complications between pregnant women (PW) and non-pregnant women (NPW) with and without pre-existing comorbidities. Special focus was placed on some understudied comorbidities of immunosuppression, chronic renal disease and chronic obstructive pulmonary disease (COPD).MethodsThe study utilized anonymized patient-related information for a population of 7,342,869 WRA from the Mexican Ministry of Health data repository on COVID-19. Descriptive variables were characterized using frequencies, percentages, means, and standard deviations. Adjusted odds ratios (aORs) were used to assess the associations between risk factors and outcomes of hospitalisation and mortality. The study covered the entire COVID-19 pandemic period from January 30, 2020, to May 5, 2023.ResultsThe findings revealed that PW were not more likely to get COVID-19 infections than NPW. PW with COVID-19 infections were more likely to require hospital admission, intubation treatments, and ICU admission compared to NPW with COVID-19. PW with immunosuppression had an increased odds ratio (aOR) of getting COVID-19 infections compared to NPW (PW: aOR = 1.0396; NPW: aOR = 0.8373). NPW with immunosuppression had higher risk of mortality (all-cause death: aOR = 1.7084; COVID-19-associated death: aOR = 1.4079) and hospitalisation (all-cause hospitalisation: aOR = 4.1328; COVID-19-associated hospitalisation: aOR = 3.0451) than NPW without immunosuppression. Renal disease was identified as a concerning pre-existing condition that increased the risks of COVID-19 associated mortality/hospitalizations and all-cause mortality/hospitalizations for both PW and NPW. NPW with renal disease had much higher odds ratio (aOR) of either COVID-19-associated-hospitalisations (NPW: aOR = 8.639; PW: aOR = 1.7603) or all-cause hospitalisations (NPW: aOR = 8.8594; PW: aOR = 1.786) than PW with renal disease.ConclusionsThis study provides valuable insights into the impact of pregnancy and pre-existing comorbidities on COVID-19 outcomes in WRA. The findings underscore the importance of considering demographic factors and pre-existing comorbidities in the management of PW with COVID-19. The study also highlights the need for further research to understand the unique impacts of different comorbidities, particularly immunosuppression and renal disease, on COVID-19 outcomes in WRA.

A Systematic Review of Point-of-View Video Prompting to Teach Daily Living Skills to Individuals With Autism

The acquisition of daily living skills (DLS) represents an important component in establishing independence and increasing the quality of life for individuals diagnosed with autism spectrum disorder. Video prompting has become a popular intervention to teach DLS and researchers have used different perspectives when filming the video (e.g., point-of-view, spectator view). This literature review sought to systematically examine research on the use of the point-of-view perspective when using video prompting to teach DLS to individuals with autism. This review investigated the overall quality of the evidence, based on the What Works Clearinghouse standards for single-case experimental design and used Tau-U to calculate the effects of the interventions. Additionally, the researchers examined and summarized various descriptive variables found within this literature. Overall, point-of-view video prompting produced larger to very large effects. Suggestions for future research and considerations are discussed.

Evaluation of adherence, safety and effectiveness of an antibiotic de-escalation strategy in patients with febrile neutropenia during autologous hematopoietic stem cell transplantation.

Introduction: There are ongoing concerns about optimal antibiotic regimens for febrile neutropenia during autologous hematopoietic stem cell transplantation (ASCT). Objectives: We assessed adherence, safety, and clinical outcomes of an antibiotic de-escalation protocol at a hematopoietic stem cell transplant reference center. Methods: We conducted a retrospective analysis of clinical data from 100 patients who developed febrile neutropenia during autologous stem cell transplantation between January 2020 and June 2021. In addition to presenting descriptive variables, we compared clinical outcomes, including treatment duration, hospitalization length, ICU admission, and mortality, among intervention groups. Results: Approximately 61% of the patients underwent the antibiotic de-escalation strategy, with an adherence rate of approximately 80% and only 20 protocol deviations. Comparing intervention groups, statistically significant differences favored the de-escalation and early termination group, which had shorter hospital stays (16 vs. 18 days, p 0.01) and fewer days of antibiotic treatment (5 vs. 8 days, p 0.006). There were no differences in safety outcomes. Conclusions: The antibiotic de-escalation strategy demonstrated significant adherence and proved to be safe and effective, with the added benefit of shorter hospital stays and reduced antibiotic exposure.

Characteristics of clinical descriptive variables and polysomnographic findings of catathrenia.

Catathrenia has been classified as a sleep-related breathing disorder variant in the third edition of the International Classification of Sleep Disorders, but its validity remains unverified. We analyzed the clinical descriptive variables and polysomnographic findings of catathrenia and discussed the similarities and differences to those of obstructive sleep apnea (OSA), non-REM parasomnias, and sleep bruxism (SB). A retrospective analysis was conducted on 47 patients diagnosed with nocturnal groaning through polysomnography. We examined sex, body mass index, age at symptom onset, weekly symptom frequency, and presence/absence of comorbidities, including OSA, periodic limb movement disorder, non-REM parasomnia, and SB. The groaning event (GE) index was calculated according to sleep position and sleep stage. The distribution of patients with catathrenia did not show sex difference (male/female = 20:27), body mass index was 20.6 ± 3.0 kg/m2, and age of onset was 18.2 ± 7.4 years. The GE index was higher in stages N1 and R than in stage N3 and in the supine position than in the lateral position. There were no cases complicated with non-REM parasomnia, but the complication of SB was observed in 30% of the participants, and SB events appeared immediately before or during the interictal period of the GE episodes in these cases. Given the clinical background, posture- and sleep stage-dependent appearance of GEs, and the relatively high complication rate of SB, catathrenia pathogenesis may be heterogeneous or comprise elements of different sleep disorders.

Cognitive functions explain discrete parameters of normal walking and dual-task walking, but not postural sway in quiet stance among physically active older people.

Postural control is dependent on the central nervous system's accurate interpretation of sensory information to formulate and execute adequate motor actions. Research has shown that cognitive functions are associated with both postural control and fall risk, but specific associations are not established. The aim of this study was to explore how specific components of everyday postural control tasks are associated with both general and specific cognitive functions. Forty-six community-dwelling older adults reported their age, sex, physical activity level, falls and fall-related concerns. The following cognitive aspects were assessed: global cognition, executive functions, processing speed and intraindividual variability. Postural control was quantified by measuring postural sway in quiet stance, walking at a self-selected pace, and walking while performing a concurrent arithmetical task. Separate orthogonal projections of latent structures models were generated for each postural control outcome using descriptive and cognitive variables as explanatory variables. Longer step length and faster gait speed were related to faster processing speed and less intraindividual variability in the choice reaction test. Moreover, longer step length was also related to less fall-related concerns and less severe fall-related injuries, while faster gait speed was also related to female sex and poorer global cognition. Lower dual-task cost for gait speed was explained by the executive function inhibition and faster processing speed. Postural sway in quiet stance was not explained by cognitive functions. Cognitive functions explained gait speed and step length during normal walking, as well as the decrease of gait speed while performing a concurrent cognitive task. The results suggest that different cognitive processes are important for different postural control aspects. Postural sway in quiet stance, step time and gait variability seem to depend more on physical and automatic processes rather than higher cognitive functions among physically active older people. The relationships between cognitive functions and postural control likely vary depending on the specific tasks and the characteristics of different populations.

Sex differences in perceived discrimination among patients with obesity.

The negative impacts of perceived discrimination on health have been documented, but how perceptions of discrimination vary by sex among people with obesity (PWO) is not well understood. This study assessed sex differences in perceived discrimination among PWO. This cross-sectional study analysed self-reported data from racially/ethnically diverse PWO attending an academic obesity program. The primary outcome was perceived discrimination, assessed by the Major Experiences of Discrimination (MED) and Everyday Discrimination Scale (EDS). Sex differences were evaluated by univariate and multivariable regression analysis adjusted for key descriptive variables. The final analytical sample included 60 PWO (62% female, 61% non-Hispanic white (NHW), 12% Hispanic, 39% non-Hispanic black (NHB), mean age 53 years, mean BMI 34 kg/m2). Women experienced everyday discrimination 59% less than men but this was not significant (OR 0.41; 95% CI 0.08-2.16; p = .29). Participant highest BMI was correlated with acute discrimination (total MED score) (r = 0.39; p = .0024) and chronic discrimination (total EDS score) (r = 0.28; p = .03). Most participants reported more chronic discrimination compared to acute discrimination (85% vs. 48%). Mean MED (β -0.18; 95% CI -0.93 to +0.56; p = .62) and EDS scores (β -0.25; 95% CI -3.37 to +2.87; p = .87) were not significantly different between women and men. Perceived discrimination was common and experienced equally between men and women with obesity. Incorporating discrimination experiences into obesity care models may be an important step to improving quality of care and outcomes.

Infection Mortality in Acute Promyelocytic Leukemia in Children

Abstract Background Acute promyelocytic leukemia (APL) is a rare entity in children. The percentage of APL patients is 5-7% of all pediatric acute myeloid leukemia cases; a higher frequency (about 20%) is reported in children of Latino/Hispanic ancestry. The introduction of trans retinoic acid has been crucial for both antileukemic efficacy in APL and for prevention of early deaths. Furthermore, the use of arsenic trioxide (ATO) demonstrated to be highly effective in achieving high cure rates with reduced toxicity. However, there is a paucity of data concerning infection related deaths in APL. The objective was to describe the percentage of infection-related-deaths in APL in children; to describe the event free survival (EFS) and describe other main complications observed. Methods We identified 30 patients, as part of the Hospital Alejandro Posadas registry from a single center. We conducted a retrospective observational descriptive analysis. The patients were treated with the GIMEMA-AIDA 2000 protocol (n=23, 76.7%) and 1-LPA pediatrico-18-GALTA/CLEHOP (n=6, 20%). One patient died before treatment was given. The patients were diagnosed between 2000 to 2022. We used frequencies for descriptive variables, Chi2 /Fisher test for categorical data and time to event techniques for survival analysis. Any cause of mortality was extracted and analyzed. Results There were 66.7% of males; and median age was 12-year (IQR 8-15). PML-Rar alfa was positive (cytogenetics) in 23 (76.7%); Negative 6 (20%) and failed in 1 patient (3.3%). 100% had positive molecular biology for PML-rarAlfa transcript. Median white cells were 3.35x 109 /l (IQR 1.675-13.25). The patients were classified as high-risk (n=10, 33.3%) and standard risk (n=20, 66.7%). Four patients showed molecular relapse, 2 had CNS and one bone marrow involvement. Three patients died (10%), 2 due to endocranial hemorrhage, 1 as a consequence of complications of a hematological relapse. No patient died due to microbiologically documented infection or febrile neutropenia. With a mean estimated survival time (median not achieved) in years of 17.7 years, (CI 95% 14.6-20.7) the event free survival was 79% (SE 0.75), with 6 events. Cumulative competitive incidence of relapse 14% (SE 0.65). Conclusion In patients with APL, we could not find infections as cause of death. The overall results of APL management were very promising. Figure 1. Event Free Survival Acute Promyelocytic Leukemia.

Variation in air sac morphology and postcranial skeletal pneumatization patterns in the African grey parrot.

The anatomy of the avian lower respiratory system includes a complex interaction between air-filled pulmonary tissues, pulmonary air sacs, and much of the postcranial skeleton. Hypotheses related to the function and phylogenetic provenance of these respiratory structures have been posed based on extensive interspecific descriptions for an array of taxa. By contrast, intraspecific descriptions of anatomical variation for these features are much more limited, particularly for skeletal pneumatization, and are essential to establish a baseline for evaluating interspecific variation. To address this issue, we collected micro-computed tomography (μCT) scans of live and deceased African grey parrots (Psittacus erithacus) to assess variation in the arrangement of the lungs, the air sacs, and their respective invasion of the postcranial skeleton via pneumatic foramina. Analysis reveals that the two pairs of caudalmost air sacs vary in size and arrangement, often exhibiting an asymmetric morphology. Further, locations of the pneumatic foramina are more variable for midline, non-costal skeletal elements when compared to other pneumatized bones. These findings indicate a need to better understand contributing factors to variation in avian postcranial respiratory anatomy that can inform future intraspecific and interspecific comparisons.

Assessing variations in care delivered to rural out of hospital cardiac arrest patients in the interfacility transfer setting.

There is significant variation in out-of-hospital cardiac arrest (OHCA) outcomes between different regions. We sought to evaluate outcomes of OHCA patients in the interfacility transfer (IFT) setting, between critical care transport (LifeFlight) and community Emergency Medical Services (EMS), in the state of Maine. This was a retrospective analysis of our institution's electronic medical record and the Maine EMS database. Data were collected from January 1, 2019, to December 31, 2021. Only adult OHCA encounters requiring an IFT for definitive post-cardiac-arrest care were included. Demographics, EMS agency, IFT vital signs, targeted temperature management (TTM) medications, cerebral performance category (CPC) scores, survival to discharge, and other descriptive variables were collected. Ninety-three patients met inclusion criteria, with LifeFlight transferring 30 of them (32.3%). LifeFlight was more likely to initiate TTM compared to other EMS agencies (p=0.012), have run-sheets reported (p=0.001), and serve rural areas (p=0.036). LifeFlight was associated with more epinephrine (0.034) and norepinephrine (<0.001) use. Only 37% of IFTs had physician orders, with none (0.0%) of them defining vital sign targets. No difference in survival to discharge or CPC scores was observed between LifeFlight and other EMS agencies. No significant variation in comorbidities or vital signs was observed. There was no difference in survival to discharge or CPC scores between LifeFlight and ad hoc EMS agency. LifeFlight was associated with more TTM and vasopressor utilization during IFT. Most IFT encounters did not have dedicated physician orders, and none of the orders included vital sign targets.

The short-term postoperative pain and impact upon quality of life of pulpotomy and root canal treatment, in teeth with symptoms of irreversible pulpitis: A randomized controlled clinical trial.

Few studies focus upon patient-reported outcomes in endodontics. To determine whether full pulpotomy offers a less painful, improved health-related quality of life (HRQoL) compared with root canal treatment (RCT) in cases of irreversible pulpitis (IP) in the 7 days after the treatment. One hundred sixty-eight participants presenting with symptoms of IP were randomized to either pulpotomy (n = 86) or RCT (n = 82). Two participants were excluded, 61 participants underwent full pulpotomy with Biodentine (35.7%), 80 had RCT (46.8%), and 25 were randomized to have pulpotomy which progressed to RCT (PRCT) due to uncontrollable bleeding (14.6%). Clinical and radiographic assessments, using CBCT and periapical radiographs, were carried out preoperatively, for the evaluation of the results only CBCT images were used. Pain (VAS) and HRQoL (EQ 5D) assessments were carried out at baseline and Days 1, 3, 5 and 7 post-baseline. Analysis included descriptive and continuous variables, chi-squared, Fisher's exact, and two-sample t-tests. In pulpotomy and RCT groups, VAS pain decreased significantly over the first week (p < .001). The magnitude of reduction was similar in RCT and pulpotomy (p = .804), RCT and PRCT (p = .179), pulpotomy vs. PRCT (p = .144) and in the comparison of combined RCT /PRCT groups (ORCT) with Pulpotomy (0.729). However, the overall level of VAS pain was significantly higher in the PRCT group than in the Pulpotomy (p = .045) and RCT group (p = .049). Using CBCT, significantly more radiolucencies were found in the PRCT group than in the pulpotomy group and overall teeth presenting with CBCT radiolucencies had significantly higher pain scores (p = .015), particularly at Days 1, 3 and 5. There were significant differences in many OHRQoL domains (Questions 1, 6, 11 and 12) between RCT and PRCT groups with higher frequencies of the impact of oral health problems at Day 0 and Day 7 in the PRCT group. In the treatment of IP, pulpotomy is as effective as RCT in reducing post-operative pain, and improving QoL and HRQoL, teeth displaying uncontrollable bleeding and periapical radiolucencies detected using CBCT are associated with more intense postoperative pain and lower QoL.

Similarities and differences between systemic juvenile idiopathic arthritis and adult-onset Still's disease: a multicenter Spanish study.

To describe the characteristics of systemic juvenile idiopathic arthritis (sJIA) and adult-onset Still's disease (AOSD), compare their presentation and evolution, and analyse possible complication predictors. Multicenter study. Data were retrieved from a hospital-based study of patients with a diagnosis or suspected diagnosis of sJIA or AOSD according to the responsible physician and followed-up for at least one year. Descriptive variables (classification criteria, clinical manifestations, complications, family, and personal history) were collected at disease onset and during follow-up. We present the clinical characteristics of 326 patients, 67% of whom had a diagnosis of sJIA and 33% of AOSD. Clinical manifestation frequencies were similar between the two groups, except for odynophagia, which was significantly more frequent in AOSD than in sJIA (78.4% vs. 25.5%; p < 0.0001). Among the complications, macrophage activation syndrome (MAS) was significantly more common in sJIA than in AOSD (24.4% vs. 9.5%; p = 0.002), to the extent that an sJIA diagnosis significantly increased the risk of MAS, together with serositis presence, and the need for biological therapy. Patients with sJIA and AOSD showed similar characteristics, supporting the idea that they are both part of Still's disease, but are expressed at different ages. Differences in manifestations and complications might be due to different management between diseases and immune response maturity.

Predicting DNA Reactions with a Quantum Chemistry-Based Deep Learning Model.

In this study, a deep learning model based on quantum chemistry is introduced to enhance the accuracy and efficiency of predicting DNA reaction parameters. By integrating quantum chemical calculations with self-designed descriptor matrices, the model offers a comprehensive description of energy variations and considers a broad range of relevant factors. To overcome the challenge of limited labeled data, an active learning method is employed. The results demonstrate that this model outperforms existing methods in predicting DNA hybridization free energies and strand displacement rate constants, thus advancing the understanding of DNA molecular interactions, and aiding in the precise design and optimization of DNA-based systems.

A mixed methods study on poisoning and injury-related emergency department visits associated with opioids in Canada, 2011 to 2022: from the Canadian hospitals injury reporting and prevention program

BackgroundThe opioid crisis is a serious public health issue in Canada. There have been many surveillance programs and research studies on opioid-related emergency department (ED) visits at a national, provincial, regional or municipal level. However, no published studies have investigated the in-depth contexts surrounding opioid-related ED visits. In addition, few studies have examined injuries other than poisonings in those visits. The objective of this study is to investigate the contextual factors and co-occurrence of poisonings and injuries among the opioid-related ED visits in a Canadian sentinel surveillance system on injuries and poisonings from 2011 to 2022.MethodsThis study used a mixed methods design. The data source was the Canadian Hospitals Injury Reporting and Prevention Program. We first selected all opioid-related ED visits during our study period and then identified the contextual factors through a content analysis of the combination of the narrative description and other variables in the patients’ records. The contextual factors were organized into themes as opioid use context, social resource utilization, bystander involvement, and prior naloxone use. The opioid use context was used as a co-variable to examine the other themes and ED presentations (poisonings and other injuries). Quantitative descriptive approach was used to analyze all the contexts and ED presentations.ResultsThe most common opioid use context was non-prescribed opioid use without intention to cause harm, followed by self-poisoning, children’s exposure, and medication error. Various rare contexts occurred. Paramedics participated in 27.9% of visits. Police and security guards were involved in 5.1% and 2.3% of visits, respectively. Child welfare or social workers were involved in 0.4% of visits. Bystanders initiated 18.9% of the ED visits. Naloxone use before arriving at the ED occurred in 23.4% of the visits with a variety of administrators. The majority of patients presented with poisoning effects, either with poisoning effects only or with other injuries or conditions.ConclusionsOur study has provided an in-depth analysis of contextual factors and co-occurrence of poisonings and injuries among opioid-related ED visits in Canada. This information is important for ED programming and opioid-related poisoning and injury intervention and prevention.

Optimizing Fall Risk Diagnosis in Older Adults Using a Bayesian Classifier and Simulated Annealing.

The aim of this study was to improve the diagnostic ability of fall risk classifiers using a Bayesian approach and the Simulated Annealing (SA) algorithm. A total of 47 features from 181 records (40 Center of Pressure (CoP) indices and 7 patient descriptive variables) were analyzed. The wrapper method of feature selection using the SA algorithm was applied to optimize the cost function based on the difference of the mean minus the standard deviation of the Area Under the Curve (AUC) of the fall risk classifiers across multiple dimensions. A stratified 60-20-20% hold-out method was used for train, test, and validation sets, respectively. The results showed that although the highest performance was observed with 31 features (0.815 ± 0.110), lower variability and higher explainability were achieved with only 15 features (0.780 ± 0.055). These findings suggest that the SA algorithm is a valuable tool for feature selection for acceptable fall risk diagnosis. This method offers an alternative or complementary resource in situations where clinical tools are difficult to apply.