Good Compliance Research Articles

Edpidemiology, Clinical Profile and Short- Term Outcome of Hypertensive Crisis in N'Djamena (Chad)

Objective Hypertensive crisis is an increasingly frequent medical condition in our context. Its management in medical emergencies is a real challenge for physicians. Few data on hypertensive crisis are available in Chad. The aim of this study was to investigate the epidemiological, clinical and prognostic characteristics of hypertensive crisis in the medical emergency department of Reference National Teaching Hospital in N'Djamena. Patient and methods This was a prospective cohort study running from 1er March 2020 to October 31 2020. Patients presenting with a sudden and severe rise in blood pressure (systolic ≥ 180 mmHg and/or diastolic ≥ 110 mmHg) with or without acute target-organs damage, had been consecutively included and followed up over a period of one (01) month. Epidemic and clinical characteristics on admission, and morbidity and mortality parameters during the course of the disease were collected. The Kaplan-Meier method and the Cox model were used to analyze survival and factors associated with death, with a significance level of p<0.05. Results Of the 3978 hypertensive patients admitted to medical emergencies, 252 had a hypertensive crisis, i.e. a prevalence of 6.3%. Two hundred and seventeen (217) patients were included in the study, divided into 149 cases (69%) of hypertensive emergency and 67 cases (31%) of hypertensive hypertensive urgencies. The mean age of the patients was 55.2 ± 14 years (20 and 80 years) and 67% were male. Hypertension was known in 138 patients (64%). At least one complication was present on admission in 69% of patients. Complications were classified as cardiac (50.7%), neurological (38.2%), kidney impairment (46.5%) and ocular (46.1%). The average number of antihypertensive drugs used was 2 ± 0.83 1, 4. Calcium antagonists (86.5%), diuretics (35.5%), converting enzyme inhibitors or angiotensin II receptor antagonists (33.3%) and betablockers (18%) were the pharmacological classes prescribed. Good compliance during follow-up was observed in 124 patients. One-month survival was 84% for all patients, with a 16% mortality rate. Factors associated with death were the duration of hypertension, and the occurrence of cardiovascular, renal dysfunction and ocular disease (p < 0.05). Conclusion Hypertensive crisis is a frequent pathology in sub-Saharan Africa, with high morbidity and mortality. Prevention requires early detection and effective management of hypertension.

An agent-based model on antimicrobial de-escalation in intensive care units: Implications on clinical trial design.

Antimicrobial de-escalation refers to reducing the spectrum of antibiotics used in treating bacterial infections. This strategy is widely recommended in many antimicrobial stewardship programs and is believed to reduce patients' exposure to broad-spectrum antibiotics and prevent resistance. However, the ecological benefits of de-escalation have not been universally observed in clinical studies. This paper conducts computer simulations to assess the ecological effects of de-escalation on the resistance prevalence of Pseudomonas aeruginosa-a frequent pathogen causing nosocomial infections. Synthetic data produced by the models are then used to estimate the sample size and study period needed to observe the predicted effects in clinical trials. Our results show that de-escalation can reduce colonization and infections caused by bacterial strains resistant to the empiric antibiotic, limit the use of broad-spectrum antibiotics, and avoid inappropriate empiric therapies. Further, we show that de-escalation could reduce the overall super-infection incidence, and this benefit becomes more evident under good compliance with hand hygiene protocols among health care workers. Finally, we find that any clinical study aiming to observe the essential effects of de-escalation should involve at least ten arms and last for four years-a size never attained in prior studies. This study explains the controversial findings of de-escalation in previous clinical studies and illustrates how mathematical models can inform outcome expectations and guide the design of clinical studies.

Capacitive biophysical stimulation improves the healing of vertebral fragility fractures: a prospective multicentre randomized controlled trial

BackgroundCapacitively coupling electric fields (CCEF) is a method of non-invasive biophysical stimulation that enhances fracture repair and spinal fusion. This multicentre randomized controlled trial aimed to further examine the roles of CCEF in (1) the resolution of vertebral bone marrow oedema (VBME) using a follow-up MRI study and (2) pain relief, analgesic drug consumption and quality of life improvement in stimulated patients who were referred with acute vertebral fragility fractures (VFFs) compared to non-stimulated patients.MethodsBetween September 2016 and December 2019, patients who were referred to the spine centres that participated in this multicentre randomized clinical study with acute VFFs of type OF1 or OF2 were included in the present study. All the VFFs were conservatively managed according to Good Clinical Practice. Moreover, the patients were randomized into two groups: the CCEF group received, as an adjunct to the clinical study protocol, biophysical stimulation with a CCEF device (Osteospine, IGEA) for 8 h per day for 60 days, whereas the control group was treated according to the clinical study protocol. At baseline (T0), the 30-day follow-up (T1), the 60-day follow-up (T2), and the 6-month follow-up (T3), each patient underwent clinical evaluation using the Visual Analogue Scale (VAS) for Pain and the Oswestry Disability Index (ODI). Analgesic therapy with paracetamol 1000 mg tablets for 7 days—or longer, depending on the pain intensity—was performed; patients were required to report their paracetamol consumption on a specific sheet between study day 8 to 180 days of follow-up. MRI studies of the thoracolumbar spine were performed at 0 (T0), 30 (T1) and 60 days of follow-up (T2) using a 1.5-T MRI system in all of the centres that took part in the study. For each VBME area examined via MRI, the vertebral body geometry (i.e. anterior wall height/posterior wall height and vertebral kyphosis) were assessed.ResultsA total of 66 patients (male: 9, 13.63%; mean age: 73.15 years old) with 69 VFFs were included in the present study and randomized as follows: 33 patients were included in the control group and the remaining 33 patients were randomized into the CCEF group. In the CCEF group, good compliance with CCEF therapy was observed (adherence = 94%), and no adverse effects were recorded. In the stimulated patients, faster VBME resolution and significantly less vertebral body collapse during follow-up were observed compared to the control patients. Moreover, in the active group, faster pain reduction and improvement in the ODI mean score were observed. Stimulated patients also reported a significantly lower paracetamol consumption rate from the third follow-up after treatment until the 6-month follow-up. In terms of sex-related differences, in the CCEF group, VBME showed a faster resolution in male patients compared with females.ConclusionBiophysical stimulation with CCEF, as an adjunct to traditional conservative treatment, is a useful tool to hasten the VBME resolution process and prevent vertebral body deformation. These MRI findings also correlate with faster back pain resolution and quality of life improvement. From the third follow-up after treatment untilthe 6-month follow-up, stimulated patients reported a significantly lower paracetamol consumption than control patients, even though back pain and quality of life showed no significant differences between the two groups.Level of evidenceII.Trial Registration Register: ClinicalTrials.gov, number: NCT05803681.

Vonoprazan is Not Inferior to Proton Pump Inhibitors in Bismuth-containing Quadruple Therapy for Helicobacter pylori Eradication: A Meta-analysis of 10 Studies From East Asia.

To investigate the efficacy and safety of vonoprazan based bismuth-containing quadruple therapy (VBCQ) in eradicating Helicobacter pylori (Hp). The VBCQ and the proton pump inhibitor-based bismuth-containing quadruple regimen (PBCQ) were compared by retrieving relevant studies in Pubmed, Embase, Cochrane Library, CNKI, and Wanfang data. Combined analysis was performed with risk ratio (RR) and 95% CI as effect values. A total of 10 studies were enrolled, including 7 randomized controlled trials and 3 cohort studies. In intention-to-treat analysis, the eradication rate of VBCQ (89.24%, 1103/1236) was significantly higher than that of PBCQ (84.03%, 1021/1215), with RR = 1.06 (95% CI: 1.03~1.10). In per-protocol analysis, the eradication rates of VBCQ and PBCQ were 92.94% (895/963) and 87.82% (829/944), respectively, with a significant difference (RR = 1.06, 95% CI: 1.03~1.09). Subgroup analysis of study design types shared similar results. VBCQ and PBCQ showed an incidence of adverse reactions of 37.30% (304/815) and 34.94% (282/807), respectively. Significant differences were not found between the two groups (RR = 1.07, 95% CI: 0.96-1.19), nor in subgroup analysis. The good compliance rates in VBCQ and PBCQ groups were 94.32% (216/229) and 95.13% (215/226), respectively, with no significant difference (RR = 0.99, 95% CI: 0.95~1.04). VBCQ has a higher eradication rate on Hp than PBCQ, while its adverse reactions and compliance are similar to PBCQ. However, we conservatively believe that in Hp eradication, the VBCQ is not inferior to PBCQ because of the small absolute difference.

Challenges of Compliance with Infection Prevention and Control (IPC) Standard Procedures among Healthcare Workers: A Hospital-Based Cross-Sectional Study

Introduction: This hospital-based cross-sectional study aimed to assess the compliance of 251 healthcare workers (HCWs) with Infective Prevention and Control (IPC) standard procedures. The study addresses the critical issue of IPC compliance among HCWs, as it plays a pivotal role in reducing the risk of infectious disease transmission within healthcare settings. Methodology: Analytical cross-sectional study was conducted at St. Francis Referral Hospital, involving 251 healthcare workers from different departments including Internal medicine, Surgery, and Emergency. The Compliance with Standard Precautions Scale (CSPS) tool developed by WHO was used. Descriptive and regression analysis was done. A P-value of less than 0.05 indicated statistical significance. Results: Overall average compliance with IPCSPs was 54% whereby only 24.7% (62/251) of healthcare workers had a good compliance. The majority of HCWs (85.3%) reported highest compliance on proper disposal of used sharp items into sharp boxes and low compliance rate (11.6%) was on the disposal of the sharp box, sharp box is only disposed when it is full. Statistically significant were found between IPCSPs and number of years of working experience, level of education, profession, IPC training and IPC meeting attendance. Conclusion: This cross-sectional study has shed light on the critical challenges faced by healthcare workers in complying with IPCSPs. Findings revealed a concerning compliance with IPCSPs which is below the WHO standard and national level standard as well. We therefore recommend enhancement of IPC training program, IPC awareness campaign, and more implementational research for IPCSPs compliance.

An Alternative In-Home Protocol to Diagnose and Treat Obstructive Sleep Apnea

Abstract Objective Obstructive sleep apnea (OSA) is a major public health problem of pandemic proportions. In-laboratory OSA diagnosis and continuous positive airway pressure (CPAP) titration are insufficient, considering the number of patients affected. Finding alternative ways to diagnose and treat OSA is mandatory, especially in this era of the coronavirus disease 2019 (COVID-19) pandemic. The present study aims to describe an alternative in-home protocol to diagnose and treat OSA. Materials and Methods We enrolled consecutive patients aged ≥ 18 years with moderate/severe OSA, who underwent in-home type-III polysomnography and home-based titration with automatic CPAP, coupled with an oximetry sensor for 3 consecutive nights. Patients were remotely monitored for 90 days to evaluate CPAP compliance and the use of an engagement tool was encouraged. Results We included 86 participants. The median time until the diagnosis was of one day. The mean time from the baseline visit until the acquisition and initiation of the CPAP therapy was of 33 (range: 17 to 52) days. Telemonitoring ensured good compliance in the first 30 (79.2%), 60 (76.3%) and 90 (74.3%) days, with an average daily use of 6.2 ± 1.4 h, 6.0 ± 1.4 h, and 6.0 ± 1.3 h respectively. About 1/3 of the patients used the engagement tool, and CPAP compliance was significantly higher among these patients compared with those who did not used the tool: 89.9% versus 73.5% (p < 0.002), 87.9% versus 70% (p < 0.003), and 86.6% versus 67.6% (p < 0.001) at 30, 60, and 90 days respectively. Conclusion We demonstrated that an alternative in-home protocol to diagnose and treat OSA is effective, ensuring good CPAP compliance after 90 days. Telemonitoring and engagement tools could be strategies to improve CPAP compliance.

Compliant Iontronic Triboelectric Gels with Phase-Locked Structure Enabled by Competitive Hydrogen Bonding

HighlightsA bionic phase-locked structure-inspired iontronic triboelectric gel is proposed with good mechanical compliance for wearable haptic sensing applications.Competitive hydrogen bonding systems are constructed through polymer-solvent-nonsolvent interactions, and regeneration of polymers with weak hydrogen bond donors triggers controlled phase separation.Self-powered haptic skin constructed with iontronic triboelectric gel has a modulus (150.6 kPa) and stretchability (> 400%) similar to that of the human body, enabling fidelity transmission of haptic signals and precise recognition of sensing objects.

Slotted Patch Antenna with Wide Bandwidth for In-body Biotelemetry Applications

This paper proposes a slotted patch antenna with wide bandwidth covering ISM frequency band (2.40-2.48 GHz) for implantable biotelemetry applications. A homogeneous skin phantom (HSP) model proves the usability of the proposed antenna in in-body environments. At a resonance frequency of 2.42 GHz, the design shows an S11 parameter of -35.56 dB, a percentage impedance bandwidth of 66.6% (2-4 GHz), and the maximum peak gain of -24.80 dBi. To validate the simulated results, the designed antenna was fabricated and measured, showing good compliance with the expected results. To ensure tissue safety, a specific absorption rate (SAR) is simulated for the proposed antenna which satisfies the requirements of IEEE standards, with a value of 87.75 W/kg for 10 g of tissue. The proposed antenna shows a telemetry range of 11 and 6.3 m at 7 kbps and 100 kbps data rates, respectively. The key features of the proposed antenna include the following: miniaturization, good S parameters, wide bandwidth, low SAR, good telemetry range, and high gain.

Impact of negative signs on therapeutic compliance in patients with schizophrenia

IntroductionSchizophrenia is characterized by a heterogeneous clinical expression. Schizophrenic symptoms fall into three main dimensions: positive, negative, and disorganized. Negative symptoms may be primary or secondary to positive symptoms. Therapeutic compliance is essential in the management of mental illnesses and in particular schizophrenia. The associations between poor compliance and negative symptomatology are little studied even though it is found in several patients suffering from schizophrenia and is associated with a poor functional prognosis.ObjectivesThe objective of this study is to evaluate the link between negative symptoms and medication adherence in patients with schizophrenia.MethodsThis is a cross-sectional study with a descriptive and analytical aim carried out among patients in whom a diagnosis of schizophrenia was made according to the diagnostic criteria of the DSM-5.Data will be collected using an anonymous hetero-questionnaire including patients’ personal and sociodemographic data, as well as the negative symptoms subscale of the PANSS and Medication Adherence Rating Scale (MARS) which assesses therapeutic compliance.ResultsIn total, we obtained a sample of 109 patients. The median age of the population is 37 years (+/- 8.2), the age varies between 18 and 64 years. The majority of patients were single, i.e. 79.6%. On average, patients had good compliance with the MARS with a mean score of 6.3 ± 1.9 [0;10]. A negative correlation between the negative symptoms subscale of the PANSS and the MARS was found significant (p=0.003), with a moderate effect.ConclusionsThis study showed that the negative signs of schizophrenia have an impact on therapeutic compliance. Therefore, it would be useful to enlarge the sample and study this association in depth in order to be able to improve these signs to ensure good care and better quality of life for these patients.Disclosure of InterestNone Declared

A computational study of binary eutectic system with convection under volumetric freezing: A Moving Boundary Problem

A reduction in the operating time during the solidification of an eutectic alloy is one of the prime demands in front of the investigators. The classical theory of solidification was not able to offer rapid solidification of an alloy due to not account the structural property of the material. To account convection and external heat sink effect, an external volumetric heat sink is considered and it depends on the distance and time. The thermal conductivity, density, and specific heat of the mushy zone are assumed to be the linear combination of solid and liquid regions properties with a solid fraction distribution. The mathematical model accounts for the solid fraction distribution, which has a linear relationship with the temperature of the mushy zone. The analytical solution of the problem has been determined via similarity transformation. To explore the current study, numerical data of the Copper-Aluminum alloy with 5% Copper is presented. It has been found that with a volumetric heat sink, the rate of solidification becomes faster than usual. Further, the rate of heat removal from the surface accelerates. Convection enhances the rate of freezing of the eutectic alloy. The temperature of the mushy region is going up for the increasing value of the solid fraction in mushy zone, which is lying in [0,1] and when we increase the strength of volumetric heat, then the temperature profile decreases and, the first-interface and second-interface increase gradually in the whole medium. We compared the current result with Tien and Geiger’s result, and it is found in good compliance. It is expected that the current study will improve the fundamental understanding of the solidification of an eutectic alloy and reduce the time for freezing, which is useful to design industrial freezing devices for alloys.

Application of Thermoresponsive Smart Polymers based in situ Gel as a Novel Carrier for Tumor Targeting.

The temperature-triggered in situ gelling system has been revolutionized by introducing an intelligent polymeric system. Temperature-triggered polymer solutions are initially in a sol state and then undergo a phase transition to form a gel at body temperature due to various parameters like pH, temperature, and so on. These smart polymers offer a number of advantages, including ease of administration, long duration of release of the drug, low administration frequency with good patient compliance, and targeted drug delivery with fewer adverse effects. Polymers such as poly(N-isopropylacrylamide) (PNIPAAm), polyethylene glycol (PEG), poly (N, N'-diethyl acrylamide), and polyoxypropylene (PPO) have been briefly discussed. In addition to various novel Drug Delivery Systems (DDS), the smart temperature-triggered polymeric system has various applications in cancer therapy and many other disease conditions. This review focuses on the principals involved in situ gelling systems using various temperature-triggered polymers for chemotherapeutic purposes, using smart DDS, and their advanced application in cancer therapy, as well as available marketed formulations and recent advances in these thermoresponsive sol-gel transforming systems.

Modeling and Experimental Study of the Inrush Current of a High-Temperature Superconducting Transformer

Inrush current in high-temperature superconducting (HTS) transformers is a little-studied phenomenon. After connecting to the power grid, a current flow through the windings which exceeding the critical current value of the superconducting tape. It may cause significant overheating and thermal damage of winding. The purpose of the study is to develop a mathematical model for calculating inrush current pulses in a HTS transformer and its verification by physical experiments. To achieve the goal of the study, a mathematical model has been developed that accurately represents the electromagnetic and thermal transient processes after HTS transformer is turned on at idling or under load. The model considers the critical parameters of the HTS tapes, the process of heating and cooling of the windings, quench characteristics, and the electrical and magnetic parameters of the transformer. Good compliance of the experimental results and mathematical modeling with a deviation of 1.99 % allowed us to verify the model. The most important result is the creation of a mathematical model of the HTS transformer at the moment of connecting to power grid. This model represents the temperature changing of the windings during the loss of superconductivity. The developed model can be used in the analysis and modeling of inrush current in designed and operating HTS transformers for any power. The obtained results are significant for determine the optimal starting characteristics, geometric and electrical parameters of HTS transformers. The proposed methods for reducing the inrush current ensure safe and reliable operation of the HTS transformer when switched on at idling or under load.

Air and noise pollution analyses near oil and gas fields in the Mahakam Delta, Kalimantan, Indonesia

The Mahakam Delta is a strategic industrial area in East Kalimantan, Indonesia, in which oil and gas industries reduce ambient air quality and generate excessive noise. This research aimed to analyze the ambient air and noise pollution attributed to oil and gas production activities in the delta. Relevant parameters at five sampling points (UA-02 to UA-06) were measured and further analyzed in the laboratory, including total suspended particulate (TSP), SO2, Pb CO, NO2, O3, temperature, humidity, wind direction, wind speed, and noise. Indonesia’s air pollutant standard index (locally abbreviated as ISPU) with four parameters (CO, NO2, SO2, and O3) was used to determine the ambient air quality, and provisions written in the Decree of the Minister of Environment No. 50 Kep-48/MENLH/11/1996 were consulted for the noise quality assessment. Results showed ISPU values in the range of 0–50 at the five sampling points, suggesting good ambient air quality and compliance with Government Regulation No. 22 of 2021. In addition, it was revealed that the noise parameter was lower than the upper threshold set in the Ministerial Decree, namely 65 dB. Nevertheless, monitoring air and noise quality at the main pollutant sources should be regulated through policies and implemented to protect the public from exposure to potential pollutants.

Turkish cultural adaptation, validity, and reliability of the stroke activity scale in individuals with Hemiparesis

ABSTRACT Aim The aim of this study was to make the Turkish cultural adaptation of the the Stroke Activity Scale (SAS). Method This study was designed as a methodological research. The psychometric properties of the SAS scale were evaluated by validity and reliability analyses. Results The average age of 84 stroke patients (mean ± SD) was 59.52 ± 14.03 years. Kaiser-Meyer-Olkin (0.816) and Bartlett’s Test of Sphericity (χ2 = 288.968, df = 10, p < 0.001) showed that the data set can be factored. A one-factor structure was obtained with Principal Component Analysis (PCA). The factor loads of the items obtained with PCA and Confirmatory Factor Analysis (CFA) were found to be statistically significant. The obtained chi-square statistics (χ2 = 2.227, p = 0.694), normalized chi-square/freedom (χ2/sd) value (0 ≤ 0.557 ≤ 2) and other goodness of fit indices showed good compliance. The positive highly significant correlation (r = 0.846, p < 0.001) between the SAS and Rivermead Mobility Index (RMI) scales confirmed the Concurrent validity. Cronbach’s alpha (0.864) value showed high reliability and Intraclass Correlation Coefficient (ICC) value (0.983, p < 0.001) showed excellent agreement. Conclusions In this study, which was conducted for the Turkish adaptation of the SAS scale, the 5-item and 1-factor structure was evaluated as a valid and reliable scale for evaluating the balance abilities of stroke patients living in Turkey.

Investigating the Level of Quarantine Compliance among People in Close Contact With a Person Infected With COVID-19 Patients

Background and aims: COVID-19 has emerged as a novel pandemic, emphasizing the crucial role of prevention and quarantine measures. Compliance with these measures becomes particularly important for individuals in close contact with COVID-19-infected individuals. This study aimed to investigate the level of quarantine compliance among individuals who had close contact with COVID-19 patients in Hamadan province, as well as identify predictors associated with compliance. Methods: This descriptive-analytical, cross-sectional study was conducted between March and July 2022, involving 350 individuals who had close contact with COVID-19 patients in Hamadan province, Iran. A researcher-designed questionnaire was employed to gather participants’ demographic and clinical information, as well as their adherence to quarantine principles, through a 7-question assessment. The collected data were statistically analyzed using Stata software, version 16. Results: The study participants had a mean age of 40.23±12.91 years. The rate of good compliance with quarantine measures among individuals in close contact with COVID-19 patients was found was 58.66%. Adjusted logistic regression analysis revealed that men in close contact with COVID-19 patients had a 1.66 times higher chance of complying with quarantine compared to women (odds ratio [OR]=1.66, 95% CI=1.06, 2.56), P=0.025). Additionally, individuals over the age of 60 who had close contact with COVID-19 patients exhibited a 2.28 times higher chance of non-compliance with quarantine (OR=2.28, 95% CI=1.17, 4.45, P=0.015). Conclusion: Demographic characteristics could significantly influence compliance with quarantine principles among individuals in close contact with COVID-19 patients. Addressing these factors is crucial for effective health planning and patient education in the country.

Comparison between tendon-driven and soft pneumatic actuators in soft robotic hands

Bionic robotic hands have huge potential for applications. Traditional rigid robotic hands have the disadvantages of complex control and poor compliance, while soft robotic hands can well overcome these difficult drawbacks. Tendon-driven actuators and soft pneumatic actuators are two main actuating methods in soft robotic hands which are increasingly used due to their good compliance. This article first reviews the basic principles and structures of these two actuating methods in order to develop a basic understanding of different actuating methods. Then through comparing the dexterity and grasp performance of two specific designs, this article analyzes the characteristics of both methods in terms of their structures. Through discussion of structural differences, the systematic impact of the two actuating methods on function is analyzed and a general conclusion about differences in applicability is drawn. This article aims to help researchers have a better understanding of the two main actuating methods for soft robotic hands before they choose a specific actuating method, which can contribute to better completion of expected functions.

Exploiting Domain Partition in Response Function-Based Dynamic Surrogate Modeling: A Continuous Crystallizer Study

Given the exponential rise in the amount of data requiring processing in all engineering fields, phenomenological models have become computationally cumbersome. For this reason, more efficient data-driven models have been recently used with the purpose of substantially reducing simulation computational times. However, especially in process engineering, the majority of the proposed surrogate models address steady-state problems, while poor studies refer to dynamic simulation modeling. For this reason, using a response function-based approach, a crystallization unit case study was set up in order to derive a dynamic data-driven model for crystal growth whose characteristic differential parameters are derived via Response Surface Methodology. In particular, multiple independent variables were considered, and a well-established sampling technique was exploited for sample generation. Then, different sample sizes were tested and compared in terms of accuracy indicators. Finally, the domain partition strategy was exploited in order to show its relevant impact on the final model accuracy. In conclusion, the outcome of this study proved that the proposed procedure is a suitable methodology for dynamic system metamodeling, as it shows good compliance and relevant improvement in terms of computational time. In terms of future research perspectives, testing the proposed procedure on different systems and in other research fields would allow for greater improvement and would, eventually, extend its validity.

Conocimientos y prácticas de prevención frente al covid-19 de los padres de familia de pacientes pediátricos en un hospital de referencia del Perú, 2022

Objective. To determine the association between preventive knowledge and practices in parents of pediatric patients hospitalized in a reference hospital in 2022. Materials and methods. Observational, analytical, and cross-sectional study conducted between October and December 2022. Preventive practices against COVID-19 were evaluated using an instrument developed by Fernández-Guzmán et al., and knowledge about COVID-19 was assessed using the KNOW-PCOVID-19 by Mejía et al. Prevalence ratios were calculated with a 95% confidence interval. Crude and adjusted analyses were performed, considering a significant p-value &lt;0.05. STATA v.16 software was used for the analysis. Results. The final sample included 338 participants, mostly women (74.6%), aged between 32 and 35 years. 26.6% of parents had a high level of preventive practices, and 26.3% of them had a high level of knowledge about COVID-19. A significant association was found between gender and preventive practices, with men showing a 50% lower prevalence than women (PR: 0.50; 95%CI: 0.29-0.86, p=0.013). Conclusions. An association was found between a high level of knowledge and preventive practices in parents of hospitalized children. Although close to three out of ten parents demonstrated good compliance with preventive practices; men showed lower compliance than women. Therefore, we highlight the need for strategies to strengthen communication to improve understanding and promote a more effective response to COVID-19.

Chinese expert consensus on clinical application of percutaneous endoscopic gastrostomy / jejunostomy (2024 edition)

Percutaneous endoscopic gastrostomy / jejunostomy (PEG/J) is a relatively safe and effective minimally invasive surgical approach to establish long-term enteral nutrition (EN) channels. Due to the good compliance and the reduced incidence of reflux and aspiration pneumonia, PEG/J is the preferred way for long-term EN and has been widely used in clinical applications. However, few technical guidelines or expert consensus guiding the clinical practice of PEG/J have been published. The formation of "Chinese expert consensus on clinical application of percutaneous endoscopic gastrostomy / jejunostomy (2024 edition)" is led by the Committee of Parenteral and Enteral Nutrition, Chinese Research Hospital Association. This consensus is based on the latest clinical evidence as well as the clinical experience of Chinese experts. This consensus is divided into PEG/J indications and contraindication, perioperative management, operational techniques, prevention, and treatment of related complications and other issues. All recommendations and their strengths were carried out by expert-voting method and presented as the basic framework of "Recommended Opinions (level of evidence and strength of recommendation) and Summary of Evidence". This consensus is registered on the International Practice Guide Registration Platform (IPGRP-2022CN329).

Can we improve therapeutic compliance in cancer patients? Report of a cross-sectional case series study in Morocco.

Therapeutic compliance (TC) refers to the patient's compliance with the prescriptions and recommendations of a doctor. Patients with cancer often exhibit unsatisfactory TC. The objective of our study was to assess TC levels in cancer patients and identify predictors of poor compliance. The authors conducted a cross-sectional study in March 2023 at the oncology centre, where the vast majority of medical activity is performed in the day hospital. TC was measured using a questionnaire or survey. Various parameters were analyzed to identify predictive factors of poor therapeutic compliance. The authors' study included 175 cancer patients with a mean age of 55 years. The study revealed that 85% exhibited good compliance (GC) as indicated by the CI [8.500 ± 0.075], signifying patients who consistently adhered to their medication schedule. Conversely, 15% demonstrated poor compliance (PC), as indicated by the confidence interval [0.825 ± 0.750]. Compliance status was assessed by considering patients who adhered to the prescribed medication timing as good compliance (GC) and those who did not adhere as poor compliance (PC). The analysis of our study results indicated that poor therapeutic compliance was associated with low socio-economic and educational levels. Therefore, it is important to utilize all available resources to improve therapeutic compliance. The majority of factors contributing to poor compliance can be mitigated through effective coordination between the patient and their support network.