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PloS One 2023Food insecurity is prevalent in the U.S. and is associated with deleterious health, behavioral, and social consequences. Food insecurity is currently addressed largely...
INTRODUCTION
Food insecurity is prevalent in the U.S. and is associated with deleterious health, behavioral, and social consequences. Food insecurity is currently addressed largely through public and private food assistance programs (e.g., the Supplementary Nutrition Assistance Program, and food pantries). A body of research has explored racial and ethnic disparities and differences in food insecurity and coping strategies. However, limited literature has explored these experiences among Asian Americans and Asian origin groups in the United States.
OBJECTIVE
The aim of this review is to establish what is known about the experience of food insecurity and nutrition program participation in the Asian American population and among Asian origin groups and to suggest further research and policy action to better address food insecurity in this population.
METHODS
Our review is guided by the methodological framework proposed by Arksey and O'Malley and refined and outlined by Levac and colleagues and the Joanna Briggs Institute. We will search key terms related to food insecurity and Asian Americans in Medline (Ovid), the Cochrane Library (Wiley), CINAHL Plus with Full Text (Ebsco), PsycINFO (Ebsco), and Scopus (Elsevier). An article will be included if it was published in the English language; is a peer reviewed research manuscript and reports primary research findings from analyses; and describes food insecurity or strategies to cope with food insecurity among individuals of Asian origins living in the U.S. An article will be excluded if it is a book, conference proceedings, or grey literature (e.g., thesis or dissertation); is a commentary, editorial, or opinion piece without primary research data; contains only research conducted outside of the U.S.; includes Asians in the sample but does not provide separate data on food insecurity or strategies to cope with food insecurity among Asians; and describes only dietary changes or patterns but not food insecurity. Two or more reviewers will participate in the study screening and selection process. We will record information from the final articles chosen to be included in the review in a data table template and will also prepare a summary narrative with key findings.
EXPECTED OUTPUTS
Results will be disseminated through peer-reviewed publications and conference presentations. The findings from this review will be of interest to researchers and practitioners and inform further research and policy to better address food insecurity among this population.
Topics: Humans; Asian; Nutritional Status; Research Design; Review Literature as Topic; Food Insecurity
PubMed: 37399223
DOI: 10.1371/journal.pone.0287895 -
Drug Design, Development and Therapy 2023The aim of this study was to compare the effects of remimazolam and propofol on emergence agitation (EA) in elderly patients undergoing hip replacement. (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
The aim of this study was to compare the effects of remimazolam and propofol on emergence agitation (EA) in elderly patients undergoing hip replacement.
METHODS
A total of 60 elderly patients undergoing hip replacement were recruited for this prospective, single-center, clinical, randomized, controlled study from February to April 2023. They were randomly assigned to two groups: the remimazolam group (group R) and the propofol group (group P). In group R, remimazolam was administered intravenously during the induction and maintenance of anesthesia, In group P, propofol was used during the induction and maintenance of anesthesia. The incidence of EA was recorded as the primary indicator. Secondary indicators included heart rate (HR) and mean arterial pressure (MAP) values at the following moments: 5 min prior to anesthetic induction (T), 1 min following induction (T), 5 min after the laryngeal mask was inserted (T), the beginning of surgery (T), the moment the laryngeal mask was removed (T), and the overall incidence of postoperative adverse events (bleeding or splitting of the surgical incision, removal of the intravenous infusion needle, falling off the bed, hypoxemia, and hypertension).
RESULTS
The incidence of EA was significantly lower in group R than in group P (10% vs 33%, < 0.05). At T, T, and T, the HR and MAP values of group R were higher than those of group P ( < 0.05). The overall incidence of postoperative adverse events was significantly lower in group R than in group P ( < 0.05).
CONCLUSION
Remimazolam further reduced the incidence of emergence agitation when compared to propofol during geriatric hip replacement. Moreover, it has a minor hemodynamic effect and lower the incidence of postoperative adverse events.
Topics: Aged; Humans; Emergence Delirium; Propofol; Prospective Studies; Research Design
PubMed: 37680862
DOI: 10.2147/DDDT.S419146 -
BMJ Open Dec 2023Radiological imaging is one of the most frequently performed diagnostic tests worldwide. The free-text contained in radiology reports is currently only rarely used for...
INTRODUCTION
Radiological imaging is one of the most frequently performed diagnostic tests worldwide. The free-text contained in radiology reports is currently only rarely used for secondary use purposes, including research and predictive analysis. However, this data might be made available by means of information extraction (IE), based on natural language processing (NLP). Recently, a new approach to NLP, large language models (LLMs), has gained momentum and continues to improve performance of IE-related tasks. The objective of this scoping review is to show the state of research regarding IE from free-text radiology reports based on LLMs, to investigate applied methods and to guide future research by showing open challenges and limitations of current approaches. To our knowledge, no systematic or scoping review of IE from radiology reports based on LLMs has been published. Existing publications are outdated and do not comprise LLM-based methods.
METHODS AND ANALYSIS
This protocol is designed based on the , chapter 11.2: 'Development of a scoping review protocol'. Inclusion criteria and a search strategy comprising four databases (PubMed, IEEE Xplore, Web of Science Core Collection and ACM Digital Library) are defined. Furthermore, we describe the screening process, data charting, analysis and presentation of extracted data.
ETHICS AND DISSEMINATION
This protocol describes the methodology of a scoping literature review and does not comprise research on or with humans, animals or their data. Therefore, no ethical approval is required. After the publication of this protocol and the conduct of the review, its results are going to be published in an open access journal dedicated to biomedical informatics/digital health.
Topics: Humans; Research Design; Information Storage and Retrieval; Radiology; Radiography; Language; Review Literature as Topic
PubMed: 38070902
DOI: 10.1136/bmjopen-2023-076865 -
BMC Geriatrics Aug 2023Efforts are needed to strengthen evidence and guidance for appropriate deprescribing for older nursing home (NH) residents, who are disproportionately affected by... (Review)
Review
BACKGROUND
Efforts are needed to strengthen evidence and guidance for appropriate deprescribing for older nursing home (NH) residents, who are disproportionately affected by polypharmacy and inappropriate prescribing. Given the challenges of conducting randomized drug withdrawal studies in this population, data from observational studies of routinely collected healthcare data can be used to identify patients who are apparent candidates for deprescribing and evaluate subsequent health outcomes. To improve the design and interpretation of observational studies examining determinants, risks, and benefits of deprescribing specific medications in older NH residents, we sought to propose a conceptual framework of the determinants of deprescribing in older NH residents.
METHODS
We conducted a scoping review of observational studies examining patterns and potential determinants of discontinuing or de-intensifying (i.e., reducing) medications for NH residents. We searched PubMed through September 2021 and included studies meeting the following criteria: conducted among adults aged 65 + in the NH setting; (2) observational study designs; (3) discontinuation or de-intensification as the primary outcome with key determinants as independent variables. We conceptualized deprescribing as a behavior through a social-ecological lens, potentially influenced by factors at the intrapersonal, interpersonal, organizational, community, and policy levels.
RESULTS
Our search in PubMed identified 250 potentially relevant studies published through September 2021. A total of 14 studies were identified for inclusion and were subsequently synthesized to identify and group determinants of deprescribing into domains spanning the five core social-ecological levels. Our resulting framework acknowledges that deprescribing is strongly influenced by intrapersonal, patient-level clinical factors that modify the expected benefits and risks of deprescribing, including index condition attributes (e.g., disease severity), attributes of the medication being considered for deprescribing, co-prescribed medications, and prognostic factors. It also incorporates the hierarchical influences of interpersonal differences relating to healthcare providers and family caregivers, NH facility and health system organizational structures, community trends and norms, and finally healthcare policies.
CONCLUSIONS
Our proposed framework will serve as a useful tool for future studies seeking to use routinely collected healthcare data sources and observational study designs to evaluate determinants, risks, and benefits of deprescribing for older NH residents.
Topics: Humans; Aged; Nursing Homes; Deprescriptions; Inappropriate Prescribing; Polypharmacy; Research Design; Observational Studies as Topic
PubMed: 37542226
DOI: 10.1186/s12877-023-04194-5 -
BMJ Open Oct 2023Despite strong evidence for the efficacy of low-radiation dose CT (LDCT) in reducing lung cancer (LC) mortality, implementing LC screening (LCS) programmes remains a...
INTRODUCTION
Despite strong evidence for the efficacy of low-radiation dose CT (LDCT) in reducing lung cancer (LC) mortality, implementing LC screening (LCS) programmes remains a challenge. We aim to systematically review the evidence on the strategies used to recruit the adult population at risk of LC to LDCT within LCS programmes and to estimate the effectiveness of interventions identified, used to reach the potentially eligible population, increase participation and informed choice, and ensure equitable access.
METHODS AND ANALYSIS
This sequential systematic literature review will consist of three steps: (1) a scoping review of existing strategies and organisational models for LCS; (2) selecting papers reporting relevant outcomes (test coverage, screening participation and informed choice) and comparing results among different models; (3) a systematic review of interventions implemented to increase participation in LCS programmes. Each step will follow the methodological guidelines provided by the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data sources include electronic databases such as Medline (PubMed version), Embase, CINAHL (Ebsco version), Scopus and Cochrane CENTRAL. The search will be limited to studies published from January 2000 to March 2023 in English, Italian, French, Spanish, Serbian and Croatian language. Findings will be synthesised quantitatively and qualitatively as appropriate. Risk of bias assessment will be only applied to studies selected in the second and third steps. The quality of evidence will be summarised for each outcome using the Grading Recommendation Assessment, Development and Evaluation methodology.
ETHICS AND DISSEMINATION
Given that this is a review of existing literature, ethics approval is not required. The results will be published in peer-reviewed scientific journals and presented at relevant conferences. The findings of this review will help guide health authorities in organising LCS programmes and developing recommendations, policies, and actions at national and regional levels.
PROSPERO REGISTRATION NUMBER
CRD42023408357.
Topics: Adult; Humans; Early Detection of Cancer; Lung Neoplasms; Systematic Reviews as Topic; Research Design; Review Literature as Topic
PubMed: 37907293
DOI: 10.1136/bmjopen-2023-074140 -
BMJ Open Sep 2023Participatory research science deals with partnerships underlying research, governance and ownership of research products. It is concerned with relationships behind...
INTRODUCTION
Participatory research science deals with partnerships underlying research, governance and ownership of research products. It is concerned with relationships behind research objectives and methods. Participatory research has gained significant traction in design of health interventions, contextualising these to local settings and stakeholder groups. Despite a massive increase in participatory research exercises, the field remains undertheorised, and the mechanisms for improving health outcomes remain unclear. This realist review seeks to understand how and under what circumstances participatory research impacts health and social outcomes.
METHODS AND ANALYSIS
The review will follow four steps: (1) searching for and selecting evidence, (2) assessing the quality of evidence, (3) extracting and categorising data and (4) synthesising the data in the form of context-mechanism-outcomes configurations. The review will follow the Realist And Meta Narrative Evidence Syntheses: Evolving Standards (RAMESES) II guidelines for reporting realist evaluations. We categorise and synthesise data in four steps: (1) identifying outcomes, (2) identifying contextual components of outcomes, (3) theoretical redescription (abduction) and (4) identifying mechanisms. A retroductive analysis will identify mechanisms by moving between empirical data and theories, using inductive and deductive reasoning to explain the outcomes-context matches. The output will generate middle-range theories on how participatory research works, for whom and under what circumstances.
ETHICS AND DISSEMINATION
This study is a review of a published literature. It does not involve human participants. We will convene a workshop to share and discuss the preliminary results with partners and key stakeholders involved in participatory health research. We will publish the review results in peer-reviewed journals and academic conferences.
Topics: Humans; Community-Based Participatory Research; Research Design; Narration; Review Literature as Topic
PubMed: 37775285
DOI: 10.1136/bmjopen-2023-074075 -
Scientific Reports Jun 2023Research continues to identify genetic variation, environmental exposures, and their mixtures underlying different diseases and conditions. There is a need for screening...
Research continues to identify genetic variation, environmental exposures, and their mixtures underlying different diseases and conditions. There is a need for screening methods to understand the molecular outcomes of such factors. Here, we investigate a highly efficient and multiplexable, fractional factorial experimental design (FFED) to study six environmental factors (lead, valproic acid, bisphenol A, ethanol, fluoxetine hydrochloride and zinc deficiency) and four human induced pluripotent stem cell line derived differentiating human neural progenitors. We showcase the FFED coupled with RNA-sequencing to identify the effects of low-grade exposures to these environmental factors and analyse the results in the context of autism spectrum disorder (ASD). We performed this after 5-day exposures on differentiating human neural progenitors accompanied by a layered analytical approach and detected several convergent and divergent, gene and pathway level responses. We revealed significant upregulation of pathways related to synaptic function and lipid metabolism following lead and fluoxetine exposure, respectively. Moreover, fluoxetine exposure elevated several fatty acids when validated using mass spectrometry-based metabolomics. Our study demonstrates that the FFED can be used for multiplexed transcriptomic analyses to detect relevant pathway-level changes in human neural development caused by low-grade environmental risk factors. Future studies will require multiple cell lines with different genetic backgrounds for characterising the effects of environmental exposures in ASD.
Topics: Humans; Autistic Disorder; Autism Spectrum Disorder; Fluoxetine; Research Design; Transcriptome; Induced Pluripotent Stem Cells
PubMed: 37386098
DOI: 10.1038/s41598-023-37488-0 -
Antimicrobial Resistance and Infection... Nov 2023We aimed to identify interventions used to implement antimicrobial stewardship practices among hospitalized patients in least-developed countries. (Review)
Review
BACKGROUND
We aimed to identify interventions used to implement antimicrobial stewardship practices among hospitalized patients in least-developed countries.
METHODS
The research team searched PubMed, EMBASE, and Cochrane Central Register of Controlled Trials for studies of AMS interventions in the least developed and low-income countries, published between 2000 and 2023. Included studies had a population of hospitalized patients of all age groups in least-developed countries, implemented an AMS intervention, and reported its impact on prescription practices, clinical outcomes, or microbiological results. The risk of bias was assessed using the integrated quality criteria for review of multiple study designs. A total of 443 articles were identified, 386 articles were screened, 16 full-text papers were reviewed, and 10 studies were included in the analysis.
RESULTS
The ten studies included three controlled before and after, two qualitative, one controlled interrupted time series, two non-controlled interrupted time series, one quasi-experimental study, and one randomized controlled trial. Three studies implemented either enabling, persuasive, or structural interventions respectively. The rest used bundled strategies, including a combination of persuasive, enabling, structural, and restrictive interventions. Bundled interventions using enabling and persuasive strategies were the most common. These involved creating a prescription guideline, training prescribers on updated methods, and subsequent review and feedback of patient files by members of an AMS team. Improved microbiological surveillance was important to most studies but, sustained improvement in appropriate prescriptions was dependent on enabling or persuasive efforts. Studies noted significant improvements in appropriate prescriptions and savings on the costs of antibiotics. None evaluated the impact of AMS on AMR.
CONCLUSION
AMS practices generally involve multiple strategies to improve prescription practices. In the setting of least-developed countries, enabling and persuasive interventions are popular AMS measures. However, measured outcomes are heterogeneous, and we suggest that further studies assessing the impact of AMS should report changes in AMR patterns (microbiological outcomes), patient length of stay and mortality (patient outcomes), and changes in prescription practices (prescription outcomes). Reporting on these as outcomes of AMS interventions could make it easier for policymakers to compare which interventions have desirable outcomes that can be generalized to similar settings.
Topics: Humans; Antimicrobial Stewardship; Developing Countries; Patients; Policy; Research Design
PubMed: 37993964
DOI: 10.1186/s13756-023-01335-8 -
BMJ Open Dec 2023Interpregnancy weight change may impact two important adverse perinatal outcomes: stillbirth and infant mortality. This systematic review aims to synthesise the existing... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Interpregnancy weight change may impact two important adverse perinatal outcomes: stillbirth and infant mortality. This systematic review aims to synthesise the existing evidence on the association between interpregnancy weight change and stillbirth and infant mortality.
METHODS AND ANALYSIS
This systematic review and meta-analysis will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols guidelines and has been registered in the International Prospective Register of Systematic Reviews (PROSPERO). A comprehensive literature search of four online databases (Embase, Cochrane Libraries, Web of Science and Medline) will be conducted from inception to October 2023. Observational (longitudinal, cohort, case-control) and randomised controlled trials will be included. Interpregnancy weight/body mass index change between two consecutive pregnancies will be the exposure. The primary outcomes will be the incidence of stillbirth and infant mortality in subsequent pregnancy. The Cochrane Risk of Bias tool will be used to assess the risk of bias in the randomised controlled studies and the Risk of Bias in Non-Randomised Studies of Interventions tool will be used for observational studies. If there are sufficient data, a meta-analysis will be conducted to estimate the pooled effect size. Otherwise, qualitative descriptions of individual studies will be summarised. The heterogeneity will be statistically assessed using a χ test and I statistic.
ETHICS AND DISSEMINATION
Ethics approval is not required for this study as all results will be based on published papers. No primary data collection will be needed. Study findings will be presented at scientific conferences or published in a peer-reviewed scientific journal.
TRIAL REGISTRATION NUMBER
A registration for this review has been submitted to PROSPERO under CRD42020222977.
Topics: Female; Humans; Infant; Pregnancy; Body Mass Index; Infant Mortality; Research Design; Stillbirth
PubMed: 38135309
DOI: 10.1136/bmjopen-2023-080757 -
Philosophical Transactions of the Royal... Oct 2023, if we are to do so in a way that is sensible, begins at the root. All too often, we jump to discussing specific postulated causes but do not first consider what we... (Review)
Review
, if we are to do so in a way that is sensible, begins at the root. All too often, we jump to discussing specific postulated causes but do not first consider what we mean by, for example, of obesity or how we discern whether something is a cause. In this paper, we address what we mean by a cause, discuss what might and might not constitute a reasonable causal model in the abstract, speculate about what the causal structure of obesity might be like overall and the types of things we should be looking for, and finally, delve into methods for evaluating postulated causes and estimating causal effects. We offer the view that different meanings of the concept of causal factors in obesity research are regularly being conflated, leading to confusion, unclear thinking and sometimes nonsense. We emphasize the idea of different kinds of studies for evaluating various aspects of causal effects and discuss experimental methods, assumptions and evaluations. We use analogies from other areas of research to express the plausibility that only inelegant solutions will be truly informative. Finally, we offer comments on some specific postulated causal factors. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part II)'.
Topics: Humans; Research Design; Causality; Obesity
PubMed: 37661742
DOI: 10.1098/rstb.2022.0227