-
The American Journal of Tropical... Jul 2024Diarrheal disease is the second leading cause of death worldwide in children under 5 years old, after pneumonia. Fortunately, diarrhea is a preventable disease that can...
Diarrheal disease is the second leading cause of death worldwide in children under 5 years old, after pneumonia. Fortunately, diarrhea is a preventable disease that can be avoided by implementing basic home management strategies. Mothers are essential to its management and prevention; therefore, this study assessed the knowledge, attitudes, and practices of mothers in Pakistan related to diarrheal disease prevention and management. The study was conducted using a cross-sectional design in three cities of Pakistan from September 2022 to December 2022. A questionnaire was used to collect data on mothers' sociodemographic characteristics and their knowledge, attitudes, and practices related to the prevention and management of diarrheal diseases. A total of 356 mothers (81.7% of them were housewives, and 58.4% were 25-34 years old) participated in the study. Data were analyzed using descriptive statistics and tests of association. Significant associations were found between mothers' income, education, and ethnicity and their knowledge, attitudes, and practices regarding the prevention and management of diarrheal diseases (P <0.05). However, no significant association was found between the other variables. The knowledge and attitudes of the mothers regarding the prevention and management of diarrhea were satisfactory; however, their prevention-related practices and home-based management were unsatisfactory. Therefore, community education, formation of health and hygiene committees, and dissemination of user-friendly information are crucial for creating awareness about the prevention and management of diarrheal diseases. These measures can help improve the practices of mothers and reduce the incidence of diarrheal diseases in Pakistan.
PubMed: 38955190
DOI: 10.4269/ajtmh.23-0655 -
Nanotechnology Jul 2024Low-temperature KSCN molten salt is a promising technique to synthesize defect-rich MoS2 catalysts for hydrogen evolution reaction (HER). However, owing to the fast ion...
Low-temperature KSCN molten salt is a promising technique to synthesize defect-rich MoS2 catalysts for hydrogen evolution reaction (HER). However, owing to the fast ion diffusion rate for rapid crystal growth, the resultant catalysts show a morphology of microsphere, which aggregates from MoS2 nanosheets, to suppress the catalytic performance. In this work, large-sized few-layer MoS2 nanosheets are synthesized via a spatial confinement strategy by adding inert NaCl into the KSCN molten salt. With the NaCl spacer to physically block the long-distance ion diffusion and isolate the chemical reaction, the MoS2 nucleation and subsequent crystal growth could be controlled, guiding the nanosheets to grow along the narrow gap between the NaCl crystals to avoid aggregation. As a result, ultrathin MoS2 nanosheets with a large geometry size are constructed. Profiting from the architecture to expose active sites and boost charge transfer kinetics, the large-sized few-layer MoS2 nanosheets exhibit an impressive HER performance, showing a small η10 of 160 mV and a low Tafel slope of 53 mV dec-1 with excellent stability. This work provides not only an efficient HER catalyst but also a facile spatial confinement technique to design and synthesize a large spectrum of transition metal sulfides for broad uses.
PubMed: 38955176
DOI: 10.1088/1361-6528/ad5dc3 -
Laryngo- Rhino- Otologie Jul 2024Allergies play a pivotal role in the daily practice of ENT specialists. Allergic symptoms induced by inhalant allergens are widespread in the population and can manifest... (Review)
Review
Allergies play a pivotal role in the daily practice of ENT specialists. Allergic symptoms induced by inhalant allergens are widespread in the population and can manifest through a wide range of symptoms, including rhinorrhea, sneezing, conjunctival redness, cough and dyspnea. Inconsistent diagnosis and treatment of allergic conditions can lead to reduced quality of life, decreased work performance, and socioeconomically significant secondary diseases. In addition to the medical history, the skin prick test and serological IgE diagnostics are the most important diagnostic procedure for detecting type-I allergies. To clarify clinical relevance, molecular diagnostics and nasal provocation testing may be employed. The key to effective treatment lies in a comprehensive allergological diagnosis coupled with a detailed patient history. General treatment recommendations such as allergen avoidance and nasal irrigation should complement pharmacological therapy. In the treatment of allergic rhinitis topical steroids are first line treatment options. The primary goal of treatment is symptom control, and if control is insufficient, causal therapy through specific allergen immunotherapy is recommended. Challenges in the ENT clinic involve selecting the necessary diagnostics and appropriate, effective treatments. Hence, using diagnostic and treatment algorithms, as well as standardized patient history questionnaires, can serve as invaluable tools in daily patient interactions, especially considering limited time availability.
Topics: Humans; Immunoglobulin E; Skin Tests; Desensitization, Immunologic; Referral and Consultation; Hypersensitivity
PubMed: 38955155
DOI: 10.1055/a-2073-9474 -
Nanotechnology Jul 2024Electron backscatter diffraction and cathodoluminescence are complementary scanning electron microscopy modes widely used in the characterisation of semiconductor films,...
Electron backscatter diffraction and cathodoluminescence are complementary scanning electron microscopy modes widely used in the characterisation of semiconductor films, respectively revealing the strain state of a crystalline material and the effect of this strain on the light emission from the sample. Conflicting beam, sample and detector geometries have meant it is not generally possible to acquire the two signals together during the same scan. Here, we present a method of achieving this simultaneous acquisition, by collecting the light emission through a transparent sample substrate. We apply this combination of techniques to investigate the strain field and resultant emission wavelength variation in a deep-ultraviolet micro-LED. For such compatible samples, this approach has the benefits of avoiding image alignment issues and minimising beam damage effects.
PubMed: 38955132
DOI: 10.1088/1361-6528/ad5dba -
Journal of Photochemistry and... Jun 2024Nasopharyngeal cancer (NPC) is a malignant tumor with high prevalence in Southeast Asia and highly invasive and metastatic characteristics. Radiotherapy is the primary...
Nasopharyngeal cancer (NPC) is a malignant tumor with high prevalence in Southeast Asia and highly invasive and metastatic characteristics. Radiotherapy is the primary strategy for NPC treatment, however there is still lack of effect method for predicting the radioresistance that is the main reason for treatment failure. Herein, the molecular profiles of patient plasma from NPC with radiotherapy sensitivity and resistance groups as well as healthy group, respectively, were explored by label-free surface enhanced Raman spectroscopy (SERS) based on surface plasmon resonance for the first time. Especially, the components with different molecular weight sizes were analyzed via the separation process, helping to avoid the possible missing of diagnostic information due to the competitive adsorption. Following that, robust machine learning algorithm based on principal component analysis and linear discriminant analysis (PCA-LDA) was employed to extract the feature of blood-SERS data and establish an effective predictive model with the accuracy of 96.7% for identifying the radiotherapy resistance subjects from sensitivity ones, and 100% for identifying the NPC subjects from healthy ones. This work demonstrates the potential of molecular separation-assisted label-free SERS combined with machine learning for NPC screening and treatment strategy guidance in clinical scenario.
PubMed: 38955080
DOI: 10.1016/j.jphotobiol.2024.112968 -
Currents in Pharmacy Teaching & Learning Jul 2024Clinical decision-making (CDM) is crucial in pharmacy practice, necessitating effective teaching in undergraduate and postgraduate pharmacy education. This study aims to...
BACKGROUND AND PURPOSE
Clinical decision-making (CDM) is crucial in pharmacy practice, necessitating effective teaching in undergraduate and postgraduate pharmacy education. This study aims to explore undergraduates and postgraduates' perceptions of how a new teaching model supports their CDM when addressing patient cases.
EDUCATIONAL ACTIVITY AND SETTING
Implemented in a full-day CDM course for pharmacy students and a half-day course for pharmacists in the Netherlands, the model, accompanied by a learning guide, facilitated CDM in patient cases. Eight courses were conducted between September 2022 to June 2023, followed by an online survey measuring participants' agreement on how the model supported their CDM, using a 5-point Likert scale. Additionally, three open-ended questions were included to elicit learning outcomes and self-development opportunities.
FINDINGS
Of 175 invited participants, 159 (91%) completed the survey. Most agreed the teaching model supported their CDM, particularly in considering the patient's healthcare needs and context (96%), and exploring all available options (96%). Participants found the model provided a clear structure (97%), and fostered critical thinking (93%). The most frequently mentioned learning outcomes and self-development opportunities included collecting sufficient relevant information, maintaining a broad perspective, and decelerating the process to avoid premature closure.
SUMMARY
Participants agreed that the teaching model helped them to make clinical decisions. Both undergraduate and postgraduate pharmacy education could possibly benefit from the teaching model's implementation in supporting pharmacy students and pharmacists conducting CDM in pharmacy practice.
PubMed: 38955060
DOI: 10.1016/j.cptl.2024.102136 -
Asian Journal of Psychiatry Jun 2024Seizures are considered to be one of the dreaded side effects of clozapine, and due to this, the use of clozapine is avoided in patients with treatment-resistant...
BACKGROUND
Seizures are considered to be one of the dreaded side effects of clozapine, and due to this, the use of clozapine is avoided in patients with treatment-resistant schizophrenia. Resultantly, there is little information about the use of clozapine among patients with seizure disorder.
AIM
To assess the safety of clozapine in patients with history of seizures in their lifetime before starting clozapine and receiving clozapine for the management of psychotic disorders.
RESULTS
Out of the 958 patients, 35 (3.65 %) had a history of at least one seizure episode before starting clozapine, with a mean of 5.06 (SD: 7.23; Median: 3.00) seizures before starting clozapine. The mean duration between the last seizure and the starting of clozapine was 123.75 (SD: 124.99; Median: 84) months, with nine patients having an episode of seizure in the previous 12 months and 15 patients being seizure-free for more than ten years. About one-fourth (25.7 %; nine out of 35) of the patients had recurrence of seizure while receiving clozapine for a mean duration of about five years. When the recurrence of seizure after starting clozapine was evaluated in patients receiving antiepileptics along with clozapine, the incidence of at least one seizure was 26.67 % (4 out of 15), and among those not receiving antiepileptics, the incidence of at least one seizure was 25 % (5 out of 20). The dose of clozapine at which seizure was noted ranged from 12.5 mg to 600 mg/day with a mean of 236.25 (SD: 169.04; Median: 162.5) mg/day. In none of the patients, clozapine had to be stopped due to the continuation of seizures.
CONCLUSION
About one-fourth of the patients with history of an episode of seizure have recurrence of seizure while receiving clozapine. The demographic and clinical variables do not differ between those who develop and who do not develop seizures after starting clozapine, including concomitant use of antiepileptics.
PubMed: 38955034
DOI: 10.1016/j.ajp.2024.104144 -
Reproductive Biomedicine Online Mar 2024Does ibuprofen, a non-steroidal anti-inflammatory drug (NSAID), delay ovulation?
RESEARCH QUESTION
Does ibuprofen, a non-steroidal anti-inflammatory drug (NSAID), delay ovulation?
DESIGN
Two-stage, proof-of-concept, controlled study, assessing the percentage of non-ovulated follicles 42 h after HCG injection in patients taking ibuprofen. The intervention group consisted of women undergoing natural cycle IVF treatment taking ibuprofen 3 × 400 mg per day. The control group consisted of women undergoing timed sexual intercourse or intrauterine insemination. The proportion of patients with non-ovulated follicles in the ibuprofen group was first compared against a reference of 50% using a one-sample binomial test, and second against the proportion observed in the control group using an adjusted logistic regression.
RESULTS
A total of 26 women were recruited in the ibuprofen intervention group. Twenty-five patients were recruited in the control group. The proportion of patients with delayed ovulation observed (22/26 [84.6%]; 95% CI 65.1% to 95.6%) was significantly higher than the reference of 50% (P < 0.001). In the control group, the proportion of patients with delayed ovulation was 20.0% ([5/25], 95% CI 6.8% to 40.7%). Compared with the ibuprofen group, a significantly increased probability of a delayed ovulation was found in the ibuprofen intervention group (adjusted OR 22.72, 95% CI 5.77 to 115; P < 0.001). Of the 22 women with delayed ovulation, oocytes were retrieved in 20 women (90.9%) and all oocytes were mature (metaphase II).
CONCLUSIONS
Women trying to conceive should avoid non-selective NSAIDs around the time of ovulation. Ibuprofen or other NSAID can be used to delay ovulation for several hours in assisted reproductive technology and other infertility treatments if required.
PubMed: 38954900
DOI: 10.1016/j.rbmo.2024.103975 -
Social Science & Medicine (1982) Jun 2024Young people's mental health globally has been in decline. Because of their low perceived need, young people's services tend to be the first cut when budgets are...
Regional trends in mental health inequalities in young people aged 16-25 in the UK and the role of cuts to local government expenditure: Repeated cross-sectional analysis using the British household panel Survey/UK household longitudinal survey.
Young people's mental health globally has been in decline. Because of their low perceived need, young people's services tend to be the first cut when budgets are reduced. There is a lack of evidence on how a reduction in services and opportunities for young people is associated with their mental health. Additionally, how this may be magnified by place and the assets and challenges of place. The aim of this study is to explore trends in young people's mental health measured by GHQ-12 over time in the twelve regions of the UK. We estimated an interrupted time series model using 2010 as a break point from which there was a shift in government policy to a prolonged period of large reductions in central government funding. Repeated cross-sectional data on young people aged 16-25 is used from the British Household Panel Survey and its successor survey UK Household Longitudinal Survey. Results showed a statistically significant reduction in mental health for young people living in the North East, Wales, and the East of England. The North East was the region with the largest reduction in funding and saw the greatest reduction in young people's mental health. Next, we look at how reductions in local government expenditure related to services for children and young people: children's social services, education, transportation, and culture; explain the observed decline in mental health. We employ a Blinder-Oaxaca Decomposition approach comparing young people's mental health between 2011 and 2017. Results show a marginally statistically significant decrease in young people's mental health over this time. Unobserved factors related to transport spending and children's social services explain some of this gap. Area level factors such as deprivation, infrastructure, and existing assets need to be considered when distributing funding for young people's services to avoid exacerbating regional inequalities in mental health.
PubMed: 38954859
DOI: 10.1016/j.socscimed.2024.117068 -
Interdisciplinary Cardiovascular and... Jul 2024Composite end-points are common primary outcomes in clinical trials. Their main benefit of utilizing a composite outcome is increasing the number of primary outcome...
Composite end-points are common primary outcomes in clinical trials. Their main benefit of utilizing a composite outcome is increasing the number of primary outcome events meaning fewer participants are required to deliver an adequately powered trial. By combining multiple important end-points in the primary outcome rather than having to select only one, composite end-points potentially make clinically meaningful benefits easier to detect and avoid ranking outcomes hierarchically. However there are a number of important considerations when designing and interpreting clinical trials that utilize composite end-points. In this Statistical Primer, issues with composite end-points such as competing events, halo effect, risk of bias, time to event limitations and the win ratio are discussed in the context of real world clinical trials.
PubMed: 38954830
DOI: 10.1093/icvts/ivae126