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Clinical Chemistry and Laboratory... Jun 2024Metabolomics aims for comprehensive characterization and measurement of small molecule metabolites (<1700 Da) in complex biological matrices. This study sought to...
OBJECTIVES
Metabolomics aims for comprehensive characterization and measurement of small molecule metabolites (<1700 Da) in complex biological matrices. This study sought to assess the current understanding and usage of metabolomics in laboratory medicine globally and evaluate the perception of its promise and future implementation.
METHODS
A survey was conducted by the IFCC metabolomics working group that queried 400 professionals from 79 countries. Participants provided insights into their experience levels, knowledge, and usage of metabolomics approaches, along with detailing the applications and methodologies employed.
RESULTS
Findings revealed a varying level of experience among respondents, with varying degrees of familiarity and utilization of metabolomics techniques. Targeted approaches dominated the field, particularly liquid chromatography coupled to a triple quadrupole mass spectrometer, with untargeted methods also receiving significant usage. Applications spanned clinical research, epidemiological studies, clinical diagnostics, patient monitoring, and prognostics across various medical domains, including metabolic diseases, endocrinology, oncology, cardiometabolic risk, neurodegeneration and clinical toxicology.
CONCLUSIONS
Despite optimism for the future of clinical metabolomics, challenges such as technical complexity, standardization issues, and financial constraints remain significant hurdles. The study underscores the promising yet intricate landscape of metabolomics in clinical practice, emphasizing the need for continued efforts to overcome barriers and realize its full potential in patient care and precision medicine.
PubMed: 38915248
DOI: 10.1515/cclm-2024-0550 -
JMIR Cardio May 2024Background: Although telemedicine has been proven to have significant potential for improving cardiac patient care, there remains a substantial risk of introducing...
Analysis of Demographic and Socioeconomic Factors Influencing the Adherence to a Web-based Intervention Among Patients after Acute Coronary Syndrome: a Prospective Observational Cohort Study.
BACKGROUND
Background: Although telemedicine has been proven to have significant potential for improving cardiac patient care, there remains a substantial risk of introducing disparities linked to the utilization of digital technology, especially for older or socially vulnerable subgroups.
OBJECTIVE
We investigated factors influencing adherence to a telemedicine-delivered health education intervention in ischemic patients, emphasizing demographic and socioeconomic considerations.
METHODS
We conducted a descriptive, observational, prospective cohort study in consecutive patients referred to our cardiology center for acute coronary syndrome, from February 2022 to January 2023. Patients were invited to join a web-based health educational meeting (WHEM) after hospital discharge, as part of a secondary prevention program. The WHEM sessions were scheduled monthly and used a teleconference software program for remote synchronous videoconferencing, accessible through standard computer, tablet, or smartphone based on patient preference or availability.
RESULTS
Out of the 252 patients (median age 70 years [interquartile range: 61.0-77.3 years]; 189 males [75%]), 98 (39%) declined the invitation to participate in the WHEM. The reasons for non-acceptance were mainly challenges in handling digital technology (70/98, 71.4%), followed by lack of confidence in telemedicine as an integrative tool for managing their medical condition (45/98, 45.9%), and lack of Internet-connected devices (43/98, 43.8%). Out of the 154 patients who agreed to participate in the WHEM, 40 (26%) were unable to attend. Univariable logistic regression analysis showed that the presence of a caregiver with digital proficiency and a higher education level were associated with increased likelihood of attendance to the WHEM, while the converse was true for increasing age and female gender. After multivariable adjustment, higher education level (odds ratio, 2.26 [95% confidence interval, 1.53-3.32], p<0.001) and caregiver with digital proficiency (odds ratio, 12.83 [95% confidence interval, 5.93-27.75], p<0.001) remained independently associated with the outcome. The model discrimination was good even when corrected for optimism (optimism corrected C-index, 0.812), as was the agreement between observed and predicted probability of participation (optimism corrected calibration intercept and slope, 0.010 and 0.948).
CONCLUSIONS
The current study identifies a notable lack of suitability for a specific cohort of ischemic patients to participate in our telemedicine intervention, emphasizing the risk of digital marginalization for a significant portion of the population. Addressing low digital literacy rates among patients or their informal caregivers, and overcoming cultural bias against remote care, were identified as critical issues in our study findings to facilitate the broader adoption of telemedicine as an inclusive tool in healthcare.
PubMed: 38912920
DOI: 10.2196/57058 -
Frontiers in Oncology 2024CAR-T cell therapy has shown remarkable promise in treating B-cell malignancies, which has sparked optimism about its potential to treat other types of cancer as well.... (Review)
Review
CAR-T cell therapy has shown remarkable promise in treating B-cell malignancies, which has sparked optimism about its potential to treat other types of cancer as well. Nevertheless, the Expectations of CAR-T cell therapy in solid tumors and non-B cell hematologic malignancies have not been met. Furthermore, safety concerns regarding the use of viral vectors and the current personalized production process are other bottlenecks that limit its widespread use. In recent years the use of gene editing technology in CAR-T cell therapy has opened a new way to unleash the latent potentials of CAR-T cell therapy and lessen its associated challenges. Moreover, gene editing tools have paved the way to manufacturing CAR-T cells in a fully non-viral approach as well as providing a universal, off-the-shelf product. Despite all the advantages of gene editing strategies, the off-target activity of classical gene editing tools (ZFNs, TALENs, and CRISPR/Cas9) remains a major concern. Accordingly, several efforts have been made in recent years to reduce their off-target activity and genotoxicity, leading to the introduction of advanced gene editing tools with an improved safety profile. In this review, we begin by examining advanced gene editing tools, providing an overview of how these technologies are currently being applied in clinical trials of CAR-T cell therapies. Following this, we explore various gene editing strategies aimed at enhancing the safety and efficacy of CAR-T cell therapy.
PubMed: 38912057
DOI: 10.3389/fonc.2024.1388475 -
Scientific Reports Jun 2024In the healthcare domain, the essential task is to understand and classify diseases affecting the vocal folds (VFs). The accurate identification of VF disease is the key...
In the healthcare domain, the essential task is to understand and classify diseases affecting the vocal folds (VFs). The accurate identification of VF disease is the key issue in this domain. Integrating VF segmentation and disease classification into a single system is challenging but important for precise diagnostics. Our study addresses this challenge by combining VF illness categorization and VF segmentation into a single integrated system. We utilized two effective ensemble machine learning methods: ensemble EfficientNetV2L-LGBM and ensemble UNet-BiGRU. We utilized the EfficientNetV2L-LGBM model for classification, achieving a training accuracy of 98.88%, validation accuracy of 97.73%, and test accuracy of 97.88%. These exceptional outcomes highlight the system's ability to classify different VF illnesses precisely. In addition, we utilized the UNet-BiGRU model for segmentation, which attained a training accuracy of 92.55%, a validation accuracy of 89.87%, and a significant test accuracy of 91.47%. In the segmentation task, we examined some methods to improve our ability to divide data into segments, resulting in a testing accuracy score of 91.99% and an Intersection over Union (IOU) of 87.46%. These measures demonstrate skill of the model in accurately defining and separating VF. Our system's classification and segmentation results confirm its capacity to effectively identify and segment VF disorders, representing a significant advancement in enhancing diagnostic accuracy and healthcare in this specialized field. This study emphasizes the potential of machine learning to transform the medical field's capacity to categorize VF and segment VF, providing clinicians with a vital instrument to mitigate the profound impact of the condition. Implementing this innovative approach is expected to enhance medical procedures and provide a sense of optimism to those globally affected by VF disease.
Topics: Humans; Vocal Cords; Machine Learning
PubMed: 38910146
DOI: 10.1038/s41598-024-64987-5 -
Clinical Nutrition (Edinburgh, Scotland) Jun 2024This study aimed to develop a prediction model for identifying a woman with gestational diabetes mellitus (GDM) at high risk of type 2 diabetes (T2DM) post-birth.
Development of a risk prediction model for postpartum onset of type 2 diabetes mellitus, following gestational diabetes; the lifestyle InterVention in gestational diabetes (LIVING) study.
AIMS
This study aimed to develop a prediction model for identifying a woman with gestational diabetes mellitus (GDM) at high risk of type 2 diabetes (T2DM) post-birth.
METHODS
Utilising data from 1299 women in the Lifestyle Intervention IN Gestational Diabetes (LIVING) study, two models were developed: one for pregnancy and another for postpartum. Key predictors included glucose test results, medical history, and biometric indicators.
RESULTS
Of the initial cohort, 124 women developed T2DM within three years. The study identified seven predictors for the antenatal T2DM risk prediction model and four for the postnatal one. The models demonstrated good to excellent predictive ability, with Area under the ROC Curve (AUC) values of 0.76 (95% CI: 0.72 to 0.80) and 0.85 (95% CI: 0.81 to 0.88) for the antenatal and postnatal models, respectively. Both models underwent rigorous validation, showing minimal optimism in predictive capability. Antenatal model, considering the Youden index optimal cut-off point of 0.096, sensitivity, specificity, and accuracy were measured as 70.97%, 70.81%, and 70.82%, respectively. For the postnatal model, considering the cut-off point 0.086, sensitivity, specificity, and accuracy were measured as 81.40%, 75.60%, and 76.10%, respectively.
CONCLUSIONS
These models are effective for predicting T2DM risk in women with GDM, although external validation is recommended before widespread application.
PubMed: 38909514
DOI: 10.1016/j.clnu.2024.06.006 -
Comprehensive Psychiatry Jun 2024The activation of permissive beliefs is a cognitive mechanism through which individuals permit themselves to engage in pleasurable, yet potentially unregulated...
BACKGROUND
The activation of permissive beliefs is a cognitive mechanism through which individuals permit themselves to engage in pleasurable, yet potentially unregulated activities. Existing measures are heterogenous, focusing either on specific behaviors or on particular licensing mechanisms. The new Permissive Beliefs Questionnaire (PBQ) seeks to integrate self-licensing mechanisms from various research domains and to be applicable to different behaviors.
METHODS
Study 1 aimed at exploring the factor structure and reduce the number of items. In study 2, we used confirmatory factor analysis and tested convergent and discriminant validity in three subsamples of individuals playing videogames (n = 489), shopping online (n = 506), and drinking alcohol (n = 511). We tested the hypothesis whether individuals who experience a self-regulatory conflict show a greater expression of permissive beliefs.
RESULTS
The final version of the PBQ consists of 12 items which represent two factors: Deserving Reward and Defensive Optimism. The PBQ exhibited robust model fit indices and internal consistencies in the three samples. Permissive beliefs were heightened among individuals intending to downregulate their gaming, shopping, or drinking behaviors as compared to individuals without this intention.
CONCLUSION
The PBQ is a valid measure of permissive beliefs for gaming, online shopping, and drinking alcohol. It serves an ecologic and psychometrically valid tool to address empirical research questions regarding the functioning of permissive beliefs. Additionally, it may be used in clinical settings to measure and raise an understanding for permissive beliefs in clients.
PubMed: 38905774
DOI: 10.1016/j.comppsych.2024.152507 -
Nursing ResearchHypertension rates have increased worldwide, with the most significant increase in morbidity and mortality observed among African Americans. Resilience is a potential...
BACKGROUND
Hypertension rates have increased worldwide, with the most significant increase in morbidity and mortality observed among African Americans. Resilience is a potential factor influencing how individuals manage health-related challenges or self-management tasks for hypertension. Research is scarce related to resilience and self-management frameworks in African Americans with hypertension.
OBJECTIVES
We aimed to describe a conceptualized resilience framework and preliminary findings of the association among resilience precursors, stress response, hypertension self-management behaviors, and health outcomes in African Americans with hypertension.
METHODS
This cross-sectional, descriptive-correlational study included African American adults with hypertension, aged 25 years and older, recruited from an academic university and surrounding urban communities in the Midwest. Participants completed standardized, validated questionnaires to examine the association among resilience precursors, stress response, hypertension self-management behaviors, health-related quality of life (HRQOL), and blood pressure at baseline. Descriptive statistics were used to describe the sample demographic characteristics, whereas Pearson's correlational and multiple regression analyses were conducted to determine the associations among the variables.
RESULTS
African Americans with hypertension (N = 30) were included in this preliminary study, with a mean age of 59.17 years; 66.7% were female. The mean systolic blood pressure was 136 (SD = 16.8) mmHg; the mean diastolic blood pressure was 78.1 (SD = 13) mmHg. Pearson's correlation analysis revealed significant relationships between resilience precursors, stress response, hypertension self-management behaviors and capability, and health outcome components. Multiple regression analysis showed that poor perceived resilience significantly predicted depression. Low dispositional optimism and low perceived resilience were significant predictors of stress. Higher perceived resilience significantly predicted self-efficacy. Perceived stress was negatively and significantly associated with HRQOL. Finally, higher self-efficacy significantly predicted better HRQOL.
DISCUSSION
This study underscores the significant association between resilience, stress, self-management behaviors, and health outcomes in African Americans with hypertension. Further research with larger sample sizes and longitudinal designs is warranted to confirm and expand upon these findings.
Topics: Humans; Female; Male; Black or African American; Hypertension; Middle Aged; Resilience, Psychological; Self-Management; Cross-Sectional Studies; Adult; Aged; Quality of Life; Surveys and Questionnaires
PubMed: 38905621
DOI: 10.1097/NNR.0000000000000743 -
Journal of Religion and Health Jun 2024Turning toward religion to make sense of and cope with challenging circumstances is an area of interest for many recent researchers working on wellbeing and mental...
Turning toward religion to make sense of and cope with challenging circumstances is an area of interest for many recent researchers working on wellbeing and mental health. The present study extends this interest by assessing whether psychological capital explains the association between religious coping and mental wellbeing in Pakistani engineers. Psychological capital was assessed from four factors, namely optimism, resilience, hope, and self-efficacy. A sample of 501 Muslim engineers from Pakistan (M age = 33.41, SD = 6.37 years) was assessed on measures of religious coping, psychological capital, and mental wellbeing. Results from correlation and a multimediation model showed that positive religious coping was positively predictive of mental wellbeing and psychological capital; however, negative religious coping remained insignificant for mental wellbeing. Further analysis showed that of four psychological capital factors, only self-efficacy explained the positive association between positive religious coping and mental wellbeing. Implications of the findings along with future directions have been discussed.
PubMed: 38904718
DOI: 10.1007/s10943-024-02075-8 -
ACS ES&T Water Jun 2024[This corrects the article DOI: 10.1021/acsestwater.2c00428.].
[This corrects the article DOI: 10.1021/acsestwater.2c00428.].
PubMed: 38903199
DOI: 10.1021/acsestwater.4c00418 -
Musculoskeletal Science & Practice Jun 2024There is a lack of qualitative research on how patients with lumbar spinal stenosis (LSS) undergoing surgery perceive their health-related quality of life (HRQOL)....
BACKGROUND
There is a lack of qualitative research on how patients with lumbar spinal stenosis (LSS) undergoing surgery perceive their health-related quality of life (HRQOL). Research that increases our understanding in this area could facilitate a biopsychosocial approach to care.
AIM
We aimed to investigate the experiences of patients with LSS undergoing decompression surgery regarding their pre- and post-surgery perceptions of HRQOL and the pre-and post-operative information and physiotherapy.
METHOD
We used a qualitative design with semi-structured interviews to perform content analysis using an inductive approach. Twelve patients (7 female, 5 male) were included post-surgery and interviewed by phone. The interviews were recorded and transcribed verbatim.
RESULTS
Four distinct categories with nine associated subcategories were identified: Patients' feelings of safety and empowerment are enhanced by healthcare professionals; Divided perceptions of information and physiotherapy in a group context; Health-related quality of life is associated with patients' perceived physical capacity; Patients' optimism and concerns influence health-related quality of life.
CONCLUSION
Both physical and psychological factors pre- and post-surgery appear to influence patients' HRQOL. Inherent optimism and feelings of empowerment in the care process appear to be important factors, regardless of physical health status. A strong patient-provider relationship is important to promote self-efficacy, which may positively affect perceived HRQOL and is in line with the generally recommended biopsychosocial approach in the treatment of people with low back pain. As qualitative studies in this area are scarce, there is a need for further studies to validate our findings.
PubMed: 38901062
DOI: 10.1016/j.msksp.2024.103124