-
Critical Care Explorations Jul 2024To review recruitment and retention strategies of randomized family-centered interventional studies in adult ICUs.
OBJECTIVES
To review recruitment and retention strategies of randomized family-centered interventional studies in adult ICUs.
DATA SOURCES
The MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Library database from inception to February 2023.
STUDY SELECTION
Randomized controlled trials with family-centered interventions in the ICU setting that reported at least one family-centered outcome that were included in our previously published systematic review.
DATA EXTRACTION
For recruitment: Number of family members approached and enrolled, type of approach, location, time of day approached, whether medical team approached first, compensation offered, and type of consent. For retention: Number of family members enrolled and completed initial follow-up visit, mode of follow-up, location of follow-up visit, data collection method, timing of follow-up visits, number of follow-up visits, and compensation offered. Recruitment (participants approached/enrolled) and retention (participants enrolled/completed initial follow-up) percentage were calculated.
DATA SYNTHESIS
There were 51 studies in the analysis. The mean recruitment percentage was 49.3% ± 24.3%. There were no differences in recruitment percentage by study country, ICU type, recruitment approach, or whether the medical team approached the family member first (all p > 0.05). The mean retention percentage for the initial follow-up visit was 81.6% ± 18.0%. There were no differences in retention percentage by mode of participant contact, data collection type, or follow-up location (all p > 0.05). Minimal data were available to determine the impact of time of day approached and compensation on recruitment and retention outcomes.
CONCLUSIONS
About half of family members of ICU patients approached participated in trials and more than eight in ten completed the initial follow-up visit. We did not identify specific factors that impacted family recruitment or retention. There is a strong need for further studies to characterize optimal strategies to ensure family participation in clinical trials.
Topics: Humans; Intensive Care Units; Randomized Controlled Trials as Topic; Family; Patient Selection
PubMed: 38912720
DOI: 10.1097/CCE.0000000000001112 -
Resuscitation Plus Sep 2024To examine speed and accuracy of newborn heart rate measurement by various assessment methods employed at birth. (Review)
Review
AIM
To examine speed and accuracy of newborn heart rate measurement by various assessment methods employed at birth.
METHODS
A search of Medline, SCOPUS, CINAHL and Cochrane was conducted between January 1, 1946, to until August 16, 2023. (CRD 42021283364) Study selection was based on predetermined criteria. Reviewers independently extracted data, appraised risk of bias and assessed certainty of evidence.
RESULTS
Pulse oximetry is slower and less precise than ECG for heart rate assessment. Both auscultation and palpation are imprecise for heart rate assessment. Other devices such as digital stethoscope, Doppler ultrasound, an ECG device using dry electrodes incorporated in a belt, photoplethysmography and electromyography are studied in small numbers of newborns and data are not available for extremely preterm or bradycardic newborns receiving resuscitation. Digital stethoscope is fast and accurate. Doppler ultrasound and dry electrode ECG in a belt are fast, accurate and precise when compared to conventional ECG with gel adhesive electrodes.
LIMITATIONS
Certainty of evidence was low or very low for most comparisons.
CONCLUSION
If resources permit, ECG should be used for fast and accurate heart rate assessment at birth. Pulse oximetry and auscultation may be reasonable alternatives but have limitations. Digital stethoscope, doppler ultrasound and dry electrode ECG show promise but need further study.
PubMed: 38912532
DOI: 10.1016/j.resplu.2024.100668 -
Heliyon Jun 2024With high fatality and no cure, chronic wasting disease (CWD) has infected cervids in multiple regions, including the United States, Canada, Europe, and South Korea....
With high fatality and no cure, chronic wasting disease (CWD) has infected cervids in multiple regions, including the United States, Canada, Europe, and South Korea. Despite the rapid growth of literature on CWD, the full scope of its ecological, social, and economic impacts and the most effective and socially acceptable management strategies to mitigate the disease is unclear. Of 3008 initially identified published peer-reviewed papers, 134 were included in a final systematic literature review to synthesize the current knowledge on CWD transmission patterns, impacts, and the effectiveness of management interventions. The number of publications on CWD has increased steadily since 2000 with an average of six papers per year. Most papers were related to CWD prevalence (39 %), human behavior (33 %), CWD impacts (31 %), and management interventions (16 %). Environmental factors such as soil, water, and plants were identified as the most common transmission medium, with a higher prevalence rate among adult male cervids than females. Hunters showed a higher risk perception and were more likely to change hunting behavior due to CWD detection than non-hunters. Ecological impacts included the decreased survival rate accompanied by lower population growth, eventually leading to the decline of cervid populations. Culling was found to be an effective and widely implemented management strategy across countries, although it often was associated with public resistance. Despite potentially high negative economic impacts anticipated due to CWD, studies on this subject were limited. Sustained surveillance, ongoing research, and engagement of affected stakeholders will be essential for future disease control and management.
PubMed: 38912477
DOI: 10.1016/j.heliyon.2024.e31951 -
Frontiers in Microbiology 2024Colistin is used as a last resort for managing infections caused by multidrug-resistant bacteria. However, the high emergence of colistin-resistant strains has...
BACKGROUND
Colistin is used as a last resort for managing infections caused by multidrug-resistant bacteria. However, the high emergence of colistin-resistant strains has restricted the clinical use of this antibiotic in the clinical setting. In the present study, we evaluated the global prevalence of the mutation in the gene, one of the most important mechanisms of colistin resistance in .
METHODS
Several databases, including Scopus, Medline (via PubMed), and Web of Science, were searched (until August 2023) to identify those studies that address the mutation in clinical isolates of . Using Stata software, the pooled prevalence of mutation and subgroup analyses for the year of publication, country, continent, mutation types, and detection methods of mutation were analyzed.
RESULTS
Out of the 115 studies included in the analysis, the prevalence of mutations in colistin-resistant isolates was estimated at 65% of isolates, and variations with insertional inactivation had the highest prevalence among the five investigated mutations with 69%. The year subgroup analysis indicated an increase in mutated from 46% in 2014 to 61% in 2022. Europe had the highest prevalence of mutated at 73%, while Africa had the lowest at 54%.
CONCLUSION
Mutations in the gene are reported as one of the most common mechanisms of colistin resistance in and the results of the present study showed that 65% of the reported colistin-resistant had a mutation in this gene.
PubMed: 38912352
DOI: 10.3389/fmicb.2024.1386478 -
Frontiers in Microbiology 2024() is a strict microaerophilic bacterial species that exists in the stomach, and infection is one of the most common chronic bacterial infections affecting humans.... (Review)
Review
() is a strict microaerophilic bacterial species that exists in the stomach, and infection is one of the most common chronic bacterial infections affecting humans. Eradicating is the preferred method for the long-term prevention of complications such as chronic gastritis, peptic ulcers, gastric mucosa-associated lymphoid tissue lymphoma, and gastric cancer. However, first-line treatment with triple therapy and quadruple therapy has been unable to cope with increasing antibacterial resistance. To provide an updated review of infections and antibacterial resistance, as well as related treatment options, we searched PubMed for articles published until March 2024. The key search terms were "", " infection", " diseases", " eradication", and " antibacterial resistance." Despite the use of antimicrobial agents, the annual decline in the eradication rate of continues. Emerging eradication therapies, such as the development of the new strong acid blocker vonoprazan, probiotic adjuvant therapy, and vaccine therapy, are exciting. However, the effectiveness of these treatments needs to be further evaluated. It is worth mentioning that the idea of altering the oxygen environment in gastric juice for to not be able to survive is a hot topic that should be considered in new eradication plans. Various strategies for eradicating , including antibacterials, vaccines, probiotics, and biomaterials, are continuously evolving. A novel approach involving the alteration of the oxygen concentration within the growth environment of has emerged as a promising eradication strategy.
PubMed: 38912349
DOI: 10.3389/fmicb.2024.1418129 -
Frontiers in Medicine 2024Preoxygenation before endotracheal intubation (ETI) maintains asphyxiated oxygenation and reduces the risk of hypoxia-induced adverse events. Previous studies have...
BACKGROUND
Preoxygenation before endotracheal intubation (ETI) maintains asphyxiated oxygenation and reduces the risk of hypoxia-induced adverse events. Previous studies have compared various preoxygenation methods. However, network meta-analyses (NMAs) of the combined comparison of preoxygenation methods is still lacking.
METHODS
We searched for studies published in PubMed, Embase, Web of Science, Scopus, and the Cochrane Library. Review Manager version 5.3 was used to evaluate the risk of bias. The primary outcome of this meta-analysis was low oxygen saturation (SpO) during ETI. The secondary outcomes included SpO <80%, SpO <90%, and apnea time during ETI. NMA was performed using R 4.1.2 software gemtc packages in RStudio.
RESULTS
A total of 15 randomized controlled trials were included in this study. Regarding the lowest SpO, the noninvasive ventilation (NIV) with high-flow nasal cannula (HFNC) group performed better than the other groups. For SpO <80%, the NIV group (0.8603467) performed better than the HFNC (0.1373533) and conventional oxygen therapy (COT, 0.0023) groups, according to the surface under the cumulative ranking curve results. For SpO <90%, the NIV group (0.60932667) performed better than the HFNC (0.37888667) and COT (0.01178667) groups. With regard to apnea time, the HFNC group was superior to the COT group (mean difference: -50.05; 95% confidence interval: -90.01, -10.09; = 0.01).
CONCLUSION
Network analysis revealed that NIV for preoxygenation achieved higher SpO levels than HFNC and COT and offered a more significant advantage in maintaining patient oxygenation during ETI. Patients experienced a longer apnea time after HFNC preoxygenation. The combination of NIV with HFNC proved to be significantly superior to other methods. Given the scarcity of such studies, further research is needed to evaluate its effectiveness.
SYSTEMATIC REVIEW REGISTRATION
identifier CRD42022346013.
PubMed: 38912343
DOI: 10.3389/fmed.2024.1379369 -
Frontiers in Medicine 2024Tuberculosis is a contagious bacterial disease caused by . The emergence and spread of drug-resistant strains of in both developing and developed countries has made...
INTRODUCTION
Tuberculosis is a contagious bacterial disease caused by . The emergence and spread of drug-resistant strains of in both developing and developed countries has made diagnosis, treatment, and control of tuberculosis more difficult. The PCR assay, which is a fast and sensitive technique and an alternative method for detecting multidrug-resistant tuberculosis, is used to determine rifampicin (RIF) resistance. There is no single figure in Ethiopia that represents rifampicin-resistant tuberculosis and that is why this study was conducted to overcome the inconsistency of the results of the previous studies.
METHODS
Studies were researched from five major electronic databases. Studies which were cross-sectional in design, published, and written in English were included. The data were extracted using Microsoft Excel, and the data were managed and analyzed using Stata™ Version 17.0 statistical software. The Forest plot was used to check the presence of heterogeneity. The publication bias, meta-regression, and subgroup analysis were used to find out the source of heterogeneity. A random effect analysis model was used to pool the prevalence of RR TB from primary studies, and associated factors of RR among TB patients were identified using Meta regression. The presence of association was reported using OR with 95% CI.
RESULTS
The overall pooled prevalence of tuberculosis was 14.9% (95% CI: 13.34, 16.46), of these approximately 7.48% (95% CI: 6.30, 8.66) showed rifampicin-resistant tuberculosis in Ethiopia. Among the computed variables, 2.05% living with HIV1.39 (95%CI: 1.13, 1.72) and having a history of TB treatment (95%CI: 1.34, 3.15) were identified as significant factors associated with RR TB in Ethiopia.
CONCLUSION
Drug-resistant TB is one of the prevalent emerging infectious diseases among TB patients, which affects approximately one out of every thirteen TB patients. Having TB-HIV coinfection and a history of prior TB treatment were identified as significant factors associated with RR TB. To prevent and control RR TB, patients should complete their follow-up course; the health professionals should educate the actions taken by the patients when they experience drug toxicity and side effects; and the Minister of Health should initiate telemedicine and recruit tracers to overcome TB patients' default and have good drug adherence and retention after initiation of the treatment.
PubMed: 38912342
DOI: 10.3389/fmed.2024.1319845 -
Frontiers in Medicine 2024The rapid spread of COVID-19 pandemic across the world has not only disturbed the global economy but also raised the demand for accurate disease detection models....
The rapid spread of COVID-19 pandemic across the world has not only disturbed the global economy but also raised the demand for accurate disease detection models. Although many studies have proposed effective solutions for the early detection and prediction of COVID-19 with Machine Learning (ML) and Deep learning (DL) based techniques, but these models remain vulnerable to data privacy and security breaches. To overcome the challenges of existing systems, we introduced Adaptive Differential Privacy-based Federated Learning (DPFL) model for predicting COVID-19 disease from chest X-ray images which introduces an innovative adaptive mechanism that dynamically adjusts privacy levels based on real-time data sensitivity analysis, improving the practical applicability of Federated Learning (FL) in diverse healthcare environments. We compared and analyzed the performance of this distributed learning model with a traditional centralized model. Moreover, we enhance the model by integrating a FL approach with an early stopping mechanism to achieve efficient COVID-19 prediction with minimal communication overhead. To ensure privacy without compromising model utility and accuracy, we evaluated the proposed model under various noise scales. Finally, we discussed strategies for increasing the model's accuracy while maintaining robustness as well as privacy.
PubMed: 38912338
DOI: 10.3389/fmed.2024.1409314 -
Frontiers in Oncology 2024The prognostic relevance of the platelet-to-lymphocyte ratio (PLR) in gastric cancer (GC) patients undergoing immune checkpoint inhibitor (ICI) treatment remains...
OBJECTIVES
The prognostic relevance of the platelet-to-lymphocyte ratio (PLR) in gastric cancer (GC) patients undergoing immune checkpoint inhibitor (ICI) treatment remains unclear. This meta-analysis aimed to determine the prognostic impact of PLR in this specific patient cohort.
METHODS
We searched the PubMed, Cochrane Library, CNKI, and EMBASE databases, including literature published up to September 2023, to investigate the prognostic implications of PLR in patients with gastric cancer undergoing immune checkpoint inhibitor therapy. Outcome measures encompassed overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rates (DCR).
RESULTS
Nine studies from seven articles comprising 948 eligible patients were selected. The results revealed a significant correlation between elevated PLR and poorer OS and progression-free survival (PFS) (OS: HR 1.67, 95% CI 1.39-2.00, p < 0.001; PFS: HR 1.51, 95% CI 1.29-1.76, p < 0.001). Subgroup analyses were performed to validate the robustness of the results. Moreover, a meta-analysis of four studies investigating the correlation between the PLR in gastric cancer (GC) patients and the objective response rate/disease control rate (ORR/DCR), showed no significant association between the PLR and ORR/DCR (ORR: RR = 1.01, p = 0.960; DCR: RR = 0.96, p = 0.319).
CONCLUSIONS
This meta-analysis indicates that elevated PLR in GC patients undergoing ICI treatment is significantly linked to worse OS and PFS. Therefore, PLR can serve as a prognostic indicator of post-treatment outcomes in patients with GC receiving ICIs. Further prospective studies are required to assess the reliability of these findings.
SYSTEMATIC REVIEW REGISTRATION
https://inplasy.com/, identifier INPLASY2023120103.
PubMed: 38912061
DOI: 10.3389/fonc.2024.1367990 -
Frontiers in Psychology 2024To examine the scope of existing literature on the conceptualization, use, and outcomes associated with compassion in the care of youth with childhood-onset disabilities.
INTRODUCTION
To examine the scope of existing literature on the conceptualization, use, and outcomes associated with compassion in the care of youth with childhood-onset disabilities.
METHODS
A protocol was developed based on the Joanna Briggs Institute (JBI) scoping review method. MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and EBSCOhost CINAHL, were searched.
RESULTS
Eight studies were selected for inclusion; four used quantitative methodology, and four used qualitative methods. Compassion was not defined or in any of the included studies. The concept of self-compassion was explicitly defined only for parents of youth with childhood-onset disabilities in three studies . The most reported outcome measure was self-compassion in parents of youth with childhood-onset disabilities. Self-compassion among parents was associated with greater quality of life and resiliency and lower stress, depression, shame and guilt.
DISCUSSION
There is limited evidence on the conceptualization, use, and outcomes associated with compassion among youth with childhood-onset disabilities. Self-compassion may be an effective internal coping process among parents of youth with childhood-onset disabilities. Further research is required to understand the meaning of compassion to youth with childhood-onset disabilities, their parents and caregivers.
SYSTEMATIC REVIEW REGISTRATION
https://doi.org/10.17605/OSF.IO/2GRB4.
PubMed: 38911955
DOI: 10.3389/fpsyg.2024.1365205