Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.440
Filtrar
1.
Iran J Public Health ; 53(7): 1549-1559, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39086411

RESUMO

Background: The increasing accumulation of plastic waste is the most serious threat to the marine ecosystem. People who still have the habit of disposing of solid waste, especially plastic-type waste, in the marine environment have led to the discovery of microplastic content in various marine biota such as fish and shellfish. We aimed to assess the environmental health risks of microplastics due to consumption of marine life in the coastal area. Methods: We used an observational method with the Environmental Health Risk Assessment (EHRA) design to analyze the health risks of humans consuming fish and shellfish containing microplastics. This research was conducted in the coastal area of Takalar Regency, Indonesia in 2022. The samples used consisted of human (n = 30) and marine biota (fish, n=20; shellfish, n=20) samples. The data were obtained from observations, physical measurements of biota, laboratory tests, polymer type identification by Fourier Transform Infrared (FTIR) spectroscopy, and microscopy. Results: The average concentration of microplastics containing styrene compounds in shellfish was 2.01 mg/kg. The abundance of MPs in the fish and shellfish samples was 0.01 particles/g or 10 particles/kg in fish and 7 particles/individual in shellfish. The MPs were found in line, fragment, film, and pellet forms, with different size and color variations. The average MPs exposure risk level (RQ value) for both fish and shellfish was 0.02. Conclusion: All samples had RQ values < 1, which means that the microplastic-containing tofu shellfish were still safe for consumption by people living in the Takalar coastal area.

2.
Ulus Travma Acil Cerrahi Derg ; 30(8): 596-602, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39092976

RESUMO

BACKGROUND: Head trauma is a leading cause of death and disability. While standard treatment protocols exist for severe head trauma, no clear follow-up standards are available for mild head trauma with positive imaging findings in infants and newborns. Although routine follow-up brain computed tomography (CT) imaging is not recommended for children with moderate and mild head trauma, the necessity for follow-up imaging in infants and newborns remains uncertain. METHODS: Our study is a retrospective, observational, and descriptive study. Infants under 1 year old presenting to the emergency department with isolated head trauma were reviewed with the approval of the Ethics Committee of Ankara Etlik City Hospital. Inclusion criteria included presentation to the emergency department, undergoing more than one brain CT scan, and sustaining mild head trauma (Glasgow Coma Scale [GCS] >13). Patients with incomplete follow-up data or multiple traumas were excluded. Age, gender, mechanism of trauma, initial and follow-up brain CT findings, hospital admission, and surgical procedures were recorded and analyzed using the SPSS statistical package. RESULTS: Out of 238 screened patients, 154 were included in the study. Of these, 66.9% were male and the average age was 5.99 months. The most common presenting symptom was swelling at the trauma site, observed in 79.2% of cases. The most common mechanism of injury was falling from a height of less than 90 cm, accounting for 85.1% of cases. Pathological progression on follow-up CT was observed in 5.2% of the patients, and only 1.9% required surgical treatment. A total of 34.4% of the patients required hospitalization. Patients with parenchymal brain pathology had a higher rate of pathological progression on follow-up CT and a longer hospital stay. CONCLUSION: Follow-up CT scans in infants with mild head trauma do not alter patient outcomes except in cases with brain parenchymal pathology. Study data indicated that repeat imaging is not beneficial for isolated skull fractures. Imaging artifacts often necessitated repeated scans, contributing to increased radiation exposure. Unnecessary repeat imaging escalates radiation exposure and healthcare costs. Only a small percentage of patients exhibited progression of intracranial pathology, justifying follow-up imaging solely in the presence of brain parenchymal injury. Larger prospective studies are necessary to confirm these findings.


Assuntos
Traumatismos Craniocerebrais , Serviço Hospitalar de Emergência , Tomografia Computadorizada por Raios X , Humanos , Feminino , Estudos Retrospectivos , Masculino , Lactente , Recém-Nascido , Traumatismos Craniocerebrais/diagnóstico por imagem , Escala de Coma de Glasgow , Encéfalo/diagnóstico por imagem , Encéfalo/patologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-39093389

RESUMO

The increasing global demand for palm oil and its derivatives has led to significant environmental and social concerns, prompting the need for sustainable practices in oil palm production. In recent years, digital technologies have emerged as a potential solution to enhance sustainability in this sector. The objective of this review was to provide insights into the potential benefits and limitations of digital technologies in promoting sustainable practices in the oil palm industry, and to identify key challenges that must be addressed to ensure that digitalization contributes to sustainable development in this sector. To obtain valuable insights on this topic, this review employed a thorough analysis and exploration of relevant literature. Our findings highlight the transformative potential of digital technologies such as precision agriculture, data analytics, blockchain, and robotics to optimize resource utilization, improving efficiency, promoting social welfare, improving supply chain transparency, mitigating environmental impacts, and enhancing sustainability in oil palm production. However, the adoption of these technologies is hindered by several challenges, including high cost, lack of knowledge, and inadequate infrastructure. Our findings emphasize the importance of supportive policies, collaborative efforts, and targeted research to promote technology adoption and ensure equitable benefits across the oil palm industry. Recommendations are provided for industry stakeholders, policymakers, and researchers to leverage digitalization effectively and promote sustainable practices in the oil palm industry, ultimately contributing to global sustainability goals.

4.
Arch Gynecol Obstet ; 2024 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-39110209

RESUMO

PURPOSE: There is no standardized best method on monitoring of patients with gestational diabetes on diet modification in the country. This study aims to investigate the optimum method of self-monitoring blood glucose. METHODS: This is a randomized clinical trial in a single tertiary centre involving patients with gestational diabetes mellitus (GDM) diagnosed based on NICE guideline on diet modification. The patients are randomized in 1:1 ratio to 4 or 7 points self-monitoring blood glucose. The monitoring was required to be done monthly with ultrasound for fetal growth. Blood was taken at recruitment for measurement of serum HbA1c and fructosamine. RESULTS: A total of 200 patients were recruited. There were significantly more Malay patients in the 7 points group (88.9% vs 78.2%, p = 0.033). Multiparous patients were significantly more in the 4 points group (82.2% vs 68.7%, p = 0.033). Both groups were similar in clinical characteristics. There was no statistical difference in the neonatal outcome particularly fetal macrosomia and admission to neonatal intensive care unit. CONCLUSIONS: In patients with GDM on diet modification, self-blood glucose monitoring using either 4 or 7 points resulted in similar maternal and perinatal outcomes. The research was registered under ClinicalTrials.gov (NCT04101396) on 17/9/2019 ( https://register. CLINICALTRIALS: gov/prs/app/action/SelectProtocol?sid=S00098EN&selectaction=Edit&uid=U0004RD4&ts=2&cx=-qlk1w2 ).

5.
Acta Neurochir (Wien) ; 166(1): 326, 2024 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-39105874

RESUMO

INTRODUCTION: The management of spinal sarcomas is complex, given their widespread involvement and high recurrence rates. Despite consensus on the need for a multidisciplinary approach with surgery at its core, there is a lack of definitive guidelines for clinical decision-making. This study examines a case series of primary spinal sarcomas, focusing on the surgical strategies, clinical results, and survival data to inform and guide therapeutic practices. METHODS: We conducted a retrospective analysis of patients who underwent surgical resection for primary spinal sarcomas between 2005 and 2022. The study focused on gathering data on patient demographics, surgical details, postoperative complications, overall hospital stay, and mortality within 90 days post-surgery. RESULTS: The study included 14 patients with a primary diagnosis of spinal sarcoma, with an average age of 48.6 ± 12.6 years. Chondrosarcoma emerged as the most common tumor type, representing 57.1% of cases, followed by Ewing sarcoma at 35.7%, and synovial sarcoma at 7.1%. Patients with chondrosarcoma were treated with en-bloc resection, while the patient with synovial sarcoma underwent intra-lesional excision and those with Ewing sarcoma received decompression and tumor debulking. Postoperative assessments revealed significant improvements in neurological conditions. Notably, functional status as measured by the Karnofski Performance Index (KPI), improved substantially post-surgery (from 61.4 to 80.0%) The mean follow-up was 34.9 ± 9.2 months. During this time period one patient experienced fatal bleeding after en-bloc resection complications involving the vena cava. None of the patient needed further surgery. CONCLUSIONS: Our 16-year study offers vital insights into managing primary spinal sarcomas, showcasing the effectiveness of surgical intervention, particularly en-bloc resection. Despite their rarity and complexity, our multidisciplinary treatment approach yields improved outcomes and highlights the potential for refined surgical strategies to become standardized care in this challenging domain.


Assuntos
Sarcoma , Neoplasias da Coluna Vertebral , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Masculino , Feminino , Adulto , Sarcoma/cirurgia , Sarcoma/mortalidade , Neoplasias da Coluna Vertebral/cirurgia , Neoplasias da Coluna Vertebral/mortalidade , Resultado do Tratamento , Procedimentos Neurocirúrgicos/métodos , Idoso , Sarcoma Sinovial/cirurgia , Sarcoma Sinovial/mortalidade , Condrossarcoma/cirurgia , Condrossarcoma/mortalidade , Condrossarcoma/patologia , Sarcoma de Ewing/cirurgia , Sarcoma de Ewing/mortalidade , Complicações Pós-Operatórias/etiologia , Equipe de Assistência ao Paciente
6.
Toxicol Appl Pharmacol ; : 117048, 2024 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-39102946

RESUMO

Cisplatin (CDDP) often leads to kidney impairment, limiting its effectiveness in cancer treatment. The lack of mitophagy in proximal tubules exacerbates this issue. Hence, targeting SIRT-3 and PGC1-α shows promise in mitigating CDDP-induced kidney damage. The potential renoprotective effects of linagliptin, however, remain poorly understood. This study represents the first exploration of linagliptin's impact on CDDP-induced kidney impairment in rats, emphasizing its potential role in mitophagic pathways. The experiment involved four rat groups: Group (I) received saline only, Group (II) received a single intraperitoneal injection of CDDP at 6 mg/kg. Groups (III) and (IV) received linagliptin at 6 and 10 mg/kg p.o., respectively, seven days before CDDP administration, continuing for an additional four days. Various parameters, including renal function tests, oxidative stress, TNF-α, IL-1ß, IL-6, PGC-1α, FOXO-3a, p-ERK1, and the gene expression of SIRT-3 and P62 in renal tissue, were assessed. Linagliptin improved renal function, increased antioxidant enzyme activity, and decreased IL-1ß, TNF-α, and IL-6 expression. Additionally, linagliptin significantly upregulated PGC-1α and PINK-1/Parkin-2 expression while downregulating P62 expression. Moreover, linagliptin activated FOXO-3a and SIRT-3, suggesting a potential enhancement of mitophagy. Linagliptin demonstrated a positive impact on various factors related to kidney health in the context of CDDP-induced impairment. These findings suggest a potential role for linagliptin in improving cancer treatment outcomes. Clinical trials are warranted to further investigate and validate its efficacy in a clinical setting.

7.
J Abdom Wall Surg ; 3: 13114, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38974808

RESUMO

Purpose: To determine normal anatomical variation of abdominal wall musculature. Methods: A retrospective analysis of CT scans was performed on adults (>18 years) with normal abdominal wall muscles. Two radiologists analysed the images independently. Distances from three fixed points in the midline were measured. The fixed points were; P1, mid-way between xiphoid and umbilicus, P2, at the umbilicus, and P3, mid-way between umbilicus and pubic symphysis. From these three fixed points the following measurements were recorded; midline to lateral innermost border of the abdominal wall musculature, midline to lateral edge of rectus abdominis muscle, and midline to medial edges of all three lateral abdominal wall muscles. To obtain aponeurotic width, rectus abdominis width was subtracted from the distance to medial edge of lateral abdominal wall muscle. Results: Fifty normal CT scan were evaluated from between March 2023 to August 2023. Mean width of external oblique aponeurosis at P1 was 16.2 mm (IQR 9.2 mm to 20.7 mm), at P2 was 23.5 mm (IQR 14 mm to 33 mm), and at P3 no external oblique muscle was visible. Mean width of the internal oblique aponeurosis at P1 was 32.1 mm (IQR 17.5 mm to 45 mm), at P2 was 10.13 (IQR 1 mm to 17.5 mm), and at P3 was 9.2 mm (IQR 3.0 mm to 13.7 mm). Mean width of the transversus abdominis aponeurosis at P1 was -25.1 mm (IQR 37.8 mm to -15.0 mm), at P2 was 29.4 mm (IQR 20 mm to 39.8 mm), and at P3 was 20.3 mm (IQR 12 mm to 29 mm). Conclusion: In this study we describe normal anatomical variation of the abdominal wall muscles. Assessing this variability on the pre-operative CT scans of ventral hernia patients allows for detailed operative planning and decision making.

8.
Heliyon ; 10(12): e32189, 2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38975107

RESUMO

Meat is a source of essential amino acids that are necessary for human growth and development, meat can come from dead, alive, Halal, or non-Halal animal species which are intentionally or economically (adulteration) sold to consumers. Sharia has prohibited the consumption of pork by Muslims. Because of the activities of adulterators in recent times, consumers are aware of what they eat. In the past, several methods were employed for the authentication of Halal meat, but numerous drawbacks are attached to this method such as lack of flexibility, limited application, time,consumption and low level of accuracy and sensitivity. Machine Learning (ML) is the concept of learning through the development and application of algorithms from given data and making predictions or decisions without being explicitly programmed. The techniques compared with traditional methods in Halal meat authentication are fast, flexible, scaled, automated, less expensive, high accuracy and sensitivity. Some of the ML approaches used in Halal meat authentication have proven a high percentage of accuracy in meat authenticity while other approaches show no evidence of Halal meat authentication for now. The paper critically highlighted some of the principles, challenges, successes, and prospects of ML approaches in the authentication of Halal meat.

9.
Cureus ; 16(6): e61855, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38975544

RESUMO

Introduction Persistent olfactory dysfunction was seen in many patients upon coronavirus disease 2019 (COVID-19) infection recovery. However, research on its management was very limited, especially among the Southeast Asian population. Objectives We aim to investigate the role of olfactory rehabilitation and topical corticosteroids among post-COVID-19 olfactory dysfunction patients in Malaysia, and at the same time to determine factors leading to olfactory recovery post-COVID-19 infection. Methods Adult Malaysians with persistent olfactory dysfunction one month post-COVID-19 recovery were recruited. Thirty-one patients were randomly assigned into three groups with 10 patients being given olfactory training (Group 1), another 10 being given mometasone furoate nasal spray/olfactory training (Group 2), and 11 patients being assigned to the control group (Group 3). All groups were followed up for an average duration of six months. Olfactory function was evaluated by Top International Biotech Smell Identification Test (TIBSIT) scores and Olfactory Disorder Questionnaire (eODQ) prior to randomization, at three and six months after recruitment. Results The baseline characteristics of patients were similar in all groups. Generally, patients of all three groups showed a statistically significant improvement in the TIBSIT scores after six months. The TIBSIT scores for Group 2 were statistically significantly higher than the control at three months but not at six months. As for Group 1, no statistically significant differences in TIBSIT scores at both three and six months were noted when compared to control. Statistically significant improvements were seen in the eODQ scores in all three groups. Conclusion No superiority of intervention for post-COVID-19 olfactory dysfunction was seen compared to control.

10.
Heliyon ; 10(14): e34454, 2024 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-39082032

RESUMO

Introduction: Poor indoor air quality (IAQ) in healthcare settings may adversely impact occupants' well-being and promote transmission of infectious respiratory disease. However, evidence on its potentially modifiable determinants, including occupant behaviour, remains scarce. This study aims to determine the relationship between occupant behaviour and IAQ in Malaysian hospital outpatient departments (OPDs). Methods: A multistage cross-sectional study of six randomly selected Malaysian public hospital OPDs was conducted. In stage one, IAQ parameters, including temperature, relative humidity (RH), air velocity (AV), carbon dioxide (CO2), total bacterial count (TBC), and total fungal count (TFC) were measured. In stage two, an observation form based on the Korsavi and Montazami tool for measuring adaptive behaviour was used to examine occupant density, activities, and operation of building envelopes and appliances. Simple correlation, partial correlation, and linear regression analyses were performed to examine the relationship between occupant behaviour and IAQ parameters. Results: The IAQ of selected hospital OPDs complied with established standards, except for temperature and AV. Occupant density was positively correlated with temperature and CO2. Meanwhile, occupants' activities including slow walking and brisk walking were positively correlated with temperature, AV, CO2, TBC and TFC. Conversely, occupants' opening of windows and doors were positively correlated with temperature and AV but negatively correlated with CO2, TBC and TFC. Finally, turning on fans was positively correlated with AV but negatively correlated with TBC, whereas turning on air conditioner was positively correlated with CO2. Among occupants' behaviour, opening of windows and doors contributed the most to variation in IAQ parameters. Conclusions: The study findings suggest that IAQ in hospital OPDs are influenced by occupant density, activities, and operation of doors, windows, and appliances. Prospective hospital IAQ guidelines should incorporate policies and measures targeting these factors to ensure occupants' best practices in maintaining healthy hospital indoor air environments.

11.
Pestic Biochem Physiol ; 203: 105982, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39084787

RESUMO

The tropical climate in Malaysia provides an ideal environment for the rapid proliferation of Aedes mosquitoes, notably Aedes aegypti and Aedes albopictus, prominent vectors of dengue fever. Alarmingly, these species are increasingly developing resistance to conventional pesticides. This study aimed to evaluate the efficacy of Metarhizium anisopliae isolate HSAH5 spores, specifically on conidia (CO) and blastospores (BL), against Ae. albopictus larvae. The study centered on evaluating their pathogenic effects and the resultant changes in protein expression. Spore suspensions with varying concentrations were prepared for larvicidal bioassays, and protein expressions were analysed using liquid chromatography-mass spectrometry. Subsequently, protein annotation and network analysis were conducted to elucidate infection mechanisms and the proteomic response. Based on the lethal concentrations and time frames, CO exhibited faster larval mortality than BL at lower concentrations. Despite this, both spore types demonstrated comparable overall pathogenic effects. Results from the proteomic profiling revealed 150 proteins with varied expressions following exposure to Ae. albopictus extract, shedding light on distinct infection strategies between the spores. Gene Ontology enrichment and network analysis illustrated the diverse metabolic adaptations of M. anisopliae and interactions with mosquito larvae. This highlighted the complexity of host-pathogen dynamics and the significance of biosynthetic processes, energy storage, and cellular interaction pathways in disease progression. The BL network, consisting 80 proteins and 74 connections, demonstrates the intricate fungal mechanisms triggered by host stimuli. Conversely, the CO network, though smaller, displayed notable interconnectivity and concentrated involvement at the cell periphery, suggesting a deliberate strategy for initial host contact. This study offers valuable insights into proteome dynamics of M. anisopliae's BL and CO for managing mosquito populations and combating disease transmission, thereby significantly advancing public health and environmental conservation efforts.


Assuntos
Aedes , Larva , Metarhizium , Proteômica , Esporos Fúngicos , Aedes/microbiologia , Metarhizium/patogenicidade , Metarhizium/genética , Animais , Larva/microbiologia , Proteômica/métodos , Virulência , Proteínas Fúngicas/metabolismo , Proteínas Fúngicas/genética , Controle Biológico de Vetores , Controle de Mosquitos/métodos
12.
Res Sq ; 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38978571

RESUMO

Hereditary SDHB-mutant pheochromocytomas (PC) and paragangliomas (PG) are rare tumours with a high propensity to metastasize although their clinical behaviour is unpredictable. To characterize the genomic landscape of these tumours and identify metastasis biomarkers, we performed multi-omic analysis on 94 tumours from 79 patients using seven molecular methods. Sympathetic (chromaffin cell) and parasympathetic (non-chromaffin cell) PCPG had distinct molecular profiles reflecting their cell-of-origin and biochemical profile. TERT and ATRX-alterations were associated with metastatic PCPG and these tumours had an increased mutation load, and distinct transcriptional and telomeric features. Most PCPG had quiet genomes with some rare co-operative driver events observed, including EPAS1/HIF-2α mutations. Two mechanisms of acquired resistance to DNA alkylating chemotherapies were also detected - MGMT overexpression and mismatch repair-deficiency causing hypermutation. Our comprehensive multi-omic analysis of SDHB-mutant PCPG therefore identified features of metastatic disease and treatment response, expanding our understanding of these rare neuroendocrine tumours.

13.
PLoS One ; 19(7): e0305538, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38990851

RESUMO

Despite efforts in improving medication safety, medication administration errors are still common, resulting in significant clinical and economic impact. Studies conducted using a valid and reliable tool to assess clinical impact are lacking, and to the best of our knowledge, studies evaluating the economic impact of medication administration errors among neonates are not yet available. Therefore, this study aimed to determine the potential clinical and economic impact of medication administration errors in neonatal intensive care units and identify the factors associated with these errors. A national level, multi centre, prospective direct observational study was conducted in the neonatal intensive care units of five Malaysian public hospitals. The nurses preparing and administering the medications were directly observed. After the data were collected, two clinical pharmacists conducted independent assessments to identify errors. An expert panel of healthcare professionals assessed each medication administration error for its potential clinical and economic outcome. A validated visual analogue scale was used to ascertain the potential clinical outcome. The mean severity index for each error was subsequently calculated. The potential economic impact of each error was determined by averaging each expert's input. Multinomial logistic regression and multiple linear regression were used to identify factors associated with the severity and cost of the errors, respectively. A total of 1,018 out of 1,288 (79.0%) errors were found to be potentially moderate in severity, while only 30 (2.3%) were found to be potentially severe. The potential economic impact was estimated at USD 27,452.10. Factors significantly associated with severe medication administration errors were the medications administered intravenously, the presence of high-alert medications, unavailability of a protocol, and younger neonates. Moreover, factors significantly associated with moderately severe errors were intravenous medication administration, younger neonates, and an increased number of medications administered. In the multiple linear regression analysis, the independent variables found to be significantly associated with cost were the intravenous route of administration and the use of high-alert medications. In conclusion, medication administration errors were judged to be mainly moderate in severity costing USD 14.04 (2.22-22.53) per error. This study revealed important insights and highlights the need to implement effective error reducing strategies to improve patient safety among neonates in the neonatal intensive care unit.


Assuntos
Unidades de Terapia Intensiva Neonatal , Erros de Medicação , Humanos , Erros de Medicação/economia , Erros de Medicação/prevenção & controle , Erros de Medicação/estatística & dados numéricos , Unidades de Terapia Intensiva Neonatal/economia , Recém-Nascido , Feminino , Masculino , Estudos Prospectivos , Malásia
14.
Cureus ; 16(6): e62117, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38993435

RESUMO

Background and aim Primary care is an important element for every healthcare system around the world. Providing and optimizing the connection between the primary care centers and advanced clinical centers is a key concept for a well-functioning healthcare system. Our aim in this study was to analyze and review the referral data of primary care centers located in Ankara, Türkiye. Materials and methods We collected the entire referral data from the primary care centers, totaling 8,746 patients between January 1, 2019 and December 31, 2023 by using emergency medical services (EMS) transfer in Ankara. Demographic data, call reasons, transfer centers and transfer-related characteristics of the patients were recorded retrospectively, grouped by year, using EMS data. Results Our findings have shown that most of the referrals were made for Turkish citizens with 8,360 (95.6%) (p<0.001). Healthcare centers located in inner city had the most referrals made with 7,087 (81.0%) (p<0.001). Majority of the referrals were made by physicians in family healthcare centers with 6,583 (75.3%) (p<0.001) with chest pain being the most common diagnosis for referral initiation with 1,429 (16.3%) (p<0.001). This was followed by trauma, with 1,172 (13.4%) (p<0.001). Most common cause for trauma was falls with 613 (52.3%) (p<0.001). Conclusion Our data revealed important elements of local referral patterns. According to our data, majority of the referrals were made by inner city healthcare facilities. Family healthcare centers formed most of the referral requests. For this reason, strengthening these centers is important to prevent unnecessary resource use and delays.

15.
Radiol Case Rep ; 19(9): 3861-3863, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39035024

RESUMO

Atrioventricular valve parachute deformity is rare and is generally seen in the mitral position, called the parachute mitral valve. It is rare to see it in the tricuspid valve and up to now, there have been approximately 14 cases of parachute abnormalities in tricuspid valves in a literature review. We present here a 21-year-old male who presented to the emergency department with progressive shortness of breath over several months. Despite the absence of chest pain, palpitations, or weight changes, examination revealed a soft, holosystolic murmur at the left lower sternal border. Further investigation through electrocardiogram and echocardiogram identified a rare structural abnormality known as parachute tricuspid valve, resulting in significant tricuspid regurgitation with mild right chamber enlargement. The patient was recommended to go abroad for further management since a cardiothoracic surgeon is not available in our country.

16.
Cureus ; 16(6): e62999, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-39050317

RESUMO

BACKGROUND/AIM: The Craig Hospital Inventory of Environmental Factors (CHIEF) is a tool designed to assess and quantify the impact of environmental factors on an individual's functioning and social participation. In this study, we aim to culturally adapt the CHIEF from its original English version into the Malay language (M-CHIEF) and examine its validity and reliability among older adults in Malaysia. METHODS: The original CHIEF was cross-culturally adapted into the Malay language following the published guidelines on cross-cultural adaptation of health questionnaires. Its content and convergent validity were assessed using the content validity index and correlation with participants' gait speed, respectively. The reliability of M-CHIEF was assessed for its internal consistency using Cronbach's coefficient alpha and Cohen's kappa and its test-retest reliability was assessed using intraclass correlation coefficients (ICCs). RESULTS: The M-CHIEF was rated with excellent content validity with a scale-level content validity index (S-CVI) of 0.86. Its internal consistency was demonstrated to be high with Cronbach's alpha of 0.84. The test-retest reliability at a two-week interval showed a stable score of the M-CHIEF and its subscales with an ICC value of 0.89. CONCLUSIONS: The M-CHIEF is deemed relevant for use among Malay speakers. It can function as an instrument to quantify the environmental barriers of an individual while considering broad environmental factors including policy, physical/ structural, work/school, attitude/support, and services/assistance.

17.
Am J Otolaryngol ; 45(5): 104403, 2024 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-39047624

RESUMO

OBJECTIVE: To investigate age-related disparities in the diagnosis and treatment of borderline/mild hearing loss (HL) in the United States. STUDY DESIGN: A cross-sectional epidemiologic study. SETTING: The National Health and Nutrition Examination Survey (NHANES). METHODS: Multivariable logistic regressions controlling for hearing level were performed to investigate the association between: (1) age and recent hearing test; (2) age and hearing aid use. Age was grouped into quartiles (<25, 25-49, 50-74, ≥75 years). The first quartile of life was used as a reference group in all odds ratios, controlling for hearing level. RESULTS: Of 2115 participants with borderline/mild HL, 3 % (n = 53) were in age quartile Q1; 7 % (n = 147) were in Q2, 56 % (n = 1190) were in Q3, and 34 % (n = 725) were in Q4. Compared to Q1, those in Q2, Q3, and Q4 had 4.06 times (95 % CI = 2.11-8.02, p < 0.001), 4.51 times (2.56-8.19, p < 0.001), and 4.56 times (2.55-8.39, p < 0.001) lower odds of a hearing test within the past 4 years. Similar, although slightly larger, odds ratios were obtained when the outcome was hearing test within 1 year. Compared to Q1, those in Q2, Q3, and Q4 respectively had 4.38 times (1.47-13.5, p < 0.05), 5.41 times (2.27-11.8, p < 0.001), and 3.95 times (1.65-8.72, p < 0.05) lower odds of using a hearing aid. CONCLUSION: We have characterized a large, unaddressed, and modifiable disparity in the treatment of borderline/mild HL as individuals age out of the first quartile of life. Future studies are needed to explore factors, such as ageism, that may underlie these findings.

18.
BMC Psychol ; 12(1): 389, 2024 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-38997786

RESUMO

The main objective of this study is to examine the relationship of emotional intelligence with psychological well-being and academic achievement through positive psychological characteristics among university students in China. The study was conducted with postgraduate and undergraduate students. The integration of emotional intelligence theory and positive psychological theory was used in this study. The introduced framework included emotional intelligence as the main independent variable, self-efficacy, motivation, and resilience as three mediators, and psychological well-being and academic achievement as two dependent variables. A survey was conducted among 518 students, and structural equation modelling was used to analyse the data. The study found that emotional intelligence was positively related to positive psychological characteristics, psychological well-being, and academic achievement, and the effects were stronger among postgraduate students. Also, positive psychological characteristics, which include self-efficacy, motivation, and resilience, mediate the relationship between emotional intelligence and psychological well-being and academic achievement, and the relationship was stronger among postgraduate students. Proper coping strategies and mechanisms can be helpful to improve both psychological well-being and academic achievement at the same time among university students.


Assuntos
Sucesso Acadêmico , Inteligência Emocional , Motivação , Resiliência Psicológica , Autoeficácia , Estudantes , Humanos , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Masculino , Feminino , Universidades , Adulto Jovem , Adulto , China , Adaptação Psicológica , Saúde Mental , Adolescente , Inquéritos e Questionários , Bem-Estar Psicológico
19.
Mar Pollut Bull ; 205: 116668, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38972217

RESUMO

Two concentrations (6.25 and 1.25 mg/L) were used for two Parkinson's disease medications, Benserazide, and Trihexyphenidyl, to test their effects on the meiobenthic nematofauna. It is predicted that these highly hydrosoluble drugs will end up in marine environments. The results showed that both medications when added alone, induced (i) important changes in the numbers and (ii) taxonomic composition. The impact of Benserazide and Trihexyphenidyl was also reflected in the (iii) functional traits of nematofauna, with the most affected categories following exposure being the trophic group 1B, the clavate tails, the circular amphids, the c-p2 life history, and the body length of 1-2 mm. These results were supported by the molecular interactions of the studied drugs with both GLD-3 and SDP proteins of Caenorhabditis elegans. (iv) The mixtures of both drugs did not show any changes in the nematode communities, suggesting that no synergistic or antagonistic interactions exist between them.


Assuntos
Antiparkinsonianos , Benserazida , Caenorhabditis elegans , Triexifenidil , Animais , Antiparkinsonianos/farmacologia , Caenorhabditis elegans/efeitos dos fármacos , Caenorhabditis elegans/fisiologia , Poluentes Químicos da Água , Nematoides/efeitos dos fármacos
20.
Vet Anim Sci ; 25: 100375, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39005967

RESUMO

Pangasius catfish, a significant player in the global whitefish market, encounters challenges in aquaculture production sustainability. Quality broodstock maintenance and seed production are impeded by growth, maturation, and fecundity issues. This review investigates the efficacy of strategic nutrient composition and molecular strategies in enhancing broodstock conditions and reproductive performance across various fish species. A notable knowledge gap for Pangasius catfish hampers aquaculture progress. The review assesses nutrient manipulation's impact on reproductive physiology, emphasizing pangasius broodstock. A systematic review analysis following PRISMA guidelines was conducted to identify research trends and hotspots quantitatively, revealing a focus on P. bocourti and fertilization techniques. Addressing this gap, the review offers insights into dietary nutrients manipulation and genetic tool utilization for improved seed production, contributing to pangasius catfish aquaculture sustainability.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...