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1.
J Orthop ; 57: 40-43, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38973968

RESUMO

Introduction: Megaprostheses provide a reconstructive option for patients with bone loss after musculoskeletal tumor resection. However, the postoperative surgical site infection (SSI) risk is significant. This study aims to evaluate outcomes of extended postoperative antibiotic regimens in patients after megaprosthesis surgery and gather insight into strategies to minimize SSI. Methods: This retrospective cohort study evaluated patients who underwent megaprosthesis surgery by a single surgeon at a single center from 2014 to 2022. Patient demographics, comorbidities, cancer treatment details, and antibiotic regimens were collected. Excluded were patients with less than 1 year of follow-up, active infection at time of surgery, non-healing wounds unrelated to SSI, and preoperative antibiotic regimens secondary to being immunocompromised. Measures of interest included the development of SSI within 1 year of surgery and development of antibiotic-related complications. Results: Included were 49 patients, with a mean age of 61.2 ± 2.0 years and a mean BMI of 29.4 ± 7.0. The mean drain duration was 6.5 days (standard deviation [SD], 6.9 days), and the mean intravenous antibiotic administration duration was 6.4 days (SD, 6.9 days). The median time to drain removal was five days, and the median time for intravenous antibiotic cessation was five days. The mean total antibiotic administration duration (intravenous and oral) was 25.4 days (SD, 13.4 days). Only 1 patient in the included cohort (2.04 %) developed an SSI requiring operative intervention. No other patient within the cohort experienced an antibiotic-related complication. Discussion: This study suggests that the site's current protocol for managing post-megaprosthesis antibiotic prophylaxis based on drain duration and incision healing status has resulted in a low rate of SSI and antibiotic-related complications. Further research is needed to validate these findings and gain additional insights into managing antibiotic prophylaxis after megaprosthesis surgery.

2.
J Neural Eng ; 21(4)2024 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-38986465

RESUMO

Objective.Micro-electrocorticographic (µECoG) arrays are able to record neural activities from the cortical surface, without the need to penetrate the brain parenchyma. Owing in part to small electrode sizes, previous studies have demonstrated that single-unit spikes could be detected from the cortical surface, and likely from Layer I neurons of the neocortex. Here we tested the ability to useµECoG arrays to decode, in rats, body position during open field navigation, through isolated single-unit activities.Approach. µECoG arrays were chronically implanted onto primary motor cortex (M1) of Wistar rats, and neural recording was performed in awake, behaving rats in an open-field enclosure. The signals were band-pass filtered between 300-3000 Hz. Threshold-crossing spikes were identified and sorted into distinct units based on defined criteria including waveform morphology and refractory period. Body positions were derived from video recordings. We used gradient-boosting machine to predict body position based on previous 100 ms of spike data, and correlation analyses to elucidate the relationship between position and spike patterns.Main results.Single-unit spikes could be extracted during chronic recording fromµECoG, and spatial position could be decoded from these spikes with a mean absolute error of prediction of 0.135 and 0.090 in the x- and y- dimensions (of a normalized range from 0 to 1), and Pearson's r of 0.607 and 0.571, respectively.Significance. µECoG can detect single-unit activities that likely arise from superficial neurons in the cortex and is a promising alternative to intracortical arrays, with the added benefit of scalability to cover large cortical surface with minimal incremental risks. More studies should be performed in human related to its use as brain-machine interface.


Assuntos
Eletrocorticografia , Eletrodos Implantados , Córtex Motor , Ratos Wistar , Animais , Ratos , Eletrocorticografia/métodos , Eletrocorticografia/instrumentação , Córtex Motor/fisiologia , Masculino , Microeletrodos , Potenciais de Ação/fisiologia , Desenho de Equipamento/métodos , Navegação Espacial/fisiologia , Interfaces Cérebro-Computador , Análise de Falha de Equipamento/métodos
3.
Ophthalmic Genet ; : 1-8, 2024 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-39044686

RESUMO

OBJECTIVE: To describe the current status of clinical trials of genetic eye diseases with identified molecular targets for future areas of research. METHOD: Data analysis of the clinical trials database on clinicaltrials.gov with keywords for eight common, genetically tractable inherited eye diseases and their common molecular targets was performed during the period from 20 March 2021 to 31 December 2023. RESULTS: Two hundred and eighty-eight trials involving our keywords have been identified, excluding 25 (8.7%) trials which were unknown (verification expired with no update), 14 (4.9%) trials which were terminated early and 6(2.1%) trials which were withdrawn. In total there were 243 (84.4%) trials included. Out of the 243 trials, 120 trials were completed, 76 trials were active and still open to recruitment and 44 trials were active without any more recruitment on the way. There were only 32 (13.2%) trials with posted results. CONCLUSIONS: A low percentage of results were posted for completed trials. However, current and future clinical trials in the genetic eye diseases with molecular targets identified, have a promising future. The results of these trials will enhance and allow a better understanding of the potential to develop treatments for these conditions.

4.
Int J Mol Sci ; 25(14)2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-39062860

RESUMO

The actions of the retinoic acid nuclear receptor gamma (RARγ) agonist, palovarotene, on pre-existing osteochondromas were investigated using a mouse multiple osteochondroma model. This approach was based on the knowledge that patients often present to the clinic after realizing the existence of osteochondroma masses, and the findings from preclinical investigations are the effects of drugs on the initial formation of osteochondromas. Systemic administration of palovarotene, with increased doses (from 1.76 to 4.0 mg/kg) over time, fully inhibited tumor growth, keeping the tumor size (0.31 ± 0.049 mm3) similar to the initial size (0.27 ± 0.031 mm3, p = 0.66) while the control group tumor grew (1.03 ± 0.23 mm3, p = 0.023 to the drug-treated group). Nanoparticle (NP)-based local delivery of the RARγ agonist also inhibited the growth of osteochondromas at an early stage (Control: 0.52 ± 0.11 mm3; NP: 0.26 ± 0.10, p = 0.008). Transcriptome analysis revealed that the osteoarthritis pathway was activated in cultured chondrocytes treated with palovarotene (Z-score = 2.29), with the upregulation of matrix catabolic genes and the downregulation of matrix anabolic genes, consistent with the histology of palovarotene-treated osteochondromas. A reporter assay performed in cultured chondrocytes demonstrated that the Stat3 pathway, but not the Stat1/2 pathway, was stimulated by RARγ agonists. The activation of Stat3 by palovarotene was confirmed using immunoblotting and immunohistochemistry. These findings suggest that palovarotene treatment is effective against pre-existing osteochondromas and that the Stat3 pathway is involved in the antitumor actions of palovarotene.


Assuntos
Condrócitos , Modelos Animais de Doenças , Osteocondroma , Receptores do Ácido Retinoico , Receptor gama de Ácido Retinoico , Animais , Camundongos , Receptores do Ácido Retinoico/agonistas , Receptores do Ácido Retinoico/metabolismo , Osteocondroma/tratamento farmacológico , Osteocondroma/patologia , Osteocondroma/metabolismo , Condrócitos/metabolismo , Condrócitos/efeitos dos fármacos , Condrócitos/patologia , Fator de Transcrição STAT3/metabolismo , Proliferação de Células/efeitos dos fármacos , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/patologia , Neoplasias Ósseas/metabolismo , Masculino
5.
Artigo em Inglês | MEDLINE | ID: mdl-38579958

RESUMO

OBJECTIVE: To determine the efficacy of neural interface-based neurorehabilitation, including brain-computer interface, through conventional and individual patient data (IPD) meta-analysis and to assess clinical parameters associated with positive response to neural interface-based neurorehabilitation. DATA SOURCES: PubMed, EMBASE, and Cochrane Library databases up to February 2022 were reviewed. STUDY SELECTION: Studies using neural interface-controlled physical effectors (functional electrical stimulation and/or powered exoskeletons) and reported Fugl-Meyer Assessment-upper-extremity (FMA-UE) scores were identified. This meta-analysis was prospectively registered on PROSPERO (#CRD42022312428). PRISMA guidelines were followed. DATA EXTRACTION: Changes in FMA-UE scores were pooled to estimate the mean effect size. Subgroup analyses were performed on clinical parameters and neural interface parameters with both study-level variables and IPD. DATA SYNTHESIS: Forty-six studies containing 617 patients were included. Twenty-nine studies involving 214 patients reported IPD. FMA-UE scores increased by a mean of 5.23 (95% confidence interval [CI]: 3.85-6.61). Systems that used motor attempt resulted in greater FMA-UE gain than motor imagery, as did training lasting >4 vs ≤4 weeks. On IPD analysis, the mean time-to-improvement above minimal clinically important difference (MCID) was 12 weeks (95% CI: 7 to not reached). At 6 months, 58% improved above MCID (95% CI: 41%-70%). Patients with severe impairment (P=.042) and age >50 years (P=.0022) correlated with the failure to improve above the MCID on univariate log-rank tests. However, these factors were only borderline significant on multivariate Cox analysis (hazard ratio [HR] 0.15, P=.08 and HR 0.47, P=.06, respectively). CONCLUSION: Neural interface-based motor rehabilitation resulted in significant, although modest, reductions in poststroke impairment and should be considered for wider applications in stroke neurorehabilitation.

6.
J Pers Assess ; 106(1): 116-126, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37036124

RESUMO

We examined the incremental validity of character in predicting health outcomes and well-being beyond personality traits and investigated the extent to which health-related behaviors mediate the relationship between character and well-being. Findings indicate that several character cores (e.g., transcendence, fortitude) predict well-being, health behaviors, and health outcomes beyond different measures of personality traits, indicating that character is discriminable from personality as indicated by incremental prediction. In particular, fortitude, temperance, transcendence, and sincerity appear to be key players. Implications for character research are discussed.


Assuntos
Personalidade , Temperamento , Humanos , Inventário de Personalidade , Transtornos da Personalidade , Caráter
7.
Digit Health ; 9: 20552076231210725, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37928335

RESUMO

Objective: This article describes a protocol for a randomized controlled trial to evaluate the effects of a three-level Health App for Post-Pandemic Years (HAPPY) on alleviating post-pandemic physiological and psychosocial distress. Methods: Convenience and snowball sampling methods will be used to recruit 814 people aged 18+ with physiological and/or psychosocial distress. The experimental group will receive a 24-week intervention consisting of an 8-week regular supervision phase and a 16-week self-help phase. Based on their assessment results, they will be assigned to receive interventions on mindfulness, energy conservation techniques, or physical activity training. The waitlist control group will receive the same intervention in Week 25. The primary outcome will be changes in psychosocial distress, measured using the Kessler Psychological Distress Scale (K10). Secondary outcomes will include changes in levels of fatigue (Chinese version of the Brief Fatigue Inventory), sleep quality (Chinese version of the Pittsburgh Sleep Quality Index), pain intensity (Numeric Rating Scale), positive appraisal (Short version of the 18-item Cognitive Emotion Regulation Questionnaire), self-efficacy (Chinese version of the General Self-efficacy Scale), depression and anxiety (Chinese version of the 21-item Depression Anxiety Stress Scale), and event impact (Chinese version of the 22-item Impact of Event Scale-Revised). All measures will be administered at baseline (T0), Week 8 after the supervision phase (T1), and 24 weeks post-intervention (T2). A generalized estimating equations model will be used to examine the group, time, and interaction (Time × Group) effect of the interventions on the outcome assessments (intention-to-treat analysis) across the three time points, and to compute a within-group comparison of objective physiological parameters and adherence to the assigned interventions in the experimental group. Conclusions: The innovative, three-level mobile HAPPY app will promote beneficial behavioral strategies to alleviate post-pandemic physiological and psychosocial distress. Trial registration: ClinicalTrials.gov, NCT05459896. Registered on 15 July 2022.

8.
Opt Express ; 31(22): 36236-36244, 2023 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-38017778

RESUMO

Optical microresonators offer a highly-attractive new platform for the generation of optical frequency combs. Recently, several groups have been able to demonstrate the generation of dual-frequency combs in a single microresonator driven by two optical pumps. This opens the possibility for microresonator-based dual-comb systems suitable for measurement applications such as spectroscopy, ranging and imaging. Key to the performance of these systems are the parameters of the radio-frequency comb spectrum that arises from the interference of the two optical combs. In this work, we present a simple mechanism to enable the discrete fine-tuning of these parameters by driving the two optical combs with optical pumps with different azimuthal mode numbers. The mechanism consists of tuning the difference in azimuthal mode number between the two pumps by selection of the pumps' frequencies. We are able to implement this technique when the two counter-propagating pumps are set to drive resonances of the same spatial mode family, as well as different mode families. In each case, we experimentally observe ∼1 MHz of discrete tunability in the line-spacing of the radio-frequency comb as the frequency offset between the two pumps is scanned between 0 to 80 free-spectral-ranges.

9.
Artigo em Inglês | MEDLINE | ID: mdl-37695950

RESUMO

Recent years have seen the successful application of large pretrained models of source code (CodePTMs) to code representation learning, which have taken the field of software engineering (SE) from task-specific solutions to task-agnostic generic models. By the remarkable results, CodePTMs are seen as a promising direction in both academia and industry. While a number of CodePTMs have been proposed, they are often not directly comparable because they differ in experimental setups such as pretraining dataset, model size, evaluation tasks, and datasets. In this article, we first review the experimental setup used in previous work and propose a standardized setup to facilitate fair comparisons among CodePTMs to explore the impacts of their pretraining tasks. Then, under the standardized setup, we re-pretrain CodePTMs using the same model architecture, input modalities, and pretraining tasks, as they declared and fine-tune each model on each evaluation SE task for evaluating. Finally, we present the experimental results and make a comprehensive discussion on the relative strength and weakness of different pretraining tasks with respect to each SE task. We hope our view can inspire and advance the future study of more powerful CodePTMs.

10.
J Pers ; 2023 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-37578033

RESUMO

BACKGROUND: The growth of positive psychology has birthed debate on the nature of what "positive" really means. Conceptualizations of positive attributes vary across psychological perspectives, and it appears these definitional differences stem from standards for "positive" espoused by three normative ethical frameworks: consequentialism, deontology, and virtue ethics. When definitions of "positive" do not align with one of these ethical schools, it appears researchers rely on preference to distinguish positive attributes. In either case, issues arise when researchers do not make their theoretical alignment explicit, leading to value-laden, often subjective criteria being smuggled into science as a description of what is positive. OBJECTIVE: To foster a deeper critical understanding of the different approaches, we examine how these conceptual definitions of positive attributes (mis)align with their ethical traditions or fail to align with an ethical school. METHOD: We review several positive attribute theories across psychological disciplines that serve as examples of the ethical and non-ethical sources of "positivity." Through this, we assess the conceptual criteria for what each approach considers "positive," note the degree of alignment between definition and ethical school, and draw attention to potential issues. CONCLUSION: We advance the conceptual assessment of positive attributes by considering the implications of failing to explicitly address the theoretical foundation from which a construct is defined.

11.
JMIR Med Educ ; 9: e44789, 2023 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-37590059

RESUMO

BACKGROUND: The potential of popular culture as a tool for knowledge delivery and enhancing engagement in education is promising but not extensively studied. Furthermore, concerns exist regarding learning fatigue due to increased reliance on videoconferencing platforms following the COVID-19 pandemic. To ensure effective web-based teaching sessions that maintain attention spans and enhance understanding, innovative solutions are necessary. OBJECTIVE: This study aims to evaluate the use of specific popular culture case studies to enhance student engagement in a web-based near-peer teaching session. METHODS: We delivered a web-based teaching session to undergraduate medical students in the United Kingdom. The session included clinical vignettes and single-best-answer questions using characters from "The Simpsons" television show as patient analogies for various causes of jaundice. A pre-post survey, employing a 7-point Likert scale, was distributed to gather data from participants. RESULTS: A total of 53 survey responses were collected. Participants reported significantly improved understanding of jaundice after the session compared to before the session (median 6, IQR 5-6 vs median 4, IQR 3-4.5; P<.001). The majority of participants agreed that the inclusion of "The Simpsons" characters enhanced their knowledge and made the teaching session more memorable and engaging (memorability: median 6, IQR 5-7; engagement: median 6, IQR 5-7). CONCLUSIONS: When appropriately integrated, popular culture can effectively engage students and improve self-perceived knowledge retention. "The Simpsons" characters can be used pedagogically and professionally as patient analogies to deliver teaching on the topic of jaundice.

13.
Opt Express ; 31(4): 5475-5482, 2023 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-36823826

RESUMO

Parametric oscillation in Kerr microresonators provides an attractive pathway for the generation of new optical frequencies in a low-power, small-footprint device. The frequency shift of the newly generated parametric sidebands is set by the phasematching of the underlying four-wave-mixing process, with the generation of large frequency shift sidebands typically placing exacting requirements on a resonator's dispersion profile. In practice, this limits the range of viable pump wavelengths, and ultimately the range of output frequencies. In this paper, we consider a multimode four-wave-mixing process in which the pump and sidebands propagate in different mode families of the resonator. We show that this multimode configuration yields a considerable relaxation in the phasematching requirements needed to generate large frequency shift parametric sidebands, allowing their formation even in resonators with strong second-order dispersion. Experimentally we use a magnesium-fluoride micro-disk resonator to demonstrate this multimode phasematching. By accessing different pump and sideband modes, four distinct multimode parametric processes generating frequency shifts between 118 and 216 THz are reported. The resulting separation between the two sidebands is almost three octaves.

14.
Cureus ; 15(1): e34057, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36824552

RESUMO

Ollier's disease is a rare syndrome characterized by multiple enchondromas with the potential for malignant transformation. The treatment for secondary chondrosarcoma is surgical resection, which can be a morbid procedure depending on the location and size of the tumor. We present a successful limb salvage in which the majority of the tibia was removed and replaced with a megaprosthesis. The complex reconstruction in this case required the use of a novel uncemented stem.

15.
BMC Med Educ ; 23(1): 128, 2023 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-36823563

RESUMO

BACKGROUND: Near-peer medical education serves as an important method of delivering education to junior students by senior students. Due to the reduced clinical exposure because of the COVID-19 pandemic, we developed a mentorship scheme to help medical students with their Integrated Structured Clinical Examinations (ISCEs) by providing a combination of near-peer mentorship together with lecture-based teaching on a weekly basis for a 12-week period. Students attended a specialty-focused lecture every Tuesday followed by a small group teaching session organised by their tutor. METHODS: A longitudinal evaluative interventional study was undertaken by the international student led medical education organisation, OSCEazy. The teaching programme was organised and conducted by third year medical students to a recruited cohort of second year medical students. Students' perceptions of ISCEs (confidence, anxiety, and overall performance) were evaluated using 5-point Likert scales while their knowledge of the specialty was assessed using 10 single best answer questions which were distributed via Google® forms at the start and end of each week. In addition, we assessed tutor perceptions of their teaching and learning experience. RESULTS: Seventy-two tutees were enrolled in the programme (mean age: 24.4, female: 77.8%). 88.9% of the participants had not attended any online ISCE teaching prior to this. They preferred in-person ISCE teaching as compared to virtual sessions [median 4.5 (IQR 4-5) vs 3 (IQR 3-4), p <  0.0001), respectively]. There was a significant overall increase in knowledge when comparing pre-session and post-session performance [mean 53.7% vs 70.7%, p <  0.0001)]. There was a significant increase in student confidence [Confidence: median 3 (IQR:3-4) vs 4 (IQR 3-4), p <  0.0001] while no change was seen in the anxiety and perception of their overall performance in an ISCE. [Anxiety: median 3 (IQR 2-4) vs 3 (IQR 3-4), p = 0.37, Performance: median 3 (IQR 3-4) vs median 3 (IQR 3-4), p <  0.0001]. The tutors reported an increase in their confidence in teaching ISCEs online [median 3 (IQR 2-3.25) vs median 4 (IQR 4-5), p <  0.0001)]. CONCLUSION: Online near-peer teaching increases the confidence of both tutees and tutors involved while enhancing the tutees' knowledge of the specialty. Thus, medical schools should incorporate near-peer teaching in their curriculum to enhance the student learning experience.


Assuntos
COVID-19 , Educação de Graduação em Medicina , Estudantes de Medicina , Humanos , Feminino , Adulto Jovem , Adulto , Pandemias , Educação de Graduação em Medicina/métodos , Aprendizagem , Currículo , Grupo Associado , Ensino
16.
Clin Infect Dis ; 76(3): e1463-e1466, 2023 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-36104853

RESUMO

Periprosthetic joint infections are a devastating complication of joint replacement surgery. One novel therapeutic that has potential to change the current treatment paradigm is bacteriophage therapy. Herein, we discuss our experiences with bacteriophage therapy for 10 recalcitrant periprosthetic joint infections and review the treatment protocols utilized to achieve successful outcomes.


Assuntos
Artrite Infecciosa , Bacteriófagos , Terapia por Fagos , Infecções Relacionadas à Prótese , Humanos , Antibacterianos/uso terapêutico , Infecções Relacionadas à Prótese/tratamento farmacológico , Terapia Combinada , Artrite Infecciosa/tratamento farmacológico , Desbridamento/métodos , Resultado do Tratamento , Estudos Retrospectivos
17.
Antibiotics (Basel) ; 11(5)2022 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-35625260

RESUMO

Prosthetic joint infections are a devastating complication of joint replacement surgery. Consequently, novel therapeutics are needed to thwart the significant morbidity and enormous financial ramifications that are associated with conventional treatments. One such promising adjuvant therapeutic is bacteriophage therapy given its antibiofilm activity and its ability to self-replicate. Herein we discuss the case of a 70-year-old female who had a recalcitrant MRSA prosthetic knee and femoral lateral plate infection who was successfully treated with adjuvant bacteriophage therapy. Moreover, this case discusses the importance of propagating bacteriophage therapeutics on bacteria that are devoid of toxins and the need to ensure bacteriophage activity to all bacterial morphologies. Overall, this case reinforces the potential benefit of using personalized bacteriophage therapy for recalcitrant prosthetic joint infections, but more translational research is needed to thereby devise effective, reproducible clinical trials.

18.
BMC Geriatr ; 22(1): 333, 2022 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-35428266

RESUMO

INTRODUCTION: Aneurysmal subarachnoid haemorrhage (aSAH) is a condition with significant morbidity and mortality. Traditional markers of aSAH have established their utility in the prediction of aSAH outcomes while frailty markers have been validated in other surgical specialties. We aimed to compare the predictive value of frailty indices and markers of sarcopaenia and osteopaenia, against the traditional markers for aSAH outcomes. METHODS: An observational study in a tertiary neurosurgical unit on 51 consecutive patients with ruptured aSAH was performed. The best performing marker in predicting the modified Rankin scale (mRS) on discharge was selected and an appropriate threshold for the definition of frail and non-frail was derived. We compared various frailty indices (modified frailty index 11, and 5, and the National Surgical Quality Improvement Program score [NSQIP]) and markers of sarcopaenia and osteopaenia (temporalis [TMT] and zygoma thickness), against traditional markers (age, World Federation of Neurological Surgery and modified Fisher scale [MFS]) for aSAH outcomes. Univariable and multivariable analysis was then performed for various inpatient and long-term outcomes. RESULTS: TMT was the best performing marker in our cohort with an AUC of 0.82, Somers' D statistic of 0.63 and Tau statistic 0.25. Of the frailty scores, the NSQIP performed the best (AUC 0.69), at levels comparable to traditional markers of aSAH, such as MFS (AUC 0.68). The threshold of 5.5 mm in TMT thickness was found to have a specificity of 0.93, sensitivity of 0.51, positive predictive value of 0.95 and negative predictive value of 0.42. After multivariate analysis, patients with TMT ≥ 5.5 mm (defined as non-frail), were less likely to experience delayed cerebral ischaemia (OR 0.11 [0.01 - 0.93], p = 0.042), any complications (OR 0.20 [0.06 - 0.069], p = 0.011), and had a larger proportion of favourable mRS on discharge (95.0% vs. 58.1%, p = 0.024) and at 3-months (95.0% vs. 64.5%, p = 0.048). However, the gap between unfavourable and favourable mRS was insignificant at the comparison of 1-year outcomes. CONCLUSION: TMT, as a marker of sarcopaenia, correlated well with the presenting status, and outcomes of aSAH. Frailty, as defined by NSQIP, performed at levels equivalent to aSAH scores of clinical relevance, suggesting that, in patients presenting with acute brain injury, both non-neurological and neurological factors were complementary in the determination of eventual clinical outcomes. Further validation of these markers, in addition to exploration of other relevant frailty indices, may help to better prognosticate aSAH outcomes and allow for a precision medicine approach to decision making and optimization of best outcomes.


Assuntos
Fragilidade , Hemorragia Subaracnóidea , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Humanos , Complicações Pós-Operatórias , Valor Preditivo dos Testes , Estudos Retrospectivos , Hemorragia Subaracnóidea/diagnóstico , Hemorragia Subaracnóidea/terapia , Resultado do Tratamento
19.
Int J Ment Health Nurs ; 31(3): 591-600, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35075757

RESUMO

The global prevalence of mental health conditions and the associated wide treatment gaps have led to increased demand for quality mental healthcare services. In Singapore, despite a shift towards a joint provision of mental healthcare in hospitals and the community, experiences of mental healthcare teams in such hospital-community partnerships have remained unclear. Through a qualitative descriptive approach, this study explored community mental health workers' experiences and perceptions of working with partners from tertiary hospitals and other community organisations. Eighteen participants were individually interviewed with a semi-structured question guide through video conferencing. This study was guided by the 32-item checklist from the Consolidated Criteria for Reporting Qualitative Research. Data were subjected to Braun and Clark's six-step thematic analysis. Three themes emerged: (i) the need for supportive partners, due to institutional and legal challenges faced in the participants' liaison with hospital partners and other community organisations; (ii) the need for a supportive organisation, whose presence and importance were revealed by the interviews; and (iii) the necessity of advanced training, identified by the participants as a contributor to their professional growth. The findings highlighted the importance of inter-sectoral communication and positive effects of a robust organisational support system. Accordingly, hospitals and community mental healthcare organisations should consider strengthening networking and boosting case discussions through regular inter-sectoral meetings that would prioritise the clients' continuity of care. Furthermore, opportunities for advanced trainings should be created for community-based mental healthcare workers.


Assuntos
Transtornos Mentais , Saúde Mental , Atenção à Saúde , Pessoal de Saúde/psicologia , Humanos , Transtornos Mentais/terapia , Pesquisa Qualitativa
20.
J Appl Psychol ; 107(8): 1323-1351, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34110849

RESUMO

Organizations are increasingly adopting automated video interviews (AVIs) to screen job applicants despite a paucity of research on their reliability, validity, and generalizability. In this study, we address this gap by developing AVIs that use verbal, paraverbal, and nonverbal behaviors extracted from video interviews to assess Big Five personality traits. We developed and validated machine learning models within (using nested cross-validation) and across three separate samples of mock video interviews (total N = 1,073). Also, we examined their test-retest reliability in a fourth sample (N = 99). In general, we found that the AVI personality assessments exhibited stronger evidence of validity when they were trained on interviewer-reports rather than self-reports. When cross-validated in the other samples, AVI personality assessments trained on interviewer-reports had mixed evidence of reliability, exhibited consistent convergent and discriminant relations, used predictors that appear to be conceptually relevant to the focal traits, and predicted academic outcomes. On the other hand, there was little evidence of reliability or validity for the AVIs trained on self-reports. We discuss the implications for future work on AVIs and personality theory, and provide practical recommendations for the vendors marketing such approaches and organizations considering adopting them. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Assuntos
Transtornos da Personalidade , Personalidade , Humanos , Determinação da Personalidade , Reprodutibilidade dos Testes , Autorrelato
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