A randomized controlled study to compare the 2% lignocaine and aqueous lubricating gels for female urethral catheterization.

OBJECTIVE: The 2% lignocaine gel has long been used for male urethral catheterization, but aqueous gel as lubricant has been used for females. However, studies report that females experience pain during urethral catheterization. We compared the effectiveness of 2% lignocaine gel (intervention) and aqueous gel (control) for female urethral catheterization in reducing procedural pain. METHODS: A double-blinded, randomized controlled trial (RCT) was conducted from November 2011 to April 2012 in an acute care hospital in Singapore. In total, 52 adult female inpatients (26 interventions vs. 26 controls) requiring urethral catheterization were included in the study. The intervention included patients receiving 2% lignocaine gel as a lubricant for urethral catheterization. Patients' pre- and postprocedural visual analog scale (VAS) were collected prospectively and nonparametric tests were used for data analysis. RESULTS: There was a significant reduction from the preprocedure pain score (Median = 22.0 mm) to the postprocedural pain score (Median = 6.6 mm) in the 2% lignocaine group (Z = -3.8, P < 0.001), but not in the aqueous gel group (pre vs. post: 16.5 mm vs. 18.2 mm; Z = -0.36, P = 0.716). Subjects using 2% lignocaine gel had significantly more reduction in the postprocedural pain score than the aqueous gel group (U = 209.5, P = 0.019). CONCLUSIONS: The 2% lignocaine gel significantly reduces the procedural pain of female urethral catheterization as compared with aqueous gel. This study provides evidence for the hospital to change the current practice in the hope of reducing procedural pain for female patients during urethral catheterization.

Advancing language concordant care: a multimodal medical interpretation intervention.

BACKGROUND: Ensuring language concordant care through medical interpretation services (MIS) allows for accurate information sharing and positive healthcare experiences. The COVID-19 pandemic led to a regional halt of in-person interpreters, leaving only digital MIS options, such as phone and video. Due to longstanding institutional practices, and lack of accessibility and awareness of these options, digital MIS remained underused. A Multimodal Medical Interpretation Intervention (MMII) was developed and piloted to increase digital MIS usage by 25% over an 18-month intervention period for patients with limited English proficiency. METHODS: Applying quality improvement methodology, an intervention comprised digital MIS technology and education was trialled for 18 months. To assess intervention impact, the number of digital MIS minutes was measured monthly and compared before and after implementation. A questionnaire was developed and administered to determine healthcare providers' awareness, technology accessibility and perception of MIS integration in the clinical workflow. RESULTS: Digital MIS was used consistently from the beginning of the COVID-19 pandemic (March 2020) and over the subsequent 18 months. The total number of minutes of MIS use per month increased by 44% following implementation of our intervention. Healthcare providers indicated that digital MIS was vital in facilitating transparent communication with patients, and the MMII ensured awareness of and accessibility to the various MIS modalities. CONCLUSION: Implementation of the MMII allowed for an increase in digital MIS use in a hospital setting. Providing digital MIS access, education and training is a means to advance patient-centred and equitable care by improving accuracy of clinical assessments and communication.

Of Climate Change and Competing Risks.

Of Climate Change and Competing Risks This Stats, STAT! animated video explores the concept of competing risks - and discusses why it is so important for investigators to consider whether the occurrence of one event can prevent or change the likelihood of the occurrence of another.

How Statistical Power Works.

How Statistical Power WorksThis Stats, STAT! animated video explores the concept of statistical power and explains how clinical investigators determine how many participants to enroll in a randomized trial.

Large Language Models.

Large Language ModelsIn the latest edition of Stats, STAT!, Fralick and colleagues explain the statistics behind large language models - used in chat bots like ChatGPT and Bard. While these new tools may seem remarkably intelligent, at their core they just assemble sentences based on statistics from large amounts of text.

Comparing the reliability of relative bird abundance indices from standardized surveys and community science data at finer resolutions.

Biodiversity loss is a global ecological crisis that is both a driver of and response to environmental change. Understanding the connections between species declines and other components of human-natural systems extends across the physical, life, and social sciences. From an analysis perspective, this requires integration of data from different scientific domains, which often have heterogeneous scales and resolutions. Community science projects such as eBird may help to fill spatiotemporal gaps and enhance the resolution of standardized biological surveys. Comparisons between eBird and the more comprehensive North American Breeding Bird Survey (BBS) have found these datasets can produce consistent multi-year abundance trends for bird populations at national and regional scales. Here we investigate the reliability of these datasets for estimating patterns at finer resolutions, inter-annual changes in abundance within town boundaries. Using a case study of 14 focal species within Massachusetts, we calculated four indices of annual relative abundance using eBird and BBS datasets, including two different modeling approaches within each dataset. We compared the correspondence between these indices in terms of multi-year trends, annual estimates, and inter-annual changes in estimates at the state and town-level. We found correspondence between eBird and BBS multi-year trends, but this was not consistent across all species and diminished at finer, inter-annual temporal resolutions. We further show that standardizing modeling approaches can increase index reliability even between datasets at coarser temporal resolutions. Our results indicate that multiple datasets and modeling methods should be considered when estimating species population dynamics at finer temporal resolutions, but standardizing modeling approaches may improve estimate correspondence between abundance datasets. In addition, reliability of these indices at finer spatial scales may depend on habitat composition, which can impact survey accuracy.

Nanotechnology based approaches for anti-diabetic drugs delivery.

Nanotechnology science has been diverged its application in several fields with the advantages to operate with nanometric range of objects. Emerging field of nanotechnology has been also being approached and applied in medical biology for improved efficacy and safety. Increased success in therapeutic field has focused several approaches in the treatment of the common metabolic disorder, diabetes. The development of nanocarriers for improved delivery of different oral hypoglycemic agents compared to conventional therapies includes nanoparticles (NPs), liposomes, dendrimer, niosomes and micelles, which produces great control over the increased blood glucose level and thus becoming an eye catching and most promising technology now-a-days. Besides, embellishment of nanocarriers with several ligands makes it more targeted delivery with the protection of entrapped hypoglycaemic agents against degradation, thereby optimizing prolonged blood glucose lowering effect. Thus, nanocarriers of hypoglycemic agents provide the aim towards improved diabetes management with minimized risk of acute and chronic complications. In this review, we provide an overview on distinctive features of each nano-based drug delivery system for diabetic treatment and current NPs applications in diabetes management.

A Study on Scalp Hair Health and Hair Care Practices among Malaysian Medical Students.

INTRODUCTION: Scalp care is essential because it determines the health and condition of the hair and prevents the diseases of scalp and hair. The objectives of our study were to correlate race and hair types, to determine the awareness of hair care among Malaysian medical students, and to distinguish the factors that affect the health of hair and scalp. METHODOLOGY: It was a cross-sectional study wherein validated questionnaires were given to 240 medical undergraduate students who belonged to three ethnic races of Malaysia, i.e., Chinese, Malay, and Malaysian Indians after their informed consent. The results were then analyzed using percentage statistics. RESULTS: Chinese students had comparatively healthier scalp without dandruff. Most Chinese and Indians had silky type of hair while Malay had dry, rough hair. Chinese and Indians colored their hair and used various styling methods; while among the Malays, this percentage was very less. Regarding hair care practices, males used only shampoo and females used shampoo and conditioner for hair wash. Students also faced dietary and examination-related stress. CONCLUSION: Results indicate that there exist morphological differences in hair among the studied population. Since most students color their hair and employ various hairstyling methods, they should be educated regarding best hair care practices to improve their scalp hair condition and health.

Arenavirus stable signal peptide is the keystone subunit for glycoprotein complex organization.

UNLABELLED: The rodent arenavirus glycoprotein complex encodes a stable signal peptide (SSP) that is an essential structural component of mature virions. The SSP, GP1, and GP2 subunits of the trimeric glycoprotein complex noncovalently interact to stud the surface of virions and initiate arenavirus infectivity. Nascent glycoprotein production undergoes two proteolytic cleavage events: first within the endoplasmic reticulum (ER) to cleave SSP from the remaining precursor GP1/2 (glycoprotein complex [GPC]) glycoprotein and second within the Golgi stacks by the cellular SKI-1/S1P for GP1/2 processing to yield GP1 and GP2 subunits. Cleaved SSP is not degraded but retained as an essential glycoprotein subunit. Here, we defined functions of the 58-amino-acid lymphocytic choriomeningitis virus (LCMV) SSP in regard to glycoprotein complex processing and maturation. Using molecular biology techniques, confocal microscopy, and flow cytometry, we detected SSP at the plasma membrane of transfected cells. Further, we identified a sorting signal (FLLL) near the carboxyl terminus of SSP that is required for glycoprotein maturation and trafficking. In the absence of SSP, the glycoprotein accumulated within the ER and was unable to undergo processing by SKI-1/S1P. Mutation of this highly conserved FLLL motif showed impaired glycoprotein processing and secretory pathway trafficking, as well as defective surface expression and pH-dependent membrane fusion. Immunoprecipitation of SSP confirmed an interaction between the signal peptide and the GP2 subunit; however, mutations within this FLLL motif disrupted the association of the GP1 subunit with the remaining glycoprotein complex. IMPORTANCE: Several members of the Arenaviridae family are neglected human pathogens capable of causing illness ranging from a nondescript flu-like syndrome to fulminant hemorrhagic fever. Infections by arenaviruses are mediated by attachment of the virus glycoprotein to receptors on host cells and virion internalization by fusion within an acidified endosome. SSP plays a critical role in the fusion of the virus with the host cell membrane. Within infected cells, the retained glycoprotein SSP plays a neglected yet essential role in glycoprotein biosynthesis. Without this 6-kDa polypeptide, the glycoprotein precursor is retained within the endoplasmic reticulum, and trafficking to the plasma membrane where SSP, GP1, and GP2 localize for glycoprotein assembly into infectious virions is inhibited. To investigate SSP contributions to glycoprotein maturation and function, we created an SSP-tagged glycoprotein to directly detect and manipulate this subunit. This resource will aid future studies to identify host factors that mediate glycoprotein maturation.