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Real-world communication frequently requires language producers to address more than one comprehender at once, yet most psycholinguistic research focuses on one-on-one communication. As the audience size grows, interlocutors face new challenges that do not arise in dyads. They must consider multiple perspectives and weigh multiple sources of feedback to build shared understanding. Here, we ask which properties of the group's interaction structure facilitate successful communication. We used a repeated reference game paradigm in which directors instructed between one and five matchers to choose specific targets out of a set of abstract figures. Across 313 games (N = 1,319 participants), we manipulated several key constraints on the group's interaction, including the amount of feedback that matchers could give to directors and the availability of peer interaction between matchers. Across groups of different sizes and interaction constraints, describers produced increasingly efficient utterances and matchers made increasingly accurate selections. Critically, however, we found that smaller groups and groups with less-constrained interaction structures ("thick channels") showed stronger convergence to group-specific conventions than large groups with constrained interaction structures ("thin channels"), which struggled with convention formation. Overall, these results shed light on the core structural factors that enable communication to thrive in larger groups.
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Comunicación , Humanos , Masculino , Femenino , Adulto , Lenguaje , Procesos de Grupo , Relaciones Interpersonales , Adulto Joven , PsicolingüísticaRESUMEN
Recent studies have demonstrated the significant role that circRNA plays in the progression of human diseases. Identifying circRNA-disease associations (CDA) in an efficient manner can offer crucial insights into disease diagnosis. While traditional biological experiments can be time-consuming and labor-intensive, computational methods have emerged as a viable alternative in recent years. However, these methods are often limited by data sparsity and their inability to explore high-order information. In this paper, we introduce a novel method named Knowledge Graph Encoder from Transformer for predicting CDA (KGETCDA). Specifically, KGETCDA first integrates more than 10 databases to construct a large heterogeneous non-coding RNA dataset, which contains multiple relationships between circRNA, miRNA, lncRNA and disease. Then, a biological knowledge graph is created based on this dataset and Transformer-based knowledge representation learning and attentive propagation layers are applied to obtain high-quality embeddings with accurately captured high-order interaction information. Finally, multilayer perceptron is utilized to predict the matching scores of CDA based on their embeddings. Our empirical results demonstrate that KGETCDA significantly outperforms other state-of-the-art models. To enhance user experience, we have developed an interactive web-based platform named HNRBase that allows users to visualize, download data and make predictions using KGETCDA with ease. The code and datasets are publicly available at https://github.com/jinyangwu/KGETCDA.
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ARN Circular , ARN Largo no Codificante , Humanos , Reconocimiento de Normas Patrones Automatizadas , Aprendizaje , Bases de Datos Factuales , Bases del Conocimiento , Biología ComputacionalRESUMEN
Horticultural plants contribute immensely to the quality of human's life. The rapid development of omics studies on horticultural plants has resulted in large volumes of valuable growth- and development-related data. Genes that are essential for growth and development are highly conserved in evolution. Cross-species data mining reduces the impact of species heterogeneity and has been extensively used for conserved gene identification. Owing to the lack of a comprehensive database for cross-species data mining using multi-omics data from all horticultural plant species, the current resources in this field are far from satisfactory. Here, we introduce GERDH (https://dphdatabase.com), a database platform for cross-species data mining among horticultural plants, based on 12 961 uniformly processed publicly available omics libraries from more than 150 horticultural plant accessions, including fruits, vegetables and ornamental plants. Important and conserved genes that are essential for a specific biological process can be obtained by cross-species analysis module with interactive web-based data analysis and visualization. Moreover, GERDH is equipped with seven online analysis tools, including gene expression, in-species analysis, epigenetic regulation, gene co-expression, enrichment/pathway and phylogenetic analysis. By interactive cross-species analysis, we identified key genes contributing to postharvest storage. By gene expression analysis, we explored new functions of CmEIN3 in flower development, which was validated by transgenic chrysanthemum analysis. We believe that GERDH will be a useful resource for key gene identification and will allow for omics big data to be more available and accessible to horticultural plant community members.
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Epigénesis Genética , Multiómica , Humanos , Filogenia , Productos Agrícolas/genética , Bases de Datos Genéticas , Minería de DatosRESUMEN
PURPOSE: Inborn errors of immunity (IEI) represent a heterogeneous group of rare genetically determined diseases. In some cases, patients present with complex or atypical phenotypes, not fulfilling the accepted diagnostic criteria for IEI and, thus, at high risk of misdiagnosis or diagnostic delay. This study aimed to validate a platform that, through the opinion of immunologist experts, improves the diagnostic process and the level of care of patients with atypical/complex IEI. METHODS: Here, we describe the functioning of the IEI-Virtual Consultation System (VCS), an innovative platform created by the Italian Immunodeficiency Network (IPINet). RESULTS: In the validation phase, from January 2020 to June 2021, 68 cases were entered on the IEI-VCS platform. A final diagnosis was achieved in 35/68 cases (51%, 95% CI 38.7 to 64.2). In 22 out of 35 solved cases, the diagnosis was confirmed by genetic analysis. In 3/35 cases, a diagnosis of secondary immunodeficiency was made. In the remaining 10 cases, an unequivocal clinical and immunological diagnosis was obtained, even though not substantiated by genetic analysis. CONCLUSION: From our preliminary study, the VCS represents an innovative and useful system to improve the diagnostic process of patients with complex unsolved IEI disorders, with benefits both in terms of reduction of time of diagnosis and access to the required therapies. These results may help the functioning of other international platforms for the management of complex cases.
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Diagnóstico Tardío , Enfermedades Raras , Humanos , Fenotipo , Derivación y Consulta , ItaliaRESUMEN
Data on post-coronavirus disease (COVID) in healthcare workers (HCWs) are scarce. We aimed to assess prevalence, determinants, and consequences of post-COVID in HCWs. In fall 2022, we performed a cross-sectional survey in a tertiary care hospital with a web-based questionnaire sent to HCWs. Post-COVID was defined as persistent/new symptoms 3 months after acute COVID. Propensity score weighting was performed to assess the impact of post-COVID on return-to-work. 1062 HCWs completed the questionnaire, 713 (68%) reported at least one COVID, and 109 (10%) met the definition for post-COVID, with workplace contamination reported in 51 (47%). On multivariable analysis, risk factors for post-COVID were female gender (p = 0.047), ≥50 years (p = 0.007), immunosuppression (p = 0.004), ≥2 COVID episodes (p = 0.003), and ≥5 symptoms during acute COVID (p = 0.005). Initial sick leave was prescribed for 94 HCWs (86% post-COVID), for a median duration of 7 [7-9] days, and extended for 23. On return-to-work, 91 (84%) had residual symptoms, primarily asthenia/fatigue (72%) and cognitive impairment (25%). Cognitive impairment at return-to-work was associated with post-COVID. Ten HCWs (9%) received a medical diagnosis of post-COVID, 8 consulted the occupational physician, and four required work adaptation. Post-COVID affected 10% of HCWs. Long-term consequences included repeated sick leaves and residual symptoms on return-to-work.
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COVID-19 , Personal de Salud , Humanos , COVID-19/epidemiología , Masculino , Estudios Transversales , Femenino , Personal de Salud/estadística & datos numéricos , Persona de Mediana Edad , Prevalencia , Adulto , Encuestas y Cuestionarios , Factores de Riesgo , Reinserción al Trabajo/estadística & datos numéricos , SARS-CoV-2 , Ausencia por Enfermedad/estadística & datos numéricos , Síndrome Post Agudo de COVID-19RESUMEN
INTRODUCTION: Human metabolism is sustained by functional networks that operate at diverse scales. Capturing local and global dynamics in the human body by hierarchically bridging multi-scale functional networks is a major challenge in physiological modeling. OBJECTIVES: To develop an interactive, user-friendly web application that facilitates the simulation and visualization of advection-dispersion transport in three-dimensional (3D) microvascular networks, biochemical exchange, and metabolic reactions in the tissue layer surrounding the vasculature. METHODS: To help modelers combine and simulate biochemical processes occurring at multiple scales, KiPhyNet deploys our discrete graph-based modeling framework that bridges functional networks existing at diverse scales. KiPhyNet is implemented in Python based on Apache web server using MATLAB as the simulator engine. KiPhyNet provides the functionality to assimilate multi-omics data from clinical and experimental studies as well as vascular data from imaging studies to investigate the role of structural changes in vascular topology on the functional response of the tissue. RESULTS: With the network topology, its biophysical attributes, values of initial and boundary conditions, parameterized kinetic constants, biochemical species-specific transport properties such as diffusivity as inputs, a user can use our application to simulate and view the simulation results. The results of steady-state velocity and pressure fields and dynamic concentration fields can be interactively examined. CONCLUSION: KiPhyNet provides barrier-free access to perform time-course simulation experiments by building multi-scale models of microvascular networks in physiology, using a discrete modeling framework. KiPhyNet is freely accessible at http://pallab.cds.iisc.ac.in/kiphynet/ and the documentation is available at https://deepamahm.github.io/kiphynet_docs/ .
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Simulación por Computador , Programas Informáticos , Humanos , Cinética , Transporte Biológico/fisiología , Modelos Biológicos , InternetRESUMEN
BACKGROUND: Up to 70% of people diagnosed with upper gastrointestinal (GI) tract or hepato-pancreato-biliary (HPB) cancers experience substantial reductions in quality of life (QoL), including high distress levels, pain, fatigue, sleep disturbances, weight loss and difficulty swallowing. With few advocacy groups and support systems for adults with upper GI or HPB cancers (i.e. pancreas, liver, stomach, bile duct and oesophageal) and their carers, online supportive care programs may represent an alternate cost-effective mechanism to support this patient group and carers. iCare is a self-directed, interactive, online program that provides information, resources, and psychological packages to patients and their carers from the treatment phase of their condition. The inception and development of iCare has been driven by consumers, advocacy groups, government and health professionals. The aims of this study are to determine the feasibility and acceptability of iCare, examine preliminary efficacy on health-related QoL and carer burden at 3- and 6-months post enrolment, and the potential cost-effectiveness of iCare, from health and societal perspectives, for both patients and carers. METHODS AND ANALYSIS: A Phase II randomised controlled trial. Overall, 162 people with newly diagnosed upper GI or HPB cancers and 162 carers will be recruited via the Upper GI Cancer Registry, online advertisements, or hospital clinics. Patients and carers will be randomly allocated (1:1) to the iCare program or usual care. Participant assessments will be at enrolment, 3- and 6-months later. The primary outcomes are i) feasibility, measured by eligibility, recruitment, response and attrition rates, and ii) acceptability, measured by engagement with iCare (frequency of logins, time spent using iCare, and use of features over the intervention period). Secondary outcomes are patient changes in QoL and unmet needs, and carer burden, unmet needs and QoL. Linear mixed models will be fitted to obtain preliminary estimates of efficacy and variability for secondary outcomes. The economic analysis will include a cost-consequences analysis where all outcomes will be compared with costs. DISCUSSION: iCare provides a potential model of supportive care to improve QoL, unmet needs and burden of disease among people living with upper GI or HPB cancers and their carers. AUSTRALIAN AND NEW ZEALAND CLINICAL TRIALS REGISTRY: ACTRN12623001185651. This protocol reflects Version #1 26 April 2023.
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Neoplasias , Tracto Gastrointestinal Superior , Adulto , Humanos , Calidad de Vida/psicología , Cuidadores/psicología , Australia , Neoplasias/terapia , Ensayos Clínicos Controlados Aleatorios como Asunto , Ensayos Clínicos Fase II como AsuntoRESUMEN
BACKGROUND: This study aimed to develop and validate a novel risk stratification model and a web-based survival rate calculator to improve discriminative and predictive accuracy for diffuse large B-cell lymphoma (DLBCL) in the rituximab era. METHODS: We retrospectively collected pre-treatment data from 873 primary DLBCL patients who received R-CHOP-based immunochemotherapy regimens at the Cancer Hospital, Chinese Academy of Medical Sciences, from January 1, 2005, to December 31, 2018. An independent cohort of 175 DLBCL patients from Fujian Cancer Hospital was used for external validation. FINDINGS: Age, ECOG PS, number of extranodal sites, Ann Arbor stage, bulky disease, and LDH levels were screened to develop the nomogram and web-based survival rate calculator. The C-index of the nomogram in the training, internal validation, and external validation cohorts was 0.761, 0.758, and 0.768, respectively. The risk stratification model generated based on the nomogram effectively stratified patients into three distinct risk groups. K-M survival curves demonstrated that the novel risk stratification model exhibited a superior level of predictive accuracy compared to IPI, R-IPI, and NCCN-IPI both in training and two validation cohorts. Additionally, the area under the curve (AUC) value of the novel model (0.763) for predicting 5-year overall survival rates was higher than those of IPI (0.749), R-IPI (0.725), and NCCN-IPI (0.727) in the training cohort. Similar results were observed in both internal and external validation cohort. CONCLUSIONS: In conclusion, we have successfully developed and validated a novel risk stratification model and a web-based survival rate calculator that demonstrated superior discriminative and predictive accuracy compared to IPI, R-IPI, and NCCN-IPI in the rituximab era.
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Protocolos de Quimioterapia Combinada Antineoplásica , Linfoma de Células B Grandes Difuso , Humanos , Rituximab/uso terapéutico , Tasa de Supervivencia , Estudios Retrospectivos , Pronóstico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Estudios de Cohortes , Linfoma de Células B Grandes Difuso/patología , Ciclofosfamida/uso terapéutico , Prednisona/uso terapéutico , Vincristina/uso terapéutico , Doxorrubicina/uso terapéutico , Medición de RiesgoRESUMEN
BACKGROUND: Ghana is among the top 10 highest malaria burden countries, with about 20,000 children dying annually, 25% of which were under five years. This study aimed to produce interactive web-based disease spatial maps and identify the high-burden malaria districts in Ghana. METHODS: The study used 2016-2021 data extracted from the routine health service nationally representative and comprehensive District Health Information Management System II (DHIMS2) implemented by the Ghana Health Service. Bayesian geospatial modelling and interactive web-based spatial disease mapping methods were employed to quantify spatial variations and clustering in malaria risk across 260 districts. For each district, the study simultaneously mapped the observed malaria counts, district name, standardized incidence rate, and predicted relative risk and their associated standard errors using interactive web-based visualization methods. RESULTS: A total of 32,659,240 malaria cases were reported among children < 5 years from 2016 to 2021. For every 10% increase in the number of children, malaria risk increased by 0.039 (log-mean 0.95, 95% credible interval = - 13.82-15.73) and for every 10% increase in the number of males, malaria risk decreased by 0.075, albeit not statistically significant (log-mean - 1.82, 95% credible interval = - 16.59-12.95). The study found substantial spatial and temporal differences in malaria risk across the 260 districts. The predicted national relative risk was 1.25 (95% credible interval = 1.23, 1.27). The malaria risk is relatively the same over the entire year. However, a slightly higher relative risk was recorded in 2019 while in 2021, residing in Keta, Abuakwa South, Jomoro, Ahafo Ano South East, Tain, Nanumba North, and Tatale Sanguli districts was associated with the highest malaria risk ranging from a relative risk of 3.00 to 4.83. The district-level spatial patterns of malaria risks changed over time. CONCLUSION: This study identified high malaria risk districts in Ghana where urgent and targeted control efforts are required. Noticeable changes were also observed in malaria risk for certain districts over some periods in the study. The findings provide an effective, actionable tool to arm policymakers and programme managers in their efforts to reduce malaria risk and its associated morbidity and mortality in line with the Sustainable Development Goals (SDG) 3.2 for limited public health resource settings, where universal intervention across all districts is practically impossible.
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Malaria , Masculino , Niño , Humanos , Ghana/epidemiología , Teorema de Bayes , Malaria/epidemiología , Servicios de Salud , RiesgoRESUMEN
PURPOSE OF REVIEW: Web-based programs to prevent sexual offense perpetration could provide an opportunity that avoids many of the barriers associated with in-person treatment. The aim of this systematic review is to give an overview of the literature on web-based initiatives aimed at sexual offense perpetration prevention published during the last 10 years (2013-2023) and to report data on the efficacy as well as issues of the discussed initiatives. RECENT FINDINGS: We included 18 empirical studies discussing web-based perpetration prevention initiatives, of which six are randomized controlled trials. Among the articles, four cover programs focusing on prevention of sexual reoffending and 14 discuss programs aimed at preventing initial sexual offenses. Evaluations and observations of web-based initiatives aimed at preventing sexual offense perpetration show overall promising results and are well-appreciated. However, evaluation studies are scarce and more randomized controlled trials replicating this effect are warranted.
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Delitos Sexuales , Humanos , Delitos Sexuales/prevención & control , Intervención basada en la Internet , InternetRESUMEN
BACKGROUND: Electronic patient-reported outcomes (ePROs) assess patients' health status and quality of life, improving patient care and treatment effects, yet little is known about their use and adherence in routine patient care. AIMS: We evaluated the adherence of invasive breast cancer and ductal carcinoma in situ (DCIS) patients to ePROs follow-up and whether specific patient characteristics are related to longitudinal non-adherence. METHODS: Since November 2016, the Breast Center at Charité - Universitätsmedizin Berlin has implemented an ongoing prospective PRO routine program, requiring patients to complete ePROs assessments and consent to email-based follow-up in the first 12 months after therapy starts. Frequencies and summary statistics are presented. Multiple logistic regression models were performed to determine an association between patient characteristics and non-adherence. RESULTS: Out of 578 patients, 239 patients (41.3%, 95%CI: 37.3-45.5%) completed baseline assessment and all five ePROs follow-up during the first 12 months after therapy. On average, above 70% of those patients responded to the ePROs follow-up assessment. Adherence to the ePROs follow-up was higher during the COVID-19 pandemic than in the time periods before (47.4% (111/234) vs. 33.6% (71/211)). Factors associated with longitudinal non-adherence were younger age, a higher number of comorbidities, no chemotherapy, and a low physical functioning score in the EORTC QLQ-C30 at baseline. CONCLUSIONS: The study reveals moderate adherence to 12-month ePROs follow-up assessments in invasive early breast cancer and DCIS patients, with response rates ranging from 60 to 80%. Emphasizing the benefits for young patients and those with high disease burdens might further increase adherence.
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Neoplasias de la Mama , Cooperación del Paciente , Medición de Resultados Informados por el Paciente , Calidad de Vida , Humanos , Femenino , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/psicología , Neoplasias de la Mama/terapia , Persona de Mediana Edad , Estudios Longitudinales , Anciano , Estudios Prospectivos , Cooperación del Paciente/estadística & datos numéricos , Adulto , Estudios de Seguimiento , Carcinoma Intraductal no Infiltrante/terapia , Carcinoma Intraductal no Infiltrante/psicología , Carcinoma Intraductal no Infiltrante/tratamiento farmacológico , COVID-19RESUMEN
BACKGROUND: Digitizing surgical data infrastructure is critical for policymakers to make informed decisions. The implementation of the first web-based operating theater (OT) recordings at Muhimbili Orthopedic Institute (MOI) represents significant advancements in data management for Tanzania. This study aims to share post-platform implementation outcomes, challenges, and insights gained offering guidance to settings facing similar data repository challenges. METHODS: In July 2023, after training clinicians, the platform was deployed at MOI operating theaters (OTs) to facilitate prospective data entry following procedures, ensuring timely updates of perioperative outcomes. Semi-structured interviews were conducted with key stakeholders to gather insights into the platform's functionality and efficient data management systems. We presented data from August 2023 to February 2024 along with platform insights. RESULTS: Over 4449 procedures were conducted, comprising 1321 emergencies and 3128 electives, with orthopedics/trauma accounting for the majority (3606). Trauma-related emergencies (921) predominate among interventions. General anesthesia was prevalent; 60.56% in emergencies and 44.51% in electives. Orthopedics/trauma utilized 90.91% of assigned operating days in electives, while neurosurgery utilized 93.39% (p < 0.011). The cancellation rate was 7.5%, primarily due to emergency interferences (32%). Of procedures, 96.76% were discharged, while 2.81% died. Challenges encountered during platform implementation included securing local support, integrating technology, and navigating administrative adjustments. Lessons learned emphasized continuous communication for stakeholder buy-in and training for platform familiarity. CONCLUSION: The web-based OT recordings at MOI succeeded with local support and showed promise for wider scalability. To ensure sustainability, ongoing follow-up, monitoring of platform functionality, local funding establishment, and strengthening global partnerships are recommended.
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Quirófanos , Adulto , Femenino , Humanos , Masculino , Países en Desarrollo , Quirófanos/economía , Quirófanos/organización & administración , Estudios Prospectivos , Configuración de Recursos Limitados , Procedimientos Quirúrgicos Operativos , TanzaníaRESUMEN
INTRODUCTION: Digital technologies have enabled new possibilities to assess dietary intake and have shown promise in terms of decreased participant burden, improved accuracy and lower costs. However, their potential and validity in pregnant populations are scarcely explored. OBJECTIVES: This study aimed to (a) validate energy intakes obtained from a web-based dietary recall method developed for national surveys (RiksmatenFlex) against total energy expenditure (TEE) by means of the doubly labelled water (DLW) method, and (b) to compare intakes of macronutrients, key unhealthy and healthy foods as well as adherence to food-based dietary guidelines between RiksmatenFlex and repeated 24 h telephone dietary recalls in healthy Swedish pregnant women. METHODS: This study was conducted as a nested validation within the HealthyMoms trial. Intakes of foods, macronutrients and energy were assessed during three days through RiksmatenFlex and 24 h telephone dietary recalls, and Swedish Healthy Eating Index (SHEI) scores were also calculated for both methods (n = 52). For 24 women, TEE was also assessed through the DLW method. Paired Samples T-tests and Wilcoxon Signed Ranks Tests were used to identify differences between means for foods, macronutrients, energy and SHEI scores. Pearson correlation coefficient or Spearman's rho were performed to identify relationships between variables. To compare energy intake (RiksmatenFlex) with TEE (DLW method) and 24 h telephone dietary recalls, Bland and Altman plots were constructed. RESULTS: Average energy intake from RiksmatenFlex (10,015 [SD 2004] kJ) was not statistically different from TEE (10,252 [SD 1197] kJ) (p = 0.596) (mean difference: -237 kJ/24 h). Correspondingly, there were small mean differences between average intakes of key unhealthy and healthy foods and average SHEI scores between RiksmatenFlex and 24 h telephone dietary recalls. However, the Bland and Altman plots showed wide limits of agreement for all dietary variables (e.g., for energy intake using RiksmatenFlex versus TEE: ±4239 kJ/24 h). High correlations between the investigated dietary variables for the two dietary methods were observed (r = 0.751 to 0.931; all p < 0.001). CONCLUSION: RiksmatenFlex captured average intakes of energy, unhealthy and healthy food groups and adherence to food-based dietary guidelines in a comparable way to 24 h telephone dietary recalls and the DLW method. Our results support the validity of RiksmatenFlex as a web-based dietary assessment method for future use in pregnancy for intervention studies and national dietary surveys.
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Ingestión de Energía , Metabolismo Energético , Internet , Recuerdo Mental , Evaluación Nutricional , Humanos , Femenino , Embarazo , Adulto , Metabolismo Energético/fisiología , Dieta/métodos , Dieta/estadística & datos numéricos , Reproducibilidad de los Resultados , Registros de Dieta , Suecia , Encuestas sobre Dietas/métodos , Encuestas sobre Dietas/normasRESUMEN
Objective: This study aimed to build and validate a practical web-based dynamic prediction model for predicting renal progression in patients with primary membranous nephropathy (PMN). Method: A total of 359 PMN patients from The First Affiliated Hospital of Fujian Medical University and 102 patients with PMN from The Second Hospital of Longyan between January 2018 to December 2023 were included in the derivation and validation cohorts, respectively. Renal progression was delineated as a decrease in eGFR of 30% or more from the baseline measurement at biopsy or the onset of End-Stage Renal Disease (ESRD). Multivariable Cox regression analysis was employed to identify independent prognostic factors. A web-based dynamic prediction model for renal progression was built and validated, and the performance was assessed using. An analysis of the receiver operating characteristic and the decision curve analysis. Results: In the derivation cohort, 66 (18.3%) patients experienced renal progression during the follow-up period (37.60 ± 7.95 months). The final prediction rule for renal progression included hyperuricemia (HR=2.20, 95%CI 1.26 to 3.86), proteinuria (HR=2.16, 95%CI 1.47 to 3.18), significantly lower serum albumin (HR=2.34, 95%CI 1.51 to 3.68) and eGFR (HR=1.96, 95%CI 1.47 to 2.61), older age (HR=1.85, 95%CI 1.28 to 2.61), and higher sPLA2R-ab levels (HR=2.08, 95%CI 1.43 to 3.18). Scores for each variable were calculated using the regression coefficients in the Cox model. The developed web-based dynamic prediction model, available online at http://imnpredictmodel1.shinyapps.io/dynnomapp, showed good discrimination (C-statistic = 0.72) and calibration (Brier score, P = 0.155) in the validation cohort. Conclusion: We developed a web-based dynamic prediction model that can predict renal progression in patients with PMN. It may serve as a helpful tool for clinicians to identify high-risk PMN patients and tailor appropriate treatment and surveillance strategies.
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Progresión de la Enfermedad , Tasa de Filtración Glomerular , Glomerulonefritis Membranosa , Humanos , Glomerulonefritis Membranosa/patología , Glomerulonefritis Membranosa/diagnóstico , Masculino , Femenino , Persona de Mediana Edad , Adulto , Pronóstico , Fallo Renal Crónico , Receptores de Fosfolipasa A2/inmunología , Estudios Retrospectivos , Riñón/patología , Riñón/fisiopatología , Factores de Riesgo , Curva ROC , ProteinuriaRESUMEN
BACKGROUND: Oral tongue squamous cell carcinoma (OTSCC) often presents with aggressive clinical behaviour that may require multimodality treatment based on reliable prognostication. We aimed to evaluate the prognostic ability of five online web-based tools to predict the clinical behaviour of OTSCC resection and biopsy samples. METHODS: A total of 135 OTSCC resection cases and 33 OTSCC biopsies were included to predict recurrence and survival. Area under the receiver operating characteristic curves (AUC), χ2 tests, and calibration plots constructed to estimate the prognostic power of each tool. RESULTS: The tool entitled 'Prediction of risk of Locoregional Recurrences in Early OTSCC' presented an accuracy of 82%. The tool, 'Head & Neck Cancer Outcome Calculator' for 10-year cancer-related mortality had an accuracy 77% and AUC 0.858. The other tool entitled 'Cancer Survival Rates' for 5-year mortality showed an accuracy of 74% and AUC of 0.723. For biopsy samples, 'Cancer Survival Prediction Calculators' predicted the recurrence free survival with an accuracy of 70%. CONCLUSIONS: Web-based tools can aid in clinical decision making of OTSCC. Three of five online web-based tools could predict recurrence risk and cancer-related mortality in resected OTSCC and one tool could help in clinical decision making for biopsy samples.
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BACKGROUND: Mild Cognitive Impairment (MCI) is frequently a precursor to dementia, affecting aspects of cognition such as language, thinking, or memory. Lifestyle interventions are increasingly studied as potential means to slow the progression from MCI to dementia. OBJECTIVE: A systematic review was conducted to investigate the effectiveness of home-based lifestyle interventions in reducing cognitive decline in older adults with MCI. METHODS: A systematic review of randomized controlled trials (RCTs) was conducted to identify home-based lifestyle interventions for individuals with MCI from 1980 to 2023. These interventions were either single-component or multi-component and included diet, physical activity, stress-reduction, or cognitive stimulation treatments to assess their impact on cognition. We performed a comprehensive search in the PubMed, Web of Science, Google Scholar, Embase, and MEDLINE databases. RESULTS: From 320 abstracts, 20 (6.25%) studies met the criteria for inclusion, with five multi-component and fifteen single-component studies. Eighteen home-based lifestyle interventions for MCI patients were focused on physical activity, diet, and/or cognitive training, while two studies were identified that incorporated stress reduction training as a method to improve cognitive function. Nineteen studies reported significant improvements in cognitive performance between the experimental and control groups post-intervention for at least one aspect of cognition. Four studies reported nonsignificant improvements in cognitive function between the two groups for at least one area of cognition. CONCLUSIONS: Home-based lifestyle interventions have the potential to improve cognition in elderly patients with MCI. However, future RCTs with larger sample sizes and longer intervention durations are needed to confirm these findings.
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Terapia Cognitivo-Conductual , Disfunción Cognitiva , Demencia , Humanos , Anciano , Disfunción Cognitiva/terapia , Cognición , Estilo de VidaRESUMEN
BACKGROUND: This study aimed to investigate the knowledge, attitudes, and practices (KAP) toward cardiovascular complications among end-stage renal disease patients undergoing maintenance hemodialysis. METHODS: This web-based cross-sectional study was conducted at Guangdong Provincial People's Hospital between December 2022, and May 2023. RESULTS: A total of 545 valid questionnaires were collected, with an average age of 57.72 ± 13.47 years. The mean knowledge, attitudes and practices scores were 8.17 ± 2.9 (possible range: 0-24), 37.63 ± 3.80 (possible range: 10-50), 33.07 ± 6.10 (possible range: 10-50) respectively. Multivariate logistic regression analysis showed that patients from non-urban area had lower knowledge compared to those from urban area (odds ratio (OR) = 0.411, 95% CI: 0.262-0.644, P < 0.001). Furthermore, higher levels of education were associated with better knowledge, as indicated by OR for college and above (OR = 4.858, 95% CI: 2.483-9.504), high school/vocational school (OR = 3.457, 95% CI: 1.930-6.192), junior high school (OR = 3.300, 95% CI: 1.945-5.598), with primary school and below as reference group (all P < 0.001). Besides, better knowledge (OR = 1.220, 95% CI: 1.132-1.316, P < 0.001) and higher educational levels were independently associated with positive attitudes. Specifically, individuals with a college degree and above (OR = 2.986, 95% CI: 1.411-6.321, P = 0.004) and those with high school/vocational school education (OR = 2.418, 95% CI: 1.314-4.451, P = 0.005) have more positive attitude, with primary school and below as reference group. Next, better attitude (OR = 1.174, 95% CI: 1.107-1.246, P < 0.001) and higher education were independently associated with proactive practices. Those with college and above (OR = 2.870, 95% CI: 1.359-6.059, P = 0.006), and those with high school/vocational school education (OR = 1.886, 95% CI: 1.032-3.447, P = 0.039) had more proactive practices, with primary school and below as reference group. CONCLUSIONS: End-stage renal disease patients undergoing maintenance hemodialysis demonstrated insufficient knowledge, positive attitudes, and moderate practices regarding cardiovascular complications. Targeted interventions should prioritize improving knowledge and attitudes, particularly among patients with lower educational levels and income, to enhance the management of cardiovascular complications in end-stage renal disease.
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Enfermedades Cardiovasculares , Conocimientos, Actitudes y Práctica en Salud , Fallo Renal Crónico , Diálisis Renal , Humanos , Masculino , Femenino , Diálisis Renal/psicología , Estudios Transversales , Fallo Renal Crónico/terapia , Fallo Renal Crónico/psicología , Persona de Mediana Edad , Adulto , Anciano , Encuestas y Cuestionarios , China/epidemiologíaRESUMEN
BACKGROUND: Child abuse is one of the major health and social problems in the world and has severe short-term and long-term consequences on children's psychological, social and physical functioning. One of the effective strategies to control and prevent child abuse is training parent through web-based applications. The aim of this study is to design and evaluation of child abuse web-based application for parent education and strengthen. METHODS: This study is an applied-developmental study that performed in Razi Educational and Therapeutic Center in Tabriz. The study consisted of three main phases. The requirements assessment and design phases were completed between November 2022 and February 2023. The research community was parents referring to Razi Center and convenience sampling was used to select the samples. In firststage, a questionnaire was designed by searching in library sources and consulting with specialists for needs assessment and application design. The questionnaire was completed by psychiatric specialists, health information management and health information technology.Finally, the usability of designed application was evaluated with the participation of 30 parents and specialists. RESULTS: Based on the identified information elements and capabilities, a child abuse web-based application was designed. Application capabilities were such as concepts of child abuse, prevention and treatment strategies, parenting skills, childrens behavioral disorders, child abuse laws and interaction with clinical specialists. Finally, the result of the web-based application usability evaluation was evaluated at a good level equal to an average of 7.6 out of a total of 9 points. CONCLUSIONS: The possibility of expressing experiences, exchanging message, attractiveness, ease of use, and accessibility of parents, they were designed as application features. The usability of the web-based application was satisfactory to users in various of overall functionality, display, terminology, learning ability and overall application capability.
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Maltrato a los Niños , Aprendizaje , Niño , Humanos , Escolaridad , Maltrato a los Niños/prevención & control , Padres , InternetRESUMEN
BACKGROUND: Structural and behavioral interventions to manage work-related stress are effective in employees. Nonetheless, they have been implemented insufficiently, particularly in micro- and small-sized enterprises (MSE). Main barriers include a lack of knowledge and limited resources, which could potentially be overcome with simplified web-based alternatives for occupational stress prevention. However, there is a lack of implementation research about web-based prevention in realistic settings of MSE. OBJECTIVE: The aim of this study is to evaluate the implementation process and success of an integrated web-based platform for occupational stress prevention ("System P") and to identify potential barriers for its uptake and use in MSE in Germany. METHODS: This study with a mixed-methods approach investigates eight process-related outcomes in a quantitative part I (adoption, reach, penetration, fidelity/dose, costs, acceptability) and a qualitative part II (acceptability, appropriateness and feasibility). Part I has a pre-post design with two measurements (6 months apart) with 98 individual participants and part II consists of 12 semi-structured interviews with managers and intercorporate stakeholders. RESULTS: Part I revealed shortcomings in the implementation process. Adoption/Reach: Despite extensive marketing efforts, less than 1% of the contacted MSE responded to the offer of System P. A total of 40 MSE registered, 24 of which, characterized by good psychosocial safety climate, adopted System P. Penetration: Within these 24 MSE, 15% of the employees used the system. Fidelity/Dose: 11 MSE started a psychosocial risk-assessment (PRA), and no MSE finished it. The stress-management training (SMT) was started by 25 users and completed by 8. COSTS: The use of System P was free of charge, but the time required to engage with was an indirect cost. Part II added insights on the perception of the web-based intervention: Acceptance of System P by users and stakeholders was good and it was assessed as appropriate for MSE. Results for feasibility were mixed. CONCLUSIONS: Although System P was generally perceived as useful and appropriate, only a small number of contacted MSE implemented it as intended. Prior experience and sensitivity for occupational (stress) prevention were mentioned as key facilitators, while (perceived) indirect costs were a key barrier. Enabling MSE to independently manage stress prevention online did not result in successful implementation. Increasing external support could be a solution. ⺠FULL PROJECT NAME: "PragmatiKK - Pragmatische Lösungen für die Implementation von Maßnahmen zur Stressprävention in Kleinst- und Kleinbetrieben" (= Pragmatic solutions for the implementation of stress prevention interventions in micro and small-sized enterprises). TRIAL REGISTRATION: German Register of Clinical Studies (DRKS) DRKS00026154, date of registration 2021-09-16.
Asunto(s)
Estrés Laboral , Humanos , Alemania , Estrés Laboral/prevención & control , Femenino , Masculino , Adulto , Persona de Mediana Edad , Pequeña Empresa , Internet , Evaluación de Programas y Proyectos de Salud , Intervención basada en la Internet , Investigación CualitativaRESUMEN
AIM: We evaluated the effect on body mass index standard deviation score (BMI-SDS) of a combined treatment (Web-COP) for children with obesity, including a web-based component targeting their parents. METHODS: This randomised controlled trial recruited children 5-12 years of age with obesity (International Obesity Task Force BMI [IOTF-BMI] ≥30 kg/m2 ) from school health care and outpatient paediatric clinics in in Northern Sweden from 1 June 2019 to 21 June 2020. The children were randomised to Web-COP, an intervention with group sessions and a 12-week web-based component, or standard care. The primary outcome was the change in IOTF BMI-SDS after 6 months. RESULTS: In total, 75 children (33 girls), mean age 9.5 years, were randomised, and 65/75 (87%) children and their parents completed the study, 35/39 (90%) in the Web-COP intervention and 30/36 (83%) in the standard care group. BMI-SDS at 6 months was changed from 3.08 to 2.81 in the intervention group compared to an increase from 3.07 to 3.16 in the standard care group, representing a significant difference between groups (p < 0.001). In the intervention group, 14/30 (47%) reduced their BMI-SDS ≥0.25, compared to none in the standard care group. CONCLUSION: The parent-focused intervention significantly improved BMI-SDS in children with obesity as compared to children in standard care.