Displaying publications 561 - 580 of 11203 in total

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  1. Lim SC, Chan YM, Gan WY
    PMID: 36900997 DOI: 10.3390/ijerph20053977
    Quality of life (QOL) of older adults is a complex issue that requires an understanding of the intersection between socioeconomic and health factors. A poor quality of life (QOL) is frequently reported as sub-optimal among older adults whereby concerted and collective actions are required through an evidence-based approach. Hence, this cross-sectional study aims to determine the social and health predictors of the QOL of a community-dwelling older adult Malaysian population through a quantitative household survey using multi-stage sampling. A total of 698 respondents aged 60 years old and older were recruited and the majority of them had a good quality of life. Risk of depression, disability, living with stroke, low household income, and lack of social network were identified as the predictors of a poor QOL among the community-dwelling older Malaysians. The identified predictors for QOL provided a list of priorities for the development of policies, strategies, programmes, and interventions to enhance the QOL of the community-dwelling older Malaysians. Multisectoral approaches, especially collective efforts from both social and health sectors, are required to address the complexities of the ageing issues.
    Matched MeSH terms: Middle Aged
  2. Power S, Biondi A, Saatci I, Bennett K, Mahadevan J, Januel AC, et al.
    Interv Neuroradiol, 2022 Jun;28(3):311-322.
    PMID: 34516279 DOI: 10.1177/15910199211030783
    BACKGROUND AND PURPOSE: Women's representation in medicine has increased over time yet the proportion of women practicing neurointervention remains low. We conducted an anonymous online survey through which we could explore the gender gap in neurointervention, identify potential issues, difficulties, or obstacles women might face, and evaluate if men encounter similar issues.

    METHODS: An online questionnaire was designed in SurveyMonkey®. Invitation to participate was emailed through national and international neurointerventional societies as well as directly through private mailing lists to men and women working in neurointervention. Responses were collected from 10 May 2019 to 10 September 2019.

    RESULTS: There were 295 complete responses, 173 (59%) male and 122 (41%) female. Most respondents (83%) fell within age categories 35-60 years, with representation from 40 countries across five continents. In all 95% were working full time, 73% had worked as a neurointerventionalist for >6 years, 77% worked in University-affiliated teaching institutions. Almost half of the respondents indicated no female neurointerventionalist worked in their center. Female respondents were younger and age-adjusted analysis was undertaken. Significantly fewer females than males were married and had children. Significantly fewer females held supervisory roles, held academic titles, and significantly less had a mentor. Females were less satisfied in their careers. More females felt they receive less recognition than colleagues of the opposite sex. Males had a greater proportion of work time dedicated to neurointervention. Similar proportions of both genders experienced bullying in work (40%-47%); however, sexual harassment was more common for females. There were no differences between genders in how they dealt with complications or their effects on mental well-being.

    CONCLUSION: There are many potential reasons why women are underrepresented in neurointervention, however, the literature suggests this is not unique to our specialty. Multiple long-term strategies will be necessary to address these issues, some of which are discussed in the article.

    Matched MeSH terms: Middle Aged
  3. Liu Q, Yan W, Qin C, Du M, Wang Y, Liu M, et al.
    Glob Health Res Policy, 2023 Jun 23;8(1):22.
    PMID: 37349771 DOI: 10.1186/s41256-023-00306-1
    BACKGROUND: People in China and the countries in the Association of Southeast Asian Nations (ASEAN) are affected by neglected tropical diseases and malaria (NTDM). In this study, we aimed to assess the current status and trends of NTDM burden from 1990 to 2019 in China and ASEAN countries, and also explore the association of NTDM burden with socio-demographic index (SDI).

    METHODS: The data from the Global Burden of Diseases Study 2019 (GBD 2019) results were used. Absolute incidence and death number, and age-standardized incidence and mortality rate (ASIR and ASMR) of NTDM in China and ASEAN were extracted. The estimated annual percentage change (EAPC) and join-point regression in the rates quantified the trends. Nonlinear regression (second order polynomial) was used to explore the association between SDI and ASRs.

    RESULTS: The ASIR of NTDM increased in China, Philippines, Singapore and Brunei, at a speed of an average 4.15% (95% CI 3.83-4.47%), 2.15% (1.68-2.63%), 1.03% (0.63-1.43%), and 0.88% (0.60-1.17%) per year. Uptrends of ASIR of NTDM in recent years were found in China (2014-2017, APC = 10.4%), Laos (2005-2013, APC = 3.9%), Malaysia (2010-2015, APC = 4.3%), Philippines (2015-2019, APC = 4.2%), Thailand (2015-2019, APC = 2.4%), and Vietnam (2014-2017, APC = 3.2%, all P 

    Matched MeSH terms: Middle Aged
  4. Rahman NA, Ariaratnam S, Hashim NA, Azhar ZI
    PLoS One, 2024;19(7):e0307992.
    PMID: 39058752 DOI: 10.1371/journal.pone.0307992
    BACKGROUND: Managing chronic pain was not only a major challenge but also a source of significant disability associated with mental illness. Studies on generalized anxiety disorder (GAD) in chronic pain population was rather limited. This study was aimed to determine the prevalence of GAD and its associated factors among patients attending a pain clinic at a general hospital.

    METHODS: This cross-sectional study recruited 201 patients. The Hospital Anxiety Depression Scale (HADS) was used to determine anxiety level. Subsequently, patients who had scored 8 and above on the HADS were interviewed using Mini International Neuropsychiatric Interview (M.I.N.I) to ascertain the diagnosis of GAD. Whilst the Numerical Rating Scale (NRS) assessed pain severity. Multiple logistic regression analysis was used to determine factors associated with GAD.

    RESULTS: Among those patients with chronic pain, the prevalence of GAD was 18.9%. Gender (AOR:7.94; 95% CI:2.34, 26.93), duration of the pain (AOR:1.30; 95% CI:1.03,1.63) and pain severity (AOR:18.75; CI:1.23,285.13) were significant factors associated with GAD.

    CONCLUSION: GAD is a prevalent condition among chronic pain patients.

    Matched MeSH terms: Middle Aged
  5. Navvabi-Rigi SD, Mohammadi-Shahboulaghi F, Foroughan M, Momtaz YA
    PLoS One, 2022;17(11):e0276797.
    PMID: 36318522 DOI: 10.1371/journal.pone.0276797
    During menopause, women experience major changes, including the onset of aging as a natural and inevitable event. The present study aimed to explore and explain the process of aging perception during menopausal transition. This study was a qualitative grounded theory research, which was going to be implemented in 2019-2020 on 18 Baluch women settled in the Sistan & Baluchestan province in South-East Iran and among midlife or older menopause experienced women. Sampling was started first by Purposive sampling, and then it was performed with theoretic sampling. Data analysis was performed according to Corbin and Straus's approach (2015) in four phases: (1) identifying and developing concepts; (2) analyzing data for the context; (3) entering the process stage into analysis; and (4) integrating categories to build a theory. In this study, seven main categories were obtained: "Sunset of youth", "aging as the other side of the coin of menopause", "Weaving a cocoon", "aging as a mental trap", "social acceptance", "aging domino", and "feeling of transcendence". It seems that menopause plays an important role in Baluch women's view toward aging. The practical results of this study can be applied to better understand the middle-aged and older Baluch women's attitudes toward aging. Also study shows a new evolutionary and situational perspective on the lives of middle-aged menopausal Baluch women. Baluch women in menopause accept the sunset of youth and look forward to experiencing the Feeling of transcendence. Identify and respond to their needs by developing and establishing health policies to change their negative attitudes.
    Matched MeSH terms: Middle Aged
  6. Anggreini SN, Said FM, Ayudytha Ezdha AU, Filri DE, Wahyuni F, Ovari I
    J Pak Med Assoc, 2024 May;74(5 (Supple-5)):S27-S30.
    PMID: 39221794 DOI: 10.47391/JPMA.Ind-RInC-08
    OBJECTIVES: To determine the effect of hypertension education on self-care management in hypertensive patients in a rural setting.

    METHODS: The quasi-experimental study was conducted in January and February 2022 at the Senderak Village Health Centre, Bengkalis, Indonesia, and comprised hypertension patients without any complications referred to the community health centre between August 2021 and January 2022. The subjects underwent self-care education intervention. The knowledge level was assessed at baseline and post-intervention using the Hypertension Self-Management Behaviour Questionnaire. Data was analysed using IBM SPSS Statistic v23 software.

    RESULTS: All the 30(100%) patients were females, 12(40%) were aged 46-55 years, 20(66.7%) had received elementary school education and 25(83.3%) were housewives. There were 21(70%) respondents with stage II hypertension having systolic blood pressure ≥160mmHg. The mean level of knowledge about self-care management of hypertension increased significantly post-intervention (p<0.0001).

    CONCLUSION: Health education could improve knowledge on self-care management of hypertension in hypertensive patients.

    Matched MeSH terms: Middle Aged
  7. Ghauth S, Tan SH
    J Laryngol Otol, 2024 Jun;138(6):696-698.
    PMID: 37926907 DOI: 10.1017/S0022215123001858
    BACKGROUND: This paper reports the innovative use of a modified nasopharyngeal airway device as a temporary stent in patients with laryngotracheal stenosis. It also discusses the technique of endoscopic stent placement, and our experience in terms of the indications and suitability.

    METHOD: The nasopharyngeal airway device was modified to use as an airway stent by trimming it to the desired length. Next, the stent was inserted endoscopically and anchored using a novel approach.

    RESULTS: The surgery was performed successfully without complications. The patients had full use of their voice while the stent was in situ. No significant granulation tissue was observed.

    CONCLUSION: This paper demonstrates the feasibility of using a nasopharyngeal airway device as a temporary stent to prevent restenosis in cases where the patients have a strong demand for phonation. The modified nasopharyngeal airway device is potentially very promising, but cases must be selected carefully to avoid compromising efficacy and safety.

    Matched MeSH terms: Middle Aged
  8. Yaghi AR, Shaheed HS, Harun SN, Hyder Ali IA, Khan AH
    Adv Respir Med, 2022 Nov 14;90(6):467-482.
    PMID: 36412638 DOI: 10.3390/arm90060054
    BACKGROUND: Multidrug resistance TB (MDR-TB) has emerged as a public health issue worldwide, and the mortality rate is worrying. Therefore, this study was conducted to investigate the factors related to MDR-TB occurrence and the survival experience of TB patients.

    METHODS: A retrospective cohort study was conducted at Hospital Pulau Pinang in Malaysia. Medical records of active TB patients from 2014-2018 were reviewed. Cox regression was used to identify the factors associated with MDR-TB development and mortality among TB patients.

    RESULTS: The patients had a mean age of 48.84 ± 16.713 years, and a majority of the Chinese race (46.4%). Out of 351 TB patients, 325 (92.6%) were drug-susceptible TB, and 26 (7.4%) were diagnosed with MDR-TB. Among drug-susceptible TB patients, 245 (75.4%) achieved successful outcomes, and 73 (22.5%) passed away. In multivariable Cox regression, drug addiction, levels of white blood cells, urea, platelets, and albumin were significantly associated with death. Relapsed TB, alcohol consumption, and being single were significant risk factors for MDR-TB development.

    CONCLUSION: Patients achieved a success rate of 75.4%, which is encouraging but still far below the WHO target (at least an 85% success rate) and has room for further improvement.

    Matched MeSH terms: Middle Aged
  9. Rahman MS, Islam KR, Prithula J, Kumar J, Mahmud M, Alam MF, et al.
    BMC Med Inform Decis Mak, 2024 Sep 09;24(1):249.
    PMID: 39251962 DOI: 10.1186/s12911-024-02655-4
    BACKGROUND: Sepsis poses a critical threat to hospitalized patients, particularly those in the Intensive Care Unit (ICU). Rapid identification of Sepsis is crucial for improving survival rates. Machine learning techniques offer advantages over traditional methods for predicting outcomes. This study aimed to develop a prognostic model using a Stacking-based Meta-Classifier to predict 30-day mortality risks in Sepsis-3 patients from the MIMIC-III database.

    METHODS: A cohort of 4,240 Sepsis-3 patients was analyzed, with 783 experiencing 30-day mortality and 3,457 surviving. Fifteen biomarkers were selected using feature ranking methods, including Extreme Gradient Boosting (XGBoost), Random Forest, and Extra Tree, and the Logistic Regression (LR) model was used to assess their individual predictability with a fivefold cross-validation approach for the validation of the prediction. The dataset was balanced using the SMOTE-TOMEK LINK technique, and a stacking-based meta-classifier was used for 30-day mortality prediction. The SHapley Additive explanations analysis was performed to explain the model's prediction.

    RESULTS: Using the LR classifier, the model achieved an area under the curve or AUC score of 0.99. A nomogram provided clinical insights into the biomarkers' significance. The stacked meta-learner, LR classifier exhibited the best performance with 95.52% accuracy, 95.79% precision, 95.52% recall, 93.65% specificity, and a 95.60% F1-score.

    CONCLUSIONS: In conjunction with the nomogram, the proposed stacking classifier model effectively predicted 30-day mortality in Sepsis patients. This approach holds promise for early intervention and improved outcomes in treating Sepsis cases.

    Matched MeSH terms: Middle Aged
  10. Kouhi Fayegh A, Mat Din H, Wan Sulaiman WA, Ravanipour M, Basri H, Bin Mohamed MH, et al.
    Neuropsychiatr, 2024 Dec;38(4):174-181.
    PMID: 37184819 DOI: 10.1007/s40211-023-00467-y
    PURPOSE: Disturbances of sleep have frequently been reported in individuals with migraine. On top of this, an elderly patient with migraine also suffers from sleep disturbances due to changes in physiologic and mental health associated with aging. This study aimed to compare several sleep factors, namely sleep quality, chronotype, and obstructive sleep apnea (OSA) risk, between elderly people with and without migraine.

    METHODS: This was a multicenter cross-sectional study conducted in 10 neurologic clinics located in Tehran, Iran, over 2 years. The sample size was calculated as 189, including 63 migraine and 126 non-migraine patients.

    RESULTS: A significant difference was observed in the mean score of the global Pittsburgh Sleep Quality Index (PSQI) between migraine and non-migraine groups (p-value = 0.002), and in the individual components of the PSQI. However, there were no significant differences in the frequency of different types of chronotype (p-value = 0.125, T = 1.541) or OSA risk between the two groups (p-value = 0.568, T = -0.573). The binary logistic regression model showed that the relationship between global PSQI and migraine was significant (p = 0.002).

    CONCLUSION: Sleep quality is a problem for elderly migraine sufferers. Meanwhile, certain factors such as chronotype and OSA have no significant relationship with migraine among community-dwelling seniors. Further studies are required to enhance our understanding of this observation.

    Matched MeSH terms: Middle Aged
  11. Ahmad Bakir A, Martin DM, Alduraywish A, Dokos S, Loo CK
    J ECT, 2024 Dec 01;40(4):277-285.
    PMID: 39024187 DOI: 10.1097/YCT.0000000000001045
    INTRODUCTION: Electroconvulsive therapy (ECT) is effective in treating severe depression and other neuropsychiatric disorders, but how the presence of an anatomical anomaly affects the electrical pathways between the electrodes remains unclear. We investigate the difference in electric field (E-field) distribution during ECT in the brain of a patient with an arachnoid cyst relative to hypothetical condition where the cyst was not present.

    METHODS: Magnetic resonance imaging scans of the head of a patient with a large left frontal cyst were segmented to construct a finite element model to study the E-field distribution during ECT. Five electrode configurations were investigated: right unilateral, left unilateral, bifrontal, and bitemporal and left anterior right temporal. The E-field distributions for all montages were compared with a hypothetical condition where brain tissue and electrical conductivity from the right frontal region was mirrored across the longitudinal fissure into the cyst.

    RESULTS: Differences in mean E-field and 90th percentile E-fields were mainly observed in brain regions closest to the cyst including the left inferior frontal gyrus and left middle frontal gyrus. This trend was most pronounced in montages where the electrodes were closest to the cyst such as left unilateral and bitemporal.

    CONCLUSION: The presence of a highly conductive cyst close to the ECT electrode tended to attract current into the cyst region, altering current pathways, with potential implications for therapeutic efficacy and safety. Placing electrodes farther away from the cyst is likely to minimize any effects on the E-field distribution and potentially clinical outcomes.

    Matched MeSH terms: Middle Aged
  12. R N, Sen P, Griger Z, Day J, Joshi M, Nune A, et al.
    Rheumatology (Oxford), 2024 Jan 04;63(1):127-139.
    PMID: 37084267 DOI: 10.1093/rheumatology/kead180
    OBJECTIVES: Disease flares in the post-coronavirus disease 2019 (COVID-19) vaccination period represent a prominent concern, though risk factors are poorly understood. We studied these flares among patients with idiopathic inflammatory myopathies (IIMs) and other autoimmune rheumatic diseases (AIRDs).

    METHODS: The COVAD-1 and -2 global surveys were circulated in early 2021 and 2022, respectively, and we captured demographics, comorbidities, AIRDs details, COVID-19 infection history and vaccination details. Flares of IIMs were defined as (a) patient self-reported, (b) immunosuppression (IS) denoted, (c) clinical sign directed and (d) with >7.9-point minimal clinically significant improvement difference worsening of Patient-Reported Outcomes Measurement Information System (PROMIS) PROMISPF10a score. Risk factors of flares were analysed using regression models.

    RESULTS: Of 15 165 total respondents, 1278 IIMs (age 63 years, 70.3% female, 80.8% Caucasians) and 3453 AIRDs were included. Flares of IIM were seen in 9.6%, 12.7%, 8.7% and 19.6% patients by definitions (a) to (d), respectively, with a median time to flare of 71.5 (10.7-235) days, similar to AIRDs. Patients with active IIMs pre-vaccination (OR 1.2; 95% CI 1.03, 1.6, P = 0.025) were prone to flares, while those receiving rituximab (OR 0.3; 95% CI 0.1, 0.7, P = 0.010) and AZA (OR 0.3, 95% CI 0.1, 0.8, P = 0.016) were at lower risk. Female gender and comorbidities predisposed to flares requiring changes in IS. Asthma (OR 1.62; 95% CI 1.05, 2.50, P = 0.028) and higher pain visual analogue score (OR 1.19; 95% CI 1.11, 1.27, P 

    Matched MeSH terms: Middle Aged
  13. Ng BHK, Hoe KC, Lim YN, Wong CY, Voon PJ, Tang IP
    Eur Arch Otorhinolaryngol, 2024 Dec;281(12):6493-6498.
    PMID: 39242419 DOI: 10.1007/s00405-024-08955-9
    AIM: Nasopharyngeal carcinoma (NPC) is prevalent in certain regions, particularly Southeast Asia and Southern China. In Malaysia, it is notably frequent among the Bidayuh community. This study presents a comprehensive review of NPC cases diagnosed and treated at Sarawak General Hospital from 2010 to 2020.

    METHOD: A retrospective data collection was conducted using the clinical records of patients who were histopathologically diagnosed with NPC at the Otolaryngology-Head & Neck Clinic and the Radiotherapy & Oncology Clinic at Sarawak General Hospital.

    RESULT: The study comprised a total of 892 patients from 2010 to 2020. Males outnumbered females 3-to-1, with a mean age of 51 years (standard deviation: 13.9). The largest groups of patients were the Iban (34%) and the Bidayuh (21%), followed by the Chinese (19%) and the Malay (15%). The Bidayuh had the highest incidence rate with 81 cases per 100,000. Only 10% of the study population had a family history of NPC. The most common presentation was a neck lump (64.5%). Distant metastasis was discovered in 20% of patients. 82% of the cases were stage 3 or 4 at the time of presentation. The histological types of the 892 cases were mainly undifferentiated carcinoma (73%). Eighty-six patients developed recurrence, with 83% experiencing local recurrence, 10% developing distant metastasis, and 7% developing regional recurrence. Treatment for recurrence included nasopharyngectomy, neck dissection, and chemotherapy.

    CONCLUSION: The study highlights a significant incidence of NPC among the Bidayuh. Emphasis on screening and early detection is crucial for better outcomes, with lifelong follow-up recommended.

    Matched MeSH terms: Middle Aged
  14. Kwa YC, Suboh N, Kay DSW, Lee CIS, Walsh CL, Goodson ML
    Med J Malaysia, 2024 Jul;79(4):397-407.
    PMID: 39086336
    INTRODUCTION: As climate change is threatening every region of the world, extreme weather events resultant of global warming is occurring at increasing rate and scale in Malaysia. Weather-related disasters such as flood and haze pose critical challenges to the infrastructure and raise public health concerns in the country, especially when main economic sectors rely heavily on climate variability. Public perception on environmental issues is crucial for development of pro-environmental policies. Among studies conducted to understand public awareness regarding global warming, reports of perception on the health impacts were very limited. Taking this limitation into account, this study was designed to examine the perception on the health impacts of climate change among the diverse communities living in the Johor River Basin.

    MATERIALS AND METHODS: The cross-sectional study was conducted through cloud-data-based digital questionnaires completed by randomly selected residents in the Johor River Basin (n=647). Data was analysed with descriptive statistics using SPSS 27 (IBM®) Software. Comparisons between indigenous and non-indigenous communities were performed using Chi square analysis.

    RESULTS: Respondents in this study consisted of indigenous people (n=79) and non-indigenous people (n=568). Indigenous respondents generally perceived more frequent occurrence of extreme weather events in the next 20 years, even for the phenomena unfamiliar in Malaysian settings. All respondents showed similar concerns for health impacts of global warming, although the non-indigenous respondents perceived the risk further into the future (25 years) compared to the indigenous respondents who perceived current or imminent (<10 years) risks. Intense concerns for self, children, family members and community were shown by nearly all indigenous respondents (97-99%), while the non-indigenous people in this study expressed stronger concerns at country level and for future generations. During the last haze episode, most indigenous respondents (85%) did not notice any change in air quality nor discomfort among family members, in contrast 70% of the nonindigenous respondents claimed to have suffered from breathing problems themselves as well as others in the family. All respondents were concerned about air quality in their surroundings, indigenous people were concerned for the near future (<10 years), and non-indigenous people were concerned for the next 25 years.

    CONCLUSION: In this study, respondents were generally concerned about the health impacts of unimpeded global warming. There was significant difference in perceptions between indigenous and non-indigenous respondents. The findings were useful, complemented with further studies, to improve understanding of public awareness and to help develop relevant education programmes accessible for wider audience.

    Matched MeSH terms: Middle Aged
  15. Zhang X, Dolah J
    PLoS One, 2024;19(7):e0305662.
    PMID: 39074094 DOI: 10.1371/journal.pone.0305662
    The continuous development of the economy and the constant improvement in living standards have led tourists to have higher expectations for the entire travel experience. However, outdated Pingyao lacquerware tourism souvenirs have struggled to attract tourists' attention and cannot better meet their demands. It is worth considering whether analyzing tourists' demands could solve the current issues with lacquerware tourism souvenirs. To address this question, tourists in the Pingyao region were surveyed, and semi-structured interviews and questionnaires as research methods. Initially, semi-structured interviews were conducted with tourists in the Pingyao region to obtain the initial demand indicators for Pingyao lacquerware tourism souvenirs. Based on a literature review and expert summaries, 21 demand indicators were selected for the KANO model questionnaire, and 400 tourists were surveyed using stratified sampling. Data analysis revealed that of the 21 demand indicators evaluated by tourists, 5 as must-be quality, 7 as one-dimensional quality, 5 as attractive quality, and 4 as indifferent quality. The results of this study indicate that the demand attributes evaluated are related to tourists' satisfaction levels, and the lack of these attributes could lead to dissatisfaction with lacquerware tourism souvenirs. Tourists have shown a strong demand for appearance and a desire for functional diversification in lacquerware souvenirs, with higher expectations for regional and commemorative aspects. Due to the uniqueness of lacquerware materials, tourists have highly prioritized safety and environmental friendliness. Combining the KANO model and AHP have better-assisted researchers in identifying the quality types and importance of tourist demands, providing more targeted insights for designing Pingyao lacquerware tourism souvenirs.
    Matched MeSH terms: Middle Aged
  16. Leong LX, Chai SC, Howell JW, Mohd Rasdi HF, Abdul Rahman NR
    PLoS One, 2024;19(8):e0307033.
    PMID: 39137205 DOI: 10.1371/journal.pone.0307033
    BACKGROUND: Evidence supports the use of hand-based metacarpophalangeal joint (MCPJ) blocking splints as an intervention for trigger finger (TF). In practice, finger-based relative motion (RM) splints are also implemented without evidence.

    PURPOSE: This randomized comparative trial (RCT) aims to evaluate implementation of MCPJ blocking and RM splints for effectiveness, function, occupational performance and wearability after 6 weeks of TF management.

    METHODS AND ANALYSIS: Priori analysis determined 36 individuals were needed for random assignment to the RM or MCPJ blocking splint groups. Individuals must be aged ≥21 years, and diagnosed with TF involving ≥1 finger. For blinding purposes, the primary author screens for eligibility, fabricates the splints and educates. Therapist A administers the primary outcome measures Week-1 and Week-6-stage of stenosing tenosynovitis and secondary outcome measures- number of triggering events in 10 active fists, visual analog scales (VAS) for pain, splint comfort and satisfaction, Disabilities of the Arm, Shoulder and Hand, and Canadian Occupational Performance Measure. Therapist B in Week-3 instructs participants in deep tissue massage and administers splint wearability VASs. The RM pencil test is used to determine the affected finger(s) MCPJ splint position i.e., more extension or flexion based on participant response. The MCPJ blocking splint holds the MCPJ in a neutral position. Analysis involves a mixed-effects ANOVA to compare Week-1 and Week-6 primary and secondary outcomes.

    RESULTS: Recruitment and data collection are ongoing.

    DISCUSSION: Biomechanically RM splints control tendon excursion and reduce passive tendon tension while allowing unencumbered finger motion and hand function. Hence clinicians use RM splints as an intervention for TF, despite the lack of implementation evidence. This RCT implements a function-focused as well as patient-centered approach with partial blinding of assessors and participants.

    CONCLUSION: We anticipate that this study will provide evidence for the implementation of RM splints to manage adults with TF.

    TRIAL REGISTRATION: Clinical trial registration This trial is registered with ClinicalTrials.gov (NCT05763017).

    Matched MeSH terms: Middle Aged
  17. Darbandi A, Koupaei M, Kiani P, Ghanavati R, Najafi P, Hosseini J, et al.
    Immun Inflamm Dis, 2024 Nov;12(11):e70076.
    PMID: 39570098 DOI: 10.1002/iid3.70076
    BACKGROUND: Despite the advent of vaccines against COVID-19, there is considerable variation in the acceptance and hesitancy towards the vaccination program across different countries. The objective of this study was to ascertain the prevalence of hesitancy and acceptance regarding the use of the vaccine against the novel coronavirus, also known as COVID-19, and to identify the factors that influence these attitudes.

    MATERIALS AND METHODS: All the cross-sectional studies were retrieved from the PubMed databases, the Web of Science ISI, Scopus, and the Cochrane Library. Papers published in English between 2 November 2019 and 23 May 2023 were subjected to further assessment based on their title, abstract, and main text, with a view to ensuring their relevance to the present study.

    RESULTS: Following an exhaustive investigation, 59 studies were selected for screening in this systematic review. The most frequently employed method of data collection was the online survey. The study sample comprised 59.12% women and 40.88% men, with ages ranging from 16 to 78 years. The proportion of individuals accepting the vaccine ranged from 13% to 96%, while the proportion of those exhibiting hesitancy ranged from 0% to 57.5%. The primary reasons for accepting the COIVD-19 vaccine were a heightened perception of risk associated with the virus and a general trust in the healthcare system. The most frequently cited reasons for vaccine hesitancy in the context of the ongoing pandemic include concerns about the potential dangers of the vaccines, the rapid pace of their development, the possibility of adverse effects (such as infertility or death), and the assumption that they have been designed to inject microchips.

    DISCUSSION: A variety of socio-demographic factors are implicated in determining the rate of vaccine acceptance. A number of socio-demographic factors have been identified as influencing vaccine acceptance. These include high income, male gender, older age, marriage, the presence of older children who have been vaccinated and do not have chronic diseases, high education, and health insurance coverage.

    CONCLUSION: Eliminating vaccine hesitancy or increasing vaccine acceptance is a crucial factor that should be addressed through various means and in collaboration with regulatory and healthcare organizations.

    Matched MeSH terms: Middle Aged
  18. Swank Z, Borberg E, Chen Y, Senussi Y, Chalise S, Manickas-Hill Z, et al.
    Clin Microbiol Infect, 2024 Dec;30(12):1599-1605.
    PMID: 39389851 DOI: 10.1016/j.cmi.2024.09.001
    OBJECTIVES: To determine the proportion of individuals with detectable antigen in plasma or serum after SARS-CoV-2 infection and the association of antigen detection with postacute sequelae of COVID-19 (PASC) symptoms.

    METHODS: Plasma and serum samples were collected from adults participating in four independent studies at different time points, ranging from several days up to 14 months post-SARS-CoV-2 infection. The primary outcome measure was to quantify SARS-CoV-2 antigens, including the S1 subunit of spike, full-length spike, and nucleocapsid, in participant samples. The presence of 34 commonly reported PASC symptoms during the postacute period was determined from participant surveys or chart reviews of electronic health records.

    RESULTS: Of the 1569 samples analysed from 706 individuals infected with SARS-CoV-2, 21% (95% CI, 18-24%) were positive for either S1, spike, or nucleocapsid. Spike was predominantly detected, and the highest proportion of samples was spike positive (20%; 95% CI, 18-22%) between 4 and 7 months postinfection. In total, 578 participants (82%) reported at least one of the 34 PASC symptoms included in our analysis ≥1 month postinfection. Cardiopulmonary, musculoskeletal, and neurologic symptoms had the highest reported prevalence in over half of all participants, and among those participants, 43% (95% CI, 40-45%) on average were antigen-positive. Among the participants who reported no ongoing symptoms (128, 18%), antigen was detected in 28 participants (21%). The presence of antigen was associated with the presence of one or more PASC symptoms, adjusting for sex, age, time postinfection, and cohort (OR, 1.8; 95% CI, 1.4-2.2).

    DISCUSSION: The findings of this multicohort study indicate that SARS-CoV-2 antigens can be detected in the blood of a substantial proportion of individuals up to 14 months after infection. While approximately one in five asymptomatic individuals was antigen-positive, roughly half of all individuals reporting ongoing cardiopulmonary, musculoskeletal, and neurologic symptoms were antigen-positive.

    Matched MeSH terms: Middle Aged
  19. Vékony B, Nyirő G, Herold Z, Fekete J, Ceccato F, Gruber S, et al.
    Hypertension, 2024 Dec;81(12):2479-2488.
    PMID: 39417220 DOI: 10.1161/HYPERTENSIONAHA.124.23418
    BACKGROUND: Distinguishing between unilateral and bilateral primary aldosteronism, a major cause of secondary hypertension, is crucial due to different treatment approaches. While adrenal venous sampling is the gold standard, its invasiveness, limited availability, and often difficult interpretation pose challenges. This study explores the utility of circulating microRNAs (miRNAs) and machine learning in distinguishing between unilateral and bilateral forms of primary aldosteronism.

    METHODS: MiRNA profiling was conducted on plasma samples from 18 patients with primary aldosteronism taken during adrenal venous sampling on an Illumina MiSeq platform. Bioinformatics and machine learning identified 9 miRNAs for validation by reverse transcription real-time quantitative polymerase chain reaction. Validation was performed on a cohort consisting of 108 patients with known subdifferentiation. A 30-patient subset of the validation cohort involved both adrenal venous sampling and peripheral, the rest only peripheral samples. A neural network model was used for feature selection and comparison between adrenal venous sampling and peripheral samples, while a deep-learning model was used for classification.

    RESULTS: Our model identified 10 miRNA combinations achieving >85% accuracy in distinguishing unilateral primary aldosteronism and bilateral adrenal hyperplasia on a 30-sample subset, while also confirming the suitability of peripheral samples for analysis. The best model, involving 6 miRNAs, achieved an area under curve of 87.1%. Deep learning resulted in 100% accuracy on the subset and 90.9% sensitivity and 81.8% specificity on all 108 samples, with an area under curve of 86.7%.

    CONCLUSIONS: Machine learning analysis of circulating miRNAs offers a minimally invasive alternative for primary aldosteronism lateralization. Early identification of bilateral adrenal hyperplasia could expedite treatment initiation without the need for further localization, benefiting both patients and health care providers.

    Matched MeSH terms: Middle Aged
  20. Chan CY, Subramaniam S, Chin KY, Ima-Nirwana S, Muhammad N, Fairus A, et al.
    Int J Environ Res Public Health, 2022 May 17;19(10).
    PMID: 35627609 DOI: 10.3390/ijerph19106072
    Background: Osteoporosis is an emerging geriatric condition with high morbidity and healthcare cost in developing nations experiencing rapid population ageing. Thus, identifying strategies to prevent osteoporosis is critical in safeguarding skeletal health. This study aimed to evaluate the effects of a bone health screening and education programme on knowledge, beliefs, and practice regarding osteoporosis among Malaysians aged 40 years and above. Methods: A longitudinal study was conducted from April 2018 to August 2019. During the first phase of the study, 400 Malaysians (190 men, 210 women) aged ≥ 40 years were recruited in Klang Valley, Malaysia. Information on subjects’ demography, medical history, knowledge, and beliefs regarding osteoporosis, physical activity status, and dietary and lifestyle practices were obtained. Subjects also underwent body anthropometry measurement and bone mineral density scan (hip and lumbar spine) using a dual-energy X-ray absorptiometry device. Six months after the first screening, similar investigations were carried out on the subjects. Results: During the follow-up session, 72 subjects were lost to follow up. Most of them were younger subjects with a lower awareness of healthy practices. A significant increase in knowledge, beliefs (p < 0.05), calcium supplement intake (p < 0.001), and dietary calcium intake (p = 0.036) and a reduction in coffee intake (p < 0.001) were found among subjects who attended the follow-up. In this study, the percentage of successful referrals was 41.86%. Subjects with osteoporosis were mostly prescribed alendronate plus vitamin D3 by medical doctors, and they followed the prescribed treatment accordingly. Conclusions: The bone health screening and education programmes in this study are effective in changing knowledge, beliefs, and practice regarding osteoporosis. The information is pertinent to policymakers in planning strategies to prevent osteoporosis and its associated problems among the middle-aged and elderly population in Malaysia. Nevertheless, a more comprehensive bone health education program that includes long-term monitoring and consultation is needed to halt the progression of bone loss.
    Matched MeSH terms: Middle Aged
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