OBJECTIVE

This seven-year, two-center retrospective cross-sectional study aimed to describe the demographic, clinical characteristics and surgical indications of patients managed with open or laparoscopic cholecystectomy in the pediatric age group, and determine these variables’ associations with patient outcomes.

Records of all patients less than 19 years old who underwent laparoscopic or open cholecystectomy at Jose R. Reyes Memorial Medical Center (JRRMMC) and National Children’s Hospital (NCH) from January 2015 to December 2021 were reviewed. The gathered data were organized, described and analyzed using univariate and multivariate statistics.

A total of 32 patients underwent open or laparoscopic cholecystectomy at the two institutions. Majority were female (78.1%). The diagnoses included chronic calculous cholecystitis (62.5%), acute calculous cholecystitis (21.9%), choledocholithiasis (12.5%). One (3.1%) patient had empyema of the gallbladder. The 15 – 18 year age group made up 78.1%, with the rest (21.9%) from the 10 – 14 year age group. By BMI percentile, 62.5% were normal, 15.6% were overweight, and 12.5% were obese. Most patients across all conditions (96.9%) had no known hemolytic disorder. Underweight patients (9.4% of the cohort) had statistically higher lengths of stay [F(3,28) = 3.444, p = .030]. No significant associations were found between the categorical outcomes (discharged well, morbidity, mortality) and patient variables (age group, sex, BMI percentile, presence of co-morbidities, symptoms, indication for surgery, operation done).

In pediatric patients undergoing laparoscopic or open cholecystectomy, BMI percentile is inversely related to the length of hospital stay.

INTRODUCTION: Obstructive sleep apnoea (OSA) is a serious but underdiagnosed condition. Demand for the gold standard diagnostic polysomnogram (PSG) far exceeds its availability. More efficient diagnostic methods are needed, even in tertiary settings. Machine learning (ML) models have strengths in disease prediction and early diagnosis. We explored the use of ML with oximetry, demographic and anthropometric data to diagnose OSA. METHODS: A total of 2,996 patients were included for modelling and divided into test and training sets. Seven commonly used supervised learning algorithms were trained with the data. Sensitivity (recall), specificity, positive predictive value (PPV) (precision), negative predictive value, area under the receiver operating characteristic curve (AUC) and F1 measure were reported for each model. RESULTS: In the best performing four-class model (neural network model predicting no, mild, moderate or severe OSA), a prediction of moderate and/or severe disease had a combined PPV of 94%; one out of 335 patients had no OSA and 19 had mild OSA. In the best performing two-class model (logistic regression model predicting no-mild vs. moderate-severe OSA), the PPV for moderate-severe OSA was 92%; two out of 350 patients had no OSA and 26 had mild OSA. CONCLUSION Our study showed that the prediction of moderate-severe OSA in a tertiary setting with an ML approach is a viable option to facilitate early identification of OSA. Prospective studies with home-based oximeters and analysis of other oximetry variables are the next steps towards formal implementation.
Humans ; Oximetry/methods* ; Sleep Apnea, Obstructive/diagnosis* ; Male ; Female ; Middle Aged ; Machine Learning ; Polysomnography ; Adult ; Anthropometry ; ROC Curve ; Aged ; Algorithms ; Predictive Value of Tests ; Sensitivity and Specificity ; Neural Networks, Computer ; Demography

OBJECTIVE: Observational studies have shown inconsistent associations of loneliness or social isolation (SI) with ischemic heart disease (IHD), with unknown mediators. METHODS: Using data from genome-wide association studies of predominantly European ancestry, we performed a bidirectional two-sample Mendelian Randomization (MR) study to estimate causal effects of loneliness ( N = 487,647) and SI traits on IHD ( N = 184,305). SI traits included whether individuals lived alone, participated in various types of social activities, and how often they had contact with friends or family ( N = 459,830 to 461,369). A network MR study was conducted to evaluate the mediating roles of 20 candidate mediators, including metabolic, behavioral and psychological factors. RESULTS: Loneliness increased IHD risk ( OR= 2.129; 95% confidence interval [ CI]: 1.380 to 3.285), mediated by body fat percentage, waist-hip ratio, total cholesterol, and low-density lipoprotein cholesterol. For SI traits, only fewer social activities increased IHD risk ( OR= 1.815; 95% CI: 1.189 to 2.772), mediated by hypertension, high-density lipoprotein cholesterol, triglycerides, fasting insulin, and smoking cessation. No reverse causality of IHD with loneliness and SI was found. CONCLUSION These findings suggested more attention should be paid to individuals who feel lonely and have fewer social activities to prevent IHD, with several mediators as prioritized targets for intervention.
Loneliness/psychology* ; Humans ; Mendelian Randomization Analysis ; Social Isolation ; Myocardial Ischemia/etiology* ; Male ; Female ; Middle Aged ; Genome-Wide Association Study ; Risk Factors ; Aged

INTRODUCTION

Nurses handling the Tuberculosis Directly Observed Treatment Short Course (TB-DOTS) are crucial in implementing the National Tuberculosis Program (NTP), which faced challenges during COVID-19. Hence, this study aimed to explore and to understand the TB DOTS Nurses' lived experiences on implementing NTP amidst the COVID-19 pandemic.

A descriptive phenomenology research design was used in this study among purposively selected 15 TB DOTS nurses during the pandemic, using in-depth interviews. Descriptive phenomenology was chosen to focus on capturing and describing the nurses' direct experiences. Data were manually transcribed into EXCEL software, coded, clustered, and thematized. Data were also collected from January to April 2023, following IATF Guidelines. Colaizzi's descriptive phenomenology method was employed for analysis, allowing the study to remain true to the participants' own words and perspectives.

This study revealed three major themes with associated subthemes anchored from the significant statements extracted from the participants' verbatims. The first theme, “Menace of Uncertainties,” echoed nurses’ fears of contracting the disease, struggles with implementing the NTP, and balancing patient care with personal well-being. Despite obstacles, nurses formed support systems and remained determined, leading to the emergence of the second theme, "Seeing Light in the Darkness." The third theme, "Establishing a Strong Foundation," outlined nurses' ideas for managing the NTP during a pandemic.

The study underscored the significant challenges TB DOTS nurses faced during the pandemic, including fear, uncertainty, and difficulty balancing personal well-being with patient care. Despite these obstacles, nurses demonstrated resilience, adaptability, and a commitment to their work. The findings underscored the importance of support systems, flexibility, and enhanced resources in managing TB cases during crises. These insights had direct implications for nursing practice, education, and research, while having emphasized the need for improved facilities, support mechanisms, and training to better equip nurses for future health emergencies.

Objectives: This study described the clinical profile of patients with keratoconus at a single tertiary referral hospital. Methods: This was a single-center, retrospective, cross-sectional study that reviewed medical records of patients diagnosed with keratoconus from January 2015 to August 2022. Data on the clinical profile, intervention, and clinical outcomes were collected from the chart review. Results: Forty (40) patients (79 eyes) were included in the study. Majority (98%) had bilateral disease in which 22 (55.5%) were affected asymmetrically. The mean age was 21 years. Most patients (72.5%) were male. Blurring of vision was the chief complaint in all patients. Atopy was present in 23 patients (57.5%). History of vigorous eye rubbing was present in 31 (77.5%). The mean interval from onset of symptoms to consult was 46.4 ± 33.38 months. The mean pinhole corrected distance visual acuity was 0.47 ± 0.41 (Snellen equivalent of 20/59). The average spherical equivalent was -7.48D ± 6.99D. Corneal protrusion on slit-lamp biomicroscopy was seen in 78 eyes (98.7%). Other findings included Fleischer ring (53.2%), Vogt's striae (19.0%), and apical corneal scar (24.0%). Only one eye (1.3%) had no corneal findings. Thirty-nine eyes (49.3%) were classified as advancedsevere keratoconus. Rigid contact lens was planned for 60 eyes (75.9%). Sixty-two eyes (78.5%) were for collagen cross-linking. Deep anterior lamellar keratoplasty was planned in 10 eyes (12.7%) and penetrating keratoplasty in two eyes (2.5%). Conclusion Keratoconus at the Philippine General Hospital was most frequently seen in young males and asymmetrically affects both eyes. Patients consulted relatively late and presented with a more advanced stage of the disease. History of ocular allergy and eye rubbing were significant risk factors. Improving awareness of this condition must be emphasized to detect keratoconus earlier.
Keratoconus ; Cornea ; Demography ; Philippines

In this study, we investigated how empathic neural responses unfold over time in different empathy networks when viewing same-race and other-race individuals in dynamic painful conditions. We recorded magnetoencephalography signals from Chinese adults when viewing video clips showing a dynamic painful (or non-painful) stimulation to Asian and White models' faces to trigger painful (or neutral) expressions. We found that perceived dynamic pain in Asian models modulated neural activities in the visual cortex at 100 ms-200 ms, in the orbitofrontal and subgenual anterior cingulate cortices at 150 ms-200 ms, in the anterior cingulate cortex around 250 ms-350 ms, and in the temporoparietal junction and middle temporal gyrus around 600 ms after video onset. Perceived dynamic pain in White models modulated activities in the visual, anterior cingulate, and primary sensory cortices after 500 ms. Our findings unraveled earlier dynamic activities in multiple neural circuits in response to same-race (vs other-race) individuals in dynamic painful situations.
Adult ; Humans ; Brain Mapping ; Pain ; Empathy ; Racism ; Gyrus Cinguli/physiology* ; Magnetic Resonance Imaging ; Brain/physiology*

Background: The majority of women described hysterosalpingography (HSG) as a painful procedure. There is little information on the features of HSG-associated pain and factors that predispose to increased pain experience. Objectives: This study investigated preprocedure psychological state and related demographic factors as predictors of pain perception in women undergoing HSG. Methods: The sample included 99 women selected through consecutive sampling at the Radiology Department, University of Benin Teaching Hospital, Benin City, Nigeria. The study utilized a cross-sectional survey design to collect data using Spielberger's State-Trait Anxiety Inventory, Zung Self-rating Depression Scale, and Visual Analog Scale for the perception of pain and state anxiety. Results: The women with lower state anxiety reported significantly lower pain perception (X̅ = 6.69) than the women with high anxiety (X̅ = 7.93). Trait anxiety, state anxiety, and depression jointly predicted pain perception among the women undergoing HSG, with R2 = 0.117, F (3,95) = 6.797; P < 0.001. They collectively accounted for about 17.7% variance in pain perception. Conclusion Patients being prepared for the HSG procedure can be educated on concerns related to anxiety and coping strategies and be provided with anxiolytics or other medication as clinically indicated.
Demography ; Pain Perception ; Women

OBJECTIVE: To evaluate the psychometric properties and applicability of the 6-item University of California Los Angeles (UCLA) Loneliness Scale (ULS-6) in adults. METHODS: We conducted 2 surveys to assess the validity of different measurement scales and questionnaires. In Survey 1, a total of 1480 adults were measured using the UCLA Loneliness Scale (ULS), Patient Health Questionnaire-9 (PHQ-9) and Perceived Social Support Scale (PSSS), and the data were used for item analysis and assessment of the reliability, validity and measurement invariance. In Survey 2, UCLA Loneliness Scale was used for measurement in 652 college students, and the data were used for analysis of the criterion validity of ULS-6; 3 weeks later, 300 of the students were retested using ULS-6 to assess the retest reliability of the scale. RESULTS: Item analysis suggested that the items in ULS-6 all had good discrimination power with discrimination indexes all above 0.775 (r=0.775-0.820, P < 0.001). Measuring only one dimension, ULS-6 had an internal consistency reliability of 0.891, a split-half reliability of 0.875, and a retest reliability of 0.726. The correlation coefficients of ULS-6 with ULS, ULS-8, PHQ-9 and PSSS were 0.882, 0.967, 0.528 and -0.532, respectively. The measurement invariances of ULS-6 across genders and age groups were all acceptable. Among the adult participants, the mean total score of ULS-6 was 12.97 ± 3.96; While only 20% of the adults had no loneliness, 80% of them exhibited varying degrees of loneliness, ranging from mild (39.6%) and moderate (25.7%) to intense (14.7%) feelings of loneliness. CONCLUSION The ULS-6 has good reliability, validity and applicability for measurement of loneliness in Chinese adults.
Adult ; Female ; Humans ; Male ; Asian People ; Emotions ; Reproducibility of Results ; Students ; Loneliness

Objective: To investigate the demographic characteristics and clinical influencing factors which associates with the occurrence probability of persistent or intermittent hypoviremia (LLV) in patients with chronic hepatitis B (CHB) treated with nucleos(t)ide analogues (NAs). Methods: A single-center retrospective analysis was performed on patients with CHB who received outpatient NAs therapy for≥48 ± 2 weeks. According to the serum hepatitis B virus (HBV) DNA load at 48±2 weeks treatment, the study groups were divided into LLV (HBV DNA < 20 IU/ml and < 2 000 IU/ml) and MVR group (sustained virological response, HBV DNA < 20 IU/ml). Demographic characteristics and clinical data at the start of NAs treatment (considered as baseline) were retrospectively collected for both patient groups. The differences in the reduction of HBV DNA load during treatment was compared between the two groups. Correlation and multivariate analysis were further conducted to analyze the associated factors influencing the LLV occurrence. Statistical analysis was performed using the independent samples t-test, c2 test, Spearman analysis, multivariate logistic regression analysis, or area under the receiver operating characteristic curve. Results: A total of 509 cases were enrolled, with 189 and 320 in the LLV and MVR groups, respectively. Compared to patients with MVR group at baseline: (1) the demographics characteristics of patients showed that LLV group was younger in age (39.1 years, P = 0.027), had a stronger family history (60.3%, P = 0.001), 61.9% received ETV treatment, and higher proportion of compensated cirrhosis (20.6%, P = 0.025) at baseline; (2) the serum virological characteristics of patients showed that LLV group had higher HBV DNA load, qHBsAg level, qHBeAg level, HBeAg positive rate, and the proportion of genotype C HBV infection but decreased HBV DNA during treatment (P < 0.001) at baseline; (3) the biochemical characteristics of patients showed that LLV group had lower serum ALT levels (P = 0.007) at baseline; (4) the noninvasive fibrosis markers of patients showed that LLV group were characterized by high aspartate aminotransferase platelet ratio index (APRI) (P = 0.02) and FIB-4 (P = 0.027) at baseline. HBV DNA, qHBsAg and qHBeAg were positively correlated with LLV occurrence (r = 0.559, 0.344, 0.435, respectively), while age and HBV DNA reduction were negatively correlated (r = -0.098, -0.876, respectively). Logistic regression analysis showed that ETV treatment history, high HBV DNA load at baseline, high qHBsAg level, high qHBeAg level, HBeAg positive, low ALT and HBV DNA level were independent risk factors for patients with CHB who developed LLV with NAs treatment. Multivariate prediction model had a good predictive value for LLV occurrence [AUC 0.922 (95%CI: 0.897 ~ 0.946)]. Conclusion: In this study, 37.1% of CHB patients treated with first-line NAs has LLV. The formation of LLV is influenced by various factors. HBeAg positivity, genotype C HBV infection, high baseline HBV DNA load, high qHBsAg level, high qHBeAg level, high APRI or FIB-4 value, low baseline ALT level, reduced HBV DNA during treatment, concomitant family history, metabolic liver disease history, and age < 40 years old are potential risk factors for developing LLV in patients with CHB during the therapeutic process.
Humans ; Adult ; Hepatitis B, Chronic/complications* ; Retrospective Studies ; Cross-Sectional Studies ; Hepatitis B e Antigens ; DNA, Viral ; Antiviral Agents/therapeutic use* ; Hepatitis B virus/genetics* ; Demography

With the advance of molecular biology, DNA analysis technology has been widely applied in forensic science. Non-human DNA analysis can be used in some special cases and has unique forensic value to provide investigation clues and trial basis. Animal DNA typing plays a more prominent role in the detection of all kinds of non-human DNA related cases and is the main content of forensic non-human DNA analysis. This paper reviews the development history, present situation, advantages and disadvantages of animal DNA typing according to its technology, characteristic, challenges facing forensic science application scenarios, and also its future development.
Animals ; DNA Fingerprinting ; Forensic Medicine ; DNA/analysis* ; Forensic Sciences ; Molecular Biology ; Forensic Genetics