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Enteric parasites are endemic in many of the countries from which refugees originate. Clinical guidelines vary in approaches to screening for and treating intestinal parasites in refugee receiving countries. This study aims to investigate the prevalence and species of intestinal parasites identified in stool ova and parasite (O&P) specimens in a sample of newly arrived refugees in Toronto, Canada.
We conducted a retrospective chart review of 1042 refugee patients rostered at a specialized primary care clinic in Toronto from December 2011 to September 2016. Patients who completed recommended stool O&P analyses were included. Basic sociodemographic and clinical variables and results of stool O&P were examined.
419 patients (40.2%) had a stool O&P positive for any protozoan or helminth species. Sixty-nine patients (6.6%) had clinically significant parasite species (excluding B hominis, D fragilis, and E dispar, given their lower risk for causing symptoms/complications) 2.3% had clinically significant protozoans and 4.2% had helminths on stool analysis.
Given the relatively low prevalence of clinically significant parasites identified, our findings do not support universal screening for enteric parasites with stool O&P among refugee claimants/asylum seekers. However, stool analysis should be considered in certain clinical situations, as part of a more tailored approach.
Given the relatively low prevalence of clinically significant parasites identified, our findings do not support universal screening for enteric parasites with stool O&P among refugee claimants/asylum seekers. However, stool analysis should be considered in certain clinical situations, as part of a more tailored approach.
The increasing number of cases of prediabetes in the UK is concerning, particularly in Wales where there is no standard programme of support. The aim of the current service evaluation was to examine the effectiveness of brief lifestyle interventions on glucose tolerance in people at risk of developing type 2 diabetes.
In this pragmatic service evaluation clinical data on people deemed at risk of developing type 2 diabetes were evaluated from two GP clusters. Patients (n= 1207) received a single 15 to 30-min, face-to-face, consultation with a health care practitioner. Interventions were assessed by changes in HbA1c and distribution across the HbA1c ranges 12 months following intervention. Statistical significance of reversion to normoglycaemia and development of diabetes were assessed through comparison with expected rates without intervention.
Between baseline and 12-month follow-up HbA1c fell from 43.85 ± 1.57 mmol/mol (6.16 ± 0.14%) to 41.63 ± 3.84 mmol/mol (5.96 ± 0.35%), a decrease of 2.22 mmol/mol (0.20%) (95% CI 2.01 (0.18%), 2.42 (0.22%); p< 0.0001). The proportion of people with normal glucose tolerance at 12 months (0.50 95%CI 0.47, 0.52) was significantly larger than the lower (0.06 (p< 0.0001) and the upper (0.19 (p< 0.0001)) estimates based on no intervention.
Results indicate significant improvement in glucose tolerance across GP clusters. The brief intervention has the potential to offer a robust and effective option to support people at risk of developing type 2 diabetes. Further research in the form of a randomised trial is needed to confirm this and identify those likely to benefit most from this intervention.
Results indicate significant improvement in glucose tolerance across GP clusters. The brief intervention has the potential to offer a robust and effective option to support people at risk of developing type 2 diabetes. Further research in the form of a randomised trial is needed to confirm this and identify those likely to benefit most from this intervention.
Black females in the United States face unique sociocultural conditions that impact their sexual development and increase their risk for sexually transmitted infections (STI), including but not limited to chlamydia, gonorrhea, and HIV. Research has not adequately explained how sociocultural conditions contribute to this increased risk. The purpose of our investigation was to explore the sociocultural conditions that influence Black cisgender females risk for STI.
This grounded theory study involved in-depth audio-recorded interviews with 20, primarily heterosexual, Black females ages 19-62.
Findings informed a conceptual model that builds on previous theory about the sexual development of Black females and explains how sociocultural conditions impact two, participant identified, sexual pathways Fast and Cautious. Movement on these sexual pathways was not always a linear trajectory; some participants shifted between pathways as their sociocultural contexts changed (i.e., sexual assault, STI, and level of protection). AMG-900 cost The Fast sexual pathway often led to greater STI risk.
This model may inform future research designed to prevent STI/HIV and promote the sexual health of Black females across the life course.
This model may inform future research designed to prevent STI/HIV and promote the sexual health of Black females across the life course.
The aim of this study was to develop and evaluate a deep neural network model in the automated detection of pulmonary embolism (PE) from computed tomography pulmonary angiograms (CTPAs) using only weakly labelled training data.
We developed a deep neural network model consisting of two parts a convolutional neural network architecture called InceptionResNet V2 and a long-short term memory network to process whole CTPA stacks as sequences of slices. Two versions of the model were created using either chest X-rays (Model A) or natural images (Model B) as pre-training data. We retrospectively collected 600 CTPAs to use in training and validation and 200 CTPAs to use in testing. CTPAs were annotated only with binary labels on both stack- and slice-based levels. Performance of the models was evaluated with ROC and precision-recall curves, specificity, sensitivity, accuracy, as well as positive and negative predictive values.
Both models performed well on both stack- and slice-based levels. On the stack-based level, Model A reached specificity and sensitivity of 93.5% and 86.6%, respectively, outperforming Model B slightly (specificity 90.7% and sensitivity 83.5%). However, the difference between their ROC AUC scores was not statistically significant (0.94 vs 0.91, p = 0.07).
We show that a deep learning model trained with a relatively small, weakly annotated dataset can achieve excellent performance results in detecting PE from CTPAs.
We show that a deep learning model trained with a relatively small, weakly annotated dataset can achieve excellent performance results in detecting PE from CTPAs.
To investigate the expression of serum S-adenosylhomocysteine (SAH), interleukin-1β (IL-1β), serum homocysteine (Hcy), tumor necrosis factor-α (TNF-α) and brain derived neurotrophic factor (BDNF) in coronary heart disease and their relationship with the degree of coronary artery disease.
A total of 132 patients with coronary heart disease (CHD) from March 2020 to April 2021 were included in this retrospective study. The experimental group was composed of CHD patients, including single-vascular group (46 cases), dual-vascular group (49 cases), and multi-vascular group (37 cases). 145 healthy subjects during the same period for physical examination constituted the control group.
The levels of SAH, IL-1β, Hcy, TNF-α and BDNF in single-vascular group, dual-vascular group and multi-vascular group were higher than that in control group, and the differences were statistically significant (P < 0.05). The serum levels of SAH, IL-1β, Hcy, TNF-α and BDNF in multi-vascular group were higher than those in single-vascular group and dual-vascular group, and the serum levels of SAH, IL-1β, Hcy, TNF-α and BDNF in dual-vascular group were higher than those in single-vascular group, with statistical significance (P < 0.05). Kendall's tau-b correlation showed that the levels of SAH, IL-1β, Hcy, TNF-α and BDNF were positively correlated with the number of stenosis vessels (r = 0.421, 0.533, 0.301, 0.265, 0.678, P = 0.016, 0.009, 0.023, 0.036, 0.004).
SAH, IL-1β, Hcy, TNF-α and BDNF in serum of patients with CHD can be used as effective biological indicators to monitor the degree of CHD and severity of coronary stenosis.
SAH, IL-1β, Hcy, TNF-α and BDNF in serum of patients with CHD can be used as effective biological indicators to monitor the degree of CHD and severity of coronary stenosis.
Citizen science and models for public participation in health research share normative ideals of participation, inclusion, and public and patient engagement. Academic researchers collaborate in research with members of the public involved in an issue, maximizing all involved assets, competencies, and knowledge. In citizen science new ethical issues arise, such as who decides, who participates, who is excluded, what it means to share power equally, or whose knowledge counts. This article aims to present an ethics framework that offers a lens of understanding and heuristic guidelines to deal with ethical issues in citizen science.
We conducted seven case studies between 2015 and 2021 to attune and validate the ethics framework for the context of citizen science. The cases related to studies with older adults, people with a psychiatric vulnerability, people dependent on community care, people who are unemployed or living in poverty or both, and young adults with respiratory disease.
Ethics in citizen sciens a heuristic guide to reflect on ethics. Reflection on ethics is a pathway towards ethical citizen science, especially if researchers collaboratively reflect in partnership with non-academics who are subject to the moral issue.
Ethical issues in citizen science often relate to power differentials, partnership, and collaboration between academics and non-academics. The ethics framework prepares researchers for the work needed in citizen science to act responsibly and offers a heuristic guide to reflect on ethics. Reflection on ethics is a pathway towards ethical citizen science, especially if researchers collaboratively reflect in partnership with non-academics who are subject to the moral issue.
Fall risk screening using multiple methods was strongly advised as the initial step for preventing fall. Currently, there is only one such tool which was proposed by the U.S. Centers for Disease Control and Prevention (CDC) for use in its Stopping Elderly Accidents, Death & Injuries (STEADI) program. Its predictive validity outside the US context, however, has never been investigated. The purpose of this study was to determine the predictive validity (area under the receiver operating characteristic curve AUC), sensitivity, and specificity of the two-step sequential fall-risk screening algorithm of the STEADI program for Thai elderly in the community.
A 1-year prospective cohort study was conducted during October 2018-December 2019. Study population consisted of 480 individuals aged 65 years or older living in Nakhon Ratchasima Province, Thailand. The fall risk screening algorithm composed of two serial steps. Step 1 is a screening by the clinician's 3 key questions or the Thai Stay Independent brochure (Thai-SIB) 12 questions.
Homepage: https://www.selleckchem.com/products/amg-900.html
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