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INTRODUCTION: Clinical utility is an important attribute in selecting an assessment tool. The study aimed to determine the perceptions of South African occupational therapists of the clinical utility of Modular Arrangement of Predetermined Time Standards (MODAPTS) work samples when assessing a client's work ability. The research objectives were to determine whether MODAPTS is perceived to be credible, practical, useful, and easy to use. METHODOLOGY: A quantitative, cross-sectional, descriptive research design was used. Non-probability sampling with elements of voluntary response- and snowball sampling was used to recruit respondents. An electronic questionnaire was developed using Qualtrics, which was distributed electronically via the Occupational Therapy Association of South Africa, WhatsApp and Telegram. RESULTS: Data were based on 52 completed questionnaires, analysed through descriptive statistics MODAPTS was perceived as practical, useful, credible, and asy to use in practice. Main barriers to the use of MODAPTS included the timeliness of developing work samples, lack of MODAPTS training, and having other more useful and reliable assessment tools. Experienced occupational therapists used MODAPTS more often than inexperienced occupational therapists. CONCLUSION: Clinical utility of work samples developed using MODAPTS has been confirmed. This supports the use of work samples developed using MODAPTS as part of work assessments as a cost-effective, practical tool. IMPLICATIONS FOR PRACTICE: • Development of contextually relevant work samples. •Use of MODAPTS work samples as an outcome measure during intervention. • Application during rehabilitation goal setting. • Cost effective application of MODAPTS work samples in a variety of settings.

Directrices para los protocolos de ensayos clínicos de intervenciones con inteligencia artificial: la extensión SPIRIT-AI
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Cruz Rivera, Samantha

; Liu, Xiaoxuan

; Chan, An-Wen

; Denniston, Alastair K.

; Calvert, Melanie J.

; Denniston, Alastair K.

; Chan, An-Wen

; Darzi, Ara

; Holmes, Christopher

; Yau, Christopher

; Moher, David

; Ashrafian, Hutan

; Deeks, Jonathan J.

; Ferrante di Ruffano, Lavinia

; Faes, Livia

; Calvert, Melanie J.

; Keane, Pearse A.

; Cruz Rivera, Samantha

; Vollmer, Sebastian J.

; Liu, Xiaoxuan

; Lee, Aaron Y.

; Jonas, Adrian

; Esteva, Andre

; Beam, Andrew L.

; Chan, An-Wen

; Panico, Maria Beatrice

; Lee, Cecilia S.

; Haug, Charlotte

; Kelly, Christophe J.

; Yau, Christopher

; Mulrow, Cynthia

; Espinoza, Cyrus

; Fletcher, John

; Moher, David

; Paltoo, Dina

; Manna, Elaine

; Price, Gary

; Collins, Gary S.

; Harvey, Hugh

; Matcham, James

; Monteiro, Joao

; Khair ElZarrad, M.

; Ferrante di Ruffano, Lavinia

; Oakden-Rayner, Luke

; Calvert, Melanie J.

; McCradden, Melissa

; Keane, Pearse A.

; Savage, Richard

; Golub, Robert

; Sarkar, Rupa

; Rowley, Samuel

Revista Panamericana de Salud Pública

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2024, Volume 48 elocation e12

Abstract: Es En Pt | Text: Es En Pt | PDF: Es | PDF: En | PDF: Pt

resumen está disponible en el texto completo

ABSTRACT The SPIRIT 2013 statement aims to improve the completeness of clinical trial protocol reporting by providing evidence-based recommendations for the minimum set of items to be addressed. This guidance has been instrumental in promoting transparent evaluation of new interventions. More recently, there has been a growing recognition that interventions involving artificial intelligence (AI) need to undergo rigorous, prospective evaluation to demonstrate their impact on health outcomes. The SPIRIT-AI (Standard Protocol Items: Recommendations for Interventional Trials–Artificial Intelligence) extension is a new reporting guideline for clinical trial protocols evaluating interventions with an AI component. It was developed in parallel with its companion statement for trial reports: CONSORT-AI (Consolidated Standards of Reporting Trials–Artificial Intelligence). Both guidelines were developed through a staged consensus process involving literature review and expert consultation to generate 26 candidate items, which were consulted upon by an international multi-stakeholder group in a two-stage Delphi survey (103 stakeholders), agreed upon in a consensus meeting (31 stakeholders) and refined through a checklist pilot (34 participants). The SPIRIT-AI extension includes 15 new items that were considered sufficiently important for clinical trial protocols of AI interventions. These new items should be routinely reported in addition to the core SPIRIT 2013 items. SPIRIT-AI recommends that investigators provide clear descriptions of the AI intervention, including instructions and skills required for use, the setting in which the AI intervention will be integrated, considerations for the handling of input and output data, the human–AI interaction and analysis of error cases. SPIRIT-AI will help promote transparency and completeness for clinical trial protocols for AI interventions. Its use will assist editors and peer reviewers, as well as the general readership, to understand, interpret and critically appraise the design and risk of bias for a planned clinical trial.

RESUMO A declaração SPIRIT 2013 tem como objetivo melhorar a integralidade dos relatórios dos protocolos de ensaios clínicos, fornecendo recomendações baseadas em evidências para o conjunto mínimo de itens que devem ser abordados. Essas orientações têm sido fundamentais para promover uma avaliação transparente de novas intervenções. Recentemente, tem-se reconhecido cada vez mais que intervenções que incluem inteligência artificial (IA) precisam ser submetidas a uma avaliação rigorosa e prospectiva para demonstrar seus impactos sobre os resultados de saúde. A extensão SPIRIT-AI (Standard Protocol Items: Recommendations for Interventional Trials - Artificial Intelligence) é uma nova diretriz de relatório para protocolos de ensaios clínicos que avaliam intervenções com um componente de IA. Essa diretriz foi desenvolvida em paralelo à sua declaração complementar para relatórios de ensaios clínicos, CONSORT-AI (Consolidated Standards of Reporting Trials - Artificial Intelligence). Ambas as diretrizes foram desenvolvidas por meio de um processo de consenso em etapas que incluiu revisão da literatura e consultas a especialistas para gerar 26 itens candidatos. Foram feitas consultas sobre esses itens a um grupo internacional composto por 103 interessados diretos, que participaram de uma pesquisa Delphi em duas etapas. Chegou-se a um acordo sobre os itens em uma reunião de consenso que incluiu 31 interessados diretos, e os itens foram refinados por meio de uma lista de verificação piloto que envolveu 34 participantes. A extensão SPIRIT-AI inclui 15 itens novos que foram considerados suficientemente importantes para os protocolos de ensaios clínicos com intervenções que utilizam IA. Esses itens novos devem constar dos relatórios de rotina, juntamente com os itens básicos da SPIRIT 2013. A SPIRIT-AI preconiza que os pesquisadores descrevam claramente a intervenção de IA, incluindo instruções e as habilidades necessárias para seu uso, o contexto no qual a intervenção de IA será integrada, considerações sobre o manuseio dos dados de entrada e saída, a interação humano-IA e a análise de casos de erro. A SPIRIT-AI ajudará a promover a transparência e a integralidade nos protocolos de ensaios clínicos com intervenções que utilizam IA. Seu uso ajudará editores e revisores, bem como leitores em geral, a entender, interpretar e avaliar criticamente o delineamento e o risco de viés de um futuro estudo clínico.

https://doi.org/10.26633/rpsp.2024.12

Directrices para presentación de informes de ensayos clínicos sobre intervenciones con inteligencia artificial: extensión CONSORT-AI
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Liu, Xiaoxuan

; Cruz Rivera, Samantha

; Moher, David

; Calvert, Melanie J.

; Denniston, Alastair K.

; Chan, An-Wen

; Darzi, Ara

; Holmes, Christopher

; Yau, Christopher

; Moher, David

; Ashrafian, Hutan

; Deeks, Jonathan J.

; Ferrante di Ruffano, Lavinia

; Faes, Livia

; Calvert, Melanie J.

; Keane, Pearse A.

; Cruz Rivera, Samantha

; Vollmer, Sebastian J.

; Liu, Xiaoxuan

; Lee, Aaron Y.

; Jonas, Adrian

; Esteva, Andre

; Beam, Andrew L.

; Chan, An-Wen

; Panico, Maria Beatrice

; Lee, Cecilia S.

; Haug, Charlotte

; Kelly, Christophe J.

; Yau, Christopher

; Mulrow, Cynthia

; Espinoza, Cyrus

; Fletcher, John

; Moher, David

; Paltoo, Dina

; Manna, Elaine

; Price, Gary

; Collins, Gary S.

; Harvey, Hugh

; Matcham, James

; Monteiro, Joao

; Khair ElZarrad, M.

; Ferrante di Ruffano, Lavinia

; Oakden-Rayner, Luke

; Calvert, Melanie J.

; McCradden, Melissa

; Keane, Pearse A.

; Savage, Richard

; Golub, Robert

; Sarkar, Rupa

; Rowley, Samuel

Revista Panamericana de Salud Pública

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2024, Volume 48 elocation e13

Abstract: Es En Pt | Text: Es En Pt | PDF: Es | PDF: En | PDF: Pt

resumen está disponible en el texto completo

ABSTRACT The CONSORT 2010 statement provides minimum guidelines for reporting randomized trials. Its widespread use has been instrumental in ensuring transparency in the evaluation of new interventions. More recently, there has been a growing recognition that interventions involving artificial intelligence (AI) need to undergo rigorous, prospective evaluation to demonstrate impact on health outcomes. The CONSORT-AI (Consolidated Standards of Reporting Trials–Artificial Intelligence) extension is a new reporting guideline for clinical trials evaluating interventions with an AI component. It was developed in parallel with its companion statement for clinical trial protocols: SPIRIT-AI (Standard Protocol Items: Recommendations for Interventional Trials–Artificial Intelligence). Both guidelines were developed through a staged consensus process involving literature review and expert consultation to generate 29 candidate items, which were assessed by an international multi-stakeholder group in a two-stage Delphi survey (103 stakeholders), agreed upon in a two-day consensus meeting (31 stakeholders) and refined through a checklist pilot (34 participants). The CONSORT-AI extension includes 14 new items that were considered sufficiently important for AI interventions that they should be routinely reported in addition to the core CONSORT 2010 items. CONSORT-AI recommends that investigators provide clear descriptions of the AI intervention, including instructions and skills required for use, the setting in which the AI intervention is integrated, the handling of inputs and outputs of the AI intervention, the human–AI interaction and provision of an analysis of error cases. CONSORT-AI will help promote transparency and completeness in reporting clinical trials for AI interventions. It will assist editors and peer reviewers, as well as the general readership, to understand, interpret and critically appraise the quality of clinical trial design and risk of bias in the reported outcomes.

RESUMO A declaração CONSORT 2010 apresenta diretrizes mínimas para relatórios de ensaios clínicos randomizados. Seu uso generalizado tem sido fundamental para garantir a transparência na avaliação de novas intervenções. Recentemente, tem-se reconhecido cada vez mais que intervenções que incluem inteligência artificial (IA) precisam ser submetidas a uma avaliação rigorosa e prospectiva para demonstrar seus impactos sobre os resultados de saúde. A extensão CONSORT-AI (Consolidated Standards of Reporting Trials – Artificial Intelligence) é uma nova diretriz para relatórios de ensaios clínicos que avaliam intervenções com um componente de IA. Ela foi desenvolvida em paralelo à sua declaração complementar para protocolos de ensaios clínicos, a SPIRIT-AI (Standard Protocol Items: Recommendations for Interventional Trials – Artificial Intelligence). Ambas as diretrizes foram desenvolvidas por meio de um processo de consenso em etapas que incluiu revisão da literatura e consultas a especialistas para gerar 29 itens candidatos. Foram feitas consultas sobre esses itens a um grupo internacional composto por 103 interessados diretos, que participaram de uma pesquisa Delphi em duas etapas. Chegou-se a um acordo sobre os itens em uma reunião de consenso que incluiu 31 interessados diretos, e os itens foram refinados por meio de uma lista de verificação piloto que envolveu 34 participantes. A extensão CONSORT-AI inclui 14 itens novos que, devido à sua importância para as intervenções de IA, devem ser informados rotineiramente juntamente com os itens básicos da CONSORT 2010. A CONSORT-AI preconiza que os pesquisadores descrevam claramente a intervenção de IA, incluindo instruções e as habilidades necessárias para seu uso, o contexto no qual a intervenção de IA está inserida, considerações sobre o manuseio dos dados de entrada e saída da intervenção de IA, a interação humano-IA e uma análise dos casos de erro. A CONSORT-AI ajudará a promover a transparência e a integralidade nos relatórios de ensaios clínicos com intervenções que utilizam IA. Seu uso ajudará editores e revisores, bem como leitores em geral, a entender, interpretar e avaliar criticamente a qualidade do desenho do ensaio clínico e o risco de viés nos resultados relatados.

https://doi.org/10.26633/rpsp.2024.13

Response to Brand et al. (2022) 'Data sharing governance in sub-Saharan Africa during public health emergencies'
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Thaldar, Donrich

; Abdulrauf, Lukman

; Ogendi, Paul

; Gooden, Amy

; Donnelly, Dusty-Lee

; Townsend, Beverley

South African Journal of Science

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dec 2023, Volume 119 N. 11-12 Pages 1 - 3

Abstract: En | Text: En | PDF: En

SIGNIFICANCE: Various aspects of Brand et al.'s (S Afr J Sci. 2022;118(11/12), Art. #13892) overview of Africa's data protection legislation require clarification. Most pertinently, we provide the following clarifications: • Ghanaian law does provide for cross-border data transfers; statements about the law being "inadequate" ought to be well substantiated. • Nigerian law provides for adequacy decisions - not authorisations - in respect of cross-border data transfers. • Kenyan law provides for an important exception relevant to public health emergencies. • South African law currently requires, amongst others, prior authorisation from the Information Regulator for cross-border transfers of health data. • South Africa does not yet have a code of conduct for research.

https://doi.org/10.17159/sajs.2023/15722

How to interpret core concepts in POPIA? Recommendations on the draft Code of Conduct for Research
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Thaldar, Donrich

; Edgcumbe, Aliki

; Donnelly, Dusty-Lee

South African Journal of Science

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aug 2023, Volume 119 N. 7-8 Pages 1 - 4

Abstract: En | Text: En | PDF: En

SIGNIFICANCE: The draft Code of Conduct for Research is a welcome development, but there is room for improvement in the way that it interprets core concepts in POPIA. In particular, it should: remove the provision regarding consent to future research; clarify that special personal information is a subclass of personal information that must comply with an extra layer of requirements; not exclude an individual researcher employed by a research institution from qualifying as a responsible party; and clearly differentiate de-identification in POPIA from corresponding terms used in other jurisdictions.

https://doi.org/10.17159/sajs.2023/15062

Toward an open access genomics database of South Africans: Legal considerations
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Thaldar, Donrich

; Gooden, Amy

; Donnelly, Dusty-Lee

South African Journal of Science

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aug 2023, Volume 119 N. 7-8 Pages 1 - 4

Abstract: En | Text: En | PDF: En

SIGNIFICANCE: There may be significant benefits to an open access genomics database of South Africans. The proposed Code of Conduct for Research should be amended to provide a clear roadmap - aligned with the Protection of Personal Information Act 4 of 2013 - for open access genomics projects.

https://doi.org/10.17159/sajs.2023/15069

Ribosomal, mitochondrial and bacterial (Wolbachia) reference sequences for Dipetalonema gracile obtained from a wild pied tamarin (Saguinus bicolor) host in Manaus, Brazil
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COSTA, Carlos Henrique Aguiar

; CRAINEY, James Lee

; VICENTE, Ana Carolina Paulo

; CONGA, David Fernandez

; GORDO, Marcelo

; LUZ, Sérgio Luiz Bessa

; DIAS, Cindy Alves

; SILVA, Túllio Romão Ribeiro da

; FERREIRA, Caroline Coelho

; NAVA, Alessandra Ferreira Dales

Acta Amazonica

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jun 2023, Volume 53 N. 2 Pages 130 - 140

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT The primates that inhabit the rainforest surrounding the city of Manaus (Amazonas, Brazil) have long been recognised as potentially important reservoirs of emerging and re-emerging infectious diseases (ERIDs). PCR amplification of filarial sequences from wild-caught Simulium oyapockense has been used to incriminate potentially important Amazon-region ERID bridge vectors by showing they had previously fed on non-human primates. The broader use of filarial parasite sequences for the incrimination of biting insects as potentially important zoonotic disease vectors is limited by a paucity of primate-derived filarial parasite reference sequences which can be matched to the PCR amplified sequences obtained from insect-vector vectors. Here we have used shotgun sequencing to obtain reference data from an adult Dipetalonema gracile parasite which was found infecting a wild pied tamarin (Saguinus bicolor) in a peripheral region of Manaus. We report the parasite´s complete mitochondrial genome (which is 13,647 base pairs in length), 894,846 base pairs of its Wolbachia genome and 6,426 base pairs of its ribosomal DNA locus (spanning from the start of its 18S subunit to the end of its 28S subunit). Despite being critically endangered, S. bicolor is commonly encountered around the periphery of Manaus and in urban forest fragments. The reported sequences may be a useful reference tool for identifying ERID bridge vectors and potentially provide some insights into the amount and the nature of contact between primate pathogen reservoirs and the residents of Manaus.

RESUMO Os primatas que habitam a floresta tropical ao redor da cidade de Manaus (Amazonas, Brasil) há muito são reconhecidos como reservatórios potencialmente importantes de doenças infecciosas emergentes e reemergentes. Sequências de DNA de parasitas filariais detectadas por PCR em amostras de Simulium oyapockense foram usadas para demonstrar que eles haviam se alimentado anteriormente de primatas não humanos e, dessa maneira, incriminar vetores-ponte da região amazônica. O uso mais amplo de detecção de parasitas filariais para a incriminação de vetores-ponte é limitado por uma escassez de sequências referência de parasitas filarias obtidas de hospedeiros. Aqui nós usamos o sequenciamento tipo shotgun para obter dados de referência de um parasita adulto Dipetalonema gracile encontrado infectando um sauim-de-coleira, Saguinus bicolor no entorno de Manaus. Relatamos o genoma mitocondrial completo do parasita (que tem 13.647 pares de bases de comprimento), 894.846 pares de bases de seu genoma de Wolbachia e 6.426 pares de bases de seu locus de DNA ribossômico (desde o início de sua subunidade 18S até o final de sua subunidade 28S). Apesar de criticamente ameaçado, S. bicolor é comumente encontrado no entorno de Manaus e em fragmentos florestais urbanos. As sequências relatadas podem ser uma ferramenta de referência útil para identificar vetores ponte e potencialmente fornecer algumas informações sobre o contato entre reservatórios de patógenos de primatas e os moradores de Manaus.

https://doi.org/10.1590/1809-4392202201741

Cepas de Yarrowia lipolytica, aisladas de lagunas altoandinas del Perú contaminadas con relaves mineros, como potenciales agentes para la biorremediación de metales pesados
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Sánchez-Rojas, Tito L.

; Macedo-Prada, Diego

; Ramírez, Pablo S.

; Arrieta, Lee K.

; Durán, Yerson

; Flores, Abad

; Manya, Walter F.

; Guerra, Gregory

Ecología Aplicada

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jan 2023, Volume 22 N. 1 Pages 1 - 16

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract The objective of this work was to study the mean lethal concentration (LC50) and the biosorption capacity of heavy metals in isolated yeasts from Lake Junín and the Yanamate tailings facility. In both bodies of water were evaluated: pH, electrical conductivity, temperature, total dissolved solids (STD) and heavy metals by ICM-MS, according to the Environmental Quality Standards (ECA) of the Ministry of the Environment-MINAM of Peru. The physicochemical parameters evaluated in Lake Junín were higher than the maximum permissible limits (MPL) for the following metals: arsenic, cadmium, copper, chromium and lead. In the Yanamate tailings facility, the evaluated parameters were out of the LMP for type IV water ECAs: pH below 3 (acids), high electrical conductivities and high concentrations of heavy metals. From the sampled waters, yeasts were isolated in YPG medium at 10 ° C and 20 ° C. The LC50 of the Cr+6, Cu+2, Cd+2 and Hg+2 ions in Y. lipolytica AMJ3 were 0.24 mM, 1.34 mM, 0.54 mM y 7.5 0.04 mM in the order described; while the strain Y. lipolytica AMJ6 showed a LC50 of 1.06 mM, 1.42 mM, 0.49 mM y 0.05 mM in the same order. The biosorption capacity of the Cu+2 ion was 90% in the case of the AMJ3 strain, and 92% in the AMJ6 strain, at a concentration of 1.26 mM; likewise, the biosorption of the Cr+6 ion was close to 90% in both strains (AMJ3 and AMJ6) at concentrations of 0.24 mM and 0.96 mM, respectively. Nucleotide sequence analysis of AMJ3 and AMJ6 strains confirmed 100% identity in the Yarrowia lipolytica clade. These LC50 and biosorption capacity results indicate that the studied yeasts have potential in the bioremediation of water bodies and soils contaminated with heavy metals.

Resumen El objetivo del presente trabajo fue estudiar la concentración letal media (CL50) y la capacidad de biosorción de metales pesados en levaduras aisladas del Lago Junín y la relavera Yanamate. Se evaluaron en ambos cuerpos de agua: pH, conductividad eléctrica, temperatura, sólidos totales disueltos (STD) y metales pesados por ICM-MS, según los Estándares de Calidad Ambiental (ECA) del Ministerio del Ambiente-MINAM del Perú. Los parámetros fisicoquímicos evaluados en el Lago Junín fueron superiores a los límites máximos permisibles (LMP) para los siguientes metales: arsénico, cadmio, cobre, cromo y plomo. En la relavera Yanamate, los parámetros evaluados estuvieron fuera del LMP para los ECA de aguas tipo IV: pH inferiores a 3 (ácidos), altas conductividades eléctricas y elevadas concentraciones de metales pesados. A partir de las aguas muestreadas, se aislaron levaduras en medio YPG a 10 °C y 20 °C. La CL50 de los iones Cr+6, Cu+2, Cd+2 y Hg+2 en Y. lipolytica AMJ3 fue 0.24 mM, 1.34 mM, 0.54 mM y 7.5 0.04 mM en el orden descrito; en tanto la cepa Y. lipolytica AMJ6 mostró una CL50 de 1.06 mM, 1.42 mM, 0.49 mM y 0.05 mM en el mismo orden. La capacidad de biosorción del ion Cu+2 fue del 90% en el caso de la cepa AMJ3 y 92% en la cepa AMJ6, a una concentración de 1.26 mM; asimismo, la biosorción del ion Cr+6 fue cercana al 90% en ambas cepas (AMJ3 y AMJ6) a concentraciones de 0.24 mM y 0.96 mM, respectivamente. Los análisis de las secuencias nucleotídicas de las cepas AMJ3 y AMJ6 confirmaron una identidad del 100% en el clado de Yarrowia lipolytica. Los resultados obtenidos de CL50 y la capacidad de biosorción indican que las levaduras bajo estudio tienen potencial en la biorremediación de cuerpos de agua y suelos contaminados con metales pesados.

https://doi.org/10.21704/rea.v22i1.1978

Trans-anal small bowel evisceration in a patient with a perforated rectal prolapse
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Lee, HJ

; Hendricks, D

; Rangaka, T

; Abd Elrahman, A

South African Journal of Surgery

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2023, Volume 61 N. 3 Pages 42 - 43

Abstract: En | Text: En | PDF: En

An 85-year-old lady with a history of chronic constipation presented with gangrenous small bowel protruding from the anus through a hole in a prolapsed rectum. At surgery, a resection of 125 cm of gangrenous small bowel was performed in the perineum prior to laparotomy, where rectal repair was followed by the creation of a sigmoid loop colostomy and double-barrel ileostomy. This avoided an intrabdominal anastomosis which was felt likely to complicate due to the lady's intraoperative haemodynamic instability requiring inotropic support. This tailored management of a trans-anal small bowel evisceration through a rectal prolapse resulted in recovery and a patient who was content with her stomas and preferred to live with them rather than have continuity restored.

https://doi.org/10.36303/sajs.3998

10.

Directrices para los protocolos de ensayos clínicos de intervenciones con inteligencia artificial: la extensión SPIRIT-AI
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Cruz Rivera, Samantha

; Liu, Xiaoxuan

; Chan, An-Wen

; Denniston, Alastair K.

; Calvert, Melanie J.

; Denniston, Alastair K.

; Chan, An-Wen

; Darzi, Ara

; Holmes, Christopher

; Yau, Christopher

; Moher, David

; Ashrafian, Hutan

; Deeks, Jonathan J.

; Ferrante di Ruffano, Lavinia

; Faes, Livia

; Calvert, Melanie J.

; Keane, Pearse A.

; Cruz Rivera, Samantha

; Vollmer, Sebastian J.

; Liu, Xiaoxuan

; Lee, Aaron Y.

; Jonas, Adrian

; Esteva, Andre

; Beam, Andrew L.

; Chan, An-Wen

; Panico, Maria Beatrice

; Lee, Cecilia S.

; Haug, Charlotte

; Kelly, Christophe J.

; Yau, Christopher

; Mulrow, Cynthia

; Espinoza, Cyrus

; Fletcher, John

; Moher, David

; Paltoo, Dina

; Manna, Elaine

; Price, Gary

; Collins, Gary S.

; Harvey, Hugh

; Matcham, James

; Monteiro, Joao

; Khair ElZarrad, M.

; Ferrante di Ruffano, Lavinia

; Oakden-Rayner, Luke

; Calvert, Melanie J.

; McCradden, Melissa

; Keane, Pearse A.

; Savage, Richard

; Golub, Robert

; Sarkar, Rupa

; Rowley, Samuel

Revista Panamericana de Salud Pública

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2023, Volume 47 elocation e149

Abstract: Es En Pt | Text: Es En Pt | PDF: Es | PDF: En | PDF: Pt

resumen está disponible en el texto completo

https://doi.org/10.26633/rpsp.2023.149

11.

Accuracy of the urine point-of-care circulating cathodic antigen assay for diagnosing Schistosomiasis mansoni infection in Brazil: A multicenter study
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Pieri, Otavio Sarmento

; Bezerra, Fernando Schemelzer Moraes

; Coelho, Paulo Marcos Zech

; Enk, Martin Johannes

; Favre, Tereza Cristina

; Graeff-Teixeira, Carlos

; Oliveira, Ricardo Riccio

; Reis, Mitermayer Galvão dos

; Andrade, Lee Senhorinha de Almeida

; Beck, Lilian Christina Nóbrega Holsbach

; Favero, Vivian

; Fialho, Thainá Rodrigues de Souza

; Guimarães, Ricardo José de Paula Souza e

; Oliveira, Bruna Souza Santos

; Pascoal, Vanessa Fey

; Pinheiro, Marta Cristhiany Cunha

; Santos, Ronald Alves dos

; Silva, Luciano Kalabric

; Siqueira, Isadora Cristina de

; Souza, Renata Perotto de

; Katz, Naftale

Revista da Sociedade Brasileira de Medicina Tropical

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2023, Volume 56 elocation e0238-2022

Abstract: En | Text: En | PDF: En

ABSTRACT Background: The World Health Organization recommends a market-ready, urine-based point-of-care diagnostic test for circulating cathodic antigens (CCA) to determine the prevalence of S. mansoni. This study evaluated the performance of the URINE CCA (SCHISTO) ECO TESTE® (POC-ECO), which is currently available in Brazil. Methods: Residents from eight sites with different prevalence estimates provided one urine sample for POC-ECO and one stool sample for Kato-Katz (KK) and Helmintex® (HTX) testing as an egg-detecting reference for infection status. Results: None of the study sites had significantly higher POC-ECO accuracy than KK. Conclusions: POC-ECO is not currently recommended in Brazilian schistosomiasis elimination programs.

https://doi.org/10.1590/0037-8682-0238-2022

12.

Septic shock, hyperferritinemic syndrome, and multiple organ dysfunction without respiratory failure in a patient with disseminated histoplasmosis and advanced HIV disease
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Silva, Jussemara Souza da

; Ernandes, Bruno Correia

; Fernandes, Carol Lee Luna

; Correia, Ademir Silva

; Ponce, Cesar Cilento

; Sztajnbok, Jaques

; Rodrigues, Camila

; Vidal, José Ernesto

Revista do Instituto de Medicina Tropical de São Paulo

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2023, Volume 65 elocation e28

Abstract: En | Text: En | PDF: En

ABSTRACT AIDS-related disseminated histoplasmosis (DH) can cause septic shock and multiorgan dysfunction with mortality rates of up to 80%. A 41-year-old male presented with fever, fatigue, weight loss, disseminated skin lesions, low urine output, and mental confusion. Three weeks before admission, the patient was diagnosed with HIV infection, but antiretroviral therapy (ART) was not initiated. On day 1 of admission, sepsis with multiorgan dysfunction (acute renal failure, metabolic acidosis, hepatic failure, and coagulopathy) was identified. A chest computed tomography showed unspecific findings. Yeasts suggestive of Histoplasma spp. were observed in a routine peripheral blood smear. On day 2, the patient was transferred to the ICU, where his clinical condition progressed with reduced level of consciousness, hyperferritinemia, and refractory septic shock, requiring high doses of vasopressors, corticosteroids, mechanical ventilation, and hemodialysis. Amphotericin B deoxycholate was initiated. On day 3, yeasts suggestive of Histoplasma spp. were observed in the bone marrow. On day 10, ART was initiated. On day 28, samples of peripheral blood and bone marrow cultures revealed Histoplasma spp. The patient stayed in the ICU for 32 days, completing three weeks of intravenous antifungal therapy. After progressive clinical and laboratory improvement, the patient was discharged from the hospital on oral itraconazole, trimethoprim-sulfamethoxazole, and ART. This case highlights the inclusion of DH in the differential diagnosis of patients with advanced HIV disease, septic shock and multiorgan dysfunction but without respiratory failure. In addition, it provides early in-hospital diagnosis and treatment and comprehensive management in the ICU as determining factors for a good outcome.

https://doi.org/10.1590/s1678-9946202365028

13.

Preliminary outcomes from a single-session, asynchronous, online stress and anxiety management workshop for college students
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Lee, Carol S.

; Bowman, Margaret

; Wu, Jenny L.

Trends in Psychiatry and Psychotherapy

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2023, Volume 45 elocation e20210448

Abstract: En | Text: En | PDF: En

Abstract Objectives Self-guided, asynchronous, online interventions may provide college students access to evidence-based care, while mitigating barriers like limited hours of service. Thus, we examined the preliminary effectiveness of a 45-minute, self-guided, asynchronous, online, dialectical behavior therapy (DBT)-informed stress and anxiety management workshop. College undergraduates (n = 131) were randomized to either workshop (n = 65) or waitlist control (n = 66) conditions. Methods Participants in the workshop condition completed baseline measures of depression, stress, and anxiety, before completing the workshop. Participants in the waitlist control condition only completed the baseline measures. All participants were reassessed at 1-week follow-up. Results Controlling for baseline measures, students in the workshop condition experienced significantly less stress and greater self-efficacy to regulate stress and anxiety at follow-up, compared to waitlist controls. Conclusion A 45-minute, self-guided, asynchronous, online DBT skills-informed stress and anxiety management workshop may reduce stress and improve self-efficacy to regulate stress and anxiety.

https://doi.org/10.47626/2237-6089-2021-0448

14.

Referral Patterns of Outpatient Palliative Care among the Head and Neck Cancer Population
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Saravia, Ari

; Kong, Keonho Albert

; Roy, Ryan

; Barry, Rachel

; Guidry, Christine

; McDaniel, Lee S.

; Raven, Mary C.

; Pou, Anna M.

; Mays, Ashley C.

International Archives of Otorhinolaryngology

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dec 2022, Volume 26 N. 4 Pages 538 - 547

Abstract: En | Text: En | PDF: En

Abstract Introduction Patients with head and neck cancer (HNC) experience unique physical and psychosocial challenges that impact their health and quality of life. Early implementation of palliative care has been shown to improve various health care outcomes. Objective The aim of the present study was to evaluate the patterns of referral of patients with HNC to outpatient palliative care as they relate to utilization of resources and end-of-life discussions. Methods We performed a retrospective review of 245 patients with HNC referred to outpatient palliative care services at two Louisiana tertiary care centers from June 1, 2014, to October 1, 2019. The control group consisted of those that were referred but did not follow-up. Reasons for referral were obtained, and outcome measures such as emergency department (ED) visits, hospital readmissions, and advance care planning (ACP) documentation were assessed according to predictive variables. Results There were 177 patients in the treatment group and 68 in the control group. Patients were more likely to follow up to outpatient palliative care services if referred for pain management. Hospital system, prior inpatient palliative care, and number of outpatient visits were associated with an increased likelihood for ED visits and hospital readmissions. Those in the palliative care treatment group were also more likely to have ACP discussions. Conclusion Early implementation of outpatient palliative care among patients with HNC can initiate ACP discussions. However, there are discrepancies in referral reasons to palliative care and continued existing barriers to its effective utilization.

https://doi.org/10.1055/s-0041-1741436

15.

Management of laryngopharyngeal reflux in Brazil: a national surveys
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Lechien, Jerome R.

; Perazzo, Paulo S.

; Ceccon, Fabio P.

; Eckley, Claudia A.

; Lopes, Karen de Carvalho

; Maunsell, Rebecca

; Avelino, Melissa A.G.

; Akst, Lee M.

; Sant’Anna, Geraldo D.

; Imamura, Rui

Brazilian Journal of Otorhinolaryngology

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nov 2022, Volume 88 N. 6 Pages 850 - 857

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Introdução: Estudos que avaliaram o manejo do refluxo laringofaríngeo por otorrinolaringologistas mostraram uma importante heterogeneidade em relação à definição, diagnóstico e tratamento, o que leva a discrepâncias no tratamento do paciente. Faltam informações sobre o conhecimento e as práticas atuais dos otorrinolaringologistas brasileiros sobre o refluxo laringofaríngeo. Objetivo: Investigar as tendências no manejo da doença do refluxo laringofaríngeo entre os otorrinolaringologistas brasileiros. Método: O questionário foi enviado por e-mail aos membros da Associação Brasileira de Otorrinolaringologia-Cirurgia de Cabeça e Pescoço. Esta pesquisa foi inicialmente conduzida pelo LPR Study Group of Young Otolaryngologists da International Federation of Otolaryngological Societies. Resultados: De acordo com os respondentes da pesquisa, a prevalência de refluxo laringofaríngeo foi estimada em 26,8% dos pacientes consultados e os sintomas mais comuns foram sensação de globus, pigarro, tosse e refluxo de ácido estomacal. Obstrução nasal, disfunção da trompa de Eustáquio, otite média aguda e crônica, nódulos nas pregas vocais e hemorragia foram considerados como não associados ao refluxo laringofaríngeo pela maioria dos respondentes. Cerca de 2/3 dos otorrinolaringologistas brasileiros basearam o diagnóstico de refluxo laringofaríngeo na avaliação dos sintomas e achados e na resposta positiva a testes terapêuticos empíricos. Inibidores de bomba de prótons uma ou duas vezes ao dia foi o esquema terapêutico mais usado. Somente 21,4% dos otorrinolaringologistas brasileiros já ouviram falar sobre refluxo laringofaríngeo não ácido e misto e o conhecimento sobre a utilidade do monitoramento de pH por impedância intraluminal multicanal foi mínimo; 30,5% dos respondentes não se consideraram tão bem informados sobre o refluxo laringofaríngeo. Conclusão: Embora os sintomas relacionados ao refluxo laringofaríngeo e as principais abordagens diagnósticas e terapêuticas referidas pelos otorrinolaringologistas brasileiros sejam consistentes com a literatura, a pesquisa identificou algumas limitações, como o conhecimento insuficiente do papel do refluxo laringofaríngeo em diversas condições otorrinolaringológicas e da possibilidade de refluxo não ácido ou misto em casos refratários. Estudos futuros são necessários para estabelecer recomendações internacionais para o manejo de doença do refluxo laringofaríngeo.

Abstract Introduction: Studies assessing the management of laryngopharyngeal reflux by otolaryngologists have reported an important heterogeneity regarding the definition, diagnosis, and treatment, which leads to discrepancies in the management of the patient. Information about the current knowledge and practices of Brazilian otolaryngologists in laryngopharyngeal reflux is lacking. Objective: To investigate the trends in management of laryngopharyngeal reflux disease among Brazilian otolaryngologists. Methods: A survey was sent by email to the members of the Brazilian Association of Otolaryngology-Head Neck Surgery. This survey has initially been conducted by the laryngopharyngeal reflux study group of young otolaryngologists of the International Federation of Otolaryngological Societies. Results: According to the survey responders, the prevalence of laryngopharyngeal reflux was estimated to be 26.8% of patients consulting in otolaryngology and the most common symptoms were globus sensation, throat clearing, cough and stomach acid reflux. Nasal obstruction, Eustachian tube dysfunction, acute and chronic otitis media, vocal fold nodules and hemorrhage were considered not associated with laryngopharyngeal reflux by the majority of responders. About 2/3 of Brazilian otolaryngologists based the diagnosis of laryngopharyngeal reflux on the assessment of both symptoms and findings and a positive response to empiric therapeutic trials. Proton pump inhibitor utilized once or twice daily, was the most commonly used therapeutic scheme. Only 21.4% of Brazilian otolaryngologists have heard about nonacid and mixed laryngopharyngeal reflux and the awareness about the usefulness of multichannel intraluminal impedance pH monitoring (MII-pH) was minimal; 30.5% of responders did not consider themselves as well-informed about laryngopharyngeal reflux. Conclusion: Although the laryngopharyngeal reflux-related symptoms, main diagnostic and treatment approaches referred by Brazilian otolaryngologists are consistent with the literature, the survey identified some limitations, such as the insufficient awareness of the role of laryngopharyngeal reflux in many otolaryngological conditions and of the possibility of non-acid or mixed reflux in refractory cases. Future studies are needed to establish international recommendations for the management of laryngopharyngeal reflux disease.

https://doi.org/10.1016/j.bjorl.2020.11.017

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