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Alcohol consumption and HIV disease prognosis among virally unsuppressed in Rural KwaZulu Natal, South Africa 南非夸祖鲁纳塔尔省农村病毒未被抑制人群中的酒精消费与HIV疾病预后
IF 0.7 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.3934/medsci.2023018
Manasseh B. Wireko, J. Hendricks, K. Bedu-Addo, M. Van Staden, E. A. Ntim, S. Odoom, I. Owusu
Background The effect of alcohol consumption and human immunodeficiency virus (HIV) disease prognosis has been examined in several studies with inconsistent findings. We sought to determine the effect of alcohol consumption on HIV disease prognosis by examining CD4+ T cell count/µL (CD4+ count) and HIV RNA concentration [HIV viral load (VL)] independent of anti-retroviral therapy (ART). Methods A secondary analysis was performed on a cross-sectional survey data of 1120 participants between 2018 and 2020. Questionnaires were used to obtain the participants' history of alcohol consumption. Blood samples were assayed for CD4+ T cell count/µL (CD4+ count) and HIV RNA concentration (HIV viral load). The history of alcohol consumption was categorized into non-alcohol consumers, non-heavy alcohol consumers, and heavy-alcohol consumers. Age, cigarette smoking, gender, and ART use were considered potential confounders. Participants were categorized into two cohorts for the analysis and a multivariate logistic regression was used to establish relationships among virally unsuppressed participants who were ART-experienced and ART-naïve. Results A total of 1120 participants were considered for analysis. The majority were females (65.9%) between 15–39 years (72.4%). The majority were non-smokers and non-alcohol consumers (88% and 79%, respectively). ART-experienced females had an increased risk of having a higher VL (VL > 1000). This finding was statistically significant [RR, 0.425, 95% CI, (0.192–0.944), p-value, 0.036]. However, ART-experienced participants aged above 64 years had an increased risk of having a lower VL (VL < 1000 copies/mL) and a lower risk of having a higher VL (VL > 1000). However, ART-naïve participants aged between 40–64 years had a significantly lower risk of having higher CD4 count (CD4+ > 500 cells) and an increased risk of having a lower CD4 count [OR, 0.566 95% CI, (0.386–0.829), p-value, 0.004]. History of alcohol consumption did not have a significant effect on CD4+ cell count and VL in neither the ART-experienced nor the naïve cohort. Conclusions Female middle-aged people living with HIV (PLWH) are more likely to have a poorer HIV disease state, independent of alcohol consumption. Alcohol consumption may not have a direct effect on CD4+ cell count and VL in either ART-naïve or experienced patients.
背景:饮酒和人类免疫缺陷病毒(HIV)疾病预后的影响已经在几项研究中进行了检验,但结果不一致。我们试图通过检测独立于抗逆转录病毒治疗(ART)的CD4+ T细胞计数/µL (CD4+计数)和HIV RNA浓度[HIV病毒载量(VL)]来确定饮酒对HIV疾病预后的影响。方法对2018 - 2020年1120名参与者的横断面调查数据进行二次分析。通过问卷调查获得参与者的饮酒史。检测血样中CD4+ T细胞计数/µL (CD4+计数)和HIV RNA浓度(HIV病毒载量)。酒精消费史分为非酒精消费者、非重度酒精消费者和重度酒精消费者。年龄、吸烟、性别和使用抗逆转录病毒治疗被认为是潜在的混杂因素。参与者被分为两个队列进行分析,并使用多变量逻辑回归来建立病毒未受抑制的参与者(有art经验的参与者和ART-naïve)之间的关系。结果共纳入1120名受试者进行分析。15 ~ 39岁以女性居多(65.9%),占72.4%。大多数是不吸烟和不饮酒的消费者(分别为88%和79%)。接受过art治疗的女性VL升高的风险增加(VL > 1000)。这一发现具有统计学意义[RR, 0.425, 95% CI, (0.192-0.944), p值,0.036]。然而,年龄在64岁以上的接受过art治疗的参与者具有较低VL (VL < 1000拷贝/mL)的风险增加,而具有较高VL (VL > 1000)的风险较低。然而,年龄在40-64岁之间的ART-naïve参与者具有较高CD4计数(CD4+ > 500细胞)的风险显着降低,并且具有较低CD4计数的风险增加[OR, 0.566 95% CI, (0.386-0.829), p值,0.004]。在接受art治疗的患者和naïve队列中,饮酒史对CD4+细胞计数和VL均无显著影响。结论女性中年HIV感染者(PLWH) HIV疾病状态较差的可能性较大,与饮酒无关。饮酒可能对ART-naïve或有经验的患者的CD4+细胞计数和VL没有直接影响。
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引用次数: 0
The association of dual-mobility total hip arthroplasty with dislocation compared to conventional hip arthroplasty for neck of femur fracture 双活动全髋关节置换术与常规髋关节置换术治疗股骨颈骨折脱位的关系
Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.3934/medsci.2023023
Matthew C.A. Arnold, John W. Kennedy, Evan Wright, Madeleine Reece, R.M. Dominic Meek
Introduction Neck of femur fractures are extremely common worldwide and have a mortality rate of 15% at 1 year. Dual-mobility cups (DMCs) have demonstrated a reduction in dislocation and revision rates for elective total hip arthroplasty (THA) but the benefits of DMC use in neck of femur fractures are less clear. The aim of this study was to compare the rate of dislocation between conventional and DMC THA following neck of femur fracture. Materials and methods Data was retrospectively collected for patients who received either DMCs or standard acetabular components for neck of femur fractures at our institution. Patients were excluded if they had less than 2 years follow-up. Dislocation and revision rates were collected for all patients in addition to radiographic analysis to assess for loosening. Results Data was collected for 39 patients with DMCs and 95 patients with conventional THA. Two patients with DMCs suffered a dislocation (5.1%) compared to 7 patients (7.3%) who underwent a conventional THA (p = 0.49). Both patients in the DMC group had additional risk factors for dislocation. One DMC patient required revision surgery for dislocation and one conventional THA patient underwent a revision for aspetic loosening. There were no cases of radiographic loosening in the DMC group. Conclusions Our study showed a trend towards lower dislocation rates in patients treated with a DMC compared to conventional THA. Although there are potential issues associated with DMC implants and cost implications, this study suggests they may be advantageous in patients at high risk for dislocation.
& lt; abstract> & lt; sec>& lt; title> Introduction< / title><p>股骨颈骨折在世界范围内极为常见,1年死亡率为15%。双活动杯(DMC)已经证明可减少选择性全髋关节置换术(THA)的脱位和翻修率,但DMC用于股骨颈骨折的益处尚不清楚。本研究的目的是比较股骨颈骨折后常规THA和DMC THA的脱位率。& lt; / sec> & lt; sec><title>材料和方法<我们回顾性收集了我院接受dmc或标准髋臼假体治疗股骨颈骨折患者的数据。随访时间少于2年的患者被排除在外。收集所有患者的脱位率和翻修率,并进行影像学分析以评估松动情况。& lt; / sec> & lt; sec>& lt; title> Results< / title>< >收集39例dmc患者和95例常规THA患者的数据。2例dmc患者发生脱位(5.1%),而7例患者(7.3%)接受了常规THA (p = 0.49)。DMC组的两名患者均有脱位的其他危险因素。1例DMC患者因脱位需要翻修手术,1例常规THA患者因骨软化松动需要翻修手术。DMC组无影像学松动病例。</p>& lt; / sec> & lt; sec>& lt; title> Conclusions< / title>我们的研究显示,与传统THA相比,DMC治疗的患者脱位率更低。尽管存在与DMC植入物相关的潜在问题和成本问题,但本研究表明,它们可能对脱位风险高的患者有利。& lt; / sec> & lt; / abstract>
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引用次数: 0
Chronic kidney disease report differently on change in sexual function dependent on treatment: a cohort study 一项队列研究表明,慢性肾脏疾病对性功能变化的影响取决于治疗
IF 0.7 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.3934/medsci.2023013
J. Fryckstedt, M. Norrbäck, Charlotte Kaviani, B. Hylander
Patients with Chronic Kidney Disease (CKD) report sexual dysfunction to a large extent. The objective of this study was to investigate if CKD-stage and mode of treatment correlate to self-reported experience in sexual function before and after onset of symptomatic CKD in patients without active treatment, after transplantation or on dialysis. Participants (N = 234) answered a questionnaire on frequency of sexual desire, initiative, intercourse, erection (men) /vaginal lubrication (women), and orgasm, currently and compared with before onset of symptomatic CKD. Clinical data were taken from medical charts. Within-group differences in sexual function were compared for patients without active treatment (PreT), patients with a renal transplant (Tx) and patients on dialysis treatment (D). In a subgroup analysis, five patient groups were created based on mode of treatment and CKD stage. Between-group differences in sexual function were analyzed as differences in mean composite scores and 95% CI and were estimated using ordinary least square regression with robust standard errors. In the first analysis of the study, all CKD patients reported a decrease in the frequency of sexual desire, initiative, intercourse, erection (men)/vaginal lubrication (women), and orgasm (Bonferroni p < 0.001) compared to before disease onset, irrespective of treatment mode. In the subgroup analysis, when adjusting for sex and age, dialysis patients reported a statistically significant decrease in their average score of sexual function (−2.65; 95% CI: −4.19 to −1.11; p = 0.001) compared to patients without active treatment CKD 2–3 (the reference group). The self-reported experience of CKD-patients of a deteriorating sexual function over time correlates to treatment modality and CKD stage. It is important for health-care personnel to be aware of the patients' experience of a deterioration in sexual function over time regardless of treatment modalities.
慢性肾脏疾病(CKD)患者在很大程度上报告性功能障碍。本研究的目的是调查CKD分期和治疗方式是否与没有积极治疗、移植或透析后出现症状性CKD患者前后自我报告的性功能经历相关。参与者(N = 234)回答了一份关于性欲、主动性、性交、勃起(男性)/阴道润滑(女性)和性高潮频率的问卷,目前与症状性慢性肾病发病前进行了比较。临床资料取自医学图表。比较未接受积极治疗的患者(PreT)、肾移植患者(Tx)和接受透析治疗的患者(D)的组内性功能差异。在亚组分析中,根据治疗方式和CKD分期划分了5组患者。性功能的组间差异以平均综合评分和95% CI的差异进行分析,并使用具有稳健标准误差的普通最小二乘回归进行估计。在该研究的第一个分析中,与疾病发作前相比,所有CKD患者的性欲、主动性、性交、勃起(男性)/阴道润滑(女性)和性高潮的频率(Bonferroni p < 0.001)均有所下降,与治疗模式无关。在亚组分析中,当对性别和年龄进行调整时,透析患者的性功能平均分(- 2.65;95% CI:−4.19 ~−1.11;p = 0.001),与未经积极治疗的CKD 2-3患者(对照组)相比。随着时间的推移,性功能恶化的CKD患者的自我报告经历与治疗方式和CKD分期相关。无论采用何种治疗方式,保健人员都应了解患者的性功能随着时间的推移而恶化的经历。
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引用次数: 0
Hydroxyurea and pyridostigmine repurposed for treating Covid-19 multi-systems dysfunctions 羟基脲和吡哆斯的明用于治疗Covid-19多系统功能障碍
IF 0.7 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.3934/medsci.2023010
M. Foster, A. Hijazi, Raymond C. Sullivan, Rebecca Opoku
Early in the COVID-19 pandemic, medical care providers at an acute illness hospital received increasing numbers of post-acute advanced COVID-19 patients from referring hospitals where they were showing no signs of improvement after receiving treatments from standard Emergency Use Authorization (EUA)-type protocols. The care providers turned to repurposing medications to treat these patients and added hydroxyurea, a medication commonly used for treating sickle cell anemia, to the hospital's COVID-19 treatment protocol and began to see notable clinical improvements. As the pandemic continued and new concerns arose concerning COVID-19 complications, those same care providers again turned to repurposing drugs. Focusing on the neuromuscular effects seen in COVID-19 patients, care providers turned to medications used to treat chronic neuromuscular conditions. Post-acute advanced Covid-19 patients initially received an abbreviated course of hydroxyurea followed by titrated doses of pyridostigmine. Positive responses were noted with cognition, diminished oxygen demands, progressive decrease in ventilator support, improved swallowing, and mobility. The authors suggest repurposed drugs could have great utility for treating COVID-19. It is recommended larger, COVID-19 clinical trials be completed to include hydroxyurea and pyridostigmine for validating the outcomes and clinical observations seen in these presented cases.
在COVID-19大流行早期,急性病医院的医疗服务提供者接收了越来越多来自转诊医院的急性后晚期COVID-19患者,这些患者在接受标准紧急使用授权(EUA)类型的治疗后没有出现好转迹象。医护人员转向重新利用药物来治疗这些患者,并在医院的COVID-19治疗方案中添加了羟基脲(一种通常用于治疗镰状细胞性贫血的药物),并开始看到显着的临床改善。随着大流行的持续和对COVID-19并发症的新担忧的出现,这些医护人员再次转向改变药物的用途。针对COVID-19患者的神经肌肉效应,医护人员转向用于治疗慢性神经肌肉疾病的药物。急性后晚期Covid-19患者最初接受缩短疗程的羟基脲,然后滴定剂量的吡哆斯的明。积极的反应是认知、耗氧量减少、呼吸机支持逐渐减少、吞咽和活动能力改善。作者认为,重新利用的药物可能对治疗COVID-19有很大的用处。建议完成更大规模的COVID-19临床试验,包括羟基脲和吡哆斯的明,以验证这些病例的结果和临床观察结果。
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引用次数: 1
Evolution of the COVID-19 pandemic in Italy at the national and regional levels from February 2020 to March 2022 2020年2月至2022年3月意大利COVID-19大流行在国家和区域层面的演变情况
Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.3934/medsci.2023019
Rosario Megna

The COVID-19 pandemic initially hit Italy at the end of February 2020. In the following two years, there were about 13 million diagnosed cases and more than 150000 deaths. For this period, we have performed a study that evaluates and compares the impacts on public health of the SARS-CoV-2 waves at the national and regional levels. Based on contagion trends, we considered four pandemic waves. For each wave, we also analyzed a restricted time interval of one month around the peak. We found an underestimation of diagnosed cases and a saturation of available intensive care unit (ICU) beds during the first wave. The second wave had a more significant impact on public health, highlighting that the system of physical distancing measures was less effective than the lockdown implemented during the first wave. Instead, during the first three peaks, the incidence of ICU bed occupancy was superimposable. In general, odds ratios of case fatality rate showed a more significant risk for males than females from the age of thirty onwards. We verified that regional responses to the health emergency were not homogeneous. In particular, in contrast with the national temporal trend, some regions showed a significant increase in the incidence of deaths. Furthermore, we found positive correlations between availability and occupancy of hospital beds from the second wave onward. In contrast, a significant correlation was verified for ICU bed occupancy and deaths only during the second peak. In light of what happened, it would be desirable to plan an increase in public health funds for new emergencies and issue a rigorous plan to face pandemics.

& lt; abstract>2019冠状病毒病大流行最初于2020年2月底袭击意大利。在接下来的两年里,确诊病例约为1300万例,死亡人数超过15万。在此期间,我们进行了一项研究,评估和比较了SARS-CoV-2波在国家和地区层面对公共卫生的影响。根据传染趋势,我们考虑了四次大流行浪潮。对于每一波,我们还分析了峰值周围一个月的有限时间间隔。我们发现在第一波确诊病例的低估和可用重症监护病房(ICU)床位的饱和。第二波疫情对公共卫生的影响更为显著,凸显出与第一波疫情期间实施的封锁相比,保持身体距离的措施体系效果较差。相反,在前三个高峰期间,ICU床位占用发生率是重叠的。总的来说,病死率的比值比显示,从30岁起,男性比女性有更大的风险。我们证实,各区域对突发卫生事件的反应并不一致。特别是,与全国时间趋势相反,一些地区的死亡率显著增加。此外,我们发现从第二次浪潮开始,医院床位的可用性和占用率之间存在正相关关系。相比之下,只有在第二个高峰期间,ICU床位占用与死亡之间才有显著的相关性。鉴于所发生的情况,最好计划增加公共卫生资金,以应对新的紧急情况,并发布一项严格的计划,以应对流行病。& lt; / abstract>
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引用次数: 0
Healthcare workers: diminishing burnout symptoms through self-care 医护人员:通过自我护理减少倦怠症状
IF 0.7 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.3934/medsci.2023006
A. Rokach
Being part of the health care system involves facing stress, loneliness and the emotional toll of assisting, listening and caring for patients who come into the office or hospital, and seek or even demand assistance. Healthcare workers, like physicians, nurses and therapists, are trained, on assisting and healing others. They are less effective in taking care of themselves. This article, which aims to heighten clinicians' awareness of the need for self-care, especially now in the post-pandemic era, addresses the demanding nature of medicine and health work, and the resistance that clinicians commonly display in the face of suggestions that they engage in self-care. The consequences of neglecting to care for oneself are delineated. The demanding nature of medicine is reviewed, along with the loneliness and isolation felt by clinicians particularly those in private practice, the professional hazards faced by those caring for others, and the ways that are available to them (should they decide to care for themselves) for the benefit of their clients, their families and, obviously, themselves.
作为医疗保健系统的一部分,要面对压力、孤独和帮助、倾听和照顾来到办公室或医院、寻求甚至要求帮助的病人的情感代价。医护人员,如医生、护士和治疗师,都接受过帮助和治疗他人的培训。他们在照顾自己方面效率较低。本文旨在提高临床医生对自我保健需求的认识,特别是在现在大流行后时代,讨论了医学和卫生工作的高要求性质,以及临床医生在面对要求他们从事自我保健的建议时通常表现出的抵制。文中描述了忽视照顾自己的后果。本书回顾了医学的苛刻本质,以及临床医生(尤其是私人执业的临床医生)所感受到的孤独和孤立,以及那些照顾他人的人所面临的职业危险,以及他们(如果他们决定照顾自己)为了客户、家人、当然还有他们自己的利益而可以采取的方式。
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引用次数: 0
The correlation between obesity and other cardiovascular disease risk factors among adult patients attending a specialist clinic in Kumasi. Ghana 库马西一家专科诊所成年患者肥胖与其他心血管疾病危险因素的相关性加纳
IF 0.7 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.3934/medsci.2023003
I. Owusu, Emmanuel Acheamfour-Akowuah, Lois Amoah-Kumi, Y. Wiafe, S. Opoku, E. Anto
Background

Obesity is a complex and multifactorial disease marker, which has become a major threat to cardiovascular health. We sought to assess the correlation of obesity and other cardio-metabolic risk factors in patients seen at the outpatient specialist clinic in Ghana.

Methods

A prospective cross-sectional study was conducted on 395 patients at Precise Specialist Clinic in Kumasi, Ghana. A standardized questionnaire was used to obtain demographic, anthropometric and clinical data of patients. Fisher's exact test for statistical significance at a 95% confidence interval was used to evaluate associations between categorical variables. The associations between obesity indices and cardiovascular disease risk factors were analyzed by Pearson's correlation.

Results

Of the 395 participants, 187 were males and 208 were females. The mean (± standard deviation) age of study participants was 59.29 (± 13.93); more than half of the participants were between 50 and 69 years. The mean BMI of male participants was significantly lower than the mean BMI of female participants (28.18 kg/m2 vs 31.16 kg/m2, P-value < 0.0001). Gender was significantly associated with the weight categories (P = 0.0144). Obesity was seen more in females (49.0%) than in males (35.8%). The Pearson correlation analysis also showed a significant positive correlation between obesity, increasing systolic blood pressure (r = 0.1568, P-value = 0.0018) and increasing diastolic blood pressure (r = 0.2570, P-value < 0.0001).

Conclusions

Obesity was found to be significantly associated with female gender, increasing age, increasing systolic blood pressure, and increasing diastolic blood pressure. Efforts to step-up preventive measures to reduce the increasing prevalence of obesity in Ghana are highly recommended.

背景肥胖是一种复杂的多因素疾病标志物,已成为心血管健康的主要威胁。我们试图评估在加纳门诊专科诊所就诊的患者中肥胖和其他心脏代谢危险因素的相关性。方法对加纳库马西精确专科诊所的395例患者进行前瞻性横断面研究。采用标准化的调查问卷获取患者的人口学、人体测量学和临床资料。采用Fisher在95%置信区间的统计显著性精确检验来评价分类变量之间的相关性。采用Pearson相关分析肥胖指数与心血管疾病危险因素的相关性。结果在395名参与者中,男性187人,女性208人。研究参与者的平均(±标准差)年龄为59.29(±13.93);超过一半的参与者年龄在50岁到69岁之间。男性参与者的平均BMI显著低于女性参与者的平均BMI (28.18 kg/m2 vs 31.16 kg/m2, p值< 0.0001)。性别与体重类别显著相关(P = 0.0144)。女性肥胖率(49.0%)高于男性(35.8%)。Pearson相关分析也显示肥胖与收缩压升高(r = 0.1568, p值= 0.0018)和舒张压升高(r = 0.2570, p值< 0.0001)呈正相关。结论肥胖与女性、年龄、收缩压升高、舒张压升高有显著相关性。强烈建议努力加强预防措施,以减少加纳日益流行的肥胖症。
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引用次数: 0
Neuropsychiatric sequelae of medication non-adherence in people living with HIV 艾滋病毒感染者药物不依从性的神经精神后遗症
IF 0.7 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.3934/medsci.2023014
D. Moreira, R. Khan, P. Sales
Non-adherence to anti-retroviral therapy (cART) among people living with HIV/AIDS (PLWHA) is complex, multifactorial, and leads to increases in viral load, immunosuppression, and HIV burden related to direct CNS virulence and cART re-initiation (i.e., immune reconstitution syndrome). Among behavioral disturbances, which may become long-lasting without proper treatment, major depressive disorder, generalized anxiety disorder, schizophrenia, and bipolar spectrum disorders are frequent, as well as exacerbation of other premorbid underlying psychiatric conditions, such as post-traumatic stress disorder (PTSD) and substance use and related conditions, not to mention neurocognitive disorders that are encompassed under the umbrella term of HIV-Associated Neurocognitive Disorders (HAND). In this review, we summarized the neuropsychiatric sequelae of medication non-adherence in PLWHA by utilizing two clinical vignettes to illustrate how syndemic factors may interact and lead to unique presentations.
艾滋病毒/艾滋病感染者(PLWHA)不坚持抗逆转录病毒治疗(cART)是复杂的、多因素的,并导致病毒载量增加、免疫抑制和与中枢神经系统直接毒力和cART重新启动(即免疫重建综合征)相关的艾滋病毒负担。在行为障碍中,如果没有适当的治疗,可能会持续很长时间,重度抑郁症、广泛性焦虑症、精神分裂症和双相情感障碍是常见的,以及其他病前潜在精神疾病的恶化,如创伤后应激障碍(PTSD)和物质使用及相关疾病。更不用说在hiv相关神经认知障碍(HAND)的总称下包含的神经认知障碍。在这篇综述中,我们总结了PLWHA患者药物依从性不良的神经精神后遗症,通过两个临床小插曲来说明综合征因素如何相互作用并导致独特的表现。
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引用次数: 0
Quality evaluation of digital voice assistants for diabetes management 糖尿病管理数字语音助手的质量评价
IF 0.7 Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.3934/medsci.2023008
Joy Qi En Chia, L. Wong, K. Yap
Background Digital voice assistants (DVAs) are increasingly used to search for health information. However, the quality of information provided by DVAs is not consistent across health conditions. From our knowledge, there have been no studies that evaluated the quality of DVAs in response to diabetes-related queries. The objective of this study was to evaluate the quality of DVAs in relation to queries on diabetes management. Materials and methods Seventy-four questions were posed to smartphone (Apple Siri, Google Assistant, Samsung Bixby) and non-smartphone DVAs (Amazon Alexa, Sulli the Diabetes Guru, Google Nest Mini, Microsoft Cortana), and their responses were compared to that of Internet Google Search. Questions were categorized under diagnosis, screening, management, treatment and complications of diabetes, and the impacts of COVID-19 on diabetes. The DVAs were evaluated on their technical ability, user-friendliness, reliability, comprehensiveness and accuracy of their responses. Data was analyzed using the Kruskal-Wallis and Wilcoxon rank-sum tests. Intraclass correlation coefficient was used to report inter-rater reliability. Results Google Assistant (n = 69/74, 93.2%), Siri and Nest Mini (n = 64/74, 86.5% each) had the highest proportions of successful and relevant responses, in contrast to Cortana (n = 23/74, 31.1%) and Sulli (n = 10/74, 13.5%), which had the lowest successful and relevant responses. Median total scores of the smartphone DVAs (Bixby 75.3%, Google Assistant 73.3%, Siri 72.0%) were comparable to that of Google Search (70.0%, p = 0.034), while median total scores of non-smartphone DVAs (Nest Mini 56.9%, Alexa 52.9%, Cortana 52.5% and Sulli the Diabetes Guru 48.6%) were significantly lower (p < 0.001). Non-smartphone DVAs had much lower median comprehensiveness (16.7% versus 100.0%, p < 0.001) and reliability scores (30.8% versus 61.5%, p < 0.001) compared to Google Search. Conclusions Google Assistant, Siri and Bixby were the best-performing DVAs for answering diabetes-related queries. However, the lack of successful and relevant responses by Bixby may frustrate users, especially if they have COVID-19 related queries. All DVAs scored highly for user-friendliness, but can be improved in terms of accuracy, comprehensiveness and reliability. DVA designers are encouraged to consider features related to accuracy, comprehensiveness, reliability and user-friendliness when developing their products, so as to enhance the quality of DVAs for medical purposes, such as diabetes management.
数字语音助手(DVAs)越来越多地用于搜索健康信息。然而,dva提供的信息质量在各种健康状况下并不一致。据我们所知,目前还没有研究评估DVAs对糖尿病相关问题的响应质量。本研究的目的是评估与糖尿病管理查询相关的DVAs质量。材料与方法向智能手机(苹果Siri、谷歌助手、三星Bixby)和非智能手机DVAs(亚马逊Alexa、Sulli the Diabetes Guru、谷歌Nest Mini、微软Cortana)提出74个问题,并将其回答与互联网谷歌搜索进行比较。问题被分类为糖尿病的诊断、筛查、管理、治疗和并发症,以及COVID-19对糖尿病的影响。评估了dva的技术能力、用户友好性、可靠性、全面性和准确性。数据分析采用Kruskal-Wallis和Wilcoxon秩和检验。分类内相关系数用于报告分类间信度。结果google Assistant (n = 69/74, 93.2%)、Siri和Nest Mini (n = 64/74,各占86.5%)的成功和相关回答比例最高,Cortana (n = 23/74, 31.1%)和Sulli (n = 10/74, 13.5%)的成功和相关回答比例最低。智能手机DVAs的总得分中位数(Bixby为75.3%,Google Assistant为73.3%,Siri为72.0%)与Google Search的总得分中位数相当(70.0%,p = 0.034),而非智能手机DVAs的总得分中位数(Nest Mini为56.9%,Alexa为52.9%,Cortana为52.5%,Sulli the Diabetes Guru为48.6%)显著低于前者(p < 0.001)。与谷歌搜索相比,非智能手机dva的中位数全能性(16.7%对100.0%,p < 0.001)和可靠性得分(30.8%对61.5%,p < 0.001)要低得多。结论在回答糖尿病相关问题时,google Assistant、Siri和Bixby是表现最好的DVAs。然而,Bixby缺乏成功和相关的响应可能会让用户感到沮丧,特别是当他们有与COVID-19相关的查询时。所有dva在用户友好性方面得分都很高,但在准确性、全面性和可靠性方面可以改进。鼓励DVA设计人员在开发产品时考虑与准确性、全面性、可靠性和用户友好性相关的特性,以提高用于医疗目的的DVA的质量,例如糖尿病管理。
{"title":"Quality evaluation of digital voice assistants for diabetes management","authors":"Joy Qi En Chia, L. Wong, K. Yap","doi":"10.3934/medsci.2023008","DOIUrl":"https://doi.org/10.3934/medsci.2023008","url":null,"abstract":"Background Digital voice assistants (DVAs) are increasingly used to search for health information. However, the quality of information provided by DVAs is not consistent across health conditions. From our knowledge, there have been no studies that evaluated the quality of DVAs in response to diabetes-related queries. The objective of this study was to evaluate the quality of DVAs in relation to queries on diabetes management. Materials and methods Seventy-four questions were posed to smartphone (Apple Siri, Google Assistant, Samsung Bixby) and non-smartphone DVAs (Amazon Alexa, Sulli the Diabetes Guru, Google Nest Mini, Microsoft Cortana), and their responses were compared to that of Internet Google Search. Questions were categorized under diagnosis, screening, management, treatment and complications of diabetes, and the impacts of COVID-19 on diabetes. The DVAs were evaluated on their technical ability, user-friendliness, reliability, comprehensiveness and accuracy of their responses. Data was analyzed using the Kruskal-Wallis and Wilcoxon rank-sum tests. Intraclass correlation coefficient was used to report inter-rater reliability. Results Google Assistant (n = 69/74, 93.2%), Siri and Nest Mini (n = 64/74, 86.5% each) had the highest proportions of successful and relevant responses, in contrast to Cortana (n = 23/74, 31.1%) and Sulli (n = 10/74, 13.5%), which had the lowest successful and relevant responses. Median total scores of the smartphone DVAs (Bixby 75.3%, Google Assistant 73.3%, Siri 72.0%) were comparable to that of Google Search (70.0%, p = 0.034), while median total scores of non-smartphone DVAs (Nest Mini 56.9%, Alexa 52.9%, Cortana 52.5% and Sulli the Diabetes Guru 48.6%) were significantly lower (p < 0.001). Non-smartphone DVAs had much lower median comprehensiveness (16.7% versus 100.0%, p < 0.001) and reliability scores (30.8% versus 61.5%, p < 0.001) compared to Google Search. Conclusions Google Assistant, Siri and Bixby were the best-performing DVAs for answering diabetes-related queries. However, the lack of successful and relevant responses by Bixby may frustrate users, especially if they have COVID-19 related queries. All DVAs scored highly for user-friendliness, but can be improved in terms of accuracy, comprehensiveness and reliability. DVA designers are encouraged to consider features related to accuracy, comprehensiveness, reliability and user-friendliness when developing their products, so as to enhance the quality of DVAs for medical purposes, such as diabetes management.","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","volume":"1 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84269142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correlates of sedentary behaviors in Austrian children and adolescents 奥地利儿童和青少年久坐行为的相关因素
Q4 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2023-01-01 DOI: 10.3934/medsci.2023022
Klaus Greier, Clemens Drenowatz, Carla Greier, Elisabeth Haas, Markus Posch, Gerhard Ruedl, Herbert Riechelmann

A large proportion of children and adolescents spend their leisure time with predominantly sedentary pursuits and do not reach the WHO physical activity recommendations. As there remains limited research on specific sedentary behaviors in Austrian children and adolescents, we investigated time spent sitting and the utilization of various media during school days and the weekend in 6- to 15-year-old schoolchildren. Data for this cross-sectional study were collected in Spring 2022 with a standardized questionnaire that was based on the “Heidelberger Questionnaire for the Assessment of Sitting Behavior in Children and Adolescents”. Questions examined the frequency and duration of different sedentary behaviors separately for weekdays and weekends. A total of 2061 students were included in the analyses. Various factors, including school grade, sex, or recreational behavior, were implemented in a multifactorial ANOVA accounting for 1st order interactions. The mean sitting time of children and adolescents of all eight school grades was 10.4 ± 1.7 hours, with 56.7% associated with school. A significant increase in sitting time was observed from 1st grade (10.0 ± 1.3 h) to 8th grade (12.3 ± 1.2 h; p &lt; 0.01), while sleep duration decreased with increasing age (p &lt; 0.01). Media use was 1.2 ± 0.7 h in 1st grade and increased to 3.2 ± 1.2 h by 8th grade (p &lt; 0.01). Physical activity decreased from 4.5 ± 1.4 h to 3.6 ± 1.0 h during the same period. While the increase in sitting time on weekdays was at the expense of sleep duration, the increase in sitting time on weekend days was at the expense of time spent in physical activity. In summary, there was a substantial increase in sedentary time from 1st to 8th grade, with school-related sedentary time accounting for the largest proportion, followed by a large increase in time spent with electronic media with increasing age. In addition, high sedentary time may come at the expense of sufficient sleep time, which further emphasizes the need to address sedentary behavior and sleep as important health correlates.

& lt; abstract>很大一部分儿童和青少年的闲暇时间主要是久坐不动,没有达到世卫组织的身体活动建议。由于对奥地利儿童和青少年特定久坐行为的研究仍然有限,我们调查了6至15岁学童在上学日和周末坐着的时间和各种媒体的使用情况。这项横断面研究的数据是在2022年春季通过标准化问卷收集的,该问卷基于“海德堡儿童和青少年坐着行为评估问卷”。这些问题分别调查了工作日和周末不同久坐行为的频率和持续时间。共有2061名学生被纳入分析。各种因素,包括学校年级,性别,或娱乐行为,在多因素方差分析中实现了一阶相互作用。所有8个年级的儿童和青少年的平均坐着时间为10.4±1.7小时,其中56.7%与学校有关。从1年级(10.0±1.3小时)到8年级(12.3±1.2小时),观察到静坐时间显著增加;p, lt;0.01),睡眠时间随年龄增长而减少(p <0.01)。1年级时介质使用时间为1.2±0.7 h, 8年级时增加到3.2±1.2 h (p <0.01)。在同一时期,身体活动从4.5±1.4小时减少到3.6±1.0小时。工作日久坐时间的增加是以睡眠时间为代价的,而周末久坐时间的增加是以身体活动时间为代价的。综上所述,从一年级到八年级,久坐时间大幅增加,与学校有关的久坐时间占最大比例,其次是随着年龄的增长,花在电子媒体上的时间大幅增加。此外,久坐时间过长可能会以牺牲充足的睡眠时间为代价,这进一步强调了将久坐行为和睡眠作为重要的健康相关因素来解决的必要性。& lt; / abstract>
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引用次数: 0
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AIMS Medical Science
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