• Frederick Houston posted an update 1 week, 3 days ago

    Diabetes mellitus technology (DMT) is increasingly used for routine management in developed countries, yet its uptake in developing countries is not as consistent. Multiple factors may influence this, including country specific patient perception regarding DMT. We conducted a pilot study in Pakistan to understand this important question which has not been studied yet.

    A cross-sectional pilot study was conducted in Pakistan. An anonymous survey exploring perceptions of diabetes technology was circulated on social media platforms, collecting responses over 2 weeks. Target population included adults (≥18 years) living in Pakistan, with DM1 or 2.

    A total of 40 responses were received. The majority (36/40) reported using conventional glucometers. Nine used continuous glucose monitoring (CGM). Thirty-two of 40 patients believed DMT improved diabetes care, 22 felt it helped decreased risk of Diabetes-related complications. 15/40 stated that DMT results in increased cost of care. Sixteen reported their diabetesey) and small sample size, but this data can help inform larger studies, to look at this important topic in greater detail.While forensic psychologists have some access to their patients’ thoughts when deciding on a diagnosis or appraising risk, others, such as police investigators, must rely on physical evidence and behavioral markers to make sense of a crime. Studies showing that offense-supportive cognitions constitute a risk factor for sexual offending, including offenses that take place on the internet, highlight the need for some access to offenders’ thoughts. check details This exploratory study examines the associations between offense-supportive statements about the sexual exploitation of children and adolescents and proxy behaviors. As part of PRESEL, a collaborative research project between Québec provincial police and academic researchers, the case files of 137 men convicted of using child sexual exploitation material or committing child-luring offenses were analyzed. Results showed that many meaningful risk factors and sexual offending behavioral markers were associated with the cognitive themes Sexualization of children, Child as partner, Dangerous world, Entitlement, and Uncontrollability. The use of encryption was negatively associated with the cognition Virtual is not real while Internet is uncontrollable was associated with fewer contacts with minors over the internet. Findings are useful for understanding the psychological needs that should be targeted in treatment, as well as helping prioritize police workloads.

    Healthcare workers must be protected during extubation of patients with coronavirus disease 2019 (COVID-19) owing to the presence of aerosolized droplets. Herein, we report a technique for extubating a patient with COVID-19 while minimizing aerosol dispersion.

    We retrospectively identified a total of 79 patients admitted to our hospital from February 2020 to January 2021. Six of these patients were intubated for mechanical ventilation, 2 of whom had to be extubated. We prepared a clear vinyl sheet in the shape of a tent to place over the patient, and 2 staff members, both well experienced in airway management, stood outside the tent on either side of the patient. Before extubation, we confirmed that the patient’s consciousness level was good and the patient had no distress by adjusting the dose of sedative drugs. After extubation, a surgical mask was placed on the patient’s face.

    Our experience indicates that this method of extubation in a patient with COVID-19 could be safely implemented to protect healthcare workers.

    Our experience indicates that this method of extubation in a patient with COVID-19 could be safely implemented to protect healthcare workers.

    To compare the educational value of endoscopic ear surgery versus microscopic ear surgery among medical students.

    Medical students anonymously completed a cross-sectional survey immediately after observing endoscopic or microscopic ear surgery. A Likert scale (1 = worst, 5 = best) was used to analyze variables across 3 domains including (1) area of interest visibility, (2) optical quality, (3) education and understanding. The Mann-Whitney

    -test and multivariable linear regression were used to compare mean scores of individual items and domain means between endoscopic and microscopic groups.

    Forty-four surveys were analyzed (20 endoscopic and 24 microscopic ear surgeries). Across domains, the endoscope was superior to the microscope (adjusted

     < .05) for visibility of the area of interest (mean ± SD 4.74 ± 0.26 vs 4.28 ± 0.50), optical quality (4.78 ± 0.38 vs 4.28 ± 0.64), and education and understanding (4.70 ± 0.47 vs 4.13 ± 0.61). In multivariable linear regression, the mean domain score for visibility of the area of interest was 1.23 (95% CI = 0.56, 1.90; adjusted

     < .01) points higher for the endoscopic group, compared to the microscopic group, adjusting for surgeon, procedure, and student type. The mean domain score for education and understanding was 1.19 (95% CI = 0.49. 1.90; adjusted

     < 0.01) points higher for the endoscopic group, compared to the microscopic group, adjusting for the same confounders.

    Among medical students, endoscopic ear surgery was superior to microscopic ear surgery for several visual quality indicators and perceived educational benefit. These findings have implications for medical student education and surgical training.

    Among medical students, endoscopic ear surgery was superior to microscopic ear surgery for several visual quality indicators and perceived educational benefit. These findings have implications for medical student education and surgical training.

    We investigated whether preoperative nutritional indicators predicted the prognosis for patients with early-stage non-small cell lung cancer.

    Data for stage I or stage IIA non-small cell lung cancer without lymph node metastasis patients who received anatomical lung resection and were followed-up at least five years after surgery (

    =286) were analyzed. We calculated geriatric nutritional risk index, prognostic nutritional index, controlling nutritional status score, and modified Glasgow prognostic score. Multivariate Cox proportional hazard model adjusting for age, BMI, complication, pathological stage, histology of squamous cell carcinoma, T factor, diffusing capacity for carbon monoxide, surgery and smoking status was fitted to evaluate the association between these nutritional indicators and mortality and recurrence within five years.

    After adjusted for covariates other than type of surgery and diffusing capacity for carbon monoxide, controlling nutritional status of ≥3 was significantly associated with mortality (hazard ratio (HR) = 2.