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Abstract Background We evaluated the frequency of genomic testing and treatment patterns by age category in patients with newly diagnosed (ND) acute myeloid leukemia (AML) treated in both academic‐ and community‐based health systems within a single Midwestern State. Methods Retrospective analysis of data from the Indiana University Health System Enterprise Data Warehouse and two local cancer registries, of 629 patients aged ≥18 years with ND AML during 2011–2018. Primary outcome variables were, proportion of patients with genomic analysis and frequency of mutations. Chemotherapy was categorized as “standard induction” or “other chemotherapy”/targeted therapy, and hypomethylating agents. Results Overall, 13% of ND AML patients between 2011 and 2018 had evidence of a genomic sequencing report with a demonstrated increase to 37% since 2016. Genomic testing was more likely performed in patients: aged ≤60 years than >60 years (45% vs. 30%; p = 0.03), treated in academic versus community hospitals (44% vs. 26%; p = 0.01), and in chemotherapy recipients than non‐therapy recipients (46% vs. 19%; p

Background: Machine learning (ML) techniques improve disease prediction by identifying the most relevant features in multidimensional data. We compared the accuracy of ML algorithms for predicting incident diabetic kidney disease (DKD). Methods: We utilized longitudinal data from 1365 Chinese, Malay, and Indian participants aged 40–80 y with diabetes but free of DKD who participated in the baseline and 6-year follow-up visit of the Singapore Epidemiology of Eye Diseases Study (2004–2017). Incident DKD (11.9%) was defined as an estimated glomerular filtration rate (eGFR)

Objective: This study on the prevalence of diabetic nephropathy (DN) and coexistence of non-diabetic renal disease (NDRD) in a cohort of 255 non-insulin-dependent diabetes mellitus (NIDDM) patients aims to determine the value of performing renal biopsies in these patients and elucidate the factors which could affect their progression to end-stage renal disease (ESRD). Methods: Among 255 NIDDM patients, 93 had DN alone, 69 had NDRD alone, and the remaining 93 had DN plus NDRD (mixed group). The indications for renal biopsy were based on clinical suspicion of superimposed NDRD, including heavy or rapidly increasing proteinuria, renal impairment even though diabetes is of relatively short duration, rapidly declining renal function, and presence of hematuria with dysmorphic red blood cells suggesting presence of glomerulonephritis. Results: The following were predictors of ESRD: high systolic BP at biopsy, longer duration of diabetes, heavy proteinuria, and presence of diabetic retinopathy. Comparing patients in the NDRD group with the DN group and the mixed group, the NDRD group had lower serum creatinine and higher eGFR with lower urinary proteinuria and higher serum albumin at presentation and on follow-up. Kimmelstiel-Wilson nodules were associated with a poorer prognosis leading to a higher occurrence of ESRD among patients with DN. Conclusion: Renal biopsy is of value in indicating the prognosis of NIDDM patients with DN based on the diabetic lesions. For NIDDM patients with atypical course and suspicion of associated NDRD, a renal biopsy would enable us to diagnose the underlying NDRD and offer appropriate therapy. Most nephrologists would consider renal biopsy for an NIDDM patient based on clinical indications like atypical clinical course and suspicion of an associated NDRD, but they would not perform a routine renal biopsy like for a CKD patient, unless it is for a research indication.

Play allows young children to acquire and practice mathematics skills and concepts while engaging in meaningful and enjoyable activities (Bobis, 2010; Reed & Young, 2018). In particular, open-ended play provides children opportunities to discover materials, explore concepts, and solve problems (Rosli & Lin, 2018) and in the process, develop confidence and positive attitudes toward mathematics (Chen et al., 2017; Trawick-Smith et al., 2016). Despite the opportunities for mathematics learning during play, the author's observations as a preservice teacher in preschools did not typically include such opportunities. This article describes how an open-ended activity such as sand play affords young children an openness to construct, experiment, and explore mathematical concepts (Montessori, 2013; Olowe et al., 2020). The article will show that children acquire and practice mathematics skills, like counting and measurement, when they compare the heights of their sandcastles or count the number of scoops of sand they need to fill a bucket (Lee, 2012; Olowe et al., 2020).

Background: We evaluated the frequency of genomic testing and treatment patterns by age category in patients with newly diagnosed (ND) acute myeloid leukemia (AML) treated in both academic‐ and community‐based health systems within a single Midwestern State. Methods: Retrospective analysis of data from the Indiana University Health System Enterprise Data Warehouse and two local cancer registries, of 629 patients aged ≥18 years with ND AML during 2011–2018. Primary outcome variables were, proportion of patients with genomic analysis and frequency of mutations. Chemotherapy was categorized as "standard induction" or "other chemotherapy"/targeted therapy, and hypomethylating agents. Results: Overall, 13% of ND AML patients between 2011 and 2018 had evidence of a genomic sequencing report with a demonstrated increase to 37% since 2016. Genomic testing was more likely performed in patients: aged ≤60 years than >60 years (45% vs. 30%; p = 0.03), treated in academic versus community hospitals (44% vs. 26%; p = 0.01), and in chemotherapy recipients than non‐therapy recipients (46% vs. 19%; p < 0.001). Most common mutations were ASXL1, NPM1, and FLT3. Patients ≥75 years had highest proportion (46%) of multiple (≥3) mutations. Overall, 31.2% of patients with AML did not receive any therapy for their disease. This subgroup was older than chemotherapy recipients (mean age: 71.4 vs. 55.7 years, p < 0.001), and was highest (66.2%) in patients ≥75 years. Conclusions: Our results highlight the unmet medical need to increase access to genomic testing to afford treatment options, particularly to older AML patients in the real‐world setting, in this new era of targeted therapies. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives: To compare the relation of quality of life to occupational coping and verify the association of these indicators with sociodemographic variables of tenured and outsourced nurses. Methods: Cross-sectional study, carried out from June to November 2014, with 145 outsourced nurses and 45 tenured nurses. We applied an identification instrument (WHOQOL-bref) and Occupational Coping Scale. Student’s t-tests and Pearson’s correlation coefficient were used. Results: Tenured nurses had better quality of life (p=0.011) and a mean in the Avoidance factor with a strong correlation (p=0.001). Female public servants (p=0.006; p

Este trabajo da cuenta de la construcción de un cuestionario para determinar las representaciones de conceptos y procesos físicos en estudiantes de bachillerato. La elaboración del instrumento pasó por diferentes etapas de revisión y aplicación entre grupos de alumnos y expertos en Física. La versión final se aplicó a una muestra de 120 alumnos de 6o. año de bachillerato del Colegio de Ciencias y Humanidades de la UNAM. El instrumento transitó por diversos criterios de validez (pertinencia, inteligibilidad, completitud y estructura equivalente) y pruebas de confiabilidad (Alfa de Cronbach y Modelo de Crédito Parcial de Rasch), de tal manera que se obtuvo un instrumento confiable para caracterizar diversos tipos de representaciones externas, como son las respuestas escritas, los esquemas, las gráficas y los dibujos. Los resultados muestran que este tipo de cuestionarios puede contribuir a los nuevos enfoques en enseñanza de las ciencias centrados en las construcciones representacionales y en la dinámica de cambio del pensamiento de los estudiantes.

Objective: this study aimed to evaluate the hand hygiene routine of companions in inpatient units. Methods: it was an observational study with 50 companions, aged over 18 years and with clear language. A questionnaire and observation of hand hygiene moments were used. For analysis, descriptive statistics was applied. Results: the use of liquid soap (p=0.939), alcohol-based hand gel (p=0.939), collective use towel (p=0.939), disposable towels (p=0.939), higher frequency after going to the bathroom (p

Abstract Objectives: To report a methodological experience of learning-based on problems in the discipline of Thanatology. Method: Experience report of professors of the baccalaureate degree in nursing using problem situations influenced by the methodology of questioning and problem-based learning. Results: The elaboration of three problem situations broadened the development of the formative process in Thanatology, favored reflections during the program of the discipline and approached the theory of real situations experienced by the students. Conclusions and implications for practice: This methodology was assessed as a viable and low-cost strategy in promoting empowerment on issues of death and dying. In addition, students self-assessed as reflective agents and builders of their own personal and professional growth.

Summary: Background: Artificial Intelligence (AI) has been used to automate detection of retinal diseases from retinal images with great success, in particular for screening for diabetic retinopathy, a major complication of diabetes. Since persons with diabetes routinely receive retinal imaging to evaluate their diabetic retinopathy status, AI-based retinal imaging may have potential to be used as an opportunistic comprehensive screening for multiple systemic micro- and macro-vascular complications of diabetes. Methods: We conducted a qualitative systematic review on published literature using AI on retina images to detect systemic diabetes complications. We searched three main databases: PubMed, Google Scholar, and Web of Science (January 1, 2000, to October 1, 2024). Research that used AI to evaluate the associations between retinal images and diabetes-associated complications, or research involving diabetes patients with retinal imaging and AI systems were included. Our primary focus was on articles related to AI, retinal images, and diabetes-associated complications. We evaluated each study for the robustness of the studies by development of the AI algorithm, size and quality of the training dataset, internal validation and external testing, and the performance. Quality assessments were employed to ensure the inclusion of high-quality studies, and data extraction was conducted systematically to gather pertinent information for analysis. This study has been registered on PROSPERO under the registration ID CRD42023493512. Findings: From a total of 337 abstracts, 38 studies were included. These studies covered a range of topics related to prediction of diabetes from pre-diabetes or non-diabeticindividuals (n = 4), diabetes related systemic risk factors (n = 10), detection of microvascular complications (n = 8) and detection of macrovascular complications (n = 17). Most studies (n = 32) utilized color fundus photographs (CFP) as retinal image modality, while others employed optical coherence tomography (OCT) (n = 6). The performance of the AI systems varied, with an AUC ranging from 0.676 to 0.971 in prediction or identification of different complications. Study designs included cross-sectional and cohort studies with sample sizes ranging from 100 to over 100,000 participants. Risk of bias was evaluated by using the Newcastle–Ottawa Scale and AXIS, with most studies scoring as low to moderate risk. Interpretation: Our review highlights the potential for the use of AI algorithms applied to retina images, particularly CFP, to screen, predict, or diagnose the various microvascular and macrovascular complications of diabetes. However, we identified few studies with longitudinal data and a paucity of randomized control trials, reflecting a gap between the development of AI algorithms and real-world implementation and translational studies. Funding: Dr. Gavin Siew Wei TAN is supported by: 1. DYNAMO: Diabetes studY on Nephropathy And other Microvascular cOmplications II supported by National Medical Research Council (MOH-001327-03): data collection, analysis, trial design 2. Prognositc significance of novel multimodal imaging markers for diabetic retinopathy: towards improving the staging for diabetic retinopathy supported by NMRC Clinician Scientist Award (CSA)–Investigator (INV) (MOH-001047-00).

Este artigo tem como objetivo relatar as vivências e práticas durante a realização da especialização em ativação de processos de mudanças na formação superior de profissionais de saúde. É um estudo descritivo caracterizado como artigo de atualização a partir do relato que descreve a trajetória de profissionais de saúde egressos do curso ofertado pela Escola Nacional de Saúde pública Sergio Arouca, que tem como finalidade a busca reflexiva e atual pela reorganização do processo ensino-aprendizagem pela competência nas áreas político- gerencial, educacional e cuidado à saúde com ênfase na integralidade. Foi realizado no período de 15/01/2013 a 28/02/2014 na cidade de Fortaleza no Ceará. É perceptível que a formação profissional ainda encontra-se fragmentada e tecnicista, porém conseguimos observar a possibilidade real de melhorias nos processos de ensino-aprendizagem vindo a corroborar para a construção da formação de profissionais mais críticos, reflexivos e com práticas integrativas e éticas.

ABSTRACT Objectives: to analyze hand hygiene determinants of informal caregivers in a hospital environment. Methods: qualitative study conducted with 55 caregivers at a university hospital in the Northeast of Brazil. A semi-structured instrument was used, adapted from Nola Pender's Health Promotion Model, from which the deductive categories were derived. Results: the general behavior included hand hygiene before meals and after using the bathroom. Sensitivity to the requirements for hand hygiene was observed, but the barriers and self-efficacy consisted of the availability of soap or alcohol-based hand sanitizers, the lack of knowledge on the importance of and forgetfulness of the practice. The reinforcement on the importance of the practice and being in a contaminated environment were influencers, and commitment, warnings, and training were indispensable. Conclusions: benefits related to protection from infections were seen as positive determinants for hand hygiene adherence. For non-adherence, factors such as lack of sanitizing supplies, ignorance towards the importance of the activity, and forgetfulness stood out.