Search Results (87)

Background: Genetic insights from diverse populations are key to advancing cancer detection, treatment, and prevention. Unlike other Latin American countries, Colombia lacks a centralized registry for germline and somatic mutations in breast and ovarian cancer. This study describes the country’s first national variant registry, and the occurrence of recurrent mutations and potential founder effects in Colombia. Methods: To address this gap, we implemented the first capturing protocol using the REDCap system. In a group of 213 breast and/or ovarian cancer patients harboring genetic mutations, we collected genetic, clinical, and demographic data from 13 regional centers across Colombia. Statistical analyses assessed variant distribution and patient demographics. Results: Among 229 identified variants (105 germline, 124 somatic), most were classified as pathogenic or likely pathogenic (72.4% germline, 87% somatic). BRCA1 and BRCA2 accounted for the majority of recurrent mutations. Germline recurrent variants (seen >3 times) were recorded for BRCA1 (77.7%; 21/27) and BRCA2 (22.3%; 6/27). Similarly, recurrent somatic variants were identified for BRCA1 (82.6%; 38/46) and BRCA2 (17.4%; 8/46). Notably, four recurrent variants were previously reported as founder mutations: BRCA1 c.1674del (14.3% germline and 23.7% somatic), BRCA1 c.3331_3334del (33.3% germline and 52.6% somatic), BRCA1 c.5123C>A (52.4% germline and 23.7% somatic), and BRCA2 c.2808_2811del (50% germline and 50% somatic). Most cases originated from the Andean region, highlighting regional disparities. Conclusions: This registry offers the first overview of genetic variants in Colombian breast and ovarian cancer patients. Recurrent and region-specific mutations highlight the need for population-focused data to guide targeted screening and personalized care strategies. Full article

Background: Local audits of Helicobacter pylori (H. pylori) prescriptions and outcomes are necessary to assess guideline awareness among clinicians and treatment effectiveness. Aims: The aims were to investigate first-line prescriptions and effectiveness over a 10-year period in Ireland and evaluate the influence of the 2017 Irish consensus guidelines on these trends. Methods: Data were collected at e-CRF AEG-REDCap from the European Registry on H. pylori management (Hp-EuReg) and quality reviewed from 2013 to 2022. All treatment-naïve cases were assessed for effectiveness by modified intention-to-treat (mITT) analysis. Multivariate analysis was also performed. Results: Data from 1000 patients (mean age 50 ± 15 years; 54% female) were analyzed. Clarithromycin (C) and amoxicillin (A) triple therapy represented 88% of treatments, followed by sequential C, A, and metronidazole (M) therapy (4.3%) and triple C + M (2.7%). Bismuth quadruple therapy was prescribed in 1.7% of cases. Treatment durations of 14, 10, and 7 days accounted for 87%, 4.5%, and 8.5% of prescriptions, respectively. High-, standard-, and low-dose proton pump inhibitors (PPIs; 80 mg, 40 mg, and 20 mg omeprazole equivalent b.i.d.) were used in 86%, 0.9%, and 13% of cases, respectively. The overall eradication rate was 80%, while it was 81% for triple C + A. Good compliance and high-dose PPI were associated with higher overall mITT eradication rates (OR 4.5 and OR 1.9, respectively) and triple C + A eradication rates (OR 4.2 and OR 1.9, respectively). Overall eradication rates increased from 74% pre-2017 to 82% (p < 0.05) by the end of 2022. Similarly, the triple C + A eradication rates increased from 76% to 83% (p < 0.05). Conclusions: While first-line treatment effectiveness improved in clinical practice over time, cure rates remain below 90%. Alternative first-line strategies are required in Ireland. Full article

The stigma associated with food assistance can be a barrier to resolving food insecurity. Self-reliance expectations likely contribute to this stigma. Aim: This cross-sectional study identified factors that predict perceptions of food assistance stigma. Demographics (age, sex, race, and ethnicity) were collected, and food assistance stigma (Food Resource Acceptability) and self-reliance (Self-Reliance Scale) were measured via REDCap questionnaires from 531 online participants. The research volunteer repository, Research Match, was used for recruitment. Multiple regression was conducted to determine food assistance stigma predictors. Older age, being male, and reporting higher self-reliance significantly predicted the likelihood of stigmatizing food assistance. The social expectation of self-reliance in adulthood contributes to an assigned and anticipated stigma associated with accepting food assistance. This stigma permeates many regions, particularly the United States, and likely contributes to unresolved food insecurity despite the availability of multiple food assistance resources. Future qualitative research should be conducted among older individuals and males with high levels of self-reliance to gain a deeper understanding of how food assistance stigma could be lessened so that appropriate stigma reduction interventions could be tested among this target group. Full article

Introduction: This study aimed to better understand patient-reported human papillomavirus (HPV) vaccination rates and barriers to vaccination among transgender patients receiving care at a gender-affirming clinic in urban New York. Methods: All patients with arrived appointments at the Center for Transgender Care at Northwell Health from 1 January 2020 through 14 July 2021, aged 14 and up, were invited to participate. Participants were sent an online consent form followed by a survey that assessed HPV knowledge, personal vaccination history, and reasons for or against vaccination. Data were collected in RedCap and analyzed using descriptive and basic inferential statistics. We received 79 completed consent forms and 70 completed surveys. Results: At least 68 of the 70 participants identified as transgender or gender diverse. Only 61.4% (43/70) of participants reported ever being offered the HPV vaccine and 55.7% (39/70) reported ever receiving at least one dose. Common reasons in favor of vaccination included doctor recommendation and decreasing cancer risk. Common reasons mentioned against HPV vaccination included sexual inactivity, concern over side effects, and assumption of low-risk HPV status. Of unvaccinated participants, 58.1% (18/31) reported they were more likely to get vaccinated after completing the survey. Conclusions: The HPV vaccination rate in this study was higher than the rates seen in previous studies involving sexual and gender minority participants. Provider recommendation was found to be important in promoting vaccination. Full article

Given the critical role of fatherhood in child development and the significant challenges faced by fathers in underserved communities, there is a pressing need to better understand the specific barriers they encounter. This exploratory mixed-methods study examines the prevalence of adverse childhood experiences (ACEs) among fathers, including English, Spanish, and Creole speakers, and explores how social determinants of health exacerbate these barriers. Quantitative data were collected from June 2022–2023 using REDCap survey software. Additionally, three focus groups were conducted with 18 fathers residing in Palm Beach County (PBC), each group based on the primary language spoken at home. The focus groups were conducted in person via the Healthy Mothers Healthy Babies Coalition (HMHB) outreach team at community centers within the PBC. Stated barriers to fatherhood were thematically classified according into three main themes: (1) limited access to and knowledge of resources in the community; (2) challenges in navigating new roles, resources, and fatherhood responsibilities; and (3) important values in parenting. Over 40% of the fathers reported barriers to being involved in their child’s life. The most frequent barriers included work (35.4%) and lack of transportation distance (12.5%). Bivariate analysis using the fisher’s exact test showed a significant association between scoring greater than 4 on the ACE criteria checklist and experiencing barriers to being involved in the child’s life (p-value = 0.013). Findings from this study aim to inform the development of culturally tailored interventions that address disparities in fatherhood support, ultimately contributing to improved outcomes for both fathers and their children. Full article

Background: This study examines disparities in HIV-related healthcare access, support, and treatment adherence between rural and urban Black/African American populations in Georgia, USA, emphasizing structural, socioeconomic, and stigma-related barriers affecting health outcomes. Methods: A cross-sectional quantitative study was conducted using structured surveys administered via RedCap from August to December 2023. Participants (n = 55) were recruited through community-based HIV organizations, healthcare providers, and advocacy networks. The survey assessed demographic factors, healthcare access, adherence to treatment, support systems, and experiences with stigma. Data were analyzed using IBM SPSS Statistics, version 28.0 (IBM Corp., Armonk, NY, USA), with chi-square tests examining associations between geographic location and HIV-related outcomes. Results: Findings indicate significant disparities in HIV care access and support. Urban participants were more likely to receive family and friend support (p < 0.01), financial assistance through the Ryan White Program (p = 0.01), and timely linkage to care within one week of diagnosis (p < 0.05). Rural participants reported lower educational attainment, income levels, and limited healthcare access, contributing to poorer health outcomes. No significant differences were observed in PrEP or condom use. Conclusions: The study underscores the need for targeted interventions. Expanding telehealth, enhancing community outreach, and reducing stigma through policy reforms are critical to improving HIV-related health outcomes in rural Georgia. Full article

The Farmworker Family Health Program (FWFHP) annually supports 600 farmworkers in connectivity-challenged rural areas. Traditional paper-based data collection poses validity concerns, prompting a pilot of direct data entry using tablets and satellite internet to enhance efficiency. The purpose of this article is to describe, using the TIDier checklist, a real-time, live data-entry EMR intervention made possible by satellite internet. Utilizing a customized REDCap database, direct data entry occurred through tablets and satellite internet. Patients received a unique medical record number (MRN) at the mobile health clinic, with an interprofessional team providing care. Medication data, captured in REDCap before the mobile pharmacy visit, exhibited minimal defects at 6.9% of 319 prescriptions. To enhance data collection efficiency, strategies such as limiting free text variables and pre-selecting options were employed. Adequate infrastructure, including tablets with keyboards and barcode scanners, ensured seamless data capture. Wi-Fi extenders improved connectivity in open areas, while backup paper forms were crucial during connectivity disruptions. These practices contributed to enhanced data accuracy. Real-time data entry in connectivity-limited settings is viable. Replacing paper-based methods streamlines healthcare provision, allowing timely collection of occupational and environmental health metrics. The initiative stands as a scalable model for healthcare accessibility, addressing unique challenges in vulnerable communities. Full article

In January of 2019, the University of Iowa Stead Family Children’s Hospital (UI SFCH) formalized their Pediatric Psychosocial Oncology Program by utilizing 15 evidence-based Standards for Psychosocial Care for Children with Cancer and Families as a foundation for program development. The psychosocial oncology clinical team members identified ongoing gaps in care and a need to improve progress toward achieving these standards. Reviewing and analyzing the Pediatric Psychosocial Standard of Care Institutional Assessment Tool further highlighted the need for program development but also demonstrated the need to design institutionally specific objective measures to monitor program improvements over time. The current project focused on the creation of a program evaluation system with objective measures specific to the UI SFCH practice setting. Barriers such as staffing and cost were identified and addressed. Additionally, a REDCap^® database using a structured chart review as its foundation was initiated, which permitted the comprehensive evaluation of the standards of care at UI SFCH. The Matrix and Guidelines included in the Pediatric Psychosocial Standard of Care Institutional Assessment Tool comprised the framework to develop institution specific objective measurements for each standard of care. The objective measures of interest were social work assessments and provider biopsychosocial assessments. Data were exported and uploaded to a statistical program for data analysis. The statistical significance of percentage changes was evaluated with a one-tailed t-test; p values < 0.05 were considered significant. The development of this REDCap^® database project allowed for the evaluation of the program’s current efficiency in implementing the PSCPCC standards of care. Using the database in the future will allow psychosocial oncology team members to easily identify other areas for improvement and to ensure that all 15 standards of psychosocial care are being comprehensively addressed in the care of pediatric oncology patients and interactions with their families. Full article

Background: Falls in hospitalized patients cause injuries of varying severity and even death. There is a link between falls and low blood sodium levels in older patients. Identifying and treating hyponatremia could help prevent falls and reduce hospital stays. The purpose of this study was to evaluate the effectiveness of the correction of hyponatremia on reducing the incidence of falls and the mean stay of hospitalized patients aged more than 65 years. Methods: A crossover ecological clinical trial was conducted in adult hospitalization units of a hospital in Madrid (Spain) over 12 months. Patients meeting inclusion criteria were divided into two randomized groups. The intervention was applied in two six-month phases, alternating between groups with a 15-day washout period. Early diagnosis and treatment of hyponatremia were implemented in the intervention group, while the control group received standard care. Primary outcomes included fall incidence and length of hospital stay. Data were collected using REDCap and analyzed with SPSS v.21. Statistical significance was set at p < 0.05 (ClinicalTrials identifier of the manuscript: NCT03265691). Results: A total of 1925 patients were included (408 intervention, 1517 control). Fall incidence was significantly lower in the intervention group (6.7 vs. 9.8, p = 0.000). Hyponatremia was corrected in 72% of cases. No significant differences were found in functional scores. The intervention effectively reduced falls compared to standard care. Conclusions: Early hyponatremia treatment reduces falls and hospital stay in older patients, supporting its inclusion in fall prevention strategies. Full article

Background: Evaluating associations between fear of COVID-19 and psychopathology in clinical samples can yield valuable insights for the formulation of public health policies and for the training of mental health professionals in future major health crises. The objectives of our study were to evaluate the following aspects among patients diagnosed with insomnia disorder during the most critical period of the COVID-19 pandemic in Brazil: (a) the frequency of symptoms of depression and anxiety, fear of COVID-19, and severity of insomnia; (b) possible gender differences in the variables analyzed; and (c) associations between fear of COVID-19, symptoms of depression and anxiety, severity of insomnia, and sociodemographic variables. Method: A total of 353 individuals who sought treatment at a psychiatric hospital in the Brazilian public health system and were diagnosed with insomnia disorder (DSM-5) participated. The following instruments were used: the Hospital Depression and Anxiety Scale, Insomnia Severity Index, Fear of COVID-19 Scale, and a sociodemographic questionnaire. The assessments were carried out via the REDCap platform between March and July 2021. Results: Mild to moderate levels of fear of COVID-19 were identified in the majority of participants. Symptoms of depression, anxiety, and insomnia were reported at a moderate level. Although all scores were higher among women, only the fear of COVID-19 reached significant differences between groups. Fear of COVID-19 was positively correlated with symptoms of depression and anxiety and with the severity of insomnia. Anxiety scores had a positive and statistically significant effect on insomnia severity and on fear of COVID-19. Being a man and performing physical activity had a negative and statistically significant effect on fear of COVID-19. Conclusions: Being a woman, being sedentary, and having symptoms of anxiety were predictors of fear of COVID-19 among participants with insomnia disorder. This finding highlights the importance of gender-sensitive public health policies for the care of patients with insomnia during future major health crises. The associations between anxiety symptoms and fear of COVID-19 and the severity of insomnia verified in our study suggest the relevance of addressing anxiety symptoms through encouraging physical activity to mitigate the severity of insomnia and fear of pathogens in patients with insomnia. Full article

To conduct a multi-institutional international survey to determine the clinical utility and applicability of nephrometry scoring systems in contemporary clinical practice. Methods: A cross-sectional anonymous 15-item online survey was conducted on REDCap between January 2023 and May 2023. Survey invitations were sent via email within Australia and internationally to urologists who are either members of the Urological Society of Australia and New Zealand (USANZ) or the Urological Association of Asia (UAA) or who have direct professional relationships with their members. The survey underwent a trial run on REDCap with several urologists at our institution to test the technical functionality and comprehension prior to dissemination. Results: First, 158 responses were collected and analysed. Just over half (51%) responded that they use a nephrometry system in clinical practice, and the RENAL nephrometry scoring system is the most commonly used. Amongst respondents who use a nephrometry scoring system, 63% stated that it helps with counselling patients and 54% stated it serves as a decision-making tool on whether to perform a partial or radical nephrectomy. Furthermore, 54% use a nephrometry scoring system in surgical planning meetings, and 67% believe that it is helpful for research purposes. Common concerns included that they are too time-consuming to complete, they are unhelpful for treatment decision-making and they are only useful for research purposes. Conclusions: Nephrometry scoring systems are utilised by roughly one in two urologists in contemporary clinical practice. Further qualitative studies are required to better ascertain perspectives towards them and enhance their clinical applicability. Full article

The aim of this study was to assess the association between the use of and trust in sources of information, knowledge about human papillomavirus (HPV) and vaccines against it, perceived lack of information, and the decision to receive the HPV vaccine in undergraduate students in Belgrade. The sample of this cross-sectional study included students aged 18 to 27 who received the second dose of the HPV vaccine or used other services of the general medicine department at the Institute for Students’ Health of Belgrade during the period June–July 2024. The research instrument was a questionnaire consisting of socio-demographic data, information environment (sources of information, trust in sources of information, as well as questions related to perceived lack of information), knowledge about HPV and HPV vaccines, and vaccination status. Participants filled out an online questionnaire created on the RedCap platform of the Faculty of Medicine, University of Belgrade, which they accessed via a QR code. Hierarchical logistic regression was used to assess the association between vaccine status and socio-demographic characteristics, use and trust in information sources, knowledge, and perceived lack of information. Of the 603 participants who filled out the questionnaire completely, 78.6% were vaccinated against HPV. Key factors associated with vaccine uptake were female gender (OR = 2.33, p < 0.05), use of scientific literature (OR = 1.40, p < 0.05) and family as a source of information (OR = 1.37, p < 0.01), less frequent use of regional TV channels (OR = 0.76, p < 0.05), higher level of knowledge (OR = 1.43, p < 0.01), and lower perceived lack of information (OR = 0.50, p < 0.01). These variables explained 41% of variability in vaccine uptake in the multivariate hierarchical logistic regression model. Exposure to and trust in sources of information were significantly associated with knowledge about HPV and HPV vaccination, as well as with the perceived lack of information regarding HPV vaccination, and were the most significant determinants of the decision to accept HPV vaccine in the student population. Full article

RedCap technology is set to become a critical component in the growth of the Internet of Things (IoT), enabling sensors and wearable devices for medical, industrial, and commercial applications. However, because RedCap primarily operates in non-public networks and does not synchronize its time-division duplexing (TDD) mode with 5G NR networks, interference risks arise. This is particularly concerning as traditional 5G NR networks prioritize downlink communication, whereas RedCap is designed for uplink. This study investigates the potential interference between RedCap non-public networks and 5G NR in TDD FR1 and FR2 frequency bands using Monte Carlo simulation techniques. The results illustrate how RedCap deployments may impact 5G NR performance in urban and suburban environments. Key insights are provided to inform strategies for minimizing interference and ensuring coexistence between these technologies. Full article

Smart Cities leverage large networks of wirelessly connected nodes embedded with sensors and/or actuators. Cellular IoT, such as NB-IoT and 5G RedCap, is often preferred for these applications thanks to its long range, extensive coverage, and good quality of service. In these networks, wireless communication dominates power consumption, motivating research on energy-efficient yet resilient and robust wireless systems. Many IoT use cases require low latency but cannot afford high-power radios continuously operating to accomplish this. In these cases, wake-up receivers (WURs) are a promising solution: while the high-power main radio (MR) is turned off/idle, a lightweight WUR is continuously monitoring the RF channel; when it detects a wake-up sequence, the WUR will turn on the MR for subsequent communications. This article provides an overview of WUR hardware design considerations and challenges for 4G and 5G cellular IoT, summarizes the recent 3GPP activities to standardize NB-IoT and 5G wake-up signals, and presents a state-of-the-art WUR chip. Full article