BACKGROUND: Peptic ulcer perforation (PUP) is a surgical emergency and life-threatening complication affecting 2-10% of peptic ulcer disease (PUD) patients. Delayed diagnosis and surgical management are associated with significant morbidity and mortality. This study assessed the magnitude and outcome of PUP among patients operated on at two public hospitals in Jigjig town, Ethiopia. METHODS: A 3-year hospital-based retrospective cross-sectional study was conducted on 130 patients operated for PUP at the study hospitals in Jigjig from April 1st, 2018, to July 30th, 2021. Data were collected from medical records. Bivariate analysis identified key factors impacting outcomes in PUP patients. RESULTS: The cohort had a male-to-female ratio of 8.7:1, and a mean age of 38 ± 13.3 years, with 48.8% smokers and 56.6% chat chewers. Duodenal perforations accounted for 93.7% of cases, with post-operative complications in 29.1% and an in-hospital mortality rate of 5.5%. Significant predictors of morbidity and mortality included advanced age (AOR 23.88), comorbidities (AOR 26.80), pre-operative hypotension (AOR 32.33), and delayed hospital presentation (AOR 30.10). CONCLUSIONS: Male predominance, younger age, high smoking and chat chewing rates, and primarily duodenal perforations are common in perforated peptic ulcer cases. Advanced age, comorbidities, pre-operative hypotension, and delayed hospital presentation significantly increase postoperative complications and mortality, emphasizing the need for timely intervention and targeted public health measures to improve patient outcomes. Early intervention and careful management of comorbidities are crucial to improve survival and reduce complications in patients with PUP.

• MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Hospital Mortality trends   MeSH
• Peptic Ulcer Perforation * mortality   surgery   epidemiology   MeSH
• Cross-Sectional Studies MeSH
• Retrospective Studies MeSH
• Risk Factors MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Ethiopia MeSH

Aim: Research on the health consequences of violent victimization of people with disabilities is lacking. This study aims to identify the factors that are associated with physical and mental health impacts of anti-disability bias victimization. Methods: The study drew on a unique sample of 331 self-identified people with disabilities, all over the age of 15, residing in Czechia. From this sample, 47 questionnaires were excluded. The respondents were asked about the most serious incident of anti-disability bias victimization in the last five years. A series of bivariate binary logistic regressions were performed - with the consequences of this incident as outcomes (mental health and physical health). Results: 90 respondents (32%) reported experiencing the most serious incident of bias victimization in the last five years. 60% of victims reported anxiety and sadness, and 28% deterioration in physical health. The results suggest that victims experience physical and mental health consequences unequally. Age, perceived disability in specific areas, visibility of disability, presence of multiple disabilities, and number of offenders are associated with the experience of physical health deterioration. Education, perceived disability in specific areas, and visibility of disability are associated with the experience of mental health impacts. Conclusion: Certain groups of people with disabilities who experience victimization report poorer physical and mental health outcomes. This differential experience should be considered in immediate responses and prevention programs.

• MeSH
• Mental Health statistics & numerical data   MeSH
• Emotions MeSH
• Humans MeSH
• Logistic Models MeSH
• Violence psychology   statistics & numerical data   MeSH
• Persons with Disabilities * psychology   statistics & numerical data   MeSH
• Prejudice * psychology   statistics & numerical data   MeSH
• Social Problems psychology   statistics & numerical data   MeSH
• Health statistics & numerical data   MeSH
• Self Report MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

INTRODUCTION: The provision of optimal care for older adults with complex chronic conditions (CCCs) poses significant challenges due to the interplay of multiple medical, pharmacological, functional and psychosocial factors. To address these challenges, the I-CARE4OLD project, funded by the EU-Horizon 2020 programme, developed an advanced clinical decision support tool-the iCARE tool-leveraging large longitudinal data from millions of home care and nursing home recipients across eight countries. The tool uses machine learning techniques applied to data from interRAI assessments, enriched with registry data, to predict health trajectories and evaluate pharmacological and non-pharmacological interventions. This study aims to pilot the iCARE tool and assess its feasibility, usability and impact on clinical decision-making among healthcare professionals. METHODS AND ANALYSIS: A minimum of 20 participants from each of the seven countries (Italy, Belgium, the Netherlands, Poland, Finland, Czechia and the USA) participated in the study. Participants were general practitioners, geriatricians and other medical specialists, nurses, physiotherapists and other healthcare providers involved in the care of older adults with CCC. The study design involved pre-surveys and post-surveys, tool testing with hypothetical patient cases and evaluations of predictions and treatment recommendations. Two pilot modalities-decision loop and non-decision loop-were implemented to assess the effect of the iCARE tool on clinical decisions. Descriptive statistics and bivariate and multivariate analysis will be conducted. All notes and text field data will be translated into English, and a thematic analysis will be performed. The pilot testing started in September 2024, and data collection ended in January 2025. At the time this protocol was submitted for publication, data collection was complete but data analysis had not yet begun. ETHICS AND DISSEMINATION: Ethical approvals were granted in each participating country before the start of the pilot. All participants gave informed consent to participate in the study. The results of the study will be published in peer-reviewed journals and disseminated during national and international scientific and professional conferences and meetings. Stakeholders will also be informed via the project website and social media, and through targeted methods such as webinars, factsheets and (feedback) workshops. The I-CARE4OLD consortium will strive to publish as much as possible open access, including analytical scripts. Databases will not become publicly available, but the data sets used and/or analysed as part of the project can be made available on reasonable request and with the permission of the I-CARE4OLD consortium.

• MeSH
• Chronic Disease therapy   MeSH
• Clinical Decision-Making * methods   MeSH
• Humans MeSH
• Pilot Projects MeSH
• Prognosis MeSH
• Aged MeSH
• Machine Learning * MeSH
• Decision Support Systems, Clinical * MeSH
• Check Tag
• Humans MeSH
• Aged MeSH
• Publication type
• Journal Article MeSH

Introduction: The aim of this study was to investigate health science students' perceptions of poverty and health inequality to gain insight into the perspectives of future healthcare workers. Design: A descriptive cross-sectional study. Methods: Data was collected via an online survey that was developed based on a thorough literature review. Participants were students (n = 106) from undergraduate nursing and applied kinesiology programmes. Statistical analyses were conducted with IBM SPSS Statistics 29.0. using bivariate statistical analysis. The significance level was set at p < 0.05. Results: 28.3% of students cited lack of opportunity as the main cause of poverty. There were significant differences in perception between nursing and kinesiology students (p < 0.05), particularly in relation to personal responsibility for poverty. On average, students scored 58/85, indicating a moderate yet significant awareness of social determinants of health. Conclusion: The findings illustrate how different disciplines influence perceptions of poverty and emphasise the inclusion of empathy in health education. While views on the roots of poverty vary, a common nuanced understanding points to a move towards empathic, socially conscious healthcare education. The study highlights the importance of an education system that emphasises social determinants of health and empowers students to engage with the complexities of poverty and health inequality.

• MeSH
• Data Analysis MeSH
• Poverty MeSH
• Adult MeSH
• Humans MeSH
• Cross-Sectional Studies MeSH
• Surveys and Questionnaires MeSH
• Social Determinants of Health MeSH
• Students, Nursing psychology   statistics & numerical data   MeSH
• Students, Health Occupations * psychology   statistics & numerical data   MeSH
• Health Inequities * MeSH
• Check Tag
• Adult MeSH
• Humans MeSH

PURPOSE: Child abuse and trauma are significant risk factors in the etiology of borderline personality disorder (BPD). Apart from affecting the risk of developing BPD, adverse childhood experiences seem to increase its symptoms and related disability. Self-stigma presents another common issue with equally prominent consequences for mental health. Despite being theoretically linked, the connections among childhood trauma, self-stigma, and mental health have not been explored in patients with BPD. This study aimed to provide first insights into this understudied topic. PATIENTS AND METHODS: This cross-sectional study included 283 inpatients diagnosed with BPD participating in a residential transdiagnostic psychotherapeutic program. The patients completed several measurements - the Internalized Stigma of Mental Illness Scale, the Childhood Trauma Questionnaire - Short Form, the Clinical Global Impression - Severity, the Beck Depression Inventory-II, the Beck Anxiety Inventory, the Dissociative Experiences Scale, the Sheehan Disability Scale, and a demographic questionnaire. The data was statistically analyzed using IBM SPSS and AMOS 26 programs, and bivariate correlation tests and structural equation modeling explored the hypotheses. RESULTS: Retrospectively reported childhood trauma positively correlated with current self-stigma. Both childhood trauma and self-stigma were also positively related to several indicators of general psychopathology and disability. The significance of these connections was subsequently confirmed by structural equation modeling, where self-stigma acted as a partial mediator of childhood trauma, general psychopathology, and disability. CONCLUSION: Self-stigma significantly mediates the relationship between childhood trauma and selected mental health symptoms among adult patients diagnosed with BPD. Longitudinal studies are necessary to explore the causality of the findings. Therapeutic and societal efforts to tackle childhood trauma or self-stigma might benefit from reflecting its broader psychosocial context.

• Publication type
• Journal Article MeSH

AIMS: There is increasing evidence that plaque instability in the extracranial carotid artery may lead to an increased stroke risk independently of the degree of stenosis. We aimed to determine diagnostic accuracy of vulnerable and stable plaque using noninvasive imaging modalities when compared to histology in patients with symptomatic and asymptomatic carotid atherosclerosis. METHODS AND RESULTS: Medline Ovid, Embase, Cochrane Library, and Web of Science were searched for diagnostic accuracy of noninvasive imaging modalities (CT, MRI, US) in the detection of 1) vulnerable/stable plaque, and 2) vulnerable/stable plaque characteristics, compared to histology. The quality of included studies was assessed by QUADAS-2 and univariate and bivariate random-effect meta-analyses were performed. We included 36 vulnerable and 5 stable plaque studies in the meta-analysis, and out of 211 plaque characteristics from remaining studies, we classified 169 as vulnerable and 42 as stable characteristics (28 CT, 120 MRI, 104 US characteristics). We found that MRI had high accuracy [90% (95% CI: 82-95%)] in the detection of vulnerable plaque, similar to CT [86% (95% CI: 76-92%); P > 0.05], whereas US showed less accuracy [80% (95% CI: 75-84%); P = 0.013]. CT showed high diagnostic accuracy in visualizing characteristics of vulnerable or stable plaques (89% and 90%) similar to MRI (86% and 89%; P > 0.05); however, US had lower accuracy (77%, P < 0.001 and 82%, P > 0.05). CONCLUSION: CT and MRI have a similar, high performance in detecting vulnerable carotid plaques, whereas US showed significantly less diagnostic accuracy. Moreover, MRI visualized all vulnerable plaque characteristics allowing for a better stroke risk assessment. REGISTRATION: PROSPERO ID CRD42022329690.

• MeSH
• Plaque, Atherosclerotic * diagnostic imaging   MeSH
• Risk Assessment MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Carotid Artery Diseases diagnostic imaging   MeSH
• Tomography, X-Ray Computed methods   MeSH
• Carotid Stenosis diagnostic imaging   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Meta-Analysis MeSH
• Systematic Review MeSH

Verifying the speaker of a speech fragment can be crucial in attributing a crime to a suspect. The question can be addressed given disputed and reference speech material, adopting the recommended and scientifically accepted likelihood ratio framework for reporting evidential strength in court. In forensic practice, usually, auditory and acoustic analyses are performed to carry out such a verification task considering a diversity of features, such as language competence, pronunciation, or other linguistic features. Automated speaker comparison systems can also be used alongside those manual analyses. State-of-the-art automatic speaker comparison systems are based on deep neural networks that take acoustic features as input. Additional information, though, may be obtained from linguistic analysis. In this paper, we aim to answer if, when and how modern acoustic-based systems can be complemented by an authorship technique based on frequent words, within the likelihood ratio framework. We consider three different approaches to derive a combined likelihood ratio: using a support vector machine algorithm, fitting bivariate normal distributions, and passing the score of the acoustic system as additional input to the frequent-word analysis. We apply our method to the forensically relevant dataset FRIDA and the FISHER corpus, and we explore under which conditions fusion is valuable. We evaluate our results in terms of log likelihood ratio cost (Cllr) and equal error rate (EER). We show that fusion can be beneficial, especially in the case of intercepted phone calls with noise in the background.

• MeSH
• Speech Acoustics MeSH
• Algorithms MeSH
• Humans MeSH
• Linguistics MeSH
• Likelihood Functions MeSH
• Speech MeSH
• Forensic Sciences * methods   MeSH
• Support Vector Machine MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

Background: Although several prognostic factors for survival have been identified in glioblastoma, there are numerous other potential markers (such as hemoglobin) whose role has not yet been confirmed. The aim of this study was to evaluate a wide range of potential prognostic factors, including HIF-1α and hemoglobin levels, for survival in glioblastoma. A secondary aim was to determine whether hemoglobin levels were associated with HIF-1α expression. Methods: A retrospective study of 136 patients treated for glioblastoma at our institution between 2012 and 2021 was performed. Cox univariate and multivariate analyses were carried out. Kaplan-Meier survival curves were generated. In addition, bivariate non-parametric correlation analyses were performed for key variables. Results: Median survival was 11.9 months (range: 0-119.4). According to the univariate analysis, 13 variables were significantly associated with survival: age, performance status, extent of surgery, tumor depth, tumor size, epilepsy, postoperative chemoradiotherapy, IDH mutations, CD44, HIF-1α, HIF-1β, vimentin, and PDFGR. According to the multivariate regression analysis, only four variables remained significantly associated with survival: age, extent of surgery, epilepsy, and HIF-1α expression. No significant association was observed between hemoglobin levels (low <120 g/L in females or <140 g/L in males vs. high ≥120 or ≥140 g/L) and survival or HIF-1α/HIF-1β expression. Conclusions: In this retrospective study of patients with glioblastoma, four variables-age, extent of surgery, HIF-1α expression, and epilepsy-were significant prognostic factors for survival. Hemoglobin levels were not significantly associated with survival or HIF-1α expression. Although hypoxia is a well-recognized component of the glioblastoma microenvironment, more research is needed to understand the pathogenesis of onset tumor hypoxia and treatment implication.

• Publication type
• Journal Article MeSH

INTRODUCTION: Motor vehicle collisions are a major cause of death and injury among pregnant women and their fetuses. Seat belt use compliance during pregnancy varies in different populations. We aimed to study seat belt use among pregnant women and factors affecting seat belt use during pregnancy in Al Ain City, the United Arab Emirates. METHODS: This cross-sectional analysis used the baseline data collected from pregnant women participating in the Mutaba'ah Study from May 2017 to November 2022. Data were collected using self-administered questionnaires. Variables included sociodemographic, gestation periods and seat belt-related information. All pregnant women who responded to the questions related to seat belt use were included (N=2354). RESULTS: Seat belt use before and during pregnancy was estimated at 69.7% (95% CI 67.9% to 71.6%) and 65.5% (95% CI 63.6% to 67.4%), respectively. The reasons for not using seat belts during pregnancy included being uncomfortable to wear, habitual non-use and considering them unsafe for pregnancy. Age, higher levels of education of the pregnant woman or her spouse, being employed, having a sufficient household income, lower gestational age, and using a seat belt before pregnancy were positively associated with using a seat belt during pregnancy in the bivariate analyses. Pregnant women in their third trimester had independently significant lower odds of using a seat belt compared with those in the first trimester (OR 0.42, 95% CI 0.24 to 0.76). CONCLUSIONS: The findings indicate decreased compliance with seat belt use during pregnancy and as gestation progressed. The decrease was related to several reasons, including feeling uncomfortable wearing seat belts, habitual non-use and unsafe for pregnancy, necessitating appropriate measures to increase awareness. Raising public awareness about the advantages of wearing seat belts during pregnancy and the involvement of healthcare professionals in educating pregnant women are warranted.

• MeSH
• Seat Belts * MeSH
• Accidents, Traffic prevention & control   MeSH
• Humans MeSH
• Cross-Sectional Studies MeSH
• Pregnancy MeSH
• Pregnant People * MeSH
• Check Tag
• Humans MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• United Arab Emirates MeSH

Východiska: Pandemie covidu-19 může způsobit závažné klinické projevy u zranitelné populace, jako jsou těhotné ženy. Podle Indonéské asociace porodnictví a gynekologie (POGI) dosáhl počet úmrtí matek v důsledku covidu-19 od dubna 2020 do dubna 2021 3 % a od vzniku delta varianty covidu-19 vzrostl na 9 %. Tento výzkum byl navržen tak, aby identifikoval faktory spojené s úmrtností těhotných žen s covidem-19. Materiál a metody: Jednalo se o průřezovou studii využívající sekundární data shromážděná od června 2020 do srpna 2021. Studie byla provedena v Universitas Indonesia Hospital, národní referenční nemocnici pro covid-19. Hodnotila se charakteristika pacientky, profil těhotenství, komorbidity, laboratorní výsledky, RTG vyšetření hrudníku, možnosti léčby a závažnost symptomů. Kromě toho byla provedena bivariační analýza dat pomocí SPSS. Výsledky: Ze 114 výzkumných subjektů sedm pacientek (6,1 %) zemřelo a 107 pacientek (93,9 %) přežilo. Riziko úmrtnosti významně (p < 0,05) souviselo s věkem pacientky, délkou hospitalizace, gestačním věkem, závažností covidu-19, hladinou hemoglobinu, počtem leukocytů, počtem krevních destiček, lymfocytů, hladinami D-dimerů, C-reaktivním proteinem, transaminázovými enzymy, močovinou, kreatininem, eGFR, sodíkem, draslíkem a prokalcitoninem. Kromě toho byly také prokázány významné rozdíly (p < 0,05) související s úmrtností matek v přítomnosti komorbidit (diabetes 2. typu, městnavé srdeční selhání, ischemická choroba srdeční/akutní koronární syndrom a infekce močových cest) a při užívaní steroidů a tocilizumabu. Závěr: S úmrtností těhotných žen na covid-19 jsou významně spojeny různé faktory. Tato studie může tvořit základ pro další studie s větším počtem subjektů, modifikovat hodnocení a management těhotných žen s covidem-19 a následně snížit úmrtnost těhotných žen.

Background: The covid-19 pandemic may cause severe clinical manifestations in a vulnerable population, such as pregnant women. Based on Indonesian Obstetrics and Gynecology Association (POGI), the number of maternal deaths due to covid-19 from April 2020 to April 2021 reached 3% and increased to 9% since the delta variant of covid-19 emerged. This research was expected to identify factors that are related to the mortality rate of pregnant women with covid-19. Materials and methods: This was a cross-sectional study using secondary data collected from June 2020 to August 2021. The study was conducted in Universitas Indonesia Hospital, a national covid-19 referral hospital. Patient characteristics, pregnancy profile, comorbidities, laboratory results, chest X-ray examination, treatment options, and the severity of symptoms were evaluated. In addition, bivariate data analysis was carried out using the SPSS device. Results: Out of 114 research subjects, seven patients (6.1%) died, and 107 patients (93.9%) survived. The risk of mortality was significantly (P < 0.05) related to patients’ age, duration of hospitalization, gestational age, severity rate of covid-19, the level of hemoglobin, leukocyte count, platelet count, lymphocytes, the levels of D-dimer, C-reactive protein, transaminase enzymes, urea, creatinine, eGFR, sodium, potassium, and procalcitonin. In addition, significant differences (P < 0.05) related to maternal mortality rate were also shown in the presence of comorbidities (type 2 diabetes, congestive heart failure, coronary artery disease/acute coronary syndrome, and urinary tract infection), and the use of steroids and tocilizumab. Conclusion: Various factors significantly related to the mortality rate of pregnant women with covid-19. This study may become the basis for a further study with a larger number of subjects, adjustment of assessment and management of covid-19 infected pregnant women, thus hopefully reducing the risk of mortality in pregnant women with covid-19.

• MeSH
• COVID-19 * mortality   MeSH
• Pregnancy Complications * mortality   MeSH
• Humans MeSH
• Cross-Sectional Studies MeSH
• Risk Factors MeSH
• Statistics as Topic MeSH
• Pregnancy MeSH
• Check Tag
• Humans MeSH
• Pregnancy MeSH
• Female MeSH
• Geographicals
• Indonesia MeSH