Int J Tuberc Lung Dis. 2023 Apr 1;27(4):332-334. doi: 10.5588/ijtld.22.0417.
NO ABSTRACT
PMID:37035968 | DOI:10.5588/ijtld.22.0417
Category: Nevin Manimala
Biom J. 2023 Apr 10:e2200122. doi: 10.1002/bimj.202200122. Online ahead of print.
ABSTRACT
Causal inference is widely used in various fields, such as biology, psychology, and economics, etc. In observational studies, balancing the covariates is an important step in estimating the causal effect. This study extends the one-dimensional entropy balancing method to multiple dimensions to balance the covariates. Both parametric and nonparametric methods are proposed to estimate the causal effect of multivariate continuous treatments and theoretical properties of the two estimations are provided. Furthermore, the simulation results show that the proposed method is better than other methods in various cases. Finally, the proposed method is applied to analyze the impact of the duration and frequency of smoking on medical expenditure. The results from the parametric method indicate that the frequency of smoking increases medical expenditure while the duration of smoking does not. The results from the nonparametric method indicate that there is a short-term downward trend and then a long-term upward trend as the duration and frequency of smoking increase.
PMID:37035966 | DOI:10.1002/bimj.202200122
Diabet Med. 2023 Apr 10:e15111. doi: 10.1111/dme.15111. Online ahead of print.
ABSTRACT
OBJECTIVES: To investigate whether manganese-enhanced magnetic resonance imaging can assess functional pancreatic beta-cell mass in people with type 1 diabetes mellitus.
METHODS: In a prospective case-control study, 20 people with type 1 diabetes mellitus (10 with low (≥50 pmol/L) and 10 with very low (<50 pmol/L) C-peptide concentrations) and 15 healthy volunteers underwent manganese-enhanced magnetic resonance imaging of the pancreas following an oral glucose load. Scan-rescan reproducibility was performed in 10 participants.
RESULTS: Mean pancreatic manganese uptake was 31±6 mL/100 g of tissue/min in healthy volunteers (median 32 [interquartile range 23-36] years, 6 women), falling to 23±4 and 13±5 mL/100 g of tissue/min (p≤0.002 for both) in people with type1 diabetes mellitus (52 [44-61] years, 6 women) and low or very low plasma C-peptide concentrations respectively. Pancreatic manganese uptake correlated strongly with plasma C-peptide concentrations in people with type1 diabetes mellitus (r=0.73, p<0.001) but not in healthy volunteers (r=-0.054, p=0.880). There were no statistically significant correlations between manganese uptake and age, body-mass index, or glycated haemoglobin. There was strong intra-observer (mean difference: 0.31 (limits of agreement -1.42 to 2.05) mL/100 g of tissue/min; intra-class correlation, ICC=0.99), inter-observer (-1.23 (-5.74 to 3.27) mL/100 g of tissue/min; ICC=0.85) and scan-rescan (-0.72 (-2.9 to 1.6) mL/100 g of tissue/min; ICC=0.96) agreement for pancreatic manganese uptake.
CONCLUSIONS: Manganese-enhanced magnetic resonance imaging provides a potential reproducible non-invasive measure of functional beta-cell mass in people with type 1 diabetes mellitus. This holds major promise for the investigating type 1 diabetes, monitoring disease progression and assessing novel immunomodulatory interventions.
PMID:37035965 | DOI:10.1111/dme.15111
Biom J. 2023 Apr 10:e2200135. doi: 10.1002/bimj.202200135. Online ahead of print.
ABSTRACT
Cluster-randomized trials (CRTs) involve randomizing entire groups of participants-called clusters-to treatment arms but are often comprised of a limited or fixed number of available clusters. While covariate adjustment can account for chance imbalances between treatment arms and increase statistical efficiency in individually randomized trials, analytical methods for individual-level covariate adjustment in small CRTs have received little attention to date. In this paper, we systematically investigate, through extensive simulations, the operating characteristics of propensity score weighting and multivariable regression as two individual-level covariate adjustment strategies for estimating the participant-average causal effect in small CRTs with a rare binary outcome and identify scenarios where each adjustment strategy has a relative efficiency advantage over the other to make practical recommendations. We also examine the finite-sample performance of the bias-corrected sandwich variance estimators associated with propensity score weighting and multivariable regression for quantifying the uncertainty in estimating the participant-average treatment effect. To illustrate the methods for individual-level covariate adjustment, we reanalyze a recent CRT testing a sedation protocol in 31 pediatric intensive care units.
PMID:37035941 | DOI:10.1002/bimj.202200135
Ethn Health. 2023 Apr 9:1-12. doi: 10.1080/13557858.2023.2198684. Online ahead of print.
ABSTRACT
OBJECTIVE: Osteoarthritis (OA) is a prominent musculoskeletal disorder that affects approximately 303 million people worldwide. The challenges that language barriers present to the Latina population in regard to the diagnosis and treatment of OA remain largely unknown. The objective of this study was to examine disparities in the diagnosis and treatment of arthritic conditions in English- and Spanish-speaking Latinas over 40 years of age.
DESIGN: We analyzed data from the CDC’s Behavioral Risk Screening and Surveillance System (BRFSS), combining the 2017-2020 cycles using sampling weights provided by BRFSS, adjusted for multiple cycles. Determination of English- or Spanish-speaking groups was based on the language of the survey submitted. We calculated population estimates for arthritis diagnosis, physical limitations, and mean joint pain among language groups and by age (40-64 and 65+) and determined associations via odds ratios.
RESULTS: Rates of arthritis diagnosis between groups were similar; however we found that Spanish-speaking Latinas 65+ were statistically more likely to report being limited by pain (AOR: 1.55; 95% CI: 1.14-2.09), and among both age groups Spanish-speaking Latinas reported higher pain scores than the English-speaking group (40-64 age group: Coef: 0.74, SE = 0.14, P < .001; 65 + age group: Coef: 1.05, SE = 0.2, P < .001).
CONCLUSION: Results from this study show that while there were no significant differences in rates of diagnosis, Spanish-speaking Latinas were more likely to be limited by joint pain and report higher pain scores.
PMID:37032428 | DOI:10.1080/13557858.2023.2198684
Epilepsia. 2023 Apr 9. doi: 10.1111/epi.17614. Online ahead of print.
ABSTRACT
OBJECTIVE: To investigate efficacy, tolerability and outcome of different timing of anesthesia in adult patients with status epilepticus (SE).
METHODS: Patients with anesthesia for SE from 2015-2021 at two Swiss academic medical centers were categorized as anesthetized as recommended third-line treatment, earlier (as first- or second-line), and delayed (later as third-line). Associations between timing of anesthesia and in-hospital outcomes were estimated by logistic regression.
RESULTS: 246 of 762 patients received anesthesia. 21% were anesthetized as recommended, 55% earlier, and 24% delayed. Propofol was preferably used for earlier (86% vs. 55.5% for recommended/delayed anesthesia), and midazolam for later anesthesia (17.2% vs. 15.9% for earlier anesthesia). Earlier anesthesia was statistically significantly associated with fewer infections (17% vs. 32.7%), shorter median SE duration (0.5 vs. 1.5days), and more returns to premorbid neurologic function (52.9% vs. 35.5%). Multivariable analyses revealed decreasing odds for return to premorbid function with every additional non-anesthetic antiseizure medication given prior to anesthesia (odds ratio[OR]=0.71, 95% confidence interval[CI] 0.53-0.94) independent of confounders. Subgroup analyses revealed decreased odds for return to premorbid function with increasing delay of anesthesia independent of the status epilepticus severity score (STESS1-2: OR=0.45, 95%CI 0.27-0.74; STESS>2: OR=0.53, 95%CI 0.34-0.85), especially in patients without potentially fatal etiology (OR=0.5, 95%CI 0.35-0.73), and in patients experiencing motor symptoms (OR=0.67, 95%CI 0.48-0.93).
SIGNIFICANCE: In this SE cohort, anesthetics were administered as recommended third-line therapy in only every fifth patient and earlier in every second. Increasing delay of anesthesia was associated with decreased odds for return to premorbid function, especially in patients with motor symptoms and no potentially fatal etiology.
PMID:37032415 | DOI:10.1111/epi.17614
Environ Sci Pollut Res Int. 2023 Apr 10. doi: 10.1007/s11356-023-26863-z. Online ahead of print.
NO ABSTRACT
PMID:37032408 | DOI:10.1007/s11356-023-26863-z
J Endocrinol Invest. 2023 Apr 9. doi: 10.1007/s40618-023-02078-4. Online ahead of print.
ABSTRACT
INTRODUCTION: Radiofrequency ablation (RFA) has emerged as a minimally invasive approach to single parathyroid adenoma in primary hyperparathyroidism; however, there is limited evidence on its effectiveness.
OBJECTIVE: To evaluate the effectiveness and safety of RFA to treat hyper-functioning parathyroid lesions suggestive of adenomas.
MATERIAL AND METHODS: A prospective study was conducted in consecutive patients with primary hyperparathyroidism treated with RFA for single parathyroid lesions in our reference center between November 2017 and June 2021. Pre-treatment (baseline) and follow-up analytical data were gathered on total protein-adjusted calcium, parathyroid hormone [PTH], phosphorus, and 24-h urine calcium. Effectiveness was defined as complete response (normal calcium and PTH), partial response (reduced but not normalized PTH with normal serum calcium), or disease persistence (elevated calcium and PTH). SPSS 15.0 was used for statistical analysis.
RESULTS: Four of thirty-three enrolled patients were lost to the follow-up. The final sample comprised 29 patients (22 females) with mean age of 60.93 ± 13.28 years followed up for a mean of 16.29 ± 7.23 months. Complete response was observed in 48.27%, partial response in 37.93%, and hyperparathyroidism persistence in 13.79%. Serum calcium and PTH levels were significantly lower at 1 and 2 years of post-treatment than at baseline. Adverse effects were mild, with two cases of dysphonia (self-limited in one patient) and no cases of hypocalcaemia or hypoparathyroidism.
CONCLUSION: RFA may be a safe and effective technique to treat hyper-functioning parathyroid lesions in selected patients.
PMID:37032399 | DOI:10.1007/s40618-023-02078-4
Environ Monit Assess. 2023 Apr 10;195(5):547. doi: 10.1007/s10661-023-11172-2.
ABSTRACT
Data from monitoring programs with high spatial resolution but low temporal resolution are often overlooked when assessing temporal trends, as the data structure does not permit the use of established trend analysis methods. However, the data include uniquely detailed information about geographically differentiated temporal trends driven by large-scale influences, such as climate or airborne deposition. In this study, we used geographically weighted regression models, extended with a temporal component, to evaluate linear and nonlinear trends in environmental monitoring data. To improve the results, we tested approaches for station-wise pre-processing of data and for validation of the resulting models. To illustrate the method, we used data on changes in total organic carbon (TOC) obtained in a monitoring program of around 4800 Swedish lakes observed once every 6 years between 2008 and 2021. On applying the methods developed here, we identified nonlinear changes in TOC from consistent negative trends over most of Sweden around 2010 to positive trends during later years in parts of the country.
PMID:37032385 | DOI:10.1007/s10661-023-11172-2
BMC Palliat Care. 2023 Apr 10;22(1):37. doi: 10.1186/s12904-023-01158-9.
ABSTRACT
BACKGROUND: Palliative care teams work under challenging conditions in a sensitive setting with difficult tasks. The multi-professional team can play an important role. Mindfulness and compassion-based practices are used to build resilience. Our aim was to examine (1) feasibility and acceptability, (2) satisfaction and impact, and (3) opportunities and limitations of a mindfulness course.
METHODS: An eight-week mindfulness and compassion course was delivered in a university-based specialized palliative care unit. A meditation teacher provided preparatory evening sessions and meditation exercises that could be integrated into daily activities. The scientific analysis of the course was based on a questionnaire developed for quality assessmentThe first two parts consisted of demographic, Likert-type, and free-text items. Part 3 consisted of learning objectives that were self-assessed after finishing the course (post-then). In the analysis, we used descriptive statistics, qualitative content analysis, and comparative self-assessment.
RESULTS: Twenty four employees participated. 58% of participants attended 4 or more of the 7 voluntary mindfulness days. 91% expressed moderate to high satisfaction and would recommend the palliative care program to others. Three main categories emerged in the qualitative content analysis: providing feedback on the course, personal impact, and impact on professional life. The opportunity for self-care in a professional context was highlighted. Learning gains (CSA Gain) were high (38.5-49.4%) in terms of knowledge and techniques, moderate (26.2-34.5%) in terms of implementation of learned skills, and rather low (12.7-24.6%) in terms of changes to attitude.
CONCLUSION: Our evaluation shows that the participants of a mindfulness and compassion course considered it as a feasible and welcome tool to familiarize a multi-professional palliative care team with self-care techniques.
TRIAL REGISTRATION: Internal Clinical Trial Register of the Medical Faculty, Heinrich Heine University Düsseldorf, No. 2018074763 (registered retrospectively on 30th July 2018).
PMID:37032372 | DOI:10.1186/s12904-023-01158-9