Category: Statistics

Psychol Trauma. 2024 Nov;16(8):1294-1300. doi: 10.1037/tra0001495. Epub 2023 Apr 24.

ABSTRACT

OBJECTIVE: Research on how different types of trauma affect depression and posttraumatic stress disorder (PTSD) symptoms in veterans has yielded inconsistent results. Shame, a painful and negative self-evaluative emotion observed in PTSD and across interpersonal traumas, may help explain past findings. The present study explored (a) how trauma types (childhood abuse, combat exposure, and military sexual trauma [MST]) may be associated with depression and PTSD severity and (b) how shame may be associated with trauma type, PTSD symptoms, and depression symptoms in a treatment-seeking veteran sample.

METHOD: Veterans (N = 372) completed self-report questionnaires assessing trauma exposure, PTSD symptoms, depression symptoms, and shame upon admission to treatment programs across two Veterans Affairs Medical Centers.

RESULTS: We found that veterans with combat exposure or MST had greater depression and PTSD symptoms than those without these trauma experiences. Among veterans without a history of combat exposure and MST, a history of childhood abuse was associated with depression symptoms. Among veterans who did not experience combat but did experience MST, a history of childhood abuse was not associated with depression symptoms. We found that characterological shame (i.e., shame about oneself) partially mediated MST status and PTSD symptoms and fully mediated MST status and depression symptoms.

CONCLUSIONS: These results suggest that different trauma exposures can have complex effects on clinical presentations and that shame may be a mechanism of PTSD and depression severity in veterans with MST. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:39480286 | DOI:10.1037/tra0001495

Minerva Anestesiol. 2024 Oct 31. doi: 10.23736/S0375-9393.24.18126-6. Online ahead of print.

ABSTRACT

BACKGROUND: Following surgical procedures, over 80% of patients experience acute pain, with half of them expressing dissatisfaction with pain relief. The modern approach to surgical treatment and pain management increasingly relies on implementing multimodal analgesia, which includes the use of adjuvants in addition to long-acting local anesthetics (such as ropivacaine). This double-blind randomized study evaluated the analgesic effect of magnesium sulfate added to ropivacaine in the sciatic nerve block at the popliteal level for bunion correction surgery.

METHODS: In this double-blind study, fifty patients were enrolled and randomized in a 1:1 ratio to receive ropivacaine and MgSO<inf>4</inf> 200 mg or ropivacaine and physiological solution. The primary endpoint was the duration of sensory block.

RESULTS: A statistically significant difference was observed in the onset time for sensory block (9.2 minutes vs. 21.8 minutes, P<0.001) and its duration (18.2 hours vs. 13.9 hours, P<0.001) between the two groups. Between 12 and 24 hours postoperatively, the maximum NRS pain scores in the magnesium group were lower than those in the control group (IQR [range]) 2 (2-3.8 [0-6.5]) vs. 6.7 (5.6-7.9 [2.7-9.2], P<0.001). The need for additional opioids after 12-24 hours was significantly higher in patients in the physiological solution group compared to those in the magnesium group.

CONCLUSIONS: Our results suggest that magnesium added to the local anesthetic extends sensory block duration, reduces postoperative pain, improves the quality of analgesia, decreases the need for additional opioids. Further studies are needed to confirm these preliminary findings.

PMID:39480231 | DOI:10.23736/S0375-9393.24.18126-6

Int Ophthalmol Clin. 2024 Oct 1;64(4):75-82. doi: 10.1097/IIO.0000000000000537. Epub 2024 Oct 29.

ABSTRACT

OBJECTIVE: The initiative 2030 In Sight and the International Agency for the Prevention of Blindness have developed a plan to mitigate the global burden of preventable sight loss. One priority of this initiative is obtaining population eye health data. East Africa is a region that has historically been plagued by high rates of vision loss, and it is imperative to understand what causes are at play. Two large cross-sectional studies were previously published in 1995 and 2009, reporting the causes of childhood blindness (BL) and severe visual impairment (SVI) in East Africa. An update regarding more recent causes is warranted to better understand the trends of childhood BL/SVI in this region.

METHODS: A search strategy was developed a priori to identify relevant terms and align them with a standardized definition of East Africa. This strategy was then employed across PubMed, Google Scholar, and Scopus, with the yield of the overall search depicted in a Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 flow diagram. In the articles gathered by the search, causes of BL/SVI were typically categorized by anatomy and etiology.

RESULTS: Eight articles met the criteria, with data from 6 countries, consisting of 534 cases of childhood BL/SVI. Common anatomic locations identified included the cornea, lens, and whole globe. Among the most common etiologies were corneal scarring/opacity and cataract. Systemic etiologies and disease associations included measles, toxoplasmosis, and prematurity. Presumptive infectious disease and hereditary conditions were also identified as a category, but specific identification of etiologies and genetic diagnosis was largely unavailable.

CONCLUSIONS: BL/SVI due to the cornea was among the common anatomic sites of disease in our study. The identification of measles as an associated systemic etiology requires further understanding in the context of increased vaccination programs. Multiple articles acknowledged that cataract has become the predominant cause of BL/SVI owing to increased measles vaccination and vitamin A supplementation. Additional research should be conducted to gain a complete understanding of childhood BL/SVI in East Africa, and responses at regional and national levels are likely necessary to address treatable causes of vision impairment.

PMID:39480211 | DOI:10.1097/IIO.0000000000000537

Anal Methods. 2024 Oct 30. doi: 10.1039/d4ay01685h. Online ahead of print.

ABSTRACT

Glycosphingolipids are glycolipid complexes formed by an oligosaccharide chain covalently linked to a ceramide backbone and play important roles in the occurrence and metastasis of lung cancer. In this study, an UHPLC-HRMS method was developed for the comprehensive profiling of glycosphingolipids, with an in-house library constructed for data interpretation. Serum glycosphingolipids were profiled in 31 healthy controls (HCs) and 92 lung cancer patients with different pathologic subtypes. Over 1700 glycosphingolipids were detected in human serum based on the novel method. A total of 567 differential glycosphingolipids (adjusted P < 0.05, and fold change > 2) were found between lung cancer patients and HCs. Glycosphingolipids can be used as potential biomarkers for lung cancer diagnosis, with sensitivity much higher than that of traditional serum tumor markers. The levels of most glycosphingolipids in squamous cell carcinoma (Squa) were significantly lower than those in small cell lung cancer (SCLC) and adenocarcinoma (Aden). The highest Cer1P abundance in SCLC patients among the three different subtypes of lung cancer was thought to be related to the high malignancy and metastasis of SCLC. An artificial neural network (ANN) model was constructed for the discrimination of the three different subtypes of lung cancer, with accuracy higher than 93%. Beyond providing biomarkers and statistical models for the diagnosis of lung cancer and discrimination of lung cancer subtypes, this study uncovered the variation of glycosphingolipid networks in different subtypes of lung cancer and thereby provided a novel insight to study the pathogenesis of lung cancer and explore therapeutic targets.

PMID:39479885 | DOI:10.1039/d4ay01685h

Eur J Psychotraumatol. 2024;15(1):2416834. doi: 10.1080/20008066.2024.2416834. Epub 2024 Oct 31.

ABSTRACT

Background: Prevalence rates for posttraumatic stress symptoms (PTSS) in unaccompanied young refugees (UYRs) are high. Research with biological parents indicates low agreement rates between self and caregiver reports for PTSS, although caregivers play an important role as gatekeepers to ensure appropriate treatment.Objective: This study examines youth and caregiver agreement on the endorsement of different trauma types, the PTSS severity score and symptom clusters, as well as the potential association between youth factors (age, comorbidity, and duration in facility) and disagreement.Method: The sample consisted of N = 610 UYRs, aged M = 16.75 (SD = 1.33, range: 12-20) years. Of these, 91.0% were male, and 43.4% were from Afghanistan, currently residing in German children and youth welfare facilities.Results: Agreement rates across trauma types were poor (accidental trauma: Cohen’s k = .13; community violence: Cohen’s k = .07; domestic violence: Cohen’s k = .19; sexual abuse: Cohen’s k = .38). Agreement rates for the PTSS severity score (ICC = .22) and symptom clusters were poor (re-experiencing: ICC = .27; avoidance: ICC = .02; negative alterations in cognitions and mood ICC = .12; hyperarousal: ICC = .25), with youth reporting significantly higher scores. Regression models showed that having comorbid symptoms and a shorter duration in the facility were associated with higher disagreement at the PTSS severity score (Adjusted –R² = .21) and across symptom clusters (re-experiencing: Adjusted –R² = .13; avoidance: Adjusted –R² = .07; negative alterations in cognitions and mood: Adjusted –R² = .16; hyperarousal: Adjusted- R² = .16). Age was not significantly associated with disagreement rates.Conclusion: It is important to enhance the awareness and comprehension of caregivers regarding recognition of mental illnesses and their symptoms as well as assessing mental health among UYRs.

PMID:39479874 | DOI:10.1080/20008066.2024.2416834

Haematologica. 2024 Oct 31. doi: 10.3324/haematol.2024.285828. Online ahead of print.

ABSTRACT

This study assessed the comparative efficacy of lisocabtagene maraleucel (liso-cel) in PILOT (NCT03483103), an open-label, phase II study, versus conventional second-line (2L) chemotherapy regimens in the real world administered to patients with relapsed or refractory (R/R) large B-cell lymphoma (LBCL) who were not intended for hematopoietic stem cell transplantation (HSCT). The liso-cel-treated cohort (n=61) was based on patients who received liso-cel in the PILOT study. The conventional chemotherapy cohort included patients who met PILOT eligibility criteria and received conventional 2L chemotherapy in the real-world clinical setting (n=273). After using the trimmed stabilized inverse probability of treatment weighting method to balance cohorts according to baseline characteristics, there were statistically significant differences in all tested measures of efficacy. Compared with real-world conventional chemotherapy regimens, liso-cel demonstrated higher overall response rates (79.6% with liso-cel vs. 50.5% with conventional chemotherapy; relative risk [RR], 1.6; P.

PMID:39479862 | DOI:10.3324/haematol.2024.285828

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Oct;32(5):1594-1600. doi: 10.19746/j.cnki.issn.1009-2137.2024.05.045.

ABSTRACT

OBJECTIVE: To investigate the clinical characteristics of patients with hemophagocytic lymphohistiocytosis (HLH) and quantify the diagnostic value of various indexes in patients with elevated soluble interleukin-2 receptor (sCD25), so as to construct a diagnostic prediction model of HLH.

METHODS: The clinical characteristics of 121 patients with elevated sCD25 (≥2 400 U/ml) in the Third Affiliated Hospital of Sun Yat-Sen University were analyzed retrospectively. The patients were divided into HLH group and non-HLH group according to the diagnostic criteria of HLH. The patients with HLH were divided into infection group, tumor group, macrophage activation syndrome (MAS) group and unknown etiology group according to their etiology. The basic data and treatment of the patients were collected for univariate and multivariate logistic analysis to establish a diagnostic prediction model of HLH.

RESULTS: Among the 121 enrolled patients with elevated sCD25, 68 were diagnosed as HLH. The proportion of patients using vasopressors, the incidence rate of disseminated intravascular coagulation (DIC), and the HScore in the HLH group were higher than those in the non-HLH group (P < 0.05). Hepatomegaly, splenomegaly, and hemophagocytosis were more common in HLH patients(P < 0.05). Compared with the patients in non-HLH group, patients in HLH group had lower levels of neutrophils, platelets, fibrinogen, IgG, and IgM, while the levels of triglycerides, ferritin (FER), sCD25, serum glutamic oxaloacetic transaminase (SGOT), alkaline phosphatase (ALP), total bilirubin (TBil), lactate dehydrogenase (LDH), and D-dimer were higher (P < 0.05). In subgroup analysis, the level of sCD25 in tumor group was higher than that in infection group. The level of sCD25/ferritin in tumor group was higher than that in infection group and MAS group. Compared with HLH patients in the tumor group, the procalcitonin (PCT) level, proportion of patients using vasopressors, positive rate of hemophagocytosis, and incidence rate of DIC were all higher in the infection group, and the differences were statistically significant (P < 0.05). The results of multivariate analysis showed that fever, splenomegaly, hemophagocytosis, cytopenias, IgM, M.sCD25 [multiple of sCD25 detection value relative to the diagnostic threshold (2400 U/ml)], fibrinogen, and triglycerides were independent predictive factors for HLH (P < 0.05).The diagnostic prediction model H constructed based on temperature, splenomegaly, hemophagocytosis, cytopenias, IgM, M.sCD25, fibrinogen, triglycerides showed good predictive accuracy. The optimal cutoff value of H was 39.45, the sensitivity of the model was 94.12%, the specificity was 83.02%.

CONCLUSION: sCD25, sCD25/FER, PCT, hemophagocytosis, hemodynamic instability and DIC could help to distinguish the underlying etiology of HLH. The prediction model H has high discrimination and calibration, which could be used as a relatively accurate clinical diagnostic tool for HLH.

PMID:39479853 | DOI:10.19746/j.cnki.issn.1009-2137.2024.05.045

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Oct;32(5):1571-1577. doi: 10.19746/j.cnki.issn.1009-2137.2024.05.042.

ABSTRACT

OBJECTIVE: To explore the effect of heterozygous deletion of histone methyltransferase Kmt2c gene on the hematological system of mice.

METHODS: CRISPR/Cas9 technology was used to construct mice model of Kmt2c heterozygous deletion (Kmt2c^+/-) and the changes of whole blood cell count in mice were continuously monitored by blood routine test. The clonal expansion ability of bone marrow cells was explored by colony formation assay in vitro and the proportion of primitive hematopoietic cells, including long-term hematopoietic stem cell (LT-HSC), short-term hematopoietic stem cell (ST-HSC), and multipotent progenitor cell in mutant mice was analyzed by flow cytometry.

RESULTS: Kmt2c^+/- mice model was successfully constructed, and the mRNA expression level of Kmt2c was 28% of that of C57BL/6J mice. The colony formation ability of bone marrow cells of Kmt2c^+/- mice in vitro increased with the passage times, and the colony number in the fourth generation was significantly higher than that of control group (P <0.05). The proportions of LT-HSC and ST-HSC in the primitive hematopoietic cell population of Kmt2c^+/- mice was 19.6%±3.3% and 28.9%±4.9%, respectively, which showed an increasing trend compared with 16.9%±2.6% and 18.9%±2.5% in control group, but the difference was not statistically significant (P >0.05). The white blood cell count of Kmt2c^+/- mice gradually increased after 12 weeks of monitoring and reached (9.8±1.0)×10⁹/L at the 14^th week, which was significantly higher than (7.3±1.4)×10⁹/L of control group (P < 0.05).

CONCLUSION: The bone marrow cells of Kmt2c^+/- mice have potential of clonal expansion.

PMID:39479850 | DOI:10.19746/j.cnki.issn.1009-2137.2024.05.042

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Oct;32(5):1524-1530. doi: 10.19746/j.cnki.issn.1009-2137.2024.05.034.

ABSTRACT

OBJECTIVE: To explore the clinical application value of the Bleeding Scoring Scales (2019 Pediatric ITP Scale) in the diagnosis and treatment of children with primary immune thrombocytopenia (ITP).

METHODS: A total of 422 children with ITP were evaluated with the 2019 Pediatric ITP Scale and the 2013 ITP-BAT and their clinical data were analyzed. The correlation between the two bleeding scoring scales and disease stage, platelet count was analysed, the evaluation time, consistency of the two bleeding scoring scales was compared, and the correlation of the two methods. The changes of platelet count and the score of 2019 Pediatric ITP Scale before treatment and after treatment at 48 h and one week were analyzed to detect responsiveness of the 2019 Pediatric ITP Scale.

RESULTS: The score of the 2019 Pediatric ITP Scale was mainly one point and two points, the corresponding bleeding was skin and mucosal bleeding.404 patients (95.7%) had bleeding manifestations, including 249 patients of skin bleeding (59.0%), 144 patients of mucosal bleeding (34.1%), and 11 patients of organ bleeding (2.6%), of which 2 patients were severe bleeding. The two bleeding scoring scales were both negatively correlated with platelet counts in children with ITP (r _s=-0.5032, r _s=-0.6084) and no correlation with the stage of pediatric ITP(P ＞0.05). The 2019 Pediatric ITP Scale had good consistency with the 2013 ITP-BAT (r _s=0.7638). The average time required for the 2019 Pediatric ITP Scale was 88.64 (40-181) seconds, which was lower than that required for the 2013 ITP-BAT 104.12 (47-285) seconds (Z =17.792, P < 0.001). The 2019 Pediatric ITP Scale can well reflect the treatment of pediatric ITP. There were statistically significant differences in platelet count before treatment and after treatment at 48 h and one week among steroid group, IVIG group and steroid combined with IVIG group ( P < 0.05). There were also statistically significant differences in the score of the 2019 Pediatric ITP Scale before treatment and after treatment at one week among the three groups ( P < 0.05).

CONCLUSION: The 2019 Pediatric ITP Scale has good consistency and sensitivity in clinical application, and it takes less time to complete than the 2013 ITP-BAT, this scale can be used as an effective tool for disease assessment and efficacy determination in pediatric primary immune thrombocytopenia.

PMID:39479842 | DOI:10.19746/j.cnki.issn.1009-2137.2024.05.034

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Oct;32(5):1463-1471. doi: 10.19746/j.cnki.issn.1009-2137.2024.05.025.

ABSTRACT

OBJECTIVE: To explore and analyze the incidence rate, influencing factors and impact on prognosis of pulmonary hypertension (PH) in patients with Philadelphia chromosome negative myeloproliferative neoplasms (Ph^– MPNs).

METHODS: The clinical data of 271 patients with Ph^– MPNs were retrospectively analyzed, and different disease subtypes were classified. Patients with different disease types were further divided into PH⁺ and PH^– groups according to whether HP occurred. Statistical methods were used to analyze the incidence rate, risk factors, and impact on prognosis of PH in Ph^– MPNs patients.

RESULTS: The overall incidence rate of PH among 271 patients was 26.9%, and according to the classification of disease subtypes, it was found that the incidence rate of PH in patients with primary myelofibrosis (PMF) was significantly higher than those of patients with polycythemia vera and essential thrombocythemia (both P <0.05). Multivariate regression analysis showed that advanced age, long disease course, JAK2 positive and increased hematocrit, lactate dehydrogenase, monocyte count, and uric acid level were independent risk factors for PH in Ph^– MPNs patients (OR >1, P <0.05), and there were some differences in the independent risk factors between different disease subtypes. Survival analysis results showed that the overall survival (OS) rate of PH⁺ patients was significantly lower than that of PH^– patients in other types except for PMF (all P <0.05).

CONCLUSION: The incidence rate of PH in Ph^– MPNs patients is high, and its risk factors are diverse. The OS rate of Ph^– MPNs patients with PH is low. Therefore, we should be highly alert to the occurrence of PH in Ph^– MPNs patients clinically.

PMID:39479833 | DOI:10.19746/j.cnki.issn.1009-2137.2024.05.025