Category: Statistics

Acta Neurochir (Wien). 2024 Nov 28;166(1):484. doi: 10.1007/s00701-024-06373-8.

ABSTRACT

OBJECTIVE: This study aimed to identify predictive factors for cerebral infarction after bypass surgery in adult patients with moyamoya disease (MMD) using quantitative parameters in 4D-CT perfusion software.

METHODS: A total of 108 patients who underwent combined revascularization, including superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis and encephalo-duro-myo-synangiosis (EDMS), in our hospital between September 2019 and August 2023 were analyzed retrospectively. Preoperative relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), relative mean transit time (rMTT), and relative time to maximum residual function (rTmax) perfusion parameters were obtained using 4D-CT perfusion software. These quantitative parameters, combined with related clinical and angiographic factors, were statistically analyzed using univariate and multivariate regression analyses to determine the significant predictors of cerebral infarction after bypass surgery.

RESULTS: Acute cerebral infarction occurred in 12 patients postoperatively. Univariate analysis showed that a history of previous ischemic events (P = 0.024), higher Suzuki stage (P = 0.006), higher modified Rankin score (mRS) (P = 0.013), rCBV (P = 0.026), rMTT (P = 0.001), and rTmax (P < 0.001) were associated with postoperative cerebral infarction. Further multivariate regression analysis showed that a history of previous ischemic events (OR = 12.830, 95%CI = 1.854-875.672, P = 0.031) and higher rTmax (OR = 16.968, 95%CI = 2.035-141.451, P = 0.009) were independently associated with new postoperative cerebral infarction. The cutoff value for rTmax was 2.025 (AUC = 0.935).

CONCLUSIONS: Previous ischemic event history and rTmax greater than 2.025 are independent risk factors for predicting cerebral infarction after combined revascularization with high sensitivity in adult patients with MMD. These patients should be more cautious when deciding on combined revascularization.

PMID:39607649 | DOI:10.1007/s00701-024-06373-8

J Immigr Minor Health. 2024 Nov 28. doi: 10.1007/s10903-024-01658-7. Online ahead of print.

ABSTRACT

Xenophobia among healthcare professionals can significantly impact the quality of care provided to immigrant and refugee populations, particularly in countries with high influxes such as Türkiye. This study evaluated xenophobia among resident physicians at Pamukkale University Hospital and identified factors influencing these attitudes. This cross-sectional study involving 271 resident physicians at Pamukkale University Hospital was conducted between August 1 and August 20, 2022. The participants were randomly selected and stratified by department. Data were collected via a 38-item questionnaire, including the 11-item Xenophobia Scale. Descriptive statistics, the Mann‒Whitney U test, the Kruskal‒Wallis test, and multiple linear regression analysis were used for data analysis. The mean xenophobia scale score among participants was 57.53 (SD = 7.82), indicating high levels of xenophobic attitudes. The significant factors associated with higher xenophobia scores included being from a surgical department (B = 0.571, p < 0.001) and lacking foreign nationals in their close environment (B = 0.724, p < 0.001). Additionally, 58.7% of the resident physicians opposed providing free healthcare services to refugees, and 10.0% indicated that they might delay providing health services to these patients because of their status. Additionally, 7.7% of the resident physicians admitted to discriminating against migrant/refugee patients. The study reveals pervasive xenophobic attitudes among resident physicians in Türkiye, which are influenced by departmental affiliation and the social environment. These findings underscore the need for targeted interventions to address xenophobia in healthcare settings, including cultural competence training and policy changes, to ensure equitable healthcare access for all patients.

PMID:39607644 | DOI:10.1007/s10903-024-01658-7

Target Oncol. 2024 Nov 28. doi: 10.1007/s11523-024-01116-2. Online ahead of print.

ABSTRACT

BACKGROUND: Although anaplastic lymphoma kinase inhibitors (ALKis) are the effective initial treatment for patients with anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC), most patients experience resistance to ALKis, leading to the need for alternative therapies. Immune checkpoint inhibitors (ICIs) are a standard NSCLC treatment. On the other hand, their efficacy remains unclear for ALK-positive NSCLC.

OBJECTIVE: We aim to describe the treatment patterns and treatment outcomes for patients with ALK-positive NSCLC receiving later-line ICI treatment.

METHODS: This retrospective cohort study used claims data from Japanese acute care hospitals and included patients with lung cancer (International Classification of Diseases, 10th version (ICD-10), code: C34) diagnosed between 1 December 2015 and 31 January 2023. We extracted patients who received ALKis as first-line therapy and subsequent lines of treatment. Patient characteristics and treatment patterns and durations were descriptively summarized. Time to treatment discontinuation (TTD) for ICIs was examined using Kaplan-Meier estimates.

RESULTS: Of 478 patients who received ALKi as first-line treatment, 30 received ICIs, 249 ALKis, and 154 non-ICI/ALKi therapy as second-line treatment. Most patient characteristics showed no differences among the groups. ICIs were more likely to be administered to patients who underwent shorter durations of ALKi treatment. The median TTD for ICIs was 66 days, with a 1 year TTD rate of 13%.

CONCLUSIONS: Given the rarity of ALK-positive NSCLC, this study contributes to add evidence through an expanded database and increased sample size, supporting previous suggestions that ICIs have limited effectiveness in patients positive for ALK.

PMID:39607635 | DOI:10.1007/s11523-024-01116-2

Gastric Cancer. 2024 Nov 28. doi: 10.1007/s10120-024-01570-x. Online ahead of print.

NO ABSTRACT

PMID:39607631 | DOI:10.1007/s10120-024-01570-x

Neurol Sci. 2024 Nov 28. doi: 10.1007/s10072-024-07900-2. Online ahead of print.

ABSTRACT

BACKGROUND: The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) is the most widely used in clinical practice and the least time-consuming battery to estimate cognitive function in adults with Multiple Sclerosis (MS), while it has been included in few studies on young MS, also because of the absence of normative values.

OBJECTIVE: The aim of this study is to evaluate the impact of age, sex and education on BICAMS scores in a young adolescent population.

METHODS: We administered the BICAMS to 169, 11-to-18-year-old, healthy subjects. Linear regression models were used to assess the impact of age, sex, and education on sub-test scores. When statistically significant (p < 0.05), we used the regression coefficient to correct the raw scores.

RESULTS: younger age was associated with worse performance on SDMT (β = 1.76; p < 0.05), CVLT-II (β = 3.33; p < 0.05) and BVMT-R (β = 0.62; p < 0.05). Female sex was associated SDMT (β = 2.75 (p < 0.05) and CVLT-II (β = 2.51 (p < 0.05). Educational attainment was associated with better performance on SDMT (β = 1.79 (p = < 0.05) and BVMT-R (β = 0.61; p < 0.05). Cut-off points were suggested at the 5th lowest percentile.

CONCLUSION: Age, sex, and education must be accounted for when applying the BICAMS to young population. Its use in everyday assessment of patients with Pediatric Onset Multiple Sclerosis (POMS) could help to compare and combine data across centers, identifying patients requiring a comprehensive evaluation and ad hoc cognitive stimulation programs.

PMID:39607616 | DOI:10.1007/s10072-024-07900-2

World J Urol. 2024 Nov 28;42(1):653. doi: 10.1007/s00345-024-05364-9.

ABSTRACT

BACKGROUND: The cardiometabolic index (CMI), encompassing obesity and lipid metrics, is potentially linked to kidney stone prevalence in diabetic patients. However, studies on this association are sparse. This research evaluates CMI’s impact on kidney stone occurrence in this group.

METHODS: Utilizing data from the 2007-2018 National Health and Nutrition Examination Survey, we explored the relationship between CMI and kidney stones in diabetic patients through multivariate logistic regression, generalized additive models, and smoothed curve fitting. Robustness checks included subgroup analyses and propensity score matching (PSM).

RESULTS: This study comprised 2714 participants in total, where the prevalence of kidney stones was found to be 16.82%. Using weighted multivariate logistic regression and fully adjusted models, it was revealed that elevated CMI levels are positively associated with an increased likelihood of developing kidney stones (OR = 1.17, 95% CI: 1.06, 1.30). Smooth curve fitting demonstrated that there was no non-linear relationship between CMI and kidney stones (log-likelihood ratio test P = 0.236). Subgroup analyses and interactions indicated that the association between CMI and kidney stone prevalence was notably stronger in individuals who were living with a partner /married and had a poverty income ratio (PIR) of 1.5 to less than 3.5 (P for interaction < 0.05). propensity score matching (PSM) further verified the robustness of our results.

CONCLUSION: Elevated CMI correlates with greater kidney stone prevalence in diabetic individuals, particularly those married or living with a partner and within certain economic statuses. This study supports the hypothesis linking CMI and kidney stones in U.S. diabetic population, suggesting a target demographic for preventive strategies.

PMID:39607614 | DOI:10.1007/s00345-024-05364-9

Eur J Nutr. 2024 Nov 28;64(1):31. doi: 10.1007/s00394-024-03550-4.

ABSTRACT

BACKGROUND: Little is known regarding the impact of serum carotenoids, a class of compounds having anti-inflammatory and antioxidant properties, on migraine. This study aimed to examine the association between serum carotenoid levels and migraine risk among United States adults.

METHODS: This cross-sectional study recruited 7744 individuals aged 20 years or older from the National Health and Nutrition Examination Survey conducted between 2001 and 2004. The concentrations of five serum carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lycopene, and lutein + zeaxanthin) and retinol were measured using high-performance liquid chromatography. Migraine was diagnosed when participants reported that they had severe headaches or migraines during the past three months. Weighted multivariable logistic regression and restricted cubic spline models were used to determine the association between serum carotenoid levels and migraine risk.

RESULTS: Among the 7744 participants enrolled in the study, 1595 (20.6%) had migraine. Compared with the lowest quartiles, the highest quartiles of the three serum carotenoids were associated with a lower risk of migraine, with a multivariable-adjusted odds ratio (OR) of 0.74 (95% confidence interval [CI], 0.57-0.97) for α-carotene, 0.64 (95% CI, 0.49-0.83) for β-carotene, and 0.64 (95% CI, 0.53-0.78) for lutein + zeaxanthin, while the third quartile of serum β-cryptoxanthin had lower odds of migraine (OR, 0.70; 95% CI, 0.54-0.90). The U-shaped patterns of nonlinear relationships between serum β-cryptoxanthin and lutein + zeaxanthin levels and migraine risk were represented by restricted cubic splines. No association was observed between serum lycopene and retinol levels and migraine.

CONCLUSIONS: Low serum carotenoid levels were associated with an increased risk of migraine. Further prospective investigations are warranted to clarify the causative relationship and explore the possible prevention and treatment of migraine using carotenoid supplementation.

PMID:39607608 | DOI:10.1007/s00394-024-03550-4

Eur J Nutr. 2024 Nov 28;64(1):30. doi: 10.1007/s00394-024-03547-z.

ABSTRACT

PURPOSE: Vitamin D supplementation positively impacts anemia, but the relationship between a ferritin-related dietary pattern, iron parameters, and vitamin D in anemia is unclear.

METHODS: This cross-sectional study analyzed data from the 2017-2019 National Nutrition and Health Survey, including 1423 pregnant women over 15 years old. Dietary intake was assessed using a semi-quantitative food frequency questionnaire and a 24-hour dietary recall. The FrDP was identified using reduced rank regression with blood parameters as response variables and 32 food groups as predictors. Linear and binomial logistic regression analyses evaluated the associations between the FrDP and serum biomarkers, adjusting for demographic and dietary variables. Risk associations between the FrDP and vitamin D concentrations were also assessed.

RESULTS: The FrDP explained 18.5% of the variation in 6 response variables and was characterized by high consumption of fish, soy, gluten pasta, nuts, organ meat, pickled vegetables, and marine plants. The FrDP correlated positively with serum hemoglobin (r = 0.76), iron (r = 0.52), ferritin (r = 0.79), folate (r = 0.86), and vitamin B₁₂ (r = 0.86). Linear regression revealed a positive association between the FrDP and serum iron. Women in the highest FrDP tertile were less likely to have low serum iron (OR = 0.65, 95% CI 0.50-0.85) but more likely to have low 25(OH) vitamin D concentrations (OR = 1.79, 95% CI 1.32-2.43).

CONCLUSIONS: The FrDP was positively associated with serum iron but negatively associated with serum 25(OH) vitamin D in pregnant women.

PMID:39607573 | DOI:10.1007/s00394-024-03547-z

Am J Hosp Palliat Care. 2024 Nov 28:10499091241304728. doi: 10.1177/10499091241304728. Online ahead of print.

ABSTRACT

Introduction: Measuring palliative care needs of patients with multiple complex illnesses and their family, is essential for providing quality clinical care. The integrated palliative care outcome scale (IPOS) is a scientifically verified measure of patients’ physical, emotional symptoms, and their palliative care communication and practical needs. The patients in this study require palliative care due to both their end-of-life heart failure (HF) and vascular dementia. Purpose: The purposes are to describe and compare home palliative care needs measured by the family caregivers (N = 20) and patients (N = 20) IPOS scores and to examine whether the patient IPOS total score can predict patient HF health status and caregiving burden scores. Methods: This study uses explanatory research design with rigorous methods for obtaining information from multiple sources. Descriptive, Cohen’s Kappa (k) statistics comparing patient and caregiver IPOS scores and regression analyses to examine the patient IPOS scores impact on patient HF health status and caregiving burden scores were used. Results: There was significant agreement between patient and caregiver ratings on 16 out of 17 IPOS items (k = .34 to .80). Regression analyses found that the patient IPOS total score significantly predicted patients’ HF health status (β = -.50, P < .05), and caregiving burden scores (β = .57, P < .01). Conclusion: Patients’ and their caregivers’ IPOS scores agreement indicates palliative care needs can be consistently identified. The patient IPOS total scores can predict patients’ HF health status and caregiving burden. These measures provide information directly applicable for health professionals guiding palliative home care.

PMID:39606853 | DOI:10.1177/10499091241304728

Prim Health Care Res Dev. 2024 Nov 28;25:e64. doi: 10.1017/S1463423624000574.

ABSTRACT

BACKGROUND AND OBJECTIVE: Early and collaborative interventions are desirable to prevent long-term sick leave and promote sustainable return-to-work (RTW). The aim of this study was to evaluate if the use of the Capacity Note – a brief intervention promoting early and structured communication between general practitioners (GPs), patients, and employers – had an impact on length of sick leave in patients with common mental disorders (CMDs) in primary healthcare.

METHOD: In a pragmatic trial, GPs at eight primary healthcare centres were randomized to provide the intervention or control and recruited eligible patients: employed women and men, 18-64 years, who visited a GP due to CMD and became or were (<4 months) full- or part-time sick-listed. Patients in the intervention group (n=28) used the Capacity Note in addition to usual care. Patients in the control group (n=28) received usual care. Outcomes of interest were time until full RTW, sick leave status at end of follow-up (17 months), number of sick leave episodes during follow-up, and number of sick leave days at 6, 12, and 17 months of follow-up.

RESULTS: The proportion of patients with full RTW at the end of follow-up was 79.2% in the intervention group and 84.6% in the control group. Time until full RTW was 102 and 90 days (median) in intervention and control group, respectively. We found no statistically significant differences between the groups for any of the outcomes.

DISCUSSION: Despite efforts to increase the number of participants, the study ended up with a small sample. This prohibited us from drawing any final conclusions about the effect of the intervention. Obstacles to recruitment of patients and use of the intervention are discussed.

PMID:39606847 | DOI:10.1017/S1463423624000574