Category: Statistics

Vet Med Sci. 2024 Sep;10(5):e70008. doi: 10.1002/vms3.70008.

ABSTRACT

BACKGROUND: Hydatidosis, caused by the larval stage of the tapeworm Echinococcus granulosus, affect cattle by forming hydatid cyst in thier lungs, livers and pose great financial loss in animal production and country’s economy by both direct and indirect effect. Despite its great economic and health importance, there is an absence of current information on cystic echinococcosis in cattle slaughtered at Wolaita Sodo municipality abattoir in Ethiopia.

OBJECTIVES: Current investigation determines the prevalence, organ distribution and fertility of hydatid cysts in cattle slaughtered at the Wolaita Sodo municipality abattoir in Ethiopia.

METHODS: A cross-sectional study was conducted from February, 2023, to October, 2023, at Wolaita Sodo municipality abattoir in southern Ethiopia, through regular meat examinations and cyst characterisation to determine the prevalence, organ distribution and fertility of hydatid cysts.

RESULTS: The overall prevalence of hydatidosis recorede in current study was 17.9% (69/384) and has shown a statistically significant association (p < 0.05) with the body condition of cattle. However, there was no statistically significant association (p > 0.05) between the prevalence of hydatidosis and other risk factors such as sex, breed, production system and origin of animals. This study showed that the lungs and liver were the most affected organs in cattle, followed by the spleen and kidneys. On cyst characterisation, the majority of hydatid cysts were found sterile (55.4%) followed by fertile (38.8%) and calcified (8.7%) cysts. Out of 125 fertile hydatid cysts tested for survival, 18.8% (58/321) were viable and 20% (67/321) were nonviable.

CONCLUSION: The finding of this study shows that cystic echinococcus was important health threat of the cattle and widespread in the internal organs of affected cattle causing significant economic loss by condemning edible organs that are not suitable for human consumption. Therefore, urgent and integreted preventive action is needed to disrupt the life cycle of cystic echinococcosis to tackle subsequent financial loss and risk of zoonosis to humans in the study area.

PMID:39215458 | DOI:10.1002/vms3.70008

Ophthalmic Plast Reconstr Surg. 2024 Aug 28. doi: 10.1097/IOP.0000000000002768. Online ahead of print.

ABSTRACT

PURPOSE: The primary objective was to document change in postoperative marginal reflex distance-1 (MRD1) after Müller muscle conjunctival resection surgery. The secondary objective was to identify predictors of change in postoperative MRD1.

METHODS: A multicenter prospective cohort study was performed on patients consecutively recruited for Müller muscle conjunctival resection. MRD1 was measured immediately after Müller muscle conjunctival resection, at the 1-week postoperative visit, and the ≥3-month postoperative visit. MRD1 at the immediate and 1-week time points were compared with MRD1 ≥3 months using descriptive statistics. Predictors of change in MRD1 were analyzed using multivariate regression analysis.

RESULTS: A total of 150 patients (226 eyelids) were included. Regarding the immediate to ≥3-month interval, 53.8% of eyelids remained clinically similar (rise or fall ≤0.5 mm), 19.8% rose ≥1 mm, and 26.4% fell ≥1 mm. Regarding the 1-week to ≥3-month interval, 76.5% remained clinically similar, 17.3% rose ≥1 mm, and 6.2% fell ≥1 mm. No variable predicted change in MRD1 over either interval with both clinical and statistical significance.

CONCLUSIONS: Immediate postoperative MRD1 is likely to reflect the late result in only 54% of cases. However, 1-week postoperative MRD1 is similar to the late result in 77% of cases and is highly unlikely (6%) to fall by the final visit. No variable significantly impacts change in postoperative MRD1.

PMID:39197179 | DOI:10.1097/IOP.0000000000002768

Ophthalmic Plast Reconstr Surg. 2024 Aug 28. doi: 10.1097/IOP.0000000000002770. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study is to investigate the association between cannabis usage and thyroid eye disease (TED) in patients with autoimmune hyperthyroidism. While the association between cigarette smoking and TED is well established, the effect of cannabis on TED is unclear.

METHODS: This cohort study examined data from TriNetX, an electronic health record platform, for patients with autoimmune hyperthyroidism between December 1, 2003, and December 1, 2023. Primary outcomes were TED presentation (exophthalmos, eyelid retraction, eyelid edema, orbital edema, strabismus, and optic neuropathy) and treatment (teprotumumab, methylprednisolone, tarsorrhaphy, and orbital decompression) in cannabis users, nicotine users, and control patients. Propensity matching was performed to control for characteristics such as age, sex, race, prior thyroidectomy, and/or radio ablation. Relative risk between cohorts was calculated for each outcome in 6-month, 1-year, and 2-year intervals following diagnosis of autoimmune hyperthyroidism.

RESULTS: Of 36,186 patients with autoimmune hyperthyroidism, 783 were cannabis users, 17,310 were nicotine users, and 18,093 were control patients without cannabis or nicotine usage. Compared with control patients, cannabis users were more likely to be younger, male, and Black/African American and have anxiety or depression. After propensity matching, cannabis users were 1.9 times more likely to develop exophthalmos (p = 0.03) and 1.6 times more likely to develop any TED presentation (p = 0.049) in the 1-year interval although these differences did not remain statistically significant in the 2-year interval.

CONCLUSIONS: Cannabis users had a significantly increased risk for TED outcomes in the 1-year interval. Further research is needed to inform TED management.

PMID:39197177 | DOI:10.1097/IOP.0000000000002770

Inflamm Bowel Dis. 2024 Aug 28:izae201. doi: 10.1093/ibd/izae201. Online ahead of print.

ABSTRACT

BACKGROUND: Previous research suggests patients living with inflammatory bowel disease (IBD) understand IBD remission differently than healthcare professionals, which could influence patient expectations and clinical outcomes. We investigated 3 questions to better understand this: (1) How do patients currently understand remission; (2) Do patients currently face any barriers to communicating with their healthcare professional about remission; and (3) Can existing educational material be improved to help patients feel more prepared to discuss remission and treatment goals with their healthcare professional?

METHODS: We sent a web-based survey to adult patients with IBD in the United States. This survey included an educational experiment where patients were randomly assigned to 1 of 3 improved versions of existing educational material.

RESULTS: In total, 1495 patients with IBD completed the survey. The majority of patients (67%) agreed that remission is possible in IBD, but there was significant diversity in how they defined it with the most common being “my symptoms are reduced” (22%) and “I am no longer experiencing any symptoms” (14%). Patients reported being able to communicate openly with their healthcare professionals. Exposure to improved educational material did not have a statistically significant effect on patients’ feelings of preparedness for discussing different aspects of their care with their healthcare professionals.

CONCLUSIONS: Our study confirms that patients tend to define remission in terms of resolving symptoms. We found little evidence of barriers preventing patients from discussing remission with their healthcare professionals. This suggests that educational material could be used to resolve this discrepancy in understanding.

PMID:39197162 | DOI:10.1093/ibd/izae201

JMIR Public Health Surveill. 2024 Aug 28;10:e47465. doi: 10.2196/47465.

ABSTRACT

BACKGROUND: Hospitalized patients infected with SARS-CoV-2 should recover within a few weeks. However, even those with mild versions can experience symptoms lasting 4 weeks or longer. These post-COVID-19 condition (PCC) comprise various new, returning, or ongoing symptoms that can last for months or years and cause disability. Few studies have investigated PCC using self-reports from discharged patients infected with SARS-CoV-2 to complement clinical and biomarker studies.

OBJECTIVE: This study aimed to investigate self-reported, persistent PCC among patients infected with SARS-CoV-2 who were discharged during the second and third waves of the COVID-19 pandemic.

METHODS: We designed, pretested, and posted an ad hoc paper questionnaire to all eligible inpatients discharged between October 2020 and April 2021. At 4 months post discharge, we collected data on PCC and scores for the Multidimensional Fatigue Inventory (MFI), the Patient Health Questionnaire-4 (PHQ-4), a Brief Memory Screening Scale (Q3PC), and a posttraumatic stress disorder scale (PCL-5). Descriptive, inferential, and multivariate linear regression statistics assessed PCC symptomatology, associations, and differences regarding sociodemographic characteristics and hospital length of stay (LOS). We examined whether our variables of interest significantly predicted MFI scores.

RESULTS: Of the 1993 valid questionnaires returned, 245 were from discharged patients with SARS-CoV-2 (median age 71, IQR 62.7-77 years). Only 28.2% (69/245) of respondents were symptom-free after 4 months. Women had significantly more persistent PCC symptoms than men (P≤.001). Patients with a hospital LOS ≥11 days had more PCC symptoms as well (P<.001)-women had more symptoms and longer LOS. No significant differences were found between age groups (18-64, 65-74, and ≥75 years old; P=.50) or between intensive care units and other hospitalization units (P=.09). Patients self-reported significantly higher PHQ-4 scores during their hospitalization than at 4 months later (P<.001). Three-fourth (187/245, 76.4%) of the respondents reported memory loss and concentration disorders (Q3PC). No significant differences in the median MFI score (56, IQR 1-3, range 50-60]) were associated with sociodemographic variables. Patients with a hospital LOS of ≥11 days had a significantly higher median PCL-5 score (P<.001). Multivariate linear regression allowed us to calculate that the combination of PHQ-4, Q3PC, and PCL-5 scores, adjusted for age, sex, and LOS (of either ≥11 days [median 2 symptoms, IQR 1-5] or <11 days), did not significantly predict MFI scores (R²=0.09; F_4,7 =1.5; P=.22; adjusted R²=0.06).

CONCLUSIONS: The majority of inpatients infected with SARS-CoV-2 presented with PCC 4 months after discharge, with complex clinical pictures. Only one-third of them were symptom-free during that time. Based on our findings, MFI scores were not directly related to self-reported depression, anxiety, or posttraumatic scores adjusted for age, sex, or LOS. Further research is needed to explore PCC and fatigue based on self-reported health experiences of discharged inpatients infected with SARS-CoV-2.

PMID:39197160 | DOI:10.2196/47465

J Bone Joint Surg Am. 2024 Aug 23. doi: 10.2106/JBJS.24.00065. Online ahead of print.

ABSTRACT

ABSTRACT: The optimal treatment for small-to-medium-sized rotator cuff tears remains a topic of debate. While both tendon repair and physiotherapy have shown comparable short-term results, there are concerns about the long-term effectiveness of physiotherapy. In 2 previous reports presenting the 5 and 10-year results of this trial, significant and increasing differences were observed in favor of tendon repair. Further investigation of the unexplored time interval after 10 years is essential to fully understand the implications of our treatment approaches. A total of 103 patients with a full-thickness rotator cuff tear not exceeding 3 cm were randomly allocated to tendon repair or physiotherapy with optional secondary repair. Measurements of shoulder function were performed by a blinded assessor at 6 months and 1, 2, 5, 10, and 15 years. The outcome of primary interest was the 15-year result for the Constant score. Secondary outcome measures included the self-report section of the American Shoulder and Elbow Surgeons (ASES) score; the Short Form-36 (SF-36) Health Survey; assessments of pain, motion, and strength; and patient satisfaction. Tear-size increase in unrepaired tears was assessed by sonography. Statistical analysis was by mixed-model analysis for repeated measurements and by intention to treat. Eighty-three (81%) of 103 patients attended the 15-year follow-up. Fifteen of 51 patients in the physiotherapy group had crossed over to secondary surgery. Results from primary tendon repair were superior by a mean difference of 11.8 points for the Constant score (p = 0.001), 13.9 points for the ASES score (p < 0.001), 1.8 cm on a 10-cm visual analog scale for pain (p < 0.001), and 16.2° and 22.4°, respectively, for pain-free abduction and flexion (p = 0.04 and 0.001). On the SF-36, differences did not reach significance for any of the scoring scales. In 26 tears treated by physiotherapy only, the mean tear size had increased from 16.2 to 31.6 mm in the anterior-posterior direction. Long-term outcomes from primary tendon repair remained superior to physiotherapy up to 15 years of follow-up, supporting its use as the primary treatment for small-to-medium-sized rotator cuff tears.

LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

PMID:39197154 | DOI:10.2106/JBJS.24.00065

Neurology. 2024 Sep 24;103(6):e209752. doi: 10.1212/WNL.0000000000209752. Epub 2024 Aug 28.

ABSTRACT

BACKGROUND AND OBJECTIVES: Isolated value of MRI metrics in relapsing multiple sclerosis (RMS) as a surrogate marker of response to disease-modifying treatment (DMT) and, thus, as decision criteria for DMT escalation in the absence of clinical signs of disease activity is still a matter of debate. The aim of this study was to investigate whether DMT escalation based on isolated MRI activity affects clinical outcome.

METHODS: Combining data from 5 MS centers in Austria and Switzerland, we included patients with RMS aged at least 18 years who (1) had initiated first-line, low-to-moderate-efficacy DMT (interferon β, glatiramer acetate, teriflunomide, or dimethyl fumarate) continued for ≥12 months, (2) were clinically stable (no relapses or disability progression) on DMT for 12 months, (3) had MRI at baseline and after 12 months on DMT, and (4) had available clinical follow-up for ≥2 years after the second MRI. The primary endpoint was occurrence of relapse during follow-up. The number of new T2 lesions (T2L) and DMT strategy (continuing low-/moderate-efficacy DMT vs escalating DMT) were used as covariates in regression analyses.

RESULTS: A total of 131 patients with RMS, median age of 36 (25th-75th percentiles: 29-43) years, 73% women, were included and observed over a median period of 6 (5-9) years after second MRI. Sixty-two (47%) patients had relapse. Patients who continued first-line DMT had a 3-fold increased risk of relapse given 2 new T2L (hazard ratio [HR] 3.2, lower limit [LL] of 95% CI: 1.5) and a 4-fold increased risk given ≥3 new T2L (HR 4.0, LL-CI: 2.1). Escalation of DMT lowered the risk of relapse in patients with 2 new T2L by approximately 80% (HR 0.2, upper limit [UL] of 95% CI: 1.3) and with ≥3 new T2L by 70% (HR 0.3, UL-CI: 0.8). In case of only 1 new T2L, the increased risk of relapse and the treatment effect did not reach statistical significance of 5%.

DISCUSSION: In our real-world cohort of patients clinically stable under low-to-moderate-efficacy DMT, escalation of DMT based on isolated MRI activity decreased risk of further relapse when at least 2 new T2L had occurred.

CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that clinically stable patients with MS on low-/moderate-efficacy DMT with ≥3 new T2L on MRI who escalate DMT have a reduced risk of relapse and Expanded Disability Status Scale progression.

PMID:39197111 | DOI:10.1212/WNL.0000000000209752

Ann Behav Med. 2024 Aug 28:kaae048. doi: 10.1093/abm/kaae048. Online ahead of print.

ABSTRACT

BACKGROUND: Many individuals with lung cancer and chronic obstructive pulmonary disease (COPD) experience high levels of stigma, which is associated with psychological distress and delayed help-seeking.

PURPOSE: To identify interventions aimed at reducing the stigma of lung cancer or COPD and to synthesize evidence on their efficacy.

METHODS: A systematic review was conducted by searching PubMed, Scopus, PsycINFO, and CINAHL for relevant records until March 1, 2024. Studies were eligible if they described an intervention designed to reduce internalized or external stigma associated with COPD or lung cancer and excluded if they did not report empirical findings.

RESULTS: We identified 476 papers, 11 of which were eligible for inclusion. Interventions included educational materials, guided behavior change programs, and psychotherapeutic approaches. Interventions targeted people diagnosed with, or at high risk of developing COPD or lung cancer or clinical staff. No interventions that aimed to reduce stigma associated with lung cancer or COPD in the general community were identified. Most interventions yielded a statistically significant reduction in at least one measure of stigma or a decrease in qualitatively reported stigma.

CONCLUSIONS: The emerging literature on interventions to reduce stigma associated with lung cancer and COPD suggests that such interventions can reduce internalized stigma, but larger evaluations using randomized controlled trials are needed. Most studies were in the pilot stage and required further evaluation. Research is needed on campaigns and interventions to reduce stigma at the societal level to reduce exposure to external stigma amongst those with COPD and lung cancer.

PMID:39197098 | DOI:10.1093/abm/kaae048

Inflamm Bowel Dis. 2024 Aug 28:izae158. doi: 10.1093/ibd/izae158. Online ahead of print.

ABSTRACT

BACKGROUND: With the increasing legalization of medical and recreational cannabis, patients and providers have growing interest in the role of cannabinoids in treating inflammatory bowel disease. Prior meta-analysis has shown inconclusive evidence for efficacy of cannabinoids. We sought to produce an up-to-date meta-analysis that pools new data to evaluate the therapeutic effects of cannabinoids in both Crohn’s disease (CD) and ulcerative colitis (UC).

METHODS: PubMed, Embase, CENTRAL and CINAHL were queried for randomized-controlled trials evaluating the impact cannabinoids in CD or UC. Random effects modeling was used to compute pooled estimates of risk difference. Heterogeneity was assessed using I2.

RESULTS: Eight studies, including 4 studies of CD, 3 studies of UC, and 1 study of both diseases met inclusion criteria. Among 5 studies of CD, a statistically significant decrease in clinical disease activity following intervention was observed (risk ratios [RR], -0.91; 95% CI, CI:1.54 to CI:0.28, I2 = 71.9%). Clinical disease activity in UC was not significantly lower in the pooled analysis (RR, -2.13; 95% CI, -4.80 to 0.55; I2 = 90.3%). Improvement in quality of life (QoL) was observed in both CD and UC combined (RR, 1.79; 95% CI, 0.92-0.2.66; I2 = 82.8%), as well as individually. No differences were observed in the analysis on endoscopic disease activity and inflammatory markers.

CONCLUSIONS: This meta-analysis of clinical trials suggests that cannabinoids are associated with improved quality of life in both CD and UC, as well as improved disease activity but not inflammation.

PMID:39197096 | DOI:10.1093/ibd/izae158

J Phys Chem B. 2024 Aug 28. doi: 10.1021/acs.jpcb.4c04177. Online ahead of print.

ABSTRACT

This study investigates the conduction mechanism of ternary sodium borophosphate glass 30Na₂O-(70 – x)B₂O₃–xP₂O₅ with 0 ≤ x ≤ 35 mol % from a different perspective, focusing on previously unreported high-temperature electrical and dielectric properties for potential solid electrolytes in high-temperature batteries. The glass composition with B₂O₃/P₂O₅ = 1 exhibits a conductivity of approximately 10^-4 S/cm at 250 °C. Dielectric analysis supports this improved conduction, showing higher dielectric values and minimal energy dissipation during storage, indicating promising conductivity and favorable dielectric properties. This enhancement is attributed to the large-polaron (QMT) model, deduced from the power law exponent, due to the creation and spreading of lattice distortion of a long-range order with interconnected B⁴-O-P¹ and B⁴-O-P² linkages. Contrary to previous results, the glass transition temperature does not vary coherently with the conductivity and activation energy, displaying a discontinuity at 14 mol %. This discontinuity is caused by the initial extreme depolymerization of P₂O₅, leading to an increase in nonbridging oxygens (NBOs) within the glass network and forming B⁴-O-P⁰ linkages. Despite this, the ionic mobility of Na⁺ is continuously enhanced, correlated with the increase in the molar volume. This new perspective highlights the significant impact of both free volume expansion and reduced Coulombic effects on conduction improvement.

PMID:39197090 | DOI:10.1021/acs.jpcb.4c04177