Category: Statistics

Chron Respir Dis. 2024 Jan-Dec;21:14799731241249474. doi: 10.1177/14799731241249474.

ABSTRACT

BACKGROUND: Noninvasive mechanical ventilation (NIV) is recommended as the initial mode of ventilation to treat acute respiratory failure in patients with AECOPD. The Noninvasive Ventilation Outcomes (NIVO) score has been proposed to evaluate the prognosis in patients with AECOPD requiring assisted NIV. However, it is not validated in Chinese patients.

METHODS: We used data from the MAGNET AECOPD Registry study, which is a prospective, noninterventional, multicenter, real-world study conducted between September 2017 and July 2021 in China. Data for the potential risk factors of mortality were collected and the NIVO score was calculated, and the in-hospital mortality was evaluated using the NIVO risk score.

RESULTS: A total of 1164 patients were included in the study, and 57 patients (4.9%) died during their hospital stay. Multiple logistic regression analysis revealed that age ≥75 years, DBP <60 mmHg, Glasgow Coma Scale ≤14, anemia and BUN >7 mmol/L were independent predictors of in-hospital mortality. The in-hospital mortality was associated with an increase in the risk level of NIVO score and the difference was statistically significant (p < .001). The NIVO risk score showed an acceptable accuracy for predicting the in-hospital mortality in AECOPD requiring assisted NIV (AUC: 0.657, 95% CI: 0.584-0.729, p < .001).

CONCLUSION: Our findings identified predictors of mortality in patients with AECOPD receiving NIV, providing useful information to identify severe patients and guide the management of AECOPD. The NIVO score showed an acceptable predictive value for AECOPD receiving NIV in Chinese patients, and additional studies are needed to develop and validate predictive scores based on specific populations.

PMID:38652928 | DOI:10.1177/14799731241249474

Dent Med Probl. 2024 Mar-Apr;61(2):249-255. doi: 10.17219/dmp/133071.

ABSTRACT

BACKGROUND: As polyether ether ketone (PEEK) is a relatively new material in dentistry, its bonding properties with regard to dental acrylic base materials are not fully known. To ensure the long-term success of removable dentures with a PEEK framework, the base materials must be well bonded to each other.

OBJECTIVES: The study aimed to investigate the effects of different kinds of surface roughening treatment on PEEK and acrylic resin bonding.

MATERIAL AND METHODS: Eighty PEEK specimens (N = 80) were randomly divided into 5 groups (n = 16 per group) and subjected to various surface roughening treatment (control, grinding, sandblasting, tribochemical silica coating (CoJet), and sulfuric acid etching). Heat-polymerized acrylic resin was applied to the treated surfaces of the PEEK specimens. The shear bond strength (SBS) test, environmental scanning electron microscopy (ESEM) analysis and three-dimensional (3D) surface topography analysis were performed. The statistical analysis of the data was conducted using the analysis of variance (ANOVA) and Tukey’s multiple comparison test.

RESULTS: The one-way ANOVA showed significant differences in the SBS values between the groups (p = 0.001). Sandblasting, tribochemical silica coating and sulfuric acid etching resulted in high SBS values (p = 0.001). The highest SBS values were observed in the sulfuric acid etching group (8.83 ±3.63 MPa), while the lowest SBS values were observed in the control group (3.33 ±2.50 MPa).

CONCLUSIONS: The additional roughening treatment applied to the PEEK surface increases the bond strength with heat-polymerized acrylic resin.

PMID:38652924 | DOI:10.17219/dmp/133071

Ocul Immunol Inflamm. 2024 Apr 23:1-8. doi: 10.1080/09273948.2024.2343084. Online ahead of print.

ABSTRACT

PURPOSES: This study investigated the feasibility of adalimumab (ADA) dose reduction and withdrawal strategy in children with stable pediatric non-infectious uveitis (PNIU).

METHODS: This open-label prospective pilot trial recruited 18 stable PNIU patients (33 eyes) between two and eighteen years old who were treated with standard doses of ADA (20/40 mg every 2 weeks) plus oral methotrexate. The interval of ADA injection was extended to 4 weeks and followed up for 24 weeks. If the uveitis remained stable, ADA was discontinued and followed up for another 24 weeks. ADA was considered successfully stopped if no relapse occurred during this period. The relapse-free survival rate, best corrected visual acuity (BVCA), anterior chamber cell (ACC), vitritis, macular thickness (MT), and serum ADA levels were evaluated. Approval Number: 2021KYPJ201. ClinicalTrials.gov identifier: NCT05155592.

RESULTS: The relapse-free survival rate was 22.2% (4/18) at 48 weeks. 33.3% (6/18) of patients relapsed when ADA was given every 4 weeks, while 44.5% of patients (8/18) relapsed after ADA was stopped. The four patients successfully withdrawn from ADA were all diagnosed with BD. No statistically significant differences (p > 0.05) were observed in BCVA and MT between baseline and final follow-up. The proportion of ACC and vitritis exhibited an upward trend (p < 0.05) during follow-up. Serum ADA gradually decreased to zero during follow-up in both non-recurrence and recurrence groups.

CONCLUSIONS: In PNIU children who reached remission for 6 months, ADA dose reduction and withdrawal were associated with a high risk of inflammation recurrence. Timely adjustment of ADA to the last effective dosage frequency can regain control of the inflammation. Detection of ADA serum levels in patients with recurrence may help find the appropriate interval of ADA use.

PMID:38652891 | DOI:10.1080/09273948.2024.2343084

Menopause. 2024 Apr 23. doi: 10.1097/GME.0000000000002349. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate if and how race, ethnicity, and socioeconomic status (SES) are associated with the severity of menopause symptoms in a large, diverse sample of women.

METHODS: For this cross-sectional study conducted between March 24, 2019, and January 13, 2023, a total of 68,864 women were enrolled from the Evernow online telehealth platform. Participants underwent a clinical intake survey, which encompassed demographic information, detailed medical questionnaires, and a modified Menopause Rating Scale. The modified scale was adapted for ease of use online and is available in the supplementary material along with the full intake. Symptom severity was evaluated using a multivariate binomial generalized linear model, accounting for factors such as race, ethnicity, age, body mass index, smoking status, bilateral oophorectomy status, and SES. Odds ratios (OR) and CIs were calculated based on the linear regression coefficients.

RESULTS: Of the participants, 67,867 (98.6%) were included in the analysis after excluding outliers and those with unknown oophorectomy status. The majority of respondents identified as White (77.4%), followed by Hispanic (9.0%), Black (6.7%), two or more races/ethnicities (4.4%), Asian (1.2%), Indigenous/First Nations (0.8%), Middle Eastern (0.3%), and South Asian (0.2%). Notably, individuals identifying as Black (hot flashes OR, 1.91; 97.5% CI, 1.75-2.09; P < 0.001), Hispanic (skin/hair changes OR, 1.58; 97.5% CI, 1.45-1.71; P < 0.001), Indigenous/First Nations (painful sex OR, 1.39; 97.5% CI, 1.19-2.75; P = 0.007), Middle Eastern (weight changes OR, 2.22; 97.5% CI, 1.25-4.37; P = 0.01), or with two or more races/ethnicities (skin/hair changes OR, 1.41; 97.5% CI, 1.26-1.58; P < 0.001) reported higher levels of symptom severity compared with their White counterparts. Conversely, Asian and South Asian participants reported lower symptom severity. Even after incorporating SES into the linear model, racial and ethnic groups with lower SES (Black, Hispanic, Indigenous, and multiple ethnicities) exhibited slight shifts in OR while maintaining high statistical significance (Black [hot flashes OR, 1.87; 97.5% CI, 1.72-2.04; P < 0.001], Hispanic [skin/hair changes OR, 1.54; 97.5% CI, 1.42-1.68; P < 0.001], Indigenous/First Nations [painful sex OR, 1.74; 97.5% CI, 1.17-2.70; P = 0.009], multiple ethnicities [skin/hair changes OR, 1.41; 97.5% CI, 1.26-1.58; P < 0.001]).

CONCLUSIONS: Our study suggests that the relationship between race and ethnicity and the severity of menopause symptoms is not solely explained by differences in SES but is itself an independent factor. Understanding and addressing social, cultural, and economic factors are crucial to reduce disparities in menopausal symptoms.

PMID:38652870 | DOI:10.1097/GME.0000000000002349

ACS Nano. 2024 Apr 23. doi: 10.1021/acsnano.3c10842. Online ahead of print.

ABSTRACT

Conjugated polymers have become materials of choice for applications ranging from flexible optoelectronics to neuromorphic computing, but their polydispersity and tendency to aggregate pose severe challenges to their precise characterization. Here, the combination of vacuum electrospray deposition (ESD) with scanning tunneling microscopy (STM) is used to acquire, within the same experiment, assembly patterns, full mass distributions, exact sequencing, and quantification of polymerization defects. In a first step, the ESD-STM results are successfully benchmarked against NMR for low molecular mass polymers, where this technique is still applicable. Then, it is shown that ESD-STM is capable of reaching beyond its limits by characterizing, with the same accuracy, samples that are inaccessible to NMR. Finally, a recalibration procedure is proposed for size exclusion chromatography (SEC) mass distributions, using ESD-STM results as a reference. The distinctiveness of the molecular-scale information obtained by ESD-STM highlights its role as a crucial technique for the characterization of conjugated polymers.

PMID:38652866 | DOI:10.1021/acsnano.3c10842

Fam Med. 2024 Apr 16. doi: 10.22454/FamMed.2024.548752. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Climate change is a major threat to the health of people worldwide. The health care system deals with the immediate health-related effects of climate change and, at the same time, is a major emitter of greenhouse gas. This study aimed to investigate (a) the awareness and perception of climate change among family medicine residency program directors, and (b) the state of climate change education in family medicine residency programs.

METHODS: The Council of Academic Family Medicine Educational Research Alliance (CERA) conducted a cross-sectional survey of family medicine program directors in the United States in April 2023. We analyzed anonymous data using descriptive and bivariate statistics.

RESULTS: We analyzed responses from 284 family medicine residency program directors (response rate 41.1%). Of these, 56.8% indicated not having any lectures/seminars dedicated to climate change and no plans to introduce such curricula, with considerably higher rates in East South Central United States (92.8%). A majority considered principles of climate change, carbon emissions emitted by the health care system, and discussion of climate change with patients of lesser importance for residency program education.

CONCLUSIONS: While climate change is an emerging topic affecting health and the provision of health care worldwide, our study suggests that many family medicine residency programs do not teach about it. Family medicine trainees may not always receive sufficient education about the risks posed to their patients by climate change, which could lead to them having limited knowledge and skills when discussing this topic with their patients in the future.

PMID:38652853 | DOI:10.22454/FamMed.2024.548752

Fam Med. 2024 Apr 15. doi: 10.22454/FamMed.2024.990826. Online ahead of print.

ABSTRACT

Background &amp; Objectives: No prior studies have examined how length of training may influence wellness. As part of the Length of Training Pilot (LoTP), we explored resident and new graduate well-being according to program year and length of training in 3- and 4-year family medicine residency training programs.

METHODS: Two surveys captured data included in these analyses. One was a resident survey that included the Mayo Clinic physician-expanded Well-Being Index (eWBI) administered annually during the In-Training Examination (2014-2019). The second was administered to graduates 1 year after completion of training between 2016 and 2022 and included the same well-being questions. Response rates ranged between 77.7% and 96.8%.

RESULTS: The eWBI summary scores for burnout were highest in postgraduate year 1 (PGY1) and did not differ statistically according to length of training (PGY1: 2.02 in 3-year [3YR] programs vs 1.93 in 4-year [4YR] programs, P=.55; postgraduate year 2 [PGY2]: 2.42 in 3YR programs vs 2.38 in 4YR programs, P=.83; postgraduate year 3 [PGY3]: 2.18 in 3YR programs vs 2.28 in 4YR programs, P=.59; and 2.34 in postgraduate year 4 [PGY4] for those in 4YR programs), though some statistical differences were noted for three items. New graduates’ eWBI summary scores before the COVID-19 pandemic were 1.77 among 3YR graduates and 1.66 among 4YR graduates (P=.59). These scores were higher during COVID-19 at 1.89 for 3YR graduates and 2.02 for 4YR graduates (P=.62). Length of training was not associated with differences in well-being before or during COVID-19.

CONCLUSIONS: We found no associations between length of training and physician well-being during training or among new graduates before or during COVID-19.

PMID:38652850 | DOI:10.22454/FamMed.2024.990826

J Phys Chem B. 2024 Apr 23. doi: 10.1021/acs.jpcb.4c00899. Online ahead of print.

ABSTRACT

We propose a framework for describing the dynamics associated with the adsorption of small molecules to liquid-vapor interfaces using an intermediate resolution between traditional continuum theories that are bereft of molecular detail and molecular dynamics simulations that are replete with them. In particular, we develop an effective single particle equation of motion capable of describing the physical processes that determine thermal and mass accommodation probabilities. The effective equation is parametrized with quantities that vary through space away from the liquid-vapor interface. Of particular importance in describing the early time dynamics is the spatially dependent friction, for which we propose a numerical scheme to evaluate from molecular simulation. Taken together with potentials of mean force computable with importance sampling methods, we illustrate how to compute the mass accommodation coefficient and residence time distribution. Throughout, we highlight the case of ozone adsorption in aqueous solutions and its dependence on electrolyte composition.

PMID:38652843 | DOI:10.1021/acs.jpcb.4c00899

ACS Appl Mater Interfaces. 2024 Apr 23. doi: 10.1021/acsami.4c03369. Online ahead of print.

ABSTRACT

Poly(vinylidene fluoride) (PVDF) shows excellent chemical and thermal resistance and displays high dielectric strength and unique piezoelectricity, which are enabling for applications in membranes, electric insulators, sensors, or power generators. However, its low polarity and lack of functional groups limit wider applications. While inert, PVDF has been modified by grafting polymer chains by atom transfer radical polymerization (ATRP), albeit via an unclear mechanism, given the strong C-F bonds. Herein, we applied eosin Y and green-light-mediated ATRP to modify PVDF-based materials. The method gave nearly quantitative (meth)acrylate monomer conversions within 2 h without deoxygenation and without the formation of unattached homopolymers, as confirmed by control experiments and DOSY NMR measurements. The gamma distribution model that accounts for broadly dispersed polymers in DOSY experiments was essential and serves as a powerful tool for the analysis of PVDF. The NMR analysis of poly(methyl acrylate) graft chain-ends on PVDF-CTFE (statistical copolymer with chlorotrifluoroethylene) was carried out successfully for the first time and showed up to 23 grafts per PVDF-CTFE chain. The grafting density was tunable depending on the solvent composition and light intensity during the grafting. The initiation proceeded either from the C-Cl sites of PVDF-CTFE or via unsaturations in the PVDF backbones. The dehydrofluorinated PVDF was 20 times more active than saturated PVDF during the grafting. The method was successfully applied to modify PVDF, PVDF-HFP, and Viton A401C. The obtained PVDF-CTFE-g-PnBMA materials were investigated in more detail. They featured slightly lower crystallinity than PVDF-CTFE (12-18 vs 24.3%) and had greatly improved mechanical performance: Young’s moduli of up to 488 MPa, ductility of 316%, and toughness of 46 × 10⁶ J/m³.

PMID:38652837 | DOI:10.1021/acsami.4c03369

Clin Endocrinol (Oxf). 2024 Apr 23. doi: 10.1111/cen.15060. Online ahead of print.

ABSTRACT

CONTEXT: Epidemiological studies involving patients with acromegaly have yielded conflicting results regarding cancer incidence and causes of mortality in relation to control of growth hormone (GH) excess.

OBJECTIVE: The objective of this retrospective cohort study is to clarify these questions and identify goals for treatment and monitoring patients.

METHODS: We studied 1845 subjects from the UK Acromegaly Register (1970-2016), obtaining cancer standardised incidence rates (SIR) and all causes standardised mortality rates (SMR) from UK Office for National Statistics, to determine the relationship between causes of mortality-age at diagnosis, duration of disease, post-treatment and mean GH levels.

RESULTS: We found an increased incidence of all cancers (SIR, 1.38; 95% CI: 1.06-1.33, p < .001), but no increase in incidence of female breast, thyroid, colon cancer or any measure of cancer mortality. All-cause mortality rates were increased (SMR, 1.35; 95% CI: 1.24-1.46, p < .001), as were those due to vascular and respiratory diseases. All-cause, all cancer and cardiovascular deaths were highest in the first 5 years following diagnosis. We found a positive association between post-treatment and mean treatment GH levels and all-cause mortality (p < .001 and p < .001), which normalised with posttreatment GH levels of <1.0 µg/L or meantreatment GH levels of <2.5 µg/L.

CONCLUSION: Acromegaly is associated with increased incidence of all cancers but not thyroid or colon cancer and no increase in cancer mortality. Excess mortality is due to vascular and respiratory disease. The risk is highest in the first 5 years following diagnosis and is mitigated by normalising GH levels.

PMID:38652736 | DOI:10.1111/cen.15060