Category: Statistics

Dev Med Child Neurol. 2024 Mar 25. doi: 10.1111/dmcn.15897. Online ahead of print.

ABSTRACT

AIM: To describe the aetiological risk factors, clinical characteristics, access to rehabilitation, and educational status of children with cerebral palsy (CP) in Suriname.

METHOD: Hospital-based surveillance of children with CP aged younger than 18 years was conducted at the Academic Hospital Paramaribo, Suriname (known as the Suriname CP Register [SUR-CPR]). Data were collected on sociodemographic characteristics, aetiological risk factors, clinical characteristics, rehabilitation, and educational status. Registry data on aetiological risk factors were compared with available national prevalence rates in Suriname. Descriptive statistics were reported.

RESULTS: Between August 2018 and March 2020, 82 children with CP (mean [SD] age 5 years 10 months [3 years 10 months]) attending the Academic Hospital Paramaribo were registered in the SUR-CPR. The mean (SD) age at diagnosis was 5 years 5 months (4 years 1 month). Spastic CP was predominant in 90.8% of children and 58.8% were classified in Gross Motor Function Classification System levels III to V. Overall, 43.9% had preterm birth compared with 13.9% reported nationally (p < 0.001) and 61.6% had birth-related complications compared with 15% reported nationally (p < 0.001). Additionally, 39.1% had birth asphyxia and 23.2% had early feeding difficulties. Sixty-two percent were admitted to the neonatal intensive care unit, 54.0% of whom required ventilation. Most children (82.5%) had CP acquired pre- or perinatally and 17.5% had CP acquired postneonatally. Seventeen percent had never received any rehabilitation services, and 31.9% of the school-aged children were not enrolled in any education system.

INTERPRETATION: The high burden of known aetiological risk factors, delayed diagnosis, and severe functional impairment among children with CP registered at the Academic Hospital Paramaribo is concerning. Public health interventions targeting early diagnosis and early intervention could improve the functional outcome of children with CP in Suriname.

PMID:38525657 | DOI:10.1111/dmcn.15897

Korean J Gastroenterol. 2024 Mar 25;83(3):111-118. doi: 10.4166/kjg.2023.141.

ABSTRACT

BACKGROUND/AIMS: This study compared the effectiveness and safety of glecaprevir/pibrentasvir (GLE/PIB) and sofosbuvir/ledipasvir (SOF/LDV) in real-life clinical practice.

METHODS: The data from genotype 1 or 2 chronic hepatitis C patients treated with GLE/PIB or sofosbuvir + ribavirin or SOF/LDV in South Korea were collected retrospectively. The analysis included the treatment completion rate, sustained virologic response at 12 weeks (SVR12) test rate, treatment effectiveness, and adverse events.

RESULTS: Seven hundred and eighty-two patients with genotype 1 or 2 chronic hepatitis C who were treated with GLE/PIB (n=575) or SOF/LDV (n=207) were included in this retrospective study. The baseline demographic and clinical characteristics revealed significant statistical differences in age, genotype, ascites, liver cirrhosis, and hepatocellular carcinoma between the GLE/PIB and SOF/LDV groups. Twenty-two patients did not complete the treatment protocol. The treatment completion rate was high for both regimens without statistical significance (97.7% vs. 95.7%, p=0.08). The overall SVR12 of intention-to-treat analysis was 81.2% vs. 80.7% without statistical significance (p=0.87). The overall SVR12 of per protocol analysis was 98.7% vs. 100% without statistical significance (p=0.14). Six patients treated with GLE/PIB experienced treatment failure. They were all male, genotype 2, and showed a negative hepatitis C virus RNA level at the end of treatment. Two patients treated with GLE/PIB stopped medication because of fever and abdominal discomfort.

CONCLUSIONS: Both regimens had similar treatment completion rates, effectiveness, and safety profiles. Therefore, the SOF/LDV regimen can also be considered a viable DAA for the treatment of patients with genotype 1 or 2 chronic hepatitis C.

PMID:38522854 | DOI:10.4166/kjg.2023.141

J Dairy Sci. 2024 Mar 22:S0022-0302(24)00620-9. doi: 10.3168/jds.2023-24256. Online ahead of print.

ABSTRACT

This study documents the current state of biosecurity on dairy farms in Québec following the implementation of a mandatory biosecurity risk evaluation that was part of the proAction® accreditation program developed by Dairy Farmers of Canada. Using a cross-sectional design, 3,825 risk assessment questionnaires completed between 2018 and 2021 were extracted from Vigil-Vet database, which is a software utilized by veterinarians for conducting the proAction® risk assessment. Descriptive statistics were used to summarize the practices adopted by dairy producers. Additionally, multiple correspondence analysis was used to explore the association between the diseases of most concern and the adoption of biosecurity practices. Moreover, we used a hierarchical cluster analysis on principal components to identify distinct patterns of biosecurity practices among dairy producers. This analysis enabled the identification of typologies or clusters of farms based on the specific biosecurity practices they currently employ. The results of the descriptive statistics indicated that mastitis was the disease of most concern for most dairy farmers (40%). Moreover, given that only 10% of the 2,237 dairy farmers who acquired animals adhered to quarantine practices, there seems to be a need for improved implementation of biosecurity measures aimed at restricting the introduction of diseases when introducing new animals. Conversely, cleaning stalls and health equipment were adequately addressed by 95% and 86% of dairy producers, respectively. The multiple correspondence analysis indicated no significant association between the disease of most concern and the farm’s biosecurity profile, except for respondents who identified digital dermatitis as their disease of most concern. Through the hierarchical cluster analysis, 3 clusters were identified among 3,581 farms: (1) Cluster 1 included farms with good management of sick animals; (2) Cluster 2 included farms with good management of young animals; and (3) Cluster 3 included farms with poor management of sick animals and young animals. Our study makes an important contribution by providing valuable insights into the biosecurity practices currently adopted on Québec dairy farms. It establishes a baseline for assessing progress in biosecurity practices adoption and serves as a reference point for future evaluations. In addition, these findings play a key role in monitoring the effectiveness of interventions aimed at improving biosecurity on dairy farms. By making use of this knowledge, stakeholders can make informed decisions that prioritize animal health, increase productivity, and ensure sustainability of the dairy industry.

PMID:38522832 | DOI:10.3168/jds.2023-24256

Endocr Pract. 2024 Mar 22:S1530-891X(24)00091-0. doi: 10.1016/j.eprac.2024.03.008. Online ahead of print.

ABSTRACT

INTRODUCTION: High-resolution ultrasonography devices have led to the increased detection of thyroid nodules and the need for fine-needle aspiration biopsy (FNAB). However, FNAB is an invasive procedure that can cause discomfort and pain. Music therapy has been used for centuries to alleviate pain, and our clinical trial was conducted to investigate its impact on pain scores during thyroid FNAB.

MATERIALS AND METHODS: We conducted a randomized, controlled clinical trial, including adult patients undergoing thyroid FNAB. We evaluated the non-pharmacological intervention of listening to music before and during thyroid FNAB. We used a slow, non-lyrical, flowing melody with a tempo of 60 to 80 beats per minute as a therapeutic intervention for managing anxiety and pain. It had low tones, minimal percussion, and a volume of around 60 decibels. The Beck Anxiety Inventory and Visual Pain Scale were used.

RESULTS: The study included 529 patients assigned to either the music group (n=258, 48.7%) or the control group (n=271, 51.2%). The patients were categorized into subgroups based on either a single nodule (73.63%) or multiple nodules (24.18%). When all patients or single nodule and multiple data are examined separately, the intervention group showed statistically significantly lower pain scores than the control group.

CONCLUSION: Our study is among the first on this topic and the largest in the available literature to demonstrate that listening to music during FNAB significantly reduces pain and anxiety. Music therapy is an effective, safe, and noninvasive intervention that can improve patient care and reduce distress and pain.

PMID:38522825 | DOI:10.1016/j.eprac.2024.03.008

Endocr Pract. 2024 Mar 22:S1530-891X(24)00090-9. doi: 10.1016/j.eprac.2024.03.007. Online ahead of print.

NO ABSTRACT

PMID:38522824 | DOI:10.1016/j.eprac.2024.03.007

J Infect Chemother. 2024 Mar 22:S1341-321X(24)00083-7. doi: 10.1016/j.jiac.2024.03.008. Online ahead of print.

ABSTRACT

BACKGROUND: Time-dependent changes in cell populations during acute bacterial infections remain unclear. We assessed time-dependent changes in fluorescent light intensity of the neutrophil area (NE-SFL) and fluorescent light distribution width index of the neutrophil area (NE-WY) and their association with sepsis and bacteremia.

METHODS: Patients with acute bacterial infections were enrolled in this prospective, observational cohort study. Blood samples were collected from all patients at the onset of bacterial infections (day 0) and on days 1 and 3. Microbiological evaluation included the examination of blood bacterial load using PCR. Cell population data were assessed using an automated hematology analyzer (Sysmex series XN-2000).

RESULTS: Forty-three participants with acute bacterial infections were enrolled in the study. Twenty-five participants developed definite sepsis. All the participants improved after the onset of infection. NE-WY levels showed significant time-dependent changes in participants with sepsis, peaking on day 0 and significantly decreasing until day 3, whereas these changes were not statistically significant for NE-SFL. A significant correlation with the Sequential Organ Failure Assessment score was observed with NE-WY and NE-SFL in the entire cohort on days 0 and 1. However, only NE-WY showed a significant correlation with blood bacterial load on days 0 and 1.

CONCLUSION: This study demonstrated that NE-WY elevation in sepsis peaked earlier than NE-SFL, which may partly reflect the early bacterial invasion into circulation. These findings advocate caution in interpreting cell population data values as sepsis biomarkers and propose the potential of NE-WY as a therapeutic indicator.

PMID:38522794 | DOI:10.1016/j.jiac.2024.03.008

World Neurosurg. 2024 Mar 22:S1878-8750(24)00461-3. doi: 10.1016/j.wneu.2024.03.092. Online ahead of print.

ABSTRACT

OBJECTIVE: The process surrounding application to the national residency matching program changed drastically because of COVID. Virtual interviews, pre-interview zoom socials, and limitations on sub-internships are major changes that applicants worldwide have had to overcome. The available literature does not reflect the impact of major changes to the interview process. Here, we examine the neurosurgery resident cohort from 2021-2023 to investigate differences between United States medical schools pre- and post-COVID.

METHODS: A database was constructed reporting the number of students matched to neurosurgery for U.S. medical schools (MD and DO) from 2021-2023. Percentage of total graduates matched to neurosurgery was calculated and institutions were ranked by this metric. This rank was compared to the rank reported by Antar et al in 2021. Variables were compared across the pre- and post-COVID cohorts.

RESULTS: Case Western, Johns Hopkins, Mayo Clinic, Vanderbilt, University of Illinois and University of California San Francisco produced the most neurosurgical residents as a percentage of total graduates. There was a statistically significant difference in the post-COVID cohort between medical schools with a home program vs those without. For the top 20 ranked U.S. News medical schools, there was a statistically insignificant increase in the number of graduates matched to neurosurgery CONCLUSIONS: With the data provided, there have not been many significant changes in which medical schools produce the most neurosurgery residents since COVID changes were implemented. The playing field has remained relatively the same in the setting of major changes that were made.

PMID:38522786 | DOI:10.1016/j.wneu.2024.03.092

J Nutr. 2024 Mar 22:S0022-3166(24)00164-0. doi: 10.1016/j.tjnut.2024.03.015. Online ahead of print.

ABSTRACT

There is an increasing body of evidence supporting a link between low intakes of omega-3 long chain polyunsaturated fatty acids (LCPUFA) and numerous diseases and health conditions. However, few people are achieving the levels of fish/seafood or eicosapentaenoic acid and docosahexaenoic acid intake recommended in national and international guidelines. Knowledge of a person’s omega-3 LCPUFA status will benefit the interpretation of research results and could be expected to lead to an increased effort to increase intake. Dietary intake survey methods are often used as a surrogate for measuring omega-3 PUFA tissue status and its impact on health and functional outcomes. However, since individuals vary widely in their ability to digest and absorb omega-3 PUFA, analytical testing of biological samples is desirable to accurately evaluate omega-3 PUFA status. Adipose tissue is the reference biospecimen for measuring tissue fatty acids, but less invasive methods, such as measurements in whole blood or its components (e.g., plasma, serum, red blood cell membranes) or breast milk are often used. Numerous commercial laboratories provide fatty acid testing of blood and breast milk samples by different methods and present their results in a variety of reports such as a full fatty acid profile, omega-3 and omega-6 fatty acid profiles, fatty acid ratios, as well as the Omega-3 Index, the Holman Omega-3 Test, OmegaScore™, and OmegaCheck®, among others. This narrative review provides information about the different ways to measure omega-3 LCPUFA status (including both dietary assessments and selected commercially available analytical tests of blood and breast milk samples) and discusses evidence linking increased omega-3 LCPUFA intake or status to improved health, focusing on cardiovascular, neurological, pregnancy, and eye health, in support of recommendations to increase omega-3 LCPUFA intake and testing.

PMID:38522783 | DOI:10.1016/j.tjnut.2024.03.015

Parasitol Int. 2024 Mar 22:102889. doi: 10.1016/j.parint.2024.102889. Online ahead of print.

ABSTRACT

There are various diagnostic techniques available for chronic fasciolosis in ruminants. However, many of them exhibit low specificity and sensitivity, making them impractical for field use and in low-resource laboratories. The present study evaluates the usefulness of the Natural Sedimentation technique in diagnosing chronic fasciolosis in three domestic species conducted at the Laboratorio de Parasitología y Enfermedades Parasitarias, Facultad de Ciencias Veterinas, Universidad Nacional de Cajamarca. Fecal samples were collected from n = 323 cattle, n = 362 sheep, and n = 231 swine for Fasciola hepatica fecal egg counts. The visualization of adult parasites in animal livers post-mortem was considered the gold standard. Additionally, the sensitivity of the technique was evaluated using five different amounts of feces. In cattle, a sensitivity of 0.93 ± 0.03, specificity of 0.91 ± 0.06, positive predictive value of 0.96 ± 0.03, and negative predictive value of 0.86 ± 0.07 were obtained. In sheep, a sensitivity of 0.79 ± 0.05, specificity of 0.83 ± 0.07, positive predictive value of 0.90 ± 0.04, and negative predictive value of 0.66 ± 0.08 were observed. In swine, a sensitivity of 0.92 ± 0.06, specificity of 1.00 ± 0.00, positive predictive value of 1.00 ± 0.00, and negative predictive value of 0.96 ± 0.03 were found. There was no statistical difference in egg counts when using 1, 2, 3, 4, and 5 g of feces (p = 0.907). Furthermore, 1 to 688 fecal eggs of F. hepatica were counted in 1 g of feces. The Natural Sedimentation technique has both qualitative and quantitative applications with satisfactory results when using 1 g of feces in the diagnosis of chronic fasciolosis in domestic animals. Due to its simplicity, it can be implemented in field conditions and low-resource laboratories.

PMID:38522780 | DOI:10.1016/j.parint.2024.102889

J Shoulder Elbow Surg. 2024 Mar 22:S1058-2746(24)00215-5. doi: 10.1016/j.jse.2024.01.054. Online ahead of print.

ABSTRACT

BACKGROUND: The purpose of this study is to systematically review the evidence in the literature to ascertain the functional outcomes, recurrence rates, and subsequent revision rates following type V superior labrum anterior-posterior (SLAP) repair.

METHODS: Two independent reviewers performed a literature search based on PRISMA guidelines, utilizing the EMBASE, MEDLINE, and The Cochrane Library Databases. Studies were included if they had clinical outcomes on the patients undergoing type V SLAP repair. Statistical analysis was performed using SPSS (IBM, Armonk, NY, USA). A P value of < 0.05 was considered to be statistically significant.

RESULTS: Our review found 13 studies, including 451 shoulders meeting our inclusion criteria. The majority of patients were male (89.3%), with an average age of 25.9 years (range 15-58) and a mean follow-up of 53.8 months. The Rowe score was the most utilized functional outcome score, with a weighted mean of 88.5. Additionally, the mean Constant score was 91.0, the mean ASES score was 88.3, the mean SSV score was 85.5%, and the mean VAS pain score was 1.2. The overall rate of return to play was 84.8%, with 80.2% returning to the same level of play. The overall reoperation rate was 6.1%, with a recurrent dislocation rate of 8.2%. In the studies comparing type V SLAP and isolated Bankart repair, there were statistically insignificant differences in VAS pain scores (MD; 0.15, 95% CI, -0.13 to 0.44, I² = 0%, p = 0.29) and recurrence rates (RR; 1.38, 95% CI, 0.88 to 2.15, I² = 0%, p = 0.16).

CONCLUSION: Arthroscopic repair of type V SLAP tears results in excellent functional outcomes, with high return to play rates in athletes. There are low rates of reoperations and recurrent dislocations. Additionally, in comparison to an isolated Bankart repair, SLAP repair does not increase recurrence rates or postoperative pain.

PMID:38522776 | DOI:10.1016/j.jse.2024.01.054