Category: Statistics

Front Neurol. 2023 Jul 31;14:1218448. doi: 10.3389/fneur.2023.1218448. eCollection 2023.

ABSTRACT

INTRODUCTION: Stress is a common psychological problem present in people with epilepsy and has a serious impact on the health-related satisfaction of people with epilepsy and their cohabiters. This study aimed to assess the magnitude and related factors of stress.

METHODS: A hospital-based cross-sectional study was carried out among 301 systematically chosen people with epilepsy. The seven stress-related items of the Depression, Anxiety, and Stress -21 questionnaire was used to measure stress. Data were entered using Epi Info and analyzed by SPSS version 25. Predictors with a p-value < 0.20 in the bivariate logistic regression were transferred into the multivariate model. A p-value of less than 0.05 was viewed as statistically significant.

RESULT: The prevalence of stress symptoms in this study was 23.9%. Daily labor occupational status with Adjusted Odds ratio [(AOR) = 0.042, 95% CI: 0.004, 0.469], onset of illness at the age of 18 years and above (AOR = 0.188, 95% CI: 0.046, 0.771), perceived stigma (AOR = 3.320, 95% CI: 1.345, 8.200), the presence of anxiety symptoms (AOR = 8.275, 95% CI: 3.345, 20.471), and belief that the condition is untreatable (AOR = 6.360, 95% CI: 1.647, 24.562) were significantly associated factors.

CONCLUSION: The occurrence of stress was high, and it reinforced that there is a requisite for the identification and handling of stress-related symptoms among people with epilepsy.

PMID:37583951 | PMC:PMC10425181 | DOI:10.3389/fneur.2023.1218448

World J Clin Oncol. 2023 Jul 24;14(7):259-264. doi: 10.5306/wjco.v14.i7.259.

ABSTRACT

BACKGROUND: The incidence of anal cancer has been increasing in the United States. Smoking is a well-established risk factor; however, the impact of smoking on disease re-currence and outcome has not been well studied. The aim of this study was to assess the association between anal cancer recurrence and cigarette smoking.

AIM: To investigate the relationship between cigarette smoking status and anal cancer treatment outcome.

METHODS: The cancer registry from a single, community hospital was screened for patients with anal cancer between 2010 and 2021. The following characteristics were gathered from the database: Age; sex; cigarette smoking history; American Joint Committee on Cancer Clinical Stage Group; response to therapy; recurrence; time to recurrence; mortality; time to death; and length of follow-up. Patients were divided into the following groups: Current smokers; former smokers; and never smokers. SPSSv25.0 software (IBM Corp., Armonk, NY, United States) was used for statistical analysis.

RESULTS: A total of 95 patients from the database met the screening criteria. There were 37 never smokers, 22 former smokers, and 36 current smokers. There was no difference between groups in regards to race or sex. There was no difference in the American Joint Committee on Cancer Clinical Stage Group between groups. The former smokers were significantly older when compared to never smokers and current smokers (66.5 ± 13.17 vs 57.4 ± 7.82 vs 63.7 ± 13.80, P = 0.011). Former smokers and current smokers had a higher recurrence rate compared to never smokers (30.8% and 20.8% compared to zero, P = 0.009). There was not a significant difference in recurrence between former smokers and current smokers. There was no difference in the mortality, non-response rate, or time to death between the groups.

CONCLUSION: Our data contributes evidence that cigarette smoking status is associated with increased recurrence for patients with anal cancer.

PMID:37583947 | PMC:PMC10424090 | DOI:10.5306/wjco.v14.i7.259

Hong Kong Physiother J. 2023 Dec;43(2):129-135. doi: 10.1142/S1013702523500142. Epub 2023 Jun 26.

ABSTRACT

BACKGROUND: Impairments in postural sway have been identified in people with mechanical neck pain. The influence of cervical spine range of motion (ROM) on postural sway is unclear in mechanical neck pain (MNP).

OBJECTIVE: This study investigated the relationship between cervical spine range of motion (ROM) and postural sway in MNP.

METHODS: The cervical ROM was measured using the Cervical Range of Motion (CROM) device. Standing postural sway characterised by mean centre of pressure (COP) measurements in the anterior posterior (AP) and medio-lateral direction with eyes closed and feet together condition was recorded on a posturography platform. Pearson product moment correlation coefficient was used to identify the relationship between cervical ROM and postural sway.

RESULTS: Seventy-two MNP individuals (Mean age: $29.9\pm 11.7$) of either sex (Male: $\text{Female}=23:49$) were recruited. Overall, no statistically significant correlations were identified between cervical spine ROM in sagittal and frontal plane and postural sway (r values ranging from 0.00 to $–0.38$; p-values $>0.05$). However, a weak negative correlation was present between the cervical rotation and AP (r–$\text{value}=-0.23$; p–$\text{value}=0.04$) and mediolateral (r–$\text{value}=-0.38$; p–$\text{value}=0.01$) COP excursion.

CONCLUSION: The cervical spine ROM was found to have a weak relationship with postural sway in individuals with MNP. This suggests the investigation of other mechanisms especially muscle tension which might be responsible for altered postural sway in MNP.

PMID:37583925 | PMC:PMC10423670 | DOI:10.1142/S1013702523500142

Neurologist. 2023 Jun 27. doi: 10.1097/NRL.0000000000000507. Online ahead of print.

ABSTRACT

BACKGROUND: A pilot randomized trial evaluating whether a social support intervention improves adherence to home blood pressure (BP) monitoring among patients with cerebrovascular disease.

METHODS: Subjects with ischemic stroke, intracerebral hemorrhage, or transient ischemic attack within 5 years with BP >140/90, were given a centrally monitored home BP cuff and asked to check their BP twice a day for 90 ± 7 days. Subjects received text and/or email reminders for missed measurements and weekly reports on adherence/BP control. Subjects were randomized 1:1 to a social support intervention, in which close personal contact also received all study-related education and communications. The primary outcome was the proportion of requested measurements completed. A secondary outcome was a change in BP over time.

RESULTS: Thirty-three subjects were enrolled, 15 in the control arm and 18 in the social support arm. The social support arm completed a greater proportion of BP measurements at day 30 (88% vs 78%), day 60 (72% vs 54%), and day 83 (60% vs 40%), but none of these differences were statistically significant (P > 0.05). Comparing the first 7 days of BP readings to the last 7 days across subjects, there was a nonsignificant decrease in BP over time (systolic BP = -2.8 mm Hg, P = 0.29 and diastolic BP = -1.7, P = 0.36). The social support intervention did not modify the change in BP over time.

CONCLUSION: A social support intervention may increase adherence to home BP monitoring. This pilot study provides important preliminary data to inform the design of larger more definitive trials utilizing self-monitoring of BP in patients with cerebrovascular disease.

PMID:37582619 | DOI:10.1097/NRL.0000000000000507

ACR Open Rheumatol. 2023 Aug 15. doi: 10.1002/acr2.11588. Online ahead of print.

ABSTRACT

OBJECTIVE: In a study of physical and cognitive functioning among predominantly Black individuals with systemic lupus erythematosus (SLE), we compared remotely administered physical and cognitive performance assessments to those collected in person.

METHODS: A subset of participants who completed an in-person visit in our parent study from 2021 to 2022 (n = 30) were recruited to complete a second, remote visit within 28 days. Physical performance (measured by a modified Short Physical Performance Battery [SPPB]; range 0-12; subscale ranges 0-4; higher = better performance) and cognitive performance (episodic and working memory adjusted t-scores, measured using NIH Toolbox) were measured at both visits. Mean scores were compared using paired t-tests; intraclass correlation coefficients (ICCs) were obtained from two-way mixed effects models. Linear and logistic models were used to estimate stratified associations between performance measures and related outcomes.

RESULTS: Participants were primarily female (93.3%) and Black (93.3%). In-person versus remote overall SPPB (8.76 vs. 9.43) and chair stand (1.43 vs. 1.90) scores were statistically significantly lower. t-Scores for episodic memory (47.27 vs. 49.53) and working memory (45.37 vs. 47.90) were lower for in-person versus remote visits. The ICC for overall SPPB indicated good agreement (0.76), whereas the ICCs for episodic (0.49) and working memory (0.57) indicated poor-moderate agreement. Associations between assessments of performance with related outcomes were similar and did not statistically significantly differ by modality of visit.

CONCLUSION: To possibly expand and diversify pools of participants in studies of physical and cognitive performance in SLE, remote administration of assessments should be considered for future research.

PMID:37582606 | DOI:10.1002/acr2.11588

J Korean Med Sci. 2023 Aug 14;38(32):e248. doi: 10.3346/jkms.2023.38.e248.

ABSTRACT

The pediatric population with comorbidities is a high-risk group for severe coronavirus disease 2019 (COVID-19). As of January 2023, the COVID-19 vaccination rate for at least two doses among Korean children 5-11 years is low at 1.1%. We summarized the COVID-19 vaccination status for the pediatric population (5-17 years) with comorbidities through July 2022 using the National Health Insurance Service database. Pediatric patients with comorbidities had higher vaccination rates than the general pediatric population (2.4% vs. 1.1% in 5-11-year-olds [P < 0.001], 76.5% vs. 66.1% in 12-17-year-olds [P < 0.001]). However, there were substantial differences according to comorbidity category, and the 2-dose vaccination rate was lowest among children with immunodeficiency in all age groups (1.1% in 5-11-year-olds, 51.2% in 12-17-year-olds). The COVID-19 vaccination rate among Korean children has remained stagnant at a low proportion despite ongoing outreach. Thus, more proactive strategies are needed alongside continuous surveillance.

PMID:37582498 | DOI:10.3346/jkms.2023.38.e248

J Am Vet Med Assoc. 2023 Aug 15:1-8. doi: 10.2460/javma.23.03.0135. Online ahead of print.

ABSTRACT

OBJECTIVE: To report the short- and long-term outcomes of laparoscopic adrenalectomy (LA) for resection of unilateral adrenal masses and to document risk factors for conversion and peri- and postoperative morbidity.

ANIMALS: 255 client-owned dogs.

METHODS: Dogs were included if LA was attempted for resection of a unilateral adrenal mass. Medical records were evaluated and relevant data were reported, including complications, conversion, perioperative death, and long-term outcomes. Signalment, clinicopathological data, and surgical experience were factors statistically evaluated for possible associations with capsular penetration during surgery, conversion, surgical time, duration of hospital stay, death prior to discharge, mass recurrence, and survival time.

RESULTS: 155 dogs had left-sided tumors, and 100 had right-sided tumors. Conversion to an open approach was performed in 9.4% of cases. Capsular penetration (19.2%) and major hemorrhage (5.4%) were the most prevalent intraoperative complications. Of the dogs operated on, 94.9% were discharged from the hospital. Lesion side, portion of the gland affected, and surgeon experience influenced surgical time. Conversion rate increased with increasing body condition score and lesion size. Risk of death prior to discharge increased with increasing lesion size. Risk of conversion and death prior to discharge were lower when performed by more experienced surgeons. Capsular penetration during LA increased the risk of tumor recurrence.

CLINICAL RELEVANCE: LA for resection of unilateral adrenal masses is associated with excellent outcomes in experienced centers. Surgeons with greater experience with LA have lower surgical times, conversion rates, and risk of death prior to discharge.

PMID:37582487 | DOI:10.2460/javma.23.03.0135

J Am Med Dir Assoc. 2023 Aug 12:S1525-8610(23)00645-X. doi: 10.1016/j.jamda.2023.07.016. Online ahead of print.

ABSTRACT

OBJECTIVES: Deprescribing reduces polypharmacy in older adults. A thorough study of the effect of deprescribing interventions on clinical outcomes in older adults is presently lacking. As a result, we evaluated the impact of deprescribing on clinical outcomes in older patients.

DESIGN: Meta-analysis and systematic review of randomized controlled trials (RCTs). PubMed, EMBASE, and Cochrane Library were searched from the time of creation to March 2023.

SETTING AND PARTICIPANTS: Randomized controlled trial with participants at least 60 years old.

MEASURES: Mortality, falls (number of fallers), hospitalization rates, emergency department visits, medication adherence, HRQoL (health-regulated quality of life), incidence of ADR (adverse drug reactions), PIM (potentially inappropriate medication), and PPO (potentially prescription omission) were evaluated in the meta-analysis.

RESULTS: A total of 32 RCTs (18,670 patients) were included. Deprescribing interventions significantly reduced proportions of older adults with PIM, PPO, and the incidence of ADRs. The interventions group also improved medication compliance.

CONCLUSIONS AND IMPLICATIONS: Compared to routine care, deprescribing interventions significantly improve clinical outcome indicators for older adults.

PMID:37582482 | DOI:10.1016/j.jamda.2023.07.016

Int J Antimicrob Agents. 2023 Aug 13:106952. doi: 10.1016/j.ijantimicag.2023.106952. Online ahead of print.

ABSTRACT

INTRODUCTION: Molnupiravir and nirmatrelvir/ritonavir are antivirals used to prevent progression to severe SARS-CoV-2 infections, which reduce both hospitalization and mortality rates. Nirmatrelvir/ritonavir was authorised in Europe in December 2021, while molnupiravir is not yet licensed in Europe as of February 2022. Molnupiravir may be an alternative to nirmatrelvir/ritonavir, because it displays less frequent drug-drug interactions and contraindications. A caveat connected to molnupiravir derives from the mode of action inducing viral mutations. In clinical trials on patients without haematological malignancy, mortality rate reduction of molnupiravir appeared less pronounced than that of nirmatrelvir/ritonavir. Little is known about the comparative efficacy of the two drugs in patients with haematological malignancy at high-risk of severe COVID-19. Thus, we here assess the effectiveness of molnupiravir compared to nirmatrelvir/ritonavir in our cohort of patients with haematological malignancies.

METHODS: Clinical data of patients treated either with molnupiravir or nirmatrelvir/ritonavir monotherapy for COVID-19 were retrieved from the EPICOVIDEHA registry. Patients treated with molnupiravir were matched by sex, age (±10 years), and baseline haematological malignancy severity to controls treated with nirmatrelvir/ritonavir.

RESULTS: A total of 116 patients receiving molnupiravir for the clinical management of COVID-19 were matched to an equal number of controls receiving nirmatrelvir/ritonavir. In each of the groups, 68 (59%) patients were male; with a median age of 64 years (IQR 53-74) for molnupiravir recipients and 64 years (IQR 54-73) for nirmatrelvir/ritonavir recipients; 57% (n=66) of the patients had controlled baseline haematological malignancy, 13% (n=15) stable, and 30% (n=35) had active disease at COVID-19 onset in each of the groups. During COVID-19 infection, one third of patients from each group were admitted to hospital. Although a similar proportion of vaccinated patients was observed in both groups (molnupiravir n=77, 66% vs nirmatrelvir/ritonavir n=87, 75%), those treated with nirmatrelvir/ritonavir had more often received four doses (n=27, 23%) as compared to patients treated with molnupiravir (n=5, 4%, p<0.001). No differences were detected in COVID-19 severity (p=0.39) or hospitalization (p=1.0). No statistically significant differences were identified in overall mortality rate (p=0.78) or in survival probability (d30 p=0.19, d60 p=0.67, d90 p=0.68, last day of follow up p=0.68). In all patients, deaths were either attributed to COVID-19 or the infection contributed to death as per treating physician’s judgement.

CONCLUSIONS: In high-risk patients with haematological malignancies and COVID-19, molnupiravir showed rates of hospitalization and mortality comparable to those of nirmatrelvir/ritonavir in this matched-pair analysis. Molnupiravir appears to be a plausible alternative to nirmatrelvir/ritonavir for COVID-19 treatment in patients with haematological malignancy.

PMID:37582478 | DOI:10.1016/j.ijantimicag.2023.106952

Sci Total Environ. 2023 Aug 13:166278. doi: 10.1016/j.scitotenv.2023.166278. Online ahead of print.

ABSTRACT

Mineralogical investigations on fluvial sedimentary sequences could provide historical environmental information on the effects of human activities and natural events. This study aims to identify the provenance, mineralogical distribution mechanism, and environmental significance of sediments of the Yellow River based on topographic analysis, statistics, weathering and recycling indices. In total, 107 samples were collected from sedimentary sequences in the source area, and the upper, middle, and lower reaches and analyzed for grain size, major elements, and mineral composition. The results showed that the climate conditions were cold and arid, where weak hydrolysis under continental weathering and strong erosion accelerated physical weathering. Clay minerals primarily originated from the Tibetan Plateau, whereas the middle and lower reaches received input of aeolian deposits from Northern China. Quartz and feldspar in the middle and lower reaches may derive from the source area and upper reaches. Meanwhile, calcite and dolomite formed through diagenesis, with loess input from the Chinese Loess Plateau. Regarding heavy minerals, the dominant determinative factors of pyrite were post-depositional diagenesis and leaching. Hematite and amphibole primarily formed through magnetite conversion and contribution from regional sources, respectively. Moreover, the mineral distribution mechanism significantly affected the mobility and distribution of geochemical elements through diagenesis and alteration. The findings are instrumental in reconstructing the environmental evolution of large-scale watersheds across multiple climatic zones.

PMID:37582450 | DOI:10.1016/j.scitotenv.2023.166278