Category: Statistics

Acta Biomed. 2023 Aug 3;94(4):e2023107. doi: 10.23750/abm.v94i4.14184.

ABSTRACT

BACKGROUND AND AIM: The study aimed to evaluate the epidemiological trend of hand, foot and mouth disease (HFMD) in Italy using data on Internet search volume.

METHODS: A cross-sectional study design was used. Data on Internet searches were obtained from Google Trends (GT) and Wikipedia. We used the following Italian search term: “Malattia mano-piede-bocca” (Hand-foot-mouth disease, in English). A monthly time-frame was extracted, partly overlapping, from July 2015 to December 2022. GT and Wikipedia were overlapped to perform a linear regression and correlation analyses. Statistical analyses were performed using the Spearman’s rank correlation coefficient (rho). A linear regression analysis was performed considering Wikipedia and GT.

RESULTS: Search peaks for both Wikipedia and GT occurred in the months November-December during the autumn-winter season and in June during the spring-summer season, except for the period from June 2020 to June 2021, probably due to the restrictions of the COVID19 pandemic. A temporal correlation was observed between GT and Wikipedia search trends.

CONCLUSIONS: This is the first study in Italy that attempts to clarify the epidemiology of HFMD. Google search and Wikipedia can be valuable for public health surveillance; however, to date, digital epidemiology cannot replace the traditional surveillance system.

PMID:37539609 | DOI:10.23750/abm.v94i4.14184

Acta Biomed. 2023 Aug 3;94(4):e2023167. doi: 10.23750/abm.v94i4.14229.

ABSTRACT

BACKGROUND AND AIM: To investigate the association between CYP17A1 (rs74357) polymorphism and the risk of Polycystic Ovary Syndrome (PCOS).

METHODS: Literature on the association of CYP17rs74357 gene polymorphism and susceptibility to PCOS was retrieved by searching databases such as PubMed, Science Direct, Google Scholar and Embase from. The association measure was analyzed using an Odds Ratio (OR) and 95% Confidence Interval (CI). All the statistical analyses were executed using CMA 3.0 Software.

RESULTS: In the present meta-analysis,24 studies including 3462 PCOS and 2898 controls were analyzed. The overall results validated that the 17 CYP17 T/C (rs74357) gene polymorphism was significantly associated with PCOS risk in 5 genetic models: recessive model (fixed and random effect), dominant model (random effect), CC vs. TT (fixed effect), CT vs. TT (fixed effect), and allele contrast (random effect). Stratified analyses by ethnicity/country also detected significant association between Asian and Caucasian under the recessive, dominant, CC vs. TT, CC vs. CT, and the allele contrast models.

CONCLUSIONS: In the present study, CYP17 T/C (rs74357) gene polymorphism increase the susceptibility of PCOS, and the recessive C allele, can be proposed as a predictive factor for the risk of PCOS or an important pathway in PCOS associated metabolic and hormonal dysregulation especially insulin resistance.However, larger sample size andmultiracial studies are needed in the future to confirm the findings.

PMID:37539608 | DOI:10.23750/abm.v94i4.14229

Acta Biomed. 2023 Aug 3;94(4):e2023206. doi: 10.23750/abm.v94i4.14719.

ABSTRACT

BACKGROUND AND AIM OF THE WORK: Work-family and family-work conflict can be defined as the degree to which participation in one role, in this case as a worker, interferes with the ability to cope with the responsibilities of another role, namely that of a member of a household. The aim of the study is to investigate the presence of indicators of work- family and/or family-work conflict in a cohort of Italian nurses and possible correlations with social and work variables.

RESEARCH DESIGN AND METHODS: An observational, quantitative, multicenter survey was conducted for the study through the computerized administration of a validated questionnaire (Work-Family and Family-Work Conflict, CLF), with the implementation of sociographic variables. The cooperation of 15 Orders of Nursing Professions throughout the country was sought for sample collection. Data collection was bimonthly.

RESULTS: Among the participating nurses, there is a statistically significant predominance of conflict in the family-work direction. In particular, the phenomenon seems to be related to age and the presence of children and/or elderly at home to care for. Some work variables seem to positively affect the prevention of potential work-life conflict, such as rostering and work articulation.

CONCLUSIONS: These findings place emphasis on the need for healthcare organizations to address the work-family balance of their employees.

PMID:37539595 | DOI:10.23750/abm.v94i4.14719

Chaos. 2023 Aug 1;33(8):083109. doi: 10.1063/5.0156492.

ABSTRACT

The occurrence mechanisms of extreme events under random disturbances are relatively complex and not yet clear. In this paper, we take a class of generalized Duffing-type systems as an example to reveal three mechanisms for the occurrence of extreme events. First, it is intuitive that a very large excitation can generate extreme events, such as the Lévy noise. In such a case, extreme excitation works, while it does not require much about the systems. Second, when a system has a bifurcation structure, if the difference of the branches at the bifurcation point is large, a randomly varying bifurcation parameter can lead to extreme events. Finally, when a system has rare attractors, a random impulse excitation, such as Poisson white noise, is able to cause the system to escape from one general attractor into rare attractors. Such a kind of special regime switching behavior can lead to extreme events. These results reveal the possible mechanisms of extreme events in a class of nonlinear Duffing-type systems and provide guidance for further prediction and avoidance of extreme events.

PMID:37539590 | DOI:10.1063/5.0156492

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023 May 28;48(5):691-697. doi: 10.11817/j.issn.1672-7347.2023.220481.

ABSTRACT

OBJECTIVES: Clinically, it has been found that some patients with epilepsy are accompanied by cerebellar atrophy that is inconsistent with symptoms, but the pattern of cerebellar atrophy after epilepsy and the role of cerebellar atrophy in the mechanism of epilepsy have not been elucidated. This study aims to explore the specific pattern of cerebellar atrophy after epilepsy via analyzing magnetic resonance images in patients with postepileptic cerebellar atrophy.

METHODS: A total of 41 patients with epilepsy, who received the treatment in Xiangya Hospital of Central South University from January 2017 to January 2022 and underwent cranial MRI examination, were selected as the case group. The results of cranial MRI examination of all patients showed cerebellar atrophy. In the same period, 41 cases of physical examination were selected as the control group. General clinical data and cranial MRI results of the 2 groups were collected. The maximum area and signal of dentate nucleus, the maximum width of the brachium pontis, the maximum anterior-posterior diameter of the pontine, and the maximum transverse area of the fourth ventricle were compared between the 2 groups. The indexes with difference were further subjected to logistic regression analysis to clarify the characteristic imaging changes in patients with cerebellar atrophy after epilepsy.

RESULTS: Compared with the control group, the maximum width of the brachium pontis and the maximum anterior-posterior diameter of the pontine were decreased significantly, the maximum transverse area of the fourth ventricle was increased significantly in the case group (all P<0.05). The difference in distribution of the low, equal, and high signal in dentate nucleus between the 2 groups was statistically significant (χ²=43.114, P<0.001), and the difference in the maximum area of dentate nucleus between the 2 groups was not significant (P>0.05). The maximum width of the brachium pontis [odds ratio (OR)=3.327, 95% CI 1.454 to 7.615, P=0.004] and the maximum transverse area of the fourth ventricle (OR=0.987, 95% CI 0.979 to 0.995, P=0.002) were independent factors that distinguished cerebellar atrophy after epilepsy from the normal control, while the anterior-posterior diameter of pontine (OR=1.456, 95% CI 0.906 to 2.339, P>0.05) was not an independent factor that distinguished them.

CONCLUSIONS: In MRI imaging, cerebellar atrophy after epilepsy is manifested as significant atrophy of the brachium pontis, significant enlargement of the fourth ventricle, and increased dentate nucleus signaling while insignificant dentate nucleus atrophy. This particular pattern may be associated with seizures and exacerbated pathological processes.

PMID:37539571 | DOI:10.11817/j.issn.1672-7347.2023.220481

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023 May 28;48(5):663-670. doi: 10.11817/j.issn.1672-7347.2023.220541.

ABSTRACT

OBJECTIVES: Endothelium-dependent vasodilation dysfunction is the pathological basis of diabetic macroangiopathy. The utilization and adaptation of endothelial cells to high glucose determine the functional status of endothelial cells. Glycolysis pathway is the major energy source for endothelial cells. Abnormal glycolysis plays an important role in endothelium-dependent vasodilation dysfunction induced by high glucose. Pyruvate kinase isozyme type M2 (PKM2) is one of key enzymes in glycolysis pathway, phosphorylation of PKM2 can reduce the activity of pyruvate kinase and affect the glycolysis process of glucose. TEPP-46 can stabilize PKM2 in its tetramer form, reducing its dimer formation and phosphorylation. Using TEPP-46 as a tool drug to inhibit PKM2 phosphorylation, this study aims to explore the impact and potential mechanism of phosphorylated PKM2 (p-PKM2) on endothelial dependent vasodilation function in high glucose, and to provide a theoretical basis for finding new intervention targets for diabetic macroangiopathy.

METHODS: The mice were divided into 3 groups: a wild-type (WT) group (a control group, C57BL/6 mice) and a db/db group (a diabetic group, db/db mice), which were treated with the sodium carboxymethyl cellulose solution (solvent) by gavage once a day, and a TEPP-46 group (a treatment group, db/db mice+TEPP-46), which was gavaged with TEPP-46 (30 mg/kg) and sodium carboxymethyl cellulose solution once a day. After 12 weeks of treatment, the levels of p-PKM2 and PKM2 protein in thoracic aortas, plasma nitric oxide (NO) level and endothelium-dependent vasodilation function of thoracic aortas were detected. High glucose (30 mmol/L) with or without TEPP-46 (10 μmol/L), mannitol incubating human umbilical vein endothelial cells (HUVECs) for 72 hours, respectively. The level of NO in supernatant, the content of NO in cells, and the levels of p-PKM2 and PKM2 protein were detected. Finally, the effect of TEPP-46 on endothelial nitric oxide synthase (eNOS) phosphorylation was detected at the cellular and animal levels.

RESULTS: Compared with the control group, the levels of p-PKM2 in thoracic aortas of the diabetic group increased (P<0.05). The responsiveness of thoracic aortas in the diabetic group to acetylcholine (ACh) was 47% lower than that in the control group (P<0.05), and that in TEPP-46 treatment group was 28% higher than that in the diabetic group (P<0.05), while there was no statistically significant difference in the responsiveness of thoracic aortas to sodium nitroprusside (SNP). Compared with the control group, the plasma NO level of mice decreased in the diabetic group, while compared with the diabetic group, the phosphorylation of PKM2 in thoracic aortas decreased and the plasma NO level increased in the TEPP-46 group (both P<0.05). High glucose instead of mannitol induced the increase of PKM2 phosphorylation in HUVECs and reduced the level of NO in supernatant (both P<0.05). HUVECs incubated with TEPP-46 and high glucose reversed the reduction of NO production and secretion induced by high glucose while inhibiting PKM2 phosphorylation (both P<0.05). At the cellular and animal levels, TEPP-46 reversed the decrease of eNOS (ser1177) phosphorylation induced by high glucose (both P<0.05).

CONCLUSIONS: p-PKM2 may be involved in the process of endothelium-dependent vasodilation dysfunction in Type 2 diabetes by inhibiting p-eNOS (ser1177)/NO pathway.

PMID:37539568 | DOI:10.11817/j.issn.1672-7347.2023.220541

Dis Esophagus. 2023 Aug 3:doad053. doi: 10.1093/dote/doad053. Online ahead of print.

ABSTRACT

The aim of this study was to evaluate the effect of intraoperative botulinum toxin (BT) injection on delayed gastric emptying (DGE) and need for endoscopic pyloric intervention (NEPI) following esophagectomy. In compliance with Preferred Reporting Items for Systematic reviews and Meta-Analyses statement standards, a systematic review of studies reporting the outcomes of intraoperative BT injection in patients undergoing esophagectomy for esophageal cancer was conducted. Proportion meta-analysis model was constructed to quantify the risk of the outcomes and direct comparison meta-analysis model was constructed to compare the outcomes between BT injection and no BT injection or surgical pyloroplasty. Meta-regression was modeled to evaluate the effect of variations in different covariates among the individual studies on overall summary proportions. Nine studies enrolling 1070 patients were included. Pooled analyses showed that the risks of DGE and NEPI following intraoperative BT injection were 13.3% (95% confidence interval [CI]: 7.9-18.6%) and 15.2% (95% CI: 7.9-22.5%), respectively. There was no difference between BT injection and no BT injection in terms of DGE (odds ratio [OR]: 0.57, 95% CI: 0.20-1.61, P = 0.29) and NEPI (OR: 1.73, 95% CI: 0.42-7.12, P = 0.45). Moreover, BT injection was comparable to pyloroplasty in terms of DGE (OR: 0.85, 95% CI: 0.35-2.08, P = 0.73) and NEPI (OR: 8.20, 95% CI: 0.63-105.90, P = 0.11). Meta-regression suggested that male gender was negatively associated with the risk of DGE (coefficient: -0.007, P = 0.003). In conclusion, level 2 evidence suggests that intraoperative BT injection may not improve the risk of DGE and NEPI in patients undergoing esophagectomy. The risk of DGE seems to be higher in females and in early postoperative period. High quality randomized controlled trials with robust statistical power are required for definite conclusions. The results of the current study can be used for hypothesis synthesis and power analysis in future prospective trials.

PMID:37539558 | DOI:10.1093/dote/doad053

J Glob Health. 2023 Aug 4;13:04030. doi: 10.7189/jogh.13.04030.

ABSTRACT

BACKGROUND: Individuals with rare diseases (RD) have been historically understudied. Previous publications reported that existing primary health care (PHC) workforces and associated infrastructure had been shown to improve their access and health-related outcomes in low- and middle-income countries (LMICs). As current evidence about the impact of PHC on patients diagnosed with RD is yet highly dispersed, this scoping review aimed to collate available evidence of the impact of PHC on patients with RD and summarize published information from multiple stakeholders about the perceived usefulness and barriers to effective use of the PHC system.

METHODS: We searched Embase, Health System Evidence, PubMed, LILACS / BVS, and The Cochrane Library, from inception to September 1, 2022, for publications providing clear expert- or experience-based insights or data from patients living with RD at the PHC level of care. We included publications highlighting barriers to integrated care of patients with RD, reported by multiple social actors involved in caring for patients with RD. Two investigators screened publications, extracted data, and clustered information among records deemed eligible for inclusion. Data synthesis was performed using narrative and thematic-based analysis. Major findings identified and coded through a semantic-driven analysis were processed in vosViewer software and reported using descriptive statistics.

FINDINGS: Eighty publications were included in this review. Quali-quantitative analyses evidenced that the PHC level is essential for approaching patients with RD, mainly due to its longitudinal, multidisciplinary, and coordinated care delivery. In addition, several publications highlighted that the medical curriculum is inappropriate for preparing health care providers to deal with patients presenting unusual signs and symptoms and being diagnosed with RD. PHC teams are essential in orienting patients and families on emergency events. Technology-related concepts were reported in 19 publications, emphasizing their effectiveness on early diagnosis, optimal treatment definition, improvement of quality of life, and long-lasting follow-up.

CONCLUSIONS: We provided valuable information on the effectiveness of the PHC in fostering a creative, integrative, and supportive environment for patients living with RD. Our results can be helpful to several stakeholders in deciding what actions are still pending to achieve a solid and positive experience for patients with RD in the PHC.

REGISTRATION: PROSPERO (CRD42022332347).

PMID:37539555 | DOI:10.7189/jogh.13.04030

Rev Esp Enferm Dig. 2023 Aug 4. doi: 10.17235/reed.2023.9668/2023. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to evaluate the effects of age, period and cohort (A-P-C) on gastric cancer (GC) mortality in Spain from 1980-2021.

METHODS: We conducted an ecological trend study (with aggregated data obtained from the National Institute of Statistics). Joinpoint regression software was used to estimate rates by sex and age group (<35, 35-64, >64 years) and mortality trends. National Cancer Institute A-P-C tools were used to assess the effects of age, time of death, and birth cohort.

RESULTS: GC mortality rates in Spain decreased significantly for both sexes in Spain. In the under-35 age group, rates were stable after an initial significant decline. In the 35-64 age group, the decline was more pronounced in men than in women. In the 65+ age group, rates fell significantly for both sexes, but more so for women than for men. The net drift and local drift also showed significant decreases for all age groups from 24 years onwards. GC mortality rates increased with age and decreased with calendar time and successive birth cohorts, regardless of sex. The ratio of age-specific rates between men and women increased with age, and birth cohort relative risk estimates followed a steady downward trend until the mid-1970s, after which the decline stabilized. The relative risk decreased for both sexes, with a more pronounced decrease in men.

CONCLUSION: GC mortality rates in Spain have been decreasing over time and across successive birth cohorts, with a stabilising trend observed for those under 35 years of age.

PMID:37539520 | DOI:10.17235/reed.2023.9668/2023

Ital J Dermatol Venerol. 2023 Aug;158(4):347-352. doi: 10.23736/S2784-8671.23.07588-6.

ABSTRACT

BACKGROUND: Recently, YouTube has been frequently used by non-physicians and physicians to share information and experiences about diseases. This study aims to compare videos uploaded to YouTube about urticaria in terms of quality, reliability, usefulness, and popularity based on the uploaded source.

METHODS: YouTube was searched using the keyword “urticaria”. From the search returns, we selected the first 60 videos created by physicians and the first 60 videos created by non-physicians. We compared the two sets of videos in terms of reliability, usefulness, quality, and popularity using the Video Power Index (VPI) score, DISCERN score, global quality score (GQS) and usefulness score.

RESULTS: The mean DISCERN score, GQS, and usefulness score were statistically significantly higher (P<0.001) for videos uploaded by physicians than those uploaded by non-physicians. Although not statistically significant, the median number of likes and comments, the rate of views, and the VPI scores were higher for videos uploaded by the non-physician group. The mean DISCERN scores, GQS, and usefulness scores were statistically significantly higher (P<0.001) for videos uploaded by specialist physicians (dermatologists and allergists) than for those uploaded by non-specialists. Specialist physicians mentioned medical treatment for the condition more than non-specialists, which was statistically significant (P<0.001).

CONCLUSIONS: YouTube videos about urticaria uploaded by physicians, especially specialists, are of higher quality, reliable and useful, but videos uploaded by non-physicians are more popular and have higher viewing rates.

PMID:37539503 | DOI:10.23736/S2784-8671.23.07588-6