Category: Statistics

Dis Markers. 2022 Sep 22;2022:5062591. doi: 10.1155/2022/5062591. eCollection 2022.

ABSTRACT

OBJECTIVE: To investigate the prognosis and influencing factors of early microsurgery for severe hypertensive brainstem hemorrhage.

METHODS: The clinical data of 19 patients with severe hypertensive brainstem hemorrhage treated in the Department of Neurosurgery of the Second Affiliated Hospital of Shandong First Medical University between January 2018 and December 2021 were retrospectively analyzed. The clinical efficacy and risk factors affecting the prognosis were analyzed by chi-square test and multivariate logistic regression.

RESULTS: A total of 19 patients with severe hypertensive brainstem hemorrhage were treated by early microsurgery, including 14 cases by subtemporal approach and 5 cases by retrosigmoid approach. After 3 months of follow-up, 6 patients died and 13 patients survived. The 30-day and 90-day mortality rates were 21.1% and 31.6%, respectively, and the good prognosis rate was 15.4%. Univariate analysis showed that hematoma volume and hematoma clearance rate might be the factors affecting the prognosis of patients with severe hypertensive brainstem hemorrhage; the observed difference was statistically significant (P < 0.05). Multivariate logistic regression analysis further confirmed that hematoma volume was an independent factor affecting the death of patients with brainstem hemorrhage (P < 0.05), while hematoma volume (B: 2.909, OR: 18.332, 95% CI: 1.020-329.458, P: 0.048) was a risk factor.

CONCLUSION: Hematoma volume resulted as an independent factor affecting the death of patients with severe hypertensive brainstem hemorrhage. Early microsurgical clearance of brainstem hematoma contributed to reducing the 30-day and 90-day mortality and improving the prognosis of patients.

PMID:36193500 | PMC:PMC9526571 | DOI:10.1155/2022/5062591

Dis Markers. 2022 Sep 23;2022:2191294. doi: 10.1155/2022/2191294. eCollection 2022.

ABSTRACT

OBJECTIVE: This study was to investigate the correlation between glycated haemoglobin (HbA1c) level, cardiac function, and prognosis in patients with diabetes mellitus combined with myocardial infarction.

METHODS: Ninety-three patients with type 2 diabetes mellitus combined with acute myocardial infarction who were hospitalized and treated in our hospital from January 2021 to June 2021 were recruited for prospective analysis and equally divided into group A (HbA1c < 6.5%), group B (6.5% ≤ HbA1c ≤ 8.5%), and group C (HbA1c > 8.5%) using the random number table method, with 31 patients in each group. General data of patients were collected on admission and blood glucose and cardiac function indexes were measured; the incidence of myocardial infarction and death during the follow-up period was recorded at 6 months after discharge.

RESULTS: There was a significant difference in blood glucose (FBG) and HbA1c levels at fasting between the three groups (P < 0.05). There were statistically significant differences in plasma levels of N-terminal probrain natriuretic peptide (NT-proBNP) and uric acid (UA), left ventricular end diastolic diameter (LVEDD), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF), and cardiac function classification of the New York Heart Association (NYHA) among the three groups (P < 0.05). By statistical analysis, the HbA1c level was positively correlated with FBG, NT-proBNP, UA, LVEDD, LVESD, and NYHA grades but negatively correlated with LVEF (P < 0.05). The incidence rate of myocardial infarction and mortality was significantly higher in group C than in groups A and B (P < 0.05).

CONCLUSION: HbA1c level in patients with diabetes mellitus combined with myocardial infarction is closely related to the degree of cardiac function damage. Glycated haemoglobin levels are associated with the development of cardiac insufficiency in patients with acute myocardial infarction; glycated haemoglobin is also an independent predictor of major adverse cardiovascular events. Reasonable and effective blood glucose control is of great significance to the prognosis of patients.

PMID:36193498 | PMC:PMC9525741 | DOI:10.1155/2022/2191294

Dis Markers. 2022 Sep 22;2022:6971717. doi: 10.1155/2022/6971717. eCollection 2022.

ABSTRACT

OBJECTIVE: To systematically evaluate the clinical efficacy and safety of karelizumab combined with apatinib in the treatment of advanced gastric cancer.

METHODS: The published databases were searched by computer, Chinese: China Biomedical Literature Database (CBM), Wanfang Journal Database, China national knowledge infrastructure (CNKI), and China Science and Technology Journal Database (VIP); English: Embase, Cochrane library, and PubMed. The search time is from the establishment of the database to May 2022, and clinical randomized controlled trials (RCT) with advanced gastric cancer as the research object and karelizumab combined with apatinib as the research variables are collected. According to the bias risk evaluation standard of Cochrane System Evaluator’s Manual, the literatures meeting the inclusion standard were evaluated for bias risk, and the meta-analysis was conducted by Review Manager 5.3. Results. A total of 20 articles with 1150 patients were included in this study. All the included 20 articles reported objective remission rate (ORR), and the heterogeneity among 20 studies was low (P > 0.05, I ² = 0%). The ORR of gastric cancer patients in the observation group was significantly higher than that in the blank group [odds ratio (OR) = 1.97, 95% CI [1.53, 2.62], P < 0.01). All the included 20 articles reported disease control rate (DCR), and the heterogeneity among 20 studies was low (P = 0.87, I ² = 0%). The ORR of gastric cancer patients in the observation group was significantly higher than that in the blank group (OR = 3.09, 95% CI [2.29, 4.16], P < 0.01). Three articles in the included literature reported the median OS, and the heterogeneity among the three studies was low (P = 0.70, I ² = 0%). The median OS of gastric cancer patients in the observation group was significantly higher than that in the blank group (MD = 3.97, 95% CI [3.61, 4.39], P < 0.01). There are three reports on median progression-free survival (PFS) in the included literature, and there is high homogeneity among the three studies (P < 0.00001, I ² = 86%). There is no statistical difference between the median PFS of gastric cancer patients in the observation group and the blank group (MD = 1.21, 95% CI [-1.20, 3.70], P = 0.29). The incidence of hypertension in the observation group was significantly higher than that in the blank group [OR = 6.19, 95% CI (1.91, 20.20), P = 0.003]. The incidence of proteinuria in the observation group was significantly higher than that in the blank group [OR = 3.97, 95% CI (1.08, 14.59), P = 0.03]. There was no significant difference in the incidence of other adverse reactions such as hand-foot syndrome, diarrhea, and myelosuppression between the observation group and the blank group. The levels of IFN-γ and TNF-α in the observation group were significantly higher than those in the blank group (P < 0.0001). The levels of IL-10, IL-4, and tumor markers in the observation group were significantly lower than those in the blank group (P < 0.05). Egger’s test showed that there was no publication bias in the 20 included studies (P > 0.05).

CONCLUSION: Karelizumab combined with apatinib is effective in the treatment of advanced gastric cancer, with low incidence of adverse reactions and high safety. However, a large number of multicenter, large sample size, and high-level RCT are needed for clinical verification.

PMID:36193493 | PMC:PMC9526574 | DOI:10.1155/2022/6971717

PeerJ. 2022 Sep 28;10:e14049. doi: 10.7717/peerj.14049. eCollection 2022.

ABSTRACT

BACKGROUND: The intensity of strength training exercise is generally regarded to be the most essential element in developing muscle strength and power. The exercise intensity of strength training is known as one-repetition maximum (1RM). Velocity-based training (VBT) has been proposed as a different approach for determining training intensity. VBT relies on the use of linear position transducers and inertial measurement units, providing real-time feedback to objectively adjust the exercise intensity based on an athlete’s velocity zone.

METHODS: This study investigated the effects of two different training interventions based on individualized load velocity profiles (LVP) on maximal bench press strength (i.e., 1RM), maximum throwing velocity (TV), and skeletal muscle mass (SKMM). Twenty-two university handball players were randomly assigned to Group 1 (low-movement speed training) or Group 2 (high-movement speed training). Group 1 exercised with a bar speed of 0.75-0.96 m/s, which corresponds to a resistance of approximately 60% 1RM, whereas Group 2 trained at 1.03-1.20 m/s, corresponding to a resistance of approximately 40% 1RM. Both groups exercised three times a week for five weeks, with strength and throwing tests performed at baseline and post-intervention.

RESULTS: A two-way repeated measures ANOVA was applied, and the results showed the interaction between group and time was not statistically significant for SKMM (p = 0.537), 1RM (p = 0.883), or TV (p = 0.774). However, both groups significantly improved after the five weeks of training: SKMM (3.1% and 3.5%, p < 0.01), 1RM (15.5% and 15.0%, p < 0.01), and throwing velocity (18.7% and 18.3%, p < 0.01) in Group 1 and 2 respectively. Training at both prescribed velocities in this study elicited similar changes in strength, muscle mass, and throwing velocity.

PMID:36193438 | PMC:PMC9526411 | DOI:10.7717/peerj.14049

PeerJ. 2022 Sep 28;10:e14089. doi: 10.7717/peerj.14089. eCollection 2022.

ABSTRACT

BACKGROUND: The use of the internet as a source of information has increased during the pandemic, and YouTube has become an increasingly important source of information on Coronavirus disease 2019 (COVID-19). In the long COVID picture, which occurs when symptoms related to COVID-19 last longer than 1 month, pain involving the musculoskeletal system affects the quality of life quite negatively. The aim of this study was to investigate the informational value and quality of YouTube videos related to post-COVID pain.

METHODS: In this study, 180 videos were listed using the search terms “pain after COVID,” “post-COVID pain,” and “long COVID and pain”(15 April 2022). Videos were classified according to video parameters and content analysis. Quality, reliability and accuracy of the videos were determined with the Global Quality Score (GQS), the Journal of American Medical Association (JAMA) Benchmark Criteria and the Modified DISCERN Questionnaire, respectively.

RESULTS: One hundred videos that met the inclusion criteria were included in the assessment. Of these videos, 74 were found to be of low quality, 14 of moderate quality, and 12 of high quality; 21% contained insufficient data, 73% contained partially sufficient data, and 6% contained completely sufficient data. Videos uploaded by academic sources (66.7%) and physicians (12.5%) made up the majority of the high-quality group. A statistically significant correlation was found between the source of upload and number of views (p = 0.014), likes (p = 0.030), comments (p = 0.007), and video duration (p = 0.004). Video duration was found to have a poor positive correlation with GQS (r = 0.500), JAMA (r = 0.528), and modified DISCERN (r = 0.470) scores (p < 0.001).

CONCLUSION: The findings of this study revealed that the majority of YouTube videos on post-COVID pain had low quality and partially sufficient data. High-quality videos were found to have longer durations and were uploaded by academic sources and physicians. The fact that only videos with English content at a certain time can be counted among the limitations. For patients suffering from post-COVID pain whose access to healthcare services was interrupted during the COVID pandemic, YouTube can be considered as an alternative source as well as a means of telerehabilitation. It can be argued that higher quality videos created by healthcare professionals could aid in patient education in the future.

PMID:36193427 | PMC:PMC9526419 | DOI:10.7717/peerj.14089

Infect Dis Poverty. 2022 Oct 4;11(1):104. doi: 10.1186/s40249-022-01030-7.

ABSTRACT

BACKGROUND: Countries that aimed for eliminating the cases of COVID-19 with test-trace-isolate policy are found to have lower infections, deaths, and better economic performance, compared with those that opted for other mitigation strategies. However, the continuous evolution of new strains has raised the question of whether COVID-19 eradication is still possible given the limited public health response capacity and fatigue of the epidemic. We aim to investigate the mechanism of the Zero-COVID policy on outbreak containment, and to explore the possibility of eradication of Omicron transmission using the citywide test-trace-isolate (CTTI) strategy.

METHODS: We develop a compartmental model incorporating the CTTI Zero-COVID policy to understand how it contributes to the SARS-CoV-2 elimination. We employ our model to mimic the Delta outbreak in Fujian Province, China, from September 10 to October 9, 2021, and the Omicron outbreak in Jilin Province, China for the period from March 1 to April 1, 2022. Projections and sensitivity analyses were conducted using dynamical system and Latin Hypercube Sampling/ Partial Rank Correlation Coefficient (PRCC).

RESULTS: Calibration results of the model estimate the Fujian Delta outbreak can end in 30 (95% confidence interval CI: 28-33) days, after 10 (95% CI: 9-11) rounds of citywide testing. The emerging Jilin Omicron outbreak may achieve zero COVID cases in 50 (95% CI: 41-57) days if supported with sufficient public health resources and population compliance, which shows the effectiveness of the CTTI Zero-COVID policy.

CONCLUSIONS: The CTTI policy shows the capacity for the eradication of the Delta outbreaks and also the Omicron outbreaks. Nonetheless, the implementation of radical CTTI is challenging, which requires routine monitoring for early detection, adequate testing capacity, efficient contact tracing, and high isolation compliance, which constrain its benefits in regions with limited resources. Moreover, these challenges become even more acute in the face of more contagious variants with a high proportion of asymptomatic cases. Hence, in regions where CTTI is not possible, personal protection, public health control measures, and vaccination are indispensable for mitigating and exiting the COVID-19 pandemic.

PMID:36192815 | DOI:10.1186/s40249-022-01030-7

BMC Nutr. 2022 Oct 3;8(1):108. doi: 10.1186/s40795-022-00602-y.

ABSTRACT

BACKGROUND: To evaluate the impact of home-delivered, medically tailored meals and medical nutrition therapy among food-insecure patients following hospitalization for congestive heart failure by comparing clinical outcomes to a retrospectively matched cohort.

METHODS: Patients at high risk for readmission and food insecurity received up to three months of medically tailored meals and medical nutrition therapy after discharge. Pre-intervention and post-intervention weight, body mass index, blood pressure, and dietary intake were assessed. A combination of difference-in-difference and logistic regression models were used to compare changes between cohorts and evaluate impact attributable to the program.

RESULTS: Thirty-nine program participants were compared to a matched cohort of 117 unexposed patients. Participants experienced a marginal reduction in body mass index and an increase in systolic and diastolic blood pressure; however, these results were not statistically significant. To determine relevance to clinical cut-offs, logistic regressions were used, demonstrating that exposure to the intervention resulted in higher odds of a categorical reduction in blood pressure (OR: 1.85), though this did not reach statistical significance (95% CI: 0.67-5.32). Pre vs. post trends indicated that more-healthful foods and drinks increased numerically or remained similar to baseline, while less-healthful foods decreased numerically or remained similar to baseline.

CONCLUSIONS AND IMPLICATIONS: These findings highlight the need for more longitudinal research on medically tailored meals and medical nutrition therapy interventions using clinical outcomes while setting realistic suggestions for program implementation. This study additionally illustrates the promise of integrating electronic medical record data and matched cohorts into medical nutrition program evaluation within the health sector.

PMID:36192812 | DOI:10.1186/s40795-022-00602-y

Genome Biol. 2022 Oct 3;23(1):208. doi: 10.1186/s13059-022-02753-4.

ABSTRACT

Microbiome studies of inflammatory bowel diseases (IBD) have achieved a scale for meta-analysis of dysbioses among populations. To enable microbial community meta-analyses generally, we develop MMUPHin for normalization, statistical meta-analysis, and population structure discovery using microbial taxonomic and functional profiles. Applying it to ten IBD cohorts, we identify consistent associations, including novel taxa such as Acinetobacter and Turicibacter, and additional exposure and interaction effects. A single gradient of dysbiosis severity is favored over discrete types to summarize IBD microbiome population structure. These results provide a benchmark for characterization of IBD and a framework for meta-analysis of any microbial communities.

PMID:36192803 | DOI:10.1186/s13059-022-02753-4

Crit Care. 2022 Oct 3;26(1):304. doi: 10.1186/s13054-022-04158-y.

ABSTRACT

BACKGROUND: Inhaled nitric oxide (iNO) is used as rescue therapy in patients with refractory hypoxemia due to severe COVID-19 acute respiratory distress syndrome (ARDS) despite the recommendation against the use of this treatment. To date, the effect of iNO on the clinical outcomes of critically ill COVID-19 patients with moderate-to-severe ARDS remains arguable. Therefore, this study aimed to evaluate the use of iNO in critically ill COVID-19 patients with moderate-to-severe ARDS.

METHODS: This multicenter, retrospective cohort study included critically ill adult patients with confirmed COVID-19 treated from March 01, 2020, until July 31, 2021. Eligible patients with moderate-to-severe ARDS were subsequently categorized into two groups based on inhaled nitric oxide (iNO) use throughout their ICU stay. The primary endpoint was the improvement in oxygenation parameters 24 h after iNO use. Other outcomes were considered secondary. Propensity score matching (1:2) was used based on the predefined criteria.

RESULTS: A total of 1598 patients were screened, and 815 were included based on the eligibility criteria. Among them, 210 patients were matched based on predefined criteria. Oxygenation parameters (PaO₂, FiO₂ requirement, P/F ratio, oxygenation index) were significantly improved 24 h after iNO administration within a median of six days of ICU admission. However, the risk of 30-day and in-hospital mortality were found to be similar between the two groups (HR: 1.18; 95% CI: 0.77, 1.82; p = 0.45 and HR: 1.40; 95% CI: 0.94, 2.11; p= 0.10, respectively). On the other hand, ventilator-free days (VFDs) were significantly fewer, and ICU and hospital LOS were significantly longer in the iNO group. In addition, patients who received iNO had higher odds of acute kidney injury (AKI) (OR (95% CI): 2.35 (1.30, 4.26), p value = 0.005) and hospital/ventilator-acquired pneumonia (OR (95% CI): 3.2 (1.76, 5.83), p value = 0.001).

CONCLUSION: In critically ill COVID-19 patients with moderate-to-severe ARDS, iNO rescue therapy is associated with improved oxygenation parameters but no mortality benefits. Moreover, iNO use is associated with higher odds of AKI, pneumonia, longer LOS, and fewer VFDs.

PMID:36192801 | DOI:10.1186/s13054-022-04158-y

Implement Sci. 2022 Oct 3;17(1):67. doi: 10.1186/s13012-022-01236-1.

ABSTRACT

BACKGROUND: The Veterans Health Administration (VA) Grant and Per Diem case management “aftercare” program provides 6 months of case management for homeless-experienced veterans (HEVs) undergoing housing transitions. To standardize and improve aftercare services, we will implement critical time intervention (CTI), an evidence-based, structured, and time-limited case management practice. We will use two strategies to support the implementation and sustainment of CTI at 32 aftercare sites, conduct a mixed-methods evaluation of this implementation initiative, and generate a business case analysis and implementation playbook to support the continued spread and sustainment of CTI in aftercare.

METHODS: We will use the Replicating Effective Programs (REP) implementation strategy to support CTI implementation at 32 sites selected by our partners. Half (n=16) of these sites will also receive 9 months of external facilitation (EF, enhanced REP). We will conduct a type 3 hybrid cluster-randomized trial to compare the impacts of REP versus enhanced REP. We will cluster potential sites into three implementation cohorts staggered in 9-month intervals. Within each cohort, we will use permuted block randomization to balance key site characteristics among sites receiving REP versus enhanced REP; sites will not be blinded to their assigned strategy. We will use mixed methods to assess the impacts of the implementation strategies. As fidelity to CTI influences its effectiveness, fidelity to CTI is our primary outcome, followed by sustainment, quality metrics, and costs. We hypothesize that enhanced REP will have higher costs than REP alone, but will result in stronger CTI fidelity, sustainment, and quality metrics, leading to a business case for enhanced REP. This work will lead to products that will support our partners in spreading and sustaining CTI in aftercare.

DISCUSSION: Implementing CTI within aftercare holds the potential to enhance HEVs’ housing and health outcomes. Understanding effective strategies to support CTI implementation could assist with a larger CTI roll-out within aftercare and support the implementation of other case management practices within and outside VA.

TRIAL REGISTRATION: This project was registered with ClinicalTrials.gov as “Implementing and sustaining Critical Time Intervention in case management programs for homeless-experienced Veterans.” Trial registration NCT05312229 , registered April 4, 2022.

PMID:36192785 | DOI:10.1186/s13012-022-01236-1