Categories
Nevin Manimala Statistics

ACROMORFO study: gait analysis in a cohort of acromegalic patients

J Endocrinol Invest. 2024 Feb 28. doi: 10.1007/s40618-024-02340-3. Online ahead of print.

ABSTRACT

PURPOSE: In acromegaly, skeletal complications resulted to be associated with low quality of life (QoL) and high risk of falls. The aim of the present study was to perform a quantitative assessment of movement through gait analysis technique in patients with acromegaly.

STUDY POPULATION: Thirty-three acromegalic patients [9 with active disease (AD), 14 with controlled disease (CD) and 10 with disease remission (RD)] and 20 healthy subjects were enrolled for the study.

MEASUREMENTS: Kinetic and kinematic data were collected with 3D-gait analysis. Kinematic data were processed to compute the Gait Profile Score (GPS), a parameter that summarizes the overall deviation of kinematic gait data relative to unaffected population.

RESULTS: The acromegalic group showed longer stance phase duration (p < 0.0001) compared to controls. The GPS and several gait variable scores resulted to be statistically higher in the acromegalic group compared to healthy controls. GPS values were significantly higher in AD compared to CD (p < 0.05) and RD groups (p = 0.001). The AD group presented significantly higher values in terms of hip rotation and ankle dorsiflexion compared to CD and RD groups and with regard to the foot progression compared to RD. Interestingly, patients with RD exhibited a more physiological gait pattern.

CONCLUSION: Acromegalic patients showed quantitative alterations of gait pattern, suggesting instability and increased risk of falls. Arthropathy, along with its associated abnormal joint loading, proprioceptive impairment and hyperkyphosis could be contributing factors. Disease control and remission appear to improve postural balance. A better knowledge on walking performance in acromegaly would help to develop specific rehabilitation programmes to reduce falls’ risk and improve QoL.

PMID:38416368 | DOI:10.1007/s40618-024-02340-3

Categories
Nevin Manimala Statistics

Diagnostic performance of blue laser imaging for early detection of gastric cancer: A systematic review and meta-analysis

Indian J Gastroenterol. 2024 Feb 28. doi: 10.1007/s12664-023-01495-w. Online ahead of print.

ABSTRACT

BACKGROUND: Gastric cancer (GC) is associated with a significant global health burden and high mortality rates when diagnosed at later stages. The diagnosis often occurs at advanced stages when treatment options are limited and less effective. Early detection strategies are crucial to improving survival rates and outcomes for patients. Blue laser imaging (BLI) is an image-enhanced endoscopy technique that utilizes white light and narrow-band light to detect pathological changes in the mucosal architecture. This study aims at investigating the diagnostic performance of BLI for the detection of GC.

METHODS: A comprehensive search was conducted across multiple databases from inception until March 2023. Studies assessing the diagnostic efficacy of BLI for GC detection were included. The sensitivity, specificity and accuracy of BLI were calculated using pooled proportions and 95% confidence intervals (CI) with a random-effects model. Heterogeneity among the included studies was assessed using the I2 statistic.

RESULTS: Six studies were included in the pooled analysis. There were 708 patients with 380 GC lesions. Most of the lesions involved the lower two-thirds of the stomach. The pooled performance metrics of BLI for GC detection were as follows: sensitivity of 91.9% (95% CI 83.3-96.3%; I2 = 82.3%), specificity of 93.4% (95% CI 82.0-97.8%; I2 = 87.9%) and accuracy of 95.4% (95% CI 72.6-99.8%; I2 = 73.6%).

CONCLUSION: BLI demonstrates high diagnostic efficacy for the detection of GC. BLI can be a valuable tool in clinical practice. However, large-scale, randomized controlled studies are needed to further establish the role of BLI in routine clinical practice for GC detection.

PMID:38416344 | DOI:10.1007/s12664-023-01495-w

Categories
Nevin Manimala Statistics

Spatial Cluster Change of Schistosoma japonicum Transmission Foci in Indonesia During the Schistosomiasis Elimination Program

Acta Parasitol. 2024 Feb 28. doi: 10.1007/s11686-024-00802-5. Online ahead of print.

ABSTRACT

PURPOSE: The Government of Indonesia committed to eliminating schistosomiasis by 2025. Collaboratively snail control became one of the crucial strategies to ensure that the prevalence of Schistosoma japonicum in Oncomelania hupensis lindoensis reaches zero by the end of the program. This research investigated the spatial cluster change of S. japonicum transmission foci in Indonesia between 2017 and 2021.

METHODS: We mapped the snail foci, collected the snails, and calculated the snail density. We also conducted laboratory tests to detect the existence of cercariae in the snails. Identified infected snails were used to calculate the infection rate (IR) or snails’ prevalence of schistosome cercariae among freshwater snails. We then analysed the spatial cluster using the Getis-Ord Gi* statistic to identify the hot and cold spots.

RESULTS: The 5-year schistosomiasis elimination program successfully declined 18.84% of the snail foci and reduced 40.37% of the infected snail foci. Local spatial autocorrelation of snail density and infection rate identified that in 2017 and 2021, the number of cold spots decreased by 53.91% and 0%, while hot spots increased by 2.63% and 56.1%. The presence of more hot spots suggests a rise in the number of foci with high snail density and infection rates. The implementation of snail control was not optimal, and the parasite transmission through domestic animals still existed, causing the spatial cluster of hot spots to change during this period. Most hotspots have been observed near settlements, primarily in cocoa plantations, developed and deserted rice fields, grassland, and bush wetlands.

CONCLUSION: During the schistosomiasis elimination program, the number of hot spots increased while cold spots decreased, and there were notable changes in the geographical distribution of hot spots, indicating a shift in the clustering pattern of schistosomiasis cases. The findings become essential for policymakers, particularly in selecting priority areas for intervention. In the Discussion section, we demonstrated the selection process based on the existence of hot and cold spots. Furthermore, we proposed that enhancing cross-sector integration is crucial, particularly in connection with the management of S. japonicum transmission through domestic animals.

PMID:38416327 | DOI:10.1007/s11686-024-00802-5

Categories
Nevin Manimala Statistics

Evaluation of Effectiveness of the Unplugged Program on Gambling Behaviours among Adolescents: Study Protocol of the Experimental Controlled Study “GAPUnplugged”

J Prev (2022). 2024 Feb 28. doi: 10.1007/s10935-024-00772-4. Online ahead of print.

ABSTRACT

Gambling risk behaviour is an emerging problem among adolescents. “Unplugged” is an effective Social Influence curriculum for preventing substance use among students. This study aims to develop and test a new component focused on gambling added to the Unplugged program. Schools of Piedmont region and Rome city were invited to participate in the study. A self-completed anonymous questionnaire including questions on socio-demographic characteristics, addictive behaviours, beliefs, attitudes and risk perceptions about gambling, normative perceptions, parental practices, school climate, refusal skills, impulsiveness, self-esteem, antisocial behaviours and sensation seeking was prepared for baseline and follow-up surveys. The protocol of the study was submitted and approved by the Novara Ethical Committee and registered in ClinicalTrials.gov (NCT05630157, Protocol ID: 080.742, 11/17/2022). Twenty-nine schools accepted to participate in the study. Sixty-three classes (1325 students) satisfied the eligibility criteria for intervention and were allocated to the intervention arm, and the other 61 (1269 students) were allocated to the control arm. Because of drop-out, absentees, refusals, and invalid questionnaires, data on 1874 students (998 in the intervention and 876 in the control arm), were available for the analysis at baseline. Data management of follow-up questionnaires is in progress. Results of the present study will be useful to clarify the effectiveness of prevention interventions in reducing gambling behaviours among adolescents. Moreover, this will be the first experience of evaluating a new component focused on a different risk behaviour, added to a curriculum previously shown as effective on other risk behaviours.

PMID:38416313 | DOI:10.1007/s10935-024-00772-4

Categories
Nevin Manimala Statistics

Recent Advances in Clinical Trials in Multiple System Atrophy

Curr Neurol Neurosci Rep. 2024 Feb 28. doi: 10.1007/s11910-024-01335-0. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: This review summarizes previous and ongoing neuroprotection trials in multiple system atrophy (MSA), a rare and fatal neurodegenerative disease characterized by parkinsonism, cerebellar, and autonomic dysfunction. It also describes the preclinical therapeutic pipeline and provides some considerations relevant to successfully conducting clinical trials in MSA, i.e., diagnosis, endpoints, and trial design.

RECENT FINDINGS: Over 30 compounds have been tested in clinical trials in MSA. While this illustrates a strong treatment pipeline, only two have reached their primary endpoint. Ongoing clinical trials primarily focus on targeting α-synuclein, the neuropathological hallmark of MSA being α-synuclein-bearing glial cytoplasmic inclusions. The mostly negative trial outcomes highlight the importance of better understanding underlying disease mechanisms and improving preclinical models. Together with efforts to refine clinical measurement tools, innovative statistical methods, and developments in biomarker research, this will enhance the design of future neuroprotection trials in MSA and the likelihood of positive outcomes.

PMID:38416311 | DOI:10.1007/s11910-024-01335-0

Categories
Nevin Manimala Statistics

Altered EEG Patterns in Individuals with Disorganized Attachment: An EEG Microstates Study

Brain Topogr. 2024 Feb 28. doi: 10.1007/s10548-024-01038-2. Online ahead of print.

ABSTRACT

Over the past years, different studies provided preliminary evidence that Disorganized Attachment (DA) may have dysregulatory and disintegrative effects on both autonomic arousal regulation and brain connectivity. However, despite the clinical relevance of this construct, few studies have investigated the specific alterations underlying DA using electroencephalography (EEG). Thus, the main aim of the current study was to investigate EEG microstate parameters of DA in a non-clinical sample (N = 50) before (pre) and after (post) the administration of the Adult Attachment Interview (AAI). Two EEG eyes-closed Resting State (RS) recordings were performed before and after the AAI, which was used for classifying the participants [i.e., Disorganized/Unresolved (D/U) or Organized/Resolved (O/R) individuals] and to trigger the attachment system. Microstates parameters (i.e., Mean Duration, Time Coverage and Occurrence) were extracted from each recording using Cartool software. EEG microstates clustering analysis revealed 6 different maps (labeled A, B, C, D, E, F) in both groups (i.e., D/U and O/R individuals) and in both conditions (i.e., pre-AAI and post-AAI). In the pre-AAI condition, compared to O/R individuals, D/U participants showed a shorter Mean Duration and Time Coverage of Map F; in the post-AAI condition, a significant reduction in the Mean Duration of Map E was also observed in D/U individuals. Finally, in the “within” statistical analysis (i.e., pre-AAI vs. post-AAI), only the D/U group exhibited a significant increase in Time Coverage of Map F after the AAI. Since these maps are associated with brain networks involved in emotional information processing and mentalization (i.e., Salience Network and Default Mode Network), our result might reflect the deficit in the ability to mentalize caregiver’s interaction as well as the increased sensitivity to attachment-related stimuli typically observed in individuals with a D/U state of mind.

PMID:38416284 | DOI:10.1007/s10548-024-01038-2

Categories
Nevin Manimala Statistics

Using radial basis artificial neural networks to predict radiation hazard indices in geological materials

Environ Monit Assess. 2024 Feb 28;196(3):315. doi: 10.1007/s10661-024-12459-8.

ABSTRACT

The estimation of exposures to humans from the various sources of radiation is important. Radiation hazard indices are computed using procedures described in the literature for evaluating the combined effects of the activity concentrations of primordial radionuclides, namely, 238U, 232Th, and 40 K. The computed indices are then compared to the allowed limits defined by International Radiation Protection Organizations to determine any radiation hazard associated with the geological materials. In this paper, four distinct radial basis function artificial neural network (RBF-ANN) models were developed to predict radiation hazard indices, namely, external gamma dose rates, annual effective dose, radium equivalent activity, and external hazard index. To make RBF-ANN models, 348 different geological materials’ gamma spectrometry data were acquired from the literature. Radiation hazards indices predicted from each RBF-ANN model were compared to the radiation hazards calculated using gamma spectrum analysis. The predicted hazard indices values of each RBF-ANN model were found to precisely align with the calculated values. To validate the accuracy and the adaptability of each RBF-ANN model, statistical tests (determination coefficient (R2), relative absolute error (RAE), root mean square error (RMSE), Nash-Sutcliffe Efficiency (NSE)), and significance tests (F-test and Student’s t-test) were performed to analyze the relationship between calculated and predicted hazard indices. Low RAE and RMSE values as well as high R2, NSE, and p-values greater than 0.95, 0.71, and 0.05, respectively, were found for RBF-ANN models. The statistical tests’ results show that all RBF-ANN models created exhibit precise performance, indicating their applicability and efficiency in forecasting the radiation hazard indices of geological materials. All the RBF-ANN models can be used to predict radiation hazard indices of geological materials quite efficiently, according to the performance level attained.

PMID:38416264 | DOI:10.1007/s10661-024-12459-8

Categories
Nevin Manimala Statistics

Outcomes of treatment with short dental implants compared with standard-length implants: a retrospective clinical study

Maxillofac Plast Reconstr Surg. 2024 Feb 28;46(1):6. doi: 10.1186/s40902-024-00419-8.

ABSTRACT

BACKGROUND: The size of dental implants is a key success factor for appropriate osseointegration. Using shorter implants allows the possibility of avoiding complex surgical procedures and reduces the morbidity of treatment. Shorter implants also enable implant-prosthetic rehabilitation after maxillofacial reconstructions where only limited bone is available. In this study, the success rates of short implants were examined and compared to those of standard-sized implants.

METHODS: Patients who received dental implants between 2007 and 2016 at the Department of Oro-Maxillofacial Surgery and Stomatology Semmelweis University were enrolled in the study. Several clinical parameters were recorded and supplemented with radiological examinations. The data were statistically analysed.

RESULTS: Thirty-four patients with a total of 60 implants were included. The average time after prosthetic loading was 39.33 ± 21.96 months in the group with 8-mm implants and 41.6 ± 27.5 months in the group with > 8-mm implants. No significant differences were observed between the two groups in terms of probing depth (short implants, 2.84 ± 0.09 mm; standard implants, 2.91 ± 0.35 mm) or mean marginal bone loss (short implants, 1.2 ± 1.21-mm mesially and 1.36 ± 1.47-mm distally; standard implants: 0.63 ± 0.80-mm mesially and 0.78 ± 0.70-mm distally).

CONCLUSIONS: In this study, the success rate of short dental implants was comparable to that of standard-sized implants. Consequently, it can be claimed that the long-term success of short dental implants does not differ significantly from the long-term success of standard implants.

PMID:38416263 | DOI:10.1186/s40902-024-00419-8

Categories
Nevin Manimala Statistics

Discrepant effect of high-density lipoprotein cholesterol on esophageal and gastric cancer risk in a nationwide cohort

Gastric Cancer. 2024 Feb 28. doi: 10.1007/s10120-024-01477-7. Online ahead of print.

ABSTRACT

BACKGROUND: The relationship between high-density lipoprotein cholesterol (HDL-C) and gastroesophageal cancer is not constant.

METHODS: In this population-based cohort study, 4.518 million cancer-free individuals among those who underwent national cancer screening in 2010 were enrolled and followed up until December 2017. HDL-C level was classified into eight groups at 10 mg/dL intervals. The risk of gastroesophageal cancers by HDL-C was measured using adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs).

RESULTS: During 8 years of follow-up, 38,362 gastric and 3022 esophageal cancers developed. Low HDL-C level was associated with an increased risk of gastric cancer; aHR was 1.19 (95% CI 1.09-1.30) for HDL-C < 30 mg/dL, 1.07 (95% CI 1.03-1.12) for HDL-C of 30-39 mg/dL, and 1.07 (95% CI 1.03-1.12) for HDL-C of 40-49 mg/dL comparing to HDL-C of 60-69 mg/dL. HDL-C was positively associated with esophageal cancer risk; aHR was 1.30 (1.12-1.51) for HDL-C of 70-79 mg/dL, 1.84 (1.53-2.22) for HDL-C of 80-89 mg/dL, 2.10 (1.67-2.61) for HDL-C ≥ 90 mg/dL. These site-specific effects of HDL-C were robust in sensitivity analyses. The range of HDL-C for the lowest cancer risk was different by sex and site. The hazardous effect of low HDL-C on gastric cancer was prominent in never and past smokers, and extremely high HDL-C increased gastric cancer risk (aHR 1.19; 95% CI 1.04-1.36) only in current smokers. Unfavorable effect of high HDL-C on gastroesophageal cancer risk was remarkable in smokers.

CONCLUSIONS: Low HDL-C increased the risk of gastric cancer, wherein high HDL-C was associated with esophageal cancer risk with discrepancies by sex and smoking status.

PMID:38416240 | DOI:10.1007/s10120-024-01477-7

Categories
Nevin Manimala Statistics

Short-term outcomes of treatment switch to faricimab in patients with aflibercept-resistant neovascular age-related macular degeneration

Graefes Arch Clin Exp Ophthalmol. 2024 Feb 28. doi: 10.1007/s00417-024-06421-0. Online ahead of print.

ABSTRACT

PURPOSE: To report short-term outcomes of treatment switch to faricimab in real-world patients with aflibercept-resistant neovascular age-related macular degeneration (AMD).

METHODS: Single-center, retrospective cohort study with chart-review using electronic injection database, electronic medical records, and optical coherence tomography (OCT) data from May to September 2023.

RESULTS: A total of 50 eyes of 46 patients were analyzed. Faricimab treatment led to absence of fluid in 32% of the eyes and a reduction of fluid in 84% of the eyes. There was a statistically significant decrease in central retinal thickness (CRT) and pigment epithelial detachment (PED) height in those that responded to the switch (median difference: – 31 μm, IQR: 55, p < 0.0001 and median difference: – 21 μm, IQR: 36, p < 0.0001, respectively) and a statistically significant increase in CRT (median difference: + 19 μm, IQR: 20, p = 0.0143) and no change in PED height (median difference: + 22 μm, IQR: 64, p = 0.1508) in those that did not. Best-corrected visual acuity (BCVA) showed marginal decrease with low statistical significance. No ocular or systemic safety events were observed.

CONCLUSIONS: Our findings suggest that switching to faricimab is generally safe and effective in patients with neovascular AMD who are otherwise difficult to treat and have residual fluid despite frequent injections with aflibercept. We observed a high rate of morphological response to the treatment switch, improvement of anatomical parameters with about one-third of patients having dry macula following a single injection, and a marginal change in BCVA. Sustainability of these results requires further investigation.

STUDY REGISTRATION: ClinicalTrials.gov registration number: NCT06124677. Date of registration: 09/11/2023, retrospectively registered.

PMID:38416237 | DOI:10.1007/s00417-024-06421-0