America was unprepared for the magnitude of the pandemic, which overwhelmed many counties and filled some hospitals to capacity. A new study suggests there may have been a mathematical method, of sorts, to the madness of those early COVID days.
Altern Ther Health Med. 2022 Oct 28:AT7548. Online ahead of print.
ABSTRACT
CONTEXT: Medical treatment is critical in the healing of diabetic foot ulcers. Diabetic patients in many countries have recently started using complementary and supportive practices.
OBJECTIVES: The study intended to examine the complementary and supportive medical practices and their self-efficacy against foot ulcers that can develop in diabetic patients.
DESIGN: The research team conducted a cross-sectional and descriptive study.
SETTING: The study took place at internal-medicine outpatient clinics at a hospital in Turkey.
PARTICIPANTS: Participants were 656 diabetes patients who came the clinics between March and May 2021.
OUTCOME MEASURES: The research team collected data with a structured questionnaire and the Diabetic Foot Care Self-efficacy Scale (DFCSES).
RESULTS: Significant differences existed in gender, educational status, and average income level as well as between the (CAM) users and non-CAM A statistically significant difference existed between users and non-users of CAM. Users diabetes treatment type, go to regular doctor check-up, had other chronic disease, had a foot problem, regularly did leg and foot gymnastics, regularly did foot examination and often did foot examination.
CONCLUSIONS: The most popular products among CAM users were herbal products: Nigella sativa, Nigella sativa oil, cinnamon, and cinnamon oil. The mean scores for non-users of CAM were lower on the DFCSES.
PMID:36302232
Arch Clin Neuropsychol. 2022 Oct 27:acac083. doi: 10.1093/arclin/acac083. Online ahead of print.
ABSTRACT
OBJECTIVE: Major depression in older adults increases the statistical likelihood of dementia. It is challenging to translate statistical evidence of cognitive decline at the group level into knowledge of individual cognitive outcomes. The objective of the current study is to investigate 2-year reliable cognitive change in late-life depression (LLD), which will enhance understanding of cognitive changes in LLD and provide a means to assess individual change.
METHODS: In a sample of non-depressed cognitively normal older adults or NDCN (n = 113), we used linear regression to predict tests of global cognition, processing speed-executive functioning, and memory administered 1 and 2 years later. Stepwise regression was used to select covariates among demographics and raw test scores (either baseline or year 1) and we cross-validated the final models using the predicted residual error sum of squares (PRESS). We then derived a z-change score from the difference between actual and predicted follow-up scores and investigated the proportion of LLD patients (n = 199) and NDCN adults who experienced reliable “decline” (a z-score < -1.645), “stability” (z-scores between + – 1.645), and “improvement” (z scores > +1.645).
RESULTS: A greater proportion LLD compared with NDCN experienced cognitive decline in processing speed/executive functioning and global cognition over 2 years. When compared to NDCN, a greater proportion of LLD also significantly improved on one test of processing speed over 2 years.
CONCLUSIONS: Older adults with LLD are at risk of meaningful cognitive decline over a relatively short period, particularly in the domain of executive functioning and processing speed. This study provides a series of reliable change equations for common neuropsychological tests that can be applied clinically.
PMID:36302229 | DOI:10.1093/arclin/acac083
Coron Artery Dis. 2022 Dec 1;33(8):643-647. doi: 10.1097/MCA.0000000000001188. Epub 2022 Oct 14.
ABSTRACT
INTRODUCTION: Drug-eluting stents (DES) significantly improved angiographic and clinical outcomes compared with bare-metal stents in patients with diabetes. The clinical effects of BioMime sirolimus-eluting stent (SES) in patients with diabetes have not been evaluated. Therefore, we compared the efficacy of BioMime DES in coronary artery disease (CAD) patients with versus without diabetes.
METHODS: This prospective analytical study compared angiographic in-segment late loss and clinical effectiveness of BioMime SES stents in treating patients with (patients: 77 and lesions: 83) versus without (patients: 154 and lesions: 162) diabetes. The purpose of this study was the comparison of angiographic in-segment late loss at 12 months. Major adverse cardiac events (MACEs) were also monitored as secondary outcomes 24 months after the index procedure.
RESULTS: Of 231 patients enrolled in the study, the mean age was 63.3 years and 153 patients were male. Angiographic follow-up rate was 84.8% (patients: 196) and intravascular ultrasound (IVUS) follow-up rate was 67.9% (patients: 157) at 12 months. Diabetic patients were comparable to nondiabetic patients for 12-month in-segment late loss (0.01 ± 0.31 mm for the nondiabetes group versus 0.04 ± 0.11 mm for the diabetes group; P = 0.158; P < 0.05). At 24 months, MACEs, including death, myocardial infarction and ischemic-driven target lesion revascularization were not statistically different between the two treatment groups.
CONCLUSIONS: BioMime SES stents in treating patients with diabetes were comparable in reducing angiographic restenosis at 12 months and MACEs at 24 months compared to nondiabetic patients with CAD.
PMID:36302183 | DOI:10.1097/MCA.0000000000001188
Can J Surg. 2022 Sep 1;65(5):E573-E579. doi: 10.1503/cjs.005721. Print 2022 Sep-Oct.
ABSTRACT
BACKGROUND: During kidney procurement, after ice removal, kidneys located in the retroperitoneum are at risk for rewarming owing to the time taken to retrieve other abdominal and thoracic organs, which may lead to poorer outcomes. The purpose of this study was to evaluate the impact of prolonged kidney procurement time (PKP) on outcomes of kidney transplantation performed at the Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia, Canada.
METHODS: We retrospectively reviewed the cases of all adult (age ≥ 18 yr) patients who underwent kidney transplantation at the Queen Elizabeth II Health Sciences Centre between Jan. 1, 2010, and Dec. 31, 2015. We included all patients who received kidney transplants from deceased donors with a minimum follow-up period of 3 years. We defined PKP as more than 65 minutes from aortic cross-clamp to final organ extraction, and standard procurement time (SP) as 65 minutes or less.
RESULTS: Among the 455 transplantation procedures performed during the study period, we reviewed the cases of 145 patients who received kidneys from Nova Scotian donors and were followed in Nova Scotia. No statistically significant differences were seen in outcomes between kidney-only (n = 46) and multiorgan (n = 99) procurement, although more organs from kidney-only donors than multiorgan donors had a Kidney Donor Profile Index score greater than 50% (32 [69.6%] v. 48 [48.5%], p < 0.01). Compared to the SP group (n = 115), the PKP group (n = 30) had a higher rate of 30-day graft loss (6.7% v. 0.0%, p < 0.01), a higher incidence of de novo formation of donor-specific antibodies (3 [10.0%] v. 1 [0.9%], p < 0.01) and a lower 5-year graft survival rate (90.0% v. 97.4%, p = 0.03). Left kidneys remained 11 minutes longer on the donor than right kidneys when multiorgan procurement was performed (p < 0.01), and their 5-year survival rate was significantly lower than that of right kidneys (p = 0.03).
CONCLUSION: Procurement times longer than 65 minutes may be associated with poorer outcomes after kidney transplantation. Measures to reduce kidney exposure to rewarming during procurement may improve long-term outcomes.
PMID:36302131 | DOI:10.1503/cjs.005721
PLoS Genet. 2022 Oct 27;18(10):e1010443. doi: 10.1371/journal.pgen.1010443. Online ahead of print.
ABSTRACT
Multi-population cohorts offer unprecedented opportunities for profiling disease risk in large samples, however, heterogeneous risk effects underlying complex traits across populations make integrative prediction challenging. In this study, we propose a novel Bayesian probability framework, the Prism Vote (PV), to construct risk predictions in heterogeneous genetic data. The PV views the trait of an individual as a composite risk from subpopulations, in which stratum-specific predictors can be formed in data of more homogeneous genetic structure. Since each individual is described by a composition of subpopulation memberships, the framework enables individualized risk characterization. Simulations demonstrated that the PV framework applied with alternative prediction methods significantly improved prediction accuracy in mixed and admixed populations. The advantage of PV enlarges as genetic heterogeneity and sample size increase. In two real genome-wide association data consists of multiple populations, we showed that the framework considerably enhanced prediction accuracy of the linear mixed model in five-group cross validations. The proposed method offers a new aspect to analyze individual’s disease risk and improve accuracy for predicting complex traits in genotype data.
PMID:36302058 | DOI:10.1371/journal.pgen.1010443
PLoS One. 2022 Oct 27;17(10):e0276808. doi: 10.1371/journal.pone.0276808. eCollection 2022.
ABSTRACT
Being moved has received increased attention in emotion psychology as a social emotion that fosters bonds between individuals and within communities. This increased attention, however, has also sparked debates about whether the term “being moved” refers to a single distinct profile of emotion components or rather to a range of different emotion profiles. We addressed this question by investigating lay conceptions of the emotion components (i.e., elicitors, cognitive appraisals, subjective feelings, bodily symptoms, and consequences for thought/action) of “bewegt sein” (the German term for “being moved”). Participants (N = 106) provided written descriptions of both a moving personal experience and their conceptual prototype of “being moved,” which were subjected to content analysis to obtain quantitative data for statistical analyses. Based on latent class analyses, we identified two classes for both the personal experiences (joyfully-moved and sadly-moved classes) and the being-moved prototype (basic-description and extended-description classes). Being joyfully moved occurred when social values and positive relationship experiences were salient. Being sadly moved was elicited by predominantly negative relationship experiences and negatively salient social values. For both classes, the most frequently reported consequences for thought/action were continued cognitive engagement, finding meaning, and increased valuation of and striving for connectedness/prosociality. Basic descriptions of the prototype included “being moved” by positive or negative events as instances of the same emotion, with participants in the extended-description class also reporting joy and sadness as associated emotions. Based on our findings and additional theoretical considerations, we propose that the term “being moved” designates an emotion with an overall positive valence that typically includes blends of positively and negatively valenced emotion components, in which especially the weight of the negative components varies. The emotion’s unifying core is that it involves feeling the importance of individuals, social entities, and abstract social values as sources of meaning in one’s life.
PMID:36302051 | DOI:10.1371/journal.pone.0276808
PLoS One. 2022 Oct 27;17(10):e0276884. doi: 10.1371/journal.pone.0276884. eCollection 2022.
ABSTRACT
Reference intervals (RIs) help physicians in differentiating healthy from sick individuals. The prothrombin time (PT) and International normalized ratio (INR) fluctuate in coagulation pathway defects and have interlaboratory variability due to the instrument/reagent used. As direct method is difficult in children, we chose an indirect data mining method for the determining PT/INR RIs. The indirect method overcomes the substantial financial and logistic challenges, and ethical restrictions in children, moreover, allows partitioning in more fine-grained age groups. Prothrombin Time/INR measurements performed in patients aged birth-18 years between January 2013 and December 2020, were retrieved from laboratory management system of the Aga Khan Hospital. Reference intervals were computed using an indirect KOSMIC algorithm. The KOSMIC package function on the assumption that the non-pathologic samples follow a Gaussian distribution (after Box-Cox transformation of the data), following an elaborate statistical process to isolate distribution of physiological samples from mixed dataset. A total of 56,712 and 52,245 values were retrieved for PT and INR respectively. After the exclusion of patients with multiple specimens obtained during the study period, RIs were calculated for 37,356 (PT) and 37,192 (INR) children with stratification into 9 age groups. A comparison of 2.5th and 97.5th percentile results with those of established RIs from SickKids Handbook of Pediatric Thrombosis and Hemostasis demonstrated good agreement in between different age groups. This study supports data mining as an alternate approach for establishing PT/INR RIs, specifically in resource-limited settings. The results obtained are specific to studied population and instrument/reagent used. The study also allows understanding of fluctuations in coagulation pathways with increasing age and hence better clinical decision-making based on PT and INR results.
PMID:36302050 | DOI:10.1371/journal.pone.0276884
PLoS One. 2022 Oct 27;17(10):e0275029. doi: 10.1371/journal.pone.0275029. eCollection 2022.
ABSTRACT
BACKGROUND: Endoscopic ultrasound-guided biliary drainage (EUS-BD) was associated with better clinical success and a lower rate of adverse events (AEs) than fluoroscopy-guided percutaneous transhepatic biliary drainage (PTBD) in recent single center studies with mainly retrospective design and small case numbers (< 50). The aim of this prospective European multicenter study is to compare both drainage procedures using ultrasound-guidance and primary metal stent implantation in patients with malignant distal bile duct obstruction (PUMa Trial).
METHODS: The study is designed as a non-randomized, controlled, parallel group, non-inferiority trial. Each of the 16 study centers performs the procedure with the best local expertise (PTBD or EUS-BD). In PTBD, bile duct access is performed by ultrasound guidance. EUS-BD is performed as an endoscopic ultrasound (EUS)-guided hepaticogastrostomy (EUS-HGS), EUS-guided choledochoduodenostomy (EUS-CDS) or EUS-guided antegrade stenting (EUS-AGS). Insertion of a metal stent is intended in both procedures in the first session. Primary end point is technical success. Secondary end points are clinical success, duration pf procedure, AEs graded by severity, length of hospital stay, re-intervention rate and survival within 6 months. The target case number is 212 patients (12 calculated dropouts included).
DISCUSSION: This study might help to clarify whether PTBD is non-inferior to EUS-BD concerning technical success, and whether one of both interventions is superior in terms of efficacy and safety in one or more secondary endpoints. Randomization is not provided as both procedures are rarely used after failed endoscopic biliary drainage and study centers usually prefer one of both procedures that they can perform best.
TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT03546049 (22.05.2018).
PMID:36302047 | DOI:10.1371/journal.pone.0275029
PLoS Comput Biol. 2022 Oct 27;18(10):e1010559. doi: 10.1371/journal.pcbi.1010559. Online ahead of print.
ABSTRACT
Machine learning is increasingly introduced into medical fields, yet there is limited evidence for its benefit over more commonly used statistical methods in epidemiological studies. We introduce an unsupervised machine learning framework for longitudinal features and evaluate it using sexual behaviour data from the last 20 years from over 3’700 participants in the Swiss HIV Cohort Study (SHCS). We use hierarchical clustering to find subgroups of men who have sex with men in the SHCS with similar sexual behaviour up to May 2017, and apply regression to test whether these clusters enhance predictions of sexual behaviour or sexually transmitted diseases (STIs) after May 2017 beyond what can be predicted with conventional parameters. We find that behavioural clusters enhance model performance according to likelihood ratio test, Akaike information criterion and area under the receiver operator characteristic curve for all outcomes studied, and according to Bayesian information criterion for five out of ten outcomes, with particularly good performance for predicting future sexual behaviour and recurrent STIs. We thus assess a methodology that can be used as an alternative means for creating exposure categories from longitudinal data in epidemiological models, and can contribute to the understanding of time-varying risk factors.
PMID:36302041 | DOI:10.1371/journal.pcbi.1010559