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Nevin Manimala Statistics

Gut health of horses: effects of high fibre vs high starch diet on histological and morphometrical parameters

BMC Vet Res. 2022 Sep 8;18(1):338. doi: 10.1186/s12917-022-03433-y.

ABSTRACT

BACKGROUND: The conventional feeding management of horses is still characterized by high starch and low fibre diets, which can negatively affect horse’s gastrointestinal health. Thus, the aim of this study was to compare the effects of a high-starch (HS) vs. a high-fibre (HF) diet on gut health in horses. A total of 19 Bardigiano horses destined for slaughter and aged 14.3 ± 0.7 months were randomly allotted to two dietary groups: HS (5 fillies and 4 colts,) and HF group (7 fillies and 3 colts). They received the same first-cut meadow hay but different complementary feeds for 72 days: HS group was fed 8 kg/animal/day of a starch-rich complementary feed while HF group was fed 3.5 kg/animal/day of a fibre-rich complementary feed. At slaughter, stomachs were separated and washed for the evaluation of the glandular and squamous regions. Also, duodenum, jejunum, ileum, apex of the caecum, sternal flexure, pelvic flexure, right dorsal colon, rectum and liver were excised and submitted to histomorphometrical evaluation.

RESULTS: The glandular region of HS group presented more severe gastric mucosa lesions compared to the HF group (P = 0.006). Moreover, a statistical tendency (P = 0.060) was found for the squamous region, presenting a higher score in HS than HF diet. Regarding morphometry, in jejunum villus height to crypt depth (Cd) ratio was influenced by sex, being greater in males than in females (P = 0.037) while in ileum Cd depended on interaction between sex and diet, being greater in males of HS group (P = 0.029). Moreover, in the duodenum and right dorsal colon the severity of the inflammation depended on sex (P = 0.024 and 0.050), being greater in females than in males. On the contrary, in the jejunum and in the pelvic flexure, inflammation was influenced by diet, being more severe in HS than in HF group (P = 0.024 and 0.052).

CONCLUSIONS: These results suggested that HS diet provoked more severe mucosa lesions in the glandular region of the stomach and a higher inflammation both in the jejunum and pelvic flexure. The present study can represent a starting point for further investigations on gut health in horses.

PMID:36076239 | DOI:10.1186/s12917-022-03433-y

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Nevin Manimala Statistics

Statistical modeling of health space based on metabolic stress and oxidative stress scores

BMC Public Health. 2022 Sep 8;22(1):1701. doi: 10.1186/s12889-022-14081-0.

ABSTRACT

BACKGROUND: Health space (HS) is a statistical way of visualizing individual’s health status in multi-dimensional space. In this study, we propose a novel HS in two-dimensional space based on scores of metabolic stress and of oxidative stress.

METHODS: These scores were derived from three statistical models: logistic regression model, logistic mixed effect model, and proportional odds model. HSs were developed using Korea National Health And Nutrition Examination Survey data with 32,140 samples. To evaluate and compare the performance of the HSs, we also developed the Health Space Index (HSI) which is a quantitative performance measure based on the approximate 95% confidence ellipses of HS.

RESULTS: Through simulation studies, we confirmed that HS from the proportional odds model showed highest power in discriminating health status of individual (subject). Further validation studies were conducted using two independent cohort datasets: a health examination dataset from Ewha-Boramae cohort with 862 samples and a population-based cohort from the Korea association resource project with 3,199 samples.

CONCLUSIONS: These validation studies using two independent datasets successfully demonstrated the usefulness of the proposed HS.

PMID:36076235 | DOI:10.1186/s12889-022-14081-0

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Nevin Manimala Statistics

Does financial literacy influence preventive health check-up behavior in Japan? a cross-sectional study

BMC Public Health. 2022 Sep 8;22(1):1704. doi: 10.1186/s12889-022-14079-8.

ABSTRACT

BACKGROUND: General health check-ups are an important element of healthcare, as they are designed to detect diseases, thereby reducing morbidity and mortality. Recent studies have found that financial literacy promotes preventive healthcare usage and reduces risky health behaviors such as smoking, lack of exercise, and gambling. Based on this evidence, we hypothesize that financial literacy, as a rational decision-making tool, is positively associated with health check-up behavior in Japan.

METHODS: We extracted data on financial literacy, the main explanatory variable of this study, from the 2010 wave of the Preference Parameter Study (PPS) of Osaka University. Data on health check-up behavior as a dependent variable, along with control variables, were obtained from the 2011 PPS wave. Our sample focused on Japan’s middle-aged working population (40-64 years), and we applied probit regressions to test our hypothesis.

RESULTS: Our final sample size was 2,208 participants after merging the two datasets. Descriptive statistics show that respondents had moderate financial literacy (mean = 0.62, SD = 0.33), low financial education (mean = 0.17, SD = 0.38), and low participation (mean = 31.75%, SD = 46.56%) in the health check-up. The probit regression analysis showed that financial literacy is insignificantly associated with health check-up behavior in Japan (coefficient = -0.0229; 95% CI: -0.2011-0.1551; p-value = 0.801). However, demographic factors such as being male (coefficient = -0.2299; 95% CI: -0.3649–0.0950; p-value = 0.001), older (coefficient = 0.0280; 95% CI: 0.0188 – 0.0371; p-value = 0.000), and married (coefficient = 0.3217; 95% CI: 0.0728 – 0.5705; p-value = 0.011), as well as risky health behavior such as smoking (coefficient = -0.2784; 95% CI: -0.4262–0.1305; p-value = 0.000) are significantly related to health check-up behavior.

CONCLUSIONS: Our results suggest that financial literacy insignificantly motivates people to behave rationally and understand the value of health check-ups as a tool for sustainable health.

PMID:36076219 | DOI:10.1186/s12889-022-14079-8

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Measuring inequalities in COVID-19 vaccination uptake and intent: results from the Canadian Community Health Survey 2021

BMC Public Health. 2022 Sep 8;22(1):1708. doi: 10.1186/s12889-022-14090-z.

ABSTRACT

BACKGROUND: By July 2021, Canada had received enough COVID-19 vaccines to fully vaccinate every eligible Canadian. However, despite the availability of vaccines, some eligible individuals remain unvaccinated. Differences in vaccination uptake can be driven by health inequalities which have been exacerbated and amplified by the pandemic. This study aims to assess inequalities in COVID-19 vaccination uptake and intent in adults 18 years or older across Canada by identifying sociodemographic factors associated with non-vaccination and low vaccination intent using data drawn from the June to August 2021 Canadian Community Health Survey (CCHS).

METHODS: The CCHS is an annual cross-sectional and nationally representative survey conducted by Statistics Canada, which collects health-related information. Since September 2020, questions about the COVID-19 pandemic are asked. Adjusted logistic regression models were fitted to examine associations between vaccination uptake or intent and sociodemographic and health related variables. Region, age, gender, level of education, Indigenous status, visible minority status, perceived health status, and having a regular healthcare provider were considered as predictors, among other factors.

RESULTS: The analysis included 9,509 respondents. The proportion of unvaccinated was 11%. Non-vaccination was associated with less than university education (aOR up to 3.5, 95% CI 2.1-6.1), living with children under 12 years old (aOR 1.6, 95% CI 1.1-2.4), not having a regular healthcare provider (aOR 1.6, 95% CI 1.1-2.2), and poor self-perceived health (aOR 1.8, 95% CI 1.3-2.4). Only 5% of the population had low intention to get vaccinated. Being unlikely to get vaccinated was associated with the Prairies region (aOR 2.2, 95% CI 1.2-4.1), younger age groups (aOR up to 4.0, 95% CI 1.3-12.3), less than university education (aOR up to 3.8, 95% CI 1.9-7.6), not being part of a visible minority group (aOR 3.0, 95% CI 1.4-6.4), living with children under 12 years old (aOR 1.8, 95% CI 1.1-2.9), unattached individuals (aOR 2.6, 95% CI 1.1-6.1), and poor self-perceived health (aOR 2.0, 95% CI 1.3-2.9).

CONCLUSIONS: Disparities were observed in vaccination uptake and intent among various sociodemographic groups. Awareness of inequalities in COVID-19 vaccination uptake and intent is needed to determine the vaccination barriers to address in vaccination promotion strategies.

PMID:36076208 | DOI:10.1186/s12889-022-14090-z

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Nevin Manimala Statistics

Associations between grip strength, brain structure, and mental health in > 40,000 participants from the UK Biobank

BMC Med. 2022 Sep 9;20(1):286. doi: 10.1186/s12916-022-02490-2.

ABSTRACT

BACKGROUND: Grip strength is a widely used and well-validated measure of overall health that is increasingly understood to index risk for psychiatric illness and neurodegeneration in older adults. However, existing work has not examined how grip strength relates to a comprehensive set of mental health outcomes, which can detect early signs of cognitive decline. Furthermore, whether brain structure mediates associations between grip strength and cognition remains unknown.

METHODS: Based on cross-sectional and longitudinal data from over 40,000 participants in the UK Biobank, this study investigated the behavioral and neural correlates of handgrip strength using a linear mixed effect model and mediation analysis.

RESULTS: In cross-sectional analysis, we found that greater grip strength was associated with better cognitive functioning, higher life satisfaction, greater subjective well-being, and reduced depression and anxiety symptoms while controlling for numerous demographic, anthropometric, and socioeconomic confounders. Further, grip strength of females showed stronger associations with most behavioral outcomes than males. In longitudinal analysis, baseline grip strength was related to cognitive performance at ~9 years follow-up, while the reverse effect was much weaker. Further, baseline neuroticism, health, and financial satisfaction were longitudinally associated with subsequent grip strength. The results revealed widespread associations between stronger grip strength and increased grey matter volume, especially in subcortical regions and temporal cortices. Moreover, grey matter volume of these regions also correlated with better mental health and considerably mediated their relationship with grip strength.

CONCLUSIONS: Overall, using the largest population-scale neuroimaging dataset currently available, our findings provide the most well-powered characterization of interplay between grip strength, mental health, and brain structure, which may facilitate the discovery of possible interventions to mitigate cognitive decline during aging.

PMID:36076200 | DOI:10.1186/s12916-022-02490-2

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Surgical outcomes and observation in exotropia cerebral palsy children with cortical visual impairment

BMC Ophthalmol. 2022 Sep 8;22(1):364. doi: 10.1186/s12886-022-02581-x.

ABSTRACT

PURPOSE: Cortical visual impairment (CVI) is the common cause of pediatric visual impairment in cerebral palsy (CP) while exotropia is the most common strabismus associated with CP. We aim to observe the strabismic surgery outcomes in pediatric patients with CP and CVI.

METHOD: Our medical records were collected from pediatric patients treated in our hospital from May 1, 2017 to Jan 1, 2022. With normal intelligence assessment and diagnosis of exotropia in children with CP and CVI, microsurgeries were performed under intravenous combined inhalation anesthesia. The strabismus was examined by the prism test under best vision correction and the contrast sensitivity testing (CST) was measured at five levels of spatial frequencies.

RESULT: A total of 38 exotropia patients with CP and CVI were identified and included for analysis during the study period with age ranged from 5 to 12 years (mean 8.45 years) and mean follow up duration was 8.7 months (6-42 months). After bilateral lateral rectus recession (with/without medial rectus resection or inferior oblique transposition), the exotropia amount of participants were obviously revealed from – 30 ~ – 140 (median, IQR: – 50, 40) prism diopters (PD) preoperatively to 0 ~ – 15 (0, 5) PD postoperatively. Statistically significantly improvements were observed at all levels of spatial frequency on CST postoperatively, especially at high spatial frequency areas (p < 0.05).

CONCLUSION: Our results demonstrated that the effect of strabismus surgery on exotropia in children with CP and CVI were stable and monocular contrast sensitivity post- operation increased significantly at all spatial frequencies levels.

PMID:36076198 | DOI:10.1186/s12886-022-02581-x

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Prevalence of sarcopenia in Chinese community-dwelling elderly: a systematic review

BMC Public Health. 2022 Sep 8;22(1):1702. doi: 10.1186/s12889-022-13909-z.

ABSTRACT

BACKGROUND: Sarcopenia is associated with age-related loss of muscle mass and function and is becoming prevalent in the older Chinese population. This systematic review aims to obtain a reliable estimation of the prevalence of sarcopenia among community-dwelling Chinese populations aged 65 years and older and to characterize its epidemiology.

METHODS: A literature search was performed in the Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and CQVIP databases up to September 31, 2021. All studies that reported the prevalence of sarcopenia in Chinese community-dwelling older adults were included, and Hoy et al.’s tool was used to assess the risk of bias. The overall prevalence of sarcopenia will be calculated as the primary outcome, and subgroup analyses will be performed by study year, age, sex, muscle mass assessment method, diagnostic criteria and area.

RESULTS: A total of 26 studies were included in this study, which involved 25,921 subjects, and 3597 had sarcopenia. Although significant heterogeneity between studies was reported, no statistically significant publication bias was detected. The overall prevalence of sarcopenia in community-dwelling older adults aged over 65 years in the Chinese population was 17.4% (95% CI: 14.6%-20.2%). Subgroup analysis based on study year, age and sex, muscle mass assessment method, diagnostic criteria, region and area showed that the prevalence of sarcopenia was different in each subgroup.

IMPLICATIONS: The prevalence of sarcopenia in Chinese community-dwelling older adults was higher than that in previous studies. As a multidimensional survey of the prevalence of sarcopenia in older adults, this meta-analysis provides data support for the targeted management of sarcopenia among Chinese older adults.

PMID:36076194 | DOI:10.1186/s12889-022-13909-z

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Healthcare practitioner perceptions on barriers impacting cannabis prescribing practices

BMC Complement Med Ther. 2022 Sep 8;22(1):237. doi: 10.1186/s12906-022-03716-9.

ABSTRACT

BACKGROUND: Canadians seeking medical cannabis (MC) may encounter difficulties in finding a healthcare provider (HCP) who authorizes their access to it. Barriers that HCPs face in authorizing MC are unclear. The objectives of this study were to evaluate HCP opinions, knowledge, comfort, and practice in MC prescribing and counseling on recreational cannabis use, and whether the COVID-19 pandemic affected MC prescribing practices.

METHODS: Eligible participants included HCPs (e.g., attending physicians, nurses, pharmacists) in Canada. A questionnaire evaluating their knowledge, comfort, and practice in medical and recreational cannabis was designed based on instruments developed in previous studies. Between April 13th-December 13th 2021, ninety-one healthcare associations were asked to distribute the survey to their members, and an advertisement was placed in the online Canadian Medical Association Journal. Descriptive statistics were used to analyze the results.

RESULTS: Twenty-four organizations agreed to disseminate the survey and 70 individuals completed it. Of respondents, 71% were attending physicians or medical residents, while the remainder were nurses, pharmacists or other HCPs. Almost none (6%) received training in MC in professional school but 60% did receive other training (e.g., workshops, conferences). Over half (57%) received more questions regarding MC since recreational cannabis was legalized, and 82% reported having patients who use MC. However, 56% felt uncomfortable or ambivalent regarding their knowledge of MC, and 27% were unfamiliar with the requirements for obtaining MC in Canada. The most common symptoms for recommending MC were pain and nausea, whereas the most common conditions for recommending it were cancer and intractable pain. The strongest barrier to authorizing MC was uncertainty in safe and effective dosage and routes of administration. The strongest barrier to recommending or authorizing MC was the lack of research evidence demonstrating its safety and efficacy. During the pandemic, many respondents reported that a greater number of their patients used cannabis to relieve anxiety and depression.

CONCLUSIONS: Our results suggest that HCPs across Canada who responded to our survey are unfamiliar with topics related to MC. The strongest barriers appear to be lack of clinical research, and uncertainty in safe and effective MC administration. Increasing research, training, and knowledge may help HCPs feel more equipped to make informed treatment/prescribing decisions, which may help to improve access to MC.

PMID:36076191 | DOI:10.1186/s12906-022-03716-9

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Acute kidney injury in critically ill COVID-19 infected patients requiring dialysis: experience from India and Pakistan

BMC Nephrol. 2022 Sep 8;23(1):308. doi: 10.1186/s12882-022-02931-3.

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) was common in the first two waves of the SARS-COV-2 pandemic in critically ill patients. A high percentage of these patients required renal replacement therapy and died in the hospital.

METHODS: The present study examines the clinical presentation, laboratory parameters and therapeutic interventions in critically ill patients with AKI admitted to the ICU in two centres, one each in India and Pakistan. Patient and outcome details of all critically ill COVID 19 patients admitted to the ICU requiring renal replacement therapy were collected. Data was analysed to detect patient variables associated with mortality.

RESULTS: A total of 1,714 critically ill patients were admitted to the ICUs of the two centres. Of these 393 (22.9%) had severe acute kidney injury (AKIN stage 3) requiring dialysis. Of them, 60.5% were men and the mean (± SD) age was 58.78 (± 14.4) years. At the time of initiation of dialysis, 346 patients (88%) were oligo-anuric. The most frequent dialysis modality in these patients was intermittent hemodialysis (48.1%) followed by slow low efficiency dialysis (44.5%). Two hundred and six (52.4%) patients died. The mortality was higher among the Indian cohort (68.1%) than the Pakistani cohort (43.4%). Older age (age > 50 years), low serum albumin altered sensorium, need for slower forms of renal replacement therapy and ventilatory support were independently associated with mortality.

CONCLUSION: There was a very high mortality in patients with COVID-19 associated AKI undergoing RRT in the ICUs in this cohort from the Indian sub-continent.

PMID:36076183 | DOI:10.1186/s12882-022-02931-3

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Phase II study of carboplatin/nab-paclitaxel/atezolizumab combination therapy for advanced nonsquamous non-small cell lung cancer patients with impaired renal function: RESTART trial

BMC Cancer. 2022 Sep 8;22(1):964. doi: 10.1186/s12885-022-10056-x.

ABSTRACT

BACKGROUND: First-line treatment of nonsquamous non-small cell lung cancer (NSCLC) has undergone a paradigm shift to platinum combination therapy together with immune checkpoint inhibitors (ICIs). However, phase III studies of combinations of cytotoxic chemotherapy and ICIs have included only patients with maintained organ function, not those with renal impairment.

METHODS: Cytotoxic chemotherapy-naïve advanced nonsquamous NSCLC patients aged 20 years or older with impaired renal function (creatinine clearance of 15 to 45 mL/min) are prospectively registered in this single-arm phase II study and receive combination therapy with carboplatin, nanoparticle albumin-bound (nab-) paclitaxel, and atezolizumab. Individuals with known genetic driver alterations including those affecting EGFR, ALK, ROS1, BRAF, MET, RET, and NTRK are excluded. We plan to enroll 40 patients over 2 years at 32 oncology facilities in Japan. The primary end point is confirmed objective response rate.

DISCUSSION: If the study demonstrates efficacy and safety of carboplatin/nab-paclitaxel/atezolizumab, then this combination regimen may become a treatment option even for nonsquamous NSCLC patients with impaired renal function.

TRIAL REGISTRATION: Registered with Japan Registry for Clinical Trials on 25 February 2021 (jRCTs071200102).

PMID:36076179 | DOI:10.1186/s12885-022-10056-x