Tag: nevin manimala

Med J Aust. 2025 Apr 21;222(7):348-355. doi: 10.5694/mja2.52635.

ABSTRACT

OBJECTIVE: To examine associations between remoteness of region of residence and in-hospital mortality for people admitted to hospital with heart failure in New South Wales during 2002-21.

STUDY DESIGN: Retrospective observational cohort study; analysis of New South Wales Admitted Patient Data Collection data.

SETTING, PARTICIPANTS: Adult (16 years or older) NSW residents admitted with heart failure to NSW public hospitals, 1 January 2002 – 30 September 2021. Only first admissions with heart failure during the study period were included.

MAIN OUTCOME MEASURES: In-hospital mortality, by remoteness of residence (Australian Statistical Geography Standard), adjusted for age (with respect to median), sex, socio-economic status (Index of Relative Socioeconomic Advantage and Disadvantage [IRSAD], with respect to median), other diagnoses, hospital length of stay, and calendar year of admission (by 4-year group).

RESULTS: We included 154 853 admissions with heart failure; 99 687 people lived in metropolitan areas (64.4%), 41 953 in inner regional areas (27.1%), and 13 213 in outer regional/remote/very remote areas (8.5%). The median age at admission was 80.3 years (interquartile range [IQR], 71.2-86.8 years), and 78 591 patients were men (50.8%). The median IRSAD score was highest for people from metropolitan areas (metropolitan: 1000; IQR, 940-1064; inner regional: 934; IQR, 924-981; outer regional/remote/very remote areas: 930; IQR, 905-936). During 2002-21, 9621 people (6.2%) died in hospital; the proportion was 8.0% in 2002, 4.9% in 2021. In-hospital all-cause mortality was lower during 2018-21 than during 2002-2005 (adjusted odds ratio [aOR], 0.52; 95% confidence interval [CI], 0.49-0.56); the decline was similar for all three remoteness categories. Compared with people from metropolitan areas, the odds of in-hospital death during 2002-21 were higher for people from inner regional (aOR, 1.12; 95% CI, 1.07-1.17) or outer regional/remote/very remote areas (aOR, 1.35; 95% CI, 1.25-1.45).

CONCLUSION: In-hospital mortality during heart failure admissions to public hospitals declined across NSW during 2002-21. However, it was higher among people living in regional and remote areas than for people from metropolitan areas. The reasons for the difference in in-hospital mortality should be investigated.

PMID:40253641 | DOI:10.5694/mja2.52635

Rev Alerg Mex. 2025 Mar 30;72(1):21-27. doi: 10.29262/ram.v72i1.1426.

ABSTRACT

OBJECTIVE: Determine the prevalence of allergic rhinitis in school children.

METHODS: Cross-sectional, descriptive study in children from 6 to 10 years old. Those who underwent skin testing (mites, pollens, fungi, cockroach, dog and cat hair) were included. The diagnosis of allergic rhinitis was made based on the test recommended by the European Academy of Allergy and Clinical Immunology (EAACI) and the American College of Allergy, Asthma and Immunology (ACAAI) for the diagnosis of allergy mediated by allergen-specific IgE. The statistical analysis included confidence interval for averages and percentages.

RESULTS: In the 992 patients, the prevalence of allergic rhinitis was 15.7% (95% CI; 13.4-18.0), the predominant symptom was hyaline rhinorrhea in 94.7% (95% CI; 91.4-94.6), the main allergen was dust mites 60.4% (95% CI; 52.7-68.1) and pollen 59.3% (95% CI; 51.6-67.0).

CONCLUSION: The prevalence of allergic rhinitis in school children with positive skin tests is 15.7%, with a predominance of males with 63.1%.

PMID:40253632 | DOI:10.29262/ram.v72i1.1426

Rev Alerg Mex. 2025 Mar 30;72(1):8-13. doi: 10.29262/ram.v72i1.1388.

ABSTRACT

OBJETIVES: To evaluate the persistent symptoms in subjects with infection of COVID-19, partially or fully recovered.

METHODS: An observational, descriptive, cross-sectional, prospective study was conducted in individuals who were infected with SARS-CoV-2. We included Individuals of any gender and age who voluntarily answer a survey after developing infection to identify signs and symptoms associated, we analyzed whether there was any relationship between female sex and obesity, or age related with post-COVID-19 syndrome by X² test and t Student test.

RESULTS: 197 individuals were included with mean age 41.57 (SD 14.2 years), 61.9% were female. Post-COVID syndrome was present in 52.3%, depression, anosmia, dysgeusia, nausea, alopecia and behavior disorders were greater in women; arthralgia, dyspnea, cough, and odynophagia were greater in obesity being statistically significant (p<0.05).

CONCLUSIONS: Post-COVID syndrome was found in 52.3%, with a variety of symptoms female sex had a higher risk of presenting post-Covid syndrome with symptoms such as depression, behavior disorders, anosmia, and baldness.

PMID:40253630 | DOI:10.29262/ram.v72i1.1388

J Biopharm Stat. 2025 Apr 20:1-13. doi: 10.1080/10543406.2025.2490725. Online ahead of print.

ABSTRACT

This paper introduces the novel methodology of differential projection pursuit and its applications to the analysis of large datasets. The method was applied to a cell flow cytometry dataset as an alternative approach to analyze this type of data. Multicolor cell flow cytometry is a well-established laboratory technique to identify cell subpopulations by measuring their physical and biochemical characteristics. Differential projection pursuit helps to find regions with maximal differences between two or more treatments or distributions. Data analysis in flow cytometry relies on gating, the process of manually selecting successive subpopulations of cells using two-dimensional plots. Plotting the variables only two at a time could mask the hidden structure present in the data, and manual selection makes the analysis inconsistent and arbitrary. The new methodology could automate flow cytometry analysis by utilizing the combination of projection pursuit, data nuggets, and factor analysis. When applied to flow cytometry data, differential projection pursuit allows researchers to quickly identify differences in cell populations exposed to different experimental conditions. This methodology could create a platform to explore differences in large datasets and improve the cell flow cytometry analysis clarity and reproducibility by considering the data in its true dimensional space and through automation, respectively.

PMID:40253621 | DOI:10.1080/10543406.2025.2490725

J Biopharm Stat. 2025 Apr 20:1-18. doi: 10.1080/10543406.2025.2489291. Online ahead of print.

ABSTRACT

Biomarker-guided designs are increasingly used to evaluate personalized treatments based on patients’ biomarker status in Phase II and III clinical trials. With adaptive enrichment, these designs can improve the efficiency of evaluating the treatment effect in biomarker-positive patients by increasing their proportion in the randomized trial. While time-to-event outcomes are often used as the primary endpoint to measure treatment effects for a new therapy in severe diseases like cancer and cardiovascular diseases, there is limited research on biomarker-guided adaptive enrichment trials in this context. Such trials almost always adopt hazard ratio methods for statistical measurement of treatment effects. In contrast, restricted mean survival time (RMST) has gained popularity for analyzing time-to-event outcomes because it offers more straightforward interpretations of treatment effects and does not require the proportional hazard assumption. This paper proposes a two-stage biomarker-guided adaptive RMST design with threshold detection and patient enrichment. We develop sophisticated methods for identifying the optimal biomarker threshold and biomarker-positive subgroup, treatment effect estimators, and approaches for type I error rate, power analysis, and sample size calculation. We present a numerical example of re-designing an oncology trial. An extensive simulation study is conducted to evaluate the performance of the proposed design.

PMID:40253620 | DOI:10.1080/10543406.2025.2489291

J Biopharm Stat. 2025 Apr 20:1-15. doi: 10.1080/10543406.2025.2489280. Online ahead of print.

ABSTRACT

In the context of clinical trial practices, the study power and sample size are typically determined based on the expected treatment effects on the primary endpoint collected over time. The utilization of longitudinal modeling for the primary endpoint offers a flexible approach that has the potential to reduce the sample size and duration of the trial, thereby improving operational efficiency and costs. Joint modeling of multiple endpoints presents a unique opportunity to understand how the primary endpoint evolves over time with other clinically important endpoints, and has the potential to increase precision of estimates and therefore increase study power when designing a study at planning stage and enhance understanding and interpretation of the data at a multi-dimensional level at the analysis stage. This approach enables a comprehensive evaluation of clinical evidence from various perspectives, rather than relying solely on isolated pieces of information. Joint modeling of multiple longitudinal endpoints would also help trial monitoring process as the trial accumulates clinical evidence of efficacy data, and there is a high demand in developing tools for statistical learning the treatment benefits on the go especially when the endpoint(s) is not well-established yet in some therapeutic indications. In this article, we will illustrate the use of joint modeling of longitudinal endpoints and its applications to study design, analysis, and trial monitoring practices. Simulation studies suggest that the potential efficiency gain would be achieved via leveraging information within endpoint over time and/or between endpoints. We developed an R shiny application to aid in and support identifying promising efficacy signals from endpoints under investigation during the trial monitoring. The implementation of the joint models and the added values will be discussed through case studies and/or simulation studies.

PMID:40253614 | DOI:10.1080/10543406.2025.2489280

Vet Ophthalmol. 2025 Apr 20. doi: 10.1111/vop.70021. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine if topical serum use impacts clinical outcomes of infected corneal ulcers in dogs.

ANIMALS: A total of 252 eyes (237 dogs) undergoing medical and surgical therapy for infected corneal ulcers managed with or without topical serum.

PROCEDURES: Patients were identified retrospectively in the same geographic region of the United States. Healing times, visual outcomes, and enucleation were recorded for medically managed ulcers. Visual outcomes and enucleation were recorded for surgically managed ulcers. The number and frequency of topical medications were recorded for all groups. Statistical analyses were performed for all comparisons, with a significance level of p = 0.05.

RESULTS: In total, 252 eyes (237 dogs) were included. Of these, 203 eyes underwent medical therapy (150 without serum/53 with serum) and 49 eyes were treated surgically at presentation (35 without serum/14 with serum postoperatively). In the medical group, the use of serum had no impact on healing times (p = 0.380), visual outcomes (p = 0.751) or enucleation (p = 0.433). In the surgery group, visual outcomes (p = 0.488) and enucleation (no eyes enucleated) were not impacted by serum use. Healing times were not impacted by frequency (p = 0.092) or number of topical medications (p = 0.346).

CLINICAL RELEVANCE: To the authors’ knowledge, this is the first study to determine if topical serum use affects clinical outcomes of infected corneal ulcers in dogs. Topical serum did not impact healing times, visual outcomes, or enucleation rates of infected corneal ulcers treated medically or surgically in dogs.

PMID:40253598 | DOI:10.1111/vop.70021

J Burn Care Res. 2025 Apr 20:iraf052. doi: 10.1093/jbcr/iraf052. Online ahead of print.

ABSTRACT

Previous research has shown that 20 percent of pediatric massive burn survivors experience impairment in long-term physical function and psychosocial distress.1 Pediatric patients from the United States and Mexico with major burns likely receive similar care during the initial hospitalization given that many US burn centers treat children with injuries from Mexico. However, follow-up care may differ, possibly impacting physical and psychosocial outcomes. This retrospective cohort study investigated differences in psychological and physical outcomes between pediatric burn patients residing in the US and those residing in Mexico. Analysis included 100 patients, aged 8-17 years, residents of the US or Mexico, who were hospitalized for burn injuries between 2015 and 2023 and enrolled in the Burn Model System database. Patient-Reported Outcomes Measures Information System measures of physical and psychological functioning were analyzed. Using univariate analyses, there was a significant difference in severity of burns, with the patients from Mexico having greater total surface area of burn and increased likelihood of amputation. Differences in mechanism of burn, length of hospital stay, and ventilator days were not statistically significant when controlled for TBSA. Linear regression analyses examining the association between physical outcomes and country of residence (controlling for age, sex, TBSA, etiology of burn, and amputation) showed a significant difference in physical function outcomes at 6 months (p=0.012) but no difference in fatigue, pain interference, or pain intensity. Analysis of psychosocial outcomes showed no significant difference in anger, depression, anxiety, or peer relationships at 6 months.

PMID:40253578 | DOI:10.1093/jbcr/iraf052

Sci Rep. 2025 Apr 19;15(1):13534. doi: 10.1038/s41598-025-98489-9.

ABSTRACT

Metabolic-dysfunction associated fatty liver disease (MAFLD) is a widespread chronic liver condition that has been steadily increasing among adolescents and young adults in recent years, posing a major global public health concern. This study aims to conduct an in-depth analysis of the Global Burden of Disease (GBD) 2021 data on MAFLD, focusing on prevalence, incidence, and disability-adjusted life years (DALY) for individuals aged 15-39, spanning the period from 1990 to 2021. This research examines data from the GBD study covering 1990 to 2021 to assess the prevalence, incidence, and DALYs associated with of MAFLD in adolescents and young adults aged 15-39. The analysis is broken down by socioeconomic status, geographic regions, and specific countries. Advanced statistical methods, including the estimated annual percentage change (EAPC) and Bayesian age-period-cohort (BAPC) modeling, were used to deliver the most current and thorough epidemiological assessment of MAFLD in this demographic. In 2021, the estimated global cases of non-alcoholic fatty liver disease among adolescents and young adults reached approximately 423 million, representing a 75.31% increase from 1990. The age-standardized prevalence rate (ASPR) was 14,221.32 cases per 100,000 population, and the age-standardized incidence rate (ASIR) was 977.61 cases per 100,000 population in 2021. Between 1990 and 2021, the ASPR, ASIR, age-standardized DALY rate, and age-standardized mortality rate showed a continuous upward trend, with EAPC of 0.84, 0.79, 0.65, and 0.81, respectively. Regions with Middle and Low-middle Socio-Demographic Index (SDI), as well as High-middle SDI, emerged as “hotspots” for MAFLD prevalence, particularly in North Africa, the Middle East, East Asia, and South Asia. Males exhibited higher prevalence rates compared to females, and the rates continued to increase across all adolescents and young adult age groups. By 2050, the ASPR for MAFLD among this population is projected to reach 16,101 cases per 100,000, signaling an alarming trend. Over the last 30 years, the burden of metabolic-dysfunction associated fatty liver disease has significantly increased among adolescents and young adults worldwide. To counter this rising global health concern, it is crucial to develop and implement targeted and effective interventions tailored to socio-economic settings.

PMID:40253566 | DOI:10.1038/s41598-025-98489-9

Arch Gynecol Obstet. 2025 Apr 19. doi: 10.1007/s00404-025-08019-1. Online ahead of print.

ABSTRACT

BACKGROUND: Endometriosis has a significant negative impact on women’s lives. Unfortunately, current medical treatments often fail to provide adequate pain relief and may cause intolerable side effects. Although many women experiencing primary dysmenorrhoea employ self-management strategies to help alleviate period-related symptoms, there is a paucity of knowledge about how women with endometriosis manage their symptoms through self-management.

METHODS: A cross-sectional online survey was distributed in Germany, Austria, and Switzerland, between August and December 2022, targeting women aged 18 years or older with a diagnosis of endometriosis. The survey gathered information on (pharmacological and non-pharmacological) self-management strategies employed by the respondents in the previous six months, including their frequency, reasons for non-use, self-rated effectiveness, and impact on reducing endometriosis-related medication. Furthermore, the survey collected data on demographics, medical history, current symptomatology, and medication usage. Descriptive statistical analyses were conducted.

RESULTS: Of the 912 valid responses, 75.4% reported using self-management strategies, with the most prevalent being rest (91.6%), heat (91.1%), and exercise (63.3%). The most highly rated techniques in terms of effectiveness in pain reduction were cannabis, osteopathy, heat, and alcohol, with mean effectiveness ratings of 8.0, 7.3, 7.1, and 6.8, respectively, on the Numerical Rating Scale. Interventions, such as Tai Chi/Qi Gong, yoga/Pilates, herbal medicine, stretching, and meditation/breathing, were rated as being less effective. The lack of information and costs were identified as the primary reasons for not utilising self-management approaches.

CONCLUSION: The findings of this study may provide evidence for the reimbursement of self-management techniques by health insurance companies for the treatment of endometriosis-associated pain.

PMID:40253561 | DOI:10.1007/s00404-025-08019-1