Tag: nevin manimala

Pharmacoeconomics. 2022 Nov 30. doi: 10.1007/s40273-022-01218-7. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this study was to estimate the relationship between EQ-5D-3L and EQ-5D-5L, in both directions, using a single model.

METHODS: An online survey containing both variants of EQ-5D, with randomised ordering, was administered to a large UK sample in 2020. A joint statistical model of the ten EQ-5D responses (five at 5L, five at 3L), using a multi-equation ordinal regression framework was estimated. The joint model ensures mappings in either direction are fully consistent with the information in the sample and satisfy Bayes’ rule. Three extensions enhance model flexibility: a copula specification allows differing degrees of correlation between the 3L and 5L responses at the upper and lower extremes of health; a normal mixture residual distribution gives flexibility in the distributional form of responses; and a common factor captures correlations in responses across the five dimensions.

RESULTS: Almost 50,000 responses were received. Thirty-five percent of respondents reported an existing medical condition. Ninety percent of possible 3L and 43% of possible 5L health states were observed. The preferred model specification includes age, sex and the responses to the EQ-5D instrument. Close alignment to the observed data was observed both in within-sample and out-of-sample comparisons.

CONCLUSION: The results from this study provide a means of translating evidence to or from EQ-5D-3L to or from 5L based on a large-scale UK population survey with randomised ordering. Mapping can be performed either using descriptive system responses, individual utility scores or summary statistics.

PMID:36449173 | DOI:10.1007/s40273-022-01218-7

J Racial Ethn Health Disparities. 2022 Nov 30. doi: 10.1007/s40615-022-01477-2. Online ahead of print.

ABSTRACT

PURPOSE: This study explores whether nativity differences in health care and sociodemographic factors help to account for nativity differences in low birth weight (LBW) when comparing US-born Black women (USBW) to Black Immigrant women (BIW).

METHODS: Bivariate analyses and multinomial nested logit (MNL) models were performed using the National Survey of Family Growth (NSFG) dataset.

RESULTS: Statistically significant nativity differences between USBW and BIW were found across variables of LBW (p = .009), marital status (p < .001), education level (p < .001), receiving public assistance (p < .001), health care coverage (p < .001), age (p < .001), and poverty level income (p < .001). Results from the MNL models indicated that BIW were 91% less likely to have a LBW baby (p < .001). When accounting for other sociodemographic and health care related variables differing by nativity, although a statistically significant, narrowing gap between BIW and USBW was observed (OR = .12, p < .001), BIW were still less likely to have a LBW baby.

CONCLUSIONS: Differences between USBW and BIW across sociodemographic variables and health care related factors related to adverse pregnancy outcomes were observed in this study. Controlling for the factors attenuated nativity differences but did not eliminate the differences on LBW. Future research should continue to explore this relationship.

PMID:36449128 | DOI:10.1007/s40615-022-01477-2

Environ Geochem Health. 2022 Nov 30. doi: 10.1007/s10653-022-01441-3. Online ahead of print.

ABSTRACT

The dramatic upsurge of artisanal and small-scale gold mining (ASGM) activities in Ghana has resulted in environmental degradation, water pollution and human exposure to mercury-the main hazardous element used in gold extraction. This study evaluated the degree of human exposure to mercury based on the concentrations found in the air and soil samples taken at a resolution of 1 km² across Konongo, a historic mining town in Ghana’s Ashanti Region. The highest atmospheric mercury concentration was 193 ng/m³, which is much higher than the levels the European Union and Japan allowed, which are 10 ng/m³ and 40 ng/m³, respectively. The concentration in the soil was 3.6 mg Hg/kg, which is around ten times higher than the background concentration in nature. Additionally, the soil concentrations were higher above the worrisome levels of soil contamination in agricultural land (4 mg/kg) and industrial areas (16 mg/kg), respectively. Soils are extremely contaminated with mercury at sites artisanal mining activities take place. The concentrations of mercury in the air and soils were significantly higher (p < 0.5) at locations of prominent mining activities compared to areas not close to mining sites. The inhabitants of the Konongo community are therefore exposed to mercury, most likely emitted from artisanal mining activities. A non-carcinogenic risk is posed to the people by inhaling mercury vapour through the air and vapourisation from the soil. Children are exposed to a higher risk than adults as they receive higher daily doses of mercury than adults.

PMID:36449127 | DOI:10.1007/s10653-022-01441-3

MAGMA. 2022 Nov 30. doi: 10.1007/s10334-022-01049-9. Online ahead of print.

ABSTRACT

OBJECTIVE: An early metabolic signature associated with the responsiveness to treatment can be useful in the better management of septic shock patients. This would help clinicians in designing personalized treatment protocols for patients showing non-responsiveness to treatment.

METHODS: We analyzed the serum on Day 1 (n = 60), Day 3 (n = 47), and Day 5 (n = 26) of patients with septic shock under treatment using NMR-based metabolomics. Partial least square discriminant analysis (PLS-DA) was performed to generate the list of metabolites that can be identified as potential disease biomarkers having statistical significance (that is, metabolites that had a VIP score > 1, and p value < 0.05, False discovery rate (FDR) < 0.05).

RESULTS: Common significant metabolites amongst the three time points were obtained that distinguished the patients being responsive (R) and non-responsive (NR) to treatments, namely 3 hydroxybutyrate, lactate, and phenylalanine which were lower, whereas glutamate and choline higher in patients showing responsiveness.

DISCUSSION: The study gave these metabolic signatures identifying patients’ responsiveness to treatment. The results of the study will aid in the development of targeted therapy for ICU patients.

PMID:36449125 | DOI:10.1007/s10334-022-01049-9

J Math Biol. 2022 Nov 30;86(1):6. doi: 10.1007/s00285-022-01840-1.

ABSTRACT

It is well known that Keller-Segel models serve as a paradigm to describe the self aggregation phenomenon, which exists in a variety of biological processes such as wound healing, tumor growth, etc. In this paper, we study the existence of monotone decreasing spiky steady state and its linear stability property in the Keller-Segel model with logistic growth over one-dimensional bounded domain subject to homogeneous Neumann boundary conditions. Under the assumption that chemo-attractive coefficient is asymptotically large, we construct the single boundary spike and next show this non-constant steady state is locally linear stable via Lyapunov-Schmidt reduction method. As a consequence, the multi-symmetric spikes are obtained by reflection and periodic extension. In particular, we present the formal analysis to illustrate our rigorous theoretical results.

PMID:36449113 | DOI:10.1007/s00285-022-01840-1

Pediatr Nephrol. 2022 Nov 30. doi: 10.1007/s00467-022-05803-y. Online ahead of print.

ABSTRACT

BACKGROUND: Primary hyperoxaluria type 1 (PH1) is an autosomal recessive disease caused by the liver defect of oxalate metabolism, which leads to kidney failure and systemic manifestations. Until recently, liver transplantation was the only definitive treatment. The timing of liver transplantation can be early, while kidney function is still normal (pre-emptive liver transplantation-PLT), or when the patient reaches stage 5 chronic kidney disease (CKD) and needs combined liver-kidney transplantation. We aimed to determine the long-term kidney outcomes of PLT in PH1 patients.

METHODS: A retrospective single-center study of PH1 patients who were followed in our center between 1997 and 2017. We compared the kidney outcomes of patients who underwent PLT to those who presented with preserved kidney function and did not undergo PLT.

RESULTS: Out of 36 PH1 patients, 18 patients were eligible for PLT (eGFR > 40 mL/min/1.73 m² at the time of diagnosis). Seven patients underwent PLT (PLT group), while 11 continued conservative treatments (PLTn group). In the PLT group, the median eGFR at the time of PLT and at the end of the follow-up period (14-20 years) was 72 (range 50-89) and 104 (range 86-108) mL/min/1.73 m², respectively, and no patient died or reached stage 5 CKD. In the PLTn group, eight patients (72.7%) reached stage 5 CKD (median time to kidney replacement therapy was 11 years), and two patients died from disease complications (18.2%).

CONCLUSIONS: Pre-emptive liver transplantation preserved kidney function in patients with PH1 in our cohort. Early intervention can prevent kidney failure and systemic oxalosis in PH1. A higher resolution version of the Graphical abstract is available as Supplementary information.

PMID:36449101 | DOI:10.1007/s00467-022-05803-y

Surg Today. 2022 Nov 30. doi: 10.1007/s00595-022-02624-2. Online ahead of print.

ABSTRACT

PURPOSE: To assess the impact of surgical approach on morbidity, mortality, and the oncological outcomes of synchronous (SC) and metachronous (MC) colorectal cancer (CRC).

METHODS: All patients undergoing resection for double location CRC (SC or MC) between 2006 and 2020 were included. The exclusion criteria were polyposis or SC located on the same side.

RESULTS: Sixty-seven patients (age, 64.8 years; male, 78%) with SC (n = 41; 61%) or MC (n = 26; 39%) were included. SC was treated with segmental colectomy (right and left colectomy/proctectomy; n = 19) or extensive colectomy (subtotal/total colectomy or restorative proctocolectomy with pouch; n = 22). Segmental colectomy was associated with a higher incidence of anastomotic leakage (47.4 vs. 13.6%; p = 0.04) and a higher rate of medical morbidity (47.4 vs. 16.6%; p = 0.04). The mean number of lymph nodes harvested was similar. For MC, the second cancer was treated by iterative colectomy (n = 12) or extensive colectomy (n = 14) and there was no significant difference in postoperative outcomes between the two surgical approaches. The median follow-up period was 42.4 ± 29.1 months. The 5-year overall and disease-free survival of the SC and MC groups did not differ to a statistically significant extent.

CONCLUSIONS: Extensive colectomy should be preferred for SC to reduce morbidity and improve the prognosis. In contrast, iterative colectomy can be performed safely for patients with MC.

PMID:36449083 | DOI:10.1007/s00595-022-02624-2

Jpn J Nurs Sci. 2022 Nov 30:e12520. doi: 10.1111/jjns.12520. Online ahead of print.

ABSTRACT

AIM: To derive latent topics from free-text responses on the negative impact of the pandemic on research activities and determine similarities and differences in the resulting themes between academic-based and clinical-based researchers.

METHODS: We performed a secondary analysis of free-text responses from a cross-sectional online survey conducted by the Japan Academy of Nursing Science of its members in early 2020. The participants were categorized into two groups by workplace (academic-based and clinical-based researchers). Latent Dirichlet allocation (LDA) topic modeling was used to extract latent topics statistically and list important keywords/text associated with the topics. After organizing similar topics by principal component analysis (PCA), we finally derived topic-associated themes by reading the keywords/texts and determining the similarity and differences of the themes between the two groups.

RESULTS: A total of 201 respondents (163 academic-based and 38 clinical-based researchers) provided free-text responses. LDA identified eight and three latent topics for the academic-based and clinical-based researchers, respectively. While PCA re-grouped the eight topics derived from the former group into four themes, no merging of the topics from the latter group was performed resulting in three themes. The only theme common to the two groups was “barriers to conducting research,” with the remaining themes differing between the groups.

CONCLUSIONS: Using LDA topic modeling with PCA, we identified similarities and differences in the themes described in free-text responses about the negative impact of the pandemic between academic-based and clinical-based researchers. Measures to mitigate the negative impact of pandemics on nursing research may need to be tailored separately.

PMID:36448530 | DOI:10.1111/jjns.12520

J Appl Clin Med Phys. 2022 Nov 30:e13852. doi: 10.1002/acm2.13852. Online ahead of print.

ABSTRACT

The present study was conducted as part of a comprehensive work to establish National Diagnostic Reference Levels (NDRLs) in Sri Lanka for the first time. DRLs can be used as an effective optimization tool for identifying unusually high or low patient doses during X-ray examinations. This study aims to propose institutional DRLs (IDRLs) by measuring the kerma-area product (KAP) of adult patients undergoing routine projection X-ray examinations. The median and the 75th percentile KAP values obtained were compared with that of the single institution KAP values reported from India and Greece. This descriptive cross-sectional study was conducted in a public hospital in Uva province, Sri Lanka, with 400 adult patients aged 18-87 years and weighing 58 ± 20 kg. The patient-specific information (age, sex, weight, and height) and corresponding exposure parameters (tube voltage and current-exposure time product) were obtained. The KAP values were measured, and descriptive statistics were utilized for data analysis. The median KAP values obtained were proposed as IDRLs. The IDRLs in Gy.cm² were 0.23 for cervical spine anterior-posterior (AP), 0.19 for cervical spine lateral (LAT), 0.10 for chest posterior-anterior (PA), 0.06 for knee joint AP, 0.05 for knee joint LAT, 1.47 for KUB AP, 0.85 for lumbar spine AP, 1.97 for lumbar spine LAT, 0.29 for shoulder joint AP, 0.61 for skull PA, and 0.60 for skull LAT examinations. The maximum to minimum ratio of KAP values ranged from 2.4 for KUB AP to 6.3 for the cervical spine AP examinations. The median and the 75th percentile of most of the examinations were comparable to corresponding KAP values reported by the countries mentioned above, except for the skull PA and LAT examinations. Accordingly, interquartile ranges of exposure parameters are recommended for skull examinations to improve the optimization of patient doses.

PMID:36448529 | DOI:10.1002/acm2.13852

Int J Urol. 2022 Nov 30. doi: 10.1111/iju.15106. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the involvement of pretreatment C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR) in the prognosis of patients who underwent intravesical bacillus Calmette-Guérin (BCG) therapy for non-muscle invasive bladder cancer (NMIBC).

METHODS: The clinicopathological data of 1709 patients with NMIBC who underwent initial intravesical BCG therapy after transurethral resection of bladder tumor were retrospectively analyzed to evaluate the outcome of intravesical BCG therapy in a multicenter study conducted by the Japan Urological Oncology Group. The prognoses of these patients were analyzed to determine whether the biomarkers (CRP and NLR) could predict the efficacy of intravesical BCG therapy. Patients were divided into two groups according to the pretreatment CRP and NLR, with cutoff values defined as CRP ≥ 0.5 mg/dl and NLR ≥ 2.5, based on several previous reports.

RESULTS: In the univariable analysis, CRP ≥ 0.5 mg/dl was significantly associated with intravesical recurrence, cancer-specific survival, and bladder cancer (BC) progression, while NLR ≥ 2.5 was not significantly associated with patient prognosis. In the multivariable analysis, CRP ≥ 0.5 mg/dl was significantly associated with intravesical recurrence and BC progression. The concordance index was used to examine the accuracy in predicting recurrence and progression events. While CRP was slightly, though not statistically significant, inferior to the European Association of Urology risk classification, the combination of them showed improved predictive accuracy.

CONCLUSION: This study suggests that CRP can be a prognostic factor after intravesical BCG therapy and may provide useful data for determining treatment and follow-up strategies for patients with NMIBC.

PMID:36448522 | DOI:10.1111/iju.15106