Tag: nevin manimala

Trans R Soc Trop Med Hyg. 2023 Sep 8:trad064. doi: 10.1093/trstmh/trad064. Online ahead of print.

ABSTRACT

BACKGROUND: The objective of this study was to evaluate the spatial and temporal patterns of disease prevalence clusters of dengue (DENV), chikungunya (CHIKV) and Zika (ZIKV) virus and how socio-economic and climatic variables simultaneously influence the risk and rate of occurrence of infection in Mexico.

METHODS: To determine the spatiotemporal clustering and the effect of climatic and socio-economic covariates on the rate of occurrence of disease and risk in Mexico, we applied correlation methods, seasonal and trend decomposition using locally estimated scatterplot smoothing, hotspot analysis and conditional autoregressive Bayesian models.

RESULTS: We found cases of the disease are decreasing and a significant association between DENV, CHIKV and ZIKV cases and climatic and socio-economic variables. An increment of cases was identified in the northeastern, central west and southeastern regions of Mexico. Climatic and socio-economic covariates were significantly associated with the rate of occurrence and risk of the three arboviral disease cases.

CONCLUSION: The association of climatic and socio-economic factors is predominant in the northeastern, central west and southeastern regions of Mexico. DENV, CHIKV and ZIKV cases showed an increased risk in several states in these regions and need urgent attention to allocate public health resources to the most vulnerable regions in Mexico.

PMID:37681342 | DOI:10.1093/trstmh/trad064

Arch Esp Urol. 2023 Aug;76(6):454-459. doi: 10.56434/j.arch.esp.urol.20237606.55.

ABSTRACT

BACKGROUND: Live surgery events (LSEs) are frequently organized for sharing the surgical experiences with surgeons at the beginning of their learning curves. The aim of this study was to investigate whether the outcomes and complication rates of patients underwent retrograde intrarenal surgery (RIRS) at LSEs are comparable with regular cases.

METHODS: Ten courses were organized during 2017-2022. Data of 32 patients who operated in the LSEs were 1:3 matched (for stone burden and surgeon) with the data of patients who underwent regular RIRS within the course periods at the same centers (n = 96). All courses took place in concordance with the latest LSE policies. The primary outcomes were stone-free and complication rates. Fluoroscopy and operation times were the secondary outcomes.

RESULTS: Stone-free rates of the groups were similar (84% in LSE and 79% in control group; p = 0.520). Similarly, there were no differences in complication rates (p = 0.428) and fluoroscopy time (p = 0.477). Duration of the LSE cases (82.24 ± 31.12 min) was slightly but insignificantly longer than regular cases (73.77 ± 20.89 min, p = 0.092). Moreover, guest surgeons tend to have longer operation time with statistically insignificant prolongation (74.92 ± 30.43 min for host, 89.52 ± 28.34 min for guest surgeons, p = 0.064).

CONCLUSIONS: RIRS can be performed without jeopardizing operation efficiency and patient safety in LSEs. If surgeon is not familiar with operating room set-up or staff, live surgery must be performed by host surgeon to avoid extended operating time.

PMID:37681337 | DOI:10.56434/j.arch.esp.urol.20237606.55

Arch Esp Urol. 2023 Aug;76(6):403-410. doi: 10.56434/j.arch.esp.urol.20237606.49.

ABSTRACT

BACKGROUND: In this study, the clinical effect of lamivudine combined with leflunomide and methylprednisolone in the treatment of hepatitis B virus-associated glomerulonephritis (HBV-GN) and their influence on renal function indexes was explored.

METHODS: Patients with HBV-GN were selected for retrospective analysis and divided into the group B and group A, with 41 cases in each group. The group B was given leflunomide and methylprednisolone, whereas the group A was supplemented with lamivudine. The level of 24 h proteinuria (PRO), albumin (ALB), beta2-microglobulin (β2-MG), alanine aminotransferase (ALT), interferon-gamma (IFN-γ) and interleukin-4 (IL-4) in two groups was measured. The clinical efficacy, adverse reactions appetite, spirit, sleep and daily life scores of the two groups were recorded.

RESULTS: With the extension of treatment time to end of the treatment, the level of 24 h PRO, ALB and β2-MG in the group A significantly changed compared with that before treatment (p < 0.05). Moreover, the level of ALT, IFN-γ and IL-4 in the two groups significantly decreased compared with that before treatment, and the level of the three indexes in the group A decreased more significantly (p < 0.05). The total effective rate in the group A was higher than that in the group B (p < 0.05). The occurrence of adverse reactions showed no statistically significant difference between the two groups. After treatment, scores of appetite, spirit, sleep and daily living were increased in the two groups, and the increase in the group A was more significant than that in the group B (p < 0.05).

CONCLUSIONS: Lamivudine combined with methylprednisolone and leflunomide treatment is conducive to clearing Hepatitis B virus (HBV) and improving renal function.

PMID:37681331 | DOI:10.56434/j.arch.esp.urol.20237606.49

Arch Esp Urol. 2023 Aug;76(6):389-396. doi: 10.56434/j.arch.esp.urol.20237606.47.

ABSTRACT

OBJECTIVE: To evaluate trends in the prevalence and clinical characteristics of urogenital diseases in hospitalized patients of secondary and tertiary hospitals in Ningbo, an east coast city in China, from 2017 to 2019.

METHODS: We collected the data on hospitalized patients in Ningbo secondary and tertiary hospitals from January 1, 2017 to December 31, 2019. The data included age, sex, and diagnosis identified using the International Classification of Diseases (ICD) codes, which were obtained from Ningbo National Health Information Platform. We quantified the epidemiology (age/sex-specific) trend of urogenital system disorders.

RESULTS: From January 2017 to December 2019, there were 256750 hospitalized patients with urogenital system disorders. These hospitalized patients comprised more women than men (1.45:1.00). The number of hospitalized patients with these diseases significantly increased over the 3 years (77505, 89167, and 90078, respectively; Z = 20.03, p < 0.001). The highest prevalence of these diseases was in the 40- to 64-year-old age group (47.37%), followed by the 18- to 39-year-old age group (23.94%). Over the 3 years, the five most common diseases in hospitalized male patients were male reproductive organ disorders, urolithiasis, tubulointerstitial disease, renal failure, and glomerular disease; Whereas the five most common diseases in hospitalized female patients were non-inflammatory disorders of the female genital tract, benign or dynamic undetermined tumors of the female reproductive organs, disorders of breast (according to ICD-10, disorders of breast (N60-N64) were involved in urogenital system diseases (N00-N99)), inflammatory diseases of female pelvic organs, and renal tubulointerstitial disease. In addition, the number of inpatients with renal tubulointerstitial disease significantly increased from 5952 to 9616 over the 3 years (rank increased from 6 to 3).

CONCLUSIONS: Patients with urogenital system disorders significantly increased over the 3 years, occurring more often in women and most commonly in young and middle-aged people, which warrants more attention in clinical practice.

PMID:37681329 | DOI:10.56434/j.arch.esp.urol.20237606.47

Turk J Gastroenterol. 2023 Sep 8. doi: 10.5152/tjg.2023.22823. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: Discontinuation of nucleos(t)ide analog is controversial in HBeAg-negative chronic hepatitis B patients not achieved HBsAg loss. We aimed to evaluate re-treatment rates and risk factors in non-cirrhotic HbeAg-negative chronic hepatitis B patients for whom nucleosi(t)ides analogs were discontinued.

MATERIALS AND METHODS: Demographic, clinical, and laboratory data before and at the end after discontinuation of nucleos(t)ide analogs were collected retrospectively.

RESULTS: Seventy-two patients followed up between January 2000 and December 2019 were included; 43 were male, with a mean age of 46.3 (±10.8). Baseline median alanine aminotransferase (ALT) and hepatitis B virus DNA levels were 55.5 IU/L and 465 925 IU/mL, respectively. The median histologic activity index was 5.5 and the fibrosis score was 2. The median duration of treatment and consolidation therapy were 59 and 56 months, respectively. The median follow-up time after discontinuation of treatment was 55 months. Among 56 patients eligible for evaluation according to proposed re-treatment criteria, 29 (51.7%) patients were re-treated. The median time for relapse was 11 months. Re-treatment was significantly common in males (P = .034) and patients treated with tenofovir/entecavir (P = .04). Baseline hepatitis B virus DNA and levels of ALT, aspartate aminotransferase (AST) at the third and sixth months of treatment and at the end of treatment were statistically significantly higher in re-treated patients. A cutoff value of ≥405 000 IU/L for hepatitis B virus DNA discriminated patients for re-treatment. HBsAg was lost permanently in 2 non-re-treated patients.

CONCLUSION: In resource-limited areas where follow-up of HBsAg or other markers is not possible, nucleos(t)ide analog discontinuation can be considered in patients in the early stage, with low baseline hepatitis B virus DNA and ALT levels, after a long consolidation therapy.

PMID:37681268 | DOI:10.5152/tjg.2023.22823

Turk J Gastroenterol. 2023 Sep 8. doi: 10.5152/tjg.2023.22679. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: Liver transplantation is an acceptable treatment for some selected hepatocellular carcinoma. We report our experience of 6 patients with liver transplantation for hepatocellular carcinoma with background inherited metabolic disease.

MATERIALS AND METHODS: This is a single-center retrospective, descriptive study. Consecutive patients who underwent liver transplantation for hepatocellular carcinoma with background inherited metabolic disease were included in the study. The record of the patients was accessed, and the following data were extracted: sociodemographic variables, type of metabolic disease, date of liver transplantation, tumor characteristics, laboratory parameters, Model for End-Stage Liver Disease score, immediate- and long-term outcome after transplantation, disease-free survival, and overall survival. Data were analyzed using Statistical Package for the Social Sciences version 25.0.

RESULTS: Six patients received liver transplantation for hepatocellular carcinoma with background inherited metabolic liver disease. The median age was 4.5 years. The median Model for End-Stage Liver Disease score was 29.30. The median maximum tumor diameter was 2.15 cm. Three patients had multiple tumor nodules. Half of the patients had microvascular invasion. Four of the patients had a moderately differentiated tumor. Progressive familial intrahepatic cholestasis type II is the commonest inherited metabolic disease seen in 3 patients. Median follow-up is 46.1 months. Half of the patients are currently more than 5 years post liver transplantation with no features of recurrence. The estimated survival rates at 1, 3, and 5 years are 100%, 83.3%, and 83.3%, respectively.

CONCLUSION: Liver transplant for these categories of patients is associated with good disease-free and overall survival, even in the presence of some seemingly poor prognostic features.

PMID:37681267 | DOI:10.5152/tjg.2023.22679

Eur J Rheumatol. 2023 Jul;10(3):97-100. doi: 10.5152/eurjrheum.2023.22086.

ABSTRACT

BACKGROUND: It has been estimated that about 1% of the US population is treated with long-term glucocorticoids. High doses of glucocorticoids particularly those used by rheumatologists and oth- ers for systemic autoimmune rheumatic disease result in bone loss, causing glucocorticoid-induced osteoporosis and an increase in the risk of fractures. The increased risk is related to both the daily dose and the cumulative dose of the glucocorticoids. Despite the availability of effective preventative and treatment options, glucocorticoid-induced osteoporosis is often not mitigated with the use of these preventive therapies. The risk of glucocorticoid-induced osteoporosis often also goes under- recognized, because it occurs in a different group of patients compared to age-related osteoporosis. As a result, glucocorticoid-induced osteoporosis is not always treated until after fractures may have occurred. Our objective is to determine if a structured health-care provider’s educational interven- tion with intermittent educational updates would lead to improvement in the identification, evalu- ation, and prevention of glucocorticoid-induced osteoporosisin those patients at the highest risk of glucocorticoid-induced osteoporosis.

METHODS: In this single-center, prospective study, patients over 40 years of age, receiving a total cumu- lative dose of glucocorticoids of >5 g or a single dose of >30 mg of prednisone or its equivalent was enrolled. All providers attended an academic Journal Club, where the current American College of Rheumatology guidelines regarding glucocorticoid-induced osteoporosiswas reviewed. All providers received monthly reminders during academic meetings within the department.

RESULTS: There was a statistically significant improvement between pre- and post-educational data, with increasing use of glucocorticoid-induced osteoporosis preventive measures, which was sus- tained over the 12-month duration of the study.

CONCLUSION: This research shows the importance of provider education as a means of disseminating information and improving the quality of patient care.

PMID:37681255 | DOI:10.5152/eurjrheum.2023.22086

Astrophys J. 2023 Apr 1;946(2):107. doi: 10.3847/1538-4357/acbe3b. Epub 2023 Apr 5.

ABSTRACT

It is well known that the power spectrum is not able to fully characterize the statistical properties of non-Gaussian density fields. Recently, many different statistics have been proposed to extract information from non-Gaussian cosmological fields that perform better than the power spectrum. The Fisher matrix formalism is commonly used to quantify the accuracy with which a given statistic can constrain the value of the cosmological parameters. However, these calculations typically rely on the assumption that the sampling distribution of the considered statistic follows a multivariate Gaussian distribution. In this work, we follow Sellentin & Heavens and use two different statistical tests to identify non-Gaussianities in different statistics such as the power spectrum, bispectrum, marked power spectrum, and wavelet scattering transform (WST). We remove the non-Gaussian components of the different statistics and perform Fisher matrix calculations with the Gaussianized statistics using Quijote simulations. We show that constraints on the parameters can change by a factor of ∼2 in some cases. We show with simple examples how statistics that do not follow a multivariate Gaussian distribution can achieve artificially tight bounds on the cosmological parameters when using the Fisher matrix formalism. We think that the non-Gaussian tests used in this work represent a powerful tool to quantify the robustness of Fisher matrix calculations and their underlying assumptions. We release the code used to compute the power spectra, bispectra, and WST that can be run on both CPUs and GPUs.

PMID:37681217 | PMC:PMC10482003 | DOI:10.3847/1538-4357/acbe3b

Front Pediatr. 2023 Aug 23;11:1097152. doi: 10.3389/fped.2023.1097152. eCollection 2023.

ABSTRACT

INTRODUCTION: Energy requirements are difficult to estimate in children with cerebral palsy (CP). Resting energy expenditure (REE), necessary to implement personalized nutritional interventions, is most commonly estimated using prediction formulae since indirect calorimetry, the reference method, is not available in all nutrition units. The aims of the present study were: (1) to evaluate the accuracy of the most commonly used REE prediction formulae developed for healthy children, in children with CP; (2) to assess the accuracy of the REE population-specific formula for CP children proposed in our preliminary report; (3) to develop new population-specific methods.

METHODS: REE was measured by indirect calorimetry in 100 children and adolescents with spastic quadriplegic cerebral palsy (SQCP) and estimated on the basis of predictive formulas selected by the clinicians [World Health Organization (WHO), Harris-Benedict, Schofield weight, Schofield weight & height, Oxford, Mifflin formulae and a population-specific formula for CP children developed in our preliminary report].

RESULTS: 100 children with SQCP (35 girls, 35%) classified as level V according to gross motor function classification system (GMFCS-V); 64% with oral nutrition, 29% total enteral nutrition (nasogastric tube feeding, percutaneous endoscopic gastrostomy, percutaneous endoscopic transgastric jejunostomy) and 7% mixed nutrition. The median (IQR) REE was 41.96 (17.5) kcal/kg/day.Statistical analysis highlighted a proportional bias between the indirect calorimetry and all considered predictive formulae for REE determination. By studying the relationship between the bias and the mean values of REE, specific conversion equations were obtained. With a pre-specified model having as predictors the variable weight and the variable Triceps Skinfold (TSF) and, as response the variable REE measured by indirect calorimetry, a predictive nomogram was developed to estimate the REE in this population of children.

CONCLUSIONS: We suggest using predictive formulae for healthy children with caution, and where possible carrying out indirect calorimetry to assess REE in children with CP. However, we propose a new tool which could be developed to become an additional help for assessment of REE in the clinical practice.Future objectives will be to obtain a larger sample size, in a multicenter perspective study, to build a specific predictive model for the REE of the studied population.

PMID:37681200 | PMC:PMC10481865 | DOI:10.3389/fped.2023.1097152

Proc Mach Learn Res. 2023 Apr;206:10343-10367.

ABSTRACT

Conditional randomization tests (CRTs) assess whether a variable $x$ is predictive of another variable $y$, having observed covariates $z$. CRTs require fitting a large number of predictive models, which is often computationally intractable. Existing solutions to reduce the cost of CRTs typically split the dataset into a train and test portion, or rely on heuristics for interactions, both of which lead to a loss in power. We propose the decoupled independence test (DIET), an algorithm that avoids both of these issues by leveraging marginal independence statistics to test conditional independence relationships. DIET tests the marginal independence of two random variables: $F_{x\mid z}(x\mid z)$ and $F_{y\mid z}(y\mid z)$ where $F_{\cdot \mid z}(\cdot \mid z)$ is a conditional cumulative distribution function (CDF) for the distribution $p(\cdot \mid z)$. These variables are termed “information residuals.” We give sufficient conditions for DIET to achieve finite sample type-1 error control and power greater than the type-1 error rate. We then prove that when using the mutual information between the information residuals as a test statistic, DIET yields the most powerful conditionally valid test. Finally, we show DIET achieves higher power than other tractable CRTs on several synthetic and real benchmarks.

PMID:37681192 | PMC:PMC10484293