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Comparative analysis of clinical diagnosis application of two intrauterine adhesion scoring criteria

Zhonghua Fu Chan Ke Za Zhi. 2023 Mar 25;58(3):185-190. doi: 10.3760/cma.j.cn112141-20221207-00743.

ABSTRACT

Objective: To explore the similarities and differences of China Society of Gynecology Endoscopy (CSGE) and American Fertility Society (AFS) intrauterine adhesion (IUA) scoring criteria on IUA grading and their predictive value of reproductive prognosis. Methods: From January 2016 to January 2019, a total of 1 249 patients were diagnosed with IUA by hysteroscopy at Beijing Obstetrics and Gynecology Hospital. Totally, 378 patients with complete clinical data were enrolled, and the results diagnosed by CSGT and AFS scoring criteria were compared and analyzed.And follow-up for 2 years, the pregnancy rate and live birth rate were statistical analysis. Results: (1) The grade of IUA according to AFS and CSGE scoring criteria was less consistent (κ=0.295, P<0.001). Compared with AFS, the proportion of severe IUA cases diagnosed by CSGE was significantly lower [45.8% (173/378) vs 15.1% (57/378); RR=0.22, 95%CI: 0.15-0.30, P<0.01); the proportions of both mild and moderate IUA cases were significantly higher (RR=4.16, 95%CI: 2.38-7.14; RR=2.38, 95%CI: 1.75-3.23; both P<0.01). (2) The pregnancy rates of mild, moderate and severe IUA diagnosed according to CSGE were 11/13, 64.5% (147/228), 31.8% (7/22), live birth rates were 11/13, 54.8% (125/228) and 22.7% (5/22), respectively; there were statistically significant differences between the groups (all P<0.01). The pregnancy rates of mild, moderate and severe IUA diagnosed based on AFS were 3/3, 66.9% (97/145) and 56.5% (65/115), respectively, with no statistically significant difference between the groups (P>0.05). (3) IUA grades based on both CSGE and AFS criteria were significantly negatively correlated with pregnancy rates and live birth rates (CSGE: r=-0.210, r=-0.226; AFS: r=-0.130, r=-0.147; all P<0.05). Univariate logistic regression analysis showed that CSGE had higher OR for both pregnancy rates and live birth rates compared to AFS (3.889 vs 1.657, 3.983 vs 1.554, respectrvely). Conclusions: Compared with AFS, the IUA grade based on CSGE is better related with reproductive prognosis, suggesting that the CSGE standard might be more objective and comprehensive and has better predictive value for reproductive prognosis, thus avoiding overdiagnosis and overtreatment.

PMID:36935195 | DOI:10.3760/cma.j.cn112141-20221207-00743

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Revision of brief health literacy assessment scale among the older adults and its reliability and validity test

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023 Jan 28;48(1):123-129. doi: 10.11817/j.issn.1672-7347.2023.220011.

ABSTRACT

OBJECTIVES: The development and validation of the specific health literacy assessment tool for older adults is the basis for conducting the research on health literacy among older adults. The existing health literacy assessment scale for older adults in Chinese mainland has some limitations, such as too many items and poor compliance during the survey. It is necessary to develop or introduce simplified assessment tools to support large-scale surveys in the future. This study aims to modify the brief health literacy assessment scale compiled by Taiwan scholars, and to conduct the test for the reliability, validity and the measurement equivalence across gender in the older population in mainland China.

METHODS: From March to April 2021, 508 older adults from Jinan, Shandong Province, China were selected by cluster sampling method to conduct a questionnaire survey using the brief health literacy assessment scale and health-promoting lifestyle profile. After 4 weeks, 83 of them were selected for retesting. SPSS 25.0 statistical software was used for descriptive analysis, item analysis, exploratory factor analysis, correlation analysis, and reliability test, and Mplus 8.0 was used for confirmatory factor analysis and gender measurement equivalence test.

RESULTS: Each item of the scale had good discrimination, and there were significant differences in the scores of each item between high score and low score groups (P<0.05), and the coefficient of correlation between the scores of each item and the total score was between 0.721 and 0.891. Exploratory factor analysis extracted a factor with a characteristic root greater than 1, and the cumulative variance interpretation amount was 67.94%. The confirmatory factor analysis showed that the single factor structure fit was good [χ2/df was 2.260, the Tucker-Lewis index was 0.973, the comparison fit index (CFI) was 0.982, and the root mean square error of approximation (RMSEA) was 0.071]. The multi-group confirmatory factor analysis results showed that the brief health literacy assessment scale’s configural equivalence, weak equivalence, and strong equivalence models were all accepted. The comparison results of measurement equivalence models showed that the changes of RMSEA were less than 0.015, and the changes of CFI were less than 0.01, indicating that the brief health literacy assessment scale had measurement equivalence between different gender groups. Cronbach’s α coefficient was 0.945, and the test-retest reliability was 0.946. The correlation coefficient between health literacy and health-promotion lifestyles was 0.557 (P<0.05).

CONCLUSIONS: The brief health literacy assessment scale has good reliability, validity, and measurement equivalence across gender, and can be used as an effective measurement tool for the health literacy of the older people in Chinese mainland.

PMID:36935185 | DOI:10.11817/j.issn.1672-7347.2023.220011

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Psychosocial crisis intervention for coronavirus disease 2019 patients and healthcare workers

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023 Jan 28;48(1):92-105. doi: 10.11817/j.issn.1672-7347.2023.210803.

ABSTRACT

OBJECTIVES: Shelter hospital was an alternative way to provide large-scale medical isolation and treatment for people with mild coronavirus disease 2019 (COVID-19). Due to various reasons, patients admitted to the large shelter hospital was reported high level of psychological distress, so did the healthcare workers. This study aims to introduce a comprehensive and multifaceted psychosocial crisis intervention model.

METHODS: The psychosocial crisis intervention model was provided to 200 patients and 240 healthcare workers in Wuhan Wuchang shelter hospital. Patient volunteers and organized peer support, client-centered culturally sensitive supportive care, timely delivery of scientific information about COVID-19 and its complications, mental health knowledge acquisition of non-psychiatric healthcare workers, group activities, counseling and education, virtualization of psychological intervention, consultation and liaison were exhibited respectively in the model. Pre-service survey was done in 38 patients and 49 healthcare workers using the Generalized Anxiety Disorder 7-item (GAD-7) scale, the Patient Health Questionnaire 2-item (PHQ-2) scale, and the Primary Care PTSD screen for the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (PC-PTSD-5). Forty-eight healthcare workers gave feedback after the intervention.

RESULTS: The psychosocial crisis intervention model was successfully implemented by 10 mental health professionals and was well-accepted by both patients and healthcare workers in the shelter hospital. In pre-service survey, 15.8% of 38 patients were with anxiety, 55.3% were with stress, and 15.8% were with depression; 16.3% of 49 healthcare workers were with anxiety, 26.5% were with stress, and 22.4% were with depression. In post-service survey, 62.5% of 48 healthcare workers thought it was very practical, 37.5% thought more practical; 37.5% of them thought it was very helpful to relief anxiety and insomnia, and 27.1% thought much helpful; 37.5% of them thought it was very helpful to recognize patients with anxiety and insomnia, and 29.2% thought much helpful; 35.4% of them thought it was very helpful to deal with patients’ anxiety and insomnia, and 37.5% thought much helpful.

CONCLUSIONS: Psychological crisis intervention is feasible, acceptable, and associated with positive outcomes. Future tastings of this model in larger population and different settings are warranted.

PMID:36935182 | DOI:10.11817/j.issn.1672-7347.2023.210803

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MiR-18a-5p aggravates homocysteine-induced myocardial injury via autophagy

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023 Jan 28;48(1):24-33. doi: 10.11817/j.issn.1672-7347.2023.220364.

ABSTRACT

OBJECTIVES: Hyperhomocysteinaemia (Hcy) is an independent risk factor for cardiovascular and cerebrovascular diseases. MicroRNA (miR)-18a-5p is closely related to cardiovascular diseases. This study aims to investigate the effects of miR-18a-5p on homocysteine (Hcy)-induced myocardial cells injury.

METHODS: H9c2 cells were transfected with miR-18a-5p mimic/miR-18a-5p mimic negative control (NC) or combined with Hcy for intervention, and untreated cells were set as a control group. The transfection efficiency was verified by real-time RT-PCR, and cell counting kit-8 (CCK-8) assay was used to determine cell viability. Flow cytometry was used to detect apoptosis and reactive oxygen species (ROS) levels. Western blotting was performed to measure the protein levels of microtubule-associated protein 1 light chain 3 (LC3)-I, LC3-II, Beclin1, p62, Bax, Bcl-2, and Notch2. Dual luciferase reporter assay was used to detect the interaction of miR-18a-5p with Notch2.

RESULTS: Compared with the control, treatment with Hcy or transfection with miR-18a-5p mimic alone, or combined treatment with Hcy and miR-18a-5p mimic/miR-18a-5p mimic NC significantly reduced the H9c2 cell viability, promoted apoptosis and ROS production, up-regulated the expressions of Bax and Beclin, down-regulated the expressions of Bcl-2, p62, and Notch2, and increased the ratio of LC3-II/LC3-I (all P<0.05). Compared with the combined intervention of miR-18a-5p mimic NC and Hcy group, the above indexes were more significantly changed in the combined intervention of miR-18a-5p mimic and Hcy group, and the difference between the 2 groups was statistically significant (all P<0.05). There is a targeted binding between Notch2 and miR-18a-5p.

CONCLUSIONS: MiR-18a-5p could induce autophagy and apoptosis via increasing ROS production in cardiomyocytes, and aggravate Hcy-induced myocardial injury. Notch2 is a target of miR-18a-5p.

PMID:36935174 | DOI:10.11817/j.issn.1672-7347.2023.220364

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Standardization of near infrared spectroscopies via sample spectral correlation equalization

Anal Chim Acta. 2023 Apr 29;1252:341031. doi: 10.1016/j.aca.2023.341031. Epub 2023 Mar 7.

ABSTRACT

A novel method for near-infrared (NIR) spectroscopy spectra standardization is presented. NIR spectroscopies have been widely used in analytical chemistry, and many methods have been developed for NIR spectra standardization. To establish a robust standardization transformation, most existing methods require spectral data sets from both primal and secondary instruments for 1-1 correspondence validation. However, this limits the usage of standardization methods. This paper investigates an interesting issue, “Can spectra data in sets be arbitrarily order?” and further develops a completely different approach from existing methods in view of statistical signal processing. The key idea is to first compensate for the distortion along the wavelength and intensity of the spectra, and then transfer the second order statistic (2OS) from the primal spectra to the secondary spectra via data sphering and an inverse sphering transform so that the 2OS can be estimated regardless of the sample statistic order. To further demonstrate how the developed method can extend the usage of the NIR spectra standardization, several application-driven experiments on classification and regression are conducted for demonstration, and a comparison to the piecewise direct standardization (PDS) is also studied.

PMID:36935146 | DOI:10.1016/j.aca.2023.341031

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Effect of luting system with acidic primers on the durability of bonds with Ti-15Mo-5Zr-3Al titanium alloy and its component metals

Dent Mater J. 2023 Mar 18. doi: 10.4012/dmj.2022-184. Online ahead of print.

ABSTRACT

This study evaluated the effect of luting system with acidic primers on the durability of bonds with Ti-15Mo-5Zr-3Al titanium alloy (Ti-15Mo-5Zr-3Al) and its component metals. Adherend metals were Ti-15Mo-5Zr-3Al, Ti, Mo, Zr, and Al. Four primers were evaluated as adhesion promoters: Alloy Primer (ALP), Estenia Opaque Primer (EOP), M. L. Primer (MLP), and Super Bond liquid (SBL). An acrylic resin was used as the luting material. Pre- and post-thermocycling shear bond strength was determined to evaluate the bonding durability, and the results were compared using non-parametric statistical analyses (n=11/group). The post-thermocycling bond strength in MPa (median) associated with ALP, EOP, MLP, and SBL were 18.8, 19.8, 4.1, and 0.8, respectively, for Ti-15Mo-5Zr-3Al. The results showed that two primers containing 10-methacryloyloxydecyl dihydrogen phosphate (MDP) were effective for the durability of bonding of Ti-15Mo-5Zr-3Al to the resin. MDP enhanced the bonding durability of the resin bonded to either Ti, Zr, or Al.

PMID:36935125 | DOI:10.4012/dmj.2022-184

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Clinical manifestation score and characterization of cytokines and lymphocytes of dimethylacetamide-induced toxic hepatitis in spandex workers

Toxicol Ind Health. 2023 Mar 19:7482337231162762. doi: 10.1177/07482337231162762. Online ahead of print.

ABSTRACT

Occupational exposure to dimethylacetamide (DMAc) has been reported to cause toxic hepatitis. Sixty spandex workers were included in this study to research the clinical manifestations and expression of cytokines and lymphocytes in DMAc-induced toxic hepatitis. Chinese drugs (reduced glutathione and Hugan tablets) were used to treat them. The manifestations including jaundice, asthenia, appetite, nausea, emesis, abdominal distension, yellow urine, and dizziness were scored. The percentages of patients rated as 0-3, 4-6, 7-9, and 10-12 points were 33.3%, 43.3%, 21.7%, and 1.7%, respectively, before treatment, and all patients showed 0-3 points after the treatment. The ultrasonic and CT imaging revealed diffuse intrahepatic hypodensity, intrahepatic calcification, signs of liver injury, and splenomegaly, which improved after therapy. Blood analysis showed that ALT, AST, TBIL, IL-6, IL-10, TNF-α, IFN-γ, CD3+%, and CD4+/CD8+ statistically decreased after drug treatment. Correlation analysis demonstrated positive linear correlations between ALT and TBIL, AST and TBIL, IL-10 and ATL, IL-10 and AST, IL-10 and TBIL, IFN-γ and IL-6, IFN-γ and TNF-α, and CD3+% and ALT. Pro-inflammatory cytokines and lymphocytes in DMAc-induced toxic hepatitis reflected an active immune state that decreased after treatment. IL-10 may inhibit the immune response in this disease, as a protective mechanism.

PMID:36935113 | DOI:10.1177/07482337231162762

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Quantification of waning immunity after measles vaccination – evidence from a seroprevalence study

Am J Epidemiol. 2023 Mar 17:kwad065. doi: 10.1093/aje/kwad065. Online ahead of print.

ABSTRACT

The aim of this study was to quantify waning rates from seroprevalence data collected in a study of population with a high vaccination coverage and fixed vaccination schedule. Data were collected during the national Immunologic Survey in the Slovak Republic in 2018. The average waning rate after the first dose (age 1.5 – 10 years) is 9.7% per year from the geometric mean titre (GMT) value 2634 mUI/ml. The average waning rate after the second dose (age 10 – 33 years) is significantly lower, 4.8% per year from the lower GMT value 1331 mUI/ml. This decline in antibody levels suggests that vaccine-induced protection may be compromised and results in the increase in the proportion of seronegative/borderline individuals. These outcomes may provide a valuable source for critical assessment of direct and indirect effects of vaccination.

PMID:36935110 | DOI:10.1093/aje/kwad065

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Overinterpretation of findings in machine learning prediction model studies in oncology: a systematic review

J Clin Epidemiol. 2023 Mar 17:S0895-4356(23)00055-0. doi: 10.1016/j.jclinepi.2023.03.012. Online ahead of print.

ABSTRACT

BACKGROUND: In biomedical research, spin is the overinterpretation of findings, and it is a growing concern. To date, the presence of spin has not been evaluated in prognostic model research in oncology, including studies developing and validating models for individualised risk prediction.

STUDY DESIGN AND SETTING: We conducted a systematic review, searching MEDLINE and EMBASE for oncology-related studies that developed and validated a prognostic model using machine learning published between 01/01/2019 and 05/09/2019. We used existing spin frameworks and described areas of highly suggestive spin practices.

RESULTS: We included 62 publications (including 152 developed models; 37 validated models). Reporting was inconsistent between methods and the results in 27% of studies due to additional analysis and selective reporting. Thirty-two studies (out of 36 applicable studies) reported comparisons between developed models in their discussion and predominantly used discrimination measures to support their claims (78%). Thirty-five studies (56%) used an overly strong or leading word in their title, abstract, results, discussion or conclusion.

CONCLUSION: The potential for spin needs to be considered when reading, interpreting, and using studies that developed and validated prognostic models in oncology. Researchers should carefully report their prognostic model research using words that reflect their actual results and strength of evidence.

PMID:36935090 | DOI:10.1016/j.jclinepi.2023.03.012

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The Use of Causal Language and Inferences in Observational Shoulder Arthroplasty Database Studies

J Shoulder Elbow Surg. 2023 Mar 17:S1058-2746(23)00260-4. doi: 10.1016/j.jse.2023.02.126. Online ahead of print.

ABSTRACT

BACKGROUND: Over the last few decades, several databases and clinical registries have been used to generate studies for orthopedic surgery research including shoulder arthroplasty. Observational database studies present data that is best used to provide information regarding associations between variables but is unable to prove causation. Yet, there remains a tendency for authors to use causal language and conclusive statements in published shoulder arthroplasty literature utilizing such databases.

METHODS: We systematically identified administrative database and registry studies on shoulder arthroplasty in five orthopedic journals from January 2020 to December 2021. Papers were independently graded by two reviewers for the presence, absence, or inconsistent use of causal language throughout the publication. Chi-squared analyses were conducted to determine the relationship between causality language and article characteristics including the journal of publication.

RESULTS: There were 65 eligible articles. 67.7% of titles and abstracts were considered either consistently causal or inconsistently causal in language and inference. When reviewing the full text, 69.2% contained some degree of causal language (38.5% consistently causal, 30.8% inconsistently causal). There were no statistically significant associations between the journal and title and abstract final grading (p = 0.863) or the journal and full text grading (p = 0.726).

CONCLUSION: The use of causal language remains highly prevalent in observational database studies related to shoulder arthroplasty. Understanding the limitations of observational database studies is paramount for accurate interpretation of these publications.

PMID:36935077 | DOI:10.1016/j.jse.2023.02.126