Tag: pubmed

Int Immunopharmacol. 2023 Oct 8;124(Pt B):111021. doi: 10.1016/j.intimp.2023.111021. Online ahead of print.

ABSTRACT

The clinical and adverse effects of the therapeutic monoclonal antibodies (mAb) ocrelizumab, ofatumumab and rituximab in multiple sclerosis (MS) are presently subject to extensive study. While the two former are approved for MS, the older and less costly rituximab is used off label, and adverse effect profiles are important in their evaluation. The three mAbs all induce B cell depletion, with complement-dependent cytotoxicity (CDC) as one of several mechanisms of action. Complement activation is also postulated to underlie adverse reactions related to infusion/injection. Such administration-related reactions are associated with all three mAbs, but comparisons have so far been indirect, resting on incidence reports from separate clinical trials. The objective of this study was to perform head-to-head comparison of complement activation by ofatumumab, ocrelizumab and rituximab. In vitro experiments were performed in whole blood from healthy donors. The complement-activating potential of the three mAbs was analyzed after 30 min of exposure to 0.3 mg/mL or 0.9 mg/mL of each drug, and compared with those of the well-known TNF inhibitory mAbs adalimumab and infliximab, the latter with recognized potential for infusion reactions. Ofatumumab, ocrelizumab, and infliximab, but not rituximab and adalimumab, triggered statistically significant complement activation measured as increased levels of terminal C5b-9 complement complex (TCC), a sensitive marker of such activation. While results demand careful interpretation, they provide an indication of distinct complement-inducing potential among anti-CD20 mAbs currently used to treat MS.

PMID:37816262 | DOI:10.1016/j.intimp.2023.111021

Metab Syndr Relat Disord. 2023 Oct 10. doi: 10.1089/met.2023.0096. Online ahead of print.

ABSTRACT

Background: Our knowledge for the possible link between choline and betaine and the risk of type 2 diabetes (T2D) is very limited and contradictory. This study aimed to investigate the prospective association of dietary choline and betaine intakes with the risk of T2D in a group of Tehranian adults. Methods: In this prospective study, 6022 eligible subjects aged ≥18 years were chosen from the participants of the Tehran Lipid and Glucose Study in a secondary analysis. Diet was assessed based on a valid and reliable semiquantitative food frequency questionnaire. At baseline and follow-up examinations, biochemical and anthropometric variables were assessed. Multivariable Cox proportional hazard regression models was used to estimate the new onset of T2D concerning choline and betaine intake. Results: The mean age ± SD of 2707 men and 3315 women were, respectively, 41.4 ± 14.2 and 39.1 ± 13.1. During a median follow-up of 6.63 years, 528 cases of T2D incidence were diagnosed. Participants with a higher intake of choline had a higher intake of protein, fiber, and B12 and a lower intake of energy and carbohydrates. After controlling of confounders a significant positive association was observed between choline intake and the hazard ratio (HR) of T2D across quartiles of choline intake [HR (CI) in the fourth quartile: 1.25 (1.14-1.38), P trend = 0.01], but this significant finding was not reported for betaine intake. For every 100 milligram increase in choline consumption, the HR of T2D increased significantly in all age, sex, and BMI subgroups. Conclusions: Choline consumption increased the risk of T2D in total population and subgroups. No statistically significant association was found between dietary betaine intake and the risk of T2D in total population and subgroups.

PMID:37816243 | DOI:10.1089/met.2023.0096

Am J Speech Lang Pathol. 2023 Oct 10:1-13. doi: 10.1044/2023_AJSLP-23-00143. Online ahead of print.

ABSTRACT

PURPOSE: This study aims to investigate the prevalence of presbyphonia among older adults who report voice complaints.

METHOD: We conducted a systematic search of five medical databases to identify studies that reported on presbyphonia as the cause of voice disorders in older adults. The pooled prevalence was calculated using random-effects models and presented as percentages with 95% confidence intervals (CI). The degree of heterogeneity among studies was assessed using I² statistics. Subgroup analyses were performed to identify the sources of heterogeneity.

RESULTS: Out of 764 abstracts from five libraries, 11 studies were included in this systematic review. The pooled prevalence of presbyphonia among older adults with voice disorders is 17.78% (95% CI [12.69, 23.51]). We conducted a subgroup analysis on studies that used laryngeal visualization to confirm the diagnosis for all patients and found that the prevalence of presbyphonia was lower in studies with unrestrictive inclusion criteria (12.84%, 95% CI [8.38, 18.08]) compared to studies with restricted inclusion criteria (22.59%, 95% CI [14.49, 31.88]).

CONCLUSIONS: This study suggests that voice disorders in older adults have multiple causes, not predominantly presbyphonia. Overestimation of presbyphonia prevalence occurs if certain diagnoses are excluded at recruitment. This study emphasizes the importance of recognizing the diverse underlying etiologies of dysphonia in older adults; therefore, comprehensive examination and accurate diagnosis are crucial.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.24263029.

PMID:37816221 | DOI:10.1044/2023_AJSLP-23-00143

Biom J. 2023 Oct 10:e2200301. doi: 10.1002/bimj.202200301. Online ahead of print.

ABSTRACT

Theoretical-information approach applied to the clinical trial designs appeared to bring several advantages when tackling a problem of finding a balance between power and expected number of successes (ENS). In particular, it was shown that the built-in parameter of the weight function allows finding the desired trade-off between the statistical power and number of treated patients in the context of small population Phase II clinical trials. However, in real clinical trials, randomized designs are more preferable. The goal of this research is to introduce randomization to a deterministic entropy-based sequential trial procedure generalized to multiarm setting. Several methods of randomization applied to an entropy-based design are investigated in terms of statistical power and ENS. Namely, the four design types are considered: (a) deterministic procedures, (b) naive randomization using the inverse of entropy criteria as weights, (c) block randomization, and (d) randomized penalty parameter. The randomized entropy-based designs are compared to randomized Gittins index (GI) and fixed randomization (FR). After the comprehensive simulation study, the following conclusion on block randomization is made: for both entropy-based and GI-based block randomization designs the degree of randomization induced by forward-looking procedures is insufficient to achieve a decent statistical power. Therefore, we propose an adjustment for the forward-looking procedure that improves power with almost no cost in terms of ENS. In addition, the properties of randomization procedures based on randomly drawn penalty parameter are also thoroughly investigated.

PMID:37816142 | DOI:10.1002/bimj.202200301

PLoS One. 2023 Oct 10;18(10):e0292443. doi: 10.1371/journal.pone.0292443. eCollection 2023.

ABSTRACT

The relative age effect (RAE) has been the subject of many studies, but no relevant literature has discussed the phenomenon of RAE in Chinese tennis. Numerous studies have demonstrated that RAE significantly contributes to brain drain and other occurrences that create inequity. This paper analyzes the birth dates and year-end rankings of all male players (N = 2697) who participated in China’s junior tennis tournaments (U12, U14, U16) between 2014 and 2019 and who were selected for China’s National Junior Team in 2019 and 2020; the paper classifies the birth dates into quarters and semesters. One of the research objectives of this study is to analyze whether RAE exists in Chinese junior men’s tennis and whether RAE exerts an effect on athletes’ performance. Differences between the observed and expected birthdate distributions were tested using chi-square statistics, and subsequent calculations were tested using odds ratios. The study found that RAE was present in all Chinese junior male tennis sports groups (p<0.001). The percentages of athletes born in the first half of the year were 56.4% (U12), 60.4% (U14), and 60.4% (U16), and the percentages of those born in the first quarter were 34.1% (U12), 36.4% (U14), and 37.1% (U16). Athletes with birth dates closer to the beginning of the year had a higher probability of achieving excellent athletic performance as a result of RAE, whereas those who were born near the end of the year had a more difficult time achieving strong athletic performance.

PMID:37816070 | DOI:10.1371/journal.pone.0292443

PLoS One. 2023 Oct 10;18(10):e0289806. doi: 10.1371/journal.pone.0289806. eCollection 2023.

ABSTRACT

Based on the data of 278 prefecture-level city panels in China from 2008 to 2020, this paper presents the policy of innovative pilot city as a quasi-natural experiment. It is found that (1) the implementation of innovative urban policy can significantly improve the level of science and technology entrepreneurship, but the pilot policy has a time lag effect and has a continuous promoting effect since the third year. (2) For large cities, areas with high levels of economic development, central and eastern regions and cities with high new infrastructure, innovative cities can improve the level of technological entrepreneurship; (3) Innovative cities improve the level of technological entrepreneurship by improving the incubator of technological enterprises and strengthening the flow of human capital; (4) The effect of the establishment of innovative cities on the level of technological entrepreneurship mainly shows that the siphon effect does not show radiation effect, and this siphon effect mainly improves the level of technological entrepreneurship by increasing the number of incubators of technological enterprises.

PMID:37816043 | DOI:10.1371/journal.pone.0289806

PLoS One. 2023 Oct 10;18(10):e0292158. doi: 10.1371/journal.pone.0292158. eCollection 2023.

ABSTRACT

Market liquidity can reflect whether financial market conditions are favorable and is the primary concern for investors when making investment decisions. Therefore, investors’ psychological perception and confidence in the quality of products (assets) are particularly important. Using 264 of China’s online loan platforms from August 2017 to November 2018, we investigate the impact of the negative psychological perceptions of investors on platform liquidity. The empirical results suggest that the negative psychological perceptions of investors reduce platform liquidity and increase platform liquidity risk. Using the Baidu Search Index to measure investor sentiment, we find that the negative psychological perceptions of investors affect platform liquidity by affecting investor sentiment, which provides a good channel for explaining the main conclusions. Heterogeneity analysis shows that the impact of the negative psychological perceptions of investors on platform liquidity is smaller in high-quality platforms with higher market share and higher registered capital. Meanwhile, we also find that the impact of negative psychological perceptions of investors is greater in private platforms, after the rectification policy, with positive net inflow, and in first- and second-tier cities and coastal cities. Precautionary financial regulatory policies are necessary, not punishment ex post. The research findings of this article can assist investors, platform managers, and regulatory agencies in identifying the liquidity characteristics of platforms, which can contribute to strengthening market liquidity management and financial risk control and provide some reference and support for formulating sustainable development policies in the financial industry.

PMID:37816040 | DOI:10.1371/journal.pone.0292158

PLoS One. 2023 Oct 10;18(10):e0291387. doi: 10.1371/journal.pone.0291387. eCollection 2023.

ABSTRACT

BACKGROUND: Globally, pneumonia is the leading infectious cause of under-five mortality, and this can be reduced by prompt healthcare seeking. Data on factors associated with delays in seeking care for children with pneumonia in Uganda is scarce.

OBJECTIVES: The study aimed to determine the prevalence, factors associated with delay, barriers, and facilitators of prompt healthcare seeking for children under five years of age with severe pneumonia attending Mulago National Referral Hospital (MNRH) Uganda.

METHODS: A mixed methods cross-sectional study was conducted among 384 caregivers of children with severe pneumonia at MNRH. Quantitative data was collected using interviewer-administered structured questionnaires and qualitative data through focus group discussions with caregivers. Descriptive statistics were used to determine the prevalence of delay in care seeking. Logistic regression analysis was used to determine the factors that were independently associated with delay in seeking healthcare. Content thematic analysis was used to analyze for barriers and facilitators of prompt healthcare seeking.

RESULTS: The prevalence of delay in seeking healthcare was 53.6% (95% CI: 48.6-58.6). Long distance to a hospital (AOR = 1.94, 95% CI 1.22-3.01, p value = 0.003), first seeking care elsewhere (AOR = 3.33, 95% CI 1.85-6.01, p value = 0.001), and monthly income ≤100,000 UGX (28 USD) (AOR = 2.27,95% CI 1.33-3.86, p value = 0.003) were independently associated with delay in seeking healthcare. Limited knowledge of symptoms, delayed referrals, self-medication, and low level of education were barriers to prompt healthcare seeking while recognition of symptoms of severe illness in the child, support from spouses, and availability of money for transport were key facilitators of early healthcare seeking.

CONCLUSION: This study showed that more than half of the caregivers delayed seeking healthcare for their children with pneumonia symptoms. Caregivers who first sought care elsewhere, lived more than 5 km from the hospital, and earned less than 28 USD per month were more likely to delay seeking healthcare for their children with severe pneumonia. Limited knowledge of symptoms of pneumonia, self-medication, and delayed referral hindered prompt care-seeking. Key facilitators of prompt care-seeking were accessibility to health workers, support from spouses, and recognition of symptoms of severe illness in children. There is a need for programs that educate caregivers about pneumonia symptoms, in children less than five years.

PMID:37816023 | DOI:10.1371/journal.pone.0291387

PLoS One. 2023 Oct 10;18(10):e0292652. doi: 10.1371/journal.pone.0292652. eCollection 2023.

ABSTRACT

Globally, viral pathogens are the leading cause of acute respiratory infection in children under-five years. We aim to describe the epidemiology of viral respiratory pathogens in hospitalized children under-two years of age in Eastern Province of Sierra Leone, during the second year of the SARS-CoV-2 pandemic. We conducted a prospective study of children hospitalized with respiratory symptoms between October 2020 and October 2021. We collected demographic and clinical characteristics and calculated each participant´s respiratory symptom severity. Nose and throat swabs were collected at enrollment. Total nucleic acid was purified and tested for multiple respiratory viruses. Statistical analysis was performed using R version 4.2.0 software. 502 children less than two-years of age were enrolled. 376 (74.9%) had at least one respiratory virus detected. The most common viruses isolated were HRV/EV (28.2%), RSV (19.5%) and PIV (13.1%). Influenza and SARS-CoV-2 were identified in only 9.2% and 3.9% of children, respectively. Viral co-detection was common. Human metapneumovirus and RSV had more than two-fold higher odds of requiring O2 therapy while hospitalized. Viral pathogen prevalence was high (74.9%) in our study population. Despite this, 100% of children received antibiotics, underscoring a need to expand laboratory diagnostic capacity and to revisit clinical guidelines implementation in these children. Continuous surveillance and serologic studies among more diverse age groups, with greater geographic breadth, are needed in Sierra Leone to better characterize the long-term impact of COVID-19 on respiratory virus prevalence and to better characterize the seasonality of respiratory viruses in Sierra Leone.

PMID:37816008 | DOI:10.1371/journal.pone.0292652

PLoS One. 2023 Oct 10;18(10):e0292343. doi: 10.1371/journal.pone.0292343. eCollection 2023.

ABSTRACT

Communities of practice (CoPs) are defined as “groups of people who share a concern, a set of problems, or a passion about a topic, and who deepen their knowledge and expertise by interacting on an ongoing basis”. They are an effective form of knowledge management that have been successfully used in the business sector and increasingly so in healthcare. In May 2023 the electronic databases MEDLINE and EMBASE were systematically searched for primary research studies on CoPs published between 1st January 1950 and 31st December 2022. PRISMA guidelines were followed. The following search terms were used: community/communities of practice AND (healthcare OR medicine OR patient/s). The database search picked up 2009 studies for screening. Of these, 50 papers met the inclusion criteria. The most common aim of CoPs was to directly improve a clinical outcome, with 19 studies aiming to achieve this. In terms of outcomes, qualitative outcomes were the most common measure used in 21 studies. Only 11 of the studies with a quantitative element had the appropriate statistical methodology to report significance. Of the 9 studies that showed a statistically significant effect, 5 showed improvements in hospital-based provision of services such as discharge planning or rehabilitation services. 2 of the studies showed improvements in primary-care, such as management of hepatitis C, and 2 studies showed improvements in direct clinical outcomes, such as central line infections. CoPs in healthcare are aimed at improving clinical outcomes and have been shown to be effective. There is still progress to be made and a need for further studies with more rigorous methodologies, such as RCTs, to provide further support of the causality of CoPs on outcomes.

PMID:37815986 | DOI:10.1371/journal.pone.0292343