Br J Sports Med. 2023 Jul 17:bjsports-2023-107200. doi: 10.1136/bjsports-2023-107200. Online ahead of print.
NO ABSTRACT
PMID:37460163 | DOI:10.1136/bjsports-2023-107200
Tag: pubmed
CMAJ. 2023 Jul 17;195(27):E925-E931. doi: 10.1503/cmaj.221802.
ABSTRACT
BACKGROUND: Sensitivity and specificity are characteristics of a diagnostic test and are not expected to change as the prevalence of the target condition changes. We sought to evaluate the association between prevalence and changes in sensitivity and specificity.
METHODS: We retrieved data from meta-analyses of diagnostic test accuracy published in the Cochrane Database of Systematic Reviews (2003-2020). We used mixed-effects random-intercept linear regression models to evaluate the association between prevalence and logit-transformed sensitivity and specificity. The model evaluated all meta-analyses as nested within each systematic review.
RESULTS: We analyzed 6909 diagnostic test accuracy studies from 552 meta-analyses that were included in 92 systematic reviews. For sensitivity, compared with the lowest quartile of prevalence, the second, third and fourth quartiles were associated with significantly higher odds of identifying a true positive case (odds ratio [OR] 1.17, 95% confidence interval [CI] 1.09-1.26; OR 1.32, 95% CI 1.23-1.41; OR 1.47, 95% CI 1.37-1.58; respectively). For specificity, compared with the lowest quartile of prevalence, the second, third and fourth quartiles were associated with significantly lower odds of identifying a true negative case (OR 0.74, 95% CI 0.69-0.80; OR 0.65, 95% CI 0.60-0.70; OR 0.47, 95% CI 0.44-0.51; respectively). Pooled regression coefficients from bivariate models conducted within each meta-analysis showed that prevalence was positively associated with sensitivity and negatively associated with specificity. Findings were consistent across subgroups.
INTERPRETATION: In this large sample of diagnostic studies, higher prevalence was associated with higher estimated sensitivity and lower estimated specificity. Clinicians should consider the implications of disease prevalence and spectrum when interpreting the results from studies of diagnostic test accuracy.
PMID:37460126 | DOI:10.1503/cmaj.221802
J Am Med Dir Assoc. 2023 Jul 14:S1525-8610(23)00554-6. doi: 10.1016/j.jamda.2023.06.007. Online ahead of print.
ABSTRACT
OBJECTIVES: Because of an increasing need to build capacity for end-of-life care, improving access to palliative care is a priority. Where a physician practices (eg, hospital, outpatient clinic, home) directly relates to the type of service provided and the stage of illness at which care is provided. In this study, we describe the physician palliative care specialist workforce and the settings of care within which they practice.
DESIGN: A retrospective cohort.
SETTING AND PARTICIPANTS: All physicians with palliative care billing codes who were practicing between April 1, 2018, and March 31, 2019, in Ontario, Canada.
METHODS: Descriptive statistics of physician billing location and frequency using linked population-based health administrative data.
RESULTS: We identified 8883 physicians who provided palliative care during the study period. Of those, 723 (8.1%) were classified as palliative care specialists (>10% of their billings encounters were palliative care). The majority (57.4%) of palliative care specialists worked in 1 setting more than 90% of their time, across home visits (27.1%), indirect care (22.4%), and office (7.9%). There were 61 of the palliative care specialists practicing in mixed locations who provided home visits, meaning 310 (42.9%) of the palliative care specialists delivered some home-based care.
CONCLUSIONS AND IMPLICATIONS: This research provides a comprehensive description of the current palliative care specialist physician workforce that can support efforts to build capacity for high-quality end-of-life care.
PMID:37460087 | DOI:10.1016/j.jamda.2023.06.007
J Vasc Interv Radiol. 2023 Jul 15:S1051-0443(23)00508-0. doi: 10.1016/j.jvir.2023.07.007. Online ahead of print.
ABSTRACT
PURPOSE: To present the 36-month outcomes of the prospective randomized IN.PACT AV Access Study of participants with obstructive de novo or restenotic native upper extremity arteriovenous dialysis fistula lesions treated with drug-coated balloon (DCB) or standard percutaneous transluminal angioplasty (PTA) following successful high-pressure PTA.
MATERIALS AND METHODS: Participants at 29 international sites were randomized 1:1 IN.PACT AV DCB (n=170): PTA (n=160). Outcomes through 36 months include target lesion and access circuit primary patency (TLPP, ACPP; composites of clinically driven target lesion or access circuit revascularization and/or access circuit thrombosis), number of reinterventions, and adverse events involving the access circuit.
RESULTS: TLPP was 52.1% in the DCB group compared to 36.7% in the PTA group through 24 months and 43.1% in the DCB group compared to 28.6% in the PTA group through 36 months (both log-rank p<0.001). ACPP was 39.4% in the DCB group compared to 25.3% in the PTA group through 24 months and 26.4% in the DCB group compared to 16.6% in the PTA group through 36 months (both log-rank p<0.001). Cumulative incidence of access circuit thrombosis through 36 months was 8.2% in the DCB group compared to 18.3% in the PTA group (log-rank p=0.040). Cumulative incidence of mortality through 36 months was 26.6% in the DCB group compared to 30.8% in the PTA group (log-rank p=0.71).
CONCLUSION: This study demonstrated superior TLPP and ACPP in DCB compared to PTA with no difference in mortality through 3 years. Access circuit thrombosis was statistically significantly higher in the PTA group at 3 years.
PMID:37460061 | DOI:10.1016/j.jvir.2023.07.007
Neurosci Lett. 2023 Jul 15:137401. doi: 10.1016/j.neulet.2023.137401. Online ahead of print.
ABSTRACT
Neuroimaging studies have identified significant differences in brain structure, function, and connectivity between endurance runners and healthy controls. However, the topological organization of large-scale functional brain networks remains unexplored in endurance runners. Using resting-state functional magnetic resonance imaging data, this study examined the differences in the topological organization of functional networks between endurance runners (n = 22) and healthy controls (n = 20). Endurance runners had significantly higher clustering coefficients in the whole-brain functional network than healthy controls, but the two did not differ regarding the shortest path length or small-world index. Using network-based statistics, we identified one subnetwork in endurance runners with higher functional connectivity than healthy controls, and the mean functional connectivity of the subnetwork significantly correlated with the three aforementioned small-world parameters. In this subnetwork, the mean clustering coefficient of nodes associated with short-range connections was higher in endurance runners than in healthy controls, but the mean clustering coefficient of nodes associated with long-range connections did not differ between the two groups. In conclusion, using graph theoretical approaches, we revealed significant differences in the topological organization of the whole-brain functional network and functional connectivity between endurance runners and healthy controls. The relationship between these two features suggests that a more segregated network may arise from the optimization of the identified subnetwork in endurance runners. These findings are possibly the neural basis underlying the good performance of endurance runners in endurance running.
PMID:37460055 | DOI:10.1016/j.neulet.2023.137401
Ann Anat. 2023 Jul 15:152131. doi: 10.1016/j.aanat.2023.152131. Online ahead of print.
ABSTRACT
BACKGROUND: Functional hematopoiesis is governed by the bone marrow (BM) niche, which is compromised by radiotherapy, leading to radiation-induced BM failure. The aim of this study was to demonstrate the radiation induced pathological remodeling of the niche and the efficacy of human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) in restoring hematopoiesis via improvement of the niche.
METHODS: Thirty male Wistar rats were equally assigned to three groups: control (CON), irradiated (IR), and IR + hUCB-MSCs. Biochemical, histopathological and immunohistochemical analyses were performed to detect collagen type III and IV, Aquaporin 1+ sinusoidal endothelial cells and immature hematopoietic cells, CD11c+ dendritic cells, Iba1+ macrophages, CD9+ megakaryocytes, Sca-1+, cKit+, CD133 and N-cadherin+ hematopoietic stem and progenitor cells, CD20+, Gr1+ mature hematopoietic cells, in addition to ki67+ proliferation, Bcl-2+ anti-apoptotic, caspase-3+ apoptotic, TNF-α+ inflammatory cells. Histoplanimetry data were statistically analyzed using the one-way analysis of variance followed by the post hoc Duncan’s test. Moreover, Pearson’s correlation was used to assess the correlation between variables parameters.
RESULTS: In comparison to the IR group, the IR+hUCB-MSCs group showed restored cell populations and extracellular collagen components of the BM niche with significant increase in hematopoietic stem, progenitor, mature and proliferating cells, and a considerable decrease in apoptotic and inflammatory cells. Furthermore, highly significant correlations between BM niche and blood biochemical, histopathological, and immunohistochemical parameters were observed.
CONCLUSION: hUCB-MSCs restored functional hematopoiesis through amelioration of the BM niche components via reduction of oxidative stress, DNA damage, inflammation, and apoptosis with upregulation of cellular proliferation.
PMID:37460043 | DOI:10.1016/j.aanat.2023.152131
Value Health. 2023 Jul 15:S1098-3015(23)03061-9. doi: 10.1016/j.jval.2023.07.001. Online ahead of print.
ABSTRACT
OBJECTIVES: We present an empirical comparison of relative-efficacy estimate(s) from Matching-Adjusted Indirect Comparisons (MAICs) with estimates from corresponding standard anchored indirect treatment comparisons (ITCs).
METHODS: A total of 80 comparisons were identified from 17 publications through a systematic rapid review. A standardised metric that used reported relative treatment efficacy estimates and their associated uncertainty was used to compare the methods across different treatment indications and outcome measures.
RESULTS: On aggregate, MAICs presented for connected networks tended to report a more favourable relative-efficacy estimate for the treatment for which individual-level patient data (IPD) were available, relative to the reported ITC estimate.
CONCLUSIONS: Although we recognise the importance of MAIC and other population adjustment methods in certain situations, we recommend that results from these analyses are interpreted with caution. Researchers and analysts should carefully consider if MAICs are appropriate where presented and whether MAICs would have added value where omitted.
PMID:37460009 | DOI:10.1016/j.jval.2023.07.001
Sci Total Environ. 2023 Jul 15:165504. doi: 10.1016/j.scitotenv.2023.165504. Online ahead of print.
ABSTRACT
Two fundamental problems have inhibited progress in the simulation of river water quality under climate (and other) uncertainty: 1) insufficient data, and 2) the inability of existing models to account for the complexity of factors (e.g., hydro-climatic, basin characteristics, land use features) affecting river water quality. To address these concerns this study presents a technique for augmenting limited ground-based observations of water quality variables with remote-sensed surface reflectance data by leveraging a machine learning model capable of accommodating the multidimensionality of water quality influences. Total Suspended Solids (TSS) can serve as a surrogate for chemical and biological pollutants of concern in surface water bodies. Historically, TSS data collection in the United States has been limited to the location of water treatment plants where state or federal agencies conduct regularly-scheduled water sampling. Mathematical models relating riverine TSS concentration to the explanatory factors have therefore been limited and the relationships between climate extremes and water contamination events have not been effectively diagnosed. This paper presents a method to identify these issues by utilizing a Long Short-Term Memory Network (LSTM) model trained on Moderate Resolution Imaging Spectroradiometer (MODIS) satellite reflectance data, which is calibrated to TSS data collected by the Ohio River Valley Water Sanitation Commission (ORSANCO). The methodology developed enables a thorough empirical analysis and data-driven algorithms able to account for spatial variability within the watershed and provide effective water quality prediction under uncertainty.
PMID:37459982 | DOI:10.1016/j.scitotenv.2023.165504
Sci Total Environ. 2023 Jul 15:165558. doi: 10.1016/j.scitotenv.2023.165558. Online ahead of print.
ABSTRACT
Graphene production has dramatically increased in the last years and new ways to recycle this engineered material need to be investigated. To this purpose, a reactive model network was developed using PHREEQC-3 code to quantify the relevant biogeochemical reactions induced by graphene scraps’ incorporation in a calcareous sandy soil. The numerical model was calibrated versus a complete dataset of column experiments in water saturated conditions using two different fertilizers, a synthetic NPK fertilizer and fertigation water produced in a wastewater treatment plant. Column experiments consisted of 50 cm columns filled with a mixture of graphene scraps (0.015 % dry weight) and soil in the first 10 cm, while the remaining 40 cm had only soil. The model performance was tested using classical statistical indices (R2, Modelling Efficiency, and Index of Agreement), resulting to be satisfactory. Besides, a simple sensitivity analysis via the perturbation of relevant parameters showed a low degree of uncertainty. The main outcome of this study was the quantification of the increased denitrification rate triggered by graphene incorporation into the soil. Moreover, graphene incorporation substantially increased soil CEC and DOC sorption capacity, demonstrating a good adsorption capacity for ammonium and organic compounds, thus decreasing nutrients leaching that represents a major concern related to agricultural practice. Indeed, Graphene incorporation increased by 40 % the CEC in the first 10 cm of the CSG_NPK column (2.50e-02 mol/L) respect to the CS_NPK column (1.75e-02 mol/L) and increased it by 150 % in the first 10 cm of the CSG_FW column (2.50e-02 mol/L) in comparison with the CS_FW column 1.00e-02 (mol/L). pH fluctuations were most likely due to the precipitation of Ca5(PO4)3OH, indeed the consumption of H+ ions could have triggered the pH lowering during the experiment. These results could be relevant for future graphene applications as a soil improver or as suitable material to enhance soil bioremediation in order to include graphene in a circular economy loop.
PMID:37459980 | DOI:10.1016/j.scitotenv.2023.165558
J Affect Disord. 2023 Jul 15:S0165-0327(23)00919-9. doi: 10.1016/j.jad.2023.07.066. Online ahead of print.
NO ABSTRACT
PMID:37459974 | DOI:10.1016/j.jad.2023.07.066