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Children and caregiver proxy quality of life from peanut oral immunotherapy trials

Clin Transl Allergy. 2022 Dec;12(12):e12213. doi: 10.1002/clt2.12213.

ABSTRACT

BACKGROUND: Health-related quality of life (HRQoL) is significantly and substantially reduced in individuals with peanut allergy due to many factors associated with unanticipated or potentially fatal reactions. Further insight on the impact of peanut oral immunotherapy in managing peanut allergy on HRQoL is needed. The aim of this analysis was to assess effects of peanut (Arachis hypogaea) allergen powder-dnfp (PTAH), a biologic drug for peanut oral immunotherapy, on HRQoL from three phase 3 and two follow-on trials of PTAH.

METHODS: HRQoL assessments from participants aged 4-17 in the PALISADE (ARC003), ARC004 (PALISADE follow-on), ARTEMIS (ARC010), RAMSES (ARC007), and ARC011 (RAMSES follow-on) trials were included in this analysis. Responses on the Food Allergy Quality of Life Questionnaire (FAQLQ) and Food Allergy Independent Measure (FAIM) were evaluated by age group and respondent (self or caregiver proxy). Data were analyzed with descriptive statistics and Student t tests.

RESULTS: Baseline FAQLQ and FAIM total scores appeared comparable between PTAH- and placebo-treated participants. Self and caregiver proxy-reported total scores on the FAQLQ for PTAH-treated participants generally improved at trial exit versus baseline; FAIM total scores improved throughout all trials. The tendency for improvement in FAQLQ total scores from baseline for PTAH appeared larger in self versus caregiver proxy-reports. Between treatment groups, PTAH was generally favored in the PALISADE and ARTEMIS trials; differences varied in the RAMSES trial based on age and respondent types.

CONCLUSIONS: PTAH for the management of peanut allergy in children appeared to have a beneficial effect on HRQoL in trials. Improvements were seen despite rigors of trial participation.

PMID:36573312 | DOI:10.1002/clt2.12213

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Risk scores for predicting incident heart failure admission in patients with chronic coronary syndromes: validation in a prospective, monocentric, long-term, cohort study

Eur J Clin Invest. 2022 Dec 26:e13941. doi: 10.1111/eci.13941. Online ahead of print.

ABSTRACT

BACKGROUND: Heart failure (HF) admission in chronic coronary syndrome (CCS) patients has a prognostic impact. Stratification schemes have been described for predicting this end-point but none of them has been externally validated.

OBJECTIVES: Our aim was to develop point-scores for predicting incident HF admission with data from previous studies, to perform an external validation in an independent prospective cohort, and to compare their discriminative ability for this event.

METHODS: Independent predictive variables of HF admission in CCS patients without baseline HF were selected from four previous prospective studies (CARE, PEACE, CORONOR and CLARIFY), generating scores based on the relative magnitude of the coefficients of Cox of each variable. Finally, the scores were validated and compared in a monocentric prospective cohort.

RESULTS: The validation cohort included 1212 patients followed for up to 17 years, with 171 patients suffering at least one HF admission in follow-up. Discriminative ability for predicting HF admission was statistically significant for all, and paired comparison among them were all non-significant except for CORONOR score were superior to CLARIFY score (C-statistic 0.73, 95%CI 0.69-0.76 vs 0.69, 95%CI 0.65-0.73; p=0.03).

CONCLUSION: All tested scores showed significant discriminative ability for predicting incident HF admission in this independent validation study. Their discriminative ability was similar, with significant differences only between the two scores with higher and lower performance.

PMID:36573310 | DOI:10.1111/eci.13941

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Effect of smile esthetics on the quality of life in a Han Chinese population

J Esthet Restor Dent. 2022 Dec 26. doi: 10.1111/jerd.12999. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to explore the influence of smile esthetics on the quality of life in a Han Chinese population.

METHODS: A total of 110 Han Chinese volunteers (52 males and 58 females, mean age 26.7 years) were recruited, and frontal images of their smiles were collected. A photoediting program was used to evaluate the following components of smile esthetics: the buccal corridor ratios, the angle between the interpupillary and commissural lines, the number of visible teeth, and width-to-length ratios of the maxillary central incisors. Oral health-related quality of life (OHRQoL) in these volunteers was evaluated using the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and Oral Health Impact Profile-14 (OHIP-14). Statistical analyses were performed by using Pearson’s correlations and multiple linear regression (α = 0.05).

RESULTS: Compared to males, females scored higher on psychological impact (p = 0.017). Moreover, the number of visible teeth had a significant effect on social impact, psychological impact and esthetic concern (all p < 0.05). However, the buccal corridor ratios, the angle between the interpupillary and commissural lines, and the width-to-length ratios of the maxillary central incisor did not correlate with the OHRQoL (all p > 0.05).

CONCLUSIONS: The number of visible teeth significantly influenced the quality of life in a Han Chinese population. Smile esthetics had a significantly greater psychological impact on females than males.

CLINICAL SIGNIFICANCE: This study highlights the effects of smile esthetics on the quality of life in a Han Chinese population. Female patients may raise more esthetic concerns in clinical practice.

PMID:36573304 | DOI:10.1111/jerd.12999

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The Safety Assessment of Irrigation Fluid Management for Shoulder Arthroscopy and Its Effect on Postoperative Efficacy

Orthop Surg. 2022 Dec 26. doi: 10.1111/os.13619. Online ahead of print.

ABSTRACT

OBJECTIVE: Fluid extravasation is a potentially dangerous complication associated with shoulder arthroscopy. Most relevant studies have involved respiratory system, while the primary purpose was to reveal the effects of the fluid extravasation on cardiovascular system and postoperative function.

METHODS: The clinical data of 92 patients was retrospective analyzed, in which 84 cases with rotator cuff injury, three cases with shoulder instability, three cases with fractures of the greater tuberosity of the humerus, and two cases with frozen shoulder. All the patients were undergoing shoulder arthroscopy. The relationship between the basic information of the patients and cardiac index (CI) or pulse pressure variation (PPV) were evaluated by linear regression analysis. The change of CI or PPV at different states were evaluated by the one-way analysis of variance. The liquid retention (TR) and postoperative clinical outcomes was analyzed using linear regression.

RESULTS: The preoperative CI was affected by anesthesia status and body position, while PPV was not affected. Multivariate mixed-effects model analysis of CI found that there was a statistically significant difference in groups of older than 55 years old and those with obesity (BMI > 24). After the operation, the retention of irrigation fluid significantly influenced the circumference of the deltoid (P < 0.001 (95%CI: [0.30, 1.00])), but not on the circumference of the deltoid, neck, and arm. The multivariate analysis of the American Shoulder and Elbow Surgery (ASES) scores at 3 and 6 months after surgery showed that the fluid retention volume was correlated with the ASES score at 3 months after surgery, especially when the retention volume was greater than 2 L (P = 0.001 (95%). %CI: [-12.49, -3.22]).

CONCLUSION: The retention of irrigation fluid after shoulder arthroscopic surgery causes swelling of local limbs, and has an effect on peripheral blood vessels, which is mainly reflected in its influence on PPV and the postoperative function. Therefore, surgeons need to improve their surgical technique, shorten the operation time and reduce fluid retention.

PMID:36573289 | DOI:10.1111/os.13619

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No Association of IFNL4 Genotype With Opportunistic Infections and Cancers Among Men With Human Immunodeficiency Virus 1 Infection

Clin Infect Dis. 2022 Dec 27:ciac447. doi: 10.1093/cid/ciac447. Online ahead of print.

ABSTRACT

BACKGROUND: IFNL4 genetic variants that are strongly associated with clearance of hepatitis C virus have been linked to risk of certain opportunistic infections (OIs) and cancers, including Kaposi sarcoma, cytomegalovirus infection, and herpes simplex virus infection. As the interferon (IFN) λ family plays a role in response to viral, bacterial, and fungal infections, IFNL4 genotype might affect risk for a wide range of OIs/cancers.

METHODS: We examined associations between genotype for the functional IFNL4 rs368234815 polymorphism and incidence of 16 OIs/cancers among 2310 men with human immunodeficiency virus (2038 white; 272 black) enrolled in the Multicenter AIDS Cohort Study during 1984-1990. Our primary analyses used Cox proportional hazards models adjusted for self-reported racial ancestry to estimate hazard ratios with 95% confidence intervals, comparing participants with the genotypes that generate IFN-λ4 and those with the genotype that abrogates IFN-λ4. We censored follow-up at the introduction of highly effective antiretroviral therapies.

RESULTS: We found no statistically significant association between IFNL4 genotype and the incidence of Kaposi sarcoma (hazard ratio, 0.92 [95% confidence interval, .76-1.11]), cytomegalovirus infection (0.94 [.71-1.24]), herpes simplex virus infection (1.37 [.68-2.93]), or any other OI/cancer. We observed consistent results using additive genetic models and after controlling for CD4 cell count through time-dependent adjustment or restriction to participants with a low CD4 cell count.

CONCLUSIONS: The absence of associations between IFNL4 genotype and these OIs/cancers provides evidence that this gene does not affect the risk of disease from opportunistic pathogens.

PMID:36573283 | DOI:10.1093/cid/ciac447

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Altered DNA methylation in estrogen-responsive repetitive sequences of spermatozoa of infertile men with shortened anogenital distance

Clin Epigenetics. 2022 Dec 26;14(1):185. doi: 10.1186/s13148-022-01409-1.

ABSTRACT

BACKGROUND: It has been suggested that antenatal exposure to environmental endocrine disruptors is responsible for adverse trends in male reproductive health, including male infertility, impaired semen quality, cryptorchidism and testicular cancer, a condition known as testicular dysgenesis syndrome. Anogenital distance (AGD) is an anthropomorphic measure of antenatal exposure to endocrine disruptors, with higher exposure levels leading to shortened AGD. We hypothesized that exposure to endocrine disruptors could lead to changes in DNA methylation during early embryonic development, which could then persist in the sperm of infertile men with shortened AGD.

RESULTS: Using fluorescence activated cell sorting based on staining with either YO-PRO-1 (YOPRO) or chromomycin-3 (CMA3), we isolated four sperm fractions from eleven infertile men with short AGD and ten healthy semen donors. We examined DNA methylation in these sorted spermatozoa using reduced representation bisulfite sequencing. We found that fractions of spermatozoa from infertile men stained with CMA3 or YOPRO were more likely to contain transposable elements harboring an estrogen receptor response element (ERE). Abnormal sperm (as judged by high CMA3 or YOPRO staining) from infertile men shows substantial hypomethylation in estrogenic Alu sequences. Conversely, normal sperm fractions (as judged by low CMA3 or YO-PRO-1 staining) of either healthy donors or infertile patients were more likely to contain hypermethylated Alu sequences with ERE.

CONCLUSIONS: Shortened AGD, as related to previous exposure to endocrine disruptors, and male infertility are accompanied by increased presence of hormonal response elements in the differentially methylated regulatory sequences of the genome of sperm fractions characterized by chromatin decondensation and apoptosis.

PMID:36572941 | DOI:10.1186/s13148-022-01409-1

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Lack of sex-related analysis and reporting in Cochrane Reviews: a cross-sectional study

Syst Rev. 2022 Dec 26;11(1):281. doi: 10.1186/s13643-021-01867-3.

ABSTRACT

BACKGROUND: Sex-specific analysis and reporting may allow a better understanding of intervention effects and can support the decision-making process. Well-conducted systematic reviews (SRs), like those carried out by the Cochrane Collaboration, provide clinical responses transparently and stress gaps of knowledge. This study aimed to describe the extent to which sex is analysed and reported in a cross-section of Cochrane SRs of interventions, and assess the association with the gender of main authorships.

METHODS: We searched SRs published during 2018 within the Cochrane Database of Systematic Reviews. An investigator appraised the sex-related analysis and reporting across sections of SRs and collected data on gender and country of affiliation of the review first and last authors, and a second checked for accuracy. We conducted descriptive statistics and bivariate logistic regression to explore the association between the gender of the authors and sex-related analysis and reporting.

RESULTS: Six hundred and ten Cochrane SRs were identified. After removing those that met no eligibility criteria, 516 reviews of interventions were included. Fifty-six reviews included sex-related reporting in the abstract, 90 considered sex in their design, 380 provided sex-disaggregated descriptive data, 142 reported main outcomes or performed subgroup analyses by sex, and 76 discussed the potential impact of sex or the lack of such on the interpretations of findings. Women represented 53.1 and 42.2% of first and last authorships, respectively. Women authors (in first and last position) had a higher possibility to report sex in at least one of the review sections (OR 2.05; CI 95% 1.12-3.75, P=0.020) than having none.

CONCLUSIONS: Sex consideration amongst Cochrane SRs was frequently missing. Structured guidance to sex-related analysis and reporting is needed to enhance the external validity of findings. Likewise, including gender diversity within the research workforce and relevant authorship positions may foster equity in the evidence generated.

PMID:36572932 | DOI:10.1186/s13643-021-01867-3

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Effect of age at training initiation on hoof morphology and lameness in juvenile American Quarter Horses

Equine Vet J. 2022 Dec 26. doi: 10.1111/evj.13913. Online ahead of print.

ABSTRACT

BACKGROUND: Lameness, discipline, training intensity, environmental variability, and shoeing are all factors demonstrated to affect hoof loading and therefore act as adaptive stimuli to alter hoof morphology.

OBJECTIVES: To evaluate effect of age at training initiation on hoof morphology and lameness incidence and determine if specific hoof morphology measurements correlate with lameness in juvenile American Quarter Horses.

STUDY DESIGN: Prospective cohort study.

METHODS: American Quarter Horses (n=42; 29 2-year-olds, 13 3-year-olds) entering training were monitored for hoof morphology and lameness over six months (months 0,2,4,6). Hoof measurements (palmar/plantar angles, frog base width/length, toe length/angle, heel length/angle, heel and foot width, wall height/angle) from radiographs and photographs were recorded. Lameness was graded subjectively and objectively (Lameness locator®). Statistical analyses were performed with Fisher’s exact test and repeated measures ANOVA with P < 0.05.

RESULTS: 25/42 horses developed sub-clinical lameness (16/42 forelimb, 19/42 hindlimb), with three-year-olds developing lameness more frequently compared to two-year-olds overall (p=0.04; 84.6 vs. 48.3%) and in forelimbs (p=0.05; 61.5% vs. 27.6%); no difference was noted between two- versus three-year-olds in hindlimbs (p=0.2; 61.5% vs. 37.9%). In lame versus sound forelimbs, three-year-olds had decreased foot width (p=0.03; 11.48cm (CI 10.68-12.28) vs. 12.21cm (CI 11.99-12.42)), decreased toe length (p=0.03; 6.02cm (CI 5.69-6.36) vs. 6.45cm (CI 6.32-6.58)), shorter lateral wall height (p=0.03; 4.64cm (CI 4.31-4.96) vs. 5.11cm (CI 5.03-5.2)), and shorter medial wall height (p=0.02; 4.58cm (CI 4.06-5.10) vs. 5.15cm (CI 4.99-5.30)). In lame versus sound hindlimbs, horses overall (p = 0.05; 3.74, CI 3.53-3.96 vs 3.55, CI 3.48-3.61) and three-year-olds had longer heels p=0.01; 3.90cm (CI 3.5-4.3) vs. 3.50cm (CI 3.39-3.61)).

MAIN LIMITATIONS: Small sample size, lack of control group not entering training.

CONCLUSIONS: Three-year-old American Quarter Horses entering training were more likely to develop forelimb lameness than two-year-olds. This sub-clinical lameness was associated with specific hoof morphology characteristics (decreased foot width, toe length, heel length, and lateral/medial wall height; greater toe angle). This article is protected by copyright. All rights reserved.

PMID:36572927 | DOI:10.1111/evj.13913

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Psychological well-being among Saudi adults during the context of COVID-19 lockdown: a psychometric analysis of the 12-item General Health Questionnaire

BMC Psychol. 2022 Dec 27;10(1):319. doi: 10.1186/s40359-022-01030-0.

ABSTRACT

BACKGROUND: Most communities’ mental health and perceptions of psychological well-being are known to be profoundly disrupted by large-scale pandemics. Despite the wide range of available screening measures, few reliable and valid screening measures exist for assessing overall psychological well-being in nonclinical populations during a health emergency situation such as the COVID-19 outbreak.

OBJECTIVE: This study aims to conduct a psychometric analysis of Goldberg’s 12-item General Health Questionnaire (GHQ-12) to validate its use among a sample of Saudi adults during the COVID-19 lockdown using reliability and factor analyses.

METHODS: A total of 473 individuals (aged 18 years and over) were recruited from the general Saudi population living in the Makkah (Western) Province of Saudi Arabia to complete the virtual format of the Arabic GHQ-12 (Ar-GHQ-12). In addition to a descriptive statistics measurement and reliability analysis, confirmatory factor analyses (CFA) were performed to examine the unidimensionality and validity of the Ar-GHQ-12.

RESULTS: In line with previous works from several cultures, the Ar-GHQ-12 with two-factor solution considered to be the best-fitting model because it fits the data better than the one-factor (unidimensional) model did, and adequate reliability indices were achieved for each factor (.83 for factor 1 and .65 for factor 2).

DISCUSSION: The Ar-GHQ-12 was determined to be suitable for assessing the overall psychological well-being of the general population in Saudi Arabia in emergency contexts and may be applied among Saudis and other Arabic-speaking populations in research and primary care settings.

PMID:36572926 | DOI:10.1186/s40359-022-01030-0

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Family presence during invasive procedures: a pilot study to test a tool

BMC Health Serv Res. 2022 Dec 26;22(1):1583. doi: 10.1186/s12913-022-08876-5.

ABSTRACT

BACKGROUND: Family Presence During Invasive Procedures (FPDI) generates controversy among healthcare professionals. Twibell and her team designed an instrument that measured nurses’ Risk-Benefit and Self-Confidence perceptions regarding family presence during resuscitation and was used in numerous studies.

OBJECTIVES: Evaluate the new tool for Family Presence Risk-Benefit and Family Presence Self-Confidence during invasive procedures and find out the opinions of the medical and nursing staff on FPDIP.

METHOD: Cross-sectional methodological pilot study. Online and paper questionnaires modified from a previous translation. A factor analysis was performed for the validity of the indices and bivariate analysis for all the variables. Ethical approvals and research permissions were obtained according to national standards.

RESULTS: One hundred twenty healthcare professionals (22.18%) answered the survey. Cronbach’s α on the Family Presence Risk-Benefit scale was 0.877. Cronbach’s α on the Family Presence Self-Confidence scale was 0.937. The correlation between the Risk-Benefit and Self-confidence variables is significant and with a moderate intensity of the relationship. A lower predisposition to Family Presence During Invasive Procedures is observed. Physicians are more reluctant than nurses.

CONCLUSIONS: The FPDI generates controversy as it alters health professionals’ routines when they decide whether to allow it or not. There is a tendency for younger professionals to support FPDI. In general, health professionals, mainly physicians, do not favor FPDI. Health workers who perceive fewer risks and more benefits in FPDI and have greater self-confidence are more in favor of FPDI. The psychometric properties and internal consistency of the questionnaire indicate the validity and reliability of this tool.

PMID:36572919 | DOI:10.1186/s12913-022-08876-5