Tag: pubmed

Scand J Pain. 2022 Aug 16. doi: 10.1515/sjpain-2022-0055. Online ahead of print.

ABSTRACT

OBJECTIVES: Existing equipment for quantitative sensory testing is generally expensive and not easily applicable in a clinical setting thus simple bed-side devices are warranted. Pressure hyperalgesia is a common finding in patients with musculoskeletal pain and an experimental model is delayed-onset muscle soreness (DOMS). DOMS is characterised by muscle hyperalgesia and some studies report facilitation of temporal summation of pain. This study aimed to detect DOMS induced muscle hyperalgesia and temporal summation of pain using a newly developed bed-side quantitative sensory testing device to deliver standardised pressure.

METHODS: Twenty-two healthy participants participated in two sessions with the second session approximately 48 h after baseline. Pressure pain intensities were assessed from the gastrocnemius muscle with four probes calibrated to apply 2, 4, 6 and 8 kg, respectively. Temporal summation of pain (10 stimuli delivered at 0.5 Hz using the 6 kg probe) intensities were assessed from the same location. DOMS was evoked in the gastrocnemius muscle by an eccentric exercise. Sleepiness and physical activity were measured with the Epworth Sleepiness Scale and the Global Physical Activity Questionnaire to investigate if they were associated with the quantitative sensory testing measures.

RESULTS: Pressure pain intensity was significantly increased 48 h after induction of DOMS when compared to baseline for all four probes (p<0.05). Temporal summation of pain was not statistically significant affected by DOMS and sleep quality and physical activity did not associate with any of the measures.

CONCLUSIONS: This study introduces a simple, bed-side assessment tool for the assessment of pressure pain intensity and hence hyperalgesia and temporal summation of pain.

PMID:35969427 | DOI:10.1515/sjpain-2022-0055

Ann Am Thorac Soc. 2022 Aug 15. doi: 10.1513/AnnalsATS.202203-226OC. Online ahead of print.

ABSTRACT

Rationale: Chronic Obstructive Pulmonary Disease (COPD) mortality risk is often estimated using the BODE index (including body mass index, forced expiratory volume in one second (FEV1), dyspnea score, and six-minute walk distance). Diffusing capacity (DLCO) is a potential predictor of mortality that reflects physiology distinct from that in the BODE index. Objectives: This study evaluated DLCO as a predictor of mortality using participants from the COPDGene study. Methods: We performed time-to-event analyses of individuals with COPD (former/current smokers with FEV1/FVC <0.7) and DLCO measurements from the COPDGene Phase 2 visit. Cox proportional hazard methods were used to model survival, adjusting for age, sex, pack-years, smoking status, BODE index, computed tomography (CT) percent emphysema (low attenuation areas <-950 Hounsfield units), CT airway wall thickness, and history of cardiovascular or kidney diseases. C-statistics for models with DLCO and BODE score were used to compare discriminative accuracy. Results: Of 2329 participants, 378(16.8%) died during the follow-up period (median 4.9 years). In adjusted analyses, for every 10% decrease in DLCO %predicted, mortality increased by 29% (Hazard ratio 1.29, 95% CI 1.17 – 1.41, p<0.001). When compared to other clinical predictors, DLCO %predicted performed similarly to BODE (C-statistic DLCO 0.68, BODE 0.70), and the addition of DLCO to BODE improved its discriminative accuracy (C-statistic 0.71). Conclusions: Diffusing capacity, a measure of gas transfer, strongly predicted all-cause mortality in individuals with COPD, independent of BODE index and CT evidence of emphysema and airway wall thickness. These findings support inclusion of DLCO in prognostic models for COPD.

PMID:35969416 | DOI:10.1513/AnnalsATS.202203-226OC

JMIR Form Res. 2022 Aug 12;6(8):e37163. doi: 10.2196/37163.

ABSTRACT

BACKGROUND: The Philippines HIV epidemic is one of the fastest growing epidemics globally, and infections among men who have sex with men are increasing at an alarming rate. Connect for Life Philippines is a mobile health (mHealth) intervention that supports antiretroviral therapy (ART) adherence in this key population through individualized voice calls and SMS text messages.

OBJECTIVE: The objective of this process evaluation is to assess the intervention reach, dose delivered and received, fidelity, and acceptability and to describe contextual factors affecting the implementation of an mHealth adherence support intervention for patients on ART in a clinic in Metro Manila, Philippines.

METHODS: A mixed methods process evaluation approach was used in an observational cohort study. Quantitative data sources for the process evaluation were call and SMS text message logs obtained from the mHealth platform and questionnaires collected at 12-, 24-, and 48-week study visits. Qualitative data were collected from process reports and through a series of focus group discussions conducted with a subset of participants during the intervention development phase, after an initial 8-week pilot phase, and at the end of the study.

RESULTS: The 462 study participants received 31,095 interactive voice calls and 8234 SMS text messages during the study. Owing to technical issues, intervention fidelity was low, with only 22.1% (102/462) of the participants receiving reminders via voice calls and others (360/462, 77.9%) receiving only SMS text messages during the intervention. After 48 weeks in the study, 63.5% (293/462) of the participants reported that they would be quite likely or very likely to recommend the program to a friend, and 53.8% (249/462) of the participants reported that they benefited quite a bit or very much from the intervention. Participants who were on ART for <6 months at the beginning of the study and those who received the daily or weekly pill reminders were more likely to report that they benefited from the intervention (P=.02 and P=.01, respectively).

CONCLUSIONS: The Connect for Life intervention had high participant satisfaction and acceptability, especially among those who received high dose of the intervention. However, poor reliability of local telecommunication networks had a large impact on the intervention’s usability, fidelity, and dose received.

PMID:35969425 | DOI:10.2196/37163

JAMA Netw Open. 2022 Aug 1;5(8):e2226691. doi: 10.1001/jamanetworkopen.2022.26691.

ABSTRACT

IMPORTANCE: Despite increasing interest in assessing patient social needs in health care settings, there has been little research examining the performance of housing-related screening questions.

OBJECTIVE: To examine the performance of 2 single-item screening questions assessing emergency department (ED) patients’ self-perceived risk of future homelessness.

DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study was conducted among a randomly selected sample of adult ED patients from 2016 to 2017 in a public hospital ED in New York City. Data were analyzed from September 2019 through October 2021.

EXPOSURES: Responses on patient surveys conducted at the baseline ED visit for 2 single-item screening questions on self-perceived risk for future housing instability and homelessness were collected. One question asked patients if they were worried about having stable housing in the next 2 months, and the other question asked them to rate the likelihood that they would enter a homeless shelter in the next 6 months.

OUTCOMES: Homeless shelter entry 2, 6, and 12 months after an ED visit, assessed using shelter administrative data in the study city, which was linked with participant baseline survey responses.

RESULTS: There were 1919 study participants (976 [51.0%] men and 931 [48.6%] women among 1915 individuals with gender data; 700 individuals aged 31-50 years [36.5%] among 1918 individuals with age data; 1126 Hispanic or Latinx individuals [59.0%], 368 non-Hispanic Black individuals [19.3%], and 225 non-Hispanic White individuals [11.8%] among 1908 individuals with race and ethnicity data). Within 2, 6, and 12 months of the ED visit, 45 patients (2.3%), 66 patients (3.4%), and 95 patients (5.0%) had entered shelter, respectively. For both single-item screening questions, participants who answered affirmatively had significantly higher likelihood of future shelter entry at each time point examined (eg, at 2 months: 31 participants responding yes [6.5%] vs 14 participants responding no [1.0%] to the question concerning being worried about having stable housing in the next 2 months). Sensitivity of the screening questions ranged from 0.27 to 0.69, specificity from 0.76 to 0.97, positive predictive value from 0.07 to 0.27, and area under the receiver operating characteristic curve from 0.62 to 0.72.

CONCLUSIONS AND RELEVANCE: This study found that 2 single-item screening questions assessing ED patient self-perceived risk of future housing instability and homelessness had adequate to good performance in identifying risk for future shelter entry. Such single-item screening questions should be further tested before broad adoption.

PMID:35969399 | DOI:10.1001/jamanetworkopen.2022.26691

JAMA Netw Open. 2022 Aug 1;5(8):e2226701. doi: 10.1001/jamanetworkopen.2022.26701.

ABSTRACT

IMPORTANCE: When society introduces and accepts new transportation modes, it is important to map risks and benefits.

OBJECTIVE: To compare electric scooter (e-scooter) and bicycle injuries.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study is based on prospectively collected data on Norwegian patients who sustained e-scooter or bicycle injuries and presented to an emergency department affiliated with Oslo University Hospital between January 1, 2019, and March 31, 2020.

MAIN OUTCOMES AND MEASURES: e-Scooter and bicycle injuries were evaluated for associations with sex, age, time of injury, helmet use, intoxication, body region, and injury severity. Descriptive statistics are presented as mean (SD) or number with percentage, with significance set at P < .05 (2-tailed).

RESULTS: During the study period, 3191 patients were included (850 e-scooter riders, 2341 bicyclists) with 3839 injuries recorded (997 e-scooter, 2842 bicycle). The mean (SD) age of those injured was 34 (17) years, 2026 riders (63.5%) were male, 1474 (46.2%) were helmeted at the time of injury, and 516 (16.2%) were intoxicated by alcohol or other drugs. The annual incidence of injuries was 120 per 100 000 inhabitants for e-scooters and 340 per 100 000 inhabitants for bicycles. Men were overrepresented in both groups (529 e-scooter riders [62.2%] and 1497 bicyclists [63.9%]). e-Scooter riders were younger than bicyclists (mean [SD] age, 31 [12] vs 35 [18] years). Most injured e-scooter riders were aged 20 to 40 years, whereas injured bicyclists had a broader age distribution. e-Scooter injuries commonly occurred on weekends (378 [46.6%]) and during evening (230 [32.3%]) or nighttime (242 [34.1%]) hours. Most bicycle injuries occurred during weekdays (1586 [69.7%]) and daytime (1762 [61.3%]). e-Scooter riders were more often intoxicated (336 [39.5%] vs 180 [7.7%]) and had a lower rate of helmet use (18 [2.1%] vs 1456 [62.2%]). During nighttime, 230 injured e-scooter riders (91.3%) and 86 bicyclists (69.4%) were intoxicated. e-Scooter riders had more head and neck (317 [31.7%] vs 636 [22.4%]) and lower-limb (285 [28.6%] vs 632 [22.2%]) injuries and fewer upper-limb (341 [34.2%] vs 1276 [44.9%]), thoracic (41 [4.1%] vs 195 [6.9%]), and abdominal, pelvic, and lumbar (13 [1.3%] vs 103 [3.6%]) injuries.

CONCLUSIONS AND RELEVANCE: In this cohort study, e-scooter riders were younger than bicyclists, did not use helmets, were more often intoxicated, and were more often injured during nighttime. The rate of intoxication among e-scooter riders injured at night was high. Preventive measures, including awareness campaigns, regulating e-scooter availability, improving infrastructure, and implementing stricter helmet and alcohol policies, may prove effective for reducing injuries.

PMID:35969397 | DOI:10.1001/jamanetworkopen.2022.26701

JAMA Neurol. 2022 Aug 15. doi: 10.1001/jamaneurol.2022.2299. Online ahead of print.

ABSTRACT

IMPORTANCE: The evidence linking chronic kidney disease (CKD) to spontaneous intracerebral hemorrhage (ICH) is inconclusive owing to possible confounding by comorbidities that frequently coexist in patients with these 2 diseases.

OBJECTIVE: To determine whether there is an association between CKD and ICH risk.

DESIGN, SETTING, AND PARTICIPANTS: A 3-stage study that combined observational and genetic analyses was conducted. First, the association between CKD and ICH risk was tested in the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study, a multicenter case-control study in the US. All participants with available data on CKD from ERICH were included. Second, this analysis was replicated in the UK Biobank (UKB), an ongoing population study in the UK. All participants in the UKB were included in this study. Third, mendelian randomization analyses were implemented in the UKB using 27 CKD-related genetic variants to test for genetic associations. ERICH was conducted from August 1, 2010, to August 1, 2017, and observed participants for 1 year. The UKB enrolled participants between 2006 and 2010 and will continue to observe them for 30 years. Data analysis was performed from November 11, 2019, to May 10, 2022.

EXPOSURES: CKD stages 1 to 5.

MAIN OUTCOMES AND MEASURES: The outcome of interest was ICH, ascertained in ERICH via expert review of neuroimages and in the UKB via a combination of self-reported data and International Statistical Classification of Diseases, Tenth Revision, codes.

RESULTS: In the ERICH study, a total of 2914 participants with ICH and 2954 controls who had available data on CKD were evaluated (mean [SD] age, 61.6 [14.0] years; 2433 female participants [41.5%]; 3435 male participants [58.5%]); CKD was found to be independently associated with higher risk of ICH (odds ratio [OR], 1.95; 95% CI, 1.35-2.89; P < .001). This association was not modified by race and ethnicity. Replication in the UKB with 1341 participants with ICH and 501 195 controls (mean [SD] age, 56.5 [8.1] years; 273 402 female participants [54.4%]; 229 134 male participants [45.6%]) confirmed this association (OR, 1.28; 95% CI, 1.01-1.62; P = .04). Mendelian randomization analyses indicated that genetically determined CKD was associated with ICH risk (OR, 1.56; 95% CI, 1.13-2.16; P = .007).

CONCLUSIONS AND RELEVANCE: In this 3-stage study that combined observational and genetic analyses among study participants enrolled in 2 large observational studies with different characteristics and study designs, CKD was consistently associated with higher risk of ICH. Mendelian randomization analyses suggest that this association was causal. Further studies are needed to identify the specific biological pathways that mediate this association.

PMID:35969388 | DOI:10.1001/jamaneurol.2022.2299

JAMA Neurol. 2022 Aug 15. doi: 10.1001/jamaneurol.2022.2290. Online ahead of print.

ABSTRACT

IMPORTANCE: Drug-resistant epilepsy (DRE) is thought to be associated with increased mortality, but larger population-based studies are lacking. Additionally, the benefit of effective management in DRE lacks evidence.

OBJECTIVE: To examine the association of utilization of care with mortality in US veterans with DRE.

DESIGN, SETTING, AND PARTICIPANTS: Observational cohort study conducted between October 1, 2013, and March 31, 2020. Mortality statistics in US veterans with DRE were compared to the US general population and all veterans within the Veterans Health Administration. Epilepsy was defined as use of 1 or more antiseizure medications (ASMs) for 30 days or longer with a seizure diagnosis or 1 inpatient or 2 outpatient encounters with an epilepsy diagnosis. DRE was defined as the use of 2 or more ASMs. Among 9.6 million US veterans, 164 435 (1.7%) had epilepsy, of whom 55 571 (33.8%) had DRE. Epilepsy and DRE were administratively identified based on criteria noted in design. Identified participants were included for analysis.

EXPOSURES: Veterans with DRE.

MAIN OUTCOMES AND MEASURES: Standardized mortality ratio (SMR).

RESULTS: Among US veterans with DRE, the mean (SD) age was 58.3 (15.4) years, and 49 430 individuals (88.9%) were male. Of ethnicity data gathered, 3170 individuals (5.7%) were Hispanic or Latino, 50 599 (91.1%) were not Hispanic or Latino, 842 (1.5%) declined to answer, and 960 (1.7%) were recorded as unknown. Of race data gathered, 516 individuals (0.9%) were American Indian or Alaskan Native, 270 (0.5%) were Asian, 11 316 (20.4%) were Black or African American, 587 (1.1%) were of multiple races, 453 (0.8%) were Native Hawaiian or Pacific Islander, 39 543 (71.2%) were White, 1697 (3.1%) declined to answer, and 1189 (2.1%) were recorded as unknown. SMR was 1.50 (95% CI, 1.47-1.53) compared with the US general population and 1.56 (95% CI, 1.53-1.59) compared with all veterans. Utilization rates were 81.1% (n = 45 057) for neurology clinic evaluation, 66.4% (n = 36 905) for magnetic resonance imaging (MRI), and 49.6% (n = 27 546) for electroencephalography (EEG) testing. Only 8350 individuals (15.0%) had comprehensive epilepsy evaluations and 3357 (6.0%) had epilepsy monitoring. Multivariable analysis revealed an association between lower mortality and neurology clinic evaluation, EEG, MRI, epilepsy monitoring, and the use of more than 2 ASMs after adjusting for age and comorbidities.

CONCLUSIONS AND RELEVANCE: Mortality rates were significantly higher in US veterans with DRE compared to the general population. Better utilization of comprehensive epilepsy care, diagnostic services, and medications were each associated with reduced mortality. These findings indicate that appropriate management of DRE is critical in this population.

PMID:35969384 | DOI:10.1001/jamaneurol.2022.2290

Zebrafish. 2022 Aug;19(4):119-130. doi: 10.1089/zeb.2022.0006.

ABSTRACT

Motility is a widely available parameter that can be used to assess sperm quality of aquatic species. Sperm from fishes with external fertilization usually undergo a dynamic and short-lived period of motility after activation. The common practice of assigning a single value at an arbitrary peak of motility presents challenges for reproducibility, community-level standardization, and comparisons across studies. This study aimed to explore statistical approaches to standardize motility reporting, and to develop an initial framework for community-level standards. Sperm samples from 14 zebrafish (Danio rerio) with a total of 21,705 cells were analyzed by use of computer-assisted sperm analysis with data collection starting at 10 s after activation at 5-s intervals for 50 s. Four common motility variables were selected for analyses: curvilinear velocity, straight-line velocity, beat cross frequency, and amplitude of lateral head displacement. Cluster analysis was used to evaluate sperm subpopulations within and among males over time, least-square means was used to explore temporal aspects, and the first derivative of the regression equations was used to calculate the rate of change for the motility parameters. Cluster analysis proved informative, but overlapping ephemeral clusters were not valuable for providing standardization options. Analysis of temporal aspects and rate of change indicated opportunities for standardization by reporting the overall motility-time functions or reporting during stable time windows instead of peak motility or at random times. These approaches could minimize the inconsistencies caused by male-to-male variation and dynamic changes of subpopulations while providing comparable information. An overall temporal framework was identified for motility reporting along the collection-processing-cryopreservation-thawing sequence to provide a basis to support efforts of community-level standardization.

PMID:35969383 | DOI:10.1089/zeb.2022.0006

Pain Ther. 2022 Aug 12. doi: 10.1007/s40122-022-00422-9. Online ahead of print.

ABSTRACT

BACKGROUND: With increasing life expectancy in China, the associated burden of low back and neck pain (spinal pain) on the healthcare system increases, posing a substantial public health challenge. This study aimed to investigate trends in spinal pain incidence across China from 1990 to 2019 and to predict incidence trends between 2020 and 2030.

METHODS: Data were derived from the Global Burden of Disease Study (GBD) 2019. The annual percentage change (APC) and average annual percentage change (AAPC) between 1990 and 2019 were calculated using Joinpoint regression analysis. The effects of age, period, and cohort on spinal pain were estimated by an age-period-cohort model. An autoregressive integrated moving average (ARIMA) model was used to forecast incidence trends from 2020 to 2030.

RESULTS: From 1990 to 2019, the age-standardized incidence rate (ASIR) of low back pain (LBP) significantly decreased in both male and female subjects, while the ASIR of neck pain (NP) slightly increased regardless of sex. Joinpoint regression analysis showed that the incidence rates of LBP decreased in all age groups, and incidence rates of NP increased after 45 years old among men and women. The age effects showed that the relative risks (RR) of LBP incidence increased with age, and the group aged 40-49 years had the highest RR for NP incidence, regardless of sex. Period effects showed that the risk of NP continuously increased with increasing time periods, but not in LBP. The cohort effect showed a continuously decreasing trend in later birth cohorts. The prediction results of the ARIMA model show that the ASIR of NP in both male and female subjects in China shows an increasing trend in the next 10 years, and the ASIR of LBP increased in male but decreased in female subjects.

CONCLUSION: Spinal pain has remained a major public health burden over the past 30 years in China and will likely increase further with population aging. Therefore, spinal pain should be a priority for future research on prevention and therapy, and is especially critical as the aging population increases in China.

PMID:35969366 | DOI:10.1007/s40122-022-00422-9

Psychon Bull Rev. 2022 Aug 15. doi: 10.3758/s13423-022-02069-1. Online ahead of print.

ABSTRACT

A tradition that goes back to Sir Karl R. Popper assesses the value of a statistical test primarily by its severity: was there an honest and stringent attempt to prove the tested hypothesis wrong? For “error statisticians” such as Mayo (1996, 2018), and frequentists more generally, severity is a key virtue in hypothesis tests. Conversely, failure to incorporate severity into statistical inference, as allegedly happens in Bayesian inference, counts as a major methodological shortcoming. Our paper pursues a double goal: First, we argue that the error-statistical explication of severity has substantive drawbacks; specifically, the neglect of research context and the specificity of the predictions of the hypothesis. Second, we argue that severity matters for Bayesian inference via the value of specific, risky predictions: severity boosts the expected evidential value of a Bayesian hypothesis test. We illustrate severity-based reasoning in Bayesian statistics by means of a practical example and discuss its advantages and potential drawbacks.

PMID:35969359 | DOI:10.3758/s13423-022-02069-1