Tag: pubmed

Cancer Causes Control. 2022 Aug 2. doi: 10.1007/s10552-022-01597-4. Online ahead of print.

ABSTRACT

PURPOSE: Lung cancer incidences tend to be higher among males than females in both China and the United States, yet secular incidence patterns are different due to distinct population and environmental exposures. We examined long-term and future trends of lung cancer incidence, as well as the associations of age, period, and cohort effects with gender disparities.

METHODS: Using data from the Cancer Incidence in Five Continents from 1978 to 2012, we calculated age-standardized, age-specific incidence, and male-to-female incidence rate ratios (IRR), and conducted an age-period-cohort analysis. The average annual percentage change (AAPC) of the trends was obtained by Joinpoint Regression. Bayesian age-period-cohort analysis was also conducted to project incidences to 2032.

RESULTS: In China, age-standardized incidence revealed a decreasing trend among males, but showed increasing trends among the younger age groups (30-54 years) in females. Age-standardized incidence rates of males decreased but remained stable among females from 1972 to 2012 in the United States. Male-to-female incidence rate ratios narrowed in both countries and reversed among younger birth cohorts in the United States. Gender disparities are expected to continue to diminish in both countries, and incidence among females appears to exceed that of males in the United States by around 2023-2027.

CONCLUSION: Gender disparities in lung cancer incidence persist and will continue into the future in both countries, but our findings suggested that smoking may play different roles in gender disparities in lung cancer incidence between the two countries. Further population-based epidemiological studies among females in China are imperative.

PMID:35916964 | DOI:10.1007/s10552-022-01597-4

J Psycholinguist Res. 2022 Aug 2. doi: 10.1007/s10936-022-09905-4. Online ahead of print.

ABSTRACT

The thrust of this study was to investigate the impact of learning styles in general and Field dependence/Independence (FD/I) in particular on the receptive/productive lexical performance of language learners. It aimed to check whether FD/I learners perform differently on receptive and productive vocabulary tests. To achieve this, first, 94 Iranian language learners were given the Group Embedded Figure Test (GEFT) to determine their learning style; and second, they were put into two groups and were asked to take a receptive and a productive vocabulary test. Having collected and analyzed the data, the study revealed that first, with regard to the receptive test, although FI learners outperformed the FD ones, this outperformance was not significant statistically. Second, for the productive test, a significant difference was found between FIs and FDs with FI learners having a better performance. Third, FI learners acted significantly better in the productive test compared with receptive test. Finally, FD learners performed almost similarly in both receptive and productive tests. The pertinent implications are also discussed.

PMID:35916955 | DOI:10.1007/s10936-022-09905-4

Osteoporos Int. 2022 Aug 2. doi: 10.1007/s00198-022-06481-0. Online ahead of print.

ABSTRACT

Between 1998 and 2018, the number of hospitalizations for major osteoporotic fractures increased. After standardization for age, these numerical increases translated into a reduced incidence of hospitalizations for hip fractures and an increased incidence of hospitalizations for spine, proximal humerus, and distal radius fractures in both sexes.

INTRODUCTION: The longterm epidemiological trends of hospitalizations for major osteoporotic fractures (MOF) between 1998 and 2018 in Switzerland are unknown.

METHODS: The absolute number of acute hospitalizations for MOF (hip fractures and fractures of the spine, proximal humerus, and distal radius) and related length of acute hospital stay were extracted from the medical database of the Swiss Federal Office of Statistics. Age-standardized incidence rates were calculated using 1998 as the reference year.

RESULTS: Hospitalizations for MOF increased from 4483 to 7542 (+ 68.2%) in men and from 13,242 to 19,362 (+ 46.2%) in women. The age-standardized incidence of hospitalizations for MOF increased by 5.7% in men (p = 0.002) and by 5.1% in women (p = 0.018). The age-standardized incidence of hip fractures decreased by 15.3% in men (p < 0.001) and by 21.5% in women (p < 0.001). In parallel, the age-standardized incidence of MOF other than hip fractures increased by 31.8% in men (p < 0.001) and by 40.1% in women (p < 0.001). The mean length of acute hospital stays for MOF decreased from 16.3 to 8.5 days in men and from 16.9 to 8.1 days in women.

CONCLUSION: Between 1998 and 2018, the number of hospitalizations for MOF increased significantly by a larger extent than expected based on the ageing of the Swiss population alone. This increase was solely driven by an increased incidence of MOF other than hip fractures as incident hip fractures decreased over time in both sexes, more so in women than in men.

PMID:35916908 | DOI:10.1007/s00198-022-06481-0

World J Urol. 2022 Aug 2. doi: 10.1007/s00345-022-04110-3. Online ahead of print.

ABSTRACT

INTRODUCTION: Treatment advances in metastatic renal cell carcinoma (mRCC) have improved overall survival (OS) in mRCC patients over the last two decades. This single center retrospective analysis assesses if the purported survival benefits are also applicable in elderly mRCC patients.

METHODS: 401 patients with mRCC treated at Hannover Medical School from 01/2003-05/2016 were identified and evaluated by chart review. Treatment periods were defined as 01.01.2003-31.12.2009 (P1) and 01.01.2010-31.05.2016 (P2). Age groups were defined according to WHO classes (≤ 60 years: younger, > 60-75 years: elderly and > 75 years: old). Descriptive statistics, Kaplan-Meier analysis and logistic regression were performed.

RESULTS: Median OS improved from 35.1 months in P1 to 59.1 months in P2. Sub-division into the respective age groups revealed median survival of 38.1 (95%-CI: 28.6-47.6) months in younger patients, 42.9 (95%-CI: 29.5-56.3) months among elderly patients and 27.3 (95%-CI: 12.8-41.8) months among old patients. Risk reduction for death between periods was most evident among old patients (young: HR 0.71 (95%-CI: 0.45-1.13, p = 0.2); elderly: HR 0.62 (95%-CI: 0.40-0.97, p = 0.04); old: HR 0.43 (95%-CI: 0.18-1.05, p = 0.06)). Age ≥ 75 years was an independent risk factor for death in P1 but not in P2.

CONCLUSION: Improved OS in the targeted treatment period was confirmed. Surprisingly elderly and old patients seem to profit the most form expansion of therapeutic armamentarium, within the TKI-dominated observation period.

PMID:35916904 | DOI:10.1007/s00345-022-04110-3

Int Urogynecol J. 2022 Aug 2. doi: 10.1007/s00192-022-05290-7. Online ahead of print.

ABSTRACT

INTRODUCTION AND HYPOTHESIS: Women with missed obstetric anal sphincter injuries (OASIs) are at an increased risk of anal incontinence. Our aim was to assess the accuracy of three-dimensional (3D) transperineal ultrasound (TPUS) compared with clinical examination for detecting OASIs.

METHODS: A cross-sectional study of women undergoing their first vaginal delivery. Perineal trauma was initially assessed by the doctor or midwife performing the delivery (accoucheur) and women were then re-examined by the trained research fellow (KW). A 3D TPUS was performed immediately after delivery before suturing to identify OASIs. The research fellow’s clinical diagnosis was used as the reference standard. A power calculation determined that 216 women would be required for the study.

RESULTS: Two hundred and sixty-four women participated and 226 (86%) delivered vaginally. Twenty-one (9%) sustained OASIs. Six (29%) of these tears were missed by the accoucheur but were identified by the research fellow. TPUS identified 19 of the 21 (90.5%) OASIs. One percent (n = 2) had sonographic appearances of an anal sphincter defect that was not seen clinically. The positive and negative predictive value of TPUS to detect OASIs was 91% and 99% respectively. TPUS identified 91% of OASIs compared with 71% detected by the accoucheur, which was not statistically significant.

CONCLUSIONS: The detection rate of OASIs with TPUS and with the clinical findings of the accoucheur was similar. Given the training and financial implications needed for TPUS, attention needs to be focused on the training of midwives and doctors to identify anal sphincter injuries by clinical examination.

PMID:35916899 | DOI:10.1007/s00192-022-05290-7

J Physician Assist Educ. 2022 Jul 1. doi: 10.1097/JPA.0000000000000436. Online ahead of print.

ABSTRACT

INTRODUCTION: This study’s aim was to examine prerequisite course requirements and compare them to previous studies with a secondary aim to examine potential differences relative to program characteristics.

METHODS: Data were extracted from the websites of 265 entry-level physician assistant (PA) programs from October 2020 until December 2020. Course prerequisites as well as number of courses and semester hours required were described and examined according to program location, phase, Carnegie Classification, association with a medical school, and the public/private status of the sponsoring institution.

RESULTS: Of 264 PA programs, more than 50% of programs required 6 common prerequisites: anatomy, physiology, microbiology, statistics, general chemistry, and psychology. The total number of unique prerequisite courses was 28 for all programs with a reduction in humanities and social sciences semester hours compared to previous studies and a slight increase in credit hours required for the common 6 courses. Total prerequisite hours and courses required were higher for master’s programs; private, not-for-profit programs; newly established programs; and those not associated with a medical school. Newer programs are generally located in private, not-for-profit educational institutions that are not associated with a medical school. Programs in the Mountain Division required a lower number of prerequisites, and the South Region required the greatest number of prerequisite courses and semester hours.

DISCUSSION: The present study demonstrates a difference in prerequisite requirements across the country. This could translate to increased cost and a potential barrier to those considering a career as a PA.

PMID:35916887 | DOI:10.1097/JPA.0000000000000436

J Strength Cond Res. 2022 Jul 1. doi: 10.1519/JSC.0000000000004299. Online ahead of print.

ABSTRACT

Edwards, T, Weakley, J, Woods, CT, Breed, R, Benson, AC, Suchomel, TJ, and Banyard, HG. Comparison of countermovement jump and squat jump performance between 627 state and non-state representative junior Australian football players. J Strength Cond Res XX(X): 000-000, 2022-This cross-sectional study investigated differences in lower-body power of state and nonstate representative junior Australian football (AF) players through countermovement jump (CMJ) and squat jump (SJ) performance. A total of 627 players performed the CMJ and SJ at the end of the preseason phase over a 2-week period, with each player grouped according to their age (under 18 [U18] or under 16 [U16]), and highest competition level played (state representation and nonstate representation). One-way multivariate analysis of variance (MANOVA), follow up ANOVA’s, and Cohen’s d effect sizes were used to identify significant main effects and between-group differences. Statistical significance was set at α < 0.05. Significant small-to-moderate effect size differences were observed between competition level, with state U18 and U16 players recording greater CMJ and SJ height, and peak power (PP), compared with their nonstate representative peers, respectively. Similarly, significant small-to-moderate effect size differences existed between age groups, with nonstate U18 players recording greater CMJ and SJ height and PP than nonstate U16 counterparts. However, state U18 and state U16 only differed in CMJ PP. No differences were found between competition level or age groups for the difference between CMJ and SJ jump height (CMJSJdiff). Together, these findings suggest that state and nonstate representative junior AFs may have a similar ability to use the stretch-shortening cycle, despite state representative players jumping higher in the CMJ and SJ.

PMID:35916875 | DOI:10.1519/JSC.0000000000004299

JAMA. 2022 Aug 2;328(5):430-439. doi: 10.1001/jama.2022.9930.

ABSTRACT

IMPORTANCE: The effects of altered neural processing, defined as altering neural networks responsible for perceptions of pain and function, on chronic pain remains unclear.

OBJECTIVE: To estimate the effect of a graded sensorimotor retraining intervention (RESOLVE) on pain intensity in people with chronic low back pain.

DESIGN, SETTING, AND PARTICIPANTS: This parallel, 2-group, randomized clinical trial recruited participants with chronic (>3 months) nonspecific low back pain from primary care and community settings. A total of 276 adults were randomized (in a 1:1 ratio) to the intervention or sham procedure and attention control groups delivered by clinicians at a medical research institute in Sydney, Australia. The first participant was randomized on December 10, 2015, and the last was randomized on July 25, 2019. Follow-up was completed on February 3, 2020.

INTERVENTIONS: Participants randomized to the intervention group (n = 138) were asked to participate in 12 weekly clinical sessions and home training designed to educate them about and assist them with movement and physical activity while experiencing lower back pain. Participants randomized to the control group (n = 138) were asked to participate in 12 weekly clinical sessions and home training that required similar time as the intervention but did not focus on education, movement, and physical activity. The control group included sham laser and shortwave diathermy applied to the back and sham noninvasive brain stimulation.

MAIN OUTCOMES AND MEASURES: The primary outcome was pain intensity at 18 weeks, measured on an 11-point numerical rating scale (range, 0 [no pain] to 10 [worst pain imaginable]) for which the between-group minimum clinically important difference is 1.0 point.

RESULTS: Among 276 randomized patients (mean [SD] age, 46 [14.3] years; 138 [50%] women), 261 (95%) completed follow-up at 18 weeks. The mean pain intensity was 5.6 at baseline and 3.1 at 18 weeks in the intervention group and 5.8 at baseline and 4.0 at 18 weeks in the control group, with an estimated between-group mean difference at 18 weeks of -1.0 point ([95% CI, -1.5 to -0.4]; P = .001), favoring the intervention group.

CONCLUSIONS AND RELEVANCE: In this randomized clinical trial conducted at a single center among patients with chronic low back pain, graded sensorimotor retraining, compared with a sham procedure and attention control, significantly improved pain intensity at 18 weeks. The improvements in pain intensity were small, and further research is needed to understand the generalizability of the findings.

TRIAL REGISTRATION: ANZCTR Identifier: ACTRN12615000610538.

PMID:35916848 | DOI:10.1001/jama.2022.9930

J Minim Access Surg. 2022 Jul 20. doi: 10.4103/jmas.jmas_6_22. Online ahead of print.

ABSTRACT

CONTEXT: Gastrointestinal polyps are common gastrointestinal diseases that involve localised hyperplastic masses derived from gastrointestinal mucosa.

AIMS: To investigate the risk factors of delayed post-polypectomy bleeding (DPPB) after the treatment of gastrointestinal polyps with snare-assisted endoscopic sub-mucosal dissection (ESD) and to construct a nomogram model to predict the risk of DPPB.

SETTINGS AND DESIGN: A total of 226 patients who underwent snare-assisted ESD for gastrointestinal polyps from May 2018 to November 2020 were divided into DPPB group (n = 10) and non-DPPB group (n = 216).

SUBJECTS AND METHODS: The correlations of clinical data and endoscopic data with DPPB were compared. Univariate analysis was performed to screen the influencing factors of DPPB. Multivariate logistic regression analysis was used to screen the risk factors of DPPB, which was employed to construct a nomogram prediction model.

STATISTICAL ANALYSIS USED: SPSS 16.0 software was utilised for statistical analysis. Numerical data were expressed as percentage (n [%]), and Chi-square test was performed for univariate analysis. The significant factors (P < 0.05) in univariate analysis were included in multivariate logistic regression analysis, and the variables with statistical significance (P < 0.05) were considered as independent risk factors. The factors were used to construct a nomogram model for predicting the risk of DPPB. Bootstrap method was employed to perform repeated sampling 1000 times for internal verification. The consistency index (C-index) was used to evaluate the discrimination of the model, and C-index ≥0.70 represented a good discrimination. Two-tailed P < 0.05 indicated that a difference was statistically significant.

RESULTS: Univariate and multivariate logistic regression analyses revealed that hypertension, polyp location, polyp diameter, polyp morphology and intra-operative bleeding were the independent risk factors for DPPB (P < 0.05). The C-index of the nomogram model for predicting the risk of DPPB was 0.791, indicating a good discrimination. The calibration curve showed that the mean absolute error between predicted and actual DPPB occurrence risks was 0.014, indicating a high accuracy.

CONCLUSIONS: Hypertension, polyp location, polyp diameter, polyp morphology and intra-operative bleeding are the independent risk factors for DPPB, and the nomogram model established based on these factors for prediction has good discrimination and accuracy. Therefore, it is recommended to perform targeted intervention for high-risk groups to reduce the incidence of DPPB.

PMID:35915538 | DOI:10.4103/jmas.jmas_6_22

J Minim Access Surg. 2022 Jul 6. doi: 10.4103/jmas.jmas_79_22. Online ahead of print.

ABSTRACT

BACKGROUND: Oesophageal dilatations can be done either by bougies or balloons for differing aetiologies in children. We investigated the efficacy and safety of endoscopic balloon dilatations (EBDs) employed by a single surgeon.

PATIENTS AND METHODS: Relevant data over 12 years were retrospectively evaluated with an ethical committee approval.

RESULTS: Ninety-seven children underwent 514 EBD with a median EBD of 3 (1-50). The primary diagnoses were oesophageal atresia (OA) in 51 children, corrosive ingestion in 21, peptic strictures in 13, achalasia in 8 and congenital oesophageal stenosis in 4. The balloon size varied between 3 and 30 mm. The EBD was successfully ended in 72 patients and unsuccessful in six patients. Six children are still under EBD and 13 are lost to follow-up. The overall success rate was 92%. The age at the time of first dilatation was the youngest in OA group followed by corrosive strictures. The balloon sizes differed regarding the age of the patients with larger balloons used as the patient age increased. The sizes of the balloons used at the first and the last EBD differed among diagnostic groups. The total number of dilatations or the time interval between the first and the last EBD dilatation did not show a statistically significant difference among groups. The anatomical type of OA or the height of corrosive stricture revealed no significant difference in any of the above parameters. A transmural oesophageal perforation occurred during 2 (0.4%) EBD sessions.

CONCLUSIONS: EBD is an effective mean in relieving paediatric oesophageal pathologies with a variety of aetiologies and has a low complication rate.

PMID:35915522 | DOI:10.4103/jmas.jmas_79_22