Tag: pubmed

Eur Urol Open Sci. 2021 Nov 17;34:86-93. doi: 10.1016/j.euros.2021.10.002. eCollection 2021 Dec.

ABSTRACT

BACKGROUND: Metformin has been linked to improved survival among diabetic prostate cancer (PCa) patients, while hyperinsulinemia and insulin usage has been related to worse prognosis.

OBJECTIVE: To evaluate the association of metformin and other antidiabetic drugs with PCa death and androgen deprivation therapy (ADT).

DESIGN SETTING AND PARTICIPANTS: The study cohort included 14 424 men who underwent radical prostatectomy in Finland during 1995-2013. Cases were identified, and clinical data were collected from patient files and national registries using personal identification numbers.

INTERVENTION: Information on the use of each antidiabetic drug during 1995-2014 was collected from prescription registry of the Social Insurance Institution of Finland.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The risks of PCa death and initiation of ADT were analyzed by antidiabetic drug use with the Cox regression method. Each antidiabetic drug group was analyzed separately to model simultaneous usage. Pre- and postdiagnostic uses were analyzed separately.

RESULTS AND LIMITATIONS: Prediagnostic use of antidiabetic drugs in general had no association with the risk of PCa death. Prediagnostic use of metformin was related to a reduced risk of ADT initiation (hazard ratio [HR] 0.75, 95% confidence interval [CI] 0.59-0.96), while high-dose insulin users had an increased risk. Overall, antidiabetic drug use after PCa diagnosis was associated with an elevated risk of PCa death. Only postdiagnostic metformin use was associated with reduced risks of PCa death (HR 0.47, 95% CI 0.30-0.76) and ADT initiation compared with nonusers. Study limitations are missing information on glycemic control, smoking, living or exercise habits, prostate-specific antigen, and Gleason score.

CONCLUSIONS: Among surgically treated PCa patients, use of metformin was associated with improved disease-specific survival, while insulin and insulin secretagogues were associated with poor survival. Metformin might be a favorable diabetes treatment among men with PCa.

PATIENT SUMMARY: In this Finnish nationwide study, we found that the risks of prostate cancer death and cancer progression are lowered among metformin users, but not among other antidiabetic drug users. Metformin might be a favorable treatment choice for diabetes in men with prostate cancer.

PMID:34934970 | PMC:PMC8655383 | DOI:10.1016/j.euros.2021.10.002

Rev Esp Salud Publica. 2021 Dec 22;95:e202112200.

ABSTRACT

OBJECTIVE: Eating disorders (EDs) usually begin during puberty and adolescence, a time when attention should be paid to the factors that influence the development of the disease. The aim of this study was to assess attitudes towards eating and the risk of developing EDs, taking into account personal and family variables in a population of secondary school students.

METHODS: A total of 790 Compulsory Secondary School students enrolled in the 2019/2020 academic year in secondary schools in the Autonomous Community of Galicia participated, of whom 410 were male and 380 female (M=13.84; SD=1.37). In this descriptive-cross-sectional study, eating disorders were assessed using Garner’s Eating Attitudes Test (EAT-26), adapted to Spanish subjects. The statistical treatment of the data was carried out by means of a multivariate analysis of variance (MANOVA), which took the form of frequency analysis and contingency tables.

RESULTS: With regard to the personal variables analysed, no significant differences in eating disorders were found across adolescents’ gender (p>0.05), but there were significant differences in age (p<0.001), school year (p<0.001) and use of social networks (p<0.05). Similarly, the data do showed significant differences in eating disorders according to the level of studies of the families (p<0.01) and their family relationship (p<0.001).

CONCLUSIONS: The results obtained in this research confirm an influence of personal and family variables in attitudes associated with EDs. Further investigation of these variables may facilitate better intervention, as well as improve the design of preventive strategies.

PMID:34934040

Ann Transplant. 2021 Dec 22;26:e934163. doi: 10.12659/AOT.934163.

ABSTRACT

BACKGROUND Dobutamine stress echocardiography (DSE) is commonly used for cardiovascular assessment before orthotopic liver transplantation (OLT). The coronary artery calcium score (CACS) is a useful screening tool for coronary artery disease (CAD). We aimed to compare the sensitivity and specificity of DSE and CACS for CAD in OLT candidates. MATERIAL AND METHODS A total of 265 of the 1589 patients who underwent OLT at our center between 2008 and 2019 had preoperative coronary angiography (CAG). Of these, 173 had DSE and 133 had a CT scan suitable for CACS calculation within 1 year of OLT. Patients with a nondiagnostic DSE were excluded (n=100). Two reviewers evaluated CACS on CT scans. The sensitivity/specificity of DSE and CACS for detection of angiographically significant CAD were calculated for patients with both tests (n=36). A separate analysis compared the sensitivity/specificity of a diagnostic DSE (n=73) and CACS (n=133) against CAG for all patients with either test. RESULTS Sensitivity and specificity were 57.1% and 89.7%, respectively, for DSE, compared with 71.4% and 62.1% for CACS at ≥100 Agatston score. For the analysis of all patients with either test, the sensitivity/specificity of DSE for detection of CAD and CACS were 30.8% and 85.0% and 80.0% and 62.8%, respectively. On ROC analysis, CACS was a satisfactory predictor of obstructive CAD (AUC, 0.76±0.06, 95% CI, 0.66-0.87; P<0.001). CONCLUSIONS CACS may be an important tool for cardiovascular assessment in patients undergoing OLT. DSE was nondiagnostic in a large percentage of OLT candidates, limiting its use in this population.

PMID:34934037 | DOI:10.12659/AOT.934163

Med Sci Monit. 2021 Dec 22;27:e933450. doi: 10.12659/MSM.933450.

ABSTRACT

BACKGROUND In the field of forensic medicine, sex estimation is a critical step in personal identification. Teeth are the hardest tissue and have high temperature resistance and corrosion resistance. In cases such as an airplane crash or the corpse of an unknown person, teeth often play a crucial role in identification. This study applied 3-dimensional technology to obtain odontometrics of permanent maxillary teeth and to examine the sexual dimorphism, finding suitable discriminant indicators to construct appropriate equations for sex estimation. MATERIAL AND METHODS A total of 204 participants (104 men and 100 women) from the Han population in Kashgar were included. Plaster models of their maxillary dentition were obtained to scan and measure through an accepted and commonly used 3-dimensional digital method. Descriptive statistics, t tests, and discriminant analyses were statistically analyzed using IBM SPSS 23.0 software. RESULTS This study showed high intra- and interexaminer reliability (intraclass correlation coefficient >0.950). There were statistically significant sex-related differences (P<0.05), with male values generally being higher for buccolingual distance, mesiodistal distance, intercanine distance, crown area, crown module, crown index, and maxillary canine index. Compared with other measurements, mesiodistal distance and crown area indicator exhibited distinct sexual dimorphism. In addition, several appropriate equations were constructed through different discriminant analyses that could be used to estimate sex in our specific population. CONCLUSIONS Three-dimensional digital technology offers a promising method for odontometry. Combining mesiodistal distance and buccolingual distance of particular teeth or using maxillary canine index in discriminant functions are acceptable auxiliary tools for sex estimation in the forensic field.

PMID:34934039 | DOI:10.12659/MSM.933450

Retina. 2021 Dec 17. doi: 10.1097/IAE.0000000000003385. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the correlation of volumetric measurements of intraretinal (IRF) and subretinal fluid (SRF) obtained by deep learning and central retinal subfield thickness (CSFT) based on optical coherence tomography (OCT) in retinal vein occlusion (RVO), diabetic macular edema (DME) and neovascular age-related macular degeneration (nAMD).

METHODS: A previously validated deep learning-based approach was used for automated segmentation of IRF and SRF in spectral domain-OCT images. OCT volumes of 2.433 patients obtained from multicenter studies were analyzed. Fluid volumes were measured at baseline and under anti-vascular endothelial growth factor (VEGF) therapy in the central 1, 3, and 6 mm.

RESULTS: Patients with nAMD demonstrated generally the weakest association between CSFT and fluid volumes measurements in the central 1mm (0.107 to 0.569). In patients with DME, IRF correlated moderately with CSFT (0.668 to 0.797). In patients with RVO, IRF volumes showed a moderate correlation with CSFT (0.603 to 0.704).

CONCLUSION: The correlation of CSFT and fluid volumes depends on the underlying pathology. Although the amount of central IRF seems to partly drive CSFT in DME and RVO, it has only a limited impact on patients with nAMD. Our findings do not support the use of CSFT as primary or secondary outcome measure for quantification of exudative activity or treatment guidance.

PMID:34934034 | DOI:10.1097/IAE.0000000000003385

Proc Natl Acad Sci U S A. 2021 Dec 28;118(52):e2106178118. doi: 10.1073/pnas.2106178118.

ABSTRACT

While the social sciences have made impressive progress in adopting transparent research practices that facilitate verification, replication, and reuse of materials, the problem of publication bias persists. Bias on the part of peer reviewers and journal editors, as well as the use of outdated research practices by authors, continues to skew literature toward statistically significant effects, many of which may be false positives. To mitigate this bias, we propose a framework to enable authors to report all results efficiently (RARE), with an initial focus on experimental and other prospective empirical social science research that utilizes public study registries. This framework depicts an integrated system that leverages the capacities of existing infrastructure in the form of public registries, institutional review boards, journals, and granting agencies, as well as investigators themselves, to efficiently incentivize full reporting and thereby, improve confidence in social science findings. In addition to increasing access to the results of scientific endeavors, a well-coordinated research ecosystem can prevent scholars from wasting time investigating the same questions in ways that have not worked in the past and reduce wasted funds on the part of granting agencies.

PMID:34933997 | DOI:10.1073/pnas.2106178118

Proc Natl Acad Sci U S A. 2021 Dec 28;118(52):e2107019118. doi: 10.1073/pnas.2107019118.

ABSTRACT

The learning of first object names is deemed a hard problem due to the uncertainty inherent in mapping a heard name to the intended referent in a cluttered and variable world. However, human infants readily solve this problem. Despite considerable theoretical discussion, relatively little is known about the uncertainty infants face in the real world. We used head-mounted eye tracking during parent-infant toy play and quantified the uncertainty by measuring the distribution of infant attention to the potential referents when a parent named both familiar and unfamiliar toy objects. The results show that infant gaze upon hearing an object name is often directed to a single referent which is equally likely to be a wrong competitor or the intended target. This bimodal gaze distribution clarifies and redefines the uncertainty problem and constrains possible solutions.

PMID:34933998 | DOI:10.1073/pnas.2107019118

Glob Health Sci Pract. 2021 Dec 21;9(4):818-831. doi: 10.9745/GHSP-D-20-00349. Print 2021 Dec 31.

ABSTRACT

BACKGROUND: Over 43% of children living in low- and middle-income countries are at risk for developmental delays; however, access to protective interventions in these settings is limited. We evaluated the effect of maternal participation in Chamas for Change (Chamas)-a community-based women’s health education program during pregnancy and postpartum-and risk of developmental delay among their children in rural Kenya.

METHODS: We analyzed developmental screening questionnaire (DSQ) data from a cluster randomized controlled trial in Trans Nzoia County, Kenya (ClinicalTrials.gov, NCT03187873). Intervention clusters (Chamas) participated in community health volunteer-led, group-based health lessons twice a month during pregnancy and postpartum; controls had monthly home visits (standard of care). We screened all children born during the trial who were alive at 1-year follow-up. We labeled children with any positive item on the DSQ as “at-risk development.” We analyzed data using descriptive statistics and multilevel regression models (α=.05); analyses were intention-to-treat using individual-level data.

RESULTS: Between November 2017 and March 2018, we enrolled 1,920 pregnant women to participate in the parent trial. At 1-year follow-up, we screened 1,273 (689 intervention, 584 control) children born during the trial with the DSQ. Intervention mothers had lower education levels and higher poverty likelihood scores than controls (P<.001 and P=.007, respectively). The overall rate of at-risk development was 3.5%. Children in Chamas clusters demonstrated significantly lower rates of at-risk development than controls (2.5% vs. 4.8%, P=.025). Adjusted analyses revealed lower odds for at-risk development in the intervention arm (OR=0.50; 95% confidence interval=0.27, 0.94).

CONCLUSIONS: Maternal participation in a community-based women’s health education program was associated with lower rates of at-risk development compared to the standard of care. Overall, rates of at-risk development were lower than expected for this population, warranting further investigation. Chamas may help protect children from developmental delay in rural Kenya and other resource-limited settings.

PMID:34933978 | DOI:10.9745/GHSP-D-20-00349

Glob Health Sci Pract. 2021 Dec 21;9(4):881-889. doi: 10.9745/GHSP-D-20-00450. Print 2021 Dec 31.

ABSTRACT

BACKGROUND: In countries with a high prevalence of undernutrition, timely, accurate screening at the community level is essential to identify children with wasting. The World Health Organization recommends using either weight-for-height z-scores (WHZ) and mid-upper arm circumference (MUAC) or both measures and signs of edema to be used to identify children with severe acute malnutrition for treatment. We compared WHZ and MUAC cutoffs to identify wasting among children aged 6-59 months in Nepal, using WHZ as the reference standard.

METHODS: We used cross-sectional anthropometric data for 3,169 children aged 6-59 months from a 2017 cross-sectional dataset, representative of 42 of Nepal’s 77 districts. We used descriptive statistics, receiver operating characteristic (ROC) curves, and kappa statistics to compare the use of MUAC and WHZ to identify wasting. The Youden index was calculated to determine the optimum MUAC cutoffs.

RESULTS: The prevalence of wasting was 3.1% and 10.5% using MUAC and WHZ, respectively. We found 13.6% sensitivity for severe acute malnutrition (SAM) (MUAC <115 mm) and 21.0% sensitivity for moderate acute malnutrition (MAM) (MUAC ≥115 to <125 mm), with specificity of 99.7% and 91.2%, respectively. The sensitivity of MUAC for children aged 6-23 months was higher than for children aged 24-59 months. The total area of the ROC curve was 0.53 for the MUAC cutoff for SAM and 0.56 for MAM. The optimum MUAC cutoffs for SAM and MAM were 125 mm and 132 mm, respectively.

CONCLUSIONS: Although MUAC can be used as a rapid screening tool to detect wasting in children aged 6-59 months, using the recommended MUAC cutoffs captures only a small proportion of the total number of wasted children. The poor sensitivity and specificity of MUAC compared to WHZ suggests a need to refine admission and discharge criteria for acute malnutrition management programs to ensure that wasting among infants and children in Nepal is consistently and accurately diagnosed and treated.

PMID:34933983 | DOI:10.9745/GHSP-D-20-00450

Cancer Epidemiol Biomarkers Prev. 2021 Dec 21:cebp.0765.2021. doi: 10.1158/1055-9965.EPI-21-0765. Online ahead of print.

ABSTRACT

BACKGROUND: A high healthy lifestyle index (HLI), a composite score based on good diet quality, low alcohol consumption, no smoking, moderate to high physical activity, and waist circumference <80cm, has been consistently associated with a reduced risk of breast cancer (BC). Recently, high levels of body fat were found to be associated with an elevated risk of BC in postmenopausal women with a normal body mass index (BMI) (18.5-<25 kg/m2). Whether the HLI is associated with BC risk in women with normal BMI is unknown.

METHODS: We studied 102,572 women aged 40-69 years with a normal BMI at enrollment into the UK Biobank cohort study. The HLI was created by assigning to each component higher scores for healthier behaviors and then summing the scores. The HLI was categorized by tertiles and age- and multivariable-adjusted hazard ratios (HRs) for the association of the HLI with BC risk by menopausal status were estimated using Cox proportional hazards models.

RESULTS: In postmenopausal women, compared to a low HLI, higher scores were associated with a reduced risk of BC (HRHLI-3rd tertile 0.76; 95% CI, 0.64-0.91). Findings were similar for premenopausal women, although they did not reach statistical significance, except when smoking status was excluded from the HLI score (HLIwithout smoking: HR3rd tertile, 0.71; 95% CI, 0.56-0.90).

CONCLUSIONS: In normal BMI postmenopausal women, a high HLI score was associated with a reduced risk of BC.

IMPACT: Following a healthy lifestyle may reduce the risk of BC among normal weight postmenopausal women.

PMID:34933955 | DOI:10.1158/1055-9965.EPI-21-0765