Tag: pubmed

Stat Med. 2022 Mar 14. doi: 10.1002/sim.9375. Online ahead of print.

ABSTRACT

The marginal Fine-Gray proportional subdistribution hazards model is a popular approach to directly study the association between covariates and the cumulative incidence function with clustered competing risks data, which often arise in multicenter randomized trials or multilevel observational studies. To account for the within-cluster correlations between failure times, the uncertainty of the regression parameters estimators is quantified by the robust sandwich variance estimator, which may have unsatisfactory performance with a limited number of clusters. To overcome this limitation, we propose four bias-corrected variance estimators to reduce the negative bias of the usual sandwich variance estimator, extending the bias-correction techniques from generalized estimating equations with noncensored exponential family outcomes to clustered competing risks outcomes. We further compare their finite-sample operating characteristics through simulations and two real data examples. In particular, we found the Mancl and DeRouen (MD) type sandwich variance estimator generally has the smallest bias. Furthermore, with a small number of clusters, the Wald $t$ -confidence interval with the MD sandwich variance estimator carries close to nominal coverage for the cluster-level effect parameter. The $t$ -confidence intervals based on the sandwich variance estimator with any one of the three types of multiplicative bias correction or the $z$ -confidence interval with the Morel, Bokossa and Neerchal (MBN) type sandwich variance estimator have close to nominal coverage for the individual-level effect parameter. Finally, we develop a user-friendly R package crrcbcv implementing the proposed sandwich variance estimators to assist practical applications.

PMID:35288959 | DOI:10.1002/sim.9375

Aust Occup Ther J. 2022 Mar 15. doi: 10.1111/1440-1630.12795. Online ahead of print.

ABSTRACT

INTRODUCTION: This study was conducted to examine the impact of a group cognitive rehabilitation program for people with dementia on everyday memory function and quality of life.

METHODS: Participants included in the study were community-dwelling adults with a diagnosis of dementia. The intervention was a 5-week occupational therapy lead group cognitive rehabilitation program delivered once a week for 1.5 h. Outcome measures included standardised memory tests, subjective everyday memory function and quality of life ratings. The measures were completed at baseline, post-intervention and 3-month post-intervention.

RESULTS: Outcome measures were completed with 58 participants. Statistically significant improvements in standardised memory scores were noted following the intervention. Similarly, self-rated everyday memory function and quality of life scores significantly improved following the intervention. All standardised scores and subjective ratings were maintained at 3-month follow-up.

CONCLUSION: Group-based cognitive rehabilitation programs can positively impact the quality of life and everyday memory function among people with dementia.

PMID:35288954 | DOI:10.1111/1440-1630.12795

Thromb Haemost. 2022 Mar 14. doi: 10.1055/s-0042-1743475. Online ahead of print.

ABSTRACT

BACKGROUND: Patients hospitalized with coronavirus disease-2019 (COVID-19) are at high risk of deep venous thrombosis (DVT) and pulmonary embolism (PE).

OBJECTIVES: The aims were to provide time trends in the 2020 nation-wide prevalence of venous thromboembolism (VTE) in patients hospitalized with a COVID-19 diagnosis in France, and to describe in-hospital and up to 30-day postdischarge death.

METHODS: All patients hospitalized in France with a COVID-19 diagnosis in 2020 were selected. Crude and age-adjusted prevalence of VTE and PE was computed by 4-week intervals and for the overall study period using Poisson regression. Time trends in in-hospital and 30-day postdischarge case-fatality rates were evaluated by comparing each 4-week intervals to weeks 10 to 14 corresponding to the first part of the first lockdown using logistic regression models.

RESULTS: Among the 287,638 patients hospitalized with a COVID-19 diagnosis in 2020 in France, 14,985 (5.2%) had a concomitant VTE, with 10,453 (3.6%) having PE and 4,532 (1.6%) having DVT. In patients admitted to intensive care units, the crude prevalence of VTE and PE reached 16.1 and 11.0% respectively during the first lockdown. After adjustment, the prevalence of VTE and PE decreased during the year 2020 but a rebound was observed during the second lockdown. In-hospital case-fatality rates among hospitalized COVID-19 patients with PE globally decreased between the first and the second epidemic waves.

CONCLUSION: Our study showed a decrease in the incidence of symptomatic VTE and PE in hospitalized COVID-19 patients, and a decreased time trend of outcomes during the second wave compared with the first one.

PMID:35288889 | DOI:10.1055/s-0042-1743475

New Phytol. 2022 Mar 15. doi: 10.1111/nph.18095. Online ahead of print.

ABSTRACT

●Current crop yield of the best ideotypes is stagnating and threatened by climate change. In this scenario, understanding wild plant adaptations in extreme ecosystems offers an opportunity to learn about new mechanisms for resilience. Previous studies have shown species specificity for metabolites involved in plant adaptation to harsh environments. ●Here, we combined multi-species ecological metabolomics and machine learning-based generalised linear model predictions to link the metabolome to the plant environment in a set of 24 species and belonging to 14 families growing along an altitudinal gradient in the Atacama Desert. ●Thirty-nine common compounds predicted the plant environment with 79% accuracy, thus establishing the plant metabolome as an excellent integrative predictor of environmental fluctuations. These metabolites were independent of the species and validated both statistically and biologically using an independent dataset from a different sampling year. Thereafter, using multiblock predictive regressions, metabolites were linked to climatic and edaphic stressors like freezing temperature, water deficit and high solar irradiance. ●These findings indicate that plants from different evolutionary trajectories use a generic metabolic toolkit to face extreme environments. These core metabolites, also present in agronomic species, provide a unique metabolic goldmine for improving crop performances under abiotic pressure.

PMID:35288949 | DOI:10.1111/nph.18095

Thromb Haemost. 2022 Mar 14. doi: 10.1055/s-0042-1743470. Online ahead of print.

ABSTRACT

The objective of this study was to assess the risk of arterial thrombosis in patients who harbor the JAK2V617F allele burden ≥1% detected during workup for myeloproliferative neoplasms (MPNs). We conducted a large cross-sectional analysis consisted of 5,220 patients who were tested for JAK2V617F and 1,047,258 people matched in age from health care insurance provider, taking into account age, sex, hypertension, diabetes, atrial fibrillation. Compared with noncarriers, mutation carriers were older, less likely to be current or past smokers and had lower body mass index. There was no significant difference between the groups regarding myocardial infarction and peripheral vascular disease. However, JAK2V617F ≥1% at age 34 to 54 years was associated with eightfold more likely to have transient ischemic attack (TIA)/stroke history unrelated to hypertension, diabetes, or atrial fibrillation. Association of JAK2V617F with TIA/stroke was also observed in the older age group, albeit a weaker association and not statistically significant. Prevalence of TIA/stroke was higher in patients with JAK2V617F negative, with odds ratio of 3.93 when compared with the general population after confounder adjustments. Further research is warranted to verify the relation between allele burden of JAK2V617F mutation and TIA/stroke and the role of JAK2V617F per se as a risk factor for arterial thrombosis in the absence of overt MPN. Also, consideration should be paid to the screened group with JAK2V617F negative due to the high incidence of TIA/stroke among them in comparison to the general population.

PMID:35288888 | DOI:10.1055/s-0042-1743470

Exp Clin Endocrinol Diabetes. 2022 Mar 14. doi: 10.1055/a-1797-8317. Online ahead of print.

ABSTRACT

BACKGROUND: Not much is known about the effects of glycemic variability (GV) during the pre- and periconception period on pregnancy/perinatal complications. GV could potentially contribute to identification of high-risk pregnancies in women with type 1 diabetes.

METHODS: An explorative retrospective cohort study was conducted between January 2014 and May 2019. Glucose data were retrieved from electronic patient charts. Pre-/periconceptional GV and GV during all three trimesters was expressed as mean glucose, standard deviation (SD), Coefficient of Variation (CV), High Blood Glucose Index (HBGI), Low Blood Glucose Index (LBGI) and Average Daily Risk Range (ADRR). Maternal and neonatal complications were summarized using a composite total complication score. Binary logistic regression analyses were conducted to assess correlations between the GV measures and a total complication score >3, a maternal complication score >1 and a neonatal complication score >1.

RESULTS: Of 63 eligible women, 29 women (38 pregnancies) were included. Women in the group with a total complication score >3 had a significantly higher ADRR at conception (OR 1.1, CI 1.0-1.2, p=0.048). No statistically significant correlation between complication score and any other GV metric besides the ADRR were found. Although not significant, in the group with a complication score >3, odds ratios >1 were found for SD in trimester 1 (OR 1.6, CI 0.6-4.5, p=0.357) and trimester 2 (OR 1.8, CI 0.5-6.2, p=0.376).

CONCLUSIONS: Presence of a positive association between GV and pregnancy and perinatal complications depends on which pregnancy period is assessed and the GV metrics that are used.

PMID:35288887 | DOI:10.1055/a-1797-8317

Am J Perinatol. 2022 Mar 14. doi: 10.1055/a-1797-7005. Online ahead of print.

ABSTRACT

OBJECTIVE: International Liaison Committee on Resuscitation (ILCOR) 2015 gave a weak recommendation based on low certainty of evidence against routine endotracheal (ET) suctioning in non-vigorous (NV) neonates born through meconium stained amniotic fluid (MSAF) and suggested for immediate resuscitation without direct laryngoscopy. A need for ongoing surveillance post policy change has been stressed upon. This study compared the outcomes of NV MSAF neonates before & after implementation of the ILCOR 2015 recommendation.

STUDY DESIGN: Prospective cohort study of term NV MSAF neonates who underwent immediate resuscitation without ET suctioning (No ET group, July 2018-June 2019, n=276) compared with historical control who underwent routine ET Suction (ET group, July 2015- June 2016, n=271).

RESULTS: Baseline characteristics revealed statistically significant higher proportion of male gender and small for gestational age neonates in the prospective cohort. There was no significant difference in the incidence of primary outcome of meconium aspiration syndrome (MAS) between the groups (No ET group: 27.2% vs ET group: 25.1%; p=0.57). NV MSAF neonates with hypoxic ischemic encephalopathy (HIE) was significantly lesser in the prospective cohort (No ET group: 19.2% vs ET group: 27.3%; p=0.03). Incidence of air leaks and need for any respiratory support significantly increased after policy change. In NV MSAF neonates with MAS, need for mechanical ventilation (MV) (No ET group: 24 % vs ET group: 39.7 %; p=0.04). and mortality (No ET group: 18.7% vs ET group: 33.8%; p=0.04) were significantly lesser.

CONCLUSION: Current study from a developing country indicates that immediate resuscitation and no routine ET suctioning of NV MSAF may not be associated with increased risk of MAS and may be associated with decreased risk of HIE. Increased requirement of any respiratory support and air leak post policy change needs further deliberation. Decreased risk of MV and mortality amongst those with MAS was observed.

PMID:35288884 | DOI:10.1055/a-1797-7005

World J Pediatr. 2022 Mar 14. doi: 10.1007/s12519-022-00529-1. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this study was to analyze the clinical characteristics of 66 pediatric patients with B.1.617.2 (Delta) variant of coronavirus disease 2019 (COVID-19).

METHODS: Sixty-six pediatric patients with B.1.617.2 (Delta) variant of COVID-19 admitted to the hospital from July to August 2021 were classified into mild (n = 41) and moderate groups (n = 25). Clinical characteristics, laboratory data and dynamic trends in different time periods were analyzed retrospectively.

RESULTS: There were no statistically significant differences in age, gender ratios and clinical symptoms between the mild group and the moderate group. All the patients in the moderate group had clusters of onsets, and the incubation period was shorter than that of the mild group. Within 24 hours of admission, the levels of erythrocyte sedimentation rate, cardiac troponin I, D-dimer in the moderate group were higher than that in the mild group (P < 0.05). The titers of immunoglobulin (Ig) G and IgM antibodies gradually increased after disease onset. Thirty-five (53.03%) children were tested positive for antibodies in 4-12 days. IgG increased gradually, while IgM decreased obviously in about 15 days after disease onset. The cycle threshold values of open reading frame 1ab and nucleocapsid protein gene in the severe acute respiratory syndrome coronavirus 2 genomes increased gradually on the 3rd, 6th, 9th, and 12th days after disease onset, compared with those in day 0.

CONCLUSIONS: The symptoms of children with B.1.617.2 (Delta) variant of COVID-19 were mild. The description and analysis of the clinical characteristics and laboratory data can help medical staff to evaluate the condition of children with COVID-19 and to accumulate more clinical experience.

PMID:35287229 | DOI:10.1007/s12519-022-00529-1

Environ Sci Pollut Res Int. 2022 Mar 14. doi: 10.1007/s11356-022-19402-9. Online ahead of print.

ABSTRACT

The present work deals with a detailed study of India’s Damodar river basin’s pollution profile (groundwater, surface water, industrial water, and mine water). The present paper aims to create a large data bank comprising the latest (2019; through water sampling and analysis) and historical (1980-2018; through literature survey) data on heavy metal loads (HML) and other hydrochemical parameters in water bodies of the Damodar basin (at 99 sampling locations). Bivariate and multivariate statistical analyses were applied to determine the possible sources of the HML in the groundwater and surface water. Anthropogenic inputs from industrial effluents and mining activities were identified as the sources of the HML. The degree of HML exposure (Fe, Cu, Zn, Mn, As, Co, Cd, Hg, Cr, Ni, and Cu) was considered for computing the heavy metal pollution indices (HMPI). Associated potential health risk to the local population was also studied. Most HMPIs (vary within 50-9000) appeared to cross the critical value (~ 100). According to the results of noncarcinogenic risk, most hazard indices (varied within 0.01-116.34) surpassed the allowable limit (~ 1), demonstrating detrimental health effects on adults and children. Ni, Cd, As, and Cr showed very high cancer indices (varied within 9.5 × 10^-5-1.76 × 10^-1) that could be considered as high risk (≫ 1 × 10^-4, allowable limit) for cancer via ingestion and dermal pathways. A carcinogenic risk assessment map of the basin was also prepared for the first time. Durgapur and Burnpur-Asansol cities have been identified as the most vulnerable areas. The authors also compared the water quality parameters of the Damodar river with other highly polluted and major rivers of India. The authors recommended (i) strict regulation and efficient management of HML monitoring, (ii) initiating public awareness programme about Damodar’s pollution, and (iii) a detailed medical survey to understand the impact of water pollution on the population.

PMID:35287189 | DOI:10.1007/s11356-022-19402-9

Environ Sci Pollut Res Int. 2022 Mar 14. doi: 10.1007/s11356-022-19611-2. Online ahead of print.

ABSTRACT

Fecal pollution in surface waters is a major threat to recreational and drinking water resources, with Escherichia coli being a primary concern. The best way to mitigate fecal pollutant loading is to identify the sources and tailor remediation strategies to reduce loading. Tracking E. coli back to its source is notoriously difficult in a mixed-use watershed where input from humans, wildlife, and livestock all contribute to E. coli loading. One proposed tracking method for E. coli contamination is the use of fecal sterols and sterol ratios. This study uses fecal sterol data published globally to assess how well sterol compositions for different species clusters along with the effectiveness of sterol ratios as tracking tools. Hierarchical cluster analysis produces stronger clusters based on sterol ratios than raw sterol concentration, but the global dataset results in clustering of the same species in different levels. The accuracy of the sterol ratios was also compared to understand the rate of false negatives and false positive assignments. Overall, these ratios did not have a high success rate for determining the correct source, which was also reflected in the poor clustering trends observed. Establishing local end-member sterol profiles is essential when using sterol signatures to unravel fecal loading.

PMID:35287190 | DOI:10.1007/s11356-022-19611-2