Tag: statistics

Diabetes. 2025 Jan 6:db240380. doi: 10.2337/db24-0380. Online ahead of print.

ABSTRACT

Circulating proteins may be promising biomarkers or drug targets. Leveraging genome-wide association studies of type 1 diabetes (18,942 cases and 501,638 controls of European ancestry) and circulating protein abundances (10,708 European ancestry individuals), Mendelian randomization analyses were conducted to assess the associations between circulating abundances of 1,560 candidate proteins and the risk of type 1 diabetes, followed by multiple sensitivity and colocalization analyses, horizontal pleiotropy examinations, and replications. Bulk tissue and single-cell gene expression enrichment analyses were performed to explore candidate tissues and cell types for prioritized proteins. After validating Mendelian randomization assumptions and colocalization evidence, we found that genetically predicted circulating abundances of CTSH (OR=1.17 per one standard deviation increase; 95% CI:1.10-1.24), IL27RA (OR=1.13; 95% CI:1.07-1.19), SIRPG (OR=1.37; 95% CI:1.26-1.49), and PGM1 (OR=1.66; 95% CI:1.40-1.96) were associated with the risk of type 1 diabetes. These findings were consistently replicated in other cohorts. CTSH, IL27RA, and SIRPG were strongly enriched in immune system-related tissues, while PGM1 was enriched in muscle and liver tissues. Amongst immune cells, CTSH was enriched in B cells and myeloid cells, while SIRPG was enriched in T cells and natural killer cells. These proteins may be explored as biomarkers or drug targets for type 1 diabetes.

PMID:39761376 | DOI:10.2337/db24-0380

Vet Med Sci. 2025 Jan;11(1):e70151. doi: 10.1002/vms3.70151.

ABSTRACT

BACKGROUND: In the United Kingdom, spay surgery is routinely performed in dogs and cats by general practitioners. Data from a decade ago showed that, despite an increased attentiveness of veterinarians to peri-operative pain compared to the past, analgesia could be further improved.

OBJECTIVES: To investigate the current veterinary practice and attitude towards anaesthesia and analgesia for spay surgery in the United Kingdom.

METHODS: An electronic questionnaire composed of 57 questions organised in 6 sections was designed using the Checklist for Reporting Results of Internet E-Surveys (CHERRIES guidelines) and distributed online via a hyperlink. Participants were recruited through both personalised email invitation and publication of the hyperlink on social media. Data were analysed with descriptive statistics, analysis of means and analysis of proportions, using commercially available software.

RESULTS: Entries from 150 participants were used for data analysis. The proportion of participants who were confident in treating pain did differ by decade of graduation, with a lower proportion of confident colleagues graduated before 2001 (6%) and from 2021 (14%), compared to those graduated in the decades 2001-2010 (43%) and 2011-2020 (37%) (p = 0.007). Colleagues reported to implement multimodal analgesia for spay procedures of cats and dogs in 43% and 44% of cases, respectively. The proportions of participants who reportedly used locoregional blocks, mostly with lidocaine, in dogs (82%), were higher than that in cats (43%) (p < 0.001). Post-spay surgery pain was perceived by the participants as more intense in dogs than in cats (p < 0.001).

CONCLUSIONS: Despite an overall good level of attentiveness of British veterinary professionals to feline and canine analgesia during and following spay surgery, this study identified as areas of improvements perception and assessment of feline pain and implementation of locoregional anaesthetic techniques, particularly in cats.

PMID:39761362 | DOI:10.1002/vms3.70151

Comput Inform Nurs. 2025 Jan 6. doi: 10.1097/CIN.0000000000001248. Online ahead of print.

ABSTRACT

The global population is aging, and there is a concomitant increase in surgery for the elderly. In geriatric patients, where postoperative pain assessment is difficult, technological tools that perform automatic pain assessment are needed to alleviate the workload of nurses and to accurately assess patients’ pain. This study offers a more reliable and rapid assessment tool for assessing the pain of elderly patients undergoing surgery. The study aimed to develop a machine learning-based pain assessment application for postoperative geriatric patients. A methodological study was conducted with 68 patients in the general surgery clinic of a hospital between October 2022 and June 2024. Data were collected using a Sociodemographic Data Collection Form, the Numeric Rating Scale, and the Wong-Baker FACES Pain Scale. Then, machine learning was used. Data are summarized using descriptive statistics and presented using narrations, tables, and graphs. The study reveals that nurses assigned lower scores to patients’ pain levels. In the categorical classification, a high level of agreement was observed between the patient and the machine learning for each measurement. A machine learning-based pain assessment application is an efficacious method for assessing pain following geriatric surgery. It facilitates nursing care and supports the advancement of geriatric nursing.

PMID:39761361 | DOI:10.1097/CIN.0000000000001248

Chronobiol Int. 2025 Jan 6:1-14. doi: 10.1080/07420528.2024.2449015. Online ahead of print.

ABSTRACT

Seven-day actigraphy was performed within 1 month in 122 community-dwelling adults (mean age 24.40 y, 31 (25.4%) men) in the same city of Tyumen, Russia. Groups with different COVID-19 status (present, COVID-19(+), n = 79 vs absent, COVID-19(-), n = 43) did not differ in mean age, gender distribution, or body mass index. Vaccination status was equally represented in the COVID groups. We found that COVID-19 status, a history of SARS-CoV-2 infection, was differentially associated with daylight susceptibility. Daylight exposure was estimated using parametric and non-parametric indices: 24-h Amplitude, MESOR or M10 of white and blue light exposure (BLE) and compared between the groups. Distinctively in COVID-19(+) individuals, a smaller normalized 24-h amplitude of BLE (NAbl) was associated with lower circadian robustness, assessed by a smaller relative non-parametric amplitude (RA), a lower circadian function index (CFI), later bedtime, later onset of least active 5 h (L5), shorter total sleep duration, later phase and smaller circadian amplitude of physical motor activity. Such associations were absent in the overall COVID-19(-) population or in the vaccinated COVID(-) group. Considering COVID-status and light hygiene, defined as NAbl ≥ 1 versus NAbl < 1, only those with COVID(+) and NAbl < 1 (poorer light hygiene) had a statistically significantly delayed phase of activity and sleep, reduced circadian amplitude of physical activity, and lower circadian robustness. Accounting for gender and BMI, participants diagnosed with COVID-19 at an earlier date were older and had poorer circadian light hygiene. Altogether, our data suggest that those with COVID-19 were more vulnerable to circadian disruption due to poor circadian light hygiene, manifested as phase delay, small amplitude, a less robust circadian pattern of activity, and as delayed sleep. Our data suggest that the need for optimal circadian light hygiene is greater in individuals with a history of SARS-CoV-2 infection.

PMID:39761104 | DOI:10.1080/07420528.2024.2449015

Diabetes Technol Ther. 2025 Jan 6. doi: 10.1089/dia.2024.0472. Online ahead of print.

ABSTRACT

Objective: The recommended threshold for the time spent on continuous glucose monitoring (CGM) is established at 70%. However, glucose outcomes in children with type 1 diabetes (CwD) using CGM for a different proportion of time within this threshold have not been evaluated yet. The study aims to compare glycemic parameters among CwD who spent 70%-89% and ≥90% on CGM using the population-wide data from the Czech national pediatric diabetes registry ČENDA. Methods: CwD aged <19 years who used real-time CGM >70% of the time and did not change the type of therapy throughout the year 2023 were included and divided into two groups based on the time they spent on CGM-70%-89% versus ≥90%. HbA1c, times in standard glycemic ranges, mean glucose, and coefficient of variability (CV) were compared between the groups and by treatment modalities. Results: Data from 1977 CwD (1035 males and 942 females) were evaluated. Among them, 404 participants (20.4%) used CGM 70%-89% of the time, and 1573 participants (79.6%) ≥90% of the time. Compared with the 70-89% group, the ≥90% CGM users achieved significantly lower HbA1c levels (51 mmol/mol, 6.8% vs. 58 mmol/mol, 7.4%, P < 0.001), higher time in range (72% vs. 60%, P < 0.001), and lower mean glucose and CV (8.1 mmol/L, 146 mg/dL vs. 9.1 mmol/L, 164 mg/dL and 37% vs. 40%, respectively, both P < 0.001). Analogous results were seen irrespective of the treatment modality. The differences persisted after propensity score adjustment. Conclusion: CGM use for ≥90% is associated with tighter glycemic control compared with 70%-89% use. Therefore, it is essential to motivate CwD to use CGM for the longest possible time and search for suitable options to overcome barriers in uninterrupted CGM monitoring.

PMID:39761072 | DOI:10.1089/dia.2024.0472

JAMA Netw Open. 2025 Jan 2;8(1):e2452883. doi: 10.1001/jamanetworkopen.2024.52883.

ABSTRACT

IMPORTANCE: Intraventricular hemorrhage (IVH) has proven to be a challenging and enduring complication of prematurity. However, its association with neurodevelopment across the spectrum of IVH severity, independent of prematurity, and in the context of contemporary care remains uncertain.

OBJECTIVE: To evaluate national trends in IVH diagnosis and the association with survival and neurodevelopmental outcomes at 2 years of age.

DESIGN, SETTING, AND PARTICIPANTS: This whole-population cohort study was conducted using data from the UK National Neonatal Research Database. Infants born at less than 29 weeks’ gestation with any grade of IVH between January 2013 and December 2019 in England were included and matched with controls. Data analysis occurred from November 2023 to June 2024.

EXPOSURE: IVH grades 1 to 4 (Papile classification).

MAIN OUTCOMES AND MEASURES: The primary outcome was survival without severe neurodevelopmental impairment (NDI) at 2 years’ corrected age including severe delays (inability to understand or use >5 words or signs; being unable to walk, sit, or use hands; blindness; or uncorrectable hearing impairment). Secondary outcomes included gross and fine motor function, receptive and expressive communication, vision, hearing, and overall developmental progress. Outcomes were derived from clinician-entered data and analyzed using multiple logistic regression.

RESULTS: Between 2013 and 2019, of 26 756 infants born at less 29 weeks’ gestation in England, 8461 received a diagnosis of IVH (5570 low-grade and 2891 high-grade, and 8328 were included in the study. Overall, 5519 included infants had low-grade IVH with a median [IQR] gestational age of 26 (25-27) weeks, of which 2477 (48.88%) were male. Of the 2809 included infants with high-grade IVH, the median (IQR) gestational age was 25 (24-26) weeks and 1710 (60.88%) were male. The mean (SD) incidence of high-grade IVH (108 [6.7] per 1000 live extremely preterm births) and low-grade IVH (208 [10.4] per 1000 live extremely preterm births) increased between 2013 and 2019, although this did not reach statistical significance for high-grade IVH. Survival without severe NDI decreased significantly after high-grade IVH (a 74% reduction; aOR, 0.26; 95% CI, 0.22-0.31), and to a lesser extent after low-grade IVH (a 12% reduction; aOR, 0.88; 95% CI, 0.79-0.98). Although low-grade IVH was associated with functional impairments, most survivors, 2283 of 4379 infants (52.15%), had no NDI, and the association with NDI was accounted for by grade 2 IVH. Decreased survival without severe NDI was observed with increasing grade of IVH, decreasing gestation, bilateral compared to unilateral injuries, and increasing morbidity count (severe retinopathy of prematurity, bronchopulmonary dysplasia, and surgical necrotizing enterocolitis). Impairments in gross motor function and communication were common, especially among those with high-grade IVH (with prevalences of 44.55% [715 of 1605 infants] and 48.91% [784 of 1603 infants], respectively).

CONCLUSIONS AND RELEVANCE: In this cohort study, IVH was highlighted as a persistent issue with substantial neurodevelopmental implications despite advances in care. This study offers useful data for counseling families; however, follow-up to school age is necessary to grasp the full impact of these injuries on children’s lives.

PMID:39761048 | DOI:10.1001/jamanetworkopen.2024.52883

JAMA Netw Open. 2025 Jan 2;8(1):e2453292. doi: 10.1001/jamanetworkopen.2024.53292.

ABSTRACT

IMPORTANCE: Characterizing hospital-level factors associated with adverse outcomes following operative vaginal delivery (OVD) is crucial for optimizing obstetric care.

OBJECTIVE: To assess the association between hospital OVD volume and adverse outcomes.

DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective cohort study of OVDs in California between 2008 and 2020. OVD was determined using birth certificate and International Classification of Diseases, Ninth Revision, Clinical Modification or International Statistical Classification of Diseases, Tenth Revision, Clinical Modification codes. This study used linked vital statistics and hospital discharge data from California. The study included singleton, nonanomalous, full-term deliveries with vertex presentation. Data analysis was performed between June 10 and October 23, 2024.

EXPOSURE: Hospital OVD volume was categorized by the proportion of OVDs performed among all deliveries, grouped into low (<5.2%), medium (5.2%-7.4%), and high (≥7.4%) volume.

MAIN OUTCOMES AND MEASURES: Adverse outcomes for birthing individuals included obstetric anal sphincter injuries, cervical lacerations, and postpartum hemorrhage. Neonatal outcomes included shoulder dystocia, subgaleal hemorrhage, intracranial hemorrhage, facial nerve injury, and brachial plexus injury (BPI). χ2 and multivariable Poisson regression analyses were used to assess the association between hospital OVD volume and outcomes.

RESULTS: Among 306 818 OVDs (mean [SD] birthing parent’s age, 28.5 [6.2] years; 155 157 patients with public insurance [50.6%]), hospitals with low OVD volume had an increased proportion of obstetric anal sphincter injury compared with hospitals with medium and high volumes (12.16% [7444 patients] vs 11.07% [10 709 patients] vs 9.45% [14 064 patients]). Hospitals with low volume also had a higher proportion of adverse neonatal outcomes, including shoulder dystocia (3.84% [2351 patients] vs 3.50% [3386 patients] vs 2.80% [4160 patients]), subgaleal hemorrhage (0.27% [165 patients] vs 0.18% [172 patients] vs 0.10% [144 patients]), and BPI (0.41% [251 patients] vs 0.30% [291 patients] vs 0.20% [301 patients]) compared with hospitals with medium and high volume. In multivariable analyses, low OVD volume remained associated with increased risk of obstetric anal sphincter injury (adjusted risk ratio [aRR], 1.36; 95% CI, 1.14-1.62), shoulder dystocia (aRR, 1.30; 95% CI, 1.10-1.52), subgaleal hemorrhage (aRR, 2.57; 95% CI, 1.55-4.24), and BPI (aRR, 1.73; 95% CI, 1.30-2.2.29) compared with hospitals with high OVD volume. After multivariable analysis, medium OVD volume remained associated with increased risk of subgaleal hemorrhage (aRR, 1.72; 95% CI, 1.04-2.86) and BPI (aRR, 1.35; 95% CI, 1.02-1.79) compared with high OVD volume.

CONCLUSIONS AND RELEVANCE: This study found that undergoing OVD at hospitals with low OVD volume was associated with adverse perinatal outcomes compared with hospitals with medium and high OVD volumes. Further exploration of the reasons for these differences and prevention of these differences is needed to improve obstetric outcomes.

PMID:39761043 | DOI:10.1001/jamanetworkopen.2024.53292

J Neurotrauma. 2025 Jan 6. doi: 10.1089/neu.2024.0117. Online ahead of print.

ABSTRACT

Traumatic brain injury (TBI) and subsequent post-traumatic epilepsy (PTE) often impair daily activities and mental health (MH), which contribute to long-term TBI-related disability. PTE also affects driving capacity, which impacts functional independence, community participation, and satisfaction with life (SWL). However, studies evaluating the collective impact of PTE on multidimensional outcomes are lacking. Thus, we generated a model to investigate how PTE after moderate-to-severe (ms)TBI affects TBI-associated impairments, limits activities and participation, and influences SWL. Of 5108 participants with msTBI enrolled into the National Institute for Disability, Independent Living, and Rehabilitation Research TBI Model Systems between 2010 and 2018 and with seizure-event data available at year-1 post-TBI, 1214 had complete outcome data and 1003 had complete covariate data used for analysis. We constructed a conceptual framework illustrating hypothesized interrelationships between year-1 PTE, driving status, functional independence measure (FIM), depression and anxiety, as well as year-2 participation, and SWL. We performed univariate and multivariable linear and logistic regressions. A covariate-adjusted structural equation model (SEM), using the lavaan package (R), assessed the conceptual framework’s suitability in establishing PTE links with outcomes 1-2 years post-injury. Multiple parameters were evaluated to assess SEM fit. Year-1 PTE was correlated with year-1 FIM motor (standardized coefficient, β_std = -0.112, p = 0.007) and showed a trend level association with year-1 FIM cognition (β_std = -0.070, p = 0.079). Individuals with year-1 PTE were less likely to drive independently at year 1 (β_std = -0.148, p < 0.001). In addition, FIM motor (β_std = 0.323, p < 0.001), FIM cognition (β_std = 0.181, p = 0.012), and anxiety (β_std = -0.135, p = 0.024) influenced driving status. FIM cognition was associated with year-1 depression (β_std = 0.386, p < 0.001) and year-1 anxiety (β_std = 0.396, p < 0.001), whereas year-1 FIM motor (β_std = 0.186, p = 0.003), depression (β_std = -0.322, p = 0.011), and driving status (β_std = 0.233, p < 0.001) directly affected year-2 objective life participation metrics. Moreover, year-1 depression (β_std = -0.382, p = 0.001) and year-2 participation (β_std = 0.160, p < 0.001) had direct effects on year-2 SWL. SWL was influenced indirectly by year-1 variables, including functional impairment, anxiety, and driving status-factors that impacted year-2 participation directly or indirectly, and consequently year-2 SWL, forming a complex relationship with year-1 PTE. A sensitivity analysis SEM showed that the number of MH disorders was associated with participation and SWL (p < 0.001), and this combined MH variable was directly related to driving status (p < 0.02). Developing PTE during year-1 after msTBI affects multiple aspects of life. PTE effects extend to motor and cognitive abilities, driving capabilities, and indirectly, to life participation and overall SWL. The implications underscore the crucial need for effective PTE management strategies during the first year post-TBI to minimize the adverse impact on factors influencing multidimensional year-2 participation and SWL outcomes. Addressing transportation barriers is warranted to enhance the well-being of those with PTE and msTBI, emphasizing a holistic approach. Further research is recommended for SEM validation studies, including testing causal inference pathways that might inform future prevention and treatment trials.

PMID:39761035 | DOI:10.1089/neu.2024.0117

Child Obes. 2025 Jan 6. doi: 10.1089/chi.2024.0374. Online ahead of print.

ABSTRACT

It is unknown if children and youth who live in rural or “less rural” locations who enroll in the provincially funded Generation Health Clinic (British Columbia, Canada), a family-based lifestyle program for weight management, present with different health behaviors at baseline. Thus, we assessed sociodemographic and health behavior (diet, physical activity, and sleep) collected between 2015 and 2019. Data were stratified by age (children: ≤12 years; adolescents: ≥13 years) and geographical location (“less urban” and urban) based on Statistics Canada definitions and then analyzed using independent t-tests and chi–square tests. We found that more “urban” children consumed more daily family meals (p < 0.001), ate out weekly (p = 0.02), ate “other” vegetables (p = 0.002), and had less frequent sports drink consumption (p < 0.001) compared with less urban children. No significant differences in health behaviors were seen in adolescents. These findings suggest that a participant’s geographical location should be considered when developing family-based interventions for weight management.

PMID:39761009 | DOI:10.1089/chi.2024.0374

Disabil Rehabil. 2025 Jan 6:1-11. doi: 10.1080/09638288.2024.2449399. Online ahead of print.

ABSTRACT

AIM: Family-centred service aims to build family capacity to support their children, but behaviours supporting capacity-building vary. We explored what influences the way service providers think about and approach family-centred service.

METHOD: An online survey drew on experiences, beliefs, and perspectives of Australian providers. Descriptive statistics were applied to quantitative data and inductive content analysis to qualitative, with a comparative discussion to merge data.

RESULTS: The 73 participating medical and allied health professionals reflected family-centred service as a way of “knowing”, “being”, and “doing”. There were no observed differences in beliefs, perceptions, or behaviours between those with different professional training, experience, or work contexts. Participants described Collaborative partnerships as a way of working together with families. Work was influenced by (1) Who I am, (2) How I perceive influences beyond me, and that (3) Overlapping values and priorities supports sustained motivation.

INTERPRETATION: Findings indicated that providers “way of knowing” influenced their “way of doing”. Education is needed to align providers understanding of family-centred service with contemporary evidence. Strategies tailored to each context are required to support providers to balance competing priorities for themselves, families they work with, and surrounding services and systems, and sustain and promote family-centred service in practice.

PMID:39761007 | DOI:10.1080/09638288.2024.2449399