Tag: statistics

J Vet Pharmacol Ther. 2025 Mar 12. doi: 10.1111/jvp.13506. Online ahead of print.

ABSTRACT

Previous research has shown that azotemic dogs have a lower clearance and higher drug plasma concentrations of ampicillin compared to healthy dogs. The objective of this study was to determine the pharmacokinetics of ampicillin-sulbactam after multiple intravenous doses in hospitalized azotemic and non-azotemic dogs. This prospective study included 29 client-owned dogs; 19 azotemic and 10 non-azotemic. Ampicillin-sulbactam was administered at a combined dose of 22 mg/kg intravenously every 8 h for up to 5 days. Blood samples were obtained at baseline (prior to administration of the first dose of ampicillin-sulbactam), and 1-, 4-, and 8-h post-ampicillin-sulbactam administration each day. Plasma ampicillin was measured using LC-MS and non-compartmental pharmacokinetic modeling and dose interval modeling were performed. Plasma ampicillin exposure (azotemic mean 214.5 ug/mL × h ± 110.8, non-azotemic mean 60.3 ± 35.7; p < 0.0009) and half-life (azotemic mean 3.9 h ± 2.4, non-azotemic mean 1.5 h ± 0.3; p < 0.00001) were statistically greater in azotemic dogs compared to non-azotemic dogs. Single dose interval modeling predicted that 100% of azotemic dogs would have > 50% of the dosing interval with plasma concentrations > MIC (MIC = 2) with q12 h dosing and 79% of azotemic dogs would have > 50% of the dosing interval with plasma concentrations > MIC (MIC = 8) with q12 h dosing. Comparatively, 20% of non-azotemic dogs were predicted to have > 50% of the dosing interval with plasma concentrations > MIC (MIC = 2) with q12 h dosing and 0 non-azotemic dogs would have > 50% of the dosing interval with plasma concentrations > MIC (MIC = 8) with q12 h dosing. This study demonstrated that q12-h dosing of ampicillin-sulbactam in azotemic dogs over multiple days of administration is sufficient to reach the PK-PD target (> 50% of dosing interval > MIC) against susceptible bacteria.

PMID:40072220 | DOI:10.1111/jvp.13506

Radiol Artif Intell. 2025 Mar 12:e240287. doi: 10.1148/ryai.240287. Online ahead of print.

ABSTRACT

“Just Accepted” papers have undergone full peer review and have been accepted for publication in Radiology: Artificial Intelligence. This article will undergo copyediting, layout, and proof review before it is published in its final version. Please note that during production of the final copyedited article, errors may be discovered which could affect the content. Purpose To test a commercial artificial intelligence (AI) system for breast cancer detection at the BC Cancer Breast Screening Program. Materials and Methods In this retrospective study of 136,700 women (age: µ = 58.8, σ = 9.4, M = 59.0, IQR = 14.0) who underwent digital mammography screening in British Columbia, Canada between February 2019 and January 2020, breast cancer detection performance of a commercial AI algorithm was stratified by demographic, clinical, and imaging features and evaluated using the receiver operating characteristic curve (AUC), and AI performance was compared with radiologists using sensitivity and specificity. Results At 1-year follow-up, the AUC of the AI algorithm was 0.93 (95% CI: 0.92-0.94) for breast cancer detection. Statistically significant differences were found for mammograms across radiologist-assigned BI-RADS breast densities-A: 0.96 (0.94-0.91); B: 0.94 (0.92-0.95); C: 0.93 (0.91-0.95) and D: 0.84 (0.76-0.91) (A_AUC > D_AUC, P = .002; B_AUC > D_AUC, P = .009; C_AUC > D_AUC, P = .02). The AI showed higher performance for mammograms with architectural distortion (0.96, 0.94-0.98) versus without (0.92, 0.90-0.93, P = .003) and lower performance for mammograms with calcification (0.87, 0.85-0.90) versus without (0.92, 0.91-0.94, P < .001). Sensitivity of radiologists (92.6 ± 1.0%) exceeded the AI algorithm (89.4 ± 1.1%; P =.01), but there was no evidence of difference at 2-year follow-up (83.5 ± 1.2% versus 84.3 ± 1.2%; P = .69). Conclusion The tested commercial AI algorithm is generalizable for a large external breast cancer screening cohort from Canada but showed different performance for some subgroups, including architectural distortion or calcification in the image. ©RSNA, 2025.

PMID:40072215 | DOI:10.1148/ryai.240287

Acta Anaesthesiol Scand. 2025 Apr;69(4):e70014. doi: 10.1111/aas.70014.

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) is a serious complication after lung transplantation, but the reported incidence varies in the literature. No data on AKI have been published from the Swedish lung transplantation program.

METHODS: The aim of our study was to investigate the incidence, perioperative risk factors, and effects of early postoperative acute kidney injury (Kidney Disease Improving Global Outcomes [KDIGO] criteria) after lung transplantation. A retrospective, nationwide study of 568 lung-transplanted patients in Sweden between 2011 and 2020 was performed.

RESULTS: The incidence of AKI (any grade) was 42%. Renal replacement therapy was used in 5% of the patients. Preoperative factors independently associated with increased incidence of AKI were higher body mass index (odds ratio [OR]: 1.07, 95% CI: 1.02, 1.12) longer time on transplantation waiting list (OR: 1.05 [1.01, 1.09]), re-transplantation (OR: 2.24 [1.05, 4.80]) and moderate to severe tricuspid regurgitation (OR: 2.61 [1.36, 5.03]). Intraoperative factors independently associated with increased incidence of AKI were use of cardiopulmonary bypass (OR: 2.70 [1.57, 4.63]), increasing number of transfused red blood cell units, and use of immunosuppressive therapy other than routine (OR: 2,56 [1.47, 4.46]). A higher diuresis (OR: 0.70, 95% CI: 0.58-0.85) was associated with less incidence of acute kidney injury. Development of AKI was associated with increased time to extubation (median 30 h, IQR [9, 118] vs. 6 [3, 16]), length of stay in the intensive care unit (9 days [4, 25] vs. 3 [2, 5]) and increased rate of primary graft dysfunction (OR 2.33 [1.66, 3.29]) and 30-day mortality (OR: 10.8 [3.0, 69]).

CONCLUSIONS: Acute kidney injury is common after lung transplantation and affects clinical outcomes negatively. Preoperative factors may be used for risk assessment. The use of cardiopulmonary bypass is a potentially modifiable intraoperative risk factor.

EDITORIAL COMMENT: Acute kidney injury is a common complication after lung transplantation that severely influences patient outcomes. This large study of more than 500 patients treated over a decade identified potentially modifiable factors associated with the development of acute kidney injury.

PMID:40066686 | DOI:10.1111/aas.70014

Ann Ig. 2025 Mar 11. doi: 10.7416/ai.2025.2690. Online ahead of print.

ABSTRACT

BACKGROUND: Seafarers experience unique challenges related to their profession, including risks for mental health. The present study explored the correlates of depression among seafarers in India.

METHODS: Following ethics clearance, this cross-sectional study was conducted at an international shipping company in Mumbai, India. Using time-bound convenience sampling, 105 multi-state seafarers were recruited following verbal consent. The Beck Depression Inventory and Work-Related Quality of Life scale were used to screen for the study outcomes. Data analysis was performed using Jamovi 2.0. Descriptive statistics and Chi-square tests were used to assess associations, and logistic regression was performed to identify correlates of depression.

RESULTS: Of 105 seafarers, the majority (98.1%) were male, most were married (80%), and were aged between 18-35 years (56.2%). About 42.9% had an income of INR 3 lakh (≈$3604) and above monthly. An overwhelming majority had mild mood disturbances, which was found among 90.5% and 8.6% reported depression. Seafarers who engaged in regular physical activity and had higher monthly incomes had higher Work-Related Quality of Life. A significant association was found between depression and isolation (p=0.031) as well as with Work-Related Quality of Life (p=0.012). On logistic regression, we found that the number of hours of work per day, experiencing isolation and Work-Related Quality of Life, significantly predicted depression.

CONCLUSIONS: The existing burden and treatment gap for mental health morbidity among seafarers needs to be addressed. To address early indications of mental health conditions among seafarers, implementing mental health screening and offering counseling services on board may be the way forward.

PMID:40066682 | DOI:10.7416/ai.2025.2690

Epidemiol Prev. 2025 Jan-Feb;49(1):35-43. doi: 10.19191/EP25.1.A788.011.

ABSTRACT

OBJECTIVES: to analyse the prevalence and characteristics of the hikikomori phenomenon in Italy within a representative sample of students aged 15 to 19 years, assessing the factors associated with this behaviour to guide preventive interventions.

DESIGN: cross-sectional study based on anonymous data collected through the ESPAD®Italia (European School Survey Project on Alcohol and other Drugs) survey using a self-administered questionnaire.

SETTING AND PARTICIPANTS: a representative sample of Italian high-school students is selected annually to ensure the comparability of ESPAD®Italia estimates. In this study, the pooled 2021-2023 sample consists of 36,868 students (50.8% male), with an average age of 17.0 years (standard deviation: 1.4).

MAIN OUTCOMES MEASURES: the outcomes analysed are having experienced voluntary social withdrawal for at least six months over a lifetime (Lifetime Hikikomori) and the current behaviour of never leaving the house during the week (Current Withdrawal).

RESULTS: in 2023, 2.0% of students reported having voluntarily isolated themselves for at least six months in their lifetime, with a slightly higher prevalence among girls. Current withdrawal involved 11.3% of students, a significant increase compared to the previous two years. In the pooled 2021-2023 sample, the analysis of independent variables showed that the hikikomori phenomenon is associated with the use of psychotropic drugs, cigarette smoking, having been a victim of cyberbullying, feelings of exclusion, dissatisfaction in friendships, risky behaviours related to internet and video game use, and belonging to non-traditional families. The current withdrawal is directly associated with cigarette smoking, lack of enjoyment in social interactions, overweight/obesity, and belonging to non-traditional families.

CONCLUSIONS: the study provided the first quantitative estimate of voluntary social withdrawal among Italian students aged 15-19 years, confirming that the phenomenon is widespread and concerning, especially among girls. Factors such as the perception of social exclusion, problematic online behaviours and the use of psychotropic drugs are strongly associated with the phenomenon. Future longitudinal research could further explore these relationships and support the development of integrated educational strategies in schools to identify and support at-risk students.

PMID:40066636 | DOI:10.19191/EP25.1.A788.011

Epidemiol Prev. 2025 Jan-Feb;49(1):27-34. doi: 10.19191/EP25.1.A749.003.

ABSTRACT

OBJECTIVES: to describe the ‘IDA’ study, which aims to estimate the prevalence of School Readiness Vulnerability (SRV) in children at the beginning of primary school and the associated socioeconomic characteristics, to stimulate the attention of decision-makers on the consequences of the COVID-19 pandemic and the need for specific and timely interventions by the school community, thus preventing negative effects on children’s present and future health.

DESIGN: cross-sectional study based on a random sample of children extracted using the cluster sampling technique on the first primary school classes.

SETTING AND PARTICIPANTS: in October 2022, the IDA study assessed the SRV prevalence and associated risk factors in 628 children of the Lazio Region, aged 67-89 months, 328 males and 292 females.

MAIN OUTCOMES MEASURES: the individual school readiness score was calculated by a validated questionnaire (Early Identification of Learning Difficulties, IPDA); socioeconomic characteristics were measured by administering a questionnaire to parents (child’s age, kindergarten attendance, parents’ education, parents’ occupation).

RESULTS: the SRV prevalence was 44.9%. The most affected development areas were motor skills, pre-mathematics, and pre-literacy. SRV was associated with low educational levels of the mother, father, or both parents, and maternal and paternal unemployment. The comparison with reference values (pre-pandemic) places the subjects studied one year behind in terms of psycho-motor development.

CONCLUSIONS: because of potential negative effects, institutions and stakeholders need to intervene to promote children’s reinforcement activities and equity of access to education.

PMID:40066635 | DOI:10.19191/EP25.1.A749.003

Geriatr Gerontol Int. 2025 Mar 11. doi: 10.1111/ggi.70019. Online ahead of print.

ABSTRACT

AIM: Rehospitalization of patients with heart failure (HF) incurs high health care costs and increased mortality. Infection-related rehospitalizations in patients with HF occur frequently, and the risk increases with age. This study aimed to identify the factors associated with infection-related rehospitalizations in older patients with HF.

METHODS: Demographic, clinical, and pharmacological data from 1061 patients with acute HF who were enrolled in the Kochi Registry of Subjects With Acute Decompensated Heart Failure (Kochi YOSACOI study) were analyzed. Additionally, a machine learning approach was applied in addition to the traditional statistical analysis model. Of the patients hospitalized for HF, 729 were ultimately analyzed.

RESULTS: During the 2-year postdischarge follow-up period, 121 (17%) patients were readmitted for infections. Logistic regression analysis identified a Japanese Cardiovascular Health Study (J-CHS) score of ≥3 (odds ratio, 1.83 [95% confidence interval, 1.18-2.83]; P = 0.007) at discharge as a key factor for infection-related rehospitalizations. Machine learning models confirmed that a higher J-CHS score and lower estimated glomerular filtration rate (eGFR) increased the risk of infection-related rehospitalizations. Decision tree analysis classified the risk into high (J-CHS score ≥3), medium (J-CHS score <3; eGFR ≤35.0) and low (J-CHS score <3; eGFR >35.0) groups.

CONCLUSIONS: Infection-related rehospitalizations occur in older patients with HF and are associated with frailty and eGFR. These findings provide valuable insights for health care providers to better manage the risk of infection-related rehospitalizations in older patients with HF, potentially improving patient outcomes. Geriatr Gerontol Int 2025; ••: ••-••.

PMID:40066617 | DOI:10.1111/ggi.70019

Clin Exp Dent Res. 2025 Feb;11(1):e70061. doi: 10.1002/cre2.70061.

ABSTRACT

OBJECTIVES: Various attempts have been made to increase the rate of orthodontic tooth movement (OTM). The aim of this study was to determine the effect of different doses of heparin on OTM and paraclinical factors related to bone metabolism in rats.

METHODS AND MATERIALS: A total of 24 Sprague-Dawley rats were randomly divided into three groups of 8 animals each and injected with 0 (control), 3000, and 6000 U/Kg/d heparin sulfate for 4 weeks. Radiographs were obtained at the initiation and at the end of the study period. Orthodontic forces were applied on Day 14 and continued for the next 2 weeks, after which, OTM, optical density, parathyroid hormone (PTH) level, and histologic variables were assessed for each rat. The latter was performed on hematoxylin/eosin-stained sections of the mesial roots of the first molar and included calculation of the osteoclast number, and resorption lacunae depth and number. One-way analysis of variance, the Tukey test, and a paired-t-test were used for statistical analysis (p < 0.05).

RESULTS: A significant increase in OTM, the number of resorptive lacunae, and PTH secretion was observed in the group that received 6000 U/Kg/d compared with both the other groups. There was no significant difference in optical density, and, therefore, bone density, among the study groups (p > 0.05).

CONCLUSION: Heparin injection affects bone metabolism in rats, as shown by the increases in OTM and PTH and its impact on histologic parameters. These effects seem to be dose-dependent and may be a factor that should be taken into consideration during orthodontic treatment planning.

PMID:40066602 | DOI:10.1002/cre2.70061

Ann Med. 2025 Dec;57(1):2476735. doi: 10.1080/07853890.2025.2476735. Epub 2025 Mar 11.

ABSTRACT

BACKGROUND: Cardiovascular disease (CVD) remains a major health concern globally, contributing to a considerable disease burden. However, few studies have considered long-term cumulative blood pressure (cBP) exposure in middle-aged and older population in China. The aim of this study was to investigate whether long-term cBP was associated with subsequent cardiovascular outcomes among participants without CVD at baseline in Chinese over 45 years old.

METHODS: 6435 participants in China of the CHARLS (The China Health and Retirement Longitudinal Study) were included. Cumulative BP was calculated as the area under the curve using measurements from wave 1 (2011) to wave 2 (2013). Outcomes included CVD, heart disease and stroke.

RESULTS: During a median follow-up period of 5 years, 1101 CVD events, 826 heart disease, and 351 stroke were recorded. Each 1-SD increase in cumulative systolic blood pressure (cSBP), cumulative diastolic blood pressure (cDBP), and cumulative mean arterial pressure (cMAP) was associated with increased risk of CVD (HR, 1.12; 95%, 1.05-1.20, HR, 1.14; 95%, 1.07-1.22, HR, 1.14; 95%, 1.07-1.22), heart disease (HR, 1.05; 95%, 0.97-1.13, HR, 1.09; 95%, 1.01-1.17, HR, 1.08; 95%, 1.00-1.16) and stroke (HR, 1.35; 95%, 1.21-1.51, HR, 1.31; 95%, 1.17-1.46, HR, 1.36; 95%, 1.22-1.51). The relationship between cBP and CVD has only been found in people younger than 60 years of age. A significant association was observed for cumulative pulse pressure (cPP) with stroke (HR, 1.23; 95%, 1.10-1.38). None nonlinear relationships were identified (p-nonlinear > .05). For the prediction of cardiovascular outcomes, cBP load outperformed baseline BP in terms of C statistics (p < .001).

CONCLUSIONS: Long-term cSBP, cDBP and cMAP were associated with subsequent CVD and only found in people younger than 60 years of age, whereas cPP was associated with stroke only across all ages. Cumulative BP may provide a better prediction of cardiovascular outcomes compared with single BP measurement. Efforts are required to control long-term BP in assessing cardiovascular risks.

PMID:40066575 | DOI:10.1080/07853890.2025.2476735