Categories
Nevin Manimala Statistics

Paricalcitol and Extended Release Calcifediol for Treatment of Secondary Hyperparathyroidism in Non-Dialysis Chronic Kidney Disease: Results From a Network Meta-Analysis

J Clin Endocrinol Metab. 2023 May 26:dgad289. doi: 10.1210/clinem/dgad289. Online ahead of print.

ABSTRACT

INTRODUCTION: Secondary hyperparathyroidism (SHPT) is a complication of chronic kidney disease (CKD) affecting mineral and bone metabolism and characterized by excessive parathyroid hormone (PTH) production and parathyroid hyperplasia. The objective of this analysis was to compare the efficacy and adverse effects of extended release calcifediol (ERC) and paricalcitol (PCT) by assessing their effect on biomarkers PTH, calcium and Phosphate in patients with non-dialysis CKD (ND CKD).

METHODS: A systematic literature research (SLR) was performed in PubMed to identify randomized control trials (RCTs). Quality assessment was done with the GRADE method. The effects of ERC vs PCT were compared using random effects in a frequentist setting.

RESULTS: Nine RCTs comprising 1426 patients were included in the analyses. The analyses were performed on two overlapping networks, due to non-reporting of outcomes in some of the included studies. No head-to-head trials were identified. No statistically significant differences in PTH reduction were found between PCT and ERC. Treatment with PCT showed statistically significant increases in calcium compared to ERC (0.2 mg/dl increase, 95% CI: -0.37 to -0.05 mg/dl). No differences in effects on phosphate were observed.

CONCLUSION: This NMA showed that ERC is comparable in lowering PTH levels vs PCT. ERC displayed avoidance of potentially clinically relevant increases in serum calcium, offering an effective and well tolerated treatment option for the management of SHPT in patients with ND CKD.

PMID:37235771 | DOI:10.1210/clinem/dgad289

Powered by WPeMatico

Categories
Nevin Manimala Statistics

The impact of Covid-19 pandemic on acute burn admissions at the University College Hospital Ibadan, Nigeria

J Burn Care Res. 2023 May 26:irad079. doi: 10.1093/jbcr/irad079. Online ahead of print.

ABSTRACT

The coronavirus disease and the subsequent pandemic that followed drastically changed human civilization with disruptive effects on health and overall wellbeing of mankind. This disruptive effect has been shown to include changes in epidemiology of burn injuries. This study therefore aimed to determine the impact of COVID-19 on acute burn presentation at the University College Hospital, Ibadan. This was a retrospective study carried out between April 1st 2019 and March 31st 2021. The period was divided into two: April 1st 2019 to March 31st 2020 and April 1st 2020 to March 31st 2021. Data obtained from the burn unit registry was analyzed using the scientific package for social sciences (SPSS) version 25. The only statistically significant finding from this study was the marked reduction in burn ICU admission during the pandemic (p<0.001). A total of 144 patients presented to the burn intensive care unit at UCH Ibadan during the period under review with 92 patients in the pre-pandemic year, and 52 patients in the pandemic year. 0-9 years representing 42% in pre-pandemic, and 30.8% in the pandemic period was the most affected age group. Scald was predominantly among the pediatric age group in both groups. Males were more likely to suffer flame burn in both study periods with a near gender equilibration during the pandemic. Burn injury during the pandemic resulted in more total body surface area burned. Conclusion: The lockdown effect of the pandemic resulted in a significant reduction in acute burn admissions at the University College Hospital, Ibadan.

PMID:37235751 | DOI:10.1093/jbcr/irad079

Powered by WPeMatico

Categories
Nevin Manimala Statistics

Systematic Review of Variables Related to Instruction in Augmentative and Alternative Communication Implementation: Group and Single-Case Design

Am J Speech Lang Pathol. 2023 May 26:1-24. doi: 10.1044/2023_AJSLP-22-00314. Online ahead of print.

ABSTRACT

PURPOSE: This article provides a systematic review and analysis of group and single-case studies addressing augmentative and alternative communication (AAC) intervention with school-aged persons having autism spectrum disorder (ASD) and/or intellectual/developmental disabilities resulting in complex communication needs (CCNs). Specifically, we examined participant characteristics in group-design studies reporting AAC intervention outcomes and how these compared to those reported in single-case experimental designs (SCEDs). In addition, we compared the status of intervention features reported in group and SCED studies with respect to instructional strategies utilized.

PARTICIPANTS: Participants included school-aged individuals with CCNs who also experienced ASD or ASD with an intellectual delay who utilized aided or unaided AAC.

METHOD: A systematic review using descriptive statistics and effect sizes was implemented.

RESULTS: Findings revealed that participant features such as race, ethnicity, and home language continue to be underreported in both SCED and group-design studies. Participants in SCED investigations more frequently used multiple communication modes when compared to participants in group studies. The status of pivotal skills such as imitation was sparsely reported in both types of studies. With respect to instructional features, group-design studies were more apt to utilize clinical rather than educational or home settings when compared with SCED studies. In addition, SCED studies were more apt to utilize instructional methods that closely adhered to instructional features more typically characterized as being associated with behavioral approaches.

CONCLUSION: The authors discuss future research needs, practice implications, and a more detailed specification of treatment intensity parameters for future research.

PMID:37235744 | DOI:10.1044/2023_AJSLP-22-00314

Powered by WPeMatico

Categories
Nevin Manimala Statistics

Utilizing Simulation to Evaluate Robotic Skill Acquisition and Learning Decay

Surg Laparosc Endosc Percutan Tech. 2023 May 18. doi: 10.1097/SLE.0000000000001177. Online ahead of print.

ABSTRACT

BACKGROUND: We aim to evaluate how new robotic skills are acquired and retained by having participants train and retest using exercises on the robotic platform. We hypothesized that participants with a 3-month break from the robotic platform will have less learning decay and increased retention compared with those with a 6-month break.

METHODS: This was a prospective randomized trial in which participants voluntarily enrolled and completed an initial training phase to reach proficiency in 9 robot simulator exercises. They were then instructed to refrain from practicing until they retested either 3 or 6 months later. This study was completed at an academic medical center within the general surgery department. Participants were medical students, and junior-level residents with minimal experience in robotic surgery were enrolled. A total of 27 enrolled, and 13 participants completed the study due to attrition.

RESULTS: Overall, intragroup analysis revealed that participants performed better in their retest phase compared with their initial training in terms of attempts to reach proficiency, time for completion, penalty score, and overall score. Specifically, during the first attempt in the retesting phase, the 3-month group did not deviate far from their final attempt in the training phase, whereas the 6-month group experienced significantly worse time to complete and overall score in interrupted suturing {[-4 (-18 to 20) seconds vs. 109 (55 to 118) seconds, P=0.02] [-1.3 (-8 to 1.9) vs. -18.9 (-19.5 to (-15.0)], P=0.04} and 3-arm relay {[3 (-4 to 23) seconds vs. 43 (30 to 50) seconds, P=0.02] [0.4 (-4.6 to 3.1) vs. -24.8 (-30.6 to (-20.3)], P=0.01] exercises. In addition, the 6-month group had a significant increase in penalty score in retesting compared with the 3-month group, which performed similarly to their training phase [3.3 (2.7 to 3.3) vs. 0 (-0.8 to 1.7), P=0.03].

CONCLUSIONS: This study identified statistically significant differences in learning decay, skills retention, and proficiency between 3-month and 6-month retesting intervals on a robotic simulation platform.

PMID:37235716 | DOI:10.1097/SLE.0000000000001177

Powered by WPeMatico

Categories
Nevin Manimala Statistics

Decoding the hydrodynamic properties of microscale helical propellers from Brownian fluctuations

Proc Natl Acad Sci U S A. 2023 May 30;120(22):e2220033120. doi: 10.1073/pnas.2220033120. Epub 2023 May 26.

ABSTRACT

The complex motility of bacteria, ranging from single-swimmer behaviors such as chemotaxis to collective dynamics, including biofilm formation and active matter phenomena, is driven by their microscale propellers. Despite extensive study of swimming flagellated bacteria, the hydrodynamic properties of their helical-shaped propellers have never been directly measured. The primary challenges to directly studying microscale propellers are 1) their small size and fast, correlated motion, 2) the necessity of controlling fluid flow at the microscale, and 3) isolating the influence of a single propeller from a propeller bundle. To solve the outstanding problem of characterizing the hydrodynamic properties of these propellers, we adopt a dual statistical viewpoint that connects to the hydrodynamics through the fluctuation-dissipation theorem (FDT). We regard the propellers as colloidal particles and characterize their Brownian fluctuations, described by 21 diffusion coefficients for translation, rotation, and correlated translation-rotation in a static fluid. To perform this measurement, we applied recent advances in high-resolution oblique plane microscopy to generate high-speed volumetric movies of fluorophore-labeled, freely diffusing Escherichia coli flagella. Analyzing these movies with a bespoke helical single-particle tracking algorithm, we extracted trajectories, calculated the full set of diffusion coefficients, and inferred the average propulsion matrix using a generalized Einstein relation. Our results provide a direct measurement of a microhelix’s propulsion matrix and validate proposals that the flagella are highly inefficient propellers, with a maximum propulsion efficiency of less than 3%. Our approach opens broad avenues for studying the motility of particles in complex environments where direct hydrodynamic approaches are not feasible.

PMID:37235635 | DOI:10.1073/pnas.2220033120

Powered by WPeMatico

Categories
Nevin Manimala Statistics

Methyl(Chloro)Isothiazolinone Contact Allergy: A Monocentric Experience From Turkey

Cutan Ocul Toxicol. 2023 May 26:1-11. doi: 10.1080/15569527.2023.2217244. Online ahead of print.

ABSTRACT

INTRODUCTION: Due to their ubiquitous use, isothiazolinones caused allergic contact dermatitis epidemics and their use was restricted by legal regulations.

OBJECTIVES: We aimed to evaluate demographic data, clinical findings, and patch test features of patients with methylisothiazolinone (MI) and/or methylchloroisothiazolinone(MCI) sensitivity in our study.

METHODS: This study is a bidirectional and cross-sectional study, between July 2020 and September 2021. A total of 616 patients, including prospective and retrospective populations, demographic data, clinical findings, and patch test results were reviewed. Patients’ demographics, patch test results, allergen sources, presence of occupational contact, and the characteristics of dermatitis attacks were recorded.

RESULTS: A total of 50 patients with MI and MCI/MI sensitivity, 36 male (72%) and 14 female (28%), were included in our study. The overall prevalence of MI and MCI/MI between 2014 and 2021 was 8.4% (52/616) with two peak levels in 2015(21%) and 2021 (20%). A statistically significant relationship was found between shampoo use and facial involvement (p = 0.031), shower gel use and arm involvement (p = 0.027), wet wipe use and hand involvement (p = 0.049), detergent use and the pulps (p = 0.026) and the lateral aspects of fingers involvement (p = 0.048), water-based dye use and periungual involvement (p = 0.047).

CONCLUSION: Although legal regulations related to MI and MCI/MI cause a decrease in the frequency of their sensitivities were still common causes of allergic contact dermatitis.

PMID:37235630 | DOI:10.1080/15569527.2023.2217244

Powered by WPeMatico

Categories
Nevin Manimala Statistics

The effect of postoperative anticoagulation on acute aortic dissection: a systematic review and meta-analysis

Front Cardiovasc Med. 2023 May 10;10:1173945. doi: 10.3389/fcvm.2023.1173945. eCollection 2023.

ABSTRACT

BACKGROUND AND AIM: The evolution of the false lumen after the repair of acute aortic dissection has been linked to numerous adverse clinical outcomes, including increased late mortality and a higher risk of reoperation. Despite the widespread use of chronic anticoagulation in patients who have undergone repair for acute aortic dissection, the effects of this therapy on false lumen evolution and its subsequent consequences are yet to be fully understood. This meta-analysis aimed to investigate the impact of postoperative anticoagulation on patients with acute aortic dissection.

METHODS: In PubMed, Cochrane Libraries, Embase, and Web of Science, we performed a systematic review of nonrandomized studies, comparing outcomes with postoperative anticoagulation vs. non-anticoagulation on aortic dissection. We investigated the status of false lumen (FL), aorta-related death, aortic reintervention, and perioperative stroke in aortic dissection patients with anticoagulation and non-anticoagulation.

RESULTS: After screening 527 articles, seven non-randomized studies were selected, including a total of 2,122 patients with aortic dissection. Out of these patients, 496 received postoperative anticoagulation while 1,626 served as controls. Meta-analyses of 7 studies revealed significantly higher FL patency in Stanford type A aortic dissection (TAAD) postoperative anticoagulation with an OR of 1.82 (95% CI: 1.22 to 2.71; Z = 2.95; I²=0%; P = 0.93). Moreover, there was no statistically significant difference between the two groups in aorta-related death, aortic reintervention, and perioperative stroke with an OR of 1.31 (95% CI: 0.56 to 3.04; Z = 0.62; I² = 0%; P = 0.40), 0.98 (95% CI: 0.66 to 1.47; Z = 0.09; I² = 23%; P = 0.26), 1.73 (95% CI: 0.48 to 6.31; Z = 0.83; I² = 8%; P = 0.35), respectively.

CONCLUSIONS: Postoperative anticoagulation was associated with higher FL patency in Stanford type A aortic dissection patients. However, there was no significant difference between the anticoagulation and non-anticoagulation groups in terms of aorta-related death, aortic reintervention, and perioperative stroke.

PMID:37234372 | PMC:PMC10206123 | DOI:10.3389/fcvm.2023.1173945

Categories
Nevin Manimala Statistics

Current status of transcatheter mitral valve replacement: systematic review and meta-analysis

Front Cardiovasc Med. 2023 May 10;10:1130212. doi: 10.3389/fcvm.2023.1130212. eCollection 2023.

ABSTRACT

INTRODUCTION: Mitral Regurgitation (MR) has a strong impact on quality of life and on mid-term survival. Transcatheter mitral valve replacement (TMVR) is rapidly expanding and a growing number of studies have been published recently.

METHODS: A systematic review of studies reporting on clinical data for patients with symptomatic severe MR undergoing TMVR was performed. Early- and mid-term outcomes (clinical and echocardiographic) were evaluated. Overall weighted means and rates were calculated. Risk ratios or mean differences were calculated for pre- and post-procedural comparisons.

RESULTS: A total of 12 studies and 347 patients who underwent TMVR with devices clinically available or under clinical evaluation were included. Thirty-day mortality, stroke and major bleeding rates were 8.4%, 2.6%, and 15.6%, respectively. Pooled random-effects demonstrated a significant reduction of ≥ grade 3+ MR (RR: 0.05; 95% CI: 0.02-0.11; p < 0.001) and in the rates of patients in NYHA class 3-4 after the intervention (RR: 0.27; 95% CI: 0.22-0.34; p < 0.001). Additionally, the pooled fixed-effect mean difference for quality of life based on the KCCQ score yielded an improvement in 12.9 points (95% CI:7.4-18.4, p < 0.001), and exercise capacity improved by a pooled fixed-effect mean difference of 56.8 meters in the 6-minute walk test (95% CI 32.2-81.3, p < 0.001).

CONCLUSIONS: Among 12 studies and 347 patients comprising the updated evidence with current TMVR systems there was a statistically significant reduction in ≥ grade 3+ MR and in the number of patients exhibiting poor functional class (NYHA 3 or 4) after the intervention. Overall rate of major bleeding was the main shortcoming of this technique.

PMID:37234369 | PMC:PMC10206247 | DOI:10.3389/fcvm.2023.1130212

Categories
Nevin Manimala Statistics

Transcriptome analysis reveals ADAMTS15 is a potential inflammation-related gene in remote ischemic postconditioning

Front Cardiovasc Med. 2023 May 10;10:1089151. doi: 10.3389/fcvm.2023.1089151. eCollection 2023.

ABSTRACT

BACKGROUND: Remote ischemic postconditioning (RIPostC) induced by brief episodes of the limb ischemia is a potential therapeutic strategy for myocardial ischemia/reperfusion injury, achieved by reducing cardiomyocyte death, inflammation and so on. The actual mechanisms underlying cardioprotection conferred by RIPostC remain unclear. Exploring gene expression profiles in myocardium at transcriptional level is helpful to deepen the understanding on the cardioprotective mechanisms of RIPostC. This study aims to investigate the effect of RIPostC on gene expressions in rat myocardium using transcriptome sequencing.

METHODS: Rat myocardium samples from the RIPostC group, the control group (myocardial ischemia/reperfusion group) and the sham group were performed transcriptome analysis using RNA sequencing. The levels of cardiac IL-1β, IL-6, IL-10 and TNFα were analyzed by Elisa. The expression levels of candidate genes were verified by qRT-PCR technique. Infarct size was measured by Evans blue and TTC staining. Apoptosis was assessed by TUNEL assays and caspase-3 levels were detected using western blotting.

RESULTS: RIPostC can markedly decrease infarct size and reduce the levels of cardiac IL-1β, IL-6 and increase the level of cardiac IL-10. This transcriptome analysis showed that 2 genes were up-regulated (Prodh1 and ADAMTS15) and 5 genes (Caspase-6, Claudin-5, Sccpdh, Robo4 and AABR07011951.1) were down-regulated in the RIPostC group. Go annotation analysis showed that Go terms mainly included cellular process, metabolic process, cell part, organelle, catalytic activity and binding. The KEGG annotation analysis of DEGs found only one pathway, amino acid metabolism, was up-regulated. The relative mRNA expression levels of ADAMTS15, Caspase-6, Claudin-5 and Prodh1 were verified by qRT-PCR, which were consistent with the RNA-seq results. In addition, the relative expression of ADAMTS15 was negatively correlated with the level of cardiac IL-1β (r = -0.748, P = 0.005) and positively correlated with the level of cardiac IL-10 (r = 0.698, P = 0.012). A negative correlation statistical trend was found between the relative expression of ADAMTS15 and the level of cardiac IL-6 (r = -0.545, P = 0.067).

CONCLUSIONS: ADAMTS15 may be a potential inflammation-related gene in regulation of cardioprotection conferred by remote ischemic postconditioning and a possible therapeutic target for myocardial ischemia reperfusion injury in the future.

PMID:37234367 | PMC:PMC10206167 | DOI:10.3389/fcvm.2023.1089151

Categories
Nevin Manimala Statistics

Validation of the Short Version of the Panic Agoraphobic Spectrum (PAS-SV) Questionnaire

Clin Neuropsychiatry. 2023 Apr;20(2):151-156. doi: 10.36131/cnfioritieditore20230207.

ABSTRACT

OBJECTIVE: a spectrum model of psychopathology has allowed, in recent years, to recognize the subclinical or sub-threshold symptomatology that may be associated with full-blown mental disorders. The conceptualization of a panic – agoraphobic spectrum was developed in consideration of the substantial clinical heterogeneity revealed by studies on panic disorder with or without agoraphobia. The current study aims to determine the psychometric properties of the Panic Agoraphobic Spectrum – Short Version (PAS-SV), a new questionnaire designed to identify the spectrum of panic – agoraphobic symptoms.

METHOD: 42 subjects with panic disorder or agoraphobia (PAD) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 41 subjects with autism spectrum disorder (ASD), and 60 healthy controls (HC) were recruited from the Psychiatric Clinic of the University of Pisa and assessed with the SCID-5, the Panic Disorder Severity Scale (PDSS) and the PAS-SV.

RESULTS: PAS-SV demonstrated a high level of internal consistency and the test-retest reliability for total and domain scores was excellent. PAS-SV domain scores were positively and significantly correlated with each other (p < 0.001), with Pearson’s coefficients ranging from 0.771 to 0.943. All the PAS-SV domain scores were highly correlated with the PAS-SV total score. The correlation coefficients between PAS-SV and alternative measures of panic – agoraphobic symptoms appeared all significant and positive. Significant differences among diagnostic groups on both PAS-SV domains and total scores were found. PAS-SV total score increased significantly and progressively from HC, to the ASD up to the PA group.

CONCLUSIONS: The PAS-SV showed excellent internal consistency and test-retest reliability and strong convergent validity with alternative dimensional measures of PA. The questionnaire performed differently among the three diagnostic groups, with an increasing score gradient from HC to patients with ASD to the PA group.

PMID:37234359 | PMC:PMC10206642 | DOI:10.36131/cnfioritieditore20230207