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Nevin Manimala Statistics

Global burden of skin and subcutaneous diseases and its association with socioeconomic status in children and adolescents: an analysis of the Global Burden of Diseases Study 2019

Arch Dermatol Res. 2024 Jul 5;316(7):457. doi: 10.1007/s00403-024-03212-9.

ABSTRACT

Skin and subcutaneous diseases are one of the most common problems affecting the health of children and adolescents. The purpose of this study was to investigate the burden of skin and subcutaneous diseases among children and adolescents and its association with socioeconomic status. Data was obtained from the Global Burden of Disease Study 2019. The number of cases, incidence rate, number of deaths, and death rate in 204 countries and territories from 1990 to 2019 were extracted and stratified by age, sex, and socioeconomic status. In 2019, the global incidence and death rates of skin and subcutaneous diseases in children and adolescents were 57966.98 (95% Uncertainty Interval [UI] 53776.15 to 62521.24) per 100,000 and 0.21 (95% UI 0.13 to 0.26) per 100,000, respectively. From 1990 to 2019, the global incidence rate increased by 5.80% (95% UI 4.82-6.72%) and the death rate decreased by 43.68% (95% UI 23.04-65.27%). The incidence and death rates were negatively correlated with socioeconomic status. Incidence rates were not different between females and males, but death rates were higher among females than males. The highest incidence and death rates were found in the 1-4-year age group and < 1-year age group, respectively. The global burden of skin and subcutaneous diseases in children and adolescents was characterized by regional imbalances. The global burden of skin and subcutaneous diseases in children and adolescents from poorer regions requires more attention. This study provides strong evidence for global policymaking for childhood and adolescent diseases.

PMID:38967834 | DOI:10.1007/s00403-024-03212-9

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Nevin Manimala Statistics

Trends by race and ethnicity in incidence and mortality of acral lentiginous melanoma: analysis of Surveillance, Epidemiology, and End Results 2000-2020

Arch Dermatol Res. 2024 Jul 5;316(7):456. doi: 10.1007/s00403-024-03167-x.

ABSTRACT

Limited data describe the epidemiology and risk factors of acral lentiginous melanoma (ALM). In this retrospective analysis, we examined trends in incidence and mortality of ALM among racial and ethnic minoritized populations. We queried 22 Surveillance, Epidemiology, and End Results registries for cases of ALM among Hispanics, non-Hispanic Asians or Pacific Islanders (NHAPIs), non-Hispanic Blacks (NHBs), and non-Hispanic Whites (NHWs) from 2000 through 2020. Age-adjusted incidence and annual percentage changes (APCs) were estimated. Kaplan-Meier curves were stratified by race and ethnicity and compared with log-rank tests. Cox proportional hazard regression models were adjusted for age, sex, race, ethnicity, income, urban-rural residence, stage, and treatment. Of 4188 total cases of ALM with complete data, our study cohort was comprised of 792 (18.9%) Hispanics, 274 (6.5%) NHAPIs, 336 (8.0%) NHBs, and 2786 (66.5%) NHWs. The age-adjusted incidence of ALM increased by 2.48% (P < 0.0001) annually from 2000 to 2020, which was driven by rising rates among Hispanics (APC 2.34%, P = 0.001) and NHWs (APC 2.69%, P < 0.0001). Incidence remained stable among NHBs (APC 1.15%, P = 0.1) and NHAPIs (APC 1.12%, P = 0.4). From 2000 through 2020, 765 (18.3%) patients died from ALM. Compared to NHWs, Hispanics, NHAPIs, and NHBs had significantly increased ALM-specific mortality (all P < 0.0001). Unadjusted and adjusted cause-specific mortality modeling revealed significantly elevated risk of ALM-specific mortality among Hispanics (hazard ratio [HR] 1.46, 95% confidence interval [CI] 1.22-1.75; adjusted hazard ratio [aHR] 1.38, 95% CI 1.14-1.66), NHAPIs (HR 1.80, 95% CI 1.41-2.32; aHR 1.58, 95% CI 1.23-2.04), and NHBs (HR 1.98, 95% CI 1.59-2.47; aHR 2.19, 95% CI 1.74-2.76) (all P < 0.001). Our study finds rising incidence of ALM among Hispanics and NHWs along with elevated risk of ALM-specific mortality among racial and ethnic minoritized populations. Future strategies to mitigate health inequities in ALM are warranted.

PMID:38967822 | DOI:10.1007/s00403-024-03167-x

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Nevin Manimala Statistics

Accuracy of navigation guided implant surgery for immediate loading complete arch restorations: Prospective clinical trial

Clin Implant Dent Relat Res. 2024 Jul 5. doi: 10.1111/cid.13360. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess navigation accuracy for complete-arch implant placement with immediate loading of digitally prefabricated provisional.

MATERIALS AND METHODS: Consecutive edentulous and terminal dentition patients requiring at least one complete-arch FDP were treated between December 2020 and January 2022. Accuracy was evaluated by superimposing pre-operative and post-operative cone beam computed tomography (CBCT), recording linear (mm) and angular (degrees) deviations. T-tests were performed to investigate the potential effect of the registration algorithm (fiducial-based vs. fiducial-free), type of references for the fiducial-free algorithm (teeth vs. bone screws), site characteristic (healed vs. post-extractive), implant angulation (axial vs. tilted), type of arch (maxilla vs. mandible) on the accuracy with p-value <0.05.

RESULTS: Twenty-five patients, 36 complete-arches, and 161 implants were placed. The overall mean angular deviation was 2.19° (SD 1.26°). The global platform and apex mean deviations were 1.17 mm (SD 0.57 mm), and 1.30 mm (SD 0.62 mm). Meaningful global platform (p = 0.0009) and apical (p = 0.0109) deviations were experienced only between healed and post-extraction sites. None of the analyzed variables significantly influenced angular deviation. Minor single-axis deviations were reported for the type of jaw (y-axis at implant platform and apex), registration algorithm (y-axis platform and z-axis deviations), and type of references for the fiducial-free algorithm. No statistically significant differences were found in relation to implant angulation.

CONCLUSIONS: Within the study limitations navigation was reliable for complete-arch implant placement with immediate loading digitally pre-fabricated FDP. AI-driven surface anatomy identification and calibration protocol made fiducial-free registration as accurate as fiducial-based, teeth and bone screws equal as references. Implant site characteristics were the only statistically significant variable with healed sites reporting higher accuracy compared to post-extractive. Live-tracked navigation surgery enhanced operator performance and accuracy regardless of implant angulation and type of jaw. A mean safety room of about 1 mm and 2° should be considered.

PMID:38967100 | DOI:10.1111/cid.13360

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Profiles of healthcare use of persons living with dementia: A population-based cohort study

Geriatr Gerontol Int. 2024 Jul 5. doi: 10.1111/ggi.14930. Online ahead of print.

ABSTRACT

AIM: Persons living with dementia are a heterogeneous population with complex needs whose healthcare use varies widely. This study aimed to identify the healthcare use profiles in a cohort of persons with incident dementia, and to describe their characteristics.

METHODS: This is a retrospective cohort study of health administrative data in Quebec (Canada). The study population included persons who: (i) had an incident dementia diagnosis between 1 April 2015 and 31 March 2016; (ii) were aged ≥65 years and living in the community at the time of diagnosis. We carried out a latent class analysis to identify subgroups of healthcare users. The final number of groups was chosen based on clinical interpretation and statistical indicators.

RESULTS: The study cohort consisted of 15 584 individuals with incident dementia. Four profiles of healthcare users were identified: (i) Low Users (36.4%), composed of individuals with minimal healthcare use and fewer comorbidities; (ii) Ambulatory Care-Centric Users (27.5%), mainly composed of men with the highest probability of visiting cognition specialists; (iii) High Acute Hospital Users (23.6%), comprised of individuals mainly diagnosed during hospitalization, with higher comorbidities and mortality rate; and (iv) Long-Term Care Destined Users (12.5%), who showed the highest proportion of antipsychotics prescriptions and delayed hospitalization discharge.

CONCLUSIONS: We identified four distinct subgroups of healthcare users within a population of persons living with dementia, providing a valuable context for the development of interventions tailored to specific needs within this diverse population. Geriatr Gerontol Int 2024; ••: ••-••.

PMID:38967091 | DOI:10.1111/ggi.14930

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Multiarray screening identifies plasma proteins associated with Th17 cell differentiation and viral defense in coincident asthma and obesity

Pediatr Allergy Immunol. 2024 Jul;35(7):e14187. doi: 10.1111/pai.14187.

ABSTRACT

BACKGROUND: The immunological mechanisms behind the clinical association between asthma and obesity in adolescence are not fully understood. This study aimed to find new plasma protein biomarkers associated specifically with coincident asthma and obesity in adolescents.

METHODS: This was a cross-sectional study in children and adolescents 10-19 years old (N = 390). Relative plasma concentrations of 113 protein biomarkers related to inflammation and immune response were determined by proximity extension assay (Target 96; Olink, Uppsala, Sweden). Differences in protein concentrations between healthy controls (n = 84), subjects with asthma (n = 138), subjects with obesity (n = 107), and subjects with both asthma and obesity (AO; n = 58) were analyzed by ANCOVA, adjusting for age and sex, and in a separate model adjusting also for the sum of specific IgE antibody concentrations to a mix of food allergens (fx5) and aeroallergens (Phadiatop). Proteins elevated in the AO group but not in the obesity or asthma groups were considered specifically elevated in asthma and obesity.

RESULTS: Five proteins were elevated specifically in the AO group compared to controls (here sorted from largest to smallest effect of asthma and obesity combined): CCL8, IL-33, IL-17C, FGF-23, and CLEC7A. The effects of adjusting also for specific IgE were small but IL-33, IL-17C, and FGF-23 were no longer statistically significant.

CONCLUSION: We identified several new potential plasma biomarkers specifically elevated in coincident asthma and obesity in adolescents. Four of the proteins, CCL8, IL-33, IL-17C, and CLEC7A, have previously been associated with viral mucosal host defense and Th17 cell differentiation.

PMID:38967090 | DOI:10.1111/pai.14187

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Automatic soft-tissue analysis on orthodontic frontal and lateral facial photographs based on deep learning

Orthod Craniofac Res. 2024 Jul 5. doi: 10.1111/ocr.12830. Online ahead of print.

ABSTRACT

BACKGROUND: To establish the automatic soft-tissue analysis model based on deep learning that performs landmark detection and measurement calculations on orthodontic facial photographs to achieve a more comprehensive quantitative evaluation of soft tissues.

METHODS: A total of 578 frontal photographs and 450 lateral photographs of orthodontic patients were collected to construct datasets. All images were manually annotated by two orthodontists with 43 frontal-image landmarks and 17 lateral-image landmarks. Automatic landmark detection models were established, which consisted of a high-resolution network, a feature fusion module based on depthwise separable convolution, and a prediction model based on pixel shuffle. Ten measurements for frontal images and eight measurements for lateral images were defined. Test sets were used to evaluate the model performance, respectively. The mean radial error of landmarks and measurement error were calculated and statistically analysed to evaluate their reliability.

RESULTS: The mean radial error was 14.44 ± 17.20 pixels for the landmarks in the frontal images and 13.48 ± 17.12 pixels for the landmarks in the lateral images. There was no statistically significant difference between the model prediction and manual annotation measurements except for the mid facial-lower facial height index. A total of 14 measurements had a high consistency.

CONCLUSION: Based on deep learning, we established automatic soft-tissue analysis models for orthodontic facial photographs that can automatically detect 43 frontal-image landmarks and 17 lateral-image landmarks while performing comprehensive soft-tissue measurements. The models can assist orthodontists in efficient and accurate quantitative soft-tissue evaluation for clinical application.

PMID:38967085 | DOI:10.1111/ocr.12830

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Knowledge about HIV and Stigmatizing Attitudes of Medical Students in Saudi Arabia Towards Patients with HIV/AIDS: A Cross-Sectional Nationwide Study

Curr HIV Res. 2024 Jul 4. doi: 10.2174/011570162X306347240617192913. Online ahead of print.

ABSTRACT

BACKGROUND: The Human Immunodeficiency Virus (HIV) and the social stigma directed toward patients with HIV are serious public health issues. We aimed to evaluate the HIV knowledge base and stigmatizing attitudes toward patients with HIV among students enrolled in medical schools in Saudi Arabia.

METHODS: This cross-sectional study included students at medical colleges in Saudi Arabia and was conducted between February and March 2023. We used non-random convenience sampling with an online chain referral via a validated Arabic questionnaire composed of 35 questions. Data were analyzed using descriptive and comparative statistics.

RESULTS: A total of 1,213 medical students (women: 56.6%) participated in the study. Students in clinical years had a higher level of HIV knowledge than their pre-clinical colleagues. Logistic regression analysis revealed that participants who gave incorrect answers to questions related to mother-to-child and casual contact HIV transmission had a higher likelihood of harboring a negative attitude towards patients with HIV. Conversely, those who correctly answered queries on prevention and treatment were less likely to have stigmatizing attitudes. A significant proportion of this cohort harbored negative attitudes toward patients with HIV, with the sex and geographic location of participants being significant predictors of negative attitudes.

CONCLUSION: Our data have revealed a significant percentage of medical students in Saudi Arabia to have misconceptions about HIV transmission and prevention, and stigmatizing attitudes toward patients with HIV, indicating a need for targeted interventions to enhance the HIV knowledge base in this population of future caregivers.</p>.

PMID:38967071 | DOI:10.2174/011570162X306347240617192913

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Impact of reproductive traits on productive life in Iranian Holstein dairy cows

J Anim Breed Genet. 2024 Jul 5. doi: 10.1111/jbg.12888. Online ahead of print.

ABSTRACT

Enhancing reproductive performance is a key strategy to mitigate involuntary culling rates, thereby extending productive life (PL) and ultimately improving profitability in dairy cattle herds. A piecewise Weibull proportional hazards model was used to investigate the effect of several important reproductive traits on PL in Holstein dairy cows. Data comprised 200,747 lactation records from 82,505 cows sired by 1952 bulls across 36 dairy herds. PL was defined as the number of days from the first calving to the last milk record or censoring. The statistical model accounted for the time-dependent fixed effects of changes in herd size, year-season, milk production, fat and protein contents, and the time-independent fixed effect of age at first calving. Herd-year and sire effects were also included as random effects. Reproductive traits include calving traits such as calving ease (CE), calf size (CZ), and calf survival (CS), as well as female fertility traits such as number of inseminations per conception (NI), days from calving to first service (CFS), days from first service to conception (FSC), and days open (DO). All reproductive traits had a significant effect on PL (p < 0.001). Each reproductive trait was analysed separately. The relative risk (RR) of being culled increased as the severity of calving difficulties increased in both primiparous and multiparous cows. Cows that calved small or large calves showed a higher risk of being culled compared with those that calved medium size calves. The increased RR of culling was observed only for primiparous cows that gave birth to dead calves. In addition, cows that required more NI, a longer CFS, FSC, and DO had shorter longevity. These insights can deepen our comprehension of the factors affecting PL and provide information for refining management and breeding strategies, which could lead to increased profitability and sustainability in Iranian dairy farming.

PMID:38967064 | DOI:10.1111/jbg.12888

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Insular and limbic abnormal functional connectivity in early-stage Parkinson’s disease patients with autonomic dysfunction

Cereb Cortex. 2024 Jul 3;34(7):bhae270. doi: 10.1093/cercor/bhae270.

ABSTRACT

Autonomic symptoms in Parkinson’s disease result from variable involvement of the central and peripheral systems, but many aspects remain unclear. The analysis of functional connectivity has shown promising results in assessing the pathophysiology of Parkinson’s disease. This study aims to investigate the association between autonomic symptoms and cortical functional connectivity in early Parkinson’s disease patients using high-density EEG. 53 early Parkinson’s disease patients (F/M 18/35) and 49 controls (F/M 20/29) were included. Autonomic symptoms were evaluated using the Scales for Outcomes in Parkinson’s disease-Autonomic Dysfunction score. Data were recorded with a 64-channel EEG system. We analyzed cortical functional connectivity, based on weighted phase-lag index, in θ-α-β-low-γ bands. A network-based statistic was used to perform linear regression between Scales for Outcomes in Parkinson’s disease-Autonomic Dysfunction score and functional connectivity in Parkinson’s disease patients. We observed a positive relation between the Scales for Outcomes in Parkinson’s disease-Autonomic Dysfunction score and α-functional connectivity (network τ = 2.8, P = 0.038). Regions with higher degrees were insula and limbic lobe. Moreover, we found positive correlations between the mean connectivity of this network and the gastrointestinal, cardiovascular, and thermoregulatory domains of Scales for Outcomes in Parkinson’s disease-Autonomic Dysfunction. Our results revealed abnormal functional connectivity in specific areas in Parkinson’s disease patients with greater autonomic symptoms. Insula and limbic areas play a significant role in the regulation of the autonomic system. Increased functional connectivity in these regions might represent the central compensatory mechanism of peripheral autonomic dysfunction in Parkinson’s disease.

PMID:38967041 | DOI:10.1093/cercor/bhae270

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Effects of epidural analgesia at 1 cm cervical dilatation on multiparae: A retrospective cohort study using propensity score-matching

Int J Gynaecol Obstet. 2024 Jul 5. doi: 10.1002/ijgo.15759. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of the present study was to investigate the effects of epidural analgesia (EA) administered at cervical dilatation of 1 cm on multiparae who underwent vaginal delivery.

METHODS: This propensity score-matched retrospective cohort research was conducted between 2021 and 2022. All the singleton multiparae who had previous successful vaginal deliveries and epidural analgesia during this delivery were screened for eligibility. The primary outcome was the effect of EA on the duration of labor. The main secondary outcomes included the incidence of cesarean delivery and umbilical arterial pH.

RESULTS: This study incorporated 686 multiparae who were divided into two cohorts: EA 1 (cervical dilatation = 1 cm, n = 166) and EA 2 (cervical dilatation >1 cm, n = 520). In the propensity score-matched cohort (including 164 women in each group), there were no statistically significant differences in the incidence of cesarean delivery (4 [2.4%] vs 4 [2.4%], P = 1.000), umbilical arterial pH (7.28 ± 0.06 vs 7.28 ± 0.07, P = 0.550) and other secondary outcomes between the two groups. Based on a comparative assessment of the women who delivered vaginally to the Kaplan-Meier curves and propensity score-matching (including 160 women in each group), there was no statistical significance in the duration of the first, second and third stages of labor (log rank P, P = 0.811; P = 0.413; P = 0.773, respectively).

CONCLUSION: Initiation of epidural analgesia at cervical dilatation of 1 cm in multiparae did not cause adverse effects with regard to the duration of labor, increased cesarean deliveries, and bad neonatal outcomes.

PMID:38967034 | DOI:10.1002/ijgo.15759