Tag: statistics

Curr Probl Cardiol. 2024 Jul 5:102739. doi: 10.1016/j.cpcardiol.2024.102739. Online ahead of print.

ABSTRACT

BACKGROUND: The frequency and risk factors for gastrointestinal bleed (GIB) in patients with heart failure with reduced ejection fraction (HFrEF) have not been extensively researched.

OBJECTIVE: We aim to assess the frequency of GIB in this subset of patients and identify potential risk factors for bleeding. This study will evaluate the frequency of commonly used antiplatelet and anticoagulation agents in the HFrEF population, as well as look at some of the endoscopic features of the GIB.

METHODS: A retrospective cohort analysis of 670 patients admitted between November 2021 to August 2023 to a single urban, tertiary teaching institution with acute HFrEF ICD-10 codes. Upper or lower GIB (hematemesis, coffee ground emesis, melena or hematochezia during admission) was identified on a manual chart review. Patients with GIB were defined as our cases. No GIB was defined as our controls. Sub analysis included comparing the use of anticoagulant and antiplatelet between the cohort. Independent t test assessed statistical differences in the case and control groups RESULTS: Out of the 670 patients, 134 (20%) were identified with GIB. The cases were older than the controls (median age 77 vs. 70 years) (p = 0.001), had a lower hemoglobin (9 g/dL vs. 12 g/dL) (p =<0.05), and had higher BNP levels (7,938 pg/ml vs. 6472 pg/ml) (IQR: 3,239, 23,701) (p =<0.01). Among the anticoagulant users, 64% of cases were on an anticoagulant compared to 42% of the controls (p<0.05). Among the antiplatelet users, 68% of the controls were on one or more antiplatelet agents, compared to 52% in the controls (p = 0.01). When combining AC and AP treatment, there was no statistical difference between cases and controls. Ninety-three (69%) patients from cases had cross-sectional imaging with only 23 (25%) showing abnormal findings which included diverticulosis, colitis, and GI masses. When comparing upper endoscopy findings, the presence of esophageal diseases (esophagitis and esophageal varices) and gastric/duodenal diseases (gastritis, gastric ulcer, duodenal ulcer and AVM) were significantly higher in cases compared to controls (p < 0.05). In addition to the colonoscopy findings, polyps and diverticulosis were more prevalent in the cases compared to the controls (p = 0.01).

CONCLUSION: Heart failure patients are at risk of developing GIB. Age and high BNP on admission are risk factors for GIB, the higher the BNP levels the higher risk of GIB. Anticoagulant and antiplatelet use are associated with a higher risk of bleeding. However, the addition of dual antiplatelet therapy or concurrent antiplatelet and anticoagulation does not increase the risk of GIB. Some of the most common upper endoscopy findings include esophagitis/gastritis and esophageal/gastric ulcer. In terms of colonoscopy, findings include colonic mass, diverticulosis and hemorrhoids.

PMID:38972470 | DOI:10.1016/j.cpcardiol.2024.102739

Postgrad Med J. 2024 Jul 8:qgae045. doi: 10.1093/postmj/qgae045. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the phenotype of sarcoidosis according to the time when a malignancy is diagnosed (preexisting to the diagnosis of sarcoidosis, concomitant, or sequential) and to identify prognostic factors associated with malignancies in a large cohort of patients with sarcoidosis.

METHODS: We searched for malignancies in the SARCOGEAS cohort, a multicenter nationwide database of consecutive patients diagnosed with sarcoidosis according to the ATS/ESC/WASOG criteria. Solid malignancies were classified using the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) nomenclature, and hematological malignancies using the 2016 WHO classification. We excluded patients with a biopsy-proven diagnosis of sarcoidosis based exclusively on demonstrating granulomas in tissues also involved by malignant cells.

RESULTS: Out of 1942 patients with sarcoidosis, 233 (12%) developed 250 malignancies, including solid (n = 173), hematological (n = 57), and both types of malignancies (n = 3). Concerning the time interval between the diagnoses of both conditions, 83 (36%) patients were diagnosed with malignancy at least 1 year before sarcoidosis diagnosis, 22 (9%) had s synchronous diagnosis of both diseases, and 118 (51%) developed malignancies at least 1 year after the diagnosis of sarcoidosis (the remaining cases developed malignancies in different time intervals). The multivariate-adjusted model showed that individuals with sarcoidosis who developed a malignancy had an hazard ratio (HR) of 2.27 [95% confidence interval (CI), 1.62-3.17] for having an asymptomatic clinical phenotype at diagnosis of sarcoidosis and that spleen (presence vs. absence: HR = 2.06; 95% CI, 1.21-3.51) and bone marrow (presence vs. absence: HR = 3.04; 95% CI, 1.77-5.24) involvements were independent predictors for the development of all-type malignancies. No predictive factors were identified when the analysis was restricted to the development of solid malignancies. The analysis limited to the development of hematological malignancies confirmed the presence of involvement in the spleen (HR = 3.73; 95% CI, 1.38-10.06) and bone marrow (presence vs. absence: HR = 8.00; 95% CI, 3.15-20.35) at the time of sarcoidosis diagnosis as predictive factors.

CONCLUSION: It is essential to consider the synchronous or metachronous timing of the diagnosis of malignancies in people with sarcoidosis. We found that half of the malignancies were diagnosed after a diagnosis of sarcoidosis, with spleen and bone marrow involvement associated with a four to eight times higher risk of developing hematological malignancies. Key messages What is already known on this topic Malignancies are one of the comorbidities more frequently encountered in people with sarcoidosis What this study adds Malignancies occur in 12% of patients with sarcoidosis Malignancy may precede, coincide with, or follow the diagnosis of sarcoidosis One-third were identified before sarcoidosis, and half were diagnosed after Spleen and bone marrow involvement are risk factors for developing hematological malignancies How this study might affect research, practice or policy Patients with sarcoidosis should be regularly monitored for neoplasms, informed of the increased risk, and educated on early detection. Those with spleen or bone marrow involvement must be closely followed.

PMID:38972066 | DOI:10.1093/postmj/qgae045

Nat Prod Res. 2024 Jul 7:1-9. doi: 10.1080/14786419.2024.2375319. Online ahead of print.

ABSTRACT

This study’s main objectives are to evaluate and confirm the effects of the extraction process, operating conditions, solvent type and solvent polarity on the yield and quality of the extracts. Supercritical carbon dioxide (scCO₂) and Soxhlet were specially used in this study to extract bioactive chemicals from the seeds of a natural plant known as Plantago ovata. No studies have been published so far regarding the extraction from the seeds of this plant using scCO₂.The effects of three operating parameters (pressure, temperature and particle size) on the extraction yield, total phenolic content, total flavonoid content (TFC), total tannin content (TTC) and antioxidant activity were assessed in this study using the Box-Behnken statistical experimental design (BBD). The chemical components in the extracts were separated and identified using gas chromatography mass spectrometry. According to the antioxidant activity results, scCO₂ failed to produce bioactive compounds with interesting properties when operated within operating range conditions.

PMID:38972058 | DOI:10.1080/14786419.2024.2375319

Account Res. 2024 Jul 7:1-19. doi: 10.1080/08989621.2024.2374567. Online ahead of print.

ABSTRACT

The exponential growth of MDPI and Frontiers over the last decade has been powered by their extensive use of special issues. The “special issue-ization” of journal publishing has been particularly associated with new publishers and seen as potentially “questionable.” Through an extended case-study analysis of three journals owned by one of the “big five” commercial publishers, this paper explores the risks that this growing use of special issues presents to research integrity. All three case-study journals show sudden and marked changes in their publication patterns. An analysis of special issue editorials and retraction notes was used to determine the specifics of special issues and reasons for retractions. Descriptive statistics were used to analyse data. Findings suggest that these commercial publishers are also promoting special issues and that article retractions are often connected to guest editor manipulation. This underlies the threat that “special issue-ization” presents to research integrity. It highlights the risks posed by the guest editor model, and the importance of extending this analysis to long-existing commercial publishers. The paper emphasizes the need for an in-depth examination of the underlying structures and political economy of science, and a discussion of the rise of gaming and manipulation within higher education systems.

PMID:38972046 | DOI:10.1080/08989621.2024.2374567

Interdiscip Sci. 2024 Jul 7. doi: 10.1007/s12539-024-00640-z. Online ahead of print.

ABSTRACT

The emergence of antibiotic-resistant microbes raises a pressing demand for novel alternative treatments. One promising alternative is the antimicrobial peptides (AMPs), a class of innate immunity mediators within the therapeutic peptide realm. AMPs offer salient advantages such as high specificity, cost-effective synthesis, and reduced toxicity. Although some computational methodologies have been proposed to identify potential AMPs with the rapid development of artificial intelligence techniques, there is still ample room to improve their performance. This study proposes a predictive framework which ensembles deep learning and statistical learning methods to screen peptides with antimicrobial activity. We integrate multiple LightGBM classifiers and convolution neural networks which leverages various predicted sequential, structural and physicochemical properties from their residue sequences extracted by diverse machine learning paradigms. Comparative experiments exhibit that our method outperforms other state-of-the-art approaches on an independent test dataset, in terms of representative capability measures. Besides, we analyse the discrimination quality under different varieties of attribute information and it reveals that combination of multiple features could improve prediction. In addition, a case study is carried out to illustrate the exemplary favorable identification effect. We establish a web application at http://amp.denglab.org to provide convenient usage of our proposal and make the predictive framework, source code, and datasets publicly accessible at https://github.com/researchprotein/amp .

PMID:38972032 | DOI:10.1007/s12539-024-00640-z

Arch Orthop Trauma Surg. 2024 Jul 7. doi: 10.1007/s00402-024-05442-y. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to evaluate whether a combination of platelet-rich plasma (PRP) and hyaluronic acid (HA) is more effective and safer than injection alone for treating KOA.

MATERIALS AND METHODS: MEDLINE (PubMed), the Cochrane Library, EMBASE, and Web of Science databases were systematically searched for articles published until January 2024, and gray literature and bibliographic references were searched. All published randomized controlled trials (RCTs) compared pain, functional outcomes, and adverse events (AEs) associated with PRP + HA therapy vs. PRP or HA treatments. Two independent researchers extracted the pertinent data and evaluated the methodological quality following the PRISMA guidelines. The primary outcomes were pain, functional outcomes, and AEs. A fixed-effects model was used for data analysis in cases with low heterogeneity (P > 0.10 and I² < 50%). Otherwise, a random effects model was used.

RESULTS: Ten RCTs involving 943 patients were included in the analysis. The statistical findings did not differ between the treatment of PRP + HA and PRP alone, while a discernible enhancement in treatment efficacy was observed when compared to HA monotherapy: the visual analog scale scores at 1- (mean difference[MD], -1.00; 95% CI: -1.37 – -0.62; P < .001), 6- (MD, -1.87; 95% CI: -3.46 – -0.28; P = .02), 12-months (MD, -2.07; 95% CI: -3.77 – -0.38; P = .02), and the Western Ontario and McMaster Universities Arthritis Index total scores at 12-months (MD, -8.82; 95% CI: -14.48 – -3.16; P = .002). The incidence of adverse events was notably lower with PRP + HA than with HA alone (OR, 0.37; 95% CI: 0.19 – 0.69; P = .00) or PRP alone (OR, 0.51; 95% CI, 0.30 – 0.87; P = .01).

CONCLUSIONS: PRP + HA therapy resulted in more pronounced pain and functional improvement in symptomatic KOA patients than HA treatments, and combination therapy may have higher clinical safety than PRP or HA monotherapy.

PMID:38972025 | DOI:10.1007/s00402-024-05442-y

Ophthalmic Physiol Opt. 2024 Jul 7. doi: 10.1111/opo.13362. Online ahead of print.

ABSTRACT

PURPOSE: To assess the associations between physiology and demographics, non-ocular pathology and pharmaceutical drug use against peri-papillary retinal nerve fibre layer thickness (pRNFL T) and other optical coherence tomography (OCT) inner retinal measures in normal, healthy eyes.

METHODS: A retrospective, cross-sectional study of 705 consecutive participants with bilateral normal, healthy optic nerves and maculae. PRNFL Ts, vertical cup/disc ratio (CDR), cup volume and macular ganglion cell layer-inner plexiform layer (GCL-IPL) Ts were extracted from Cirrus OCT scans, then regressed against predictor variables of participants’ physiology and demographics (eye laterality, refraction, intraocular pressure [IOP], age, sex, race/ethnicity, etc.) and non-ocular pathology and pharmaceutical drug use according to the World Health Organisation classifications. Associations were assessed for statistical significance (p < 0.05) and clinical significance (|β| > 95% limits of agreement for repeated measures).

RESULTS: A multitude of non-ocular pathology and pharmaceutical drug use were statistically and clinically significantly associated with deviations in standard OCT inner retinal measures, exceeding the magnitude of other factors such as age, IOP and race/ethnicity. Thinner inner retina and larger optic nerve cup measures were linked to use of systemic corticosteroids, sex hormones/modulators, presence of vasomotor/allergic rhinitis and other diseases and drugs (up to -29.3 [-49.88, -8.72] μm pRNFL T, 0.31 [0.07, 0.54] vertical CDR, 0.29 [0.03, 0.54] mm³ cup volume and -10.18 [-16.62, -3.74] μm macular GCL-IPL T; all p < 0.05). Thicker inner retina and smaller optic nerve cup measures were diffusely associated with use of antineoplastic agents, presence of liver or urinary diseases and other diseases and drugs (up to 67.12 [64.92, 69.31] μm pRNFL T, -0.31 [-0.53, -0.09] vertical CDR, -0.06 [-0.11, 0] mm³ cup volume and 28.84 [14.51, 43.17] μm macular GCL-IPL T; all p < 0.05).

CONCLUSION: There are a multitude of systemic diseases and drugs associated with altered OCT inner retinal measures, with magnitudes far exceeding those of other factors such as age, IOP and race/ethnicity. These systemic factors should at least be considered during OCT assessments to ensure precise interpretation of normal versus pathological inner retinal health.

PMID:38972015 | DOI:10.1111/opo.13362

J Psychiatr Ment Health Nurs. 2024 Jul 7. doi: 10.1111/jpm.13082. Online ahead of print.

ABSTRACT

INTRODUCTION: Caring for those who have been traumatized can place mental health professionals at risk of secondary traumatic stress, particularly in those with their own experience of personal trauma.

AIM: To identify the prevalence of personal trauma history and secondary traumatic stress in mental health professionals and whether there is an association between these two variables in mental health professionals.

METHOD: We preregistered the review with PROSPERO (CRD42022322939) and followed PRISMA guidelines. Medline, Embase, PsycINFO, Web of Science and CINHAL were searched up until 17th August 2023. Articles were included if they assessed both personal trauma history and secondary traumatic stress in mental health professionals. Data on the prevalence and association between these variables were extracted. Quality assessment of included studies was conducted using an adapted form of the Newcastle-Ottawa scale.

RESULTS: A total of 23 studies were included. Prevalence of personal trauma history ranged from 19%-81%, secondary traumatic stress ranged from 19% to 70%. Eighteen studies reported on the association between personal trauma history and secondary traumatic stress, with 14 out of 18 studies finding a statistically significant positive relationship between these variables. The majority of studies were of fair methodological quality.

DISCUSSION: Mental health professionals with a personal history of trauma are at heightened risk of suffering from secondary traumatic stress.

IMPLICATIONS FOR PRACTICE: Targeted support should be provided to professionals to prevent and/or address secondary traumatic stress in the workforce.

PMID:38972012 | DOI:10.1111/jpm.13082

Clin Exp Optom. 2024 Jul 7:1-6. doi: 10.1080/08164622.2024.2374871. Online ahead of print.

ABSTRACT

CLINICAL RELEVANCE: Understanding the causes of visual symptoms in epilepsy patients is important for early diagnosis and taking precautions.

BACKGROUND: The aim of this study is to evaluate the anterior and posterior segment parameters in patients with generalized tonic-clonic epilepsy (GTCE).

METHODS: This retrospective study included 50 eyes of 50 patients with GTCE and 55 eyes of 55 healthy controls. For all participants, detailed ophthalmic examinations were obtained from the files of patients. Anterior segment parameters were measured using corneal topography and non-contact specular microscopy, and posterior segment parameters were measured using swept-source optical coherence tomography.

RESULTS: The mean age of the patients with GTCE was 43.3 ± 13.2 years, and in the healthy controls it was 47.6 ± 10.7 years (p = 0.405). In GTCE patients, 34 patients were treated with monotherapy (MT) and 16 patients with polytherapy (PT). Central macular thickness (CMT) was statistically significantly thin in GTCE patients (p = 0.001). The average and four quadrants (superior, inferior, nasal, temporal) retinal nerve fibre layer (RNFL) were thinner in GTCE patients than in the healthy controls, but there was no statistically significant difference (p > 0.05, all). The central corneal thickness was statistically significantly thin in GTCE patients (p = 0.04). Endothelial cell density (ECD), endothelial cell number (ECN), and average cell area (ACA) were statistically significantly lower in GTCE patients than in the healthy controls (p < 0.05, all). Although the CMT, average, and four-quadrants RNFL were thinner in the PT group compared to the MT group, no statistically significant difference was observed (p > 0.05, all). Total high-order aberrations (HOAs) were 0.6 ± 0.4 in the MT group and 0.4 ± 0.1 in the PT group (p = 0.01). ECD, ECN, and ACA measurements were observed to be lower in the PT group compared to the MT group, but no statistically significant difference was detected (p > 0.05, all).

CONCLUSION: There could be statistically significant differences between GTCE patients and healthy controls in anterior and posterior segment parameters. This situation may be due to the epilepsy itself or to the antiepileptic drugs.

PMID:38972001 | DOI:10.1080/08164622.2024.2374871

J Vet Emerg Crit Care (San Antonio). 2024 Jul 7. doi: 10.1111/vec.13406. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate differences in point-of-care (POC) variables obtained from arterial and jugular venous blood in dogs undergoing manual basic life support (BLS) and report changes over time.

DESIGN: Experimental study.

SETTING: Small animal research facility.

ANIMALS: Twenty-four purpose-bred research dogs.

INTERVENTIONS: Dogs were anesthetized, and arterial catheters were placed before euthanasia. One minute after cardiopulmonary arrest, BLS consisting of manual chest compressions and ventilation delivered via endotracheal intubation, face mask, mouth-to-nose, or no ventilation was initiated. Paired arterial and jugular venous blood samples were obtained for POC testing before euthanasia (T₀), at 3 minutes (T₃), and at 6 minutes (T₆) into BLS.

MEASUREMENTS AND MAIN RESULTS: The association of POC variables with arterial or venous sample type while controlling for type of ventilation and sampling timepoint was determined using a generalized linear mixed model. Variables obtained from arterial and venous blood samples were compared over time using repeated measures ANOVA or Friedman test. Pao₂, anion gap, potassium, chloride, glucose concentration, and PCV were significantly higher in arterial blood samples compared with venous samples (P < 0.03). By T₆, arterial glucose concentration, arterial and venous base excess, venous pH, and plasma lactate, potassium, creatinine, bicarbonate, and sodium concentrations were significantly increased, and arterial and venous Po₂, ionized calcium concentration, PCV, and total plasma protein concentration were significantly decreased from T₀ (P < 0.05).

CONCLUSIONS: Although statistically significant, arteriovenous differences and changes in POC blood variables during BLS were small and not clinically relevant over time. Given the challenges of arterial blood sampling, it may be reasonable to pursue venous blood sampling during CPR. Further studies in dogs undergoing BLS and advanced life support are needed to better understand the potential clinical role of POC testing during CPR.

PMID:38971981 | DOI:10.1111/vec.13406