Tag: statistics

Zh Nevrol Psikhiatr Im S S Korsakova. 2023;123(12):59-64. doi: 10.17116/jnevro202312312159.

ABSTRACT

OBJECTIVE: Studying the effectiveness of the combined use of intraosseous blockades (IOB) and intramuscular local injection therapy using bottled forms of Chondroreparant Gialripayer 02/10 in patients with lumbar dorsopathy and recurrent back pain syndrome.

MATERIAL AND METHODS: 30 patients (16 men and 14 women) with chronic recurrent lumbar dorsopathy with pain and myofascial syndromes were examined. Group 1 included 17 patients, whose treatment included the use of IOB and intramuscular local injection therapy using bottled forms of Chondroreparant Gialripayer 02/10. Group 2 included 13 patients who received only IOB. To assess the pain syndrome, a visual analogue pain scale (VAS), a Russian version of the McGill Pain Questionnaire (MPBI), and a body diagram questionnaire were used.

RESULTS: After the course of treatment, in both groups there was a decrease in the severity of pain according to VAS, RMBO, and a decrease in the area of pain distribution according to the Body Scheme questionnaire (p<0.05). The values on the RMBO questionnaire in both groups also decreased by more than 2 times compared to the initial value. A statistically more significant regression of pain syndrome and a decrease in disability were noted in group 1 (p<0.05). 2 months after the end of the course of treatment, the pain syndrome did not recur in any patient. Within 3 to 6 months, back pain recurred in 4 (23.5%) patients of the 1st group and in 6 (46.2%) patients of the 2nd group. A total of 90 IOB procedures were performed; no complications or side effects were noted.

CONCLUSION: The combination of IOB and intramuscular local injection therapy using the vial form of Chondroreparant Gialripayer in the treatment of patients with degenerative diseases of the spine and back pain is an effective and safe method of therapy. Such treatment strategy allowed to relieve back pain more effectively and improved long-term clinical outcome.

PMID:38147383 | DOI:10.17116/jnevro202312312159

JAMA Pediatr. 2023 Dec 26. doi: 10.1001/jamapediatrics.2023.5721. Online ahead of print.

ABSTRACT

IMPORTANCE: Dysfunctional patterns of behavior during infancy can predict the emergence of mental health disorders later in childhood. The Baby Pediatric Symptom Checklist (BPSC) can identify indicators of behavioral disorders among children aged 0 to 18 months. Understanding the association of early health-related social needs (HRSNs) with poor infant behavioral functioning can inform interventions to promote early childhood mental well-being.

OBJECTIVE: To examine the association between household HRSNs in the first 4 months of life and BPSC results at 6 months.

DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective cohort analysis of longitudinal electronic health record data. Covariates were selected based on the biopsychosocial ecological model. Logistic regression analyses examined the association of HRSN domains and the number of HRSNs with the 6-month BPSC outcomes. Participants were recruited from 6 primary care clinics within 1 health system. Children aged 5 to 8 months who were evaluated for 6-month well-child visits between March 30, 2021, and June 30, 2022, were included in the study.

EXPOSURE: Responses to the first HRSN screening tool that a caregiver completed for infants between 0 and 4 months of age. HRSN domains were examined individually and as the number of positive HRSNs.

MAIN OUTCOME AND MEASURES: BPSC screen identified for clinical review due to 1 or more elevated subscales (inflexibility, irritability, and difficulty with routines) at 6 months.

RESULTS: A total of 1541 children (mean [SD] age, 6.1 [0.5] months; 775 female [50.3%]) were included in the study. A total of 405 children (26.3%) had a BPSC screen identified for clinical review, and 328 caregivers (21.3%) reported at least 1 HRSN. Food insecurity (174 [11.3%]) and benefits issues (169 [11.0%]) were the most frequently reported HRSN. Children in households with food insecurity had statistically significant higher odds of inflexibility (adjusted odds ratio [aOR], 1.73; 95% CI, 1.14-2.63), difficulty with routines (aOR, 1.64; 95% CI, 1.05-2.57), and irritability (aOR, 1.86; 95% CI, 1.13-3.08) than children in households without food insecurity. Children in households with benefits issues had statistically significant higher odds of difficulty with routines (aOR, 1.70; 95% CI, 1.10-2.65) and irritability (aOR, 1.70; 95% CI, 1.03-2.82). Children in households with 2 or more HRSNs had consistently higher odds of having a BPSC screen identified for clinical review (aOR, 2.16; 95% CI, 1.38-3.39) compared with children with no HRSNs.

CONCLUSIONS AND RELEVANCE: Results of this cohort study suggest that household food insecurity, benefits issues, and the number of HRSNs were significantly associated with a BPSC screen identified for clinical review at 6 months of age. These findings highlight the urgency of intervening on HRSNs in the newborn period to prevent adverse infant behavioral outcomes.

PMID:38147349 | DOI:10.1001/jamapediatrics.2023.5721

JAMA Netw Open. 2023 Dec 1;6(12):e2349241. doi: 10.1001/jamanetworkopen.2023.49241.

ABSTRACT

IMPORTANCE: It remains unclear whether pet ownership is associated with cognitive decline and to what extent pet ownership mitigates the association between living alone and cognitive decline.

OBJECTIVE: To explore the association of pet ownership with cognitive decline, the interaction between pet ownership and living alone, and the extent to which pet ownership mitigates the association between living alone and cognitive decline in older adults.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from waves 5 (June 2010 to July 2011) to 9 (from June 2018 to July 2019) in the English Longitudinal Study of Ageing. Participants included adults 50 years and older. Data were analyzed from April 1 to June 30, 2023.

EXPOSURES: Pet ownership and living alone in wave 5.

MAIN OUTCOMES AND MEASURES: In waves 5 to 9, verbal memory and verbal fluency were assessed, and composite verbal cognition was further calculated.

RESULTS: Of the 7945 participants included, the mean (SD) age was 66.3 (8.8) years, and 4446 (56.0%) were women. Pet ownership was associated with slower rates of decline in composite verbal cognition (β = 0.008 [95% CI, 0.002-0.014] SD/y), verbal memory (β = 0.006 [95% CI, 0.001-0.012] SD/y), and verbal fluency (β = 0.007 [95% CI, 0.001-0.013] SD/y). Three-way interaction tests showed that living alone was a significant modifier in all 3 associations. Stratified analyses showed that pet ownership was associated with slower rates of decline in composite verbal cognition (β = 0.023 [95% CI, 0.011-0.035] SD/y), verbal memory (β = 0.021 [95% CI, 0.008-0.034] SD/y), and verbal fluency (β = 0.018 [95% CI, 0.005-0.030] SD/y) among individuals living alone, but not among those living with others. Joint association analyses showed no significant difference in rates of decline in composite verbal cognition, verbal memory, or verbal fluency between pet owners living alone and pet owners living with others.

CONCLUSIONS AND RELEVANCE: In this cohort study, pet ownership was associated with slower rates of decline in verbal memory and verbal fluency among older adults living alone, but not among those living with others, and pet ownership offset the associations between living alone and declining rates in verbal memory and verbal fluency. Further studies are needed to assess whether pet ownership slows the rate of cognitive decline in older adults living alone.

PMID:38147332 | DOI:10.1001/jamanetworkopen.2023.49241

Clin Exp Rheumatol. 2023 Dec 12. doi: 10.55563/clinexprheumatol/2537nv. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to describe the clinical features of patients with anti-melanoma differentiation-associated gene 5 (anti-MDA5) antibody-positive dermatomyositis (DM) who had macrophage activation syndrome (MAS).

METHODS: We retrospectively examined 44 patients with anti-MDA5-positive DM and compared the clinical features between patients with MAS (n = 11) and those without (n=33). Patients without MAS were selected randomly in the same year as those with MAS at a ratio of 3:1. Among patients with MAS, we compared the features between non-survivors and survivors. We used Fisher’s exact test, Student’s t test, the Mann-Whitney U test and the log-rank test for statistical analysis.

RESULTS: Patients complicated with MAS had a significantly higher incidence of infection, heliotrope sign, Gottron’s papule, V-neck sign, and higher serum levels of ferritin, aspartate aminotransferase (AST), lactic dehydrogenase (LDH), and creatine kinase (CK) than those without MAS (p<0.05). Among the 11 patients with MAS, 4 (36.4%) died after intensive treatment. Deceased patients were older, given more combination therapy with tofacitinib (TOF) and had a higher incidence of rapid progressive interstitial lung disease, infection, heart failure and renal impairment than those who survived (p<0.05).

CONCLUSIONS: Among anti-MDA5-positive DM, Infection, DM typical rashes, and higher serum levels of ferritin, AST, LDH, and CK were more common in patients complicated with MAS. The mortality of patients with MAS was high, particularly among patients who were older, given more combination therapy with TOF, and had RP-ILD, infection, heart failure and renal impairment.

PMID:38147318 | DOI:10.55563/clinexprheumatol/2537nv

Clin Exp Rheumatol. 2023 Dec 22. doi: 10.55563/clinexprheumatol/84kd56. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the clinical characteristics of subcutaneous emphysema (SE) and mediastinal emphysema (ME) occurring in patients with anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis associated with interstitial lung disease (anti-MDA5-positive DM-ILD).

METHODS: In this retrospective study, a total of 117 anti-MDA5-positive DM-ILD patients were admitted to our hospital. All patients underwent assessment of autoantibodies, serum ferritin levels, and lung high-resolution CT scans.

RESULTS: In patients with anti-MDA5-positive DM-ILD, the incidence of SE/ME was found to be 11.1%, which was significantly higher compared to patients with anti-synthetase syndrome (p < 0.01). The mortality rate among anti-MDA5-positive DM-ILD patients with SE/ME was significantly higher than those without SE/ME (p = 0.0022). There was no statistically significant difference in the occurrence of SE/ME between patients with positive anti-Ro-52 antibodies and those with negative anti-Ro-52 antibodies (p = 0.18). Patients with higher serum ferritin levels (1000 ng/ml≤serum ferritin≤1500 ng/ml) had a higher likelihood of developing SE/ME compared to patients with lower serum ferritin levels (serum ferritin <500 ng/ml) (p < 0.01). Among 13 anti-MDA5-positive DM-ILD patients with SE/ME, six (46.2%) developed SE/ME within 1 month of being diagnosed and 53.8% of patients underwent positive pressure ventilation prior to the onset of SE/ME.

CONCLUSIONS: 1. SE/ME is not uncommon in anti-MDA5-positive DM-ILD and is an important factor associated with poor patient prognosis. 2. The occurrence of SE/ME is correlated with high levels of serum ferritin and is not related to anti-Ro-52 antibodies. 3. Rheumatologists should pay close attention to SE/ME caused by positive pressure ventilation in anti-MDA5-positive DM-ILD patients.

PMID:38147317 | DOI:10.55563/clinexprheumatol/84kd56

Updates Surg. 2023 Dec 26. doi: 10.1007/s13304-023-01733-y. Online ahead of print.

ABSTRACT

The aim of this pooled analysis was to evaluate the impact of robotic total mesorectal excision (TME) on pathology metrics in Male Overweight patients with Low rectal cancer (MOL). This was a multicenter retrospective pooled analysis of data. Two groups were defined: MOL (Male, Overweight, Low rectal cancer) and non-MOL. Overweight was defined as BMI ≥ 25 kg/m². Low rectal cancer was defined as cancer within 6 cm from the anal verge. The primary endpoints of this study were histopathological metrics, namely circumferential resection margin (CRM) (mm), CRM involvement rate (%), and the quality of TME. Circumferential resection margin (CRM) was involved if < 1 mm. 836 (106 MOL and 730 non-MOL) patients that underwent robotic TME by six surgeons over 3 years were compared. No significant differences in demographics and perioperative variables were found, except for operating time, distal margin, and number of lymph nodes harvested. CRM involvement rate did not significantly differ (7.5% vs. 5.5%, p = 0.395). Mean CRM was statistically significantly narrower in MOL patients (6.6 vs. 7.7 mm, p = 0.04). Quality of TME did not differ. Distance of tumor from the anal verge was the only independent predictor of CRM involvement. Robotic TME may provide optimal pathology metrics in overweight males with low rectal cancer. Although CRM was a few millimeters narrower in MOL, the values were within the range of uninvolved margins making the difference statistically significant, but not clinically. Being MOL was not a risk factor for involvement of circumferential resection margin.

PMID:38147292 | DOI:10.1007/s13304-023-01733-y

Updates Surg. 2023 Dec 26. doi: 10.1007/s13304-023-01730-1. Online ahead of print.

ABSTRACT

Concerning the perioperative outcomes of patients diagnosed with COVID-19 who underwent emergency laparotomy, more data must be collected. Because COVID-19 can affect multiple organs, cause various complications, and act as a risk factor for surgery, in this study, we aimed to compare the outcomes of emergency laparotomy between SARS-CoV-2 infected and uninfected patients. This retrospective cohort study was conducted on patients who underwent emergency laparotomy from December 2021 to December 2022. Postoperative outcomes were compared between patients with and without confirmed perioperative SARS-CoV-2 infection. The primary outcome was 30-day mortality. Secondary outcomes were postoperative intensive care unit admission, hospital length of stay, re-operation, and postoperative complications. Data were analyzed by SPSS statistic version 27. In this study, 50 patients in the COVID-19 group and 91 patients in the non-COVID-19 group were assessed. The 30-day mortality in the COVID-19 group was significantly higher than in the non-COVID-19 group (34% vs. 12.1%, respectively, P = 0.004). Postoperative complications were significantly higher in the COVID-19 group (64% vs. 26.4%, P < 0.001). The frequency of ICU admission and need for re-operation were significantly higher in the COVID-19 group (P = 0.003 and P = 0.039, respectively). Length of hospital stay was significantly lower in the non-COVID-19 group (P = 0.021). In patients with confirmed COVID-19, emergency laparotomy is associated with increased postoperative morbidity and mortality. Additionally, emergency laparotomy is associated with increasing postoperative complications, length of hospital stay, intensive care admission, and additional surgery requirement.

PMID:38147291 | DOI:10.1007/s13304-023-01730-1

J Endocrinol Invest. 2023 Dec 26. doi: 10.1007/s40618-023-02263-5. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess and compare the immunogenicity of recombinant Insulin Aspart [manufactured by BioGenomics Limited (BGL-ASP)] with its originator NovoRapid® (manufactured by Novo Nordisk) in adult patients with type 2 diabetes mellitus.

RESEARCH DESIGN AND METHODS: BGL-IA-CTP301 study was a randomized, open label, parallel group, multicenter phase-III clinical study to compare the efficacy and safety of recombinant Insulin Aspart 100 U/mL [manufactured by BioGenomics Limited (BGL-ASP)] with its reference medicinal product (RMP); NovoRapid® [manufactured by Novo Nordisk], in adult patients with Type 2 diabetes mellitus (T2DM). The primary objective of the study was to compare the immunogenicity of BGL-ASP and RMP; NovoRapid® in patient serum samples collected from phase-III clinical study. Immunogenicity was studied as the incidence of patients positive for anti-insulin Aspart (AIA) antibodies, developed against BGL-ASP/RMP at baseline, end of 12 week and end of 24 week of the treatment period. The changes in incidence of patients positive for AIA antibodies post-baseline were also studied to assess and compare the treatment-emergent antibody response (TEAR) between the treatment groups (BGL-ASP and RMP). Statistical evaluation was done by Fisher’s exact test to compare the overall incidence of patients positive for AIA antibodies and the TEAR positives observed post-baseline in both the treated groups. An in-vitro neutralizing antibody assay (Nab assay) was also performed to study the effect of AIA antibodies in neutralizing the biological activity/metabolic function of the insulin. The neutralizing potential of AIA was studied by its effect on %glucose uptake. We also evaluated the association between AIA antibody levels and its impact on biological activity by studying the correlation between them.

RESULTS: Analysis of immunogenicity data suggested that the percentage of patients positive for AIA antibodies until week 24 was similar and comparable in both the treatment groups, BGL-ASP and RMP; NovoRapid®. The changes in incidence of patients positive for AIA post-baseline in terms of TEAR positives were also similar and comparable between the treatment groups. The results of the Nab assay with confirmed positive AIA samples from BGL-ASP- and RMP-treated groups did not have any negative impact on %glucose uptake by the cells in Nab assay, confirming the absence of neutralizing antibodies in both the treatment groups. The correlation studies also showed absence of association between AIA antibody levels and percentage glucose uptake in both BGL-ASP and RMP-NovoRapid® treatment groups^. CONCLUSIONS: The immunogenicity assessment based on the overall incidence of patients positive for AIA, changes in incidence of patients positive for AIA post-baseline, TEAR rates and absence of neutralizing antibodies, were found to be apparently similar and comparable in both the treatment groups (BGL-ASP and RMP). We conclude from our studies that the immunogenicity of BGL-ASP is similar and comparable to RMP and the observed immunogenicity in terms of anti-insulin Aspart antibody levels had no impact on the biological activity of insulin.

PMID:38147290 | DOI:10.1007/s40618-023-02263-5

Environ Monit Assess. 2023 Dec 26;196(1):88. doi: 10.1007/s10661-023-12257-8.

ABSTRACT

Small island ecosystems and their inhabitants face a significant threat from global warming, jeopardizing their sustainability. These communities are particularly vulnerable to the impact of climate change, as they heavily rely on natural resources for their livelihoods and are more vulnerable than mainland regions. Therefore, it is essential to take urgent action to address the challenges small island states face and promote their resilience in the face of climate change. To preserve the coastal ecosystems in Karimunjawa Islands, Indonesia, this study proposes an alternative spatial plan through micro-zonation analysis. The study conducted literature reviews and field surveys to collect data and develop recommendations for the current spatial plans through spatial, descriptive statistics, and comparative analysis. The findings show that the sea surface temperatures of Karimunjawa and Kemujan Island have increased by 1-2 ℃. Stress levels were found for coral reefs at the bleaching warning position for all Karimunjawa Island marine areas, including Kemujan Island. Legon Lele and Tanjung Gelam were found to have suspended sediment traces and indications of heavy metal contamination, making them the research focus. The Karimunjawa micro-zonation boundaries were obtained, especially in the Legon Lele and Tanjung Gelam areas, with an area of 640.63 and 817.45 ha, respectively. The proposed micro-zonation for Karimunjawa National Park refers to watershed-sedimentary cells, making it an example of implementing integrated coastal management (ICM) spatial boundaries in Karimunjawa and other nations. By applying this micro-zonation, coastal ecosystem rehabilitation efforts can be carried out precisely.

PMID:38147264 | DOI:10.1007/s10661-023-12257-8

Environ Sci Pollut Res Int. 2023 Dec 26. doi: 10.1007/s11356-023-31494-5. Online ahead of print.

ABSTRACT

As part of their pursuit to succeed the Sustainable Development Goals (SDGs), European Union (EU) countries have placed great importance on realizing SDG 11, which aims to create sustainable cities and communities. The relationship between environmental quality and municipal solid waste remains understudied despite its significant impact on achieving SDG-11. Consequently, this study seeks to peruse municipal solid waste, renewable energy consumption, human capital, and natural resources impact on load capacity as a comprehensive measure of environmental quality. By utilizing the CS-ARDL approach, this study reveals the inadequacy of municipal solid waste conversion in EU countries and highlights the favorable effect of human capital and renewable energy on enhancing environmental quality. Moreover, this study provides concrete evidence that natural resources contribute to environmental corruption. EU economies should adopt policies to bolster municipal solid waste conversion to improve environmental quality.

PMID:38147253 | DOI:10.1007/s11356-023-31494-5