Tag: statistics

Ticks Tick Borne Dis. 2023 Mar 28;14(4):102161. doi: 10.1016/j.ttbdis.2023.102161. Online ahead of print.

ABSTRACT

The geographic range of the blacklegged tick, Ixodes scapularis, is expanding northward from the United States into southern Canada, and studies suggest that the lone star tick, Amblyomma americanum, will follow suit. These tick species are vectors for many zoonotic pathogens, and their northward range expansion presents a serious threat to public health. Climate change (particularly increasing temperature) has been identified as an important driver permitting northward range expansion of blacklegged ticks, but the impacts of host movement, which is essential to tick dispersal into new climatically suitable regions, have received limited investigation. Here, a mechanistic movement model was applied to landscapes of eastern North America to explore 1) relationships between multiple ecological drivers and the speed of the northward invasion of blacklegged ticks infected with the causative agent of Lyme disease, Borrelia burgdorferi sensu stricto, and 2) its capacity to simulate the northward range expansion of infected blacklegged ticks and uninfected lone star ticks under theoretical scenarios of increasing temperature. Our results suggest that the attraction of migratory birds (long-distance tick dispersal hosts) to resource-rich areas during their spring migration and the mate-finding Allee effect in tick population dynamics are key drivers for the spread of infected blacklegged ticks. The modeled increases in temperature extended the climatically suitable areas of Canada for infected blacklegged ticks and uninfected lone star ticks towards higher latitudes by up to 31% and 1%, respectively, and with an average predicted speed of the range expansion reaching 61 km/year and 23 km/year, respectively. Differences in the projected spatial distribution patterns of these tick species were due to differences in climate envelopes of tick populations, as well as the availability and attractiveness of suitable habitats for migratory birds. Our results indicate that the northward invasion process of lone star ticks is primarily driven by local dispersal of resident terrestrial hosts, whereas that of blacklegged ticks is governed by long-distance migratory bird dispersal. The results also suggest that mechanistic movement models provide a powerful approach for predicting tick-borne disease risk patterns under complex scenarios of climate, socioeconomic and land use/land cover changes.

PMID:36996508 | DOI:10.1016/j.ttbdis.2023.102161

Radiography (Lond). 2023 Mar 28;29(3):573-576. doi: 10.1016/j.radi.2023.03.010. Online ahead of print.

ABSTRACT

INTRODUCTION: When the patient dose in mammography is assessed, it is important to evaluate both average glandular dose (AGD) and entrance surface dose (ESD). A dose survey on both AGD and ESD in mammography has never been studied in Sri Lanka. Therefore, the present study aimed to evaluate the patient dose received during a full-field digital breast tomosynthesis (DBT) examination by determining both AGD and ESD.

METHODS: The study was performed on 140 patients who underwent DBT examination. The AGD, ESD, compression breast thickness (CBT), half-value layer (HVL), target/filter combination, kVp, and mAs values were obtained from the machine, and AGD for each projection was calculated using the equation proposed by the Dance 2011.

RESULTS: The measured mean AGDs and ESDs of both the breasts were statistically significantly lower than the reference values given by European protocol (p < 0.05). There were no statistically significant differences in both AGDs and ESDs between the right and left breast, between right craniocauidal (RCC) and left craniocaudal (LCC), and between right mediolateral oblique (RMLO) and left mediolateral oblique (LMLO) examinations (p > 0.05). The measured median AGDs and ESDs received for MLO projections of both breasts were statistically significantly higher than that of CC projections (p < 0.05).

CONCLUSION: The patients receive a low radiation dose during their DBT examination with both lowered AGD and ESD than the recommended values.

IMPLICATIONS FOR PRACTICE: The results can be used as a baseline to optimize the radiation dose in mammography in Sri Lanka.

PMID:36996507 | DOI:10.1016/j.radi.2023.03.010

J Plast Reconstr Aesthet Surg. 2023 Feb 16;80:75-85. doi: 10.1016/j.bjps.2023.02.017. Online ahead of print.

ABSTRACT

Peripheral nerve injury (PNI) is a significant health problem that confers lifelong impact on those injured. Current interventions are purely surgical; however, outcomes remain poor. There is a lack of high-quality epidemiological data that is needed to identify populations involved, current healthcare demands, and ensure resources are distributed to the greatest effect, to reduce the injury burden.

METHODS: Anonymized hospital episode statistical (HES) data on admitted patient care was obtained from NHS Digital for all National Health Service (NHS) patients sustaining PNI of all body regions between 2005 and 2020. Total numbers of finished consultant episodes (FCEs) or FCEs/100,000 population were used to demonstrate changes in demographic variables, anatomical locations of injury, mechanisms of injury, speciality, and main operation.

RESULTS: There was a mean national incidence of 11.2 (95% CI 10.9, 11.6) events per 100,000 population per year. Males were at least twice as likely (p < 0.0001) to sustain a PNI. Upper limb nerves at or distal to the wrist were most commonly injured. Knife injuries increased (p < 0.0001), whereas glass injuries decreased (p < 0.0001). Plastic surgeons increasingly managed PNI (p = 0.002) as opposed to orthopaedic surgeons (p = 0.006) or neurosurgeons (p = 0.001). There was an increase in neurosynthesis (p = 0.022) and graft procedures (p < 0.0001) during the study period.

DISCUSSION: PNI is a significant national healthcare problem predominantly affecting distal, upper limb nerves of men of working age. Injury prevention strategies, improved targeted funding and rehabilitation pathways are needed to reduce the injury burden and improve patient care.

PMID:36996504 | DOI:10.1016/j.bjps.2023.02.017

J Plast Reconstr Aesthet Surg. 2023 Feb 10;80:48-55. doi: 10.1016/j.bjps.2023.02.008. Online ahead of print.

ABSTRACT

OBJECTIVES: Intramedullary cannulated headless compression screw fixation (ICHCS) is gaining popularity for managing metacarpal and phalangeal fractures, but is still relatively new to the surgical landscape. We aim to further illustrate its utility and versatility by presenting the outcomes of such fractures treated with ICHCS at two tertiary plastic surgery centres. Primary objectives were to assess functional range of motion, patient-reported outcomes, and complication rates.

MATERIALS AND METHODS: All patients with metacarpal or phalangeal fractures treated with ICHCS (n = 49) between September 2018 and December 2020 were retrospectively reviewed. Outcomes were active ranges of motion (TAM), QuickDASH scores (obtained via telephone), and complication rates. Two-tailed Student’s t-tests evaluated differences between centres.

RESULTS: TAMs were available for 59% (n = 34/58) of fractures; 70.7% were metacarpal and 29.3% were phalangeal. The mean cohort metacarpal TAMs and phalangeal TAMs were 237.7° and 234.5°, respectively. QuickDASH scores were available for 69% (n = 34/49) of patients. The mean cohort score for metacarpal fractures was 8.23, and 5.13 for phalangeal. Differences between the two centres were statistically significant (p < 0.05). Two complications occurred, giving an overall complication rate of 3.45%.

CONCLUSION: Our results corroborate previous reports on ICHCS, further demonstrating its versatility and capacity to provide excellent outcomes. More prospective, comparative studies are needed to fully determine the suitability of ICHCS.

PMID:36996502 | DOI:10.1016/j.bjps.2023.02.008

Am J Gastroenterol. 2023 Mar 30. doi: 10.14309/ajg.0000000000002266. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Chronic pancreatitis (CP) has a negative impact on quality of life (QoL). Since CP is a chronic condition, multiple assessments of QoL are required to obtain a thorough understanding of its impact on patients. Such studies are currently lacking. Present study aims to gain insight into the course and predictors of QoL in patients with CP using prospective longitudinal data from a large cohort of patients.

METHODS: Post-hoc analysis of consecutive patients with definite CP registered in a prospective database between 2011 and 2019 in the Netherlands. Patient and disease characteristics, nutritional status, pain severity, medication usage, pancreatic function and pancreatic interventions were assessed from medical records and through standard follow-up questionnaires. The physical and mental component summary scales of the Short-Form 36 were used to assess physical and mental QoL at baseline and during follow-up. The course of both physical and mental QoL and their associated factors were longitudinally assessed by using generalized linear mixed models (GLMM).

RESULTS: Overall, 1,165 patients with definite CP were included for this analysis. During 10-year follow-up, GLMM analyses revealed improvements in both physical (41.6 to 45.2, p < .001) and mental QoL (45.9 to 46.6, P = .047). Younger age, current alcohol consumption, employment, no need for dietetic consultation, no steatorrhea, lower Izbicki pain score and pain coping mechanism were positively associated with physical QoL (P < .05). For mental QoL, a positive correlation was found between employment, non-alcoholic CP, no need for dietetic consultation, no steatorrhea, lower Izbicki pain score, pain coping mechanism and surgical treatment. No association was observed between disease duration and longitudinal QoL per patient.

CONCLUSION: This nationwide study provides insight into the dynamics of physical and mental QoL in patients with CP over time. Important and potentially influenceable factors to improve QoL are nutritional status, exocrine pancreatic function, employment status, and patients’ coping strategy.

PMID:36996496 | DOI:10.14309/ajg.0000000000002266

Retina. 2023 Mar 28. doi: 10.1097/IAE.0000000000003794. Online ahead of print.

ABSTRACT

PURPOSE: To assess genetic associations for pentosan polysufate sodium maculopathy.

METHODS: Genetic testing for inherited retinal dystrophy (IRD) genes using exome testing and for 14 age-related macular degeneration (AMD) associated single nucleotide polymorphisms (SNP) using panel testing were performed. Additionally, full-field electroretinograms (ffERG) were obtained to identify any cone-rod dystrophy.

RESULTS: Eleven out of fifteen patients were female, with a mean age of 69 (range 46-85). IRD exome testing in five patients revealed six pathogenic variants but failed to confirm IRD in any patient genetically. FfERG performed in 12 patients demonstrated only non-specific a- and b-wave abnormalities in 11 cases and was normal in one case. For AMD SNPs, CFH rs3766405 (p=0.003) and CETP (p=0.027) were found to be statistically significantly associated with pentosan polysulfate maculopathy phenotype compared to the control population.

CONCLUSION: Pentosan polysulfate maculopathy is not associated with Mendelian IRD genes. However, several AMD risk alleles were identified to be associated with maculopathy compared to their frequency in the normal population. This suggests a role for genes in disease pathology, particularly the alternative complement pathway. These findings would benefit from further investigation to understand the risk of developing maculopathy in taking pentosan polysulfate.

PMID:36996461 | DOI:10.1097/IAE.0000000000003794

Retina. 2023 Mar 28. doi: 10.1097/IAE.0000000000003796. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate available rationale and outcomes of randomized trial results for complement inhibition for geographic atrophy.

METHODS: Data from recently completed randomized trials of complement inhibition, particularly for pegcetacoplan and avacincaptad pegol, were evaluated for both the outcome, area of autofluorescence loss, and functional vision tests.

RESULTS: Pegcetacoplan 2 mg showed statistically significant reduction in expansion of area of autofluorescence loss with monthly, but not every-other-month dosing, in a 12-month phase 2 trial. Nearly 40% of patients recruited for the monthly arm did not complete the trial. In two parallel phase 3 studies there was a statistically significant reduction in the area of atrophy in one but not both studies. Data released at 24 months follow-up showed statistically significant reduction in area of autofluorescence detected atrophy in both studies compared with sham. Patients did not show functional difference in best corrected visual acuity, maximum reading speed, Functional Reading Independence Index, and mean microperimetry threshold sensitivities in the treatment versus sham arms. Avacincaptad pegol was evaluated in 2 randomized pivotal studies and showed a statistically significant reduction in expansion of autofluorescence loss at 12 months. Patients in the treatment arms did not show any difference as compared with sham in best corrected visual acuity or low luminance visual acuity, the only functional outcomes mentioned. Both drugs increased the risk of macular neovascularization.

CONCLUSIONS: Both avacincaptad pegol and pegcetacoplan show significant differences compared with sham in autofluorescence imaging but no benefit in visual function at 12 and 24 months, respectively.

PMID:36996460 | DOI:10.1097/IAE.0000000000003796

Am J Occup Ther. 2023 Mar 1;77(2):7702205090. doi: 10.5014/ajot.2023.050177.

ABSTRACT

IMPORTANCE: A viable occupational therapy program based on joint attention is needed to ensure that children with autism spectrum disorder (ASD) lead lives in which they interact socially.

OBJECTIVE: To explore the benefit of a joint attention-based occupational therapy program offered simultaneously with the usual special education program (USEP) compared with USEP alone.

DESIGN: Randomized controlled study, including pre-, post-, and follow-up testing.

SETTING: Special education and rehabilitation center.

PARTICIPANTS: Twenty children with ASD in the study group, M = 4.80 yr (SD = 0.78 yr), and the control group, M = 5.10 yr (SD = 0.73 yr), were included.

INTERVENTION: All children received USEP (2 sessions/wk for 12 wk). Joint attention-based occupational therapy was applied to the study group in addition to USEP (3 sessions/wk for 12 wk).

OUTCOMES AND MEASURES: The Social Communication Questionnaire (SCQ), Autism Behavior Checklist (ABC), and Motor-Free Visual Perception Test-4 (MVPT-4) were implemented.

RESULTS: The study group had a statistically and clinically significant improvement in SCQ, ABC, and MVPT-4 scores after the intervention (p < .001). The control group did not show statistically significant improvement in measurements (p > .05). The mean values of SCQ-Total, ABC-Total, and MVPT-4 variables measured at 3-mo follow-up were significantly different than preintervention (p < .05).

CONCLUSIONS AND RELEVANCE: Joint attention-based intervention, including a child-centered approach, can improve social communication, reduce ASD-related behaviors, and improve visual perception. What This Article Adds: This study emphasizes the importance of occupational therapy with a holistic perspective, based on joint attention, in terms of increasing the effectiveness of special education programs attended by children with ASD and reinforcing visual perception, communication, and positive behaviors in children with ASD.

PMID:36996457 | DOI:10.5014/ajot.2023.050177

J Am Coll Health. 2023 Mar 30:1-8. doi: 10.1080/07448481.2023.2194435. Online ahead of print.

ABSTRACT

Objective: This research seeks to understand food insecurity experiences among students at a large public university in the southern United States. Participants: Participants consented and completed an online survey disseminated on campus in April-May 2021 (N = 418). The participants sampled were predominantly undergraduate (78.2%), females (72.4%), who lived off campus (54.1%), and were racially/ethnically diverse. Methods: Descriptive statistics, multivariable logistic regression, and chi-squared tests were used to examine the differences and association between demographic characteristics and behaviors and food insecurity status. Results: About 32% students surveyed had experienced food insecurity in the last year, which resembles national trends. There were significant differences in students’ food insecurity status by race, sexual orientation, first-generation status, residential category, and main mode of transportation. Food insecurity impacted academic and socioeconomic student behaviors. Conclusions: This research has implications for improving the academic, physical, and psychological wellbeing of university students and should inform future programs and policies.

PMID:36996426 | DOI:10.1080/07448481.2023.2194435

Int J Biostat. 2023 Apr 3. doi: 10.1515/ijb-2022-0083. Online ahead of print.

ABSTRACT

COVID-19 survival data presents a special situation where not only the time-to-event period is short, but also the two events or outcome types, death and release from hospital, are mutually exclusive, leading to two cause-specific hazard ratios (csHR _d and csHR _r ). The eventual mortality/release outcome is also analyzed by logistic regression to obtain odds-ratio (OR). We have the following three empirical observations: (1) The magnitude of OR is an upper limit of the csHR _d : |log(OR)| ≥ |log(csHR _d )|. This relationship between OR and HR might be understood from the definition of the two quantities; (2) csHR _d and csHR _r point in opposite directions: log(csHR _d ) ⋅ log(csHR _r ) < 0; This relation is a direct consequence of the nature of the two events; and (3) there is a tendency for a reciprocal relation between csHR _d and csHR _r : csHR _d ∼ 1/csHR _r . Though an approximate reciprocal trend between the two hazard ratios is in indication that the same factor causing faster death also lead to slow recovery by a similar mechanism, and vice versa, a quantitative relation between csHR _d and csHR _r in this context is not obvious. These results may help future analyses of data from COVID-19 or other similar diseases, in particular if the deceased patients are lacking, whereas surviving patients are abundant.

PMID:36996414 | DOI:10.1515/ijb-2022-0083