Tag: statistics

J Vet Intern Med. 2023 May 22. doi: 10.1111/jvim.16724. Online ahead of print.

ABSTRACT

BACKGROUND: Radiotherapy (RT) is an effective treatment for dogs presented with neurologic signs caused by pituitary tumors. However, its impact on the outcome of concurrent pituitary-dependent hypercortisolism (PDH) is controversial.

OBJECTIVES: Determine whether dogs with PDH have longer survival after pituitary RT compared with dogs with nonhormonally active pituitary masses and to evaluate whether clinical, imaging, and RT variables affect survival.

ANIMALS: Ninety-four dogs divided into 2 groups: PDH and non-PDH, based on the presence of hypercortisolism. Forty-seven dogs were allocated to the PDH group and 47 to the non-PDH group.

METHODS: Retrospective cohort study in which clinical records of dogs undergoing RT for pituitary macroadenomas between 2008 and 2018 at 5 referral centers were retrospectively evaluated.

RESULTS: Survival was not statistically different between PDH and non-PDH groups (median survival time [MST], 590 days; 95% confidence interval [CI], 0-830 days and 738 days; 95% CI, 373-1103 days, respectively; P = .4). A definitive RT protocol was statistically associated with longer survival compared with a palliative protocol (MST 605 vs 262 days, P = .05). The only factor statistically associated with survival from multivariate Cox proportional hazard analysis was total radiation dose (Gy) delivered (P < .01).

CONCLUSIONS AND CLINICAL IMPORTANCE: No statistical difference in survival was identified between the PDH and non-PDH groups, and longer survival was associated with higher Gy delivered.

PMID:37218395 | DOI:10.1111/jvim.16724

J Intellect Disabil Res. 2023 May 22. doi: 10.1111/jir.13042. Online ahead of print.

ABSTRACT

BACKGROUND: Down syndrome (DS) is the most common genetic disorder. To date, the scientific literature regarding micronutrient status in children and adolescents with DS has not been systematically reviewed. Therefore, our aim was to provide a systematic review and meta-analysis on this topic.

METHODS: We identified all relevant case-control studies published by 1 January 2022, by searching the PubMed and Scopus databases for original English-language articles analysing the micronutrient status of individuals with DS. Forty studies were included in the systematic review and 31 in the meta-analysis.

RESULTS: Statistically significant differences between individuals with DS (cases) and non-DS (controls) (P ≤ 0.05) were obtained for zinc, selenium, copper, vitamin B12, sodium and calcium. Serum, plasma and whole blood analyses showed lower zinc levels in cases than controls {standardised mean difference [SMD] serum [95% confidence interval (CI)] = -2.32 [-3.22, -1.41], P < 0.00001; SMD plasma [95% CI] = -1.29 [-2.26, -0.31], P < 0.01; SMD blood [95% CI] = -1.59 [-2.29, -0.89], P < 0.00001}. Similarly, plasma and blood selenium concentrations were significantly lower in cases than controls (SMD plasma [95% CI] = -1.39 [-2.26, -0.51], P = 0.002; SMD blood [95% CI] = -1.86 [-2.59, -1.13], P < 0.00001). Intraerythrocytic copper and serum B12 were higher in cases than controls (SMD Cu [95% CI] = 3.33 [2.19, 4.46], P < 0.00001; SMD B12 [95% CI] = 0.89 [0.01, 1.77], P = 0.048). Blood calcium was lower in cases than controls (SMD Ca [95% CI] = -0.77 [-1.34, -0.21], P = 0.007).

CONCLUSIONS: This study provides the first systematic overview of micronutrient status in children and adolescents with DS and has shown that relatively little consistent research has been executed in this field. There is a clear need for more well-designed, clinical trials to study the micronutrient status and effects of dietary supplements in children and adolescents with DS.

PMID:37218392 | DOI:10.1111/jir.13042

Br J Clin Pharmacol. 2023 May 22. doi: 10.1111/bcp.15797. Online ahead of print.

ABSTRACT

About 15 to 28% of treated patients with thiopurines experienced adverse drug reactions, such as hematological and hepatic toxicities. A part of them is related to the polymorphic activity of the thiopurine S-methyltransferase (TPMT), the key detoxifying enzyme of thiopurine metabolism. We report here a case of thiopurine-induced ductopenia with a comprehensive pharmacological analysis on thiopurine metabolism. A 34-year-old woman, with a medical history of severe systemic lupus erythematosus with recent introduction of azathioprine therapy, presented with mild fluctuating transaminase blood levels consistent with an hepatocellular patter, which evolved to a cholestatic pattern over the next weeks. A blood thiopurine metabolite assay revealed low 6-thioguanine nucleotides (6-TGN) level and a dramatically increased 6-methylmercaptopurine ribonucleotides (6-MMPN) level, together with an unfavorable [6-MMPN:6-TGN] metabolite ratio and a high TPMT activity. After a total of about six months of thiopurine therapy, a transjugular liver biopsy revealed a ductopenia and azathioprine discontinuation led to further clinical improvement. In line with previous reports from the literature, our case supports the fact that ductopenia is a rare adverse drug reaction of azathioprine. The mechanism of reaction is unknown but may involve high 6-MMPN blood level, due to unusual thiopurine metabolism (switched metabolism). Early therapeutic drug monitoring with measurement of 6-TGN and 6-MMPN blood levels may help physicians to identify patients at risk of similar duct injury.

PMID:37218386 | DOI:10.1111/bcp.15797

J Am Med Inform Assoc. 2023 May 22:ocad087. doi: 10.1093/jamia/ocad087. Online ahead of print.

ABSTRACT

OBJECTIVE: Although interactive data visualizations are increasingly popular for health communication, it remains to be seen what design features improve psychological and behavioral targets. This study experimentally tested how interactivity and descriptive titles may influence perceived susceptibility to the flu, intention to vaccinate, and information recall, particularly among older adults.

MATERIALS AND METHODS: We created data visualization dashboards on flu vaccinations, tested in a 2 (explanatory text vs none) × 3 (interactive + tailored, static + tailored, static + nontailored) + questionnaire-only control randomized between-participant online experiment (N = 1378).

RESULTS: The flu dashboards significantly increased perceived susceptibility to the flu compared to the control: static+nontailored dashboard, b = 0.14, P = .049; static-tailored, b = 0.16, P = .028; and interactive+tailored, b = 0.15, P = .039. Interactive dashboards potentially decreased recall particularly among the elderly (moderation by age: b = -0.03, P = .073). The benefits of descriptive text on recall were larger among the elderly (interaction effects: b = 0.03, P = .025).

DISCUSSION: Interactive dashboards with complex statistics and limited textual information are widely used in health and public health but may be suboptimal for older individuals. We experimentally showed that adding explanatory text on visualizations can increase information recall particularly for older populations.

CONCLUSION: We did not find evidence to support the effectiveness of interactivity in data visualizations on flu vaccination intentions or on information recall. Future research should examine what types of explanatory text can best support improved health outcomes and intentions in other contexts. Practitioners should consider whether interactivity is optimal in data visualization dashboards for their populations.

PMID:37218375 | DOI:10.1093/jamia/ocad087

J Korean Med Sci. 2023 May 22;38(20):e155. doi: 10.3346/jkms.2023.38.e155.

ABSTRACT

BACKGROUND: Before the omicron era, health care workers were usually vaccinated with either the primary 2-dose ChAdOx1 nCoV-19 (Oxford-AstraZeneca) series plus a booster dose of BNT162b2 (Pfizer-BioNTech) (CCB group) or the primary 2-dose BNT162b2 series plus a booster dose of BNT162b2 (BBB group) in Korea.

METHODS: The two groups were compared using quantification of the surrogate virus neutralization test for wild type severe acute respiratory syndrome coronavirus 2 (SVNT-WT), the omicron variant (SVNT-O), spike-specific IgG, and interferon-gamma (IFN-γ), as well as the omicron breakthrough infection cases.

RESULTS: There were 113 participants enrolled in the CCB group and 51 enrolled in the BBB group. Before and after booster vaccination, the median SVNT-WT and SVNT-O values were lower in the CCB (SVNT-WT [before-after]: 72.02-97.61%, SVNT-O: 15.18-42.29%) group than in the BBB group (SVNT-WT: 89.19-98.11%, SVNT-O: 23.58-68.56%; all P < 0.001). Although the median IgG concentrations were different between the CCB and BBB groups after the primary series (2.677 vs. 4.700 AU/mL, respectively, P < 0.001), they were not different between the two groups after the booster vaccination (7.246 vs. 7.979 AU/mL, respectively, P = 0.108). In addition, the median IFN-γ concentration was higher in the BBB group than in the CCB group (550.5 and 387.5 mIU/mL, respectively, P = 0.014). There was also a difference in the cumulative incidence curves over time (CCB group 50.0% vs. BBB group 41.8%; P = 0.045), indicating that breakthrough infection occurred faster in the CCB group.

CONCLUSION: The cellular and humoral immune responses were low in the CCB group so that the breakthrough infection occurred faster in the CCB group than in the BBB group.

PMID:37218354 | DOI:10.3346/jkms.2023.38.e155

J Korean Med Sci. 2023 May 22;38(20):e151. doi: 10.3346/jkms.2023.38.e151.

ABSTRACT

BACKGROUND: Lumbar paraspinal muscles play an important role in maintaining global spinal alignment and are associated with lower back pain; however, only a few studies on the effect of the paraspinal muscles on the surgical outcome exist. Therefore, this study aimed to analyze the association of preoperative muscularity and fatty infiltration (FI) of paraspinal muscles with the outcome of lumbar interbody fusion.

METHODS: Postoperative clinical and radiographic outcomes were analyzed in 206 patients who underwent surgery for a degenerative lumbar disease. The preoperative diagnosis was spinal stenosis or low-grade spondylolisthesis, and the surgery performed was posterior lumbar interbody fusion or minimally invasive transforaminal lumbar interbody fusion. Indications for surgery were a complaint of severe radiating pain that did not improve with conservative treatment and neurological symptoms accompanied by lower extremity motor weakness. Patients with fractures, infections, tumors, or a history of lumbar surgery were excluded from this study. Clinical outcome measures included functional status, measured using the Oswestry disability index (ODI) and visual analog scale (VAS) score for lower back and leg pain. Other radiographic parameters included measures of spinal alignment, including lumbar lordosis, pelvic tilt, sacral slope, pelvic incidence, C7 sagittal vertical axis, and pelvic incidence-lumbar lordosis mismatch. Lumbar muscularity (LM) and FI were measured preoperatively using a lumbar magnetic resonance image (MRI).

RESULTS: The high LM group showed more significant improvement in VAS score for lower back pain than the low LM group. In contrast, the VAS score for leg pain demonstrated no statistical significance. The high LM group showed more significant improvement in ODI postoperatively than the medium group. The severe FI group showed more significant improvement in ODI postoperatively, whereas the less severe FI group showed more significant improvement in the sagittal balance postoperatively.

CONCLUSION: Patients with high LM and mild FI ratio observed on preoperative MRI demonstrated more favorable clinical and radiographic outcomes after lumbar interbody fusion. Therefore, preoperative paraspinal muscle condition should be considered when planning lumbar interbody fusion.

PMID:37218352 | DOI:10.3346/jkms.2023.38.e151

J Orthop Res. 2023 May 23. doi: 10.1002/jor.25633. Online ahead of print.

ABSTRACT

Degenerative meniscus lesions have been associated with both osteoarthritis etiology and its progression. We therefore sought to establish a human meniscus ex vivo model to study the meniscal response to cytokine treatment using a proteomics approach. Lateral menisci were obtained from five knee-healthy donors. The meniscal body was cut into vertical slices, and further divided into an inner (avascular) and outer region. Explants were either left untreated (controls) or stimulated with cytokines. Medium changes were conducted every three days up to day 21 and liquid chromatography-mass spectrometry was performed at all the time points for the identification and quantification of proteins. Mixed-effect linear regression models were used for statistical analysis to estimate the effect of treatments versus control on protein abundance. Treatment by IL1ß increased release of cytokines such as interleukins, chemokines, and matrix metalloproteinases but a limited catabolic effect in healthy human menisci explants. Further, we observed an increased release of matrix proteins (collagens, integrins, prolargin, tenascin) in response to oncostatin M (OSM)+tumor necrosis factor (TNF) and TNF+interleukin-6 (IL6)+sIL6R treatments, and analysis of semi-tryptic peptides provided additional evidence of increased catabolic effects in response to these treatments. The induced activation of catabolic processes may play a role in osteoarthritis development. This article is protected by copyright. All rights reserved.

PMID:37218349 | DOI:10.1002/jor.25633

Clin Respir J. 2023 May 22. doi: 10.1111/crj.13629. Online ahead of print.

ABSTRACT

BACKGROUND: Montelukast is a highly selective and specific cysteinyl leukotriene receptor antagonist used in the treatment of asthma. Whether montelukast as adjuvant therapy can significantly and safely treat adults with cough variant asthma (CVA) remains inconclusive.

AIMS: This meta-analysis systematically evaluated the efficacy and safety of montelukast as an adjuvant treatment for adults with CVA.

MATERIALS AND METHODS: Randomized controlled trials (RCTs) on montelukast combined with inhaled corticosteroids (ICS) and long-acting β2 agonists (LABAs) to treat CVA in adults, from inception to March 6, 2023, were retrieved from the CNKI, Wanfang, VIP, CBM, PubMed, Embase, Cochrane Library, and Web of Science databases and Clinical Trials website. Review Manager (version 5.4) and Stata (version 15.0) were used to conduct the meta-analysis.

RESULTS: A total of 15 RCTs were ultimately included in the meta-analysis. It was established that montelukast as adjuvant therapy raised the total effective rate (RR = 1.20, 95% confidence interval [CI] [1.13, 1.27], P < 0.01) and improved the FEV1% (SMD = 0.91, 95% CI [0.40, 1.41], P < 0.01), PEF% (SMD = 0.63, 95% CI [0.38, 0.88], P < 0.01), FEV1 (SMD = 1.15, 95% CI [0.53, 1.77], P < 0.01), PEF (SMD = 0.64, 95% CI [0.42, 0.86], P < 0.01), and FEV1/FVC% (SMD = 0.76, 95% CI [0.51, 1.01], P < 0.01) and reduced the recurrence rate (RR = 0.28, 95% CI [0.15, 0.53], P < 0.01). The incidence of adverse reactions was higher in the montelukast auxiliary group compared to the control group but with no statistical difference (RR = 1.32, 95% CI [0.89, 1.96], P = 0.17).

CONCLUSION: Existing evidence indicated that the use of montelukast as an adjuvant therapy had therapeutic efficacy superior to ICS + LABA alone for the treatment of adult patients with CVA. However, further research is needed, especially a combination of high-quality long-term prospective studies and carefully designed RCTs.

PMID:37218346 | DOI:10.1111/crj.13629

Microsc Res Tech. 2023 May 22. doi: 10.1002/jemt.24361. Online ahead of print.

ABSTRACT

This study investigates the influence of acid exposure and thermocycling simulating erosion tooth wear, on the optical properties and surface roughness of chairside materials. Resin-ceramic, lithium disilicate, premium zirconium oxide and resin composite material comprise the materials tested. To simulate the dental erosion and aging, specimens from each material were immersed in hydrochloric acid, while the thermocycling procedure included 10,000 cycles. The translucency, the color differences and the surface roughness were calculated. The materials phase composition was tested using X-ray diffraction analysis to evaluate T-M phase transformation. The CIEDE₂₀₀₀ color difference and the translucency parameter were tested different significantly among groups. Data were statistically analyzed via independent samples t-test, and paired samples t-test. The thermocycling procedure and the exposure to the acid solution had different effect on the surface roughness of CAD/CAM materials. The present result demonstrated the negative effect the acid exposure has on the zirconia material in terms of color difference. However, no color differences over the threshold of acceptability were recorded after the thermocycling procedure. Both polymer materials exhibit an increase of the surface roughness when they were immersed in acid but they did not display an increase in roughness when they were thermocycled.

PMID:37218339 | DOI:10.1002/jemt.24361

JBI Evid Synth. 2023 May 23. doi: 10.11124/JBIES-22-00179. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this review was to evaluate the effectiveness of technology-based interventions for relieving procedural pain among hospitalized neonates compared with other non-pharmacological interventions.

INTRODUCTION: Neonates who require hospital care often experience acute pain during medical procedures. The current best practice for relieving pain in neonates is the use of non-pharmacological interventions, such as oral solutions or intervention-based human touch. Technological solutions (eg, games, eHealth applications, mechanical vibrators) have become more commonplace in pediatric pain management over recent years. However, there is a sizeable knowledge gap concerning how effective technology-based interventions are for relieving pain in neonates.

INCLUSION CRITERIA: This review considered experimental trials that include technology-based, non-pharmacological interventions for relieving procedural pain among hospitalized neonates. The primary outcomes of interest include pain response to a procedure measured by a pain assessment scale validated for neonates, behavioral indicators, and changes in physiological indicators.

METHODS: The search strategy aimed to identify both published and unpublished studies. PubMed MEDLINE (PubMed), CINAHL (EBSCOhost), Scopus, Cochrane Central Register of Controlled Trials, MedNar, and EBSCO Open Dissertations databases were searched for studies published in English, Finnish, or Swedish. Critical appraisal and data extraction were conducted by 2 independent researchers who adhered to JBI methodology. Meta-analysis could not be performed due to considerable heterogeneity in the studies; as a result, the findings are presented narratively.

RESULTS: A total of 10 randomized controlled trials involving 618 children were included in the review. The staff members delivering the interventions and the outcome assessors were not blinded in all of the studies, which introduced a potential risk of bias. The presented technology-based interventions were diverse, including laser acupuncture, noninvasive electrical stimulation of acupuncture points, robot platform, vibratory stimulation, recorded maternal voice, and recorded intrauterine voice. In the studies, pain was measured using validated pain scales, behavioral indicators, and physiological variables. In the studies in which pain was assessed with a validated pain measure (N=8), technology-based pain relief was significantly more effective than the comparator in 2 studies, whereas no statistically significant differences were observed in 4 studies and the technology-based intervention was less effective than the comparator in 2 studies.

CONCLUSIONS: The effectiveness of technology-based interventions in relieving neonatal pain, either as a standalone method or in combination with another non-pharmacological method, was mixed. Further research is needed to provide reliable evidence on which technology-based, non-pharmacological pain relief intervention is most effective for hospitalized neonates.

A FINNISHLANGUAGE VERSION OF THE ABSTRACT OF THIS REVIEW IS AVAILABLE AS SUPPLEMENTAL DIGITAL CONTENT: [http://links.lww.com/SRX/A19].

PMID:37218335 | DOI:10.11124/JBIES-22-00179