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Nevin Manimala Statistics

Gadolinium retention in the ischemic cerebrum: Implications for pain, neuron loss, and neurological deficits

Magn Reson Med. 2022 Sep 15. doi: 10.1002/mrm.29443. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the effects of gadolinium (Gd) retention of macrocyclic (gadobutrol) or linear (gadopentetate) Gd-based contrast agents (GBCAs) on neuron loss, neurological deficits, and sensory behavior in mice with or without stroke.

METHODS: Ninety C57BL/6 mice underwent sham (n = 36) or transient middle cerebral artery occlusion (tMCAO) (n = 54) surgery and then received intraperitoneal injections of 5.0 mmol/kg gadobutrol, 5.0 mmol/kg gadopentetate or saline (10 ml/kg/administration) per day for 3 consecutive days. The Gd concentration in the ischemic cerebrum was quantified by inductively coupled plasma mass spectrometry on Day 1 and Day 28 after the last injection (post-injection, p. i.). Neuron loss, glia activation and neurological deficits were assessed on Day 1 and 28 p. i. Sensory behavior was also assessed on Day 28 p. i.

RESULTS: Gd concentrations were higher in the brains of tMCAO mice than in those of sham mice on Days 1 p. i. of both GBCAs (gadobutrol, p < 0.05; gadopentetate, p < 0.001) and 28 p. i of gadopentetate. (p < 0.001). Sham or tMCAO mice injected with GBCAs showed no significant difference in neuron loss, glia activation, neurological deficits, brain atrophy, or hippocampus-dependent memory (all p > 0.05). Both gadobutrol and gadopentetate induced mechanical and heat hyperalgesia in sham mice (all p < 0.05). However, mechanical hyperalgesia but rather heat hyperalgesia was found in tMCAO mice with the highest force tested (1.0 g) and statistically significant in both paws (right and left) with gadopentetate only (p < 0.05).

CONCLUSIONS: Neither gadobutrol nor gadopentetate worsened neuron loss, glia activation, brain atrophy, neurological deficits, or hippocampus-dependent memory after tMCAO. However, GBCA administration induced mechanical hyperalgesia in sham and tMCAO mice although in the same level, which may be an important consideration for patients with central post-stroke pain and those who are sensitive to pain and about to receive multiple GBCA administrations.

PMID:36111354 | DOI:10.1002/mrm.29443

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Correlates of Price Transparency for Healthcare Services in United States Hospitals

Clinicoecon Outcomes Res. 2022 Sep 9;14:601-606. doi: 10.2147/CEOR.S378475. eCollection 2022.

ABSTRACT

PURPOSE: The purpose of this study is to investigate demographic and hospital characteristics that predict hospital price transparency in the United States.

METHODS: We identified 6214 hospitals and extracted characteristics of each using the American Hospital Association Annual Survey, as well as cash prices for a representative selection of commonly performed procedures and visits from the Turquoise Health dataset. Descriptive statistics were used to determine compliance rates and price variation, and a Poisson regression model was used to calculate incidence rate ratios (IRR) and 95% confidence intervals (CI) for predictors of price transparency.

RESULTS: Price transparency compliance ranged from 13% to 49% of hospitals, and across-center ratios ranged from 244.8 to 4789.0. Number of hospital beds was marginally associated with price transparency for more services (IRR: 1.01 [95% CI: 1.01-1.02]); in contrast, location in the Southern (IRR: 0.91 [95% CI: 0.87-0.96]) or Western (IRR: 0.94 [95% CI: 0.90-0.99]) regions of the US was associated with transparency for fewer services.

CONCLUSION: Smaller hospitals as well as those located in the South and West regions were less likely to be compliant with the CMS mandate for price transparency for hospital standard charges. Additionally, the poor usability of price transparency directories on hospital websites limits information access and undermines transparency efforts.

PMID:36111322 | PMC:PMC9469800 | DOI:10.2147/CEOR.S378475

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Analysis of sleep problem in children aged 1-3 years with autism spectrum disorder in Zhejiang province, China

Front Psychiatry. 2022 Aug 30;13:923757. doi: 10.3389/fpsyt.2022.923757. eCollection 2022.

ABSTRACT

BACKGROUND: High prevalence of sleep problems have been founded in children with Autism Spectrum Disorder (ASD), with rates ranging from 50 to 80%. We aimed to study the sleep status and the occurrence of sleep problems in children with autism spectrum disorder (ASD) aged 1-3 years, and to provide reference for guiding early comprehensive intervention for ASD children from the perspective of sleep.

METHODS: From January 1 to December 31, 2021, 74 ASD children who met the diagnostic criteria of “Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-V)” served as case group while 84 typically-developing children of the same sex and age served as control group. An original Children’s Sleep Habit Questionnaire was adopted to compare the sleep status of children in the two groups and to conduct statistical analysis on related factors.

RESULTS: The incidence of sleep problems in the case group (78.4%) was significantly higher than that in the control group (34.5%) (P < 0.001). Compared with the children in the control group, children in the case group had later bedtime (P < 0.05) and less sleep duration (P < 0.05), and required longer time to fall asleep (P < 0.001) The incidence of sleep problems in children who could fall asleep autonomously in the case group was significantly lower than that in children who needed parental help (P < 0.05). In the case group, the longer the screen exposure time, the higher the incidence of sleep problems (P < 0.05).

CONCLUSIONS: The incidence of sleep problems in ASD children aged 1-3 years is also high, mainly manifested in late bedtime, difficulty falling asleep, frequent night awakenings and less sleep duration. Both sleep patterns and screen exposure can impact their sleep. In the early comprehensive intervention of ASD children, it is necessary to pay full heed to their sleep status and take timely intervention measures in order to improve the quality of life for the ASD children and their families.

PMID:36111309 | PMC:PMC9468753 | DOI:10.3389/fpsyt.2022.923757

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The effects of acute angle closure crisis on corneal endothelial cells in patients with type 2 diabetes mellitus

Front Endocrinol (Lausanne). 2022 Aug 30;13:956780. doi: 10.3389/fendo.2022.956780. eCollection 2022.

ABSTRACT

OBJECTIVE: This study investigated the effects of acute angle closure crisis (AACC) on the corneal endothelial cells in patients with type 2 diabetes mellitus (DM) to identify the factors that cause corneal endothelial cell injury.

METHODS: We examined 154 patients who visited Qingdao Eye Hospital for AACC in one eye (154 eyes; 28 men and 126 women; mean age of 68 ± 8 years). We divided the participants into non-DM, DM well-control, and DM poor-control groups, with the unaffected eyes used as controls. Each participant was evaluated at the hospital while under AACC. We measured the relevant index and corneal parameters of the participants for statistical analysis.

RESULTS: There were significant statistical differences in corneal parameters among the three groups. The decreased levels of central endothelial cell density (CD) and the percentage of hexagonal cells (6A) were statistically relevant among the groups (P<0.05). The AACC duration was correlated with CD loss rate among the groups (P<0.05). The DM duration was correlated with CD loss rate in the DM well-control group. Compared with the non-DM group, the level of 6A decreased more significantly in the DM group after AACC (P<0.05). The AACC duration in the DM well-control group was significantly shorter than in the non-DM and DM poor-control groups (P<0.001). The DM poor-control group showed significantly worse visual acuity when compared with the other groups (P<0.05).

CONCLUSIONS: DM may impact the functional status of corneal endothelial cells. AACC can worsen the corneal endothelium damage in patients with DM. Blood glucose levels and the duration of intraocular hypertension are closely related to the severity of corneal endothelial injury.

PMID:36111300 | PMC:PMC9468933 | DOI:10.3389/fendo.2022.956780

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Prevalence of central obesity and associated factors in Ethiopia: A systematic review and meta-analysis

Front Endocrinol (Lausanne). 2022 Aug 30;13:983180. doi: 10.3389/fendo.2022.983180. eCollection 2022.

ABSTRACT

INTRODUCTION: Obesity is a global public health concern that is now on the rise, especially in low- and middle-income nations. Despite the fact that there are several studies reporting the prevalence of central obesity among adults in Ethiopia, there is a lack of a systematic review and meta-analysis synthesizing the existing observational studies. Therefore, this systematic review and meta-analysis aimed to determine the prevalence of central obesity and its associated factors in Ethiopia.

METHODS: Online libraries such as PubMed, Google Scholar, Scopus, Science Direct, and Addis Ababa University were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 16). Forest plots, Begg’s rank test, and Egger’s regression test were all used to check for publication bias. To look for heterogeneity, I2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by region and study setting. In addition, the pooled odds ratio for related covariates was calculated.

RESULTS: Out of 685 studies assessed, 20 met our criteria and were included in the study. A total of 12,603 people were included in the study. The prevalence of central obesity was estimated to be 37.31% [95% confidence interval (CI): 29.55-45.07]. According to subgroup analysis by study region and setting, the highest prevalence was observed in the Dire Dawa region (61.27%) and community-based studies (41.83%), respectively. Being a woman (AOR = 6.93; 95% CI: 3.02-10.85), having better socioeconomic class (AOR = 5.45; 95% CI: 0.56-10.34), being of age 55 and above (AOR = 5.23; 95% CI: 2.37-8.09), being physically inactive (AOR = 1.80; 95% CI: 1.37-2.24), being overweight (AOR = 4.00; 95% CI: 2.58-5.41), being obese (AOR = 6.82; 95% CI: 2.21-11.43), and having hypertension (AOR = 3.84; 95% CI: 1.29-6.40) were the factors associated with central obesity.

CONCLUSION: The prevalence of central obesity was high in Ethiopia. Being a woman, having a higher socioeconomic class, being older, being physically inactive, being overweight or obese, and having hypertension were all associated. Therefore, it is vital for the government and health organizations to design and implement preventive measures like early detection, close monitoring, and positive reversal of central obesity in all patients and the general population. High-quality investigations on the prevalence of central obesity in the Ethiopian people are required to better understand the status of central obesity in Ethiopia.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42022329234.

PMID:36111291 | PMC:PMC9468774 | DOI:10.3389/fendo.2022.983180

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Evaluation by Survival Analysis of Cold Pain Tolerance in Patients with Fibromyalgia and Opioid Use

J Pain Res. 2022 Sep 9;15:2783-2799. doi: 10.2147/JPR.S368805. eCollection 2022.

ABSTRACT

PURPOSE: The cold pressor test (CPT) is a clinical pain research method used to measure cold pain tolerance. During this test, participants immerse an extremity (ie, hand or foot) into cold water for as long as tolerable. The duration of the test (traditionally up to an experimentally imposed cut-off at 2 minutes) indicates the amount of cold pain tolerance by the participant. Prior research studies have investigated cold pain tolerance in patients with chronic pain. However, few of these studies have used survival analysis, which allows for proper handling of data censoring and is therefore, an optimal statistical method for CPT data analysis. The goal of the present study was to use survival analysis to evaluate cold pain tolerance in patients with fibromyalgia. Furthermore, we aimed to model relationships between psychological and clinical variables as well as opioid medication use and cold pain tolerance.

PATIENTS AND METHODS: A total of 85 patients with fibromyalgia (42 who were taking opioids) and 47 healthy pain-free controls provided CPT and questionnaire data (collected across 2 study sites) for a case-control study. We used survival analysis using Cox regression to evaluate group differences (patients vs controls) in cold pain tolerance and to evaluate cold pain tolerance relationships with psychological, clinical, and medication use.

RESULTS: As compared to healthy controls, patients with fibromyalgia exhibited significantly lower CPT survival (HR = 2.17, 95% CI: [1.42, 3.31], p = 0.00035). As indicated by Cox regression models, the significant group difference in CPT survival did not relate to our selected psychological and clinical measures (p > 0.05). The groups of non-opioid-taking patients and healthy controls showed consistent CPT survival across study sites. However, patients taking opioid pain medications showed differences in CPT survival across study sites.

CONCLUSION: By using survival analysis, an optimal method for time-to-event pain measures such as the CPT, we confirmed previously identified reductions in cold pain tolerance in patients with fibromyalgia. While our selected psychological and clinical measures were not significantly associated with cold pain tolerance, our data suggest that opioid medication use may impart greater cold pain tolerance in some patients.

PMID:36111289 | PMC:PMC9470281 | DOI:10.2147/JPR.S368805

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Effect of an online resourcefulness training in improving psychological well-being of front-line medical staff: a quasi-experimental study

BMC Psychol. 2022 Sep 15;10(1):217. doi: 10.1186/s40359-022-00920-7.

ABSTRACT

BACKGROUND: The global COVID-19 pandemic is still not under effective control, and strong workplace supports with comprehensive mental health interventions are urgently needed to help medical staff effectively respond to the pandemic. This study aimed to verify the effect of an online resourcefulness training program on the resourcefulness, and psychological variables of front-line medical staff working in the COVID-19 isolation ward.

DESIGN: A pre-test and post-test quasi-experimental design with control group was employed.

PARTICIPANTS: A total of 60 participants working in two isolation wards were recruited via convenience sampling. The two isolation wards were randomly assigned to the control group (isolation ward 1, n = 30) and the intervention group (isolation ward 2, n = 30).

INTERVENTION: The participants were trained online by video conferences and WeChat. The control group received conventional training (e.g., psychological training, psychological counseling), while the intervention group received a 4-h online resourcefulness training. Both groups learned updated guidelines of COVID-19 simultaneously via video conference. The primary outcomes (resourcefulness, anxiety, depression and coping styles) and the secondary outcome (psychological resilience) were measured before intervention and three time points after intervention.

RESULTS: After the intervention and one week after the intervention, the resourcefulness, resilience, and positive response scores of the participants in the intervention group were significantly higher than those of the control group. The anxiety and negative response scores in the intervention group were significantly lower than those of the control group (all p < 0.05). One month after the intervention, the scores of resourcefulness, tenacity, and positive response of the intervention group were higher than those of the control group (all p < 0.05). Repeated measures analysis of variance showed that the two groups of participants had statistically significant changes in the time-based effect and group-based effect in resourcefulness, resilience, anxiety scores and coping styles (p < 0.01).

CONCLUSION: The results showed that our online resourcefulness training can significantly improve the resourcefulness, resilience, and positive response scores and effectively reduce anxiety and depression scores of front-line medical staff. This demonstrates that online resourcefulness training would be an effective tool for the psychological adjustment of front-line medical staff in fighting against COVID-19.

PMID:36109821 | DOI:10.1186/s40359-022-00920-7

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Re-analysis on the statistical sampling biases of a mask promotion trial in Bangladesh: a statistical replication

Trials. 2022 Sep 15;23(1):786. doi: 10.1186/s13063-022-06704-z.

ABSTRACT

A recent randomized trial evaluated the impact of mask promotion on COVID-19-related outcomes. We find that staff behavior in both unblinded and supposedly blinded steps caused large and statistically significant imbalances in population sizes. These denominator differences constitute the rate differences observed in the trial, complicating inferences of causality.

PMID:36109816 | DOI:10.1186/s13063-022-06704-z

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Epidemiology and clinical features of PFAPA: a retrospective cohort study of 336 patients in western Sweden

Pediatr Rheumatol Online J. 2022 Sep 15;20(1):82. doi: 10.1186/s12969-022-00737-z.

ABSTRACT

BACKGROUND: Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome is generally regarded as the most common autoinflammatory disease, but the epidemiology of the disease is largely unknown. The objectives of this study were to estimate the annual incidence and describe the clinical features of PFAPA in a large cohort from western Sweden.

METHODS: The study retrospectively included children < 18 years of age diagnosed with PFAPA between 2006 and 2017 at three hospitals: NU Hospital Group, Skaraborg Hospital and Queen Silvia Children’s Hospital. Patients were identified by searching for relevant diagnostic ICD-10 codes in the comprehensive electronic medical records and data were retrieved by reviewing case records. To estimate incidence, patients with symptom onset from January 1, 2006, to December 31, 2016, were included. Population data for the study area during this period were retrieved from Statistics Sweden.

RESULTS: In this study, 336 patients with PFAPA were identified. Of these, 156 (46%) were girls and 180 (54%) were boys. Almost 90% of the children with PFAPA (291 patients) experienced their first symptoms before the age of 5 years and fewer than 3% presented at ages above 10 years. Pharyngitis was the most common symptom during febrile episodes, followed by cervical adenitis and aphthous stomatitis. Fourteen percent of the patients displayed atypical features, of which skin rash was the most common. To calculate incidence, 251 patients with symptom onset during the study period were identified. The mean annual incidence was estimated at 0.86/10,000 for children < 18 years of age and 2.6/10,000 for children < 5 years of age.

CONCLUSIONS: This study adds to the understanding of the epidemiology of PFAPA syndrome by presenting incidence rates based on a large cohort and in different age groups in a population-based setting. It also shows the distribution of age of onset of PFAPA, with a peak in 1-year-olds and waning at older ages. Signs and symptoms of PFAPA syndrome were similar in children with symptom onset before vs. after 5 years of age.

PMID:36109811 | DOI:10.1186/s12969-022-00737-z

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Identifying dietary patterns across age, educational level and physical activity level in a cross-sectional study: the Tromsø Study 2015 – 2016

BMC Nutr. 2022 Sep 15;8(1):102. doi: 10.1186/s40795-022-00599-4.

ABSTRACT

BACKGROUND: A healthy diet can decrease the risk of several lifestyle diseases. From studying the health effects of single foods, research now focuses on examining complete diets and dietary patterns reflecting the combined intake of different foods. The main goals of the current study were to identify dietary patterns and then investigate how these differ in terms of sex, age, educational level and physical activity level (PAL) in a general Nordic population.

METHODS: We used data from the seventh survey of the population-based Tromsø Study in Norway, conducted in 2015-2016. The study included 21,083 participants aged [Formula: see text] years, of which [Formula: see text] completed a comprehensive food frequency questionnaire (FFQ). After exclusion, the study sample included 10,899 participants with valid FFQ data. First, to cluster food variables, the participants were partitioned in homogeneous cohorts according to sex, age, educational level and PAL. Non-overlapping diet groups were then identified using repeated hierarchical cluster analysis on the food variables. Second, average standardized diet intake scores were calculated for all individuals for each diet group. The individual diet (intake) scores were then modelled in terms of age, education and PAL using regression models. Differences in diet scores according to education and PAL were investigated by pairwise hypothesis tests, controlling the nominal significance level using Tukey’s method.

RESULTS: The cluster analysis revealed three dietary patterns, here named the Meat and Sweets diet, the Traditional diet, and the Plant-based- and Tea diet. Women had a lower intake of the Traditional diet and a higher preference for the Plant-based- and Tea diet compared to men. Preference for the Meat and Sweets diet and Traditional diet showed significant negative and positive trends as function of age, respectively. Adjusting for age, the group having high education and high PAL compared favourably with the group having low education and low PAL, having a significant lower intake of the Meat and Sweets and the Traditional diets and a significant higher intake of the Plant-based- and Tea diet.

CONCLUSIONS: Three dietary patterns (Meat and Sweets, Traditional, and Plant-based- and Tea) were found by repeated clustering of randomly sampled homogeneous cohorts of individuals. Diet preferences depended significantly on sex, age, education and PAL, showing a more unhealthy dietary pattern with lower age, low education and low PAL.

PMID:36109801 | DOI:10.1186/s40795-022-00599-4