Tag: statistics

Health Soc Care Community. 2022 Jul 23. doi: 10.1111/hsc.13935. Online ahead of print.

ABSTRACT

Social prescribing (SP) has rapidly expanded over recent years. Previously a bottom-up, community-led phenomenon, SP is now a formal part of structured NHS policy and practice. This study was designed to ascertain how general practitioners and other primary healthcare professionals (HCPs) within one clinical commissioning group (CCG) perceive and engage with this new NHS model. The research comprised an online survey distributed to HCPs within a predominately rural, English CCG between June and August 2021. Qualitative data were gathered and analysed using reflexive thematic analysis. Positive portrayals of SP were found, although definitions and perceptions varied greatly. Many HCPs reported high levels of engagement with SP services; yet referral rates appeared to remain significantly lower than the previously estimated 20% of primary care attendees referred for social reasons. Moreover, 96% of HCPs reported signposting patients directly to community or external services, rather than referring them to SP. This signposting, which has been positioned as a model of SP, reflects engagement with SP in practice, which is likely to have pre-dated the introduction of the fuller NHS model. HCPs may be unaware that this could be classed as a social prescription, and this type of SP remains uncaptured within NHS statistics. These results indicate an underuse of the national system set up to deliver one particular model of SP, rather than that SP does not occur. Additionally, despite national guidance issued to accompany the NHS model, practices such as referral and feedback processes, and link worker presence within practices, were not uniform even within this single CCG. Nevertheless, understanding is increasing as SP becomes embedded within primary care. The lack of consistency in referrals between practices warrants further examination in terms of equity of service choices to patients, as does the very low self-reported referral rate to SP.

PMID:35869824 | DOI:10.1111/hsc.13935

Mol Ecol. 2022 Jul 23. doi: 10.1111/mec.16623. Online ahead of print.

ABSTRACT

Geologically recent radiations can shed light on speciation processes, but incomplete lineage sorting and introgressive gene flow render accurate evolutionary reconstruction and interpretation challenging. Independently evolving metapopulations of low-dispersal taxa may provide an additional level of phylogeographic information, given sufficiently broad sampling and genome-wide sequencing. Evolution in the marine brown algal genus Fucus in the south-eastern North Atlantic was shaped by Quaternary climate-driven range shifts. Over this timescale, divergence and speciation occurred against a background of expansion-contraction cycles from multiple refugia, together with mating-system shifts from outcrossing (dioecy) to selfing hermaphroditism. We tested the hypothesis that peripheral isolation of range edge (dioecious) F. vesiculosus led to parapatric speciation and radiation of hermaphrodite lineages. Species tree methods using 876 single-copy nuclear genes and extensive geographic coverage produced conflicting topologies with respect to geographic clades of F. vesiculosus. All methods, however, revealed a new and early diverging hermaphrodite species, Fucus macroguiryi sp. nov. Both the multispecies coalescent and polymorphism-aware models (in contrast to concatenation) support sequential paraphyly in F. vesiculosus resulting from distinct evolutionary processes. Our results support 1) peripheral isolation of the southern F. vesiculosus clade prior to parapatric speciation and radiation of hermaphrodite lineages – a “low latitude species pump”. 2) Directional introgressive gene flow into F. vesiculosus around the present-day secondary contact zone (sympatric-allopatric boundary) between dioecious/hermaphrodite lineages as hermaphrodites expanded northwards, supported by concordance analysis and statistical tests of introgression. 3) Species boundaries in the extensive sympatric range are likely maintained by reproductive system (selfing in hermaphrodites) and reinforcement.

PMID:35869812 | DOI:10.1111/mec.16623

Eur J Clin Invest. 2022 Jul 23:e13839. doi: 10.1111/eci.13839. Online ahead of print.

ABSTRACT

Social media and new tools for engagement offer democratic platforms for enhancing constructive scientific criticism which had previously been limited. Constructive criticism can now be massive, timely, and open. However, new options have also enhanced obsessive criticism. Obsessive criticism tends to focus on one or a handful of individuals and their work, often includes ad hominem aspects, and the critics often lack field-specific skills and technical expertise. Typical behaviors include: repetitive and persistent comments (including sealioning), lengthy commentaries/tweetorials/responses often longer than the original work, strong degree of moralizing, distortion of the underlying work, argumentum ad populum, calls to suspend/censor/retract the work or the author, guilt by association, reputational tarnishing, large gains in followers specifically through attacks, finding and positing sensitive personal information, anonymity or pseudonymity, social media campaigning, and unusual ratio of criticism to pursuit of one’s research agenda. These behaviors may last months or years. Prevention and treatment options may include awareness, identifying and working around aggravating factors, placing limits on the volume by editors, constructive pairing of commissioned editorials, incorporation of some hot debates from unregulated locations such as social media or PubPeer to the pages of scientific journals, preserving decency and focusing on evidence and arguments and avoiding personal statements, or (in some cases) ignoring. We need more research on the role of social media and obsessive criticism on an evolving cancel culture, the social media credibility, the use/misuse of anonymity and pseudonymity, and whether potential interventions from universities may improve or further weaponize scientific criticism.

PMID:35869811 | DOI:10.1111/eci.13839

Int Endod J. 2022 Jul 23. doi: 10.1111/iej.13802. Online ahead of print.

ABSTRACT

AIM: The aim of this study was to evaluate the IFI16 and IFN-α/β receptors expression during the genesis and development of experimental apical periodontitis (AP) in mice teeth.

METHODOLOGY: AP was induced in the lower first molars of 40 C57BL/6 mice. They were divided according to the experimental periods 2, 7, 14, 21 and 42 days (n=8 per group). Five animals were used as a control group (without AP). Specimens were submitted to histological processing for description of the inflammatory process, immunostaining for the presence/absence and localization of IFI16 and IFN-α/β receptors (qualitative and semi-quantitative analysis), and tartrate-resistant acid phosphatase (TRAP) histoenzimology.

RESULTS: The results showed a gradual development of AP over the experimental times. The expression of IFI16 was noticeably more exacerbated in the experimental early period (day 2) while the lowest expression was observed in the control group (p=0.02). For IFN-α/β receptors, a higher intensity staining was observed 42 days after AP induction, that was statistically different from the control group (p=0.02). Also, the number of TRAP positive cells was higher on the later periods (days 21 and 42) (p<0.001).

CONCLUSION: IFI16 protein expression was highest during the early periods after apical periodontitis induction in mice teeth, whilst IFN-α/β receptors expression was highest after apical periodontitis became established.

PMID:35869806 | DOI:10.1111/iej.13802

J Cosmet Dermatol. 2022 Jul 23. doi: 10.1111/jocd.15262. Online ahead of print.

ABSTRACT

Psoriasis (PsO) is a systemic autoimmune disease. Many pro-inflammatory and anti-inflammatory biomarkers have been associated with the pathogenetic process of psoriasis. IL-35 act as an anti-inflammatory cytokine through down regulation of TH-17 cell development and cytokine production. So, IL-35 might be utilized as potential future therapeutic agent for psoriasis.

AIMS: to investigate the association between Inflammatory (IL-17, TNF-α, IFN-γ) and anti-Inflammatory Cytokines (IL-35, TGF-β) in psoriasis patients.

PATIENTS AND METHODS: A case-control study enrolled two groups; (Group I: 40 patientswith psoriasis) and (Group II: 40 healthy age and sex matched subjects). Full history was taken from all cases along with full dermatologic examination. The assessment of psoriasis severity was conducted by using PASI score. Assessment of Inflammatory (IL-17, TNF-α, IFN-γ) and anti-Inflammatory Cytokines (IL-35, TGF-β) was performed by using ELISA technique.

RESULTS: There was a statistically significant increase of mean level of TNF-α, IL-17 and IFN-γ among psoriasis cases in comparison to controls. The mean level of TGF-β and IL-35 was statistically significantly reduced among the psoriasis cases in comparison to controls. TNF-α, IL-17 and IFN-γ showed a significant strong positive association in between and statistically significant strong negative relationship with IL-35 and TGF-β.

CONCLUSION: IL-35 has a significant role in the pathogenetic process of PsO, and it serves as a potential future therapeutic agent for psoriasis. The current results could be used as a clue for the utilization of inflammatory (IL-17, TNF-α, IFN-γ) versus anti-inflammatory Cytokines (IL-35, TGF-β) in psoriasis patients as a diagnostic biomarker for severity of cases with psoriasis.

PMID:35869799 | DOI:10.1111/jocd.15262

Dig Endosc. 2022 Jul 23. doi: 10.1111/den.14409. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the safety and efficacy of a new endoscopic duodenal-jejunal bypass sleeve (DJBS) in obese patients with non-alcoholic fatty liver disease (NAFLD), while in situ for 3 months, and at 6 months post-explantation.

METHODS: Patients with obesity and NAFLD were enrolled in this single-center, prospective study, wherein TONGEE® DJBS was implanted for 3 months. Primary outcomes were weight loss and changes in hepatic steatosis. Secondary outcomes included changes in liver enzymes, glycemic control, and lipid profile and device safety.

RESULTS: Twenty-six patients (age: 35.2 ± 7.2 years; 61.5% women) underwent DJBS implantation. At 3 months, body weight change from baseline was -8.0 ± 3.6 kg (P < 0.001), corresponding to 8.9 ± 4.0% of total body weight. Hepatic steatosis significantly improved based on controlled attenuation parameter, hepatic steatosis index, and fatty liver index (P < 0.001). Liver enzymes, insulin resistance, and metabolic parameters were also improved. At 6 months post-explantation, weight loss and improvements in hepatic steatosis and liver enzyme levels remained statistically significant. Only one patient had a serious adverse event, namely, upper gastrointestinal hemorrhage.

CONCLUSIONS: Three-month TONGEE® DJBS implantation resulted in significant weight loss and improvement in hepatic steatosis, liver enzymes, insulin resistance, and metabolic parameters in obese patients with NAFLD. Randomized controlled trials are required to further elucidate these initial findings.

PMID:35869797 | DOI:10.1111/den.14409

Health Soc Care Community. 2022 Jul 23. doi: 10.1111/hsc.13949. Online ahead of print.

ABSTRACT

Older people’s well-being can be bolstered by engaging with cultural activities and venues. They may be encouraged to try cultural offers by a link worker as part of social prescribing. However, the cultural sector, like all parts of life, was affected by the COVID-19 pandemic; this has had implications for cultural offers available to link workers. A study was conducted to explore the views and experiences of link workers in using the cultural sector within social prescribing, particularly for older people (aged 60+) during the pandemic. An online questionnaire was distributed to and completed by link workers in the UK. Data were analysed mainly using descriptive statistics. Open text responses were clustered into similar ideas to create key concepts. Useable responses were received from 148 link workers. They highlighted a general lack of interaction between link workers and the cultural sector about how the latter could support social prescribing. Results suggested that personal familiarity with cultural offers might prompt link workers to refer to them. Some respondents proposed that cultural offers were regarded as elitist, which deterred them from referring there. However, there was a general acknowledgement that the cultural sector could contribute to social prescribing. Link workers need to regard the cultural sector as accessible, appropriate, adequate, affordable and available before referring older people to cultural offers as part of social prescribing. Link workers may benefit from becoming more familiar with cultural sector staff and offers, including online resources, so they can then propose them to patients with confidence.

PMID:35869795 | DOI:10.1111/hsc.13949

J Paediatr Child Health. 2022 Jul 23. doi: 10.1111/jpc.16128. Online ahead of print.

ABSTRACT

AIM: The sepsis risk calculator (SRC) has been shown to reduce empirical antibiotic usage in neonates at risk of early-onset sepsis without increasing adverse clinical outcomes. However, its use for categorising and improving identification of at-risk neonates exposed to chorioamnionitis in the local population has not been reported. This study compares the management guided by the SRC to our unit’s clinical practice of administering empirical antibiotics to all term neonates (born ≥37 weeks gestation), symptomatic and asymptomatic, who were exposed to chorioamnionitis, and evaluates the performance of the SRC in managing asymptomatic term neonates exposed to chorioamnionitis.

METHODS: This single-centre retrospective study identified 178 eligible term neonates exposed to chorioamnionitis over a 17-month study period. Relevant demographic and clinical information on the mother-infant dyad was collected. The SRC was executed retrospectively in the study cohort. Descriptive statistics were used for reporting the findings.

RESULTS: The mean gestational age was 39 (standard deviation, SD 1) weeks, and the mean birth weight was 3472 (SD 482) g. Of the 178 neonates, 136 (76%) were asymptomatic and received empirical antibiotic therapy for 2 days (mean). Based on management recommendations from the SRC, empirical antibiotic therapy could have been avoided in 98% of asymptomatic neonates; 88% could have been managed by observation alone, avoiding mother-infant separation. No neonate died or had a positive blood culture result.

CONCLUSIONS: The SRC could reduce antibiotic exposure in asymptomatic neonates exposed to chorioamnionitis. It could assist clinicians to categorise risk in neonates exposed to chorioamnionitis.

PMID:35869737 | DOI:10.1111/jpc.16128

Nan Fang Yi Ke Da Xue Xue Bao. 2022 Jul 20;42(7):1038-1043. doi: 10.12122/j.issn.1673-4254.2022.07.11.

ABSTRACT

OBJECTIVE: To understand the temporal trend of and the factors affecting depressive symptoms in Chinese menopausal women to provide evidence for the development of prevention and treatment strategies.

METHODS: CHARLS data were used to select menopausal women aged 45-60 years. Complete values of the key variables were screened and missing values were removed to obtain the cross-sectional data of the years 2011 (n=4318), 2013 (n=4200), 2015 (n=3930), and 2018 (n= 4147). The panel data were matched by the cross-sectional data, and a total of 5040 cases with complete record of the follow-up data were obtained for the 4 years to constitute a balanced short panel dataset with n=1260 and T=4. The prevalence and temporal trend of depressive symptoms in the menopausal women were analyzed based on the panel data. The random-effects Logit model with a panel dichotomous choice model was used to explore the factors affecting depressive symptoms in the menopausal women.

RESULTS: The prevalence of depressive symptoms in the menopausal women calculated based on the panel data was 35.9%, 33.1%, 36.7% and 43.7% in the 4 years, respectively, showing no statistically significant changes in the temporal trend (APC=3.25%, P=0.183). The results of the random-effects Logit model analysis showed that living in the urban area (OR=0.570, 95%CI: 0.457-0.710), a high education level (OR=0.759, 95%CI: 0.655-0.879), and having a spouse (OR=0.363, 95% CI: 0.236-0.558) were associated with a decreased incidence of depressive symptoms, while poor self-reported health (OR= 2.704, 95% CI: 2.152-3.396), disability (OR=1.457, 95%CI: 1.087-1.954), chronic disease (OR=1.407, 95% CI: 1.179-1.680), falls in the last two years (OR=2.028, 95% CI: 1.613-2.550), abnormal sleep duration (OR=2.249, 95% CI: 1.896-2.664), and dissatisfaction with life (OR=4.803, 95% CI: 3.757-6.140) were associated with an increased incidence of depressive symptoms.

CONCLUSION: The prevalence of depressive symptoms is relatively high in menopausal women in China. Measures should be taken to ensure that the menopausal women living in rural areas, with low education level, without spouse, with a poor self-reported health status, disability, chronic diseases, falls in recent two years, abnormal sleep time and dissatisfaction with life have access to psychological health care services and interventions.

PMID:35869767 | DOI:10.12122/j.issn.1673-4254.2022.07.11

Cell Mol Biol (Noisy-le-grand). 2022 Feb 28;68(2):60-63. doi: 10.14715/cmb/2022.68.2.9.

ABSTRACT

This experiment was conducted to investigate the effect of taking Baihe Gujin decoction combined with Shengmai powder on IL-1β and IL-1Ra expression in peripheral blood CD14+ monocytes from patients with pulmonary tuberculosis. For this purpose, one hundred adult patients with primary pulmonary tuberculosis were selected for the study. The age of the enrolled cases ranged from 18 to 60 years old, with a controlled male to the female sex ratio of about 1:1. The Chinese medical evidence was considered to be a qi-yin deficiency type of pulmonary consumption. The patients were randomly divided into experimental and control groups, 50 cases each. In addition, 50 cases of healthy people were selected as a healthy control group, totaling 150 cases. In the experimental group, patients were given Baihe gujin decoction and Shengmai powder based on conventional western medicine, 1 dose for 1 day, 150mL/time for 2 times. The control group was treated with conventional Western medicine. 2 mL of fasting elbow venous blood from the subjects was taken in the morning. Peripheral blood mononuclear cells were isolated by density centrifugation. Monocytes were obtained after incubation with 5 μL of CD14+ immune magnetic beads at 4°C. The relative expression of IL1β and IL1R genes were measured using real-time quantitative PCR (RT-PCR), respectively. Results showed that the relative expression of IL1β and IL1R genes was significantly lower in the experimental group after 3 months compared with the control group, and the statistical difference was highly significant (p<0.01). It was concluded that the administration of Baihe gujin decoction and Shengmai powder was closely related to the relative expression of IL1β and IL1R genes in patients’ serum, indicating that Baihe gujin decoction and Shengmai powder have an important role in improving the clinical symptoms of pulmonary tuberculosis.

PMID:35869725 | DOI:10.14715/cmb/2022.68.2.9