Tag: statistics

Acta Ophthalmol. 2022 Aug 1. doi: 10.1111/aos.15219. Online ahead of print.

ABSTRACT

PURPOSE: To identify correlations between the vascular characteristics of macular neovascularization (MNV) obtained by optical coherence tomography angiography (OCTA) and distinct retinal fluid volumes in neovascular age-related macular degeneration (nAMD).

METHODS: In this prospective interventional study, 54 patients with treatment-naïve type 1 or 2 nAMD were included and treated with intravitreal aflibercept. At baseline and month 1, each patient underwent a SD-OCT volume scan and volumetric flow scan using a swept-source OCTA. A deep learning algorithm was used to automatically detect and quantify fluid in OCT scans. Angio Tool, a National Cancer Institute algorithm, was used to skeletonize MNV properties and quantify lesion size (LS), vessel area (VA), vessel density (VD), total number of endpoints (TNE), total number of junctions (TNJ), junction density (JD), total vessel length (TVL), average vessel length (AVL) and mean-e-lacunarity (MEL). Subsequently, linear regression models were used to investigate a correlation between OCTA parameters and fluid quantifications.

RESULTS: The median amount of fluid within the central 6-mm EDTRS ring was 173.7 nl at baseline, consisting of 156.6 nl of subretinal fluid (SRF) and 2.3 nl of intraretinal fluid (IRF). Fluid decreased significantly in all compartments to 1.76 nl (SRF) and 0.64 nl (IRF). The investigated MNV parameters did not change significantly after the first treatment. There was no significant correlation between MNV parameters and relative fluid decrease after anti-VEGF treatment. Baseline fluid correlated statistically significant but weakly with TNE (p = 0.002, R² = 0.17), SRF with TVL (p = 0.04, R² = 0.08), VD (p = 0.046, R² = 0.08), TNE (p = 0.001, R² = 0.20) and LS (p = 0.033, R² = 0.09). IRF correlated with VA (p = 0.042, R² = 0.08).The amount of IRF at month 1 correlated significantly but weakly with VD (p = 0.036, R² = 0.08), JD (p = 0.019, R² = 0.10) and MEL (p = 0.005, R² = 0.14).

CONCLUSION: Macular neovascularization parameters at baseline and month 1 played only a minor role in the exudation process in nAMD. None of the MNV parameters were correlated with the treatment response.

PMID:35912717 | DOI:10.1111/aos.15219

J Clin Sleep Med. 2022 Aug 1. doi: 10.5664/jcsm.10158. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: Transgender or gender nonconforming (TGNC) identity is associated with higher burden of sleep disorders relative to cisgender identity. However, the role of gender-affirming therapy (GAT) in sleep disorders is poorly understood. This study examined relationships between TGNC identity, transition, and sleep disorders among TGNC and cisgender youth.

METHODS: This retrospective cross-sectional study utilized a large US-based administrative claims database (de-identified Optum Clinformatics Data Mart Database) to identify youth aged 12-25 years who obtained a diagnosis of TGNC identity and those who pursued GAT. Descriptive statistics estimated distributions of demographic and health characteristics by gender identity. Unadjusted and age-adjusted logistic regression models were used to examine associations between TGNC identity, GAT, and sleep disorders.

RESULTS: This study included 1,216,044 youth, of which 2,603 (0.2%) were identified as TGNC. Among the 1,387 TGNC who pursued GAT, 868 and 519 were identified as transmasculine and transfeminine, respectively. Adjusted analysis showed increased odds of insomnia (OR=5.4, 95% CI 4.7, 6.2), sleep apnea (OR=3.0, 95% CI 2.3, 4.0), and other sleep disorders (OR=3.1, 95% CI 2.5, 3.9) in TGNC relative to cisgender youth. Decreased odds of any sleep disorder were observed in the TGNC youth on GAT (OR=0.5, 95% CI 0.4, 0.7) relative to those not on GAT.

CONCLUSIONS: This study demonstrated a high burden of sleep disorders in TGNC youth in comparison to cisgender. However, GAT may confer a protective effect on sleep disorders among TGNC youth. Longitudinal assessments of sleep disorders prior to and post-GAT are needed to uncover their temporal relationships.

PMID:35912700 | DOI:10.5664/jcsm.10158

J Clin Sleep Med. 2022 Aug 1. doi: 10.5664/jcsm.10152. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: Initial reports of intravenous (IV) iron administration have been promising for children with restless legs syndrome (RLS), periodic limb movement disorder (PLMD), and restless sleep disorder (RSD). The aim of the current study was to further evaluate the clinical response to IV iron supplementation in children seen in a pediatric sleep clinic.

METHODS: We performed a retrospective chart review of children cared for in a single pediatric sleep clinic who also underwent IV iron infusion. Pre and post IV data regarding their sleep symptoms and ferritin levels were abstracted.

RESULTS: Overall, 63 pediatric sleep patients underwent IV iron infusion, mostly with ferric carboxymaltose (n=60), for RLS (n=30), PLMD (n=22), and RSD (n=17) Of the 59 patients with clinical follow-up, 39 (73%) noted improvement in at least one symptom, and 14 (26%) did not notice improvement or noticed worsening symptoms. Of the 59 patients with pre- and post-infusion labs, the average ferritin level increased from 21.7 (13.3) to 147.9 (120.9), p<0.001. Comparing patients who experienced clinical improvement versus those who did not, there were no statistically significant differences in change in ferritin levels (p=0.278), sex (p=0.452), or age (p=0.391). Ferritin change with infusion according to diagnostic subgroups (RLS/PLMD/RSD) was examined, and no significant differences were noted (F(2,56)=0.852, p=0.432). In terms of immediate adverse reactions to the IV infusion, 7 (11%) experienced at least 1 side effect, with the most common being behavior change (n=6) or gastrointestinal discomfort (n=4); no episodes of anaphylaxis or extravasation were noted.

CONCLUSIONS: These data provide additional support for the efficacy and safety of IV iron for pediatric RLS, PLMD, and RSD recalcitrant to oral iron.

PMID:35912699 | DOI:10.5664/jcsm.10152

Palliat Support Care. 2022 Aug 1:1-7. doi: 10.1017/S1478951522000992. Online ahead of print.

ABSTRACT

OBJECTIVES: Final conversations (FCs) go beyond how patients want to be cared for at the end of life (EOL) and focus on messages of love, identity specific, and unique to an individual and relationship that requires self-examination, everyday talk that normalizes a difficult situation, religious/spiritual messages, and if needed, difficult relationship talk to heal broken relationships. The purpose of the Catalyzing Relationships at the End of Life (CAREol) program was to provide interdisciplinary education to nursing and medical students and clinical faculty about facilitating FCs among patients and families.

METHOD: This two-part, quasi-experimental program consisted of a cognitive (online) and experiential (live simulation) curriculum experience. Program curriculum, including video vignettes, readings, and live simulation (utilizing actors), was developed by the study team. Reflective journaling and researcher designed pre- and post-tests were used to assess comfort, confidence, importance, and distress regarding FCs and collaboration with other disciplines.

RESULTS: The pre-/post-test questions demonstrate statistical significance based on a paired t-test with effect sizes supporting the practical importance of the findings for effect size. Preliminary content and thematic analysis of qualitative responses describe categories of the mock team meeting experience and interaction with the actors to change patient and family outcomes.

SIGNIFICANCE OF RESULTS: Early intervention with the CAREol program provides a framework to help students and clinical faculty facilitate FCs that may result in peace and comfort for patients and families during a difficult time.

PMID:35912673 | DOI:10.1017/S1478951522000992

Br J Nutr. 2022 Aug 1:1-21. doi: 10.1017/S0007114522002197. Online ahead of print.

ABSTRACT

Increasing the availability of lower energy food options is a promising public health approach. However, it is unclear the extent to which availability interventions may result in consumers later ‘compensating’ for reductions in energy intake caused by selecting lower energy food options, and to what extent these effects may differ based on socioeconomic position (SEP). Our objective was to examine the impact of increasing availability of lower energy meal options on immediate meal energy intake and subsequent energy intake in participants of higher vs. lower SEP. In a within-subjects design N=77 UK adults ordered meals from a supermarket ready meal menu with standard (30%) and increased (70%) availability of lower energy options. The meals were delivered to be consumed at home, with meal intake measured using the Digital Photography of Foods Method. Post-meal compensation was measured using food diaries to determine self-reported energy intake after the meal and the next day. Participants consumed significantly less energy (196kcal, 95% CI: 138, 252) from the menu with increased availability of lower energy options versus the standard availability menu (p<.001). There was no statistically significant evidence that this reduction in energy intake was substantially compensated for (33% compensated, p=.57). The effects of increasing availability of lower energy food items were similar in participants from lower and higher SEP. Increasing the availability of lower energy food options is likely to be an effective and equitable approach to reducing energy intake which may contribute to improving diet and population health.

PMID:35912671 | DOI:10.1017/S0007114522002197

Prog Community Health Partnersh. 2022;16(2S):23-32. doi: 10.1353/cpr.2022.0035.

ABSTRACT

BACKGROUND: To ensure equity in coronavirus disease 2019 (COVID-19) vaccine access, it is critical that Black and Latine communities receive trustworthy COVID-19 information. This study uses community-based participatory research to understand sources of COVID-19 information for Black and Latine adults, how trustworthy that information is, and relationships between information sources and COVID-19 vaccine intention.

METHODS: We co-created a survey in Spanish and English and distributed it to Black and Latine adults residing in the Pittsburgh area. Data were analyzed using descriptive statistics and multivariate logistic regression.

RESULTS: There were 574 participants who completed the survey. Participants reported accessing a variety of COVID-19 information sources and generally trusted these sources. Few sources of information were associated with COVID-19 vaccine intention. We also review lessons learned from our community-academic collaboration.

CONCLUSIONS: Trustworthy COVID-19 information sources may not be sufficient for increasing vaccine intention. Results can help other community-academic partnerships working to improve COVID-19 vaccine equity.

PMID:35912654 | DOI:10.1353/cpr.2022.0035

Circ Cardiovasc Interv. 2022 Aug 1:CIRCINTERVENTIONS122012004. doi: 10.1161/CIRCINTERVENTIONS.122.012004. Online ahead of print.

ABSTRACT

BACKGROUND: The benefit of clopidogrel monotherapy after 1-month dual antiplatelet therapy (DAPT) compared with 12-month DAPT with aspirin and clopidogrel was demonstrated in the STOPDAPT-2 (Short and Optimal Duration of Dual Antiplatelet Therapy After Everolimus-Eluting Cobalt-Chromium Stent-2), but not in the STOPDAPT-2 acute coronary syndrome (ACS); however, both trials were underpowered based on the actual event rates.

METHODS: We obtained the prespecified pooled population of 5997 patients as the STOPDAPT-2 total cohort (STOPDAPT-2: N=3009/STOPDAPT-2 ACS: N=2988; ACS: N=4136/chronic coronary syndrome [CCS]: N=1861), comprising 2993 patients assigned to 1-month DAPT followed by clopidogrel monotherapy, and 3004 patients assigned to 12-month DAPT with aspirin and clopidogrel after percutaneous coronary intervention. The primary end point was the composite of cardiovascular (cardiovascular death, myocardial infarction, definite stent thrombosis, or any stroke) or bleeding (Thrombolysis in Myocardial Infarction major/minor) end points at 1 year.

RESULTS: One-month DAPT was noninferior to 12-month DAPT for the primary end point (2.84% versus 3.04%; hazard ratio [HR], 0.94 [95% CI, 0.70-1.27]; P_{noninferiority}=0.001; P_superiority=0.68). There was no significant risk-difference for the cardiovascular end point between the 1- and 12-month DAPT groups (2.40% versus 1.97%; HR, 1.24 [95% CI, 0.88-1.75]; P_{noninferiority}=0.14; P_superiority=0.23). There was a lower risk of the bleeding end point with 1-month DAPT relative to 12-month DAPT (0.50% versus 1.31%; HR, 0.38 [95% CI, 0.21-0.70]; P_superiority=0.002). One-month DAPT relative to 12-month DAPT was associated with a lower risk for major bleeding regardless of ACS or CCS (ACS: HR, 0.46 [95% CI, 0.23-0.94]; P=0.03, and CCS: HR, 0.26 [95% CI, 0.09-0.79]; P=0.02; P_interaction=0.40), while it was associated with a numerical increase in cardiovascular events in ACS patients, but not in CCS patients, although not statistically significant and without interaction (ACS: HR, 1.50 [95% CI, 0.99-2.27]; P=0.053, and CCS: HR, 0.74 [95% CI, 0.38-1.45]; P=0.39; P_interaction=0.08).

CONCLUSIONS: Clopidogrel monotherapy after 1-month DAPT compared with 12-month DAPT with aspirin and clopidogrel had a benefit in reducing major bleeding events without being associated with increase in cardiovascular events.

REGISTRATION: URL: https://www.

CLINICALTRIALS: gov; Unique identifiers: NCT02619760, NCT03462498.

PMID:35912647 | DOI:10.1161/CIRCINTERVENTIONS.122.012004

Neurol Res. 2022 Jul 31:1-7. doi: 10.1080/01616412.2022.2104293. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: Thoracic fractures can lead to death and disability. This retrospective study aimed to evaluate cases of upper and middle thoracic vertebral fractures due to trauma that had been treated, to determine the fracture type and treatment method according to age, sex, cause of injury, neurological status, fracture level, kyphotic angles, and classification methods and to discuss the results regarding that reported in the literature.

PATIENTS AND METHODS: This study included 238 patients who were evaluated for post-traumatic upper and middle thoracic vertebral fractures between January 2012 and December 2020. We classified each patient according to the Dennis, TLICS, ATLICS, and ASIA classifications using neurological examination, radiography, computed tomography, and magnetic resonance imaging. We statistically evaluated the data obtained.

RESULTS: Fifty-five percent of total patients were male. The average age was 51.11. Traffic accidents were the most common causes of trauma, with 67.2%. T8 was most affected. The ASIA classification, the Dennis, TLICS, and ATLICS classifications showed a significant increase in the severity of neurological deficits as the fracture scores increased (p < 0.001). We observed that the increase in the preoperative kyphotic angle caused an increase in the number of deficits according to the classifications (p < 0.001).

CONCLUSION: The ATLICS classification yielded more accurate results than that of the other classifications. In addition, the kyphotic angle was evaluated for upper and middle thoracic fractures, and we concluded it is important in surgical decision making.

PMID:35912638 | DOI:10.1080/01616412.2022.2104293

J Appl Biomater Funct Mater. 2022 Jan-Dec;20:22808000221114715. doi: 10.1177/22808000221114715.

ABSTRACT

The analysis of nanofluids under various physical scenarios convinced the researchers and scientists because of their broad range of applications in potential area of the current time like chemical engineering, biomedical engineering and applied thermal engineering etc. To give the final shape of many industrial and engineering processes, enhanced heat transfer desired, therefore, the study of Al₂O₃-H₂O, γAl₂O₃-H₂O, Al₂O₃-C₂H₆O₂, and γAl₂O₃– C₂H₆O₂ nanofluids is reported. The model successfully achieved after mathematical operations and by appealing similarity transforms. To examine the behavior of heat transfer, numerical tools utilized and performed the results. It is observed that enhanced heat transfer in Al₂O₃-H₂O, γAl₂O₃-H₂O, Al₂O₃-C₂H₆O₂, and γAl₂O₃-C₂H₆O₂ could be attained by setting nanoparticles concentration up to 20%. For Al₂O₃-H₂O, γAl₂O₃-H₂O, optimum heat transfer trends noticed due to their prominent thermophysical values. Also, fewer effects of combined convection on $\theta \left(\eta \right)$ examined.

PMID:35912571 | DOI:10.1177/22808000221114715

Phys Sportsmed. 2022 Jul 30. doi: 10.1080/00913847.2022.2108352. Online ahead of print.

ABSTRACT

OBJECTIVES: Selective Androgen Receptor Modulators (SARMs) social media interest is at an all-time high. The aim of this study is to analyze the: (1) quality; (2) educational content; and (3) reliability of the most relevant YouTube videos on SARMs to explain growing SARMs abuse by recreational and professional athletes.

METHODS: ‘SARMs’ was queried (November 28, 2021) through the YouTube video library. The top 100 videos filtered by relevance were categorized by source, type of content, educational quality by Global Quality Score (GQS), reliability by Journal of American Medicine Association (JAMA) criteria, YouTube tags, attitude towards SARMs use, and whether the video provided specific support on how to use SARMs. For all outcome variables, descriptive statistics and comparison among source types and category types were performed.

RESULTS: Mean JAMA score was 1.6 ± 0.7 out of 4. Mean GQS score was 2.5 ± 1.1 out of 5. Patient videos were of lower educational quality than athletic trainer videos (GQS: 2.11 ± 0.95 vs. 2.95 ± 1.00, p < 0.01), and videos categorized as user experience were of lower educational quality than videos categorized as general SARMs information (GQS: 1.92 ± 0.90 vs. 2.72 ± 1.07, p < 0.05). User experience and dosing recommendation videos were statistically significantly more positive in attitude than both general SARMs information and SARMS vs. other PEDs.

CONCLUSION: Quality, content, and reliability of SARMs YouTube videos was low. Social media likely causes SARMs abuse through disseminating biased SARMs misinformation. These results serve to educate public health oversight bodies, healthcare providers, and sports team members to better identify signs of SARMs abuse, and promote discussion to discourage SARMs abuse.

PMID:35912528 | DOI:10.1080/00913847.2022.2108352