Tag: statistics

Microcirculation. 2021 Jun 9:e12719. doi: 10.1111/micc.12719. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the distribution of capillary non-perfusion (CNP) in superficial and deep capillary plexuses (SCP and DCP) in eyes with diabetic retinopathy (DR).

METHODS: In this retrospective case series, macular optical coherence tomography angiography (OCTA) images were obtained from eyes with DR without diabetic macular edema. The area of CNP in SCP and DCP was delineated using an automated approach after excluding the foveal avascular zone and major retinal vessels. The distribution and spatial correlation of the CNP in each layer was analyzed.

RESULTS: Forty-three eyes of 27 patients with diabetic retinopathy with a mean age of 59.10± 9.05 years were included. The mean CNP area in SCP was statistically significantly higher than DCP (0.722± 0.437 mm² vs 0.184± 0.145 mm² , respectively, P<0.001). There was a statistically significant association between mean BCVA (0.28±0.21 logMAR) and CNP area in DCP (P=0.01). After automated subtraction of CNP areas in DCP from SCP, 25.43±15.05 % of CNP areas in the DCP had co-localized CNP areas in SCP. The CNP percentage was statistically significantly different between the concentric rings on foveal center, both in SCP and DCP (both P<0.001) showing a decreasing trend from the outer ring toward the center.

CONCLUSION: In DR, SCP is more ischemic than DCP. This is in contrast to the previously described oxygenation dependent ischemic cascade following acute retinal vascular occlusions. This study provides further insight into the retinal ischemia in DR.

PMID:34105840 | DOI:10.1111/micc.12719

Int J Clin Pract. 2021 Jun 9:e14457. doi: 10.1111/ijcp.14457. Online ahead of print.

ABSTRACT

BACKGROUND: Cardiovascular disease (CVD) is prevalent worldwide and for many patients, non-adherence to medication remains a problem. Motivational interviewing is a behavioural, communication strategy used as an intervention aimed to improve health outcomes.

AIMS: This systematic review sought to investigate the effect of motivational interviewing delivered as part of pharmacy care on medication adherence and the effect this has on clinical outcomes. These included systolic and diastolic blood pressure, haemoglobin A1C, lipid profiles and cardiovascular risk scores.

METHOD: A systematic review was conducted in six databases: PubMed Central UK, Cochrane Library, CINAHL (EBSCO), PsycINFO, EMBASE and MEDLINE from the inception of motivational interviewing in 1983 to November 2020. Randomised controlled trials that assessed motivational interviewing as part of pharmacy care interventions were selected. The Cochrane risk of bias tool was used to assess the risk of bias for each included study. This review was registered with PROSPERO (registration number CRD42020222954).

RESULTS: A total of eight randomised controlled trials met the inclusion criteria. Five out of eight studies demonstrated medication adherence significantly improved following motivational interviewing interventions. One study showed a significant improvement for systolic blood pressure (SBP) change by 7.2mmHg (95% CI 1.6-12.8mmHg); this reduction was observed in patients whose baseline blood pressure was above their target blood pressure. No statistically significant effect was seen across other clinical outcomes.

CONCLUSION: motivational interviewing could be an effective behavioural strategy to enhance medication adherence in patients with CVD. Although the evidence is promising thus far, further research is required to explore the impact of motivational interviewing on clinical outcomes as well as the feasibility of implementing motivational interviewing interventions within existing pharmacy care services.

PMID:34105858 | DOI:10.1111/ijcp.14457

Ginekol Pol. 2021 Jun 9. doi: 10.5603/GP.a2021.0078. Online ahead of print.

ABSTRACT

OBJECTIVES: It has been provided that if incubation time of prepared sperm can affect sperm motility and DNA fragment, but little is known about the influence of sperm preincubation time (SI) on the sperm’s fertilizing ability, subsequent embryonic development and pregnancy outcomes in in vitro fertilization (IVF). The aim of this study was to explore the association of SI with fertilization rate, embryo development and clinical outcomes in IVF, further, to find an optimal preincubation time for prepared sperm before insemination in IVF.

MATERIAL AND METHODS: This retrospective cohort study included a total of 1453 infertile couples undergoing IVF in our center performed from January 2016 to January 2019. Sperm were preincubated at 37℃ 6% CO₂ for different times before insemination. Preincubation time associated with fertilization rate (FR), 2PN rate, D3 good quality embryo rate, fresh embryo implantation rate (IR), blastocyst formation rate, cumulative pregnancy rate (CPR), cumulative ongoing pregnancy rate (COPR), cumulative live birth rate (CLBR), newborn health and gender ratio were analyzed by chi-square analysis.

RESULTS: FR and 2PN rate of SI more than four hours SI groups (> 4 h SI group) decreased significantly compared with other SI groups (p < 0.01). There were no significant differences of the D3 high quality embryo rate among five SI groups. The blastocyst formation rate of > 4 h SI group was significantly lower than that of 2-3 h SI group (45.5% vs 56.1%, p < 0.05); and 1-2 h SI group also had significant difference with 2-3 h and 3-4 h SI group (48.9% vs 56.1% and 54.6%, p < 0.05). There were a significant decrease of fresh IR and CPR in ≤1 h SI group compared with 1-2 h SI group (19.6% vs. 38.0%, p < 0.05; 62.7% vs 73.7%, p < 0.05); ≤ 1 h SI group also have the lowest CLBR (45.6%), it had statistic differences with 1-2 SI group and 3-4 SI group (45.6% vs 63.2%, p < 0.01; 45.6% vs 61.2%, p < 0.05).

CONCLUSIONS: The sperm preincubated time at 37℃ 6% CO₂ before insemination could influence sperm fertilizing ability, blastocyst formation, embryo implantation and CLBR in IVF cycles. The best time for prepared sperm preincubation at 37℃ is one to four hours before insemination in IVF.

PMID:34105750 | DOI:10.5603/GP.a2021.0078

Biometrics. 2021 Jun 9. doi: 10.1111/biom.13492. Online ahead of print.

NO ABSTRACT

PMID:34105765 | DOI:10.1111/biom.13492

J Bone Miner Res. 2021 Jun 9. doi: 10.1002/jbmr.4316. Online ahead of print.

ABSTRACT

The relationship between birth weight and osteoporosis was inconsistent in previous observational studies. Therefore, we performed a systematic evaluation to determine the inconsistent relationship and further make causal inference based on the UK Biobank datasets (~500,000 individuals) and individual/summary-level genetic datasets. Observational analyses found consistent negative associations either between birth weight and estimated bone mineral density (eBMD) or between genetic risk score (GRS) of birth weight and eBMD in total subjects, and sex-stratified subgroups. Mediation analyses detected significant mediation effects of adult weight and height on associations between birth weight and eBMD. Birth weight was causally associated not only with three BMD phenotypes (eBMD, total body [TB]-BMD, and femoral neck [FN]-BMD) under two effect models (total and fetal effect), but also with the risk of fracture using different Mendelian randomization (MR) methods. Multivariable MR analyses detected the pleiotropic effects of some environmental factors (e.g., gestational duration, head circumference, hip circumference) on the associations between birth weight and BMD/fracture. Three BMD phenotypes (eBMD, TB-BMD, and FN-BMD) have significant mediation effects on the associations between birth weight and fracture by using a novel mediation MR analysis under the multivariable MR framework. This multistage systematic study found consistent causal associations between birth weight and osteoporosis risk, fetal origin of genetic effects underlying the associations, and several mediation factors on the detected associations. The results enhanced our understanding of the effects of fetal original phenotypes on outcomes in late adulthood and provided helpful clues for early prevention research on osteoporosis. © 2021 American Society for Bone and Mineral Research (ASBMR).

PMID:34105796 | DOI:10.1002/jbmr.4316

Ginekol Pol. 2021 Jun 9. doi: 10.5603/GP.a2021.0112. Online ahead of print.

ABSTRACT

OBJECTIVES: Our study evaluates the impact of adjuvant treatment with external beam radiotherapy (EBRT) combined with vaginal high-dose-rate brachytherapy (HDR BT) on health-related quality of life (HRQL) in patients with early-stage endometrioid endometrial carcinoma.

MATERIAL AND METHODS: We assessed HRQL of patients based on the EORTC QLQ-C30 questionnaire, with endometrial cancer specific HRQL module – EORTC QLQ-EN24. From March 2019 to April 2020 we enrolled 20 patients with early-stage endometrioid endometrial carcinoma, qualified for adjuvant treatment after hysterectomy. We compared the scores measured with the questionnaires at the beginning and at the end of the treatment.

RESULTS: There was a statistically significant decrease in the mean of global health status/quality of life assessed according to the EORTC QLQ-C30 scale, from 62.25 ± 13.12 at the beginning of the adjuvant radiotherapy to 55.85 ± 14.68 at the end of the treatment (p = 0.047). The mean appetite loss score was higher at the onset of the treatment as compared to its value after EBRT, 19.9 ± 27.33 vs 11.6 ± 19.52 (p = 0.043). Similarly to the mean constipation score, which was 29.85 ± 30.40 vs 11.6 ± 19.52 (p = 0.013). The mean diarrhoea symptom scale increased from 16.55 ± 20.16 to 56.75 ± 36.10 (p = 0.001). In the EORTC QLQ-EN24 scales, gastrointestinal symptoms scores were higher at the end of the treatment, (with the mean of 26.45 ± 22.76) as compared to 14.30 ± 16.52 at the beginning of EBRT (p = 0.003).

CONCLUSIONS: Patients who receive adjuvant radiotherapy have decreased quality of life during the treatment reporting more serious gastrointestinal symptoms. The potential risk of treatment-related toxicity should be taken into account during the treatment planning process in order to minimize the deterioration of HRQL.

PMID:34105737 | DOI:10.5603/GP.a2021.0112

Ginekol Pol. 2021 Jun 9. doi: 10.5603/GP.a2021.0093. Online ahead of print.

ABSTRACT

OBJECTIVES: Endometrial endometrioid carcinoma (EEC) is the most encountered subtype of endometrial cancer (EC). Our study aimed to investigate the factors affecting recurrence in patients with stage 1A and 1B EEC.

MATERIAL AND METHODS: Our study included 284 patients diagnosed with the International Federation of Gynecology and Obstetrics stage 1A/1B EEC in our center from 2010 to 2018. The clinicopathological characteristics of the patients were obtained retrospectively from their electronic files.

RESULTS: The median age of the patients was 60 years (range 31-89). The median follow-up time of the patients was 63.6 months (range 3.3-185.6). Twenty-two (7.74%) patients relapsed during follow-up. Among the relapsed patients, 59.1% were at stage 1A ECC, and 40.9% were at stage 1B. In our study, the one-, three-, and five-year recurrence-free survival (RFS) rates were 98.9%, 95.4%, and 92.9%, respectively. In the multivariate analysis, grade and tumor size were found to be independent parameters of RFS in all stage 1 EEC patients. Furthermore, the Ki-67 index was found to affect RFS in stage 1A EEC patients, and tumor grade affected RFS in stage 1B EEC patients. In the time-dependent receiver operating characteristic curve analysis, the statistically significant cut-off values were determined for tumor size and Ki-67 index in stage 1 EEC patients.

CONCLUSIONS: Stage 1-EEC patients in the higher risk group in terms of tumor size, Ki-67, and grade should be closely monitored for recurrence. Defining the prognostic factors for recurrence in stage 1 EEC patients may lead to changes in follow-up algorithms.

PMID:34105738 | DOI:10.5603/GP.a2021.0093

J Frailty Aging. 2021;10(3):254-258. doi: 10.14283/jfa.2021.3.

ABSTRACT

BACKGROUND: The relationship between frailty and variables such as housing are the least included in models of frailty and research on frailty or social frailty and relocation is negligible. The decision to relocate is complex and demanding for older adults with a loss of independence but little is known about what makes older adults relocate to congregated housing designated for older adults, let alone in combination with social frailty, and how they navigate this transition.

OBJECTIVES: This mixed method descriptive study aims to understand the influence of social frailty for a population of French-speaking semi-independent older adults relocating to a housing continuum community.

DESIGN: Semi-structured individual interviews including sociodemographic data and the PRISMA-7 Frailty Scale were conducted with recently relocated older adults.

SETTING: A newly opened French-speaking housing continuum community in Eastern Canada that offers luxury apartments for independent older adults, two assisted living facilities for semi-independent older adults along with a long-term care facility.

PARTICIPANTS: Twenty-nine older adults with a mean age of 85 years, mostly female, married or widowed and highly educated.

MEASUREMENTS: Content analysis of the transcribed recorded interviews and descriptive statistical analyses to examine relationships between the frailty PRISMA-7 scale, answers to additional questions and the sociodemographic data.

RESULTS: There was not a significant difference in the scores for socialization before and after relocation nor between prior help and current help; however, there was a significant negative correlation between help and socialization before and after relocation. Three main themes included: imposed influences, push and pull factors and post relocation.

CONCLUSIONS: The results indicate that several social factors contributed to relocation and that participants were experiencing social frailty. Participants were at the crossover point of being vulnerable to experiencing additional deficits which would potentially have led to higher frailty had they not relocated.

PMID:34105710 | DOI:10.14283/jfa.2021.3

J Frailty Aging. 2021;10(3):272-280. doi: 10.14283/jfa.2021.7.

ABSTRACT

This systematic literature review documents the link between frailty or sarcopenia, conceptualized as dimensions of physical health, and the use of long-term care services by older individuals. Long-term care services include formal and informal care provided at home as well as in institutions. A systematic review was performed according to PRISMA requirements using the following databases: PubMed-Medline, Embase, CINAHL, Web of Science, and Academic Search Premier. We included all quantitative studies published in English between January 2000 and December 2018 focusing on individuals aged 50 or more, using a relevant measurement of sarcopenia or physical frailty and a long-term care related outcome. A quality assessment was carried out using the questionnaire established by the Good Practice Task Force Report of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Five subsets of long-term care outcome were considered: 1/ nursing home placement (NHP), 2/ nursing home short stay (NHSS), 3/ formal personal care (FPC), 4/ formal home help (FHH), 5/ informal care (IC). Out of 1943 studies, 17 were finally included in the review. With some studies covering several LTC outcomes, frailty and / or sarcopenia were associated with increased LTC use in 17 out of 26 cases (NHP: 5/6, NHSS: 3/4, FPC: 5/7, FHH: 1/4, IC: 3/5) The association was not consistent in 5 cases (NHP: 1/6, NHSS: 1/4, FPC: 2/7, FHH: 0/4, IC: 1/5) and the association was either not significant or the results inconclusive in the remaining 9 cases. Overall, while results on sarcopenia are scarce, evidence support a positive association between frailty and LTC use. The evidence is stronger for the association of physical frailty with nursing home placement / short stay as well as on FPC. There is less (more heterogeneous) evidence regarding the correlation between physical frailty and FHH or IC use. Results need to be confirmed by more advanced statistical methods or design based on longitudinal data.

PMID:34105712 | DOI:10.14283/jfa.2021.7

Am J Hypertens. 2021 Jun 9:hpab084. doi: 10.1093/ajh/hpab084. Online ahead of print.

ABSTRACT

BACKGROUND: Although previous studies have reported the gut microbiome is closely related to hypertension development, whether the change in blood microbiome is associated with the risk of hypertension remains unclear.

METHODS: One hundred and fifty incident hypertension cases and 150 age (± 2 years) and gender (1:1) matched non-hypertension controls included in this nested case-control study were recruited from a prospective cohort study of “135”. The composition of the blood microbiome was characterized using bacterial 16S ribosomal RNA gene sequencing. The relative abundance of detected bacteria was converted to a negative logarithm of 10 for the statistical analysis.

RESULTS: Totally, 10,689,961 high-quality sequences were acquired. The Chao1 index of the blood microbiome in non-hypertension controls was significantly higher than that in hypertensive group (2302.08±752.78 vs 1598.21±500.88, P < 0.001). Compared with the non-hypertension controls, the relative abundance of Proteobacteria phylum was significantly increased (P<0.001), while the relative abundance of phyla Firmicutes and Bacteroidetes were significantly reduced in the hypertensive cases (P<0.001 and P=0.039, respectively). At genus level, the risk of hypertension was directly associated with the relative abundance ofAcinetobacter(OR: 1.43, 95% CI: 1.01-2.03),Sphingomonas(OR: 1.84, 95% CI: 1.32-2.56), andStaphylococcus(OR: 0.51, 95% CI: 0.36-0.73), respectively.In addition, the relative abundance of Pseudomonas was minor positively correlated to the TC level. However, the relative Staphylococcus level was minor positively correlated to HDL-c level.

CONCLUSIONS: The composition of the blood microbiome is significantly associated with the development of hypertension.

PMID:34105723 | DOI:10.1093/ajh/hpab084