Tag: statistics

Clin Ophthalmol. 2022 Mar 23;16:893-904. doi: 10.2147/OPTH.S356436. eCollection 2022.

ABSTRACT

PURPOSE: To investigate the correlation between the photopic negative response (PhNR) of the light-adapted flash electroretinography (ERG) and measurements of standard automated perimetry (SAP) and optical coherence tomography (OCT) in assessment of retinal ganglion cells’ (RGCs) affection in glaucoma.

PATIENTS AND METHODS: A cross-sectional study included 40 eyes of glaucoma patients and 40 eyes of age- and gender-matched normal subjects. Participants underwent a complete ophthalmologic assessment, SAP, OCT, and light-adapted flash ERG using the extended PhNR protocol of the International Society for Clinical Electrophysiology of Vision (ISCEV). Glaucomatous eyes were divided into 3 subgroups: mild (n = 15), moderate (n = 11) and severe glaucoma (n = 14) according to the mean deviation (MD) of SAP. Measurements of SAP, OCT and ERG parameters were analyzed, and correlations between PhNR measurements and other study measurements were evaluated.

RESULTS: PhNR amplitudes and PhNR/b-wave ratios were significantly reduced in glaucoma cases compared to healthy controls, and they showed a significant and progressive decline across the three glaucoma subgroups (P < 0.05). An exception to this is PT (b-wave peak to PhNR trough) PhNR amplitude where its reduction was statistically non-significant when comparing between controls and mild glaucoma cases (P = 0.178), and between moderate and severe glaucoma cases (P = 0.714). PhNR amplitudes and PhNR/b-wave ratios correlated significantly with SAP and OCT parameters (P < 0.05).

CONCLUSION: PhNR correlates well with SAP and OCT parameters in glaucoma assessment. PhNR could be a valuable supplementary tool for objective assessment of the RGCs’ function in glaucoma.

PMID:35356699 | PMC:PMC8958198 | DOI:10.2147/OPTH.S356436

Res Pract Thromb Haemost. 2022 Mar 25;6(2):e12686. doi: 10.1002/rth2.12686. eCollection 2022 Feb.

ABSTRACT

BACKGROUND: BAY81-8973 (Kovaltry; Bayer, Berkeley, CA, USA) was reported with enhanced pharmacokinetic (PK) profiles compared with some other standard half-life (SHL) factor VIII (FVIII) concentrates. Limited head-to-head comparative studies were conducted in a real-world setting.

OBJECTIVE: To make head-to-head comparisons of PK and clinical outcomes between Kovaltry and three other SHL FVIII concentrates.

METHODS: Forty-seven boys with severe hemophilia A were enrolled and divided into three groups according to their previously used FVIII concentrates (Kogenate FS, N = 22; Advate, N = 14; GreenMono, N = 11). Two separate PK tests were conducted in each participant with a five-point assay during the study period from 6 months before switching to 6 months after switching. FVIII levels were detected by one-stage assay, and PK profiles were calculated by noncompartmental assay. Annualized bleeding rates were collected through participant’ bleed logs.

RESULTS: Longer half-life time (Kogenate FS group: 14.4 vs 11.9 hours, P < .0001; Advate group: 13.4 vs 9.7 hours, P < .0001; GreenMono group: 15.1 vs 10.7 hours, P < .001]) and lower clearance (Kogenate FS group: 3.3 vs 3.9 mL/kg/h, P < .01; Advate group: 3.7 vs 5.9 mL/kg/h, P < .01; GreenMono group: 3.0 vs 5.1 mL/kg/h, P < .01) were observed with Kovaltry. In addition, longer mean residential time (P < .01) and higher area under the curve (P < .01) were demonstrated. No statistical difference was found in in vivo recovery between Kovaltry and the other FVIII products. Participants who switched to Kovaltry from three other FVIII concentrates with the same dosing regimens obtained higher trough FVIII levels and better protection with reduced annualized bleeding rates.

CONCLUSION: Compared with Kogenate FS, Advate, and GreenMono, Kovaltry showed enhanced PK profiles, which contributed to reduced bleeding rates.

PMID:35356665 | PMC:PMC8956787 | DOI:10.1002/rth2.12686

Mol Ther Nucleic Acids. 2022 Feb 28;28:77-86. doi: 10.1016/j.omtn.2022.02.015. eCollection 2022 Jun 14.

ABSTRACT

DNA methylation plays a pivotal role in the progression of renal fibrosis. Methyl-CpG-binding domain protein 2 (MBD2), a protein reader of methylation, is involved in the development of acute kidney injury (AKI) caused by vancomycin. However, the role and mechanism of action of MBD2 in renal remain unclear. In this study, MBD2 mediated extracellular matrix (ECM) production induced by TGF-β1 in Boston University mouse proximal tubule (BUMPT) cells，and upregulated the expression EGR1 to promote ECM production in murine embryonic NIH 3T3 fibroblasts. ChIP analysis demonstrated that MBD2 physically interacted with the promoter region of the CpG islands of EGR1 genes and then activated their expression by inducing hypomethylation of the promoter region. In vivo, PT-MBD2-KO attenuated unilateral ureteral obstruction (UUO)-induced renal tubulointerstitial fibrosis via downregulation of EGR1, which was demonstrated by the downregulation of fibronectin (FN), collagen I and IV, α-SMA, and EGR1. Injection of MBD2-siRNA attenuated the UUO- and I/R-induced renal fibrosis. Those molecular changes were verified by biopsies from patients with obstructive nephropathy (OB). These data collectively demonstrated that inhibition of MBD2 reduces renal fibrosis via downregulating EGR1, which could be a target for treatment of fibrotic kidney disease.

PMID:35356685 | PMC:PMC8933641 | DOI:10.1016/j.omtn.2022.02.015

J Glob Health. 2022 Mar 19;12:04025. doi: 10.7189/jogh.12.04025. eCollection 2022.

ABSTRACT

BACKGROUND: Fever and malaria are highly prevalent among children under five across sub-Saharan Africa, but utilization and quality of care for febrile illness remain insufficient. Many studies examine socioeconomic and demographic determinants of care seeking; however, few assess how women’s empowerment influences care seeking and quality. We examine associations of women’s empowerment with: a) care utilization for children with fever and malaria and b) the quality of that care in 16 sub-Saharan African countries.

METHODS: This cross-sectional study used data from Demographic and Health Surveys conducted between 2010 and 2018. We constructed indices for economic, educational, sociocultural, and health-related empowerment and calculated the proportion of children with fever and malaria who sought care and received a range of recommended clinical actions. We used multivariable Poisson hurdle models to assess associations between empowerment, utilization, and number of components of quality care, controlling for socioeconomic and demographic factors.

RESULTS: Our sample consisted of 25 871 febrile children, 4731 of whom had malaria diagnosed by rapid diagnostic test. Empowerment among mothers of children with fever was 0.50 (interquartile range, 0.38-0.63). In both the fever and malaria groups, over 30% of children were not taken for care. Among care seekers, febrile children received on average 0.47 (SD = 0.37) of components of quality care, and children with malaria received 0.38 (SD = 0.34). Multidimensional women’s empowerment was significantly associated with care seeking and quality among febrile children, and with quality among children with malaria. Associations persisted after adjustment for socioeconomic and demographic characteristics.

CONCLUSIONS: Results demonstrate substantial gaps in women’s empowerment and poor utilization and quality of care for fever and malaria among children. Increased women’s empowerment is associated with seeking care and, separately, obtaining high-quality care. To improve health outcomes, consideration of how empowering women can promote care seeking and extract quality from the health system is warranted.

PMID:35356662 | PMC:PMC8932460 | DOI:10.7189/jogh.12.04025

J Glob Health. 2022 Mar 26;12:04013. doi: 10.7189/jogh.12.04013. eCollection 2022.

ABSTRACT

BACKGROUND: Complications associated with preterm birth (PTB) are the largest contributor to under-five mortality globally. Success in reaching the Sustainable Development Goal target requires identifying potentially modifiable risk factors for PTB, estimating the relative importance of these risk factors, and identifying/implementing effective prevention strategies to address them.

METHODS: We conducted a literature review to define risk relationships and estimate prevalence for established risk factors for spontaneous PTB (sPTB). We then estimated population attributable fractions (PAF) for the sPTB risk factors identified in the review as statistically significant for the 81 low- and middle-income (LMIC) countries included in the Countdown 2030 initiative. We summed country-level findings to produce PAFs for each risk factor and regional estimates for sub-Saharan Africa and South Asia.

RESULTS: Forty-four potential sPTB risk factors were identified. and the final analysis included twenty-four risk factors with evidence of significant associations with sPTB. A second model with three additional risk factors with borderline insignificant associations was also run. Taken together, the twenty-four risk factors had a total PAF of 73% for all 81 countries and 77% and 72% of sPTB in sub-Saharan Africa and South Asia, respectively. For all countries, maternal undernutrition had the highest PAF (17.5%), followed by maternal infections (16.6%), environmental exposures (16%) and pregnancy history (8.7%).

CONCLUSIONS: While multiple risk factors contribute to sPTB, no single risk factor addresses a predominant fraction, and 27% of spontaneous preterm births are not associated with risk factors that we identified. Despite the significant role of preterm birth in child survival, there are major data gaps in LMIC settings. Furthermore, there is a paucity of evidence for effective interventions to prevent preterm birth. Preventing sPTB requires understanding underlying mechanisms leading to sPTB in different populations, and the identification/implementation of effective interventions.

PMID:35356651 | PMC:PMC8959104 | DOI:10.7189/jogh.12.04013

J Glob Health. 2022 Mar 19;12:11002. doi: 10.7189/jogh.12.11002. eCollection 2022.

ABSTRACT

BACKGROUND: Creating an enabling environment (EE) can help foster the development and health of children. The Chinese government implemented a new health care reform (NHR) in 2009 in a move to promote an EE for health. The purpose of this study was to evaluate the impact of the NHR on EE for children’s health.

METHODS: An interrupted time-series analysis was used to evaluate the changes in the EE before and after 2009 in China. This study analysed the EE through five quantitative indicators, including policy element coverage rate (PECR), service meeting with children’s needs rate (SMCNR), multisector participation rate (MPR), and accountability mechanism clarity rate (AMCR), based on the content analysis of available public policy documents (updated as of 2019) from 31 provinces in mainland China, and the number of health care personnel of maternity and child care centres per 10 000 population (HP per 10 000 population), based on the 2002-2019 China Health Statistical Yearbook and China Statistical Yearbook.

RESULTS: The average values of PECR, SMCNR, and MPR increased rapidly to 90.96%, 82.46%, and 81.31%, respectively, in 2019, representing a higher value compared to the AMCR (7.38%). The NHR promoted the EE, in which HP per 10 000 population showed the fastest increase (β₁ = 0.03, P < 0.01; β₃ = 0.10, P < 0.01), followed by SMCNR (β₁ = 0.94, P < 0.01; β₃ = 1.83, P < 0.01), AMCR (β₁ = 0.13, P < 0.01; β₃ = 0.24, P = 0.14), MPR (β₁ = 1.35, P < 0.01; β₃ = 2.47, P < 0.01) and PECR (β₁ = 1.43, P < 0.01; β₃ = 1.47, P < 0.01).

CONCLUSIONS: The NHR has a positive impact on the EE, especially on the human resources and service provision for children. Efforts should be intensified to improve the clarity of the accountability mechanism of the health-related sectors.

PMID:35356653 | PMC:PMC8932608 | DOI:10.7189/jogh.12.11002

China CDC Wkly. 2022 Mar 11;4(10):199-206. doi: 10.46234/ccdcw2022.048.

ABSTRACT

INTRODUCTION: With the large-scale roll-out of the coronavirus disease 2019 (COVID-19) booster vaccination effort (a vaccine dose given 6 months after completing primary vaccination) in China, we explore when and how China could lift non-pharmacological interventions (NPIs) against COVID-19 in 2022.

METHODS: Using a modified susceptible-infectious-recovered (SIR) mathematical model, we projected the COVID-19 epidemic situation and required medical resources in Guangdong Province, China.

RESULTS: If the number of people entering from overseas recovers to 20% of the number in 2019, the epidemic in 2022 could be controlled at a low level by a containment (215 local cases) or suppression strategy (1,397 local cases). A mitigation strategy would lead to 21,722 local cases. A coexistence strategy would lead to a large epidemic with 6,850,083 local cases that would overwhelm Guangdong’s medical system. With 50% or 100% recovery of the 2019 level of travelers from overseas, the epidemic could also be controlled with containment or suppression, but enormous resources, including more hotel rooms for border quarantine, will be required. However, coexistence would lead to an uncontrollable epidemic with 12,922,032 local cases.

DISCUSSION: With booster vaccinations, the number of travelers from overseas could increase slightly in 2022, but a suppression strategy would need to be maintained to ensure a controllable epidemic.

PMID:35356641 | PMC:PMC8930405 | DOI:10.46234/ccdcw2022.048

J Healthc Eng. 2022 Mar 21;2022:8223336. doi: 10.1155/2022/8223336. eCollection 2022.

ABSTRACT

The efficacy and safety of transcatheter arterial chemoembolization (TACE) are systematically evaluated in the treatment of primary liver cancer, which provides a reference for clinical practice and more in-depth research. Cochrane Library, PubMed, EMbase, CBM, CNKI, VIP, and WanFang Data, supplemented by other searches, collected all randomized controlled trials (RCT) comparing TACE combined with TACE alone for HCC. The meta-analysis, after selecting the literature, extracting data, and evaluating the methodological quality of the included studies following the inclusion criteria, was performed using RevMan 5.1 software. There was statistical difference in 3-year survival rate of TACE combined with heat treatment for advanced hepatocellular carcinoma (OR = 1.72,95%CI (1.22,2.41), P=0.002, I² = 0%, and Z = 3.12), total effective rate (OR = 1.91,95%CI (1.31,2.78), P=0.0008, I² = 0%, and Z = 3.37), quality-of-life improvement rate (OR = 2.29,95%CI (1.62,3.23), P < 0.00001, I² = 83%, and Z = 3.37), and complication rate (OR = 2.29,95%CI (1.62,3.23), P < 0.00001, I² = 83%, and Z = 3.37). Compared with TACE alone, TACE combined with hyperthermia can significantly improve the survival rate and recent efficacy of patients, improve the quality of life, and have a trend to reduce the incidence of toxicity. However, its long-term efficacy and more comprehensive safety need to be verified by more sample and high-quality RCT.

PMID:35356619 | PMC:PMC8959991 | DOI:10.1155/2022/8223336

J Healthc Eng. 2022 Mar 21;2022:8432360. doi: 10.1155/2022/8432360. eCollection 2022.

ABSTRACT

Osteoporotic vertebral compression fractures are on the rise in modern society due to the aging population, and this often results in painful symptoms and kyphotic abnormalities in patients. Bone cement was injected into the vertebral body to reinforce the vertebral body and restore most of the damaged vertebrae’s natural height. Percutaneous kyphoplasty is the name given to this type of procedure (PKP). Bone cement leakage has been linked to several problems, according to the research. Neurological problems might arise if bone cement leaks into the spinal canal or the nerve root canal during surgery. As a result, PKP surgeons must now deal with the issue of reducing bone cement leakage. Using smart medical big data, this paper examines a sample of PKP operations and then examines different associated aspects that influence complication rates in order to better advice clinical PKP surgery use. There were 172 vertebral bodies in total in 72 patients receiving PKP surgery at a Chinese hospital that were examined by smart medical big data for vertebral degeneration and fusion. Bone cement leakage and variations in preoperative average anterior vertebral column height, preoperative Cobb angle, and the volume of injected bone cement were considered when dividing the patients into leakage and nonleakage groups; then, we figure out what is causing the bone cement to leak. Five patients experienced lung-related problems out of the 18 vertebral bodies with bone cement leaking that were selected for study. That leakage rate was 10.5%. The differences between the two groups in terms of vertebral compression and bone cement injection were statistically significant based on a single-factor analysis. Bone cement leakage in PKP surgery has been linked to the amount of bone cement injected and whether the vertebral body’s peripheral wall was injured, according to multivariate analysis. Lung-related problems are more common in patients with a prior history of illness. Osteoporotic vertebral compression fractures can be successfully treated with percutaneous kyphoplasty. An important risk factor for bone cement extravasation in PKP surgery is the amount of bone cement injected, as well as its viscosity and whether damage to the vertebral body’s peripheral wall has occurred.

PMID:35356609 | PMC:PMC8959986 | DOI:10.1155/2022/8432360

Psychiatr Danub. 2021 Spring-Summer;33(Suppl 4):1118-1129.

ABSTRACT

Addiction does not mean “addiction to substances” only. At the core of the definition of substance dependence is the loss of control. Gambling addiction belongs to non-substance / non-chemical addictions or behavioral/behavioral addictions. The concept of behavioral addictions is new and revolutionary in psychiatry. Gambling addiction, formerly pathological or problematic gambling occurs due to loss of control over gambling. There is growing evidence to suggest that behavioral addictions resemble substance addictions in many domains, including phenomenology, tolerance, comorbidity, overlapping genetic contribution, neurobiological mechanisms, and response to treatment. Behavioral addiction has been proposed as a new class in the Diagnostic Statistical Manual Fifth Revision (DSM-5), but the only category included is gambling addiction. The prevalence of gambling disorders in adolescence is very high and for certain disorders (especially related to the use of the Internet) it becomes more pronounced over time. In this paper, we presented a comprehensive overview of gambling disorders from definition, epidemiology, manifestations, comorbidities, assessment, treatment options, and existing forms of treatment. Given the complexity of the approach to the treatment of gamblers, a creative individualized integrative approach is necessary, which is the basis of creative psychopharmacotherapy. Due to the possibility of the emergence of problem gambling and other impulse-control deficits we need to be very careful when commencing a patient on dopamine replacement therapy or therapy with aripiprazole.

PMID:35354178