Demographic Parameters Research Articles

Treatment outcomes in adult patients experiencing dental anxiety: A comparative retrospective study.

To assess and compare the effectiveness of pharmacological and cognitive-behavioral modalities-behavioral methods (BM), nitrous oxide inhalation sedation (NOIS), and premedication with Diazepam-for alleviating anxiety during dental treatment, using completed treatment sessions and adverse outcomes as indicators. For 239 patients (515 dental records), 18-53 y/o, who underwent dental treatments under anxiety reduction measures, sessions under NOIS were categorized as "nitrous group" (456 sessions) versus premedication with Diazepam or behavioral strategies (control, 59 sessions). Outcomes were completed treatment sessions considering demographic and clinical parameters, and adverse outcomes during and between sessions. Adjusted logistic regression showed significantly higher odds of completing treatment sessions after NOIS (p = 0.014) as compared to controls. Univariate analyses demonstrated failure of anesthesia was higher in the control versus the nitrous group (p<0.001). Adverse outcomes were more frequent in controls (p=0.005). No significant effects of age, gender, and general health condition on completion rates of treatment plans were demonstrated. The complexity of the treatment plan had a significant effect on its completion (p = 0.03). NOIS modality yielded significantly superior outcomes as compared to BM and premedication with Diazepam, with no significant effects of age or gender on the completion of treatment plans.

A dynamic optimization model for vaccine allocation with age considerations: A study inspired by the COVID-19 pandemic

In a pandemic situation, an effective vaccination campaign is seen as a powerful tool to prevent the spread of infectious diseases and reduce fatalities. However, its success highly depends on its organization and combination with other measures. To help the decision-makers in this endeavor, this paper proposes a Mixed-Integer Linear Programming - Vaccine Allocation (MILP-VA) model to plan the vaccination campaign to minimize the number of possible fatalities over a given period. To better integrate the pandemic dynamics, this model is coupled with a single-dose Susceptible-Vaccinated-Infected-Recovered (SVIR) model where the compartmentalization of the population allows for the adjustment of different demographic and epidemiological parameters based on age categories and their social interactions. This approach is proven to suit populations with heterogeneous age groups better. The applicability of the proposed SVIR-MILP-VA model is illustrated using a case study inspired by the COVID-19 pandemic. Accordingly, an extensive numerical analysis was conducted to test various managerial, epidemiological, and behavioral conditions, such as vaccine availability, transmission rates, and vaccine hesitancy. This approach facilitates robust discussions to address the uncertainties of an emerging pandemic and provides a solid foundation for informed vaccination decisions in real-world settings. The results are discussed, and the findings are formulated as insights for researchers and practitioners.

Can Intravenous Caffeine Citrate Be Used for Severe Asthma Exacerbation in Children? A Retrospective Comparative Study.

To assess the effectiveness of intravenous caffeine citrate in paediatric asthma exacerbation unresponsive to beta2-agonists and steroids. A 10-year retrospective cohort study was conducted on asthmatic children unresponsive to beta2-agonists and steroids, who were treated with either intravenous caffeine citrate or magnesium sulphate. The study outcomes were changes in the Paediatric Respiratory Assessment Measure (PRAM) score, duration of oxygen therapy and paediatric intensive care unit (PICU) length-of-stay. Overall, 296 children were treated in the PICU between January 1, 2011, and December 31, 2020. Fifteen and 26 children unresponsive to beta2-agonists and steroids (median ages 2.3 [0.7-11] and 3.0 [1.2-8.5] years), respectively, received caffeine citrate and magnesium sulphate. The two groups showed similar demographic characteristics and baseline parameters. At 24 and 48 h, the median (IQR) PRAM scores for the caffeine and magnesium groups were 4 (2-6) and 5 (4-6), respectively (p = 0.27), and 7 (6-8) and 8 (5-9), respectively (p = 0.57). The median (IQR) durations of PICU stay for the caffeine and magnesium groups were 36 (19-46) and 32 (23-45) h, respectively (p = 0.77). The median (IQR) durations of oxygen therapy for the caffeine and magnesium groups were 25 (10-30) and 20 (15-30) h, respectively (p = 0.29). No serious adverse events occurred in the caffeine group. One occurred in the magnesium group. Caffeine citrate and magnesium sulphate demonstrated comparable effectiveness in treating steroid- and beta2-agonist-resistant asthma. A multicentre prospective study is needed to validate these results.

Clinical profile and co-morbidities in children with moderate and severe acute malnutrition

Background: Malnutrition as a problem is multidimensional and multifactorial with varied clinical profiles and comorbidities. The objectives of this study were to evaluate the clinical profile and comorbidities in children suffering from malnutrition and to estimate the association of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) with demographic parameters, feeding, and immunization. Methods: This cross-sectional study was conducted on 132 children with malnutrition, aged between 6 to 59 months, at Hind Institute of Medical Sciences, Sitapur over 18 months. Demographic details, clinical history, clinical evaluation, anthropometric measurements, and investigations, were noted on predesigned performa. All the data were analyzed by SPSS software. A p-value&lt;0.05 was considered significant. Result: The mean age of children with malnutrition was 25.79(15.68) months. Wasting and severe wasting among children with malnutrition were 51.5 % and 48.5% respectively. Major comorbidities were diarrhoea (70.5%), severe anemia (67.4%), pneumonia (62.9%), vitamin A deficiency (59.8%), sepsis (54.6%), urinary tract infection (54.5%), vitamin D deficiency (35.6%), worm infestation (30.3%), and tuberculosis (28.8%). A significant association of malnutrition was found with children of younger age (p&lt;0.0001), Hindu religion (p&lt;0.0001), not exclusively breastfed (p=0.004), delayed initiation of complementary feeding (p=0.029), and incomplete immunization (p=0.006). Conclusion: Malnutrition is closely linked to poor infant and young child feeding practices. Malnourished children suffer from various infections and micronutrient deficiencies. Adequate and timely nutritional support plays a vital role in breaking the vicious cycle of undernutrition-disease-undernutrition resulting in recovery.

Perceived ease-of-usability and local tolerability using CGRP monoclonal antibody autoinjectors &lt;i&gt;vs.&lt;/i&gt; syringes: an online questionnaire-based study in patients with migraine

Background: Monoclonal antibodies acting on the CGRP pathway (CGRP-mAbs) are characterized by subcutaneous administration via autoinjectors or prefilled syringes. Unfortunately, significant local tolerability concerns about injection site pain (ISP) may degrade patient comfort, increase the fear and stress of dose administration, and negatively impact patient adherence. The aim of the present cross-sectional study was to assess the experience of patients with migraine using either CGRP-mAbs prefilled syringes or autoinjectors regarding local tolerability and perceived ease-of-usability. Methods: A self-administered electronic questionnaire was created using “Google questionnaires” to collect from migraine inpatients treated with CGR-mAbs: i) demographic and clinical parameters; ii) data related to ongoing preventive CGRP-mAb treatments and their local tolerability (in particular, evaluated by numerical rating scale); iii) data on perceived ease-of-usability; and iv) data on putative previous onabotulinumtoxinA treatment. Results: The questionnaire was sent to 405 migraine patients. After 10 days, 283 (69.87%) patients had completed the electronic form. No significant differences were found among groups regarding data on ease-of-usability and local tolerability of CGRP-mAbs regarding simplicity and modality of administration (self-administered or not), ISP, or reactions at the site of administration. However, we did identify young females (OR=0.22; p&lt;0.001) with chronic migraine (OR=4.87; p=0.007) to be the phenotype most prone to experience ISP during CGRP-mAbs treatment. Of 96 patients who had previously received at least 3 onabotulinumtoxinA administrations, injection site pain was significantly higher with onabotulinumtoxinA compared to CGRP-mAbs (6±4 vs. 4±5; p&lt;0.001). Conclusions: Devices used for CGRP-mAbs administration (auto-injector and prefilled syringes) are characterized by several strengths and disadvantages, one compensating for the other so that no differences in perceived ease-of-usability and local tolerability can be observed. These findings may also result in economic and ecological implications, considering the lower impact on costs and environmental pollution of prefilled syringes compared to more expensive and polluting plastic autoinjectors.

Outcomes in Late Presenting Obstructed Infracardiac Total Anomalous Pulmonary Venous Connection-Single Centre Experience.

Survival beyond one month of age is rare in children born with obstructed infracardiac total anomalous pulmonary venous connection (TAPVC). There are limited data available on surgical outcomes of the same subset. We conducted this retrospective study to identify risk factors associated with surgical outcomes in this patient population. We present a retrospective study of patients presenting at our institute with obstructed infracardiac TAPVC surviving beyond one month of age during the period from January 2015 to August 2019 (n = 14). Data reviewed included demographic parameters, preoperative laboratory results, echocardiogram images, and computed tomography if performed. Intraoperative as well as postoperative data including type of surgery, use of deep hypothermic arrest, mortality, and morbidity were noted. Follow-up clinical data were also collected from institutional record or telephonically. We have also collected echocardiographic data on follow up. The mean age of our study cohort was 2.14 ± 0.68 months. Out of 14 total patients 3 patients eventually died. Risk factors that were significantly associated with mortality were low weight (odds ratio [OR] = 7.8, P = .005), preoperative bilirubin level (OR = 7.4, P = .007), use of deep hypothermic circulatory arrest (OR = 4.6, P = .031), tricuspid regurgitation grade (OR = 3.8, P = .050), and pulmonary artery hypertension (OR = 10.5, P = .001). Mean follow up for the study cohort was 2189 ± 538 days. One patient has mild flow acceleration across the anastomosis with a gradient of 5/3 mm Hg without any symptoms. The remainder of the patients are alive with excellent clinical as well as echocardiographic outcome. The presentation of infants with obstructed infracardiac TAPVC beyond one month of age is very rare. However, timely intervention can provide acceptable early and excellent late outcomes in this rare patient cohort.

Propithecus verreauxi demography spanning 40 years at Bezà Mahafaly Special Reserve, southwest Madagascar

The diverse, highly endemic flora and fauna of Madagascar make it a priority for research and conservation. Lemurs, the island’s endemic primates, exhibit a distinctive array of biological, behavioral and demographic traits. Research on these species contributes to significant theoretical issues, including the evolution of mammalian life histories and social systems. Virtually all 107 extant lemur species are threatened with extinction or critically endangered, and a better understanding of demography and the drivers of demographic change is needed to inform management strategies for surviving wild populations. Sifaka (Propithecus verreauxi) have been continuously studied and demographic parameters have been monitored at the Bezà Mahafaly Special Reserve in southwest Madagascar since 1984. We have compiled a dataset encompassing over 900 individuals that have been tagged and followed during this period, and new data continue to be added. Data provide information on male and female life history parameters, individual development and aging, and social group dynamics. The dataset is an important resource for both research and management.

Gender, FT4 levels, T stage, and BMI as predictors of TSH levels in thyroid cancer patients

BackgroundAfter initial treatment, levothyroxine (LT4) administration is necessary for thyroid cancer patients to achieve target thyroid-stimulating hormone (TSH) levels. However, the clinical efficacy of weight-based LT4 dosing has been suboptimal, highlighting the need to identify factors influencing the attainment of desired TSH levels and guide personalized treatment.MethodsWe constructed a retrospective cohort comprising 215 patients diagnosed with thyroid cancer. The identification of factors influencing the attainment of expected TSH levels was accomplished through univariate and multivariate logistic regression analyses. Subsequently, we developed a nomogram based on these prognostic factors and performed internal validation using the bootstrap resampling method.ResultsUnivariate and multivariate logistic regression analyses were conducted to analyze the clinical and demographic parameters. A nomogram was constructed using bootstrap resampling to predict the risk of TSH suppression failure, which was validated. The nomogram demonstrated moderate discrimination in estimating the risk of TSH suppression failure, with a Hosmer-Lemeshow test p-value of 0.393 and a bootstrapped calibrated C-index of 0.757 (95% CI 0.687-0.814). The calibration curve indicated good consistency of the model, and decision curve analysis suggested that the nomogram had clinical utility.ConclusionGender, preoperative serum free thyroxine (FT4) levels, T stage, and body mass index exhibit independent associations with the expected level of TSH. The established nomogram effectively predicts the risk of TSH suppression failure. Further research is warranted to investigate how these factors can be utilized in developing a personalized LT4 dosage calculator.

Piriformis muscle abnormalities in sacroiliac MRI of patients with axial spondyloarthritis.

Piriformis syndrome, an often-overlooked cause of sciatica, commonly presents as chronic gluteal pain and poses a diagnostic challenge, particularly in patients with axial spondyloarthritis (axSpA). To examine piriformis muscle abnormalities on sacroiliac magnetic resonance imaging (MRI) and their association with clinical outcomes in patients with axSpA. This cross-sectional study included 100 axSpA patients (50 radiographic [r-axSpA], 50 non-radiographic [nr-axSpA]), classified by the 2009 ASAS Axial Spondyloarthritis criteria, who underwent MRI evaluations of the sacroiliac joints over a 6-month period. Piriformis evaluation included the measurement of muscle size, signal intensity, and the assessment of fatty infiltration. Sciatic neuritis was assessed by identifying enlarged sciatic nerves or increased signal intensity. Data collection included demographic details, disease activity, and functionality parameters. Statistical analysis was performed using appropriate methods, with P < 0.05 indicating significance. Piriformis syndrome findings were identified in 10% of patients, with a slightly higher incidence in r-axSpA patients (12%) compared to nr-axSpA patients (8%); however, this difference was not statistically significant (P = 0.739). Patients with these MRI findings had significantly higher disease activity, as indicated by the Ankylosing Spondylitis Disease Activity Score with C-reactive protein (3.5 vs. 2.82; P = 0.015), and greater functional impairment, measured by the Bath Ankylosing Spondylitis Functional Index (5.45 vs. 2.7; P = 0.041). This study highlights the presence of MRI findings associated with piriformis syndrome among axSpA patients, which are linked to increased disease activity and reduced function. Recognizing piriformis syndrome as a co-morbidity may improve diagnosis and treatment, leading to better patient outcomes.

Non-linear relationship between urinary creatinine and diabetic kidney disease: implications for clinical practice

ObjectiveThis study aims to investigate the relationship between urinary creatinine (UCr) and the risk and severity of Diabetic Kidney Disease (DKD) in patients with Type 2 Diabetes Mellitus (T2DM). The goal is to establish UCr as a potential biomarker for early DKD detection and severity assessment.MethodsA retrospective cross-sectional analysis was conducted using medical records of T2DM patients. Patients were classified into groups with and without DKD, and relevant clinical data, including demographic, blood, and urine parameters, were collected. Logistic regression and receiver operating characteristic (ROC) curve analysis evaluated the association between UCr levels and DKD. Curve fitting and threshold effect model were used to further evaluate the relationship between UCr and the incidence and severity of DKD.ResultsA total of 302 T2DM patients were analyzed, with 137 diagnosed with DKD. Significant differences in clinical parameters were observed between the DKD and non-DKD groups, particularly in UCr, urine albumin levels, and eGFR. UCr levels demonstrated a strong association with DKD. Moreover, a non-linear relationship was identified, with specific inflection points indicating different correlation patterns of UCr with DKD occurrence and progression.ConclusionThe findings of this study highlight the potential of UCr as a valuable biomarker for early detection and assessment of DKD in T2DM patients. Incorporating UCr measurements into routine clinical practice could enhance early identification of patients at risk for kidney complications, leading to timely intervention and improved patient outcomes.

P0991 Laparoscopic ileocecal resection in pediatric Crohn’s disease: effect of anastomotic configuration on postoperative outcomes in the era of biologic therapy

Abstract Background Postoperative complications and recurrence (POR) frequently follow Ileocecal resection (ICR) in pediatric Crohn’s disease (pCD) patients. Evidence addressing the effect of anastomosis type on complications and POR in children remains limited. We aimed to compare laparoscopic-assisted end-to-end (ETE), side-to-side (STS), and Kono-S anastomoses and evaluate their outcomes based on the followed parameters. Methods From April 2018 to December 2023, we prospectively collected data on anastomosis configuration, colonoscopy at 6 months post-surgery, perioperative and demographic parameters from all pediatric patients referred to ICR for pCD. Complications were classified according to the Clavien–Dindo classification (CDc). Logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI) for endoscopic recurrence (ER), defined as Rutgeerts score &amp;gt;1. The ETE was set as the reference. Artificial Intelligence (AI) were not used in the production of this abstract. Results Thirty-eight patients (18 females, 47.4%) were included, 14 in ETE, 10 in STS, 14 in Kono-S. No preoperative differences were observed. Median surgery durations were 151 minutes for ETE, 142 for STS (p=0.78), and 169 for Kono-S (p=0.09). Complication rate did not significantly differ. Median hospitalisations were 6.5 days for ETE, 6 for STS (p=0.85), and 6 for Kono-S (p=0.70). Neither Kono-S nor STS showed a higher risk of ER compared to ETE, with OR=1.13 (95%CI=0.21-6.16) for STS and OR=0.41 (95%CI=0.09-1.87) for Kono-S. Conclusion Kono-S and STS anastomoses demonstrated comparable complication rates to ETE, without significantly prolonging hospitalization or operation duration. Neither type of anastomosis was associated with an increased risk of ER.

P0562 Evaluation of the impact of fistulizing disease on quality of life in Crohn's disease

Abstract Background Crohn's disease (CD) is a chronic, remitting disease with sometimes inadequate response to the treatment and these factors may impact the quality of life of patients. Our study aims to evaluate the impact of fistulizing disease, different treatment options and disease activity on the quality of life of in CD. Methods Patients who applied to the inflammatory bowel disease outpatient clinic between August 2021 and September 2023 were invited to the study respectively. Patients who agreed to participate were included in the study. The quality of life of the patients was assessed with the Inflammatory Bowel Disease Questionnaire (IBDQ), and disease activity was assessed with the Crohn's Disease Activity Index (CDAI). In addition, the Perianal Disease Activity Index (PDAI) was used in those with perianal disease. The quality of life scores of the patients were compared in terms of clinical and demographic parameters. Results A total of 209 patients enrolled in our study; 103 (49.3%) were non-fistulizing and 106 (50.7%) were fistulizing. 78 of the fistulizing patients had perianal fistula. A moderately strong and statistically significant negative correlation was found between CDAI and total IBDQ (r=-.538, p&amp;lt;0.001). A statistically significant negative correlation was found between PDAI and total IBDQ (r=-.372, p=0.001). Although the mean total IBDQ value of nonfistulizing patients (148.97 ±36.41) was higher than fistulizing patients (144.61±37.46), fistulizing status did not significantly affect the total IBDQ score (p=0.395). Being a woman significantly affects all sub-scores of IBDQ score and total IBDQ score. Although the mean total IBDQ score of patients under biological treatment was higher than who were not using them; the difference was not significant (p=0.771). In addition, the quality of life score was significantly lower in those with a diagnosis of spondyloarthropathy (p=0.012). Conclusion In the current literature, the presence of perianal fistula has been shown to have a negative effect on quality of life in several studies (1,2,3). Our study revealed a negative relationship between PDAI and CDAI values and total IBDQ score. In addition, our study showed that gender had a significant effect on total IBDQ, while fistulizing condition, use of biological agents, and surgical history did not affect the total IBDQ score. It is possible that this partial difference with the current literature is due to the difference of quality of life assesments. References 1-Spinelli A, Yanai H, Girardi P, Milicevic S, Carvello M, Maroli A, Avedano L. The Impact of Crohn's Perianal Fistula on Quality of Life: Results of an International Patient Survey. Crohns Colitis 360. 2023 Jul 25;5(3):otad036. doi: 10.1093/crocol/otad036. PMID: 37529012; PMCID: PMC10390083. 2-Kato M, Yoneyama-Hirozane M, Iwasaki K, Matsubayashi M, Igarashi A. Health-related quality of life in health states corresponding to different stages of perianal fistula associated with Crohn's disease: a quantitative evaluation of patients and non-patients in Japan. J Mark Access Health Policy. 2023 Jan 15;11(1):2166374. doi: 10.1080/20016689.2023.2166374. PMID: 36684854; PMCID: PMC9848226. 3-Karki C, Athavale A, Abilash V, Hantsbarger G, Geransar P, Lee K, Milicevic S, Perovic M, Raven L, Sajak-Szczerba M, Silber A, Yoon A, Tozer P. Multi-national observational study to assess quality of life and treatment preferences in patients with Crohn's perianal fistulas. World J Gastrointest Surg. 2023 Nov 27;15(11):2537-2552. doi: 10.4240/wjgs.v15.i11.2537. PMID: 38111766; PMCID: PMC10725550.

P0947 A switch to infliximab may be more effective than ustekinumab following adalimumab pharmacodynamic failure in pediatric patients with Crohn’s disease

Abstract Background Loss of response (LOR) to first biologic agent is not uncommon. One of the most challenging mechanisms of LOR is pharmacodynamic LOR (inflammatory activity in the presence of adequate trough concentrations, TC). We aimed to explore the outcomes of pediatric patients with Crohn’s disease following adalimumab pharmacodynamic failure. Methods We conducted a retrospective longitudinal cohort study in 6 Israeli pediatric centers. Data of patients who experienced adalimumab LOR (as first biologic agent) with adequate TC (&amp;gt;7.5 mcg/ml) and switched to either infliximab or ustekinumab were retrieved. Results The cohort included 67 patients (66% males, mean age at diagnosis 12.2±2.8, B2 or B3 phenotype 16%, perianal disease 24%), with median duration on adalimumab of 17 (IQR 8-24) months and follow-up of 13 months (IQR 7-29) on the subsequent therapy. Median adalimumab TC before switching was 11.4 (IQR 8.5-16 mcg/ml). For the overall cohort, corticosteroid-free clinical remission and response were achieved in 43% and 67%, respectively. Of 36 follow-up colonoscopies, 25% achieved endoscopic remission. Most patients (84%) received intensified regimen after switching. Nine patients (13%) underwent surgical resection during follow-up. The two treatment groups (infliximab (n=32) and ustekinumab (n=35)) were comparable for all basic, demographic and disease severity parameters at the time of switching. The median follow-up period of both groups was similar, 12 (6-24) months. The infliximab group demonstrated better outcomes over ustekinumab at the end of follow-up in terms of clinical response (97% vs. 57%; p&amp;lt;0.001), corticosteroid-free clinical remission (56% vs. 31%; p=0.04), endoscopic response (83% vs. 28%; p=0.002), fecal calprotectin&amp;lt;250 (60% vs. 27%; p=0.03), drug sustainability (91% vs. 31%; p&amp;lt;0.001) and surgical rate (3% vs. 23%; p=0.02, 1 infliximab, 8 ustekinumab). Month 3 PCDAI was significantly lower [8.7 (IQR 0-17.5) vs. 21 (IQR 9-35); p&amp;lt;0.01), CRP remission was higher (60% vs. 23%; p=0.01) and median albumin concentration was higher [4.3 (IQR 39-4.5) vs. 3.8 (IQR 3.4-4); p=0.005] in the infliximab group. Conclusion Pediatric patients with Crohn’s disease following adalimumab pharmacodynamic failure with TL&amp;gt;7.5mcg/mL demonstrated moderate response to subsequent therapy. A switch in-class to infliximab may be more effective than a switch out of class to ustekinumab.

Predictors for clinically significant prostate cancer detection: Insights from transperineal software-assisted fusion biopsy and transperineal cognitive fusion biopsy

Purpose: To compare the effectiveness of transperineal software-assisted fusion biopsy (TSAFB) and transperineal cognitive fusion biopsy (TCFB) in identifying predictors for detecting clinically significant prostate cancer (csPCa). Materials and methods: Conducted from December 2022 to December 2023 at a single center, this retrospective cohort study included male patients with prostate-specific antigen levels &gt;4 ng/mL or positive digital rectal examination findings and suspicious lesions on multiparametric magnetic resonance imaging (MRI) (Prostate Imaging and Reporting Data System ≥3). The study compared TSAFB using the KOELIS Trinity MRI TPUS Biopsy System with TCFB. The primary outcome was the detection rate of csPCa. Secondary outcomes included the detection rate of clinically insignificant prostate cancer (cisPCa) and the overall detection rate combining csPCa and cisPCa. Results: The study analyzed 31 TSAFB and 17 TCFB procedures. Baseline demographic and clinical parameters showed no significant differences between the cohorts. TSAFB had higher median total and targeted core counts. Both TSAFB and TCFB demonstrated similar detection rates for prostate cancer, csPCa, and cisPCa. Adopting a targeted-only strategy with TCFB led to nearly 20% of cancers going undetected. Logistic regression identified prostate-specific antigen density &gt;15% and lesion/prostate ratio as significant predictors for csPCa detection. Conclusion: TSAFB and TCFB are comparably effective in detecting csPCa. Prostate-specific antigen density &gt;15% and lesion/prostate ratio as strong predictors for csPCa detection highlights the importance of high-quality imaging modalities such as 3T MRI for precise volume measurements of the prostate and lesions. Nevertheless, the study underscores the critical importance of incorporating systematic biopsies in TCFB to avoid missing prostate cancer cases.

Association of environmental, demographic and clinical parameters with physical activity in children with asthma

Personal characteristics, unfavorable weather conditions and air pollution have been linked with reduced physical activity in children. However, among children with asthma the effects of these parameters remain unclear. This study objectively quantified the physical activity of children with asthma and evaluated its association with environmental, personal, and clinical parameters. Participants of the prospective LIFE-MEDEA asthma study wore the EMRACE™ smartwatch daily for continuous monitoring of physical activity and acquisition of global positioning system data. Daily physical activity, personal and clinical data were combined with daily temperature, precipitation, and air pollution levels in adjusted mixed effect regression models to examine the relationship between physical activity and the examined parameters. For a follow-up period of 4 months, 186 children with asthma demonstrated a decrease of 796 steps (95% CI: -1080, -512) on days with precipitation compared to non-precipitation days and a decrease of 96 steps (95% CI: -182, -9) for every 10 µg/m3 increase in PM10. The relationship between temperature and daily steps was characterized by an inverted U-shape. There was also evidence that gender and age-adjusted BMI z-score were negatively associated with daily steps. These results can further inform the design of physical activity interventions targeting children with asthma.

Fitness of Bactrocera dorsalis (Hendel) (Diptera: Tephritidae) on four economically important host fruits from Fujian Province, China

Abstract Bactrocera dorsalis (Hendel) (Diptera: Tephritidae) is a highly polyphagous fruit fly pest of economic importance in regions of the world where it occurs. This pest is now established in most parts of Fujian Province, an important fruit-production region in China. However, basic life history information of B. dorsalis on different fruits in this region, which is crucial for developing more effective control approaches, is poorly known. The demographic parameters of B. dorsalis on four fruit types: navel orange (Citrus sinensis Osb. var. brasliliensis Tanaka; Rutaceae), carambola (Averrhoa carambola L.; Oxalidaceae), loquat [Eriobotrya japonica (Thunb.) Lindl.; Rosaceae], and persimmon (Diospyros kaki Thunb.; Ebenaceae) were determined. Results showed that all tested fruit types were suitable for population persistence of B. dorsalis, but the suitability varied. The developmental rate, intrinsic rate of increase (R m), net reproductive rate (R 0), and finite rate of increase (λ) were significantly greater on persimmon compared with the other fruits. Under experimental conditions, fastest development, highest fecundity, highest survival, and heaviest pupal weight were observed on persimmon fruit, demonstrating that persimmon is a suitable host fruit for the growth and reproduction of B. dorsalis. The findings of this study will be valuable in the development of targeted control methods for managing B. dorsalis in orchards, with a particular focus on mixed orchards.

Which Lenke type curve is most appropriate for vertebral body tethering in adolescent idiopathic scoliosis?

Clinical trials have studied the effects of curve magnitude and flexibility, age, and skeletal immaturity on the outcomes of VBT. No studies have assessed the effect of Lenke curve type on the outcomes of VBT. This study compares outcomes in patients who underwent VBT with Lenke type 1, 3, 5, and 6 curves. Single center retrospective review of patients undergoing mini-open thoracoscopic-assisted two row vertebral body tethering (2RVBT) for the correction of AIS with a minimum 2-year follow-up were included. Patients were grouped by Lenke type, which yielded 4 groups; types 1, 3, 5, or 6. Analysis included preoperative demographic parameters, as well as radiographic and clinical outcome measures. 156 2RVBT (Lenke 1, N = 61; Lenke 3, N = 35; Lenke 5, N = 37; Lenke 6, N = 23) patients met inclusion criteria. The mean preoperative apex Cobb angle in the Lenke type 1, 3, 5, and 6 groups were 50.2 ± 9.1, 50.5 ± 10.1, 45.0 ± 8.6, and 49.0 ± 10.8, respectively. This corrected to 21.2 ± 10.2, 19.2 ± 8.5, 13.6 ± 7.2, 18.5 ± 8.3 in Lenke type 1, 3, 5, and 6 groups, respectively, demonstrating that Lenke type 5 saw greatest correction following 2RVBT. With regards to revision recommendation following tether breakage, Lenke type 3 curves were most frequently indicated for fusion, whereas Lenke type 1 curves were most frequently not indicated for revision surgery. Lenke type 5 curves are the most amenable to correction via 2RVBT, as evident by their lower post-operative apex Cobb angles and lowest rate of recommendation for revision to posterior spinal fusion.

Evidence and methods to assess preparedness among non-staff units of the Disaster Medicine Service of the Ministry of Defense of Russian Federation deployed in emergencies to eliminate emergency medical and sanitary consequences

Relevance. In Russia, emergency protection efforts by various ministries are guided by the relevant legal regulation based on the Integral National System for Emergency Prevention and Elimination. Its functionality relies on joint cross-departmental capacities to ensure national protection of the population and land from emergencies. Medical capacities are not an exception in this respect. The Medical Service of the Russian Armed Forces manages substantial resources to fulfill this goal. The Disaster Medicine Service of the Russian Defense Ministry was therefore established both as functional subunit of the Russian Armed Forces for emergency prevention and elimination and a critical link within the Russian National Disaster Medicine Service. To maintain the required level of preparedness, further studies regarding the performance of medical units within the Disaster Medicine Service is critically required.The study objective is to investigate the professional capacities among the military medical and civilian professionals employed by central and regional military medical organizations of the Defense Ministry, who are also non-staff members of the Disaster Medicine Service; to identify practical challenges in performing duties and assess the overall preparedness.Methods. This study is based on a survey among military medical and civilian professionals employed by central (n = 81) and regional (n = 146) military medical organizations of the Defense Ministry who are also non-staff members of the Disaster Medicine Service. The survey obtained data regarding the responders’ professional status, duties within non-staff teams, and demographic parameters. Mean and median values, including with upper and lower quartile are reported in the paper.Results and analysis. The study results show that the average age of among medical professionals among non-staff teams of central military medical organizations of the Russian Defense Ministry is 38.8 [6; 17] years and 38.2 [7; 14] years for those employed by regional medical organizations. In central military medical organizations, most medical teams are represented by therapists (25.9 %), followed by thoracic and abdominal surgery (17.3 %), and general surgery (13.6 %); whereas at the regional level teams comprising doctors and nurses prevail (54.8 %), followed by intensivists and general surgeons (9.6 % each), and therapists (8.2 %). Non-staff units of the Disaster Medicine Service of the Defense Ministry, operating within central military medical organizations include more subspecialty teams; on the contrary, regional non-staff units have broad and general specialties. Notably, military medical and civilian professionals employed by central military medical organizations provided emergency primary health care in 61.7 % of cases, whereas specialized medical care, including high-tech medical care was provided in 34.6 % of cases. Military medical and civilian professionals employed by regional military medical organizations provided emergency primary health care in 37.7 % of cases, and specialized medical care, including high-tech medical care in11.6 % of cases. The survey confirmed that while performing their duties, military medical and civilian professionals who were members of the non-staff teams were challenged by the following most significant factors: the level of specialized training, number and quality of staff in the teams, as well as compliance with the regulatory and legal requirements to medical activities performed within the efforts to eliminate medical and sanitary consequences of emergencies. This data allowed to develop relevant parameters and measurements to assess preparedness among the non-staff teams to perform their dutiesConclusion. Professional capacities among the military medical and civilian professionals employed by central and regional military medical organizations of the Defense Ministry, who are also non-staff members of the Disaster Medicine Service was investigated, with the most significant challenges affecting their performance identified. Preparedness was assessed among the non-staff teams of the Disaster Medicine Service of the Russian Defense Ministry in central and regional military medical organizations.

Application of Kolmogorov-Smirnov Test to Evaluation of Population Distrbution by Age in Single Years

This study examines the evaluation of population distribution by sex and age in single years. The aim is to assess the validity of the assumption that when data on population by age in single years is correctly reported then the population is uniformly distributed among end digits. The data used is a secondary data derived from the census populations reported by age in single years from Nigeria, Ghana, Indonesia and United State of America. Measures of digit preference are computed using the Ramachandran Index (RI), one of the most commonly algebraic methods of evaluation of age data in single years. The Kolmogorov-Smirnov test was used to test the Goodness-of-Fit of the discrete uniform distribution to the distribution of population among end digits in the selected countries. The results of the analyses show that the null hypotheses were all rejected at 1% level of significance, indicating that the distribution of population among the 10 end digits is not uniform for both sexes in all the selected countries. In other words, the distribution of population by age in single years in none of the countries studied is completely free from digit preference/avoidance. The study therefore, recommends that the age data should be adjusted for the error of digit/avoidance before using them for further estimation of demographic parameters or at least used with caution.

Understanding the vaginal microbiome among women with different genotypes of human papillomavirus infection in remote Andaman islands

BackgroundHuman papillomavirus (HPV) is a viral infection, and its acquisition and persistence are significantly influenced by the vaginal microbiota. Understanding and comparing the vaginal microbiome of HPV infected women in Andaman and Nicobar Islands is crucial.MethodsThe study involved collecting vaginal swabs and extracting DNA using the QIAamp DNA Minikit. The DNA was then subjected to PCR amplification to confirm HPV infection. illumina NovaSeq 6000 platform was utilized to perform sequencing utilizing 2 x 250 paired end chemistry. Taxonomic analysis was performed and Bacterial abundance plots were generated and samples were grouped based on demographic parameters, pap test diagnosis, and genotypes. To assess diversity, samples were rarefied to 49,000 sequence reads per sample, and alpha and beta diversity metrics were calculated.ResultsThe study analyzed the presence of 21 assigned phyla, with Firmicutes, Actinobacteria, Bacteriodetes, and Proteobacteria emerging as the predominant taxa. At the genus level, Lactobacillus and Gardnerella dominated across all samples. Gardnerella was significantly more abundant in HPV-positive (22.40%) compared to HPV-negative samples (10.04%). Symptomatic group of HPV-positive samples had Gardnerella, and unclassified Coriobacteriaceae being dominant. In terms of bacterial diversity, the study found statistically significant association when comprising individuals aged 21 to 30 years to those aged 31 to 40 years.ConclusionMost research concluded that exposure to HPV can boost bacterial diversity in vagina compared to healthy women, increasing the risk of cervical cancer development. Current study highlights the importance of vaginal microbiome associated with high and low risk HPV, various age group as well as the symptomatic and asymptomatic cases of HPV infected women in South Andaman.