Greater Percentage Of Responders Research Articles

Socioeconomic Disparities in Research Participation: Bias in Plastic Surgery Residency Match.

Integrated plastic surgery residency applicants have increased at a rate disproportionate to available positions. Research productivity has become a surrogate marker for competitiveness, and many applicants pursue it to distinguish themselves. To date, no study has investigated socioeconomic disparities in extended research experience (ERE) participation. A 35-question cross-sectional survey was distributed to applicants to United States-based integrated plastic surgery residency programs during the 2019-2022 application cycles. Summary tables, student t test, and chi-square tests were used for statistical analysis. A total of 161 responses (response rate: 20.9%) were recorded. Fifty-nine (40.7%) respondents participated in an ERE. The most common reason for ERE participation was strengthening one's application. The most common reason against participation was avoiding delays in career progression. A greater percentage of respondents from Northeastern medical schools participated in EREs (P = 0.019). There were no significant differences in debt burden between those who did or did not participate in an ERE. A greater percentage of applicants whose parents had advanced degrees participated in EREs (P = 0.053). There may be geographic and socioeconomic biases present in access to ERE for students interested in plastic surgery. The growing popularity of EREs may have unintended consequences for applicant diversity. As most plastic surgeons ultimately practice in nonacademic settings, applicants and plastic surgeons may consider the financial hardships and possible socioeconomic disparities in research opportunities before participating in or recommending them.

The association between serum vitamin A concentrations and virus hepatitis among U.S. adults from the NHANES database: a cross-sectional study.

According to the present study, the relationship between vitamin A (VA) levels and hepatitis virus carriage has been unclear and controversial. This study aimed to determine the potential relationship between serum VA levels and viral hepatitis and to provide ideas for future clinical treatments. A cross-sectional study was performed using the 2005-2006 and 2017-2018 National Health and Nutrition Examination Survey (NHANES) datasets. Multiple linear regression and logistic regression were adopted to analyze the association between serological hepatitis B surface antigen (HBsAg) or hepatitis C RNA (HCV-RNA) positivity and VA levels. There were 5,351 HBsAg-related responders and 242 HCV-RNA-related responders, including 52 HBsAg (+) and 104 HCV-RNA (+) responders. Compared with HBsAg (-) and HCV-RNA (-) respondents, HBsAg (+) and HCV-RNA (+) respondents tended to have lower serum VA levels, respectively [1.63 (1.33 ~ 2.01) vs. 1.92 (1.57 ~ 2.34), P < 0.001; 1.54 (1.25 ~ 1.83) vs. 1.78 (1.46 ~ 2.26), P < 0.001]. A greater percentage of responders in the subclinical VA deficiency (SVAD) group were HBsAg (+) and HCV-RNA (+) than were those in the normal VA (VAN) group [2.4% (9/374) vs. 0.9% (43/4977), p = 0.003; 61.5% (16/26) vs. 40.7% (88/215), p = 0.043]. According to the results of the multiple regression analyses of the different models, the serum VA concentration was negatively correlated with HBsAg (+) and HCV-RNA (+) status (β = -0.14, 95% CI = -0.30 to -0.01, p = 0.066; β = -0.29, 95% CI = -0.50 ~ -0.09, p = 0.005, respectively). Compared to those with SVAD, patients with VAN were less likely to be serologically HBsAg (+) or HCV-RNA (+) (OR = 0.53, 95% CI = 0.25 ~ 1.10, p = 0.089; OR = 0.39, 95% CI = 0.18 ~ 0.84, p = 0.016, respectively). Our study provides evidence that patients who are HBsAg (+) or HCV-RNA (+) have a high incidence of SVAD. Moreover, HBsAg and HCV-RNA positivity are negatively correlated with VA levels, and patients with SVAD are more likely to carry HBsAg (+) or HCV-RNA (+). These findings suggest that the relationship between hepatitis viruses and vitamin A needs to be validated by more basic studies and clinical large-sample randomized controlled trials to provide ideas for new therapeutic targets.

Pharmaceutical sales and marketing as a future career for pharmacy students in Iraq: perception and barriers

The exposure of pharmacy students to fieldwork experience throughout the early stages of their education would assist prepare them for their future career. Many students feel working in community pharmacies does not give a profitable wage when compared to other opportunities. which might influence them to choose the promotional pharmaceutical field. This study aims to examine students' perceptions of the pharmaceutical promotional sector as a potential future profession as well as the obstacles they face. This is a cross-sectional study targeting students of pharmacy in Iraq through an online questionnaire to assess students' perceptions. The perceptions were evaluated to determine the influencing factors. The greatest percentage of students work for improving their skills and for saving money for the future. Concerning the barriers that students face in pursuing a career in pharmaceutical marketing, the existence of unethical actions, as well as a lack of needed skills and knowledge, were cited as barriers by a greater percentage of respondents. In conclusion, generally, there is a favorable view of working in this industry and there is an apparent need for colleges to focus more on the aspects of this career.

Association of Reactogenicity with Immunogenicity of the ChAdOx1 nCoV-19 Vaccine in Patients Undergoing Hemodialysis.

The aim of our study was to determine whether local and systemic reactions following SARS-CoV-2 vaccination are predictive of immunogenicity in patients undergoing hemodialysis. We used an established questionnaire to survey 206 hemodialysis patients without prior SARS-CoV-2 infection regarding solicited local (pain, redness, and swelling) and systemic reactions (fatigue, headache, muscle and joint pain, nausea or vomiting, abdominal pain, diarrhea, and fever) within 7 days after receiving 1 dose of the ChAdOx1 nCoV-19 vaccine for SARS-CoV-2. The primary outcome was seroconversion of anti-SARS-CoV-2 IgG (≥50 AU/mL) at 28 days after vaccination. Local and systemic reactions were reported by 80 (38.8%) and 119 (57.8%) patients, respectively. A total of 138 (67.0%) patients developed an antibody response. Responders were younger, had a lower prevalence of coronary artery disease and use of immunosuppressants, and had a higher body mass index and lymphocyte count. In addition, a greater percentage of responders than non-responders reported reactogenicity. In multivariate logistic regression analyses, fever (OR 2.70 [95% CI 1.12–6.50]) and total symptom score (OR 1.33 [95% CI, 1.05–1.68], per one increase) remained strongly associated with a greater humoral response. In conclusion, higher reactogenicity may identify hemodialysis patients who are more responsive to SARS-CoV-2 vaccination.

Efficacy of Anti-Vascular Endothelial Growth Factor Treatment in Neovascular Age-Related Macular Degeneration and Systemic Cardiovascular Risk Factors.

This study evaluates whether the presence of cardiovascular risk factors (CRFs) affects functional and morphological responses to anti–vascular endothelial growth factor (VEGF) therapy in patients with neovascular age-related macular degeneration (nAMD). Retrospective analysis included 98 treatment-naïve eyes followed for at least 12 months. Patients received intravitreal injections of ranibizumab or aflibercept with the dosage and regimen set according to each manufacturer’s recommendations for their product. Parameters evaluated at each follow-up visit included best-corrected visual acuity and central retinal thickness. Additionally, the presence of the following CRFs was evaluated: male sex, age of older than 70 years, history of current or past smoking, systemic arterial hypertension, diabetes mellitus, total hypercholesterolemia, low-density lipoprotein hypercholesterolemia, high-density lipoprotein concentration of 45 mg/dL or less, atherogenic dyslipidemia, family history of cardiovascular disease, and chronic kidney disease. A statistically significant better letter gain in visual acuity (p = 0.012) and greater percentage of responders (p = 0.035)—that is patients in whom best corrected visual acuity was stabilized or improved at 12 months—were noted among patients without a diagnosis of arterial hypertension. A statistically significant better mean visual improvement was also achieved in patients with higher total cholesterol plasma levels (p = 0.004), but this finding was not reflected in the significantly higher percentage of responders. The presence of remaining analyzed risk factors did not substantially affect the results of treatment. Systemic arterial hypertension is an independent factor leading to a poor functional outcome following anti-VEGF therapy in patients with nAMD. Effects of anti-VEGF treatment in patients with high total cholesterol levels should be analyzed in further research.

Musculoskeletal disorders and the physical activity of territorial army soldiers during the COVID-19 pandemic

BackgroundThe aim of this study was to assess the occurrence of self-reported musculoskeletal disorders (MSD) among Polish territorial army soldiers during the COVID-19 pandemic and to investigate whether there was a relationship between occupational physical activity (OPA), leisure time physical activity (LTPA), and MSD.MethodsThe study used a cross-sectional design with a sample of 373 territorial army soldiers ages 18–55 who had not previously suffered from COVID-19 and were not convalescents. The symptoms prevalence data was collected using the standardized Nordic Musculoskeletal Questionnaire. OPA and LTPA data was collected using the Seven-Day Physical Activity Recall (SDPAR).ResultsThe OPA, LTPA, and total physical activity (PA) among the studied soldiers was very diverse and the mean level of PA was relatively high. A total of 56 and 40% of territorial army soldiers had experienced pain or other discomfort in one or more of nine body regions during the past 12 months and during the past 7 days, respectively. The most common MSD among Polish territorial army soldiers were low back pain, followed by pain in the neck and knees.ConclusionsThe study revealed that the OPA of the studied soldiers, especially vigorous-intensity and high vigorous-intensity OPA, was associated with a higher prevalence of MSD in several regions of the body, i.e. the lower back, elbows, wrists or hands, hips or thighs, and ankles or feet. Along with the increase in energy expenditure on total PA, a greater percentage of respondents experienced low back pain. Vigorous and high vigorous-intensity PA may contribute to the occurrence of MSD.

A Comparison of Reported Outcomes of Anterior Cervical Spinal Surgery Among Neurosurgeons in Africa and North America

Neurosurgical practice in some African countries has significant differences in patient load and resource availability compared with North America. We designed a survey to determine reported differences in outcome of anterior cervical decompression and fusion surgery, including blood loss, length of stay, and follow-up time, among physicians on different continents. We expected outcomes in all categories to be pronounced between respondents in Africa compared with North America due to a multitude of factors. The survey consisted of 7 questions and was sent to 352 neurosurgeons practicing on the continents of North America, Africa, or Other. A total of 62 surgeons responded, 44 from Africa, 15 from North America, and 3 from Other. A greater percentage of respondents in Africa reported an average follow-up time within 2 weeks compared with respondents practicing in North America (63.6% and 40%, respectively). On blood loss, 56% of surgeons in Africa reported >50 mL of intraoperative blood loss compared with 6.67% for respondents in North America. Over 90% reported length of stay of 2 or more days in Africa, compared with 6.67% in North America. Our findings demonstrate greater advances in reported surgical outcomes for patients in Africa than we expected, but still highlight key areas for improvement, almost certainly due to lack of resources.

PSS21 EFFECT OF ISTENT INJECT TRABECULAR MICRO-BYPASS ON PATIENT-REPORTED OUTCOMES FOR THOSE WITH OPEN-ANGLE GLAUCOMA AND COEXISTING CATARACTS

To conduct an exploratory analysis comparing cataract surgery plus implantation of the trabecular micro-bypass stent (iStent inject) versus cataract surgery alone in patient-reported outcome (PRO) scores from the Vision Function Questionnaire (VFQ-25) and the Ocular Surface Disease Index (OSDI) by key baseline characteristics. In a pivotal trial of cataract surgery plus iStent inject for the reduction of intraocular pressure (IOP) in subjects with glaucoma and cataracts, the VFQ-25 and OSDI questionnaires were administered to subjects at baseline and months 1, 6, 12, and 24. The percentage of subjects reaching an improvement based on minimally important differences (MID) in PRO scores was derived using half the standard deviation of baseline values. PRO responders were subjects with change from baseline (1) greater than or equal to the MID threshold for the VFQ composite and (2) less than or equal to the MID threshold for OSDI composite. The percentage of PRO responders was compared using a logistic generalized linear mixed model for repeated measures with stratification by (1) baseline IOP (< 25 mmHg and ≥ 25 mmHg) and (2) prostaglandin use (yes/no). A total of 382 subjects were randomized (N = 237 surgery plus iStent, N = 145 surgery alone) and had baseline and at least one postbaseline score. For composite scores, a greater percentage of responders was observed at all follow-up visits in the iStent inject group compared with the cataract surgery-alone group for the ≥ 25 mmHg IOP and for no prostaglandin use strata, with treatment differences ranging from 10.8% to 21.7% and 13.7% to 28.8%, respectively. In a post hoc exploratory analysis of the VFQ-25 and OSDI, cataract surgery plus iStent inject in subjects with high IOP (≥ 25 mmHg) or no prostaglandin use at baseline improved overall ocular symptoms and visual functioning compared with cataract surgery alone.

Determination of swine euthanasia criteria and analysis of barriers to euthanasia in the United States using expert opinion

AbstractTimely euthanasia on swine farms can help to reduce the incidence of poor welfare outcomes for compromised pigs (Sus scrofa) when recovery is prolonged or impossible. Timely euthanasia relies upon caretakers’ abilities to identify compromised pigs and administer euthanasia in various environments. To determine appropriate timelines and most common reasons for on-farm euthanasia, an online survey was conducted with members of the United States National Pork Board. Additionally, two focus groups were conducted to investigate barriers and possible solutions associated with timely euthanasia. Clinical signs related to poor locomotion (57.6%), prolapses (47.2%), and hernias (43.5%) were identified by the greatest percentage of respondents who believed immediate euthanasia was warranted, while a greater percentage of respondents believed euthanasia was not warranted for clinical signs related to the integumentary (90.3%), reproductive (75.8%), and respiratory (67.5%) systems. The most common reason for euthanasia was poor body condition in pre-weaned piglets and non-ambulatory or severely weak for both breeding and non-breeding pigs. In the focus groups, two themes were identified when evaluating barriers to euthanasia on-farm, and participants agreed that making timely decisions relies upon several dimensions of risk analysis. An unsupportive farm culture was identified as a critical barrier to timely euthanasia decision-making, suggesting that caretaker characteristics may play a role in the success of any timely euthanasia programme. This present study has highlighted areas for future research and demonstrated the need to extend educational efforts both to swine industry leaders and producers to improve overall animal welfare by ensuring timely euthanasia in swine.

Beliefs about brain injury in Britain

Primary objective: Surveys have revealed that a high proportion of the public in the US and Canada hold misconceptions pertaining to the sequelae of brain injury. This study examined whether similar misconceptions are endorsed by adults in Britain.Research design: Survey.Methods and procedures: Three hundred and twenty-two participants completed a 17-item questionnaire containing true or false statements about general knowledge of brain injury, coma and consciousness, memory impairments and recovery.Main outcomes and results: Regardless of age, sex, level of education and familiarity with brain injury, participants held mistaken beliefs about consciousness, were inclined to under-estimate the extent of memory deficits and were unaware that patients are more vulnerable and less resistant to further injury. A large proportion of respondents indicated that their knowledge of brain injury had been derived from the popular media.Conclusions: Similar misconceptions to those reported in previous studies exist in Britain. Notably in this study these misconceptions were endorsed by a greater percentage of respondents. Greater public awareness is needed for decisions concerning funding and patient care. It is therefore important for healthcare professionals and public health campaigns to dispel myths about brain injury.

Concomitant administration of travoprost and brinzolamide versus fixed latanoprost/timolol combined therapy: three-month comparison of efficacy and safety

SUMMARYPurpose: To compare the efficacy and safety of the concomitant administration of travoprost 0.004% once daily and brinzolamide 0.1% twice daily with those of a fixed combination of latanoprost 0.005%/timolol 0.5% once daily.Research, design and methods: Forty-four patients with primary open-angle glaucoma or ocular hypertension with elevated IOP insufficiently responsive to monotherapy were randomly assigned to one of the two treatment groups: concomitant administration of travoprost 0.004% once daily and brinzolamide 0.1% twice daily (TB group: 22 patients) or latanoprost 0.005% plus timolol 0.5% once daily (LT group: 22 patients). Visits were undertaken at screening (current ocular hypotensive therapy was discontinued), baseline (randomization), and after 2 weeks, 1 month, 2 months and 3 months of therapy.Main outcome measures: IOP was determined at 9 a.m., 12 p.m. and 4 p.m. at each study visit, and diurnal IOP was calculated as the mean of these recordings. Adverse events were recorded at each visit.Results: IOP at the baseline visit was similar in both groups. Overall mean IOP was significantly lower in the TB as compared to the LT group after 1 month, 2 month and 3 month follow-up; only 9 a.m. measurements were significantly different, reaching a maximum difference (16.9 ± 0.9 mmHg vs 18.4 ± 1.8 mmHg, p < 0.001) at the 3 month check. The percentage of responders (IOP decrease ≥ 30%) was higher in the TB group. Both treatments were well tolerated and there were no cases of withdrawal from treatment.Conclusions: Travoprost 0.004% and brinzolamide 0.1% concomitant therapy showed a greater efficacy than the fixed latanoprost 0.005%/timolol 0.5% combination in terms of absolute IOP decreases. Travoprost/brinzolamide therapy also offered the advantages of a greater percentage of responders.

A single-blind, randomized, controlled trial to assess the efficacy and tolerability of rofecoxib, diclofenac sodium, and meloxicam in patients with acute gouty arthritis

Background: Acute attacks of gouty arthritis are characterized by the rapid onset of severe pain, swelling, and erythema of the affected joint. Nonsteroidal anti-inflammatory drugs are considered the drugs of first choice for treating acute gout. Rofecoxib is a specific cyclooxygenase-2 inhibitor, which has demonstrated analgesic efficacy in the setting of acute pain. Whether it is effective in the treatment of acute gouty arthritis remains to be evaluated. Objective: The aim of this study was to assess the efficacy and tolerability of rofecoxib compared with diclofenac sodium sustained release (SR) and meloxicam in the treatment of acute gouty arthritis. Methods: In this single-blind, randomized, controlled, parallel-group study, patients aged ≥18 years with acute gout within 48 hours of onset were randomized to receive oral treatment with 2 tablets of rofecoxib (25 mg), diclofenac (75 mg), or meloxicam (7.5 mg) once daily for 7 days. The primary outcome measures were patients global assessment of response to therapy and investigator assessment of response to therapy on days 3 and 8. Other efficacy measurements included investigator assessment of total inflammatory scores on days 3 and 8 and patient assessment of pain intensity during the first 12 hours of treatment. Results: Sixty-two patients (53 men, 9 women; mean [SD] age, 51.1 [12.1] years) were assigned to receive rofexocib (n = 20), diclofenac (n = 21), or meloxicam (n = 21). For patient global response to therapy on days 3 and 8, rofecoxib was associated with analgesic efficacy in significantly more patients compared with meloxicam (84.2% vs 40.0% of patients [ P = 0.005] and 94.7% vs 60.0% of patients [ P = 0.02], respectively); no significant differences versus diclofenac were found. Similarly, for investigator global assessment of response to therapy, a greater percentage of responders was found in the rofecoxib group compared with the meloxicam group on day 3 (88.9% vs 40.0% of patients [ P = 0.02]), but the difference was not significant on day 8. A greater percentage of responders was found in the rofecoxib group compared with the diclofenac group on day 3 (88.9% vs 47.3% [ P = 0.007]), but the difference was not significant on day 8. Compared with baseline, all regimens showed significant improvement in total inflammatory scores on days 3 and 8 (all P < 0.01). During the first 12 hours after dosing, pain intensity score was significantly reduced with rofecoxib starting at 0.5 hours ( P < 0.05), but not with diclofenac or meloxicam. Clinical adverse events (AEs) were reported in 4 (20.0%), 7 (33.3%), and 6 (28.6%) patients in the rofecoxib, diclofenac, and meloxicam groups, respectively; the most common AEs reported were edema in 1 patient each in the rofecoxib (5.0%) and meloxicam (4.8%) groups and 2 patients (9.5%) in the diclofenac group and abdominal (1 [5.0%], 1 [4.8%], and 2 [9.5%], respectively). No significant differences in tolerability were found among the 3 treatment groups.

Clinical advantages of dual activity in allergic rhinitis.

Symptoms of allergic rhinitis include sneezing; itching of the eyes, nose, and throat; nasal obstruction; and rhinorrhoea; they may be seasonal or perennial, depending on the causative allergen. The major symptom of perennial allergic rhinitis is nasal obstruction. Sneezing and rhinorrhoea are often present, but are less troublesome than in seasonal allergic rhinitis. Symptom relief is a priority in allergic rhinitis because patients have a severely impaired quality of life. The nasal vascular system is complex. Histamine acts on postcapillary venules during both the immediate and late phase of reactivity and causes plasma extravasation. Other inflammatory mediators can also induce this reaction. Thus, histamine antagonists that also have some additional antiallergic properties have advantages in the treatment of allergic rhinitis. Mizolastine is a second-generation antihistamine that has been shown, in experimental studies, to possess 5-lipoxygenase inhibitory properties in addition to its H1-receptor antagonistic activity. In the treatment of seasonal allergic rhinitis, mizolastine 10 mg/day has been shown to be effective in reducing nasal and ocular symptoms. It has been shown to be significantly more effective than placebo with a greater percentage of responders. Another study has shown that symptoms of seasonal allergic rhinitis in mizolastine-treated patients were reduced more significantly than in cetirizine-treated patients on the second and third days of treatment. In perennial allergic rhinitis, mizolastine significantly improved symptoms of nasal obstruction compared with placebo and also significantly reduced nasal membrane colour, nasal secretions, and mucosal swelling as shown by rhinoscopy. These effects were maintained over a 5-month treatment period. Mizolastine has also been shown to be at least as effective as loratadine, and in one trial even superior in the treatment of perennial allergic rhinitis.