Confidence Interval For Odds Ratio Research Articles

Correlates of Calcidiol Deficiency in Adults-Cross-Sectional, Observational, Population-Based Study.

The prevalence, determinants, and clinical significance of vitamin D deficiency in the population are debated. The population-based study investigated the cross-sectional associations of several variables with serum 25-hydroxyvitamin D (calcidiol) measured using standardized calibrators. The study cohort consisted of 979 persons of the Moli-sani study, both sexes, ages ≥35 years. The correlates in the analyses were sex, age, education, local solar irradiance in the month preceding the visit, physical activity, anthropometry, diabetes, kidney function, albuminuria, blood pressure, serum cholesterol, smoking, alcohol intake, calorie intake, dietary vitamin D intake, and vitamin D supplement. The serum calcidiol was log transformed for linear regression because it was positively skewed (skewness = 1.16). The prevalence of calcidiol deficiency defined as serum calcidiol ≤12 ng/mL was 24.5%. In multi-variable regression, older age, lower solar irradiance, lower leisure physical activity, higher waist/hip ratio, higher systolic pressure, higher serum cholesterol, smoking, lower alcohol intake, and no vitamin D supplement were independent correlates of lower serum calcidiol (95% confidence interval of standardized regression coefficient ≠ 0) and of calcidiol deficiency (95% confidence interval of odds ratio > 1). The data indicate that low serum calcidiol in the population could reflect not only sun exposure, age, and vitamin D supplementation but also leisure physical activity, abdominal obesity, systolic hypertension, hypercholesterolemia, smoking, and alcohol intake.

A missense variant rs2585405 in clock gene PER1 is associated with the increased risk of noise-induced hearing loss in a Chinese occupational population

ObjectiveTo investigate the potential association of cochlear clock genes (CRY1, CRY2, PER1, and PER2), the DNF gene (brain-derived neurotrophic factor), and the NTF3 gene (neurotrophin3) with susceptivity to noise-induced hearing loss (NIHL) among Chinese noise-exposed workers.MethodsA nested case–control study was performed with 2056 noise-exposed workers from a chemical fiber factory and an energy company who underwent occupational health examinations in 2019 as study subjects. Propensity score matching was conducted to screen cases and controls by matching sex, age, and the consumption of tobacco and alcohol. A total of 1269 participants were enrolled. Then, general information and noise exposure of the study subjects were obtained through a questionnaire survey and on-site noise detection. According to the results of audiological evaluations, the participants were divided into the case group (n = 432, high-frequency threshold shift > 25 dB) and the matched control group (n = 837, high-frequency threshold shift ≤ 25 dB) by propensity score matching. Genotyping for PER1 rs2253820 and rs2585405; PER2 rs56386336 and rs934945; CRY1 rs1056560 and rs3809236; CRY2 rs2292910 and rs6798; BDNF rs11030099, rs7124442 and rs6265; and NTF3 rs1805149 was conducted using the TaqMan-PCR technique.ResultsIn the dominant model and the co-dominant model, the distribution of PER1 rs2585405 genotypes between the case group and the control group was significantly different (P = 0.03, P = 0.01). The NIHL risk of the subjects with the GC genotype was 1.41 times the risk of those carrying the GG genotype (95% confidence interval (CI) of odds ratio (OR): 1.01–1.96), and the NIHL risk of the subjects with the CC genotype was 0.93 times the risk of those carrying the GG genotype (95%CI of OR: 0.71–1.21). After the noise exposure period and noise exposure intensities were stratified, in the co-dominant model, the adjusted OR values for noise intensities of ≤ 85 was 1.23 (95%CI: 0.99–1.53). In the dominant model, the adjusted OR values for noise exposure periods of ≤ 16 years and noise intensities of ≤ 85 were 1.88 (95%CI: 1.03–3.42) and 1.64 (95%CI: 1.12–2.38), respectively.ConclusionThe CC/CG genotype of rs2585405 in the PER1 gene was identified as a potential risk factor for NIHL in Chinese noise-exposed workers, and interaction between rs2585405 and high temperature was found to be associated with NIHL risk.

Health extension service utilization and associated factors in East Gojjam zone, Northwest Ethiopia: A community-based cross-sectional study.

Health Extension Program is a preventive, promotive, and basic curative service targeting households to improve the health status of families with the effective implementation of 16 health extension packages. We, therefore, did this study to assess health extension package utilization and associated factors in the East Gojjam zone, Northwest Ethiopia. A community-based mixed cross-sectional study was conducted on households of East Gojjam Zone, from January 1 to April 30, 2020. A multistage sampling procedure was used to select 806 study participants in this study. We used EPI info version 7 for data entry and SPSS version 24 software for cleaning and analysis. Variables having a P-value of less than 0.25 in the bivariate logistic regression analysis were fitted into the multivariable logistic regression model. The 95% confidence interval of odds ratio was computed and a variable having P-value less than 0.05 in the multivariable logistic regression analysis was considered as statistically significant. The study showed that 119 (14.8%) respondents have utilized health extension packages. Knowledge health extension package (AOR = 1.84, 95% CI: 1.22, 2.79), residence (AOR = 3.55, 95% CI: 1.99,6.33),visited health post(AOR = 1.63, 95% CI: 1.054,2.50), home visited by health extension worker (AOR = 1,68, 95% CI: 1.025,2.74) and involving in model family training(AOR = 2.10, 95% CI: 1.38,3.215) were significant factors for health extension service utilization. The magnitude of health extension service utilization was low since the Ethiopian government recommends 100% health extension service utilization coverage. Knowledge of health extension package, residence, health post-visit, home visit, and model family training were significant factors for health extension service utilization. So expanding the model family training and strict home-to-home visit especially in rural areas may increase the health extension package utilization.

Diagnostic Value of 16S Ribosomal RNA Gene Polymerase Chain Reaction/Sanger Sequencing in Clinical Practice.

Accurate microbiologic diagnosis is important for appropriate management of infectious diseases. Sequencing-based molecular diagnostics are increasingly used for precision diagnosis of infections. However, their clinical utility is unclear. We conducted a retrospective analysis of specimens that underwent 16S ribosomal RNA (rRNA) gene polymerase chain reaction (PCR) followed by Sanger sequencing at our institution from April 2017 through March 2019. A total of 566 specimens obtained from 460 patients were studied. Patients were considered clinically infected or noninfected based on final diagnosis and management. In 17% of patients, 16S rRNA PCR/sequencing was positive and in 5% of patients, this test led to an impact on clinical care. In comparison, bacterial cultures were positive in 21% of patients. Specimens with a positive Gram stain had 12 times greater odds of having a positive molecular result than those with a negative Gram stain (95% confidence interval for odds ratio, 5.2-31.4). Overall, PCR positivity was higher in cardiovascular specimens (37%) obtained from clinically infected patients, with bacterial cultures being more likely to be positive for musculoskeletal specimens (P < .001). 16S rRNA PCR/sequencing identified a probable pathogen in 10% culture-negative specimens. 16S rRNA PCR/sequencing can play a role in the diagnostic evaluation of patients with culture-negative infections, especially those with cardiovascular infections.

Association Between Skin Injuries in Medical Staff and Protective Masks Combined with Goggles During the COVID-19 Pandemic.

To explore the relationship between wearing protective masks and goggles and skin injuries in medical staff during the COVID-19 pandemic. Researchers conducted a cross-sectional, multicenter online survey. Respondents voluntarily completed the questionnaire on their smartphones. Ordinal and multinomial logistic regressions were used to identify factors related to skin injuries. In total, 1,611 respondents wore protective masks combined with goggles in 145 hospitals in China; 1,281 skin injuries were reported (overall prevalence, 79.5%). Multiple concomitant skin injuries (68.5%) and injuries in four anatomic locations (24.0%) were the most common, followed by injuries in three (22.8%), two (21.7%), and one location (11.0%). Multinomial logistic regression indicated that sweating increased the risk of injuries in one to four anatomic locations (95% confidence interval for odds ratio 16.23-60.02 for one location and 38.22-239.04 for four locations), and wearing an N95 mask combined with goggles and a daily use longer than 4 hours increased the risk of injuries in four locations (95% confidence interval for odds ratio 1.18-5.31 and 1.14-3.93, respectively). The prevalence of skin injuries among medical staff wearing protective masks combined with goggles was very high. These were mainly device-related pressure injuries, moisture-associated skin damage, and skin tears. The combination of various factors resulted in skin injuries at multiple sites. Preventing and managing sweating should be a focus for medical staff who wear protective masks combined with goggles for more than 4 hours.

Comparison of Response to Vaccination with PCV 13 in Patients with Multiple Myeloma Versus Healthy Controls

Background:Infections remain a major cause of morbidity and mortality in individuals with multiple myeloma. These individuals show a suboptimal response to pneumococcal polysaccharide vaccine (PPV23). Pneumococcal conjugate vaccine (PCV13) elicits a T cell dependent response and may lead to greater immunogenicity, and is therefore the recommended vaccine in patients with multiple myeloma. This study compares the response to PCV 13 vaccine in patients with multiple myeloma to healthy controls.Methods:Eligible patients received PCV 13 vaccine on day 1. Streptococcal pneumonia serotype IgG titers were drawn at baseline, day 30, (+/- 7 days) and day 180 (+/- 30 days). Given the small sample size, Fisher's exact test was used to analyse odds ratio significance for the 2 X 2 contingency tables. The type I error rate was set at less than 0.05. The odds ratio confidence intervals were derived from the log odds ratios using standard methods. SAS® University Edition was used for analysis.Results:There were 7 patients with multiple myeloma and 18 healthy controls enrolled for the study. The mean age was 60 years for the multiple myeloma group, versus 68.5 years for the healthy controls. Individual serotype response was defined as the following:If < 1.3, need to increase 2 fold to above 1.3 OR increase 4 foldIf > 1.3, need to increase 2 foldResponse to 12/13 IgG serotypes are reported in the table attached.Conclusions:Vaccination with PCV13 produced a similar response in patients with multiple myeloma compared to healthy controls. A larger study may be needed to confirm these findings and find the long term clinical benefits of vaccination with PCV13 in patients with multiple myeloma. [Display omitted] DisclosuresMustafa:Shire: Research Funding; Genentech: Speakers Bureau; Teva: Speakers Bureau; Greer: Speakers Bureau. Jamshed:TAKEDA pharmaceuticals: Speakers Bureau.

Tumor size measured by multidetector CT in resectable colon cancer: correlation with regional lymph node metastasis and N stage

BackgroundLymph node metastasis (LNM) is a risk factor for poor long-term outcomes and a prognostic factor for disease-free survival in colon cancer. Preoperative lymph node status evaluation remains a challenge. The purpose of this study is to determine whether tumor size measured by multidetector computed tomography (MDCT) could be used to predict LNM and N stage in colon cancer.Material and methodsOne hundred six patients with colon cancer who underwent radical surgery within 1 week of MDCT scan were enrolled. Tumor size including tumor length (Tlen), tumor maximum diameter (Tdia), tumor maximum cross-sectional area (Tare), and tumor volume (Tvol) were measured to be correlated with pathologic LNM and N stage using univariate logistic regression analysis, multivariate logistic analysis, and receiver operating characteristic (ROC) curve analysis.ResultsThe inter- and intraobserver reproducibility of Tlen (intraclass correlation coefficient [ICC] = 0.94, 0.95, respectively), Tdia (ICC = 0.81, 0.93, respectively), Tare (ICC = 0.97, 0.91, respectively), and Tvol (ICC = 0.99, 0.99, respectively) parameters measurement are excellent. Univariate logistic regression analysis showed that there were significant differences in Tlen, Tdia, Tare, and Tvol between positive and negative LNM (p < 0.001, 0.001, < 0.001, < 0.001, respectively). Multivariate logistic regression analysis revealed that Tvol was independent risk factor for predicting LNM (odds ratio, 1.082; 95% confidence interval for odds ratio, 1.039, 1.127, p<0.001). Tlen, Tdia, Tare, and Tvol could distinguish N0 from N1 stage (p < 0.001, 0.041, < 0.001, < 0.001, respectively), N0 from N2 (all p < 0.001), N0 from N1-2 (p < 0.001, 0.001, < 0.001, < 0.001, respectively), and N0-1 from N2 (p < 0.001, 0.001, < 0.001, < 0.001, respectively). The area under the ROC curve (AUC) was higher for Tvol than that of Tlen, Tdia, and Tare in identifying LNM (AUC = 0.83, 0.82, 0.69, 0.79), and distinguishing N0 from N1 stage (AUC = 0.79, 0.78, 0.63, 0.74), N0 from N2 stage (AUC = 0.92, 0.89, 0.80, 0.89, respectively), and N0-1 from N2 stage (AUC = 0.84, 0.79, 0.76, 0.83, respectively).ConclusionTumor size was correlated with regional LNM in resectable colon cancer. In particularly, Tvol showed the most potential for noninvasive preoperative prediction of regional LNM and N stage.

The Exostosin Immunohistochemical Status Differentiates Lupus Membranous Nephropathy Subsets With Different Outcomes

The Exostosin Immunohistochemical Status Differentiates Lupus Membranous Nephropathy Subsets With Different Outcomes

Association of low birth weight and polyparasitic infection during pregnancy in Lambaréné, Gabon.

To report the prevalence of polyparasitism during pregnancy in the Lambaréné region of Gabon and its association with newborn birth weight. Pregnant women in their third trimester were recruited in a prospective study between November 2011 and March 2015. Parasite infection status was assessed microscopically in stool, urine and blood samples. Maternal demographic and obstetrical characteristics and newborns anthropometric data were collected. Multivariable logistic regression was used to assess the association between low birth weight and polyparasitism. 678 of 927 pregnant women were included for analysis with mean age (SD) of 25 (6.8) years. The analysis showed that 69% (468/678) were infected with at least one parasite (Plasmodium spp., Schistosoma spp., soil-transmitted helminths, filarial infections). This comprised of 38% with monoparasitism and 31% polyparasitism. The proportion of newborn babies with a weight below 2500g (LBW) in our study was 21% (142/678). Compared to pregnant women without infection, women with monoparasitic infection had adjusted Odds Ratio confidence interval 95% CI (aOR [95%CI]) of 1.6 [0.95-2.73], those with two parasites had aOR 95%CI of 2.63 [1.51-4.62], and those with more than two parasites had aOR of 5.08 [2.5-10.38] for delivering a newborn with low birth weight. In Lambaréné, an endemic area for multiple parasite infections, there is a high prevalence of polyparasitism in pregnant women. Polyparasitism is associated with low birth weight. Therefore, there is an urgent need for active screening and treatment of parasite infections in pregnant women to assess the potential public health benefit of such interventions.

Hepatitis B virus infection and its determinants among HIV positive pregnant women: Multicenter unmatched case-control study.

BackgroundHepatitis B virus (HBV) kills millions of people globally; it is worse in pregnant women. HBV and Human Immune Virus (HIV) co-infection is associated with increased liver diseases such as cirrhosis and hepatocellular carcinoma. This study aimed at identifying the determinants of HBV infection among HIV-positive pregnant women.MethodsA multicentre unmatched case-control study was conducted among 109 cases (HBV/HIV co-infected) and 327 controls (HIV positive) pregnant women in seven hospitals of the Eastern Amhara region. Interview and chart review data collection techniques were employed by trained personnel. A binary logistic regression model was used to identify independent predictors of hepatitis B virus infection. Variables with a p-value of <0.05 and 95% confidence interval for odds ratio not containing 1 considered independent predictors of HBV infection.ResultsThe findings of this study revealed that history of STI [AOR, 1.97, 95%CI, 1.09–3.56], hospital admission [AOR, 3.08, 95%CI, 1.69–5.61], traditional delivery care [AOR, 3.31, 95%CI, 1.72–6.37], family history of HBV [AOR, 3.33, 95%CI, 1.72–6.37], presence of opportunistic infections [AOR, 0.23, 95%CI, 0.12–0.58], viral load [AOR, 7.58, 95%CI, 3.18–8.01], CD4 count [AOR, 2.15, 95% CI, 1.01–4.59], anaemia [AOR, 3.07, 95% CI, 1.71–5.51] and unsafe sex [AOR, 1.98, 95%CI, 1.09–3.61] had a statistically significant association with HBV infection.ConclusionsSeveral exposure variables had statistically significant association with HBV infection. High Viral Load appeared to be the largest predictor of HBV infection in HIV patients. Therefore, targeted interventions such as behavioral change intervention for unsafe sex and STI should be in place, and screening tests and treatment at the early stage of conception for both partners is necessary.

Complete pathological response to neoadjuvant treatment is associated with better survival outcomes in patients with soft tissue sarcoma: Results of a retrospective multicenter study

BackgroundLocally advanced soft tissue sarcoma (STS) management may include neoadjuvant or adjuvant treatment by radiotherapy (RT), chemotherapy (CT) or chemoradiotherapy (CRT) followed by wide surgical excision. While pathological complete response (pCR) to preoperative treatment is prognostic for survival in osteosarcomas, its significance for STS is unclear. We aimed to evaluate the prognostic significance of pCR to pre-operative treatment on 3-year disease-free survival (3y-DFS) in STS patients. MethodsThis is an observational, retrospective, international, study of adult patients with primary non-metastatic STS of the extremities and trunk wall, any grade, diagnosed between 2008 and 2012, treated with at least neoadjuvant treatment and surgical resection and observed for a minimum of 3 years after diagnosis. The primary objective was to evaluate the effect of pCR. (≤5% viable tumor cells or ≥95% necrosis/fibrosis) on 3y-DFS. Effect on local recurrence-free survival (LRFS), distant recurrence-free survival (MFS) overall survival (OS) at 3 years was also analyzed. Statistical univariate analysis utilized chi-square independence test and odds ratio confidence interval (CI) estimate, multivariate analysis was performed using LASSO. ResultsA total of 330 patients (median age 56 years old, range:19–95) treated by preoperative RT (67%), CT (15%) or CRT (18%) followed by surgery were included. pCR was achieved in 74/330 (22%) of patients, of which 56/74 (76%) had received RT. 3-yr DFS was observed in 76% of patients with pCR vs 61% without pCR (p < 0.001). Multivariate analysis showed that pCR is statistically associated with better MFS (95% CI, 1.054–3.417; p = 0.033), LRFS (95% CI, 1.226–5.916; p = 0.014), DFS (95% CI, 1.165–4.040; p = 0.015) and OS at 3 years (95% CI, 1.072–5.210; p = 0.033). ConclusionsIn a wide, heterogeneous STS population we showed that pCR to preoperative treatment is prognostic for survival.

Mental health outcomes among health-care workers during the COVID-19 outbreak in Iran

PurposeThe increasing prevalence of coronavirus disease (COVID-19) is a global crisis that leads to physical and psychological outcomes for health-care workers, so this study aims to investigate the mental health outcomes (including general health, generalized anxiety disorder and posttraumatic stress disorder) in health-care workers in Rafsanjan, Iran.Design/methodology/approachBy using convenience sampling, this cross-sectional study was conducted on 332 health-care workers working in public hospitals in southern Iran. Data collection lasted from March to April 2020. General Health Questionnaire (GHQ-28), Generalized Anxiety Disorder 7-item (GAD-7) and Impact of Event Scale were used to collect data. The data were then analyzed by using SPSS 25 and descriptive and inferential statistics (chi-square and multivariate logistic regression).FindingsIn total 45.5% of the participants had psychological disorder according to GHQ. In addition, 25.3% of the participants had GAD and 31.6% had posttraumatic stress disorder (PTSD). The results using multivariate logistic regression showed that only income was significantly associated with psychological disorders (95% confidence interval for odds ratio: 1.32–6.45, P = 0.008).Practical implicationsAccording to the results, the incidence of GAD and PTSD was high among health-care workers. Therefore, it is recommended that the psychological skills of health-care workers be strengthened through counseling and training programs.Originality/valueThis paper provides a novel analysis of mental health in health-care workers in Iran.

Risk factors associated with testing positive for tuberculosis in high-yielding Holstein cows

Tuberculosis remains a significant infectious disease of farm animals and humans worldwide. The objective of this study was to assess various risk factors associated with testing positive for bovine tuberculosis (bTB) in high-yielding Holstein cows in an intensive dry-lot dairy operation. In a retrospective observational study, 9312 records from Holstein cows from a large dairy herd in northern Mexico were used. The incidence rate of lactating cows reactor to bTB was 7.3 cases/100 cow years (95% CI = 6.7-7.9%). Multiple logistic regression models indicated that cows with total milk yield during the first lactation >10,200 kg were 1.3 times (95% confidence intervals (CI) for odds ratio (OR) = 1.2-1.6) more likely to be detected as bTB reactors than cows with total milk yield <10,200 kg (8.2 vs. 6.4%; P < 0.01). The risk of being reactor to bTB increased with x̅ total milk yield/lactation >11,500 kg (OR=2.7, 95% CI = 2.3-3.3; 10.4 vs. 4.2%) compared with cows with x̅ total milk yield/lactation <11,500 kg. Cows with >10,200 kg 305-day milk yield in the last lactation was associated (P < 0.01) with 1.3 times higher odds (95% CI for OR = 1.1-1.5) of being classed as reactors than cows with <10,200 kg. Cows with peak milk yield >48 kg were 1.9 times (95% CI for OR = 1.6-2.2) more likely to be reactor to bTB than cows with peak milk yield <48 kg (9.2 vs. 5.1%; P < 0.01). Cows with either puerperal metritis (OR = 0.07, 95% CI = 0.5-0.9) or carrying twins (OR = 0.05, 95% CI = 0.01-0.19) had a protective role for being reactor to bTB. This study showed that increased milk production was associated with a higher risk of becoming positive to tuberculin skin test in high-yielding Holstein cows.

Every one-minute delay in EMS on-scene resuscitation after out-of-hospital pediatric cardiac arrest lowers ROSC by 5%

ObjectiveTo determine which aspects of prehospital care impact outcomes after pediatric cardiac arrest. MethodsIn this study, the authors examine 5 years of consecutive data from their county emergency medical system (EMS), to identify predictors of good outcome after pediatric cardiac arrest, including return of spontaneous circulation (ROSC), survival to hospital admission (HA) and survival to hospital discharge (HD). Three logistic regression models were performed using JMP 14.1 Pro for Windows, each with the following nine predictors: age, sex, ventilation method (endotracheal intubation vs. supraglottic airway), initial rhythm (pulseless electrical activity vs. asystole), epinephrine administration, bystander treatment prior to EMS arrival, time from collapse to EMS arrival, automatic external defibrillator (AED) placement, and whether the arrest was witnessed. Odds ratio confidence intervals were calculated using the Wald method, and corresponding p-values were obtained with the likelihood ratio χ2 test. ResultsFrom January 1, 2012 to December 31, 2016, there were 133 pediatric cardiac arrests, of which we had complete data on 109 patients for pediatric cardiac arrest. The median age was 8 months, with an IQR of 2.25–24 months, and a range of 0–108 months (0–9 years). There was return of spontaneous circulation (ROSC) in 20% of cases overall, with 16% making it to hospital admission, and 9% making it alive out of the hospital.The median time to EMS arrival for witnessed events was 10min, with an interquartile range (IQR) of 6.5−16min, and a range of 0−25min. The median time to EMS arrival for unwitnessed events was 30min, with an IQR of 19–62.5min, and a range of 9−490min.Predictors of ROSC included epinephrine administration (p=.00007), bystander treatment before EMS arrival (p=.0018), older age (p=.0025), shorter time to EMS arrival (p=.0048), and AED placement. Predictors of hospital admission included epinephrine NOT being administered (p=.0004), bystander treatment before EMS arrival (p=.0088), shorter time to EMS arrival (p=.0141), and AED placement (p=.0062). The only significant predictor of survival to hospital discharge alive that was identified was shorter time to EMS arrival (p=.0014), as there was insufficient data for many of the predictor variables in this analysis. ConclusionShorter time to EMS arrival from time of arrest, any bystander treatment prior to EMS arrival, and AED placement resulted in significantly higher rates of return of spontaneous circulation. Epinephrine administration significantly improved ROSC, but had the opposite effect on HA. Only shorter time to EMS arrival from time of arrest was significantly associated with survival to hospital discharge. Each additional minute for the EMS to arrive resulted in 5% decreased odds of ROSC and hospital admission, and 12% decreased odds of surviving to hospital discharge.

Maternal and perinatal outcomes of uterine rupture in Lubumbashi, Democratic Republic of Congo

Introduction: Uterine rupture is one of the peripartum complications, which cause nearly about one out of thirteen maternal deaths. This study aimed to assess the prevalence and associated factors of mortality among women with uterine rupture in referral hospitals of Lubumbashi, in the south east part of the Democratic Republic of Congo. Methods: Institution based cross sectional study was conducted from December 1st, 2012 to 31st, 2016 on uterine rupture. During the study selected 158 women were included by using exhaustive sampling method. Data were checked, coded and analyzed into STATA version 12. Chi-square test was used to identify the predictors of maternal and perinatal mortalities in women with uterine rupture and 95% Confidence Interval of odds ratio at p - value less than 0.05 was taken as a significance level. Results: The overall prevalence of uterine rupture was 0.49%. The average age of the patients was 29.5 ± 6.2 years and 71.52% of them were between 20 and 34 years old; more than 60% had a parity ≥4 (average parity: 4.7 ± 2.5). 81.17% of the cases had a fully ruptured uterus and 51.17% of the uterine ruptures were located in the lower segment. Repair of the pregnant ruptured uterus was performed in 93.04% of the cases and hysterectomy in 5.06%. Maternal and perinatal mortalities were 8.86% and 72.04% respectively. Regarding maternal mortality, no parameter showed a significant association with maternal death. As for perinatal mortality, parity ≥4, complete rupture and segmento-corporeal lesion were significantly associated with perinatal death (p &lt; 0.05). Conclusion: Uterine rupture remains one of the causes of maternal and perinatal mortality in Lubumbashi. The place occupied by uterine ruptures in obstetric activity requires joint and urgent action by all stakeholders in the health system in order to combat this scourge, witness to poor quality obstetric care.

Umbilical shapes predict future protrusion in pediatric umbilical hernias.

This study was conducted to evaluate the incidence and early predictive factors of the development of protuberant umbilicus in pediatric umbilical hernia patients. In this retrospective visual and chart review, patients younger than 3months with umbilical hernias who initially visited Ina Central Hospital from April 2011 to March 2017 and were followed until they started to walk (at the age of 1year) were evaluated. The umbilici of the patients at the age of 1year were classified into two types based on their appearance: concave and protuberant umbilici. Single-factor and logistic regression analyses of the association between the appearance of the umbilicus at the age of 1year and various clinical data were performed. Of the 103 patients, 72% had concave umbilici, and 28% had protuberant umbilici. Single-factor analysis showed significant differences in the umbilical shapes at the initial visit (P < 0.001) and straining habit (P < 0.001). The most ideal logistic regression model demonstrated that umbilici of the highly inflated balloon type (odds ratio, 27.00; 95% confidence interval odds ratio, 5.60-130.08) and crescent type (odds ratio, 14.34; 95% confidence interval odds ratio, 4.22-48.77) were more likely to develop into protuberant umbilici. Umbilical shapes at the initial visit can be used to predict the future development of protuberant umbilici in pediatric patients with umbilical hernias.

A simplex dispersion model for improving precision in the odds ratio confidence interval in mixture experiments

A new approach to data analysis in mixture experiments is proposed using the simplex regression, that is in the class of dispersion models family. The advantages of this approach are illustrated in an experiment studying the mixture effect of fat, carbohydrate, and fiber on tumors’ proportion in mammary glands of rats. Model was evaluated by goodness of fit criteria, simulated envelope charts for residuals of adjusted models, odds ratios graphics and their respective confidence intervals. The simplex regression model showed better quality of fit and smaller odds ratio confidence intervals.

Comparison of ITS-2 rDNA nemabiome sequencing with morphological identification to quantify gastrointestinal nematode community species composition in small ruminant feces

Mixed gastrointestinal nematode (GIN) infections are a common and significant cause of financial loss for small ruminant producers. Morphologic examination of third-stage larvae (L3) can be used to identify species composition in feces but has limitations due to the requirement for specialized expertise and the extensive time (8–15 d depending on method used) and labour involved. Moreover, differential development and survival of larvae during coproculture to the third stage often occurs. Deep amplicon sequencing of the ITS-2 rDNA locus of first-stage larvae (L1) allows for higher throughput with reduced specialist labour and reduces the risk of misidentification. Harvesting of L1 soon after hatching is also faster and further reduces labour as well as biases that can occur due to differential larval development and survival. This study compares the results of morphologic examination of L3 with those of ITS-2 rDNA deep amplicon sequencing of L1 from a set of pooled fecal samples. The proportions of eggs that were successfully recovered as larvae following culture to L3 and L1 were also compared. Larval recovery rate was significantly lower from L3 cultures than from L1 cultures (p < 0.001); eggs were 238.7 times less likely to develop to L3 than to L1 (95 % confidence interval for odds ratio 80.0–712.0). Significantly lower proportions of Teladorsagia circumcincta (odds ratio = 3.1, p = 0.008) and higher proportions of Trichostrongylus spp. (p = 0.009) were identified using morphologic examination of L3 compared with deep amplicon sequencing of L1 on the same samples. This is consistent with previous reports of differential survival of these species in L3 cultures. These results indicate that deep amplicon sequencing of L1 may reduce bias introduced by differential GIN survival to L3 in small ruminants.

The relationship of gene polymorphism with the heart failure risk in patients with hypertension and high adherence to treatment

Aim. To determine the heart failure (HF) risk in patients with hypertension (HTN) and high adherence to treatment, depending on the blood concentration of the N-terminal pro-brain natriuretic peptide (NT-proBNP) and gene polymorphism. Material and methods. The study included 232 patients with HTN without a verified diagnosis of HF. The mean age was 46,13±8,21 years. Patients were evaluated for genotypes by following markers: AGT Thr174Met rs4762, GNB3 C825T rs5443, MTHFR C677T rs1801133, MTRR Ile22Met rs1801394, ApoE Cys130Arg rs 429358, PPAR α G/C rs425377. We also assessed ejection fraction, diastolic function and left ventricular mass index by echocardiography and determined NT-proBNP blood levels. Patients were divided into two groups depending on the NT-proBNP concentration. The group 1 consisted of 64 (27,6%) patients with NT-proBNP >125 pg/ml, the group 2 — 168 (72,4%) patients with NT-proBNP 125 pg/ml, the most significant was the C/T genotype of MTHFR C677T polymorphism (rs1801133), 95% confidence interval (CI) for the odds ratio (OR) and relative risk (RR) of HF was 4,82 and 3,29, respectively (95% CI for OR=2,24-10,60; for OR=1,80-6,39). The A/G and G/G genotypes of the MTRR Ile22Met polymorphism (rs1801394) were statistically significant. The probability of HF with the A/G genotype of the MTRR gene increased by more than 2 times (OR=2,32, 95% CI=1,15-4,64), and the OR of its development was 1,77 (95% CI=1,11-2,69). The probability of HF with the G/G genotype increased more than 3 times (OR=3,65, 95% CI=1,37-9,76), and the OR of its development was 2,20 (95% CI=1,25-3,27). Correlation analysis revealed a direct relationship between the NTproBNP levels and polymorphism of the MTHFR (r=0,47; p 125 pg/ml depends on genetic determinism. Candidate genes for the HF in HTN patients with high adherence to treatment are the genotypes C/T of MTHFR C677T polymorphism (rs1801133), and A/G and G/G of MTRR Ile22Met polymorphism (rs1801394).

Risk factors for major adverse cardiovascular events after osteoporotic hip fracture repair surgery

Osteoporotic hip fracture (OHF) is an increasingly frequent age-related pathology, which results in high rates of functional loss and mortality within the first year after surgery. This study assessed whether preoperative levels of brain natriuretic peptide (NT-proBNP) and troponin I were related to early occurrence (30d) of major adverse cardio-vascular events (MACE) after OHF repair surgery. During a 6-month period, perioperative clinical and analytical data from consecutive patients, without known history of cardiovascular disease and undergoing surgery for OHF repair at a single centre, were prospectively collected. MACE was defined as acute myocardial ischaemia or infarction, acute heart failure or cardiovascular death. amongst the 140 patients included, 23 (16.4%) developed postoperative MACE (MACE group) and 117 did not (Control group). Compared to those from control group, patients from MACE group were older, had poorer physical status (ASA III–IV), received preoperative red blood cell transfusion (RBCT) more frequently, presented with lower haemoglobin concentrations and higher NT-proBNP, creatinine and troponin I concentrations. Overall, RBCT requirements and 30d mortality rate were also higher in MACE group. However, in multivariate analysis, only preoperative RBCT, creatinine >1 mg/dL and NT-proBNP >450 pg/mL remained as independent preoperative risks factors for postoperative MACE, while 95% confidence intervals of odds ratios were wide. Though our findings require confirmation in a larger multicentre cohort, identifying risk factors for early postoperative MACE after OHF repair surgery, might facilitate assessing patients’ risk prior to and following surgery, and targeting them the appropriate preventive and/or therapeutic interventions.