Differences Research Articles

Post Covid-19 Upturn in Acute MI Related Mortality Trends in Young to Middle Aged Type-2 Diabetics: Observations from CDC Wonder

COVID-19 outbreak negatively impacted all aspects of adequate delivery of healthcare by overburdening the modalities. Care for acute myocardial infarction was heavily impacted attributable, in part, to reduced hospitalizations and cardiac care units not being able to function at full capacity. This paper attempts to elicit the resultant trend shift in Acute myocardial infarction (AMI) related mortality in young to middle-aged diabetics.CDC WONDER database was queried from 1999-2021. Only patients younger than 54 years old were included. Age-adjusted mortality rates (AAMR) per 100,000 with 95% confidence intervals were obtained. Joinpoint 5.0 software was used to analyze trend shift with average annual percent change (AAPC) values.A total of 10,011 AMI related deaths were encountered in the young/middle aged diabetics during our study period. Of which, around 14% (1,381) deaths were recorded in the years 2020 & 2021 alone. In these 2 years, 20.24% of subjects passed away in their homes vs only 11.06% deaths recorded in-patient. Overall AAMR more than doubled from 1999 (AAMR: 0.14 [0.13,0.16]) to 2021 (AAMR: 0.32 [0.3,0.34]) (AAPC: 3.7 [2.9,5.5]). Males had higher mortality rates (AAMR1999-2020: 2.55 [2.52,2.57]) than females (AAMR1999-2020: 1.49 [1.47-1.50]). Rural counties (AAMR1999-2020: 3.68 [3.63,3.74]) had nearly triple the mortality rates of large metropolitans (AAMR1999-2020: 1.70 [1.68,1.72]). AAMR were highest in the Midwest (AAMR1999-2020:2.3 [2.27,2.32]) and lowest in the Northeast (AAMR1999-2020: 1.41 [1.39,1.43]).COVID-19 had profound effects on cardiovascular healthcare. Post-pandemic, developing robust mechanisms to reverse the damage dealt in terms of increased morbidity and mortality has become imperative.

Triple-Combination Clindamycin Phosphate 1.2%/Adapalene 0.15%/Benzoyl Peroxide 3.1% Gel for Moderate-to-Severe Acne in Children and Adolescents.

Topical clindamycin phosphate 1.2%/adapalene 0.15%/benzoyl peroxide 3.1% (CAB) gel is the only fixed-dose triple-combination approved for acne (indicated in patients 12 years and older). As topical acne treatment in pediatric patients may be complicated by tolerability and/or a perceived lack of efficacy, post hoc analyses were used to investigate efficacy/safety of CAB in children and adolescents. Data were pooled from 2 phase 3, double-blind, 12-week studies (NCT04214639; NCT04214652). Participants aged 9 years and older with moderate-to-severe acne were randomized (2:1) to once-daily CAB or vehicle gel. Endpoints included treatment success (at least 2-grade reduction from baseline in Evaluator's Global Severity Score and clear/almost clear skin) and least-squares mean percent change from baseline in inflammatory/noninflammatory lesions. Treatment-emergent adverse events (TEAEs) and cutaneous safety/tolerability were evaluated. Post hoc analyses were conducted in adolescents aged 12 to 17 years (CAB, n=123; vehicle, n=50) with descriptive data shown for children aged 10 to 11 (CAB, n=3; vehicle, n=2). At week 12, 51.5% of CAB-treated adolescents achieved treatment success vs 24.9% with vehicle (P<0.01). CAB also provided inflammatory/noninflammatory lesion reductions of 78.3%/73.7% vs 50.5%/42.9% with vehicle (P<0.001, both). Most TEAEs were of mild-to-moderate severity, and <2.5% of participants discontinued due to adverse events. Only the 3 children treated with CAB achieved treatment success, with lesion reductions ranging from 76% to 100%. One CAB-treated child experienced TEAEs and none discontinued. In 2 pooled phase 3 studies, once-daily CAB gel was well tolerated and efficacious in pediatric participants with acne, with over half achieving treatment success at week 12. J Drugs Dermatol. 2024;23(12):1049-1057. doi:10.36849/JDD.8643.

Incidence, prevalence and clinical presentation of inflammatory bowel diseases in Northern France: a 30-year population-based study

In industrialized countries, the incidence of inflammatory bowel disease (IBD) appears stabilized. This study examined the incidence and phenotype of IBD in Northern France over a 30-year period. Including all IBD patients recorded in the EPIMAD population-based registry from 1988 to 2017 in Northern France, we described the incidence and clinical presentation of IBD according to age, sex and time. A total of 22,879 incident IBD cases were documented (59% (n=13,445) of Crohn's disease (CD), 38% (n=8803) of ulcerative colitis (UC), 3% (n=631) of IBD unclassified (IBDU)). Over the study period, incidence of IBD, CD and UC was 12.7, 7.2 and 5.1 per 105 person-years, respectively. The incidence of CD increased from 5.1/105 in 1988-1990 to 7.9/105 in 2015-2017 (annual percent change (APC):+1.9%, p<0.0001). The incidence of UC increased from 4.5/105 to 6.1/105 (APC:+1.3%, p<0.0001). The largest increase was observed in children (+4.3% in CD, p<0.0001;+5.4% in UC, p<0.0001) followed by young adults aged 17-39 years (+1.9% in CD, p<0.0001;+1.5% in UC, p<0.0001). The increase in UC incidence was significantly higher in women than in men (+1.9% in women,+0.8% in men; p=0.006). We estimated that in our area, by 2030, nearly 0.6% of the population will have IBD. The persistent increase of IBD incidence among children and young adults but also in women with UC in Northern France, suggests the persistence of substantial predisposing environmental factors. Santé Publique France; INSERM; Amiens, Lille and Rouen University Hospitals.

Examining the effect of verbal feedback vs. real-time software feedback on kinetic and kinematic metrics of the Nordic hamstring exercise

Abstract Purpose A wealth of research exists for the Nordic hamstring exercise and several devices provide real-time feedback on torque profiling. However, none currently offer feedback on technique execution. This study investigated the effect of verbal and software feedback on Nordic exercise kinetic and kinematic metrics. Methods 24 recreational participants completed two sets of three bilateral repetitions on a hamstring testing device. In a crossover design, one set was performed with verbal feedback, while the other set used software-based feedback. Hamstring strain injury risk metrics (peak torque, break-torque angle, and bilateral limb percentage difference) and exercise technique metrics (relative trunk-to-thigh angle and angular velocity of the knee) were recorded for analysis. Results The feedback type significantly affected eccentric knee flexor peak torque, by a mean decrease of 7.1 Nm when performed with software feedback (Cohen’s d = 0.238, p &lt; 0.01). Altering feedback had no significant effect on bilateral limb difference percentage (Cohen’s d = 0.068, p = 0.578) or break-torque angle (Cohen’s d = 0.159, p = 0.115). Software feedback significantly decreased the mean of both the relative-trunk-to-thigh angle at peak torque by 5.7° (Cohen’s d = 0.514, p &lt; 0.01) and the angular velocity of the knee at peak torque by 8.7 deg·s−1. Conclusions An integrated software feedback system significantly improves acute Nordic exercise technique, benefitting individuals initially exhibiting poorer technique the most.

High-throughput untargeted metabolomics reveals metabolites and metabolic pathways that differentiate two divergent pig breeds

Metabolomics can describe the molecular phenome and may contribute to dissecting the biological processes linked to economically relevant traits in livestock species. Comparative analyses of metabolomic profiles in purebred pigs can provide insights into the basic biological mechanisms that may explain differences in production performances. Following this concept, this study was designed to compare, on a large scale, the plasma metabolomic profiles of two Italian heavy pig breeds (Italian Duroc, IDU, and Italian Large White, ILW) to indirectly evaluate the impact of their different genetic backgrounds on the breed metabolomes. We utilised a high-throughput untargeted metabolomics approach in a total of 962 pigs that allowed us to detect and relatively quantify 722 metabolites from various biological classes. The molecular data were analysed using a bioinformatics pipeline specifically designed for identifying differentially abundant metabolites between the two breeds in a robust and statistically significant manner, including the Boruta algorithm, which is a Random Forest wrapper, and sparse Partial Least Squares Discriminant Analysis (sPLS-DA) for feature selection. After thoroughly evaluating the impact of random components on missing value imputation, 100 discriminant metabolites were selected by Boruta and 17 discriminant metabolites (all included within the previous list) were identified with sPLS-DA. About half of the 100 discriminant metabolites had a higher concentration in one or the other breed (48 in Italian Large White pigs, with a prevalence of amino acids and peptides; 52 in Italian Duroc pigs, with a prevalence of lipids). These metabolites were from seven distinct super pathways and had an absolute mean value of percentage difference between the two breeds (|Δ|%) of 39.2±32.4. Six of these metabolites had |Δ|%>100. A general correlation network analysis based on Boruta identified metabolites consisted of 31 singletons and 69 metabolites connected by 141 edges, with two large clusters (>15 nodes), three medium clusters (3-6 nodes) and 8 additional pairs, with most metabolites belonging to the same super pathway. The major cluster representing the lipids super-pathway included 24 metabolites, primarily sphingomyelins. Overall, this study identified metabolomic differences between Italian Duroc and Italian Large White pigs explained by the specific genetic background of the two breeds. These biomarkers can explain the biological differences between these two breeds and can have potential practical applications in pig breeding and husbandry.

Joint quaternion valued features and quaternion valued long short term memory based recurrent neural network for non-invasive blood glucose estimation

For the four channel photoplethysmograms (PPGs), this paper proposes a quaternion valued based method for performing the non-invasive blood glucose estimation. First, these four channel PPGs form a quaternion valued signal. Then, the quaternion valued means and the quaternion valued medians of this quaternion valued PPGs are employed as features. Next, the quaternion valued long short term memory (QLSTM) based recurrent neural network (RNN) is employed for estimating the non-invasive blood glucose values. Unlike the traditional methods based on extracting the features in each channel of the PPGs independently and fusing all the features together in the conventional neural networks, the quaternion valued operations performed on the quaternion valued PPGs only fuse the same features among these four channels together while do not fuse different features among these four channels together. Hence, the physical interpretations of the features preserve. To demonstrate the effectiveness and the robustness of our proposed method, two datasets are evaluated. The computer numerical simulation results show that our proposed method can yield 81.43% and 83.09% of the test data falling in the zone A of the Clark error grid for the test data in the first dataset and in the second dataset, respectively. Also, it can yield the mean absolute relative difference (MARD) at 14.41% and 14.31% for the test data in the first dataset and the second dataset, respectively. This demonstrates the superior performance of our proposed method over the existing methods for the test data in the both datasets.

Improving baseline reduction for emotion recognition based on electroencephalogram signals

The baseline reduction method has been widely used to define electroencephalogram (EEG) signal patterns. However, because the baseline signal in this approach contains artifacts, the baseline reduction approach cannot perform optimally. As a result, decreasing artifacts in the baseline signal is critical. The mean, Gaussian, and Savitzky-Golay filters will be compared in this study to minimize artifacts in the baseline signal. Three secondary datasets are utilized to evaluate these approaches' capacity to remove artifacts. These three strategies are also tested with the convolution neural network classification algorithms. When applied to the dataset for emotion analysis using physiological signals (DEAP) and a dataset for multimodal research of affect, personality traits, and mood on individuals and groups (AMIGOS) datasets, the mean filter can increase baseline reduction performance based on twenty-four test scenarios. On the data readiness for machine learning research (DREAMER) dataset, however, the Gaussian filter is preferable. The relative difference approach was employed in this study's baseline reduction process to generate EEG signal patterns that are easy to recognize throughout the classification phase, which impacts increasing accuracy.

Clinical Efficacy of Ezetimibe Combined with Rosuvastatin in the Treatment of Patients with Primary Hypercholesterolemia Inadequately Controlled by Statin Therapy

Aims/Background Primary hypercholesterolemia (PHC) is a major risk factor for atherosclerotic cardiovascular disease (ASCVD). Although the fact that statins effectively lower low-density lipoprotein cholesterol (LDL-C) levels, some patients fail to achieve target LDL-C levels and continue to have a high risk of cardiovascular disease. This study aims to evaluate the clinical efficacy and safety of ezetimibe combined with rosuvastatin in patients with PHC. Methods This study retrospectively examined 101 patients with PHC who received statins at the cardiology department of Jilin Province FAW General Hospital, between 2021 and 2024. Patients were divided into the observation (ezetimibe combined with rosuvastatin, n = 45) and control (rosuvastatin, n = 66) groups in accordance with their treatment regimens. Data were sourced from the hospital's electronic health records system, and statistical analysis was performed by using SPSS 25.0 software (IBM Corporation, Armonk, NY, USA). Results Baseline characteristics were similar between the two groups. After 12 weeks of treatment, the reduction in LDL-C levels in the observation group (–0.373 [–0.427, –0.348]) was greater than that in the control group (–0.240 [–0.318, –0.222], p &lt; 0.001). The percentage changes in total cholesterol (TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) levels were significantly better in the observation group (TC: –0.230 [–0.302, –0.144], TG: –0.292 [–0.333, –0.237], and HDL-C: 0.081 [0.067, 0.111]) than in the control group (TC: –0.127 [–0.158, –0.119], TG: –0.082 [–0.101, –0.067], and HDL-C: 0.000 [–0.163, 0.133] with p &lt; 0.001, p &lt; 0.001, and p = 0.011, respectively). Regarding drug safety, the incidence of adverse events was comparable between the two groups (11.10% vs. 12.10%, p = 0.871). Conclusion The combination of ezetimibe and rosuvastatin demonstrates superior lipid-lowering efficacy and good safety in patients with PHC inadequately controlled by statin therapy, providing an effective alternative treatment option. Further large-scale, multicenter randomized controlled trials are warranted to confirm its long-term efficacy and safety.

Comparative evaluation of laboratory methods for performance assessment of cementitious materials in wastewater networks: Biological and chemical tests versus field exposure

The biodeterioration of concrete elements in sewer systems and their repair is of significant economic and societal concern. However, the available test methods to assess the performance of cementitious materials under the relevant conditions are insufficiently validated. In the present study, two biological test methods and a standardised chemical test were applied to two sewer repair mortars and a reference mortar, and the performances of these materials were compared in a severely deteriorating sewer environment. In both biological tests, the induction period was considerably shorter than that of the field, and time-resolved recording of durability indicators enabled to determine deterioration rates in the steady-state regime, which compared reasonably well with each other and with the behaviour in the sewer environment. The chemical test does not allow to obtain a deterioration rate, and the observed relative performance differences of the mortars deviated from the results of the biological tests.

Medicare reimbursement for interventional pain procedures: 2000 to 2023

BackgroundAn analysis of the financial trends of Interventional Pain (IP) procedures in the United States is lacking. Understanding these relations is necessary to help optimize future IP care delivery and costs. ObjectiveTo examine Medicare reimbursement trends for IP procedures in both facility and non-facility settings. MethodsUtilizing the Physician Fee Schedule Look-Up Tool from the Centers for Medicare and Medicaid, reimbursement data for 32 of the most performed IP procedures was collected between 2000 and 2023 for both facility and non-facility clinical sites. After adjusting for inflation, annual change, total percent change, and compound annual growth rate (CAGR) were calculated for each procedure. ResultsFollowing inflation adjustments, the average reimbursement rate decreased by an average of 61.31 % for facility procedures over the study period and by 60.40 % for non-facility procedures. The average adjusted reimbursement rate for facility procedures decreased by $6.76 per year with an average CAGR of −4.38 %, while the average adjusted reimbursement rate for non-facility procedures decreased by $18.66 per year with an average CAGR of −4.48 %. A two-tailed t-test was performed between facility and non-facility groups for total percent change (P = 0.803), annual change (P < 0.001), and CAGR (P = 0.746). ConclusionMedicare reimbursement rates in both facility and non-facility settings have decreased from 2000 to 2023, with non-facility procedures experiencing a significantly larger decrease.

Optimizing laser cutting of stainless steel using latin hypercube sampling and neural networks

Optimizing cutting parameters in fiber laser cutting of austenitic stainless steel is challenging due to the complex interplay of multiple variables and quality metrics. To solve this problem, Latin hypercube sampling was used to ensure a comprehensive and efficient exploration of the parameter space with a smaller number of trials (185), coupled with feedforward neural networks for predictive modeling. The networks were trained with a leave-one-out cross-validation strategy to mitigate overfitting. Different configurations of hidden layers, neurons, and training functions were used. The approach was focused on minimizing dross and roughness on both the top and bottom areas of the cut surfaces. During the testing phase, an average MSE of 0.063 and an average MAPE of 4.68% were achieved by the models. Additionally, an experimental test was performed on the best parameter settings predicted by the models. Initial modelling was conducted for each quality metric individually, resulting in an average percentage difference of 1.37% between predicted and actual results. Grid search was also performed to determine an optimal input parameter set for all outputs, with predictions achieving an average accuracy of 98.34%. Experimental validation confirmed the accuracy and robustness of the model predictions, demonstrating the effectiveness of the methodology in optimizing multiple parameters of complex laser cutting processes.

Study of the antimicrobial and antioxidant activity of lipsticks and soaps made with phycoerythrin coated with chitosan extracted from the cyanobacterium Aliinostoc oryzae

The use of various artificial dyes in the preparation of cosmetics for over half a century has led to an increase in cancer diseases in humans. On the other hand, the excessive use of synthetic antibiotics available on the market, which have been used for treating humans and animals for over half a century, has significantly reduced the efficacy of many antibiotics due to the development of bacterial resistance. In contrast, phycoerythrin (PE) as a natural pigment possesses potential antioxidant and antimicrobial properties. Therefore, this article aims to use PE to create soap and cosmetic lipsticks that not only ensure consumer health but also avoid the harmful effects of chemical compounds present in cosmetic products. In the present study, PE extracted from the cyanobacterium Aliinostoc oryzae was microencapsulated with chitosan and added to the formulation of solid soap and lipstick. All standard tests were performed at intervals of 1, 5, 10, 15, 20, 25, and 30 days and compared with controls. The percentage change in the hardness of lipsticks enriched with PE was significantly higher than the control (p ≤ 0.05), while the amount of force required during use was significantly lower than the control (p ≤ 0.05). In soaps enriched with PE, the moisture reduction trend over time was steeper in soaps without PE. Additionally, the antioxidant activity and insoluble substances in alcohol in PE-enriched soaps were significantly higher than the control sample, while the percentage of lipid compounds and the unsaponifiable matter of free alkali in the control sample were significantly higher than the Soap + PE sample (p ≤ 0.05). Over time, the L* color component of all enriched products decreased significantly, while the a*, b*, and ΔE color components increased significantly (p ≤ 0.05). Moreover, the total microbial population, inhibition zone diameter, and peroxide index in enriched products were significantly lower than the control. Overall, the enriched products did not cause any skin sensitivity, and color changes and stability remained consistent over time. All these results confirm the claim that chitosan-coated PE, as an effective additive, has significant efficacy in cosmetic products.

Impact of uncertainty quantification through conformal prediction on volume assessment from deep learning-based MRI prostate segmentation

ObjectivesTo estimate the uncertainty of a deep learning (DL)-based prostate segmentation algorithm through conformal prediction (CP) and to assess its effect on the calculation of the prostate volume (PV) in patients at risk of prostate cancer (PC).MethodsThree-hundred seventy-seven multi-center 3-Tesla axial T2-weighted exams from biopsied males (66.64 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm$$\\end{document} 7.47 years) at risk of PC were retrospectively included in the study. Assessment of PV based on PI-RADS 2.1 ellipsoid formula (PVref\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${{{\\rm{PV}}}}_{{ref}}$$\\end{document}) was available for included patients. Prostate segmentations were obtained from a DL model and used to calculate the PV (PVDL\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${{{\\rm{PV}}}}_{{DL}}$$\\end{document}). CP was applied at a confidence level of 85% to flag unreliable pixel segmentations of the DL model. Subsequently, the PV (PVCP\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${{{\\rm{PV}}}}_{{CP}}$$\\end{document}) was calculated when disregarding uncertain pixel segmentations. Agreement between PVDL\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${{{\\rm{PV}}}}_{{DL}}$$\\end{document} and PVCP\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${{{\\rm{PV}}}}_{{CP}}$$\\end{document} was evaluated against the reference standard PVref\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${{{\\rm{PV}}}}_{{ref}}$$\\end{document}. Intraclass correlation coefficient (ICC) and Bland–Altman plots were used to assess the agreement. The relative volume difference (RVD) was used to evaluate the PV calculation accuracy, and the Wilcoxon Signed-Rank Test was used to assess statistical differences. A p-value < 0.05 was considered statistically significant.ResultsConformal prediction significantly reduced RVD when compared to the DL algorithm (RVD = − 2.81 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm$$\\end{document} 8.85 and RVD = −8.01 ±\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\pm$$\\end{document} 11.50). PVCP\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${{{\\rm{PV}}}}_{{CP}}$$\\end{document} showed a significantly larger agreement than PVDL\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${{{\\rm{PV}}}}_{{DL}}$$\\end{document} when using the reference standard PVref\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${{{\\rm{PV}}}}_{{ref}}$$\\end{document} (mean difference (95% limits of agreement) PVCP\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${{{\\rm{PV}}}}_{{CP}}$$\\end{document}: 1.27 mL (− 13.64; 16.17 mL) PVDL\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${{{\\rm{PV}}}}_{{DL}}$$\\end{document}: 6.07 mL (− 14.29; 26.42 mL)), with an excellent ICC (PVCP\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${{{\\rm{PV}}}}_{{CP}}$$\\end{document}: 0.97 (95% CI: 0.97 to 0.98)).ConclusionUncertainty quantification through CP increases the accuracy and reliability of DL-based PV assessment in patients at risk of PC.Critical relevance statementConformal prediction can flag uncertain pixel predictions of DL-based prostate MRI segmentation at a desired confidence level, increasing the reliability and safety of prostate volume assessment in patients at risk of prostate cancer.Key PointsConformal prediction can flag uncertain pixel predictions of prostate segmentations at a user-defined confidence level.Deep learning with conformal prediction shows high accuracy in prostate volumetric assessment.Agreement between automatic and ellipsoid-derived volume was significantly larger with conformal prediction.Graphical

Epidemiological Characteristics and Spatiotemporal Analysis of Occupational Noise-Induced Deafness From 2006 to 2022 in Guangdong, China: Surveillance Study.

Occupational noise-induced deafness (ONID) has replaced occupational poisoning as the second most common occupational disease in China since 2015. However, there is a limited number of articles on epidemiological characteristics of legally diagnosed ONID. We conducted a comprehensive analysis of the epidemiological and spatiotemporal characteristics of ONID in Guangdong Province from 2006 to 2022, with the aim of providing a scientific foundation for policy formulation and health resource allocation. Surveillance data of ONID cases in Guangdong Province from 2006 to 2022 were obtained from the "Occupational Diseases and Health Hazard Factors Monitoring Information System." Joinpoint regression analysis was applied to assess the long-term trends in cases of ONID from 2006 to 2022. Global spatial autocorrelation analysis was performed to measure the overall degree of similarity of the attribute values of spatially adjacent or neighboring regional units. The local indicators of spatial autocorrelation (LISA) plots were then used to identify the local clusters of ONID in Guangdong. There were 3761 ONID cases in Guangdong Province from 2006 to 2022, showing a significantly increased trend in cases across the entire study period (average annual percentage change 21.9, 95% CI 18.7-35.1). The Moran's I values for the period of 2006 to 2022 ranged from 0.202 to 0.649 (all P<.001), indicating a positive spatial correlation of ONID across regions each year in Guangdong Province. A total of 15 high-high clusters were notably concentrated in specific counties within the Pearl River Delta. Significant spatiotemporal patterns of ONID in Guangdong Province from 2006 to 2022 were identified, characterized by a dramatic increase followed by stabilization in case numbers. ONID predominantly occur in manufacturing industries, domestically funded enterprises, among males, individuals aged 40-49 years, and those with 5+ years of occupational noise exposure. Spatial analysis demonstrated significant clustering in the Pearl River Delta region, with consistent positive spatial autocorrelation across years. These results could help prioritize the allocation of resources for targeted prevention and control measures for ONID.

Trends in gestational diabetes in Manitoba from 1981 - 2019: A descriptive study with geospatial mapping

BackgroundThere is little information describing trends in gestational diabetes incidence within sub-groups that often experience health inequities. MethodsWe leveraged provincial administrative health data to describe trends in gestational diabetes incidence between 1981-2019, stratified by sub-populations based on age, urbanicity, and neighbourhood-level average household income. We calculated yearly incidence across sub-groups and annual percent change in incidence to assess trends over time. Geospatial mapping was used to visualize changes by neighbourhood cluster. ResultsGestational diabetes incidence increased from 1.3% to 8.6% between 1981 and 2019, with an upward inflection occurring around 2010. The annual percent change (APC) between 1981-2009, prior to the inflection point, was 1.9% (95% CI: 1.4-2.5%) and was 11.7% (95% CI: 8.9-14.7%) post inflection – from 2010-2019. After 2010, gestational diabetes incidence increased most among urban residents (APC= 18.1%; 95%CI: 13.9-22.5), among those >35 years (APC = 12.0%; 95% CI: 8.4-15.7%), and among individuals in the highest SES group (APC = 14.8%; 95% CI: 9.4-20.4%).Geospatial mapping showed that incidence increased more in neighbourhoods with the highest proportion of recent immigrants to Canada. ConclusionIncidence of gestational diabetes increased six-fold in Manitoba over the last 20 years, particularly among those with high SES and higher age. Further research is required to clarify the role of screening practices in the trends observed here.

Effects of intermittent fasting on body composition, clinical health markers and memory status in the adult population: a single-blind randomised controlled trial

IntroductionDespite the popularity and potential protective effects of intermittent fasting (IF) against metabolic disorders, more human trials must be conducted to highlight its effects on human health. Therefore, the present trial aimed to investigate the effect of IF on the body composition, health markers, and memory status of obese and overweight adults.MethodsA parallel randomised controlled trial was conducted in Lahore, Pakistan, with 30 participants recruited from each of the three arms (regular diet, customised diet, and IF group) with a follow-up period of 12 weeks.ResultsThere was no significant difference in the mean percentage change in BMI at the end of the study period (p = 0.55). The IF group exhibited a negative median change (-4.41%) in systolic blood pressure compared with the other two groups (p = 0.014), with no difference among the groups in diastolic blood pressure or blood sugar levels (p > 0.05). The percentage change in waist circumference was more significant in the IF group than in the control group, with a significant improvement in the median percentage change in total cholesterol, LDL, triglyceride, and HDL levels (p < 0.05) as well as in the memory score (p < 0.05).ConclusionThis study revealed that IF helps improve participants’ lipid parameters, systolic blood pressure, and memory status.Trial RegistrationThe present study is registered at the registry of Clinicaltrials.gov with identity number NCT05521945 and registration date 30/08/22.

A comprehensive analysis of in-hospital adverse events after scopolamine administration: insights from a retrospective cohort study using a large nationwide inpatient database

BackgroundScopolamine is a widely used antiemetic in anesthetic practice, particularly for postoperative and post-discharge nausea and vomiting. Despite its frequent usage and recognized efficacy, concerns have emerged regarding the potential for increased side effects, particularly in elderly patients. Further research is needed to assess safety and determine age thresholds for adverse events. This study hypothesizes associations between perioperative scopolamine use, worse clinical outcomes, increased pneumonia, delirium, urinary retention, and readmissions.MethodsA large, retrospective cohort study was performed using the TriNetX Analytics Network database on patients undergoing major surgical procedures between Jan 1, 2009, and March 21, 2018, to examine the impact of perioperative scopolamine use on in-hospital adverse events. Patients were divided into age groups and compared to a control group. The primary outcomes assessed were delirium, pneumonia, in-hospital death, new antipsychotic use, readmission, and new onset urinary retention within 7 days post-surgery. 1:1 propensity score matching was performed to reduce bias. Relative risk and risk differences with 95% confidence intervals were estimated.ResultsAfter 1:1 propensity score matching, we identified a total of 403,816 (201,908 pairs) perioperative scopolamine users and nonusers. The cohorts of 20–29, 30–39, 40–49, 50–59, 60–69, and 70 + contained 22,910 (11,455 pairs), 44,170 (22,085 pairs), 58,590 (29,295 pairs), 71,660 (35,830 pairs), 88,386 (44,193 pairs), and 118,100 (59,050 pairs) patients respectively. Across older age cohorts, after propensity score matching, perioperative scopolamine recipients had significantly increased relative risk and risk difference of delirium, pneumonia, in-hospital mortality, new antipsychotic use, readmission, and new-onset urinary retention.ConclusionsIn this cohort study, perioperative scopolamine usage was associated with a significantly increased risk of in-hospital adverse events, both within the 70 + age cohort and among the 20–29, 30–39, 40–49, 50–59, and 60–69 age cohorts after major surgery. These findings highlight the need for careful assessment of scopolamine’s risks and benefits, especially for patients aged 40 and older. Scopolamine may be most suited for post-discharge nausea and vomiting in ambulatory patients and clinicians should reassess its standard use for postoperative nausea and vomiting, favoring shorter-acting agents with fewer side effects.

Multi-generational challenges and mental health of LGBTQ+ older adults in Slovenia

Abstract Aim. The purpose of the study was to determine whether diff erences in mental health exist among younger and older generations of LGBTQ+ older adults. Material and methods. A quantitative approach was taken. The questionnaire was completed by 318 LGBTQ+ older adults (50+) from Slovenia who met the inclusion criteria and were selected using a non-random purposive sample. For statistical analysis, we used exploratory factor analysis (EFA) and the Mann-Whitney U test to compare the two independent groups. Results. We received 318 fully completed questionnaires in the survey. EFA extracted one factor. The results demonstrate statistically signifi cant diff erences in mental health between younger and older generations of LGBTQ+ older adults for two items: I often experience stress and I have become more resilient due to facing many inequalities in society. The younger generation of LGBTQ+ older adults is more likely to report experiencing stress, but at the same time expresses a sense of resilience. Conclusions. Despite the stress, LGBTQ+ older adults – especially the younger generation – have developed resilience to overcome challenges and improve mental health. Addressing the specifi c needs of LGBTQ+ older adults and improving their mental health requires elimination of prejudice and discrimination, and taking into account the complexity of their identities and experiences.

Temporal changes in the burden of leukaemia and lymphoma in the Australasia and Oceania regions, 2010–2019: an analysis of the Global Burden of Disease Study 2019

ObjectivesLeukaemias and lymphomas are among the most prevalent and significant cancers in Australasia and Oceania. This study aims to examine the burden of leukaemias/lymphomas and its temporal trend in Australasia...

The reproducibility of protocols used to mediate a current-induced vasodilation in the human cutaneous microcirculation.

Current-induced vasodilation (CIV) can be used to assess the prostacyclin (PGI2) pathway. This study, for the first time, evaluated the reproducibility of several protocols used to mediate a CIV. Three CIV protocols were evaluated in 10 healthy participants who completed four testing sessions. Two testing sessions were conducted on the calf, separated by a period of seven days allowing interday reproducibility to be assessed. Two testing sessions were also conducted seven days apart on the forearm. At each testing session, cutaneous microvascular assessments were conducted for one hour on the right limb of interest before assessments were immediately performed on the left limb, allowing for intersite, intraday reproducibility to be evaluated. Assessments were then repeated at the same site on the right limb, allowing for intrasite, intraday reproducibility to be evaluated. Reproducibility was assessed using the within-subject coefficients of variation and the intra-class correlation coefficients. Protocol A (Pulses of 0.03, 0.06, 0.09, 0.12, 0.15, and 0.18 mA for 10 s each; 60 s intervals), Protocol B (0.1 mA for 60 s), and Protocol C (2 pulses of 0.1 mA for 10s each; 240 s interval) had good to excellent interday reproducibility for calf and forearm assessments. The intrasite, intraday reproducibility of each protocol was less clear. Intersite testing didn't improve intraday reproducibility. Reproducibility was consistently unacceptable when the microvascular response to the electrical stimulation was expressed as the absolute change and the percentage change between baseline values and the maximal plateau. A microvascular response wasn't induced ∼10% of assessments on either the calf or forearm. This study indicates that a CIV is most reproducible with interday testing and when data are expressed as the maximal plateau in perfusion units or as cutaneous vascular conductance, and as the area under the curve.