Threshold For Statistical Significance Research Articles

COVID-19 Vaccine Uptake and Associated Factors among Healthcare Workers in Lower Juba Region of Jubaland State in Somalia

Background: Somalia’s health systems were weakened by decades of conflicts, and this was made worse by the coronavirus pandemic that hit the nation like the rest of the world. Despite the existence of different types of COVID-19 vaccines, there has been a reluctance to take the vaccine by the general population and ironically by healthcare workers. Objective: The purpose of this study was to evaluate the uptake of the COVID-19 vaccine in the Lower Juba Region of the Jubaland State in Somalia among healthcare providers. Methods: The research study used a quantitative descriptive design to describe the levels of COVID-19 vaccine uptake among healthcare workers. The study recruited 191 study respondents. Stratified and simple random sampling methods were used. All the significance tests were conducted with two tails, and the threshold for statistical significance was set at P less than 0.05. Results: From this study, 46.6% of the study respondents had been vaccinated with the Covid-19 vaccine. Among the vaccinated group, 55.1% (49) received astrazeneca vaccine, 52.8% (47) received received 2 doses and males made up 51.5% (52). Regression analysis revealed that the observed differences in covid vaccine uptake for age, gender, education and work experience are not statistically significant. Trust in the protection of the vaccines (61.5%) and influence from family and friends (55.1%) were rated as having the highest influence on the participants’ decision to be vaccinated against covid. Conclusion: From this research, close to half of the study respondents had been vaccinated with COVID-19 vaccines. No significant differences have been shown in different gender, age groups, education level work experience on vaccination status. Building trust for vaccines, encouraging family/friends support and making vaccines easily accessible are seen as ways to improve uptake.

A cross-sectional study of musculoskeletal injuries related to exercise among gym members in Saudi Arabia in 2022: prevalence, common types, and predictor factors

BackgroundDespite the importance of enhancing exercise, exercising can cause injuries that lead to disability and increase the load on the medical sector. This study aimed to estimate the prevalence of exercise-related injuries among gym members in the Kingdom of Saudi Arabia (KSA) and evaluate the more common types of such injuries. It also investigated the association between injury prevalence and the factors selected.MethodsA cross-sectional study with a self-reported survey was conducted targeting members of Fitness Time gyms across the KSA. The survey consisted of three parts: part one concerns participant demographic data and part two contains four questions regarding the participants’ training experience. Part three contains ten questions targeting those with a history of injury. Descriptive statistical analysis was performed using frequencies and percentages for categorical variables. Crosstabs and chi-squared tests were used to assess the prevalence of exercise-related injuries when appropriate. Binary logistic regression was employed to investigate the association between injury prevalence and the potential associated factors. Odds ratios and their 95% confidence intervals were calculated and the threshold for statistical significance was set at p ≤ 0.05.ResultsA total of 713 subjects participated in the study. The mean age was 36.5 ± 11.2 years and (n = 422, 59.2%) of the participants were female. The study found a prevalence of injury among gym members of about (n = 404, ~57%). The most commonly reported types of injuries were muscle strain (n = 126, 37%) and bruising (n = 45, 13%). The most prevalent anatomical location of injury was the knee (n = 287, 84.3%), followed by the shoulder (n = 283, 83.3%), and the least common was the head/neck (n = 7, 2.1%). The present study suggests some factors associated with exercise-related injury. A significant statistical association (p < 0.5) was found between injury prevalence and age, gender, educational level, period of training, and presence of a trainer. However, no association was detected between injury prevalence and Body Mass Index (BMI), place of residence, or source of advice.ConclusionOver half of the participants of this study reported at least one exercise-related injury. This study identifies factors associated with injury prevalence related to exercise among gym participants. Promoting safety and minimizing the incidence of injuries are crucial.

Cross-platform proteomics signatures of extreme old age.

In previous work, we used a SomaLogic platform targeting approximately 5000 proteins to generate a serum protein signature of centenarians that we validated in independent studies that used the same technology. We set here to validate and possibly expand the results by profiling the serum proteome of a subset of individuals included in the original study using liquid chromatography tandem mass spectrometry (LC-MS/MS). Following pre-processing, the LC-MS/MS data provided quantification of 398 proteins, with only 266 proteins shared by both platforms. At 1% FDR statistical significance threshold, the analysis of LC-MS/MS data detected 44 proteins associated with extreme old age, including 23 of the original analysis. To identify proteins for which associations between expression and extreme-old age were conserved across platforms, we performed inter-study conservation testing of the 266 proteins quantified by both platforms using a method that accounts for the correlation between the results. From these tests, a total of 80 proteins reached 5% FDR statistical significance, and 26 of these proteins had concordant pattern of gene expression in whole blood generated in an independent set. This signature of 80 proteins points to blood coagulation, IGF signaling, extracellular matrix (ECM) organization, and complement cascade as important pathways whose protein level changes provide evidence for age-related adjustments that distinguish centenarians from younger individuals. The comparison with blood transcriptomics also highlights a possible role for neutrophil degranulation in aging.

EFFECTIVENESS OF THE LEBED METHOD THERAPEUTIC INTERVENTION ON PHYSICAL STABILITY AMONG ELDERLY INDIVIDUALS IN KAKAMEGA COUNTY

Background. In Kenya, falls among individuals over 60 years of age are a major concern. Despite physical activity being known to reduce fall risks, existing studies face challenges like high drop-out rates and limited exercise types. The Lebed Method, a dance program originally developed for breast cancer survivors by Sherry Lebed Davis, has shown potential to improve physical and emotional well-being. This study aimed to explore its effectiveness in improving physical stability among the elderly in Kakamega County. Methods. The study involved a community-based randomized control trial with 30 participants aged 60 and older, selected based on low social support scores. They were divided into intervention and control groups, meeting specific inclusion criteria. Baseline functional stability (mobility and balance) was assessed by Timed Up and Go (TUG), Berg Balance Scale (BBS) scores, gait speed time, and de Morton Mobility Index (DEMMI) score. To ensure the reliability of the study, biases such as selection, performance, detection, attrition, and reporting biases were addressed. Changes in physical stability between the groups were analyzed using the Analysis of Covariance, accounting for baseline differences, while within-group changes were evaluated using the dependent sample t-test. The threshold for statistical significance was set at p &lt; 0.05. Results. The findings showed that the intervention group improved significantly in physical stability compared to the control group. Specifically, notable enhancements were observed on TUG times (p &lt; .001, ηp2 = 0.53, d = 3.38), BBS scores (p &lt; .001, ηp2 = 0.64, d = 1.97), gait speed (p &lt; .001, ηp2 = 0.65, d = 1.99) and DEMMI score (p &lt; .001, ηp2 = 0.38, d = 1.94). Conclusions. The intervention significantly improved mobility and balance among participants, demonstrating the effectiveness of the Lebed method for elderly individuals. Future research could explore specific components of dance-based therapy that contribute to functional mobility and balance improvements

The relationship between emotional biases and investment decisions: a meta-analysis

PurposeThe study attempts to investigate the relationship between emotional biases (loss aversion bias, overconfidence bias, and regret aversion bias) and investment decisions through a meta-analysis approach.Design/methodology/approachA meta-correlation analysis was done using sample size and correlation (r) data from several relevant studies that look at how emotional biases (loss aversion bias, regret aversion bias, and overconfidence bias) affect investment decisions. Additionally, beta coefficients (ß) were also converted to correlation coefficients (r) from six studies.FindingsThis study analysed 31 empirical studies and found a significant positive correlation between emotional biases and investment decisions [loss aversion bias (r = 0.492), regret aversion bias (r = 0.401), and overconfidence bias (r = 0.346)]. We set the statistical significance threshold at 0.05.Research limitations/implicationsThe review covered 31 online research publications that showed significant heterogeneity, possibly influenced by various methodological, population, or other factors. Furthermore, the use of correlational data restricts the ability to establish causation.Originality/valueThis is a novel attempt to integrate the results of various studies through meta-analysis on the relation between these emotional biases (loss aversion, overconfidence, and regret aversion) and investment decisions.

A.R.R.O.W.2: once- vs twice-weekly carfilzomib, lenalidomide, and dexamethasone in relapsed/refractory multiple myeloma

AbstractTwice-weekly carfilzomib (27 mg/m2) plus lenalidomide and dexamethasone (KRd27) is a standard of care in relapsed/refractory multiple myeloma (RRMM). Once-weekly carfilzomib regimens have shown clinical benefits with improved patient convenience. This open-label, phase 3, multicenter, randomized study aimed to demonstrate noninferiority of the overall response rate (ORR) for once-weekly carfilzomib (56 mg/m2) plus Rd (KRd56) vs twice-weekly KRd27 in RRMM. A total of 454 patients were randomized (1:1) to receive carfilzomib as once-weekly 30-minute infusions of 56 mg/m2 (KRd56; n = 228) or twice-weekly 10-minute infusions of 27 mg/m2 (KRd27; n = 226). Baseline characteristics were balanced between groups. ORR was 82.5% (95% confidence interval [CI], 76.9-87.2) in the once-weekly group vs 86.3% (95% CI, 81.1-90.5) in the twice-weekly group (risk ratio, 0.954 [95% CI, 0.882-1.032]) and did not meet the threshold for statistical significance of noninferiority (P = .0666). Complete response (CR) or better was obtained in 46.9% of patients in the once-weekly arm and 36.3% in the twice-weekly arm. The proportions of patients who achieved CR and were also assessed negative for minimal residual disease were 21.5% and 18.1%, respectively (odds ratio, 1.235 [95% CI, 0.775-1.970]). Progression-free survival was comparable between groups (hazard ratio, 0.945 [95% CI, 0.617-1.447]). The safety profile was similar for both groups. In conclusion, although statistical significance for noninferiority of ORR was not achieved, the efficacy and safety of once-weekly KRd56 were similar to those of twice-weekly KRd27, and once-weekly KRd56 may be an effective and convenient treatment option for patients with RRMM. This trial was registered at www.ClinicalTrials.gov as #NCT03859427.

The Quality of Online Medical Information Regardind Hypertension

The aim of this paper is to evaluate the completeness, accuracy and credibility of the medical information found online about hypertension and to compare the quality of the Romanian and English websites. This observational, cross-sectional study included 25 Romanian and 25 English websites. Pre-established inclusion and exclusion criteria were used for sample selection. Credibility was assessed using 12 criteria based on the eEurope 2002 expert recommendations. Completeness and accuracy of information were evaluated using a quality standard based on information from literature and guidelines. The credibility, completeness and accuracy scores were rated on a scale from 0 to 10. Student t test and Mann-Whitney U were used to compare the two languages subsamples. Spearman and Pearson’s tests were applied to test the correlations. The threshold for statistical significance was set at 0.05. The average credibility score was 4.7 for the Romanian websites and 5.6 for English websites (p=0.0686). The average completeness score was 3.7 for the Romanian websites and 5.3 for English websites (p=0.0007). The average accuracy score was 3.88 for the Romanian websites and 3.62 for English websites (p=0.5215). Significant moderate intensity correlation was found between the Google rank and the accuracy of the Romanian websites (r=-0.5438, p=0.0050). The overall quality scores of the Romanian and English websites presenting information about hypertension were modest. This study found a correlation between the Google rank and the accuracy score of the Romanian websites but since this was the only significant correlation, the findings are not sufficient to infer general recommendations. The study suggests that knowing both Romanian and English doesn't offer a significant advantage in accessing high-quality online information about hypertension. The Google rank cannot be used as a quality indicator since there is no consistent correlation between it and the quality scores.

The predictive risk factors associated with non-dipper profile in patients with type 2 diabetes and hypertension

Background and aims. The non-dipper status represented by blood pressure reduction by less than 10 percent during sleep is present in about 50 percent of patients with type 2 diabetes (T2D) and hypertension, a pattern associated with more frequent cardiovascular complications and reserved prognosis. This study analyzed the predictive risk factors associated with the different dipper profiles, especially with the nocturnal pattern, following the mean arterial pressure (MAP), the mean heart rate (MHR), and the mean pulse pressure (MPP) in patients with T2D and hypertension, established by ambulatory blood pressure monitoring (ABPM). Method. 166 consecutive patients with type 2 diabetes mellitus and hypertension were included in a cross-sectional study, and they underwent 24-hour ABPM. We excluded patients with secondary hypertension, acute coronary disease and heart failure, with oncologic or endocrine disease. The simple and multiple linear regression models were performed predicting 24-hour, day and night MAP, MHR, and MPP according to various predictors, using software R version 4.3.1. Results. There were 80 non-dippers (48.20%), 57 dippers (34.34%), 22 reverse-dippers (13.25%) and seven extreme-dippers (4.21%). A statistically significant association was observed between MAP 24-hour and total cholesterol (TC) (higher TC values were associated with higher MAP /24 h values): adjusted coefficient B of the regression slope: 0.09, 95% confidence interval CI (0.04- 0.15), p=0.003. In the multivariate analysis: adjusted B: 8.64, 95% CI (-14.67- -2.61), p=0.006, beta-blockers reached the threshold of statistical significance in relation to MHR/24 h, their presence decreasing the heart rate. PP/24 hours was associated in the multivariate analysis with age: adjusted B: 0.45, 95% CI (0.05- 0.85), p=0.28; abdominal circumference: 0.26, 95% CI (0.03-0.49), p=0.028, and total cholesterol: 0.1, 95% CI (0.02-0.17), p=0.013. Diabetic nephropathy was statistically significantly associated with PP/24 h: adjusted B: 10.19, 95% CI (1.24- 19.14), p=0.027. Conclusions. High cholesterol was associated with higher values of MAP and PP. Beta-blocker treatment lowered non-dipper MHR. Age and AC were correlated with increased PP values. These are predictive risk factors associated with the status of non-dippers established by ABPM, and they represent a veritable link to the non-dipper pattern in patients with T2D and hypertension.

P-735 Is Artificial Intelligence (AI) currently able to provide evidence-based scientific responses on methods that can improve the outcomes of embryo transfers?

Abstract Study question Could chatbots potentially be used as tools for both patients’ and physicians’ education in an infertility journey? Summary answer Artificial Intelligence (AI) is not yet in a position to give clear, evidence-based recommendations in the field of fertility, particularly concerning embryo transfer. What is known already The rapid development of AI has raised questions about its potential uses in different sectors of everyday life. Individuals from diverse fields have tried to incorporate its usage in their personal but also in their professional lives, with varying levels of success. Specifically in medicine, ChatGPT has been studied intensely with more than 400 related articles having been indexed in PubMed until May 2023, while AI has reportedly also succeeded in several standardized medical tests and passed several Medical Board examinations. Hence the question arises whether chatbots could be used as tools for clinical decision-making or patients’ and physicians’ education. Study design, size, duration We used nine of the most popular free AI chatbots available (ChatGPT, Bard, Writesonic, You, Perplexity, Learnt, Bing, Magickpen, and Rytr) and entered the following command: “Write me a 300-word scientific essay about evidence-based methods that can improve the outcomes of embryo transfer” in May 2023. We collected the responses and extracted the methods each chatbot suggested. When sufficient similarity among answers was present we categorized the answers under one category to facilitate the study. Participants/materials, setting, methods We calculated descriptive statistics and the prevalence of each response. We used as a comparator for widely acceptable practices that are proven to improve embryo transfer outcomes the 2017 ASRM guideline on performing embryo transfer taking also into consideration more current literature. Data was compared using chi-squared tests and a level of p &amp;lt; 0.05 was used as the threshold of statistical significance. Main results and the role of chance The range of the recommendations was from one to nine per chatbot (median = 4, IQR = 2) with an average of 4.78 suggestions per chatbot. Out of a total of 43 recommendations, which could be grouped into 19 similar categories, only 3/19 (15.8%) were evidence-based practices, those being “ultrasound-guided embryo transfer”, which was also the most commonly appearing response, appearing in 7/9 (77.8%) chatbots, “single embryo transfer” appearing in 4/9 (44.4%) chatbots and “use of a soft catheter” in 2/9 (22.2%) chatbots. Some controversial responses appeared even more often than the two latter evidence-based ones with “preimplantation genetic testing (PGT)” being the second most common response with 6/9 chatbots suggesting it (66.7%) and the vague suggestion of “optimal endometrium preparation” being in the third place with 5/9 chatbots (55.6%), both non-evidence-based practices to improve embryo transfer. The majority of the recommendations were unique, with 10 answers appearing only once (1/9; 11.1%), those being “endometrial scratching”, “natural cycle embryo transfer”, “use of GnRH antagonist protocol”, “blastocyst transfer”, “use of specialized catheter”, “preimplantation genetic screening (PGS)”, “mock embryo transfer”, “uninterrupted embryo culture”, “minimizing transfer time”, and “maintaining temperature and pH of the culture media”. Limitations, reasons for caution Firstly, we only used some of the most popular chatbots and not all existing ones. Additionally, chatbots tend to give different answers when repeatedly asked the same questions. However, we believe that our study effectively captures the prevailing practices of chatbot users, who typically pose a question only once. Wider implications of the findings Both patients and physicians should be wary of guiding care based on chatbot recommendations in infertility since the majority of responses consists of scientifically unsupported recommendations. Chatbot results might improve with time especially if trained to obtain information from validated medical databases, however, this will have to be verified scientifically. Trial registration number N/A

Left Atrial Strain as a Predictor of Early Anthracycline-Induced Chemotherapy-Related Cardiac Dysfunction: A Pilot Systematic Review and Meta-Analysis.

Background: Chemotherapy-related cardiac dysfunction (CTRCD) significantly affects patients undergoing anthracycline (AC) therapy, with a prevalence ranging from 2% to 20%. Reduced left ventricular ejection fraction (LVEF) and left ventricular global longitudinal strain (LV GLS) are prognostic parameters for CTRCD detection. Our study aimed to investigate the role of emerging parameters such as left atrial strain (LAS). Methods: We searched multiple databases for studies comparing LAS changes post-AC versus pre-AC therapy in patients with cancer. Primary outcomes included left atrial reservoir strain (LASr), left atrial conduit strain (LAScd), and left atrial contractile strain (LASct). RevMan (v5.4) was used to pool the standardized mean difference (SMD) under a random effects model, with p < 0.05 as the threshold for statistical significance. Results: In an analysis of 297 patients across five studies, AC therapy significantly lowered LASr (SMD = -0.34, 95% CI:-0.55, -0.14, I2 = 0%, p = 0.0009) and LAScd (SMD = -0.41, 95% CI: -0.59, -0.23, I2 = 0%, p < 0.00001) levels. Conversely, LASct demonstrated no significant change (SMD = 0.01, 95% CI: -0.21, 0.23, I2 = 9%, p = 0.95). AC therapy also significantly reduced LV GLS (SMD = -0.31, 95% CI: -0.51, -0.11, I2 = 0%, p = 0.003). While not statistically significant, LVEF decreased (SMD = -0.20, 95% CI: -0.42, 0.03, I2 = 0%, p = 0.09), and left atrial volume index trended higher (SMD = 0.07, 95% CI: -0.14, 0.27, I2 = 0%, p = 0.52) after AC therapy. Conclusions: AC treatment led to reduced LAS and LV GLS values, indicating its potential as an early CTRCD indicator. Larger trials are required to fully explore their clinical significance.

Global incidence and mortality of childhood leukemia and its relationship with the Human Development Index.

Childhood leukemia (CL) is a major global concern, accounting for 33% of all new cancer cases and 31% of all cancer deaths in children aged 0-14 years. Our study aimed to analyze the global incidence and mortality rates of CL in 2020 and its relationship with the Human Development Index (HDI). In this ecologic study, we analyzed the 2020 cancer incidence and mortality data for children aged 0-14 years from the GLOBOCAN Project. We calculated the Age-Standardized Incidence Rate (ASIR) and Age-Standardized Mortality Rate (ASMR) of CL per 100,000 individuals. Pearson's correlation coefficient was used to examine the association between childhood leukemia ASIR, ASMR, and the HDI, with a statistical significance threshold of P<0.05. In 2020, there were a total of 67,008 new cases of CL worldwide, with males accounting for 57.85%. The global ASIR for CL was 3.4 per 100,000 (3.9 in males, 3 in females). Additionally, there were 25,080 CL-related deaths, with males comprising 58.86%. The overall ASMR for CL was 1.3 (1.4 in males, 1.1 in females). We found a significant positive correlation (r = 0.405, P≤0.001) between the global ASIR and ASMR for CL. There was a strong positive correlation (r = 0.770, P = 0.001) between the HDI and childhood leukemia ASIR, but no significant association (r = 0.077, P = 0.337) was observed with ASMR. Our study reveals that CL remains a significant health burden worldwide. We identified a positive correlation between the ASIR of CL and the HDI, indicating a potential role of socioeconomic factors in CL incidence.

Variants in Vitamin D-related Genes and Prostate Cancer Risk in Black Men.

The relationship between vitamin D and prostate cancer has primarily been characterized among White men. However, Black men have higher prostate cancer incidence and mortality rates, chronically low circulating vitamin D levels, and ancestry-specific genetic variants in vitamin D-related genes. Here, we examine six critical genes in the vitamin D pathway and prostate cancer risk in Black men. We assessed a total of 69 candidate variants in six genes ( GC, CYP27A1, CYP27B1, CYP24A1, VDR , and RXRA ) including functional variants previously associated with prostate cancer and circulating 25(OHD) in White men. Associations with prostate cancer risk were examined using genome-wide association study data for approximately 10,000 prostate cancer cases and 10,000 controls among Black men and over 85,000 cases and 91,000 controls among White men. A statistical significance threshold of 0.000724 was used to account for the 69 variants tested. None of the variants examined were significantly associated with prostate cancer risk among Black men after multiple comparison adjustment. Four variants tested P<0.05 in Black men, including two in RXRA (rs41400444 OR=1.09, 95% CI: 1.01-1.17, P = 0.024 and rs10881574 OR = 0.93, 0.87-1.00, P = 0.046) and two in VDR (rs2853563 OR = 1.07, 1.01-1.13, P = 0.017 and rs1156882 OR = 1.06, 1.00-1.12, P = 0.045). Two variants in VDR were also positively associated with risk in White men (rs11568820 OR = 1.04, 1.02-1.06, P = 0.00024 and rs4516035 OR = 1.03, 1.01-1.04, P = 0.00055). We observed suggestive non-significant associations between genetic variants in RXRA and VDR and prostate cancer risk in Black men. Future research exploring the relationship of vitamin D with cancer risk in Black men will need larger sample sizes to identify ancestry-specific variants relevant to risk in this population.

Adverse effects with semaglutide: a protocol for a systematic review with meta-analysis and trial sequential analysis

IntroductionSemaglutide is increasingly used for the treatment of type 2 diabetes mellitus, overweight and other conditions. It is well known that semaglutide lowers blood glucose levels and leads to significant...

Outcomes of Obese Coronavirus 2019 Patients Treated with Extra Corporeal Membrane Oxygenation

Background: Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) is used as salvage therapy in severe cases of acute respiratory distress syndrome (ARDS) caused by the coronavirus disease 2019 (COVID-19). Obesity has been linked to worse disease severity and poor outcomes in COVID-19, but there is also a hypothesized obesity survival paradox whereby obese patients fare better in severe illness than their non-obese complement. The effect of obesity on ECMO outcomes in patients with COVID-19 is not well understood. Methods: We performed a retrospective analysis of all patients admitted to our institution who underwent VV ECMO cannulation for COVID-19 in the span of one year. These were separated by body mass index (BMI) with a cutoff of 35 kg/m2 (signifying class 2 obesity or higher) and compared with each other as well as a comparator group of patients with BMI &gt;35 kg/m2 who underwent VV ECMO cannulation for any cause between 2016 and 1 March 2021. Disease severity was categorized using established scoring systems including Apache-II, Charleson-Dayeo, and Murray. Primary endpoints were 30 day mortality, survival to decannulation, and survival to discharge. Results: The study groups were similar in all respects with the exception of BMI. Illness severity, as classified by Charleson-Dayeo, Apache II, and Murray scores not significantly different between groups. The primary outcomes (30-day mortality, survival to decannulation, and survival to discharge) were not significantly different between groups. There was a trend toward more delayed inititation of ECMO therapy in the obese group that was not statistically significant. There was also a trend toward shorter duration of ECMO therapy that did not reach the threshold for statistical significance. Conclusions: There was no significant difference in outcomes between obese and non-obese patients undergoing VV ECMO for COVID-19. Trends toward shorter duration of ECMO and shorter intensive care unit (ICU) and hospital length of stay could represent the “obesity survival paradox” that has been described. Given similar outcomes, obesity should not be a contraindication to ECMO therapy for COVID-19.

Diabetes and Anaemia: A Myth or Reality

ABSTRACT Introduction: Chronic diabetes develops when the pancreas does not release enough insulin or the body cannot use it. Anemia is a disorder characterized by reduced hemoglobin or red blood cells. The body needs hemoglobin to transport oxygen. Diabetics with anemia may have micro and macro vascular problems, lowering quality of life and increasing medical costs. Aim and Objectives: To examine the prevalence of anemia among type 2 diabetics, its predictive value, and the connection between anemia and type 2 diabetes. Methodology: A prospective study was conducted on 2000 people with and without type 2 diabetes at the medical and diabetology wards of Punjab’s Desh Bhagat University and hospital for medicine and health sciences from June 2022 to June 2023. Results: A statistical significance threshold of 0.005 determined that the mean hemoglobin value was 8.44 in oral hypoglycemics, 7.93 in insulin, and 4.45 in combined insulin and oral hypoglycaemics. Conclusion: Diabetics with type 2 diabetes mellitus and anemia were more likely to have CAD, making anemia a chronic condition that negatively impacts quality of life and accelerates disease consequences.

Systematic review and meta-analysis of short-term outcomes: robot-assisted versus laparoscopic surgery for gastric cancer patients with visceral obesity.

The objective of this meta-analysis was to assess the comparative efficacy of robot-assisted and laparoscopic surgery in treating gastric cancer among patients characterized by a high visceral fat area (VFA). In April 2024, we conducted a comprehensive literature review using major international databases, such as PubMed, Embase, and Google Scholar. We restricted our selection to articles written in English, excluding reviews, protocols without published data, conference abstracts, and irrelevant content. Our analysis focused on continuous data using 95% confidence intervals (CIs) and standard mean differences (SMDs), while dichotomous data were assessed with odds ratios (ORs) and 95% CIs. We set the threshold for statistical significance at P < 0.05. Data extraction included baseline characteristics, primary outcomes (such as operative time, major complications, lymph node yield, and anastomotic leakage), and secondary outcomes. The meta-analysis included three cohort studies totaling 970 patients. The robotic-assisted group demonstrated a significantly longer operative time compared to the laparoscopic group, with a weighted mean difference (WMD) of - 55.76min (95% CI - 74.03 to - 37.50; P < 0.00001). This group also showed a reduction in major complications, with an odds ratio (OR) of 2.48 (95% CI 1.09-5.66; P = 0.03) and fewer occurrences of abdominal infections (OR 3.17, 95% CI 1.41-7.14; P = 0.005), abdominal abscesses (OR 3.83, 95% CI 1.53-9.57; P = 0.004), anastomotic leaks (OR 4.09, 95% CI 1.73-9.65; P = 0.001), and pancreatic leaks (OR 8.93, 95% CI 2.33-34.13; P = 0.001). However, no significant differences were observed between the groups regarding length of hospital stay, overall complications, estimated blood loss, or lymph node yield. Based on our findings, robot-assisted gastric cancer surgery in obese patients with visceral fat appears to be correlated with fewer major complications compared to laparoscopic surgery, while maintaining similar outcomes in other surgical aspects. However, it is important to note that robot-assisted procedures do tend to have longer operative times.

The State of Patient-Reported Outcome Measures in Rheumatology.

We sought to evaluate the quality and timeliness of patient-reported outcome (PRO) measure reporting, which have not been previously studied. Clinical trials that informed new US Food and Drug Administration (FDA) approvals for the first rheumatological indication between 1995 and 2021 were identified. Data were recorded to determine whether collected PROs were published, met minimum clinically important difference (MCID) or statistical significance (P < 0.05) thresholds, and were consistent with Consolidated Standards of Reporting Trials (CONSORT)-PRO standards. Hazard ratios and Kaplan-Meier estimate were used to assess the time from FDA approval to PRO publication. Thirty-one FDA approvals corresponded with 110 pivotal trials and 262 reported PROs. Of the 90 included studies, 1 (1.1%) met all 5 recommended items, 10 (11.1%) met 4 items, 17 (18.9%) met 3 items, 21 (23.3%) met 2 items, 26 (28.9%) met 1 item, and 15 (16.7%) met none of the reporting standards. Most PROs met MCID thresholds (149/262; 56.9%) and were statistically significant (223/262; 85.1%). Of our subset analysis, one-third of PROs were not published upfront (70/212; 33%) and 1 of 9 (22/212; 10.4%) remained unpublished ≥ 4 years after initial trial reporting. Publication rates were highest for the Health Assessment Questionnaire-Disability Index (97.4%) and lowest for the 36-item Short Form Health Survey (81.8%). Less than half of these published PROs met MCID and statistical significance thresholds (94/212; 44.3%). One in 9 PROs remained unpublished for ≥ 4 years after initial trial reporting, and compliance with CONSORT-PRO reporting guidelines was poor. Efforts should be made to ensure PROs are adequately reported and expeditiously published.

The outcome of COVID-19 infection among Saudi oncology patients.

e23085 Background: Little data are available surrounding the outcomes and risk factors of COVID-19 in Saudi oncological patients. This study aims to elucidate the outcomes of COVID-19 infection among Saudi oncology patients and associated risk factors. Methods: We retrospectively reviewed the medical files of oncology patients who were diagnosed with COVID-19 at the King Faisal Specialist Hospital and Research Centre. The time from a positive PCR until death or last follow-up was calculated as COVID-specific survival. A p-value less than 0.05 was selected as the threshold for statistical significance. Results: 161 oncological patients were included in our analysis. The mean age was 53.83±15.81. 85 (52.8%) patients were female, 17 (10.6%) had a positive history of smoking, and 57 (35.4%) were obese. 70 (43.5%) patients had diabetes mellitus, 64 (39.8%) had hypertension, and 25 (15.5%) had dyslipidemia. The most common cancer in the group was breast cancer, which was present in 24 (14.9%), followed by non-Hodgkin lymphoma, colon cancer, and acute leukemia, respectively. 57 (35.4%) patients had no evidence of disease (NED) at presentation. Furthermore, 65 (40.4%) patients had received antineoplastic therapy within 30 days before infection. 25 (15.5%) patients had stage A COVID-19, 59 (36.6%) had stage B, 48 (29.8%) had stage C, and 29 (18%) had stage D. There was no difference between active and no NED patients in remission in regard to the stages of COVID-19 infection at presentation (p = 0.05). However, the stages of COVID were less severe in patients who received antineoplastic therapy (p = 0.02). 32 (19.9%) patients received tocilizumab during the acute phase of infection. Only 5 (3.1%) patients suffered COVID-specific death. Therefore, the median COVID-specific survival was not reached. Tocilizumab (p = 0.34), corticosteroids (p = 0.77), ACE inhibitors (p = 0.45) had no impact on COVID-specific death in our patient population. In patients who received steroid treatment, the duration of corticosteroid had no impact on survival (HR: 0.76, p = 0.39). Ventilation also had no impact on survival (p = 0.55). There was no difference between patients who received antineoplastic therapy within 30 days from infection and those who did not (p = 0.99). Finally, we noted no difference in survival between patients with active disease and NED patients (p = 0.17). Conclusions: COVID-related mortality is lower in Saudi oncology patients compared to other countries. Early management and admission of oncological patients may result in overall improved outcome. In line with some studies, antineoplastic therapy can reduce COVID-19 severity, possibly due to reduced ACE receptor expression.

Pembrolizumab for advanced urothelial carcinoma: exploratory ctDNA biomarker analyses of the KEYNOTE-361 phase 3 trial.

Circulating tumor DNA (ctDNA) is emerging as a potential biomarker in early-stage urothelial cancer, but its utility in metastatic disease remains unknown. In the phase 3 KEYNOTE-361 study, pembrolizumab with and without chemotherapy was compared with chemotherapy alone in patients with metastatic urothelial cancer. The study did not meet prespecified efficacy thresholds for statistical significance. To identify potential biomarkers of response, we retrospectively evaluated the association of pre- and posttreatment ctDNA with clinical outcomes in a subset of patients who received pembrolizumab (n = 130) or chemotherapy (n = 130) in KEYNOTE-361. Baseline ctDNA was associated with best overall response (BOR; P = 0.009), progression-free survival (P < 0.001) and overall survival (OS; P < 0.001) for pembrolizumab but not for chemotherapy (all; P > 0.05). Chemotherapy induced larger ctDNA decreases from baseline to treatment cycle 2 than pembrolizumab; however, change with pembrolizumab (n = 87) was more associated with BOR (P = 4.39 × 10-5) and OS (P = 7.07 × 10-5) than chemotherapy (n = 102; BOR: P = 1.01 × 10-4; OS: P = 0.018). Tumor tissue-informed versions of ctDNA change metrics were most associated with clinical outcomes but did not show a statistically significant independent value for explaining OS beyond radiographic change by RECIST v.1.1 when jointly modeled (pembrolizumab P = 0.364; chemotherapy P = 0.823). These results suggest distinct patterns in early ctDNA changes with immunotherapy and chemotherapy and differences in their association with long-term outcomes, which provide preliminary insights into the utility of liquid biopsies for treatment monitoring in metastatic urothelial cancer. Clinical trial registration: NCT02853305 .

Anthropomorphic and Physical Fitness Characteristics of United States Air Force Basic Military Training: Special Warfare Versus Nonspecial Warfare Recruits, Fiscal Year 2019-2023.

Each year, thousands of individuals enlist in the Department of the Air Force (DAF), with some seeking to become DAF Special Warfare (SW) candidates. This study aimed to compare the anthropomorphic and physical fitness characteristics between these groups during fiscal years (FYs) 2019-2023. The sample includes male candidates below the age of 30 who attended the DAF basic military training (BMT) from FY2019 to 2023 (N = 119,415). Initial physical fitness testing was conducted during week 1 of BMT. Physical fitness results, height, weight, and body mass index (BMI) were compared between the two cohorts. A two-way analysis of variance was performed to analyze the effects of group (SWand non-SW) and FY on mean anthropomorphic and physical fitness test variables. Dependent variables were evaluated for homogeneity of variance using Levene's test and for normality using the Shapiro-Wilktest. The Tukey-Kramer test was employed for post hoc analyses with a threshold for statistical significance of α < 0.05. The cohort of SW recruits displayed superior physical fitness results across all FYs (p < 0.001) with the exception of FY2021. They were significantly taller and heavier, and had a higher BMI when compared to non-SW DAF BMT recruits (p < 0.001). Mean values for maximum push-ups and sit-ups for SW recruits were significantly lower in FY2021 (p < 0.001) and not significantly different from non-SW recruits. Additionally, run times for both SW- and non-SW-bound recruits during FY2022 and FY2023 were significantly slower than previous years. These findings can be used to establish a baseline for anthropometric and physical fitness profiles of incoming SW and non-SW DAF BMT recruits that may inform clinicians, human performance professionals, and military training leaders with information necessary to guide future research and physical fitness policy.