Threshold For Statistical Significance Research Articles

Depressive syndrome, cognitive impairment, and associated factors among community-dwelling aged persons in Cameroon.

Background: Depressive syndrome (DS) and cognitive impairment (CI) are associated with unsuccessful aging. However, little is known about Cameroon. This study aimed to assess the factors associated with DS and CI among older adults in Cameroon. Methods: A representative sample of 599 individuals aged ≥ 60 years was selected for this cross-sectional study. Sociodemographic and health data were also collected. DS and CI were assessed using the Center for Epidemiologic Studies-Depression Scale (CES-D) and Mini-Mental State Examination (MMSE), respectively. The Rosow Mobility Scale, Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL) scales were used to evaluate functional abilities. Chi-2, ANOVA, and multiple regression analyses were performed to assess the factors associated with DS and CI. The threshold of statistical significance was 5%. Results: The average age was 68.9±7.2 years, sex ratio M/F=0.93, and weight 68.5±14.7 kg. DS affected 14.5% of the population and the CI was 21.4%. In the multivariate analysis, DS was positively associated with male gender (Odds Ratio (OR)=1.7 [95% Confidence Interval (CI):1.1-2.7], p=0.031) and inactivity (OR=1.7 [95% CI:1.0-3.0], p=0.043). CI was positively associated with lack of education (OR=6.5 [95% CI:3.5-12.2], p<0.001), inactivity (OR=5.3 [95% CI:1.6-17.9], p=0.008), single (OR=3.7 [95% CI:1.2-11.3], p=0.023), and widowhood (OR=3.3 [95% CI:1.6-6.5], p=0.001), and negatively associated with no IADL (OR=0.3 [95% CI:0.2-0.6], p=0.001) and ADL disability (OR=0.5 [95% CI:0.2-0.9], p=0.032) limitations. Conclusions: The associated factors suggest that it might be of interest to fight inactivity and encourage early and long-term education to prevent DS and/or CI among older adults.

Trauma from cyberbullying: How it affects learning impairments

Investigating the effects of the traumatic experiences that adolescents with learning problems go through is the goal of our study. 160 high school students who were referred via a web-based evaluation form because of poor academic performance made up the sample for our study. In particular, the subscales for anxiety-depression and depression-withdrawal were employed in the ACHENBACH self-report questionnaire for children and teenagers. Calculations have been made for frequencies, response percentages, and means. Additionally, a one-way anova was used to conduct an analysis of variance to compare the average student responses to the variable "experiencing a traumatic event" between groups of students. The findings demonstrated that there are substantial variations in the means of students who claim having experienced a traumatic event and those who report not having, with a statistical significance threshold of p 0,01 between the two groups. Students' exposure to violence in schools and the loss of a loved one appear to be particularly significant traumatic experiences for their psyche. Additionally, a quick presentation of the application's cyberbullying-related capabilities is made.

Perioperative Outcomes of Branchial Cleft Sinus Tract Excision in Pediatric Patients Without the Use of Intraoperative Dye.

Branchial cleft cysts are pediatric congenital anomalies that can present as sinus tracts to the neck. Intraoperative methylene blue dye with fibrin glue has been suggested as an effective tool for tracking the tract's depth to help definitively excise. In this large retrospective study of 118 patients spanning a decade, we aim to elucidate outcomes of branchial cleft anomaly excision without methylene blue dye. A retrospective review was conducted with patients who received branchial cleft anomaly (BCA) with sinus tract excision at Monroe Carrell Jr. Children's Hospital from June 2012 to June 2022. We collected demographic variables, BCA characteristics, perioperative care variables (ie, prior drainage, imaging, and concurrent procedure), and perioperative outcomes (ie, intra- and post-operative complications). Median and interquartile range (IQR) were calculated for continuous demographic variables, and average and standard deviation (SD) were calculated for sinus tract length. Two-tailed Chi-square or Fisher's exact tests were performed to compare categorical samples where applicable with a statistical significance threshold set a priori at P < .05, and multivariable logistic regression assessed significant associations. The sample included 118 patients with an average tract length of 3.3 cm (SD = 1.7 cm). Incision/drainage was performed before definitive excision in 16 (13.6%) patients and was associated with age above the median (aOR = 5.29, 95% CI = 1.39-20.09, P = .015) and female sex (aOR = 3.81, 95% CI = 1.12-13.01, P = .032). Most patients (N = 85, 72.0%) did not receive imaging. Among 118 cases, 2 (1.7%) required return to the operating room for surgical site complications. No patients experienced intra-operative complications or tract recurrence necessitating revision surgery. Patients with branchial cleft sinus tracts that were surgically excised without intraoperative dye achieved definitive resection with no recurrence and limited post-operative complications. While not a direct comparison, these results suggest that using intraoperative dye may be associated with unnecessary costs without benefit in outcomes.

Relationship Between DWI-Based Acute Ischemic Stroke Volume, Location and Severity of Dysphagia

Background/Objectives: The impact of stroke location and volume on the development of post-stroke dysphagia is not fully understood. The aim of this study is to evaluate the relationship between acute ischemic lesions and the severity of dysphagia. Methods: Brain MRIs were obtained with a 1.5 Tesla MRI system (Magnetom Avanto B13, Siemens, Erlangen, Germany). The brain MRI protocol included axial echo planar diffusion-weighted imaging (DWI). The acute ischemic volume was obtained using DWI by drawing regions of interest (ROIs). The diagnosis and assessment of the severity of dysphagia was carried out by a multidisciplinary team and included the Dysphagia Outcome and Severity Scale (DOSS), the Penetration–Aspiration Scale (PAS), and the Pooling score (P-score). The threshold for statistical significance was set at 5%. Results: Among all the patients enrolled (n = 64), 28 (43.8%) were males and 36 (56.2%) were females, with a mean age of 78.8 years. Thirty-three (51.6%) of them had mild dysphagia and thirty-one (48.4%) had moderate–severe dysphagia. The total ischemic volume was negatively correlated with the DOSS (r = −0.441, p = 0.0003) and positively with the P-score (rs = 0.3054, p = 0.0328). Conclusions: There are significant associations between the severity of dysphagia and the quantitative DWI-based data of the acute ischemic volume and anatomical location.

Assessment of Midwives’ Knowledge and Application of the Modified WHO Partograph at Ga South Public Health Facilities, Greater Accra, Ghana

Background The partograph, one of the vital tools available for the midwife, was originally developed from Friedman’s 1954 Cervicograph by Philpott and Castle in 1972. It was later modified and adopted by the WHO as a universal ‘gold standard’ tool for recording and monitoring progress in labour and providing interventions in cases of abnormal labour. The goal of this study was to assess the level of knowledge of midwives and their utilisation of the modified WHO partograph at the Ga South Municipality in the Greater Accra Region of Ghana. Methodology An institution-based quantitative cross-sectional study was conducted within the municipality from February to March 2019. One hundred and ten (110) midwives were recruited using the census approach. Data were collected using a structured self-administered questionnaire. STATA statistical software version 14 was used for descriptive analysis and results were reported in the form of percentages and frequencies using charts and tables. Pearson’s Chi-Square estimation was also performed to test the association between selected variables with a p value &lt;.05 as the threshold for statistical significance. Results Of the 110 participants, 105 (95.5%) of the midwives could properly describe the partograph and 104 (94.5%) understood that it was used as a tool for vital decision-making, while 92 (83.6%) indicated that partograph contributes in reducing maternal and new-born deaths. Almost all participants, 109 (99.09%) knew all the parameters of the partograph and were also aware that plotting the partograph begins at a cervical dilation of 4 cm. Also, while a good number of participants 103 (93.64%) knew that cervical dilation on the partograph is carried out every four hours during the active phase of labour, 110 (100%) indicated that progress of labour is assessed by the degree of cervical dilation and descent of the presenting part. Routine usage of the partograph was recorded among the majority of midwives, 102 (92.7%), to record and monitor the progress of labour in expectant women. Bivariate analysis showed a significant association between the use of the modified WHO partograph and the knowledge of midwives on Ghana Health Service (GHS) policies ( p = .045). There was, however, no positive association determined among age ( p = .66), rank ( p = .77), years of professional experience ( p = 1.00), place of work ( p = .51), work shift and highest qualification ( p = 1.00) as far as knowledge and use of the WHO modified partograph are concerned. Conclusion The findings of the study underscore the desirable level of knowledge and usage of the partograph among study participants. This affirms that the knowledge and usage of the partograph within the facilities in Ga South health facilities hold the prospect of enhancing the safety of expectant mothers.

Associated Factors for the Prevalence of Bedbug Infestation (Cimex hemipterus) among Households in Nakuru Town, Kenya

Background: Infestations and the resurgence of bedbugs have recently been documented as serious health issues worldwide. Kenya reported 4000 bedbug-infested homes in 2018, so the increase in infestations is comparable to that of other African countries and the global average. Objective: the objective of the study was to determine bedbug prevalence and factors associated with bedbug infestation among heads of households in Nakuru County, Kenya. Method: The study used a cross-sectional descriptive study design. Cluster sampling and proportionate sampling were used to recruit the study respondents in this study. The Cochran formula was used to recruit 422 study respondents. The threshold for statistical significance was set at 0.05. Results: The prevalence of bedbug infestation was 53.1%. The presence of households with bedbugs was associated with the prevalence of bedbugs in the study households (p value&lt;0.001). The purchase of second-hand furniture and clothes was associated with bedbug prevalence (p value=0.002 and 0.007 respectively). The number of rooms in households was associated with the prevalence of bedbugs (p value=0.008). The number of people living in households (p value=0.021) and the type of house were associated with the prevalence of bedbugs (p value&lt;0.001). Conclusion: The prevalence of bedbug infestation was 53.1%. The type of house, number of people in a household, number of rooms in the household, and social factors including the existence of neighbors, relatives, friends, and job mates with bedbugs in their homes, heightened the chances of spreading the bedbugs to others. The purchase of second-hand furniture and clothes increased the prevalence of bedbugs.

The role of intervention timing and treatment modality in visual recovery following pituitary apoplexy: a systematic review and meta-analysis.

Pituitary apoplexy has historically been considered an emergent condition that necessitates surgical intervention when there is acute symptomatic onset. This potentially serious condition often occurs in the setting of an underlying adenoma, cystic lesion, or other sellar mass. When these mass lesions hemorrhage within the confined space of the sella turcica, the pituitary gland is subjected to hemorrhagic ischemia. Furthermore, critical neurovasculature in close proximity to the sella can sustain collateral damage. In the present study, we investigate whether early versus delayed surgical intervention (in terms of three timelines: before versus after 48h, 72h, and 7days, respectively) results in differences in visual outcomes for patients experiencing pituitary apoplexy with acute onset neurological and/or neuro-opthalmic symptoms. Furthermore, we compare the efficacy of surgical decompression versus expectant management of this condition. Accordingly, we queried the PubMed, Scopus, and Embase databases in adherence to PRISMA guidelines. Quantitative meta-analysis was performed according to the Mantel-Haenszel method and forest plots were generated using Review Manager v5.4. P-values < 0.05 were defined as the threshold for statistical significance. Twenty-nine studies remained eligible for review following initial search and screen, including 16 studies describing the role of intervention timing and 15 studies comparing intervention modality. Most patients presented with a visual deficit, and all patients underwent surgery - most commonly via the endoscopic endonasal (EEA) approach. Two hundred and twenty patients were included in the sub-analysis for the 7-day cutoff point. Furthermore, 81 patients underwent surgical decompression of the sella prior to 48h, and 32 patients underwent surgical decompression between 48-72h following presentation. Almost all patients exhibited improved vision post-decompression, including 19/19 patients (100%) in the post-72-h cohort. On meta-analysis using the Mantel-Haenszel method, there was a significant difference in vision outcomes in favor of patients who underwent surgical decompression before 7days as compared to after seven days (OR 5.88, 95% CI [1.77, 19.60], I2 = 0%, p < 0.01). In a separate sub-analysis, there was a total of 288 patients across 15 studies comparing surgical versus conservative management of pituitary apoplexy. These management options proved equivocal on meta-analysis (p > 0.05). In the present study, timing of surgical intervention for pituitary apoplexy was predictive of visual function recovery only at the 7-day timepoint, as has been reported by previous studies. Ultimately, this suggests that pituitary apoplexy involving severe visual deficits or altered mental status is best addressed within the first seven days post-presentation, and that both surgery and conservative management can offer similar outcomes. When apoplexy is suspected, IV corticosteroids should be administered independent of acuity or severity to prevent secondary adrenal crisis. Subsequently, for patients presenting without severe visual or other neurological deficits, expectant management is recommended. Management should be patient-specific and dependent upon the severity of symptoms present at onset.

Physiological Response to Speed Endurance Soccer Training in Amateur Players

Objectives. This study aimed to examine the physiological response to speed endurance soccer training (SEST), which involved the measurement of heart rate (HR), blood lactate (LAC), and blood pressure (BP) are measured during the four-week intervention period. Materials and methods. The one-group pretest-posttest pre-experimental design was used in this study. The study comprised 15 male amateur soccer players with an average age of 16.13 ± 0.52 years. The participants’ mean height was 167.4 ± 4.63 cm, weight was 57.69 ± 12.11 kg, and BMI was 20.44 ± 3.45 kg/m². The data findings are presented using the mean and standard deviation. The paired t-test was employed to assess the impact of each group. The threshold for statistical significance was set at a p-value of less than 0.05. The effect size (ES) was calculated using Cohen’s ES as a metric to quantify the magnitude of the difference between the pretest and posttest stages. Results. The HR results monitoring during the intervention period were in the high-intensity zone, with an average of 91.67 ± 0.6 % and a HR of 187.67 ± 1.24 bpm. No significant change was observed in the heart rate response from baseline to end of intervention. The LAC results showed that the lactate level was in the high category, namely an average of 11.03 ± 1.3 mmol∙L-1. BP indicated a significant difference between pretest and posttest (p ≤ 0.05). The systolic blood pressure (SBP) demonstrated an increase of Δ % = 0.95, while the diastolic blood pressure (DBP) showed an increase of Δ % = 1.39. Conclusions. The findings of this study indicate that SEST has a notable effect on the body’s physiological functions, namely on the cardiovascular system, anaerobic metabolism, and blood pressure. This effect was observed over a period of four weeks in amateur soccer players.

Smartphone addiction among medical students in the University of Monastir, Tunisia

Abstract Background Smartphone addiction is a global mental health issue with diverse psychological and socioeconomic concerns. The aim of this study was to determine the prevalence of smartphone addiction and its associated factors among medical students in the university of Monastir, Tunisia. Methods We conducted a cross-sectional survey among medical students of the faculty of medicine of Monastir in October 2020. The data were collected through a self-administered anonymous questionnaire that included the SAS-SV scale to assess smartphone addiction levels. A multivariate logistic regression model was employed to identify associated factors. The threshold of statistical significance was set at p &amp;lt; 0.05. Results A total of 626 medical students participated in this study, with an average age of 21.76 ± 3.12 years and a sex ratio of 0.41. The prevalence of smartphone addiction was 30.2% (95% CI: 26.0% - 33.79%). Associated factors with smartphone addiction included academic repetition(OR = 4.30; 95% CI [1.38 - 13.42]), fast food consumption scores (OR = 1.55; 95% CI [1.21 - 2.00]),addiction to the Facebook social network (OR = 6.36; 95% CI [1.92 - 21.07]), cohabitation with colleagues (OR = 2.13; 95% CI [1.03- 4.43]), cohabitation with family members(OR = 2.10; 95% CI [1.01 - 4.36]) and stress level (OR = 1.13; 95% CI [1.07 - 1.18]). Conclusions This study identified associations between smartphone overuse and other behavioral and mental health indicators. Based on these findings, several interventions should be undertaken to address this growing concern. Key messages • The prevalence of smartphone addiction among medical students in the University of Monastir was 30.2% (95% CI: 26.0% – 33.79%). • The main associated factors with smartphone addiction were academic repetition, fast food consumption, addiction to Facebook, cohabitation with colleagues and with family members and stress level.

Myocarditis: Differences in Clinical Expression between Patients with ST-Segment Elevation in Electrocardiogram vs. Patients without ST-Segment Elevation.

In cases of myocarditis, electrocardiograms (ECGs) may suggest a pattern of ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI). NSTEMI patterns are less frequent in myocarditis cases, but it remains unclear if the presence of ST-segment elevation in myocarditis cases is related to a more severe condition and more damage in the myocardium. This is a retrospective study involving 38 patients admitted to hospital with myocarditis. Patients were divided into two groups: patients with ST-segment elevation (STE) patterns in the ECG (25), and patients without ST-segment elevation (non-STE) patterns (13). The data compared included results from epidemiological, laboratory, and instrumental tests. Data were analysed using IBM SPSS Statistics v26.0. A p value of <0.05 was established as the threshold for statistical significance. C-reactive protein (CRP) levels were higher in the STE group (103.40 ± 82.04 mg/L vs. 43.54 ± 61.93 mg/L, p = 0.017). The left ventricle ejection fraction (LVEF) was significantly higher in the non-STE pattern group (49.71 ± 4.14 vs. 56.58 ± 3.99, p < 0.001). A lower LVEF correlates with higher TnI levels (r= -0.353, p = 0.032) and higher CRP levels (r = -0.554, p < 0.001). Lower left ventricle (LV) strain correlates with higher levels of Troponin I (TnI) (r = -0.641, p = 0.013). LVEFs in the STE group were lower compared to those in the non-STE pattern group. STE pattern was associated with higher CRP levels. Higher TnI levels in cases of myocarditis were associated with lower LV strain and lower LVEF; higher CRP levels also correlated with lower LVEF. Based on a 6-month echocardiographic follow-up, the prognosis of myocarditis was favourable.

Pathologic Response of Phase III Study: Perioperative Camrelizumab Plus Rivoceranib and Chemotherapy Versus Chemotherapy for Locally Advanced Gastric Cancer (DRAGON IV/CAP 05).

This multicenter, randomized phase III trial evaluated the efficacy and safety of perioperative camrelizumab (an anti-PD-1 antibody) plus low-dose rivoceranib (a VEGFR-2 inhibitor) and S-1 and oxaliplatin (SOX) (SOXRC), high-dose rivoceranib plus SOX (SOXR), and SOX alone (SOX) for locally advanced gastric or gastroesophageal junction (G/GEJ) adenocarcinoma. Patients with T3-4aN + M0 G/GEJ adenocarcinoma were randomly assigned (1:1:1) to receive perioperative treatment with SOXRC, SOXR, or SOX. The primary end points were pathologic complete response (pCR) and event-free survival. The Independent Data Monitoring Committee recommended stopping enrollment in the SOXR group on the basis of the safety data of the first 103 randomly assigned patients in the three groups. The patients were then randomly assigned 1:1 to the SOXRC or SOX groups. This report presents the pCR results obtained per protocol for the first 360 randomly assigned patients who had the opportunity for surgery in the SOXRC and SOX groups. In the SOXRC and SOX groups, of the 180 patients in each group, 99% and 98% of patients received neoadjuvant therapy, 91% and 94% completed planned neoadjuvant therapy, and 86% and 87% underwent surgery, respectively. The pCR was significantly higher in the SOXRC group at 18.3% (95% CI, 13.0 to 24.8) compared with 5.0% (95% CI, 2.3 to 9.3) in the SOX group (difference of 13.7%; 95% CI, 7.2 to 20.1; odds ratio of 4.5 [95% CI, 2.1 to 9.9]). The one-sided P value was <.0001, crossing the prespecified statistical significance threshold of P = .005. Surgical complications and grade ≥3 neoadjuvant treatment-related adverse events were 27% versus 33% and 34% versus 17% for SOXRC and SOX, respectively. The SOXRC regimen significantly improved pCR compared with SOX alone in patients with G/GEJ adenocarcinoma with a tolerable safety profile.

Circulating levels of micronutrients and risk of osteomyelitis: a Mendelian randomization study.

Few observational studies have investigated the effect of micronutrients on osteomyelitis, and these findings are limited by confounding and conflicting results. Therefore, we conducted Mendelian randomization (MR) analyses to evaluate the association between blood levels of eight micronutrients (copper, selenium, zinc, vitamin B12, vitamin C, and vitamin D, vitamin B6, vitamin E) and the risk of osteomyelitis. We performed the two-sample and multivariable Mendelian randomization (MVMR) to investigate causation, where instrument variables for the predictor (micronutrients) were derived from the summary data of micronutrients from independent cohorts of European ancestry. The outcome instrumental variables were used from the summary data of European-ancestry individuals (n = 486,484). The threshold of statistical significance was set at p < 0.00625. We found a significant causal association that elevated zinc heightens the risk of developing osteomyelitis in European ancestry individuals OR = 1.23 [95% confidence interval (CI) [1.07, 1.43]; p = 4.26E-03]. Similarly, vitamin B6 showed a similar significant causal effect on osteomyelitis as a risk factor OR = 2.78 (95% CI [1.34, 5.76]; p = 6.04E-03; in the secondary analysis). Post-hoc analysis suggested this result (vitamin B6). However, the multivariable Mendelian randomization (MVMR) provides evidence against the causal association between zinc and osteomyelitis OR = 0.98(95% CI [-0.11, 0.07]; p = 7.20E-1). After searching in PhenoScanner, no SNP with confounding factors was found in the analysis of vitamin B6. There was no evidence of a reverse causal impact of osteomyelitis on zinc and vitamin B6. This study supported a strong causal association between vitamin B6 and osteomyelitis while reporting a dubious causal association between zinc and osteomyelitis.

Comparative analysis of imaging data in sensory and motor disorders in lumbar neurocompressive syndrome

Introduction Lumbar neurocompressive syndrome is a condition characterized by radicular pain, motor, sensory and reflex changes, as well as paresthesia or numbness in the lower limb. These symptoms can be triggered by positions and/or movements of the spine. In lumbar radiculopathy, both mechanical and inflammatory factors play significant roles. Material and methods The study included 102 patients with signs of lumbar neurocompressive syndrome. Of these, 51 (group I) patients were examined using MRI and the other 51 patients (group II) were examined using conventional radiographic investigation of the lumbosacral region of the spine. Results By analyzing the magnetic resonance imaging data of the lumbar spine, a threshold of statistical significance was determined (of 10%, p &lt; 0.10) for patients with sensory disturbances in the lower limb in cases of stenosis of the lumbar spinal canal, and in patients with motor disorders in the lower limb, in the case of disc protrusions. The analysis of the magnetic resonance imaging data determined a significance threshold (of 5%, p &lt; 0.05) in patients with sensory disorders (in the case of disc sequestrations and in the case of disc extrusions) as well as for motor disorders (in the case of disc extrusions, disc sequestrations and static disorders of the spine). The analysis of standard radiographs of the lumbar spine allowed the determination of the threshold of statistical significance (of 5%, p &lt; 0.05) in patients with sensory disorders in the lower limb in cases of coxofemoral osteoarthritis and Schmorl’s hernias. For patients with motor disorders at the level of the lower limb, conventional radiography was informative in the presence of calcification of the intervertebral discs and in coxofemoral osteoarthritis. Conclusion MRI can be considered the first-choice imaging technique for diagnosis of the lumbar spine pathologies characterized by sensory and motor changes in the lower limbs.

Prognostic impact of body mass index on metastatic HER2-positive breast cancer survival

Background. The association between body mass index and prognosis in patients with HER2-positive metastatic breast cancer (mBC) is unclear. Purpose – the first purpose of our study was to determine whether BMI is an independent prognostic factor for progression-free survival (PFS) and overall survival (OS) in HER2-positive mBC patients. The second objective was to assess the mutual impact of baseline clinicopathological characteristics on survival outcomes. Materials and Methods. The study group included patients treated at the Sumy Regional Clinical Oncology Center. We considered the underweight patients if their BMI was &lt;18.5 kg/m2, normal weight 18.5–24.9 kg/m2, overweight 25.0–29.9 kg/m2, and obese ≥ 30 kg/m2. The following formula was used for calculations: weight/height2 (kilograms/meter2). Information about the height, weight, and other clinicopathological characteristics of the patient at the time of the start of drug therapy was taken from the primary medical documentation. Pearson’s test and Chi2 test for categorical variables were used to compare baseline clinicopathological characteristics in groups with normal, overweight, and obesity. The Kaplan-Meier method was used to establish the medians of PFS and OS. Cox regression analysis assessed the mutual impact on the survival of various clinicopathological characteristics. The statistical significance threshold was considered P ≤0.05. Results. Seventy-eight patients with HER2-positive mBC were enrolled and categorized according to their BMI in normal weight, overweight, and obese groups. BMI had a different impact on PFS and OS. Median PFS was 14.9, 11.9, and 14.2 months for normal-weight, overweight, and obese patients, respectively. There is no statistically significant difference in PFS between groups (Р = 0.110). Multivariable regression analysis confirmed no impact of BMI on PFS. Nevertheless, metastases in bones and kidneys and the nuclear grade were statistically significant determinants of PFS. Median OS was 26.4, 28.8, and 37.9 months for normal-weight, overweight, and obese patients, respectively. BMI, kidney metastases, and nuclear grade were prognostically significant determinants of OS. Conclusions. BMI is an independent prognostic factor of OS in patients with HER2-positive mBC. Obesity is associated with better OS but does not impact PFS. Metastases in bones and kidneys and the nuclear grade can predict survival outcomes.

The association of azole antifungals with overall survival in patients with non-small cell lung cancer receiving immune checkpoint inhibitors.

Preclinical data suggest antifungal azole derivatives have antitumor efficacy that may modulate response to immune checkpoint inhibitors (ICIs). We aimed to evaluate the association of azole drugs with overall survival (OS) in a population of patients with non-small cell lung cancer (NSCLC) treated with ICI within the Veterans Health Administration (VHA). In this retrospective study, the VA Corporate Data Warehouse was queried for patients diagnosed with NSCLC and treated with ICI from 2010 to 2018. Concomitant oral azole use was defined as dispensation by a VA pharmacy within 90 days of the first ICI infusion. Patients who received azole after 30 days were excluded from the analysis to mitigate immortal time bias. OS was measured from the start of ICI. Cox regression and propensity score matching were used to adjust for confounders. We identified 3413 patients with NSCLC receiving ICI; 324 (9.5%) were exposed to concomitant azoles. As a group, azole use was not associated with OS (hazard ratio [HR] = 0.96; 95% CI, 0.84-1.09; P = .51). After stratification by azole type, clotrimazole had an association with better OS on univariable (HR = 0.75; 95% CI, 0.59-0.96; P = .024) and multivariable analysis (HR = 0.71; 95% CI, 0.56-0.91; P = .007). Propensity score matching of patients who received clotrimazole vs no azole yielded 101 patients per matched cohort. Clotrimazole was associated with improved OS, although this did not meet the threshold for statistical significance (HR = 0.74; 0.54-1.01; P = .058). This observational study demonstrated an association between clotrimazole and OS among patients with advanced NSCLC receiving ICI. These findings build upon preclinical evidence and support further investigation into the potential for clotrimazole as a repurposed FDA drug to improve cancer outcomes.

Comparative study of hematological parameters among smokers and nonsmokers in Basra city, Iraq

BackgroundHematological parameters are significantly affected by both immediate and prolonged exposure to smoking. The objective of this investigation is to evaluate the influence of cigarette smoking on hematological parameters among male students enrolled at Basrah University in Iraq. MethodsThe study comprised a total of seventy male participants, divided into two groups: smokers (n = 35) and nonsmokers (n = 35). Each participant provided a 5 ml venous blood sample to analyze the complete blood count using a hematology analyzer (Spinreact, Spincell 3). ResultsCigarette smokers exhibit notably elevated levels of Red Blood Cells (RBC) counts, Hemoglobin (HGB), Red Cell Distribution Width-CV (RDW-CV), granulocytes%, and platelets%, whereas Mean Corpuscular Volume (MCV) and lymphocytes% are notably lower among smokers. On the other hand, Hematocrit percentage (HCT), Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Hemoglobin Concentration (MCHC), and White Blood Cells (WBC) counts show no significant difference between cigarette smokers and nonsmokers. In contrast, Red Cell Distribution Width-SD (RDW-SD), Mid-range cell percentage (MID%), Mean Platelet Volume (MPV), Distribution Width (PDW), Platelet Plateletcrit percentage (PCT), Platelet-Lymphocyte Cell Ratio (P_LCR) and Platelet-Lymphocyte Cell Count (P_LCC) demonstrate no substantial variance between the two groups at the statistical significance threshold. ConclusionThis investigation concludes that tobacco cigarette smoking leads to detrimental alterations in hematological parameters, posing health risks.

Assessment of Risk Factors and Prognostic Predictors for Endo-Perio Lesions in Indian Cohorts: An Observational Study.

Endodontic and periodontal tissues exhibit a significant interrelationship, whereby pathologies affecting one tissue can precipitate the involvement of the other. The primary objective of this study was to assess the risk factors associated with endo-perio lesions (EPLs). The secondary objective was to assess the prognostic predictors for such lesions and the prevalence rate of EPLs involving both pulpal and periodontal tissues in Indian cohorts. A prospective observational study was conducted on 2170 teeth with EPLs in Indian adults aged > 18 years. A detailed history of smoking, tobacco chewing, and the development of EPLs was obtained from all patients. Detailed periodontal and endodontic examinations were conducted by two calibrated examiners. Intraoral periapical radiographs (IOPAs) were obtained to diagnose EPLs. The chi-square test of association was used to analyze the association between independent and dependent variables, and the strength of association was presented by Pearsoncontingency coefficient (r). Logistic regression analysis was performed to identify reliable factors for diagnosing EPLs. A statistical significance threshold of 0.05 was established. The prevalence of EPLs involving pulpal and periodontal tissues was 29.49%. Type 1 lesions (EPLs involving only pulpal tissue) were most commonly seen at 41-45 years of age, type 2 lesions (EPLs involving primary pulpal and secondary periodontal tissue), and type 3 lesions (EPLs involving only periodontal tissue) at 26-30 years of age, and type 4 lesions (EPLs involving primary periodontal and secondary pulpal tissue) at 31-35 years of age. The pulp was found to be non-vital in all cases of type 3 lesions, and faulty restoration or improper root canal treatment (RCT) was the main risk factor for such lesions. Occupational trauma was found to be the most common risk factor for type 3 and type 4 lesions. Smoking, age, tooth type, occlusal trauma, faulty restorations and RCT, presence of caries, periapical pathology, periodontitis, bone loss, and pulp vitality were significantly associated with EPLs. Pulp vitality and bone loss were two prognostic predictors of EPLs.

To Assess the Functional outcome of Inflammatory arthritis of Knee following a Total Knee Replacement in a Tertiary Care Centre

Introduction : Inflammatory arthritis, particularly RA, can lead to significant joint destruction and functional impairment, necessitating interventions such as TKA. Despite medical therapy, severe joint damage may occur, warranting surgical intervention. This study assesses the functional outcomes post-TKA in patients having inflammatory arthritis. Materials and Methods: Patients who received TKA for inflammatory arthritis were included in this prospective observational cohort research, specifically RA, between 2019 and 2023 at Saveetha Medical College, Chennai. Clinical, radiological, and functional results have been assessed using the American Knee Society scoring system. IBM SPSS version 22.0 was utilized for analysis of data, p &lt; 0.05 is the threshold for statistical significance. Results:Twenty TKAs have been performed for RA, with all patients successfully followed up. The mean age of the patients was 58.5 years, and the majority were female. Before TKA, the average length of RA was 7.24 years, and all patients were in stage IV illness. Preoperative and postoperative knee society scores showed significant improvement, with average scores of 58.15 and 96.15, respectively. Functional scores also demonstrated substantial enhancement post-TKA, with an average increase of 130%. Radiological assessment revealed no evidence of lysis in any patient. Conclusion: Significant inverse relationship among the postoperative functional score and the length of the disease and the involvement of other joints. Utilizing the American Knee Society and functional scoring systems allows for objective prediction of surgical success. This can motivate surgeons and treating physicians to enhance care for RA patients.

Association study reveals a susceptibility locus with male pattern baldness in the Han Chinese population.

Male pattern baldness (MPB), also known as androgenetic alopecia, represents the most prevalent form of progressive hair loss in humans. It is characterized by a distinctive pattern of hair loss progression from the scalp; however, its underlying mechanism remains elusive and is influenced by hereditary, immune, and environmental factors. Genome-wide association studies (GWASs) have uncovered numerous risk genes/loci among European individuals with MPB. However, the validation of these susceptibility genes/loci within Han Chinese men remains largely unexplored. The aim of this study was to investigate whether the 71 susceptibility loci identified in a recent GWAS among European men also confer risk for MPB in Chinese men. Forty-seven single nucleotide polymorphisms (SNPs) previously reported in GWASs of MPB were selected and genotyped in independent individuals comprising 499 Han Chinese cases and 1,489 controls using the Sequenom MassArray system. After stringent quality control measures, 25 SNPs were subjected to statistical analyses. Cochran-Armitage trend test was used to evaluate the association between SNPs and disease susceptibility. To address multiple tests, Bonferroni correction was conducted, setting the threshold for statistical significance at a p-value <2 × 10-3 (0.05/25). The rs13405699 SNP located at 2q31.1 exhibited a significant association with MPB in Han Chinese men (p = 4.84 × 10-5, OR = 1.37, 95% CI: 1.18-1.59). Moreover, the difference in rs13405699 genotype distribution between MPB cases and controls was statistically significant (p = 7.00 × 10-5). Genotype-based association analysis suggested that the recessive model provided the best fit for the rs13405699 polymorphism. This study represents the first confirmation of the association between the rs13405699 SNP at 2q31.1 and MPB within the Han Chinese population, thereby enhancing our understanding of the genetic underpinnings of MPB.

Association between late pregnancy prehypertension and adverse outcomes among newborns of women delivered at a tertiary hospital in Eastern Uganda: a prospective cohort study

BackgroundPrehypertension during pregnancy is currently not considered as a high-risk pregnancy state in existing guidelines despite recent research correlating it with higher rates of morbidity and mortality in both the mother and the fetus. Studies on prehypertension have not been conducted in Africa despite high rates of poor neonatal outcomes.AimsThe study aimed to determine the association between late pregnancy prehypertension and adverse outcomes in newborns of women with late pregnancy prehypertension at Jinja Regional Referral Hospital.Methods and materialsBetween September 2022 and January 2023, a hospital-based prospective cohort study including 300 pregnant women was conducted. Participants were divided according to third-trimester blood pressure, as determined by the JNC-8 criteria. Following hospital admission for labor and delivery, 150 normotensive women and 150 prehypertensive women were identified and followed until delivery, and their neonates were followed until death or hospital discharge. A p value of ≤ 0.05 was the threshold for statistical significance when comparing the groups using the relative risk, X2, and Mantel-Haenszel adjustment.ResultsComposite adverse neonatal outcomes were more common in prehypertensive women compared to normotensive women (48.67% versus 32.67%), particularly Small-for-Gestation Age (SGA), stillbirth, and composite adverse neonatal outcomes had significantly higher likelihood, with aRRs of 1.63 (95% CI 1.10–2.42, p = 0.037), 9.0 (95% CI 1.15–70.16, p = 0.010), and 1.55 (95% CI 1.16–2.08, p < 0.001), respectively. By a linear model, birthweight decreased by 45.1 g for every 10 mmHg rise in systolic blood pressure (p = 0.041, Pearson correlation of -0.118).Conclusion and recommendationsPrehypertension in late pregnancy increased risks for adverse neonatal outcomes, thus a need to potentially lower pregnancy hypertension cut-off levels possibly through adopting the ACC/AHA blood pressure definitions for pregnant women.