Androgen deprivation therapy-related fracture risk in prostate cancer: an insurance claims database study in Japan.

INTRODUCTION: Androgen deprivation therapy (ADT) is widely used for the treatment of prostate cancer. ADT is associated with reduced bone density leading to an increased risk of osteoporotic fracture. The objective of this retrospective cohort study was to quantify fracture risk in men treated with ADT for prostate cancer in real-world practice in Japan. MATERIALS AND METHODS: Data were extracted from the Japanese Medical Data Vision (MDV) database. Men initiating ADT for treatment of prostate cancer between April 2010 and March 2021 were identified and matched to a cohort of prostate cancer patients not taking ADT using a propensity score. Fracture rates were estimated by a cumulative incidence function and compared between cohorts using a Cox cause-specific hazard model. Information was extracted on demographics, comorbidities and bone densitometry. RESULTS: 30,561 men with PC starting ADT were matched to 30,561 men with prostate cancer not treated with ADT. Following ADT initiation, <5% of men underwent bone densitometry. Prescription of ADT was associated with an increased fracture risk compared to not taking ADT (adjusted hazard ratio: 1.63 [95% CI 1.52-1.75]). CONCLUSION: ADT is associated with a 1.6-fold increase in the risk of osteoporotic fracture in men with prostate cancer. Densitometry in this population is infrequent and monitoring urgently needs to be improved in order to implement effective fracture prevention.

COVID-19 in pediatric palliative care patients: Multicenter, retrospective cohort study.

BACKGROUND: Studies have shown the risk factors for COVID-19 severity in children, including comorbidities, but information on the infection course in children with life-limiting conditions is sparse. AIM: To describe the effect of COVID-19 on pediatric patients receiving palliative care due to life-limiting conditions. DESIGN: We conducted retrospective cohort study. The WHO Clinical Progression Scale was used to measure COVID-19 severity. SETTING/PARTICIPANTS: Seven of the 24 invited pediatric palliative care centers participated in this study. We analyzed the medical records of children under palliative care with confirmed COVID-19 (January 2020-April 2022). RESULTS: Records of 60 patients with COVID-19 aged 0.24 to 21.6 years (mean (SD); 9.8 (6.6)) were collected. The largest group of patients with COVID-19 was children with congenital malformations and chromosomal abnormalities (42%); the most common manifestation was fever (85%). Bacterial coinfection was confirmed in 17 (28%) children. Fifteen (25%) children required hospitalization, including four admitted to the Intensive Care Unit. Mild COVID-19 was identified in 44 (73%) children, moderate in 11 (18%), severe in 3 (5%), and death in 2 (3%). Six of the 20 eligible children were vaccinated against SARS-CoV-2, followed by 16 mothers and fathers. CONCLUSION: In the study population initial presentation of COVID-19 was predominantly a mild; however, the small sample size precluded definitive conclusions. For children under palliative care, we should identify if they have an advance care plan for COVID-19, such as desires for intensive care support. Further studies are needed to define the short and long-term effects of COVID-19 in children with life-limiting conditions.

Patients diagnosed with COVID-19 and treated with anakinra: a real-world study in the USA.

Anakinra, a recombinant, non-glycosylated human interleukin (IL)-1 receptor antagonist, has been used in real-world clinical practice to manage hyperinflammation in coronavirus disease 2019 (COVID-19). This retrospective, observational study analyses US hospital inpatient data of patients diagnosed with moderate/severe COVID-19 and treated with anakinra between 1 April and 31 August 2020. Of the 119 patients included in the analysis, 63.9% were male, 48.6% were of black ethnicity, and the mean (standard deviation [SD]) age was 64.7 (12.5) years. Mean (SD) time from hospital admission to anakinra initiation was 7.3 (6.1) days. Following anakinra initiation, 73.1% of patients received antibiotics, 55.5% received antithrombotics, and 91.0% received corticosteroids. Overall, 64.7% of patients required intensive care unit (ICU) admittance, and 28.6% received mechanical ventilation following admission. Patients who did not require ICU admittance or who were discharged alive experienced a significantly shorter time between hospital admission and receiving anakinra treatment compared with those admitted to the ICU (5 vs. 8 days; P = 0.002) or those who died in hospital (6 vs. 9 days; P = 0.01). Patients with myocardial infarction or renal conditions were six times (P < 0.01) and three times (P = 0.01), respectively, more likely to die in hospital than be discharged alive. A longer time from hospital admission until anakinra treatment was associated with significantly higher mortality (P = 0.01). Findings from this real-world study suggest that a shorter time from hospital admission to anakinra treatment is associated with significantly lower ICU admissions and mortality among patients with moderate/severe COVID-19.

The real-life impact of vaccination on COVID-19 mortality in Europe and Israel.

OBJECTIVES: This study aimed at estimating the real-life impact of vaccination on COVID-19 mortality, with adjustment for SARS-CoV-2 variants spread and other factors across Europe and Israel. STUDY DESIGN: Time series analysis. METHODS: Time series analysis of the daily number of COVID-19 deaths was performed using non-linear Poisson mixed regression models. Variables such as variants' frequency, demographics, climate, health, and mobility characteristics of thirty-two countries between January 2020 and April 2021 were considered as potentially relevant adjustment factors. RESULTS: The analysis revealed that vaccination efficacy in terms of protection against deaths was 72%, with a lower reduction of the number of deaths for B.1.1.7 vs non-B.1.1.7 variants (70% and 78%, respectively). Other factors significantly related to mortality were arrivals at airports, mobility change from the prepandemic level, and temperature. CONCLUSIONS: Our study confirms a strong effectiveness of COVID-19 vaccination based on real-life public data, although lower than expected from clinical trials. This suggests the absence of indirect protection for non-vaccinated individuals. Results also show that vaccination effectiveness against mortality associated with the B.1.1.7 variant is slightly lower than that with other variants. Lastly, this analysis confirms the role of mobility reduction, within and between countries, as an effective way to reduce COVID-19 mortality and suggests the possibility of seasonal variations in COVID-19 incidence.

Factors influencing the COVID-19 daily deaths' peak across European countries.

OBJECTIVES: The purpose of this study was to determine predictors of the height of coronavirus disease 2019 (COVID-19) daily deaths' peak and time to the peak, to explain their variability across European countries. STUDY DESIGN: For 34 European countries, publicly available data were collected on daily numbers of COVID-19 deaths, population size, healthcare capacity, government restrictions and their timing, tourism and change in mobility during the pandemic. METHODS: Univariate and multivariate generalised linear models using different selection algorithms (forward, backward, stepwise and genetic algorithm) were analysed with height of COVID-19 daily deaths' peak and time to the peak as dependent variables. RESULTS: The proportion of the population living in urban areas, mobility at the day of first reported death and number of infections when borders were closed were assessed as significant predictors of the height of COVID-19 daily deaths' peak. Testing the model with a variety of selection algorithms provided consistent results. Total hospital bed capacity, population size, the number of foreign travellers and the day of border closure were found to be significant predictors of time to COVID-19 daily deaths' peak. CONCLUSIONS: Our analysis demonstrated that countries with higher proportions of the population living in urban areas, countries with lower reduction in mobility at the beginning of the pandemic and countries having more infected people when closing borders experienced a higher peak of COVID-19 deaths. Greater bed capacity, bigger population size and later border closure could result in delaying time to reach the deaths' peak, whereas a high number of foreign travellers could accelerate it.

Machine learning modeling of plant phenology based on coupling satellite and gridded meteorological dataset.

Changes in the timing of plant phenological phases are important proxies in contemporary climate research. However, most of the commonly used traditional phenological observations do not give any coherent spatial information. While consistent spatial data can be obtained from airborne sensors and preprocessed gridded meteorological data, not many studies robustly benefit from these data sources. Therefore, the main aim of this study is to create and evaluate different statistical models for reconstructing, predicting, and improving quality of phenological phases monitoring with the use of satellite and meteorological products. A quality-controlled dataset of the 13 BBCH plant phenophases in Poland was collected for the period 2007-2014. For each phenophase, statistical models were built using the most commonly applied regression-based machine learning techniques, such as multiple linear regression, lasso, principal component regression, generalized boosted models, and random forest. The quality of the models was estimated using a k-fold cross-validation. The obtained results showed varying potential for coupling meteorological derived indices with remote sensing products in terms of phenological modeling; however, application of both data sources improves models' accuracy from 0.6 to 4.6 day in terms of obtained RMSE. It is shown that a robust prediction of early phenological phases is mostly related to meteorological indices, whereas for autumn phenophases, there is a stronger information signal provided by satellite-derived vegetation metrics. Choosing a specific set of predictors and applying a robust preprocessing procedures is more important for final results than the selection of a particular statistical model. The average RMSE for the best models of all phenophases is 6.3, while the individual RMSE vary seasonally from 3.5 to 10 days. Models give reliable proxy for ground observations with RMSE below 5 days for early spring and late spring phenophases. For other phenophases, RMSE are higher and rise up to 9-10 days in the case of the earliest spring phenophases.

Changes in spino-pelvic alignment after surgical treatment of isthmic spondylolisthesis.

BACKGROUND AND PURPOSE: To analyze the changes in spino-pelvic parameters after surgical treatment of lumbar isthmic spondylolisthesis. MATERIALS AND METHODS: Sixty patients recruited from a group of consecutive series of 128 cases with isthmic spondylolisthesis operated on between 2002 and 2012 in the Department of Neurosurgery, Tarnow, Poland. All patients were operated on by the same surgeon (the first author). Spino-pelvic parameters: PI, SS, PT, LSA, and LL were measured manually on standing lateral view radiograms. Patients were divided according to Spinal Deformity Study Group classification which we modified for means of analysis: (A) low-grade group: subgroups with balanced pelvis and unbalanced pelvis (instead of normal and high PI subgroups), (B) high-grade group: subgroups with balanced and unbalanced pelvis. RESULTS: Twenty-nine patients had unbalanced pelvis before the operation. In 10 of them (34%), the procedure resulted in full correction of pelvis position meaning that they achieved balanced pelvis after the surgery. There were 6 patients with low-grade slip who had balanced pelvis preoperatively but showed unbalanced pelvis after the surgery but this loss of balanced pelvis did not affect the clinical outcome which overall was good among them. Patients with unbalanced pelvis presented changes towards restoration of spino-sacro-pelvic anatomy postoperatively: PT decreased while SS increased, although these changes were not statistically significant. CONCLUSION: Further studies are needed to confirm whether surgical correction of spino-pelvic parameters results in better clinical outcome in patients with isthmic spondylolisthesis.

Age as a moderator of the relationship between planning and temporal information processing.

Planning is a fundamental mental ability related to executive functions. It allows to select, order and execute subgoals to achieve a goal. Studies have indicated that these processes are characterised by a specific temporal dynamics reflected in temporal information processing (TIP) in some tens of millisecond domain. Both planning and TIP decline with age but the underlying mechanisms are unclear. The novel value of the present study was to examine these mechanisms in young (n = 110) and elderly (n = 91) participants in Tower of London task, considering two structural properties of problems: search depth related to static maintenance in working memory, and goal ambiguity reflecting dynamic cognitive flexibility. Results revealed that TIP predicted planning accuracy both directly and indirectly (via preplanning) but only in young participants in problems characterised by high goal ambiguity. Better planning is related to longer preplanning and more efficient TIP. This result demonstrates for the first time age-related differences in the contribution of TIP to planning. In young participants TIP contributed to dynamic cognitive flexibility, but not to static maintenance processes. In elderly such relation was not observed probably because the deficient planning might depend on working memory maintenance rather than on cognitive flexibility.

On the association between SARS-COV-2 variants and COVID-19 mortality during the second wave of the pandemic in Europe.

OBJECTIVE: This study aims at investigating associations between COVID-19 mortality and SARS-COV-2 variants spread during the second wave of COVID-19 pandemic in Europe. METHODS: For 38 European countries, data on numbers of COVID-19 deaths, SARS-COV-2 variants spread through time using Nextstrain classification, demographic and health characteristics were collected. Cumulative number of COVID-19 deaths and height of COVID-19 daily deaths peak during the second wave of the pandemic were considered as outcomes. Pearson correlations and multivariate generalized linear models with selection algorithms were used. RESULTS: The average proportion of B.1.1.7 variant was found to be a significant predictor of cumulative COVID-19 deaths within two months before the peak and between 1 January-25 February 2021, as well as of the deaths peak height considering proportions during the second wave and the pre-peak period. The average proportion of EU2 variant (S:477 N) was a significant predictor of cumulative COVID-19 deaths in the pre-peak period. CONCLUSIONS: Our findings suggest that spread of a new variant of concern B.1.1.7 had a significant impact on mortality during the second wave of COVID-19 pandemic in Europe and that proportions of EU2 and B.1.1.7 variants were associated with increased mortality in the initial phase of that wave.

Efficacy and safety of baloxavir marboxil versus neuraminidase inhibitors in the treatment of influenza virus infection in high-risk and uncomplicated patients - a Bayesian network meta-analysis.

OBJECTIVES: Previous network meta-analysis (NMA) demonstrated advantageous or similar efficacy of baloxavir marboxil (baloxavir) over neuraminidase inhibitors in otherwise healthy (OwH) influenza patients. This analysis assessed the efficacy and safety of baloxavir in the subgroup of high-risk (HR) patients and in the population of uncomplicated influenza consisting of OwH and HR patients with influenza. METHODS: A systematic literature review (SLR) was performed in Medline, Embase, CENTRAL and ICHUSHI up to August 8th, 2018. A Bayesian NMA was conducted to compare baloxavir with oseltamivir, zanamivir, laninamivir and peramivir in HR patients and all uncomplicated patients. RESULTS: Based on the SLR, a total of 32 studies were identified as pertinent for the analysis, including 7 studies on HR patients, 13 trials on OwH patients and 14 studies on OwH + HR population. NMA of 10 trials assessing HR patients demonstrated comparable time to alleviation of symptoms for all treatments. Mean decline in virus titer from baseline at 24 h after treatment was significantly greater for baloxavir compared with oseltamivir and peramivir. The risks of total complications and drug-related adverse events were comparable between baloxavir and zanamivir, oseltamivir and laninamivir. These findings were highly consistent with results of the NMA using pooled evidence on the uncomplicated population of OwH and HR patients.Conclusions: Baloxavir was significantly more effective than placebo regarding all outcomes except for the risk of pneumonia. Besides, baloxavir was associated with similar clinical efficacy and safety, and superior antiviral activity compared to other antivirals in HR patients, as well as in the entire population of uncomplicated patients with influenza.

Maintenance vs. Manipulation in Auditory Verbal Working Memory in the Elderly: New Insights Based on Temporal Dynamics of Information Processing in the Millisecond Time Range.

Working memory (WM) is a limited-capacity cognitive system that allows the storage and use of a limited amount of information for a short period of time. Two WM processes can be distinguished: maintenance (i.e., storing, monitoring, and matching information) and manipulation (i.e., reordering and updating information). A number of studies have reported an age-related decline in WM, but the mechanisms underlying this deterioration need to be investigated. Previous research, including studies conducted in our laboratory, revealed that age-related cognitive deficits are related to decreased millisecond timing, i.e., the ability to perceive and organize incoming events in time. The aim of the current study was: (1) to identify in the elderly the brain network involved in the maintenance and manipulation WM processes; and (2) to use an fMRI task to investigate the relation between the brain activity associated with these two processes and the efficiency of temporal information processing (TIP) on a millisecond level reflected by psychophysical indices. Subjects were 41 normal healthy elderly people aged from 62 to 78 years. They performed: (1) an auditory verbal n-back task for assessing WM efficiency in an MRI scanner; and (2) a psychophysical auditory temporal-order judgment (TOJ) task for assessing temporal resolution in the millisecond domain outside the scanner. The n-back task comprised three conditions (0-, 1-, and 2-back), which allowed maintenance (1- vs. 0-back comparisons) and manipulation (2- vs. 1-back comparisons) processes to be distinguished. Results revealed the involvement of a similar brain network in the elderly to that found in previous studies. However, during maintenance processes, we found relatively limited and focused activations, which were significantly extended during manipulation. A novel result of our study, never reported before, is an indication of significant moderate correlations between the efficiency of WM and TIP. These correlations were found only for manipulation but not for maintenance. Our results confirmed the hypothesis that manipulation in the elderly is a dynamic process requiring skilled millisecond timing with high temporal resolution. We conclude that millisecond timing contributes to WM manipulation in the elderly, but not to maintenance.

Self-image and quality of life of dermatology patients.

OBJECTIVES: The problems of self-image among patients with dermal problems have been seldom explored. As dermal diseases detrimentally affect well-being, functioning and adaptation of dermatology patients, they may decrease the level of self-acceptance. Self-image, on the other hand, may significantly affect the own mental health status and quality of life (QoL) in that group of patients. The aim of our research was to assess mental health status and quality of life of patients with dermal problems in respect of the level of their self-acceptance. MATERIALS AND METHODS: The participants were patients of the Occupational Diseases Outpatient Clinic and the Occupational and Environmental Allergy Centre of the Nofer Institute of Occupational Medicine (NIOM). In total, 112 patients were examined, including 37 with diagnosed urticaria, 50 with allergic contact dermatitis and 25 with atopic dermatitis. General Health Questionnaire (GHQ) was used to assess patients' mental health, a Polish version of Dermatology Life Quality Index (DLQI) was employed for the assessment of their life quality, while Self-Acceptance Scale (SAS) served to obtain patients' self-image. RESULTS: There were statistically significant differences in the assessment of mental health and quality of life, depending on the level of self-acceptance. People with high self-acceptance are characterised by better mental health condition than those with low self-acceptance (t=4.8; p=0.00). The patients with negative self-image (compared to those with positive self-image) deem also their quality of life to be poor (t=3.1; p=0.00). CONCLUSION: A relationship has been found to exist both between mental health condition and the subjective assessment of life quality, and self-image. Thus, both patient's mental health status and his/her self image constitute major determinants of the quality of life that are worth to be monitored in dermatology patients. Their treatment procedure should include also psychological consulting or psychotherapy.

Spatial and Spectral Auditory Temporal-Order Judgment (TOJ) Tasks in Elderly People Are Performed Using Different Perceptual Strategies.

The Temporal-Order Judgment (TOJ) paradigm has been widely investigated in previous studies as an accurate measure of temporal resolution and sequencing abilities in the millisecond time range. Two auditory TOJ tasks are often used: (1) a spatial TOJ task, in which two identical stimuli are presented in rapid succession monaurally and the task is to indicate which ear received the first stimulus and which ear received the second one (left-right or right-left), and (2) a spectral TOJ task, in which two tones of different frequencies are presented asynchronously to both ears binaurally and the task is to report the sequence of these tones (low-high or high-low). The previous literature studies conducted on young volunteers indicated that the measured temporal acuity on these two tasks depended on the procedure used. As considerable data are now available about age-related decline in temporal resolution ability, the aim of the present study was to compare in elderly subjects the pattern of performance on these two tasks. A total of 40 normal healthy volunteers aged from 62 to 78 years performed two TOJ tasks. The measurement was repeated in two consecutive sessions. Temporal resolution was indexed by the Auditory Temporal-Order Threshold (ATOT), i.e., the minimum time gap between successive stimuli necessary for a participant to report a before-after relation with 75% correctness. The main finding of the present study was the indication of differences in the elderly in performance on two tasks. In the spatial task, the distribution of obtained ATOT values did not deviate from the Gaussian distribution. In contrast, the distribution of data in the spectral task deviated significantly from the Gaussian and was spread more to the right. Although lower ATOT values were usually observed in Session 2 than in Session 1, such difference was significant only in the spectral task. We conclude that although temporal acuity and sequencing abilities in the millisecond time range are probably based in neuronal oscillatory activity, the measured ATOTs in the elderly seem to be stimulus-dependent, procedure-related, and influenced by the perceptual strategies used by participants.

["My work"--adaptation to work questionnaire]. / "Moja praca"--kwestionariusz do pomiaru przystosowania do pracy.

BACKGROUND: Although the interest in the problem of adaptation to work among psychologists is still growing, there are a few methods for investigating this issue. The present study was undertaken to develop a new instrument for assessing one's adaptation to work and to evaluate the psychometric parameters of the test. MATERIALS AND METHODS: A questionnaire called "My work", based on the person-environment fit theory model, has been elaborated. RESULTS: The questionnaire consists of 23 items, describing various aspects of adaptation to work. The results of a survey, performed on 292 individuals, provided the grounds for testing the validation parameters of the questionnaire. The following psychometric properties were assessed: Cronbach's alpha reliability coefficient (0.92), stability (0.75), and content validity. Preliminary normative values for the test were also established. CONCLUSIONS: The "My work" test shows a good psychometric characteristic and it can be useful for both research work and practical application (as a diagnostic tool).

[Readaptation to work after myocardial infarction: model considerations]. / Przystosowanie do pracy osób po zawale serca - rozwazania modelowe.

In Poland only 50-60% of persons who have experienced myocardial infarction return to work. Bearing in mind that psychophysical condition changes after such an event, this group of people has to be readapted to work. Factors that determine good work performance among post-infarction workers have been not yet investigated. The aim of our study is to identify those factors and to define their role in the readaptation process. The first stage of our project involved the development of a theoretical model of readaptation to work after myocardial infarction. This model is described in this paper. It comprises the following components: medical evaluation of the workers' health status, his or her subjective assessment of work ability, expectations (optimistic vs. pessimistic attitude), motivation to work, social support, and job characteristics.

Outcome prediction in endoscopic surgery for chronic rhinosinusitis - a multidimensional model.

PURPOSE: Chronic rhinosinusitis (CRS) is one of the most common diseases in the modern society. In recent years endoscopic sinus surgery (ESS) has become the treatment of choice for patients with CRS refractory to medical therapy. ESS proved to be successful in most, but not all patients with CRS. Currently there is no direct method available to distinguish between patients who are likely to benefit from ESS and those who are not. The aim of this study was to build multidimensional models (artificial neural networks) to predict early outcomes of ESS in individual patients. MATERIAL/METHODS: The study group comprised of 115 patients operated for CRS in the Department of Otolaryngology, Jagiellonian University Collegium Medicum, Cracow. The neural models were created using the Statistica Neural Network computer software package. The models required only information easily achievable for every patient before surgery. Consequently, the models could be readily applicable in everyday clinical practice. To define the results of surgery three different mathematical descriptions were compared. The models' predictions were compared with the actual results of surgery 3-6 months postoperatively. RESULTS: The models were able to predict the early outcome of surgery in 90% of the patients but their quality depended on mathematical representation of the surgery result. The best models were characterized by 93% sensitivity and 86% specificity. CONCLUSIONS: The results of ESS depend on many factors, so reliable outcome prognoses can be produced only by multidimensional models. Artificial neural networks are a promising multidimensional tool facilitating clinical decision making in patients with CRS.

Structural, spectroscopic, and magnetic study of bis(9,10-dihydro-9-oxo-10-acridineacetate)bis(imidazole)bis(methanol) nickel(II).

The mixed ligand complex [Ni(CMA)2(im)2(MeOH)2] (where CMA = 9,10-dihydro-9-oxo-10-acridineacetate ion, im = imidazole) was prepared, and its crystal and molecular structure were determined. The nickel ions are hexa-coordinated by four oxygen atoms of the carboxylate and hydroxyl groups and by two imidazole nitrogen atoms, to form a distorted octahedral arrangement. The structure consists of a one-dimensional network of the complex molecules connected by strong intermolecular hydrogen bonds. The weak intermolecular C-H...X hydrogen bonds and stacking interactions make up the 2-D structure. Very strong intramolecular hydrogen bonds significantly affect the geometry and vibrational characteristics of the carboxylate group. The UV-vis-NIR electronic spectrum was deconvoluted into Gaussian components. Electronic bands of the Ni(II) ion were assigned to suitable spin-allowed transitions in the D4h symmetry environment. The single ion zero-field splitting (ZFS) parameters for the S = 1 state of Ni(II), as well as the g components, have been determined by high-field and high-frequency EPR (HF-HFEPR) spectroscopy over the frequency range of 52-432 GHz and with the magnetic fields up to 14.5 T: D = 5.77(1) cm-1, E = 1.636(2) cm-1, gx = 2.29(1), gy = 2.18(1), and gz = 2.13(1). These values allowed us to simulate the powder magnetic susceptibility and field-dependent magnetization of the complex.