Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsist...Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.展开更多
Objective:To investigate the distribution of health literacy(HL)levels and the association of HL with proactive personality in patients with permanent colostomy.Methods:A cross-sectional study was conducted to measure...Objective:To investigate the distribution of health literacy(HL)levels and the association of HL with proactive personality in patients with permanent colostomy.Methods:A cross-sectional study was conducted to measure proactive personality and HL using validated scales.A total of 172 patients with permanent colostomy were selected from January 2021 to May 2022 in Yantai City,China.Descriptive statistics,t-test,ANOVA,Pearson correlation analysis,and multiple linear regression analysis techniques were used.Results:The results obtained from the study showed that the HL status of the participants was moderate.The correlation between participants’total HL scores and proactive personality scores was 0.417(P-value<0.001).In addition,HL showed statistically significant differences according to education level,place of residence,profession,and average monthly household income.Conclusions:This study showed that patients with higher proactive personality scores had higher HL.The key stakeholders require several positive strategies to improve the HL of patients with permanent colostomy by cultivating their proactive personalities,and these important policies will help to improve patient health and quality of life.展开更多
Objective To introduce the design of observational trials under real-world study(RWS),and to provide guidance for clinical development of new research trials and reference for real-world researchers.Methods Relevant l...Objective To introduce the design of observational trials under real-world study(RWS),and to provide guidance for clinical development of new research trials and reference for real-world researchers.Methods Relevant literature of RWS and observational experiments at home and abroad were reviewed and analyzed,and then the design of observational studies was summarized under RWS.Results and Conclusion The data and information provided in observational studies not only help to further verify the clinical study results obtained by randomized controlled trial(RCT)in clinical practice,but also objectively reflect the real situation in the process of clinical research and application.展开更多
AIM: To investigate if there is an association between hepatitis B virus (HBV) or hepatitis C virus (HCV) infection and the risk of pancreatic cancer. METHODS: All relevant studies published before 11 October, 2012 we...AIM: To investigate if there is an association between hepatitis B virus (HBV) or hepatitis C virus (HCV) infection and the risk of pancreatic cancer. METHODS: All relevant studies published before 11 October, 2012 were identified by a systematic search of MEDLINE, EMBASE, BIOSIS Previews and the Cochrane Library databases and with cross-referencing. The observational studies that reported RR or OR estimates with 95%CIs for the association between HBV or HCV and pancreatic cancer were included. A random-effects model was used to summarize meta-analytic estimates. The Newcastle-Ottawa quality assessment scale was applied to assess the quality of the methodology in the included studies. RESULTS: A total of 8 eligible studies were selected for meta-analysis. Overall, chronic hepatitis B and inactive hepatitis B surface antigen (HBsAg) carrier state (HBsAg positive) had a significantly increased risk of pancreatic cancer with OR of 1.20 (95%CI: 1.01-1.39), especially in the Chinese population (OR = 1.30, 95%CI: 1.05-1.56). Past exposure to HBV (possible occult HBV infection) had an increased OR of pancreatic cancer risk (OR = 1.24, 95%CI: 1.05-1.42), especially among those patients without natural immunity [anti hepatitis B core (HBc) positive/hepatitis B surface antibody (anti HBs) negative], with OR of 1.67 (95%CI: 1.13-2.22). However, past exposure to HBV with natural immunity (anti-HBc positive/anti-HBs positive) had no association with pancreatic cancer development, with OR 0.98 (95%CI: 0.80-1.16), nor did the HBV active replication (hepatitis B e antigen positive status), with OR 0.98 (95%CI: 0.27-1.68). The risk of pancreatic cancer among anti-HBs positive patients was significantly lower than among anti-HBs negative patients (OR = 0.54, 95%CI: 0.46-0.62). Past exposure to HCV also resulted in an increased risk of pancreatic cancer (OR = 1.26, 95%CI: 1.03-1.50). Significant between-study heterogeneity was observed. Evidence of publication bias for HBV/HCV infection-pancreatic cancer association was not found. CONCLUSION: Chronic HBV and HCV infection increases pancreatic cancer risk. Our findings underscore the need for more studies to confirm this potential relationship.展开更多
Ischemic stroke is a devastating,life altering event which can severely reduce patient quality of life.Despite years of research there have been minimal therapeutic advances.Endothelial progenitor cells(EPCs),stem cel...Ischemic stroke is a devastating,life altering event which can severely reduce patient quality of life.Despite years of research there have been minimal therapeutic advances.Endothelial progenitor cells(EPCs),stem cells involved in both vasculogenesis and angiogenesis,may be a potential therapeutic target.After a stroke,EPCs migrate to the site of ischemic injury to repair cerebrovascular damage,and their numbers and functional capacity may determine patients'outcome.This study aims to determine whether the number of circulating EPCs and their functional aspects may be used as biomarkers to identify the type(cortical or lacunar)and/or severity of ischemic stroke.The study will also investigate if there are any differences in these characteristics between healthy volunteers over and under 65 years of age.100 stroke patients(50 lacunar and 50 cortical strokes)will be recruited in this prospective,observational case-controlled study.Blood samples will be taken from stroke patients at baseline(within 48 hours of stroke)and days 7,30 and90.EPCs will be counted with flow cytometry.The plasma levels of pro-and anti-angiogenic factors and inflammatory cytokines will also be determined.Outgrowth endothelial cells will be cultured to be used in tube formation,migration and proliferation functional assays.Primary outcome is disability or dependence on day 90 after stroke,assessed by the modified Rankin Scale.Secondary outcomes are changes in circulating EPC numbers and/or functional capacity between patient and healthy volunteers,between patient subgroups and between elderly and young healthy volunteers.Recruitment started in February 2017,167 participants have been recruited.Recruitment will end in November 2019.West Midlands-Coventry&Warwickshire Research Ethics Committee approved this study(REC number:16/WM/0304)on September8,2016.Protocol version:2.0.The Bayraktutan Dunhill Medical Trust EPC Study was registered in ClinicalTrials.gov(NCT02980354)on November 15,2016.This study will determine whether the number of EPCs can be used as a prognostic or diagnostic marker for ischemic strokes and is a step towards discovering if transplantation of EPCs may aid patient recovery.展开更多
Based on the long-term marine ship observation data, records of meteorological stations and High-Reflective Cloud(HRC) data by satellite remote sensing , this paper has studied the circulation patterns and variability...Based on the long-term marine ship observation data, records of meteorological stations and High-Reflective Cloud(HRC) data by satellite remote sensing , this paper has studied the circulation patterns and variability in elements during onset and the established periods of the South China Sea(SCS) southwest(SW) monsoon. The averaged date of the onset SW monsoon in the SCS occurs in the middle of May climatologically. The corresponding date for the northern part is little earlier (May 12) and those for the southern parts are little later (May 20). The interannual range of the onset dates is about one month. Following the onset of the SW monsoon, the cloud amount and the precipitation increase while the convection activities enhance over the SCS. But there is a strong spatial heterogeneity within the domain. After onset of the SW monsoon the strong convective area moves northwards, while the SCS rain band moves to the center and north. Sea surface temperature(SST) increases rapidly before the onset and the leading time is about one month. The increment of SST supplies heat and vapor for the onset. From April to May the surface heat fluxes display obvious changes, e.g., latent heat exchange and evaporation enhancement. It is one of the reasons why the SW monsoon bursts firstly in the SCS.展开更多
Features of structure and propagation of the 30 to SO day atmospheric oscillations are investigated using the ECMWF analysis of 1980-1983. Evidence is provided to confirm the characteristics of the oscillation in the ...Features of structure and propagation of the 30 to SO day atmospheric oscillations are investigated using the ECMWF analysis of 1980-1983. Evidence is provided to confirm the characteristics of the oscillation in the equatorial region. Those in the mid-high latitudes, however, are revealed to be very different from the tropics and pose a strong barotropic structure. Horizontal coherence shows teleconnection patterns which can be identified as EAP and PNA. The wind field of the specified time scale of the oscillation appears as long-lived vortices and vortex pairs. Mid-latitude perturbations propagate clearly westwards, especially during the winter season. In the high latitudes, they propagate westwards in the winter but eastwards in the summer. Meridional propagations are rather different from region to region.展开更多
To estimate the true treatment effect on a censored outcome in observational studies, potential confounding effect and complex heterogeneity in the treatment assignment have to be properly adjusted. In this article, w...To estimate the true treatment effect on a censored outcome in observational studies, potential confounding effect and complex heterogeneity in the treatment assignment have to be properly adjusted. In this article, we demonstrate that the partial least squares method could be a valuable tool in this regard. It is showed that the partial least squares method not only can adequately account for the heterogeneity in treatment assignment, but also be robust to treatment assignment model misspecifications. Numerical results show that the partial least squares estimator is more efficient and robust. A real data set is analyzed to illustrate the proposed method.展开更多
BACKGROUND Osteoporosis with vertebral compression fractures is increasingly common in the elderly population.Cement augmentation is one of the effective surgical treatments for these patients.Currently,there are seve...BACKGROUND Osteoporosis with vertebral compression fractures is increasingly common in the elderly population.Cement augmentation is one of the effective surgical treatments for these patients.Currently,there are several different types of cement augmentation treatments.No studies have compared the safety and efficacy of different cement augmentation types for the treatment of such fractures;thus,we retrospectively compared vertebroplasty,balloon kyphoplasty,and kyphoplasty with SpineJack or an intravertebral expandable pillar.AIM To compare the postoperative safety and efficacy of each surgical intervention in treating vertebral compression fractures.METHODS We retrospectively analyzed 354 patients with acute vertebral compression fractures,defined as signal changes in the T1 weighted magnetic resonance imaging,and randomly divided the patients into five groups.Their visual analog scale scores for pain,kyphotic angle,average body height,rate of cement leakage,and occurrence of adjacent vertebral compression fractures were followed for 1 year.One-way analysis of variance,the post hoc Bonferroni test,and Fisher exact probability test were used for statistical analyses.RESULTS All pain scores significantly improved 12 mo postoperatively;however,there was no significant difference between the groups(P=0.325).Kyphoplasty with SpineJack significantly reduced the kyphotic angle(P=0.028)and restored the height of the vertebral body(P=0.02).The rate of adjacent compression fractures was the highest in the vertebroplasty group,with a statistically significant difference according to the Fisher exact probability test(P=0.02).The treatment with the lowest cement leakage rate cannot be identified because of the small sample size;however,kyphoplasty with SpineJack,an IVEP,and vesselplasty resulted in lower rates of cement leakage than balloon kyphoplasty and vertebroplasty.CONCLUSION Kyphoplasty with SpineJack has good outcomes in kyphotic angle reduction and body height restoration.Vertebroplasty has the highest cement leakage rate and adjacent compression fracture occurrence.展开更多
AIM:To evaluate whether red meat intake is related to the risk of endometrial cancer(EC) using meta-analysis.METHODS:We searched Pub Med,EMBASE,and the Cochrane Library up to June 2013,using common keywords related to...AIM:To evaluate whether red meat intake is related to the risk of endometrial cancer(EC) using meta-analysis.METHODS:We searched Pub Med,EMBASE,and the Cochrane Library up to June 2013,using common keywords related to red meat and EC.Case-control studies and cohort studies comparing the risk of endometrial cancer among categories by the amount of intake were included.Eleven case-control studies and five cohort studies met our criteria.We performed a conventional and a dose-response meta-analysis of case-control studies using the Der Simonian-Laird method for random-effects.For cohort studies we performed a conventional meta-analysis.Publication bias was evaluated using Egger's test.RESULTS:In the meta-analysis of 11 case-control studies including 5419 cases and 12654 controls,higher red meat consumption was associated with an increased risk of EC [summary relative risk(SRR) = 1.43,95%CI:1.15-1.79;I2 = 73.3% comparing extreme intake categories).In a dose-response analysis,for red meat intake of 100 g/d,SRR was 1.84(95%CI:1.64-2.05).In contrast,in the meta-analysis of five prospective studies including a total of 2549 cases among 247746 participants,no significant association between red meat intake and EC risk(SRR = 0.97,95%CI:0.85-1.11;I2 = 4.9% comparing extreme intake categories) was observed.CONCLUSION:Our meta-analysis found a significantlinear association between red meat intake and EC risk based on case-control studies but this was not confirmed in prospective studies.展开更多
Discontinuation of antipsychotic therapy has been a significant clinical issue among patients with schizophrenia, since the patients who discontinued antipsychotic treatment showed worse clinical and functional outcom...Discontinuation of antipsychotic therapy has been a significant clinical issue among patients with schizophrenia, since the patients who discontinued antipsychotic treatment showed worse clinical and functional outcomes, and higher risks of relapse of schizophrenia symptoms and hospitalization. We conducted a post-hoc analysis of a post-marketing research with a 12-month follow-up period to identify the predictors for discontinuation of antipsychotic monotherapy in Japan. This is a prospective, naturalistic multicenter observational study, designed to evaluate the discontinuation rates of olanzapine monotherapy and non-olanzapine antipsychotic monotherapy in Japanese adult patients with acute schizophrenia. Patients were treatment-naive, or had switched from other antipsychotics or from poly-pharmacotherapy to oral antipsychotic monotherapy. We analyzed the correlation of discontinuation of antipsychotic monotherapy with baseline characteristics of patients. A total of 1089 patients (578 patients treated with olanzapine and 511 with non-olanzapine antipsychotics) were eligible for analysis. By the end of the 12-month study period, 614 patients (56.4%) discontinued antipsychotic therapy. Multivariate logistic regression analyses indicated significantly lower discontinuation rates in all patients treated with antipsychotics: older age (Odds ratio [OR], 0.871;95% confidence interval [CI], 0.797 to 0.953;p = 0.003), outpatient status (OR, 0.508;95% CI, 0.383 to 0.675;p < 0.001), prior use of antipsychotics (OR, 0.693;95% CI, 0.516 to 0.930;p = 0.015), and olanzapine group showed lower discontinuation rate than that of non-olanzapine group (OR, 1.416;95% CI, 1.086 to 1.846;p = 0.010). The present study indicated that the outpatient status, older age, and prior use of antipsychotics have better adherence to antipsychotic treatment. In addition to these factors, use of anti-parkinson agents showed lower discontinuation rates in the olanzapine monotherapy group.展开更多
Background: 70% of all gynecological consultations are for abnormal uterine bleeding. Any approach to optimal management begins with an appropriate diagnosis. 40% of premenopausal women with abnormal uterine bleeding ...Background: 70% of all gynecological consultations are for abnormal uterine bleeding. Any approach to optimal management begins with an appropriate diagnosis. 40% of premenopausal women with abnormal uterine bleeding were found to have some intrauterine pathology. This study aims to compare the diagnostic value of transvaginal ultrasonography in comparison to hysteroscopy in detecting uterine abnormalities in patients with abnormal uterine bleeding. Methods: Retrospective observational cross sectional study of 250 women presented with abnormal uterine bleeding. The patients who fulfilled the selection criteria and have been sequentially investigated by transvaginal ultrasound (TVS) and hysteroscopy were included. Results: 90% of patients were from 35 - 49 yrs. 81.2% of patients have body mass index above 25 kg/m2. Transvaginal ultrasound (TVS) compared well with high sensitivity as regards normal endometrium. (TVS) missed 4 patients of endometrial polyps and one patient of sub mucous fibroid. Three patients of adenomyosis were only diagnosed by (TVS);they were reported as being normal by hysteroscopy. Conclusion: (TVS) is considered as an excellent approach to the initial evaluation of uterine pathologies in patients with abnormal uterine bleeding.展开更多
In this part, the temporal evolution and interaction across the equator of 30-50 day oscillation in the atmosphere are investigated further. The annual variation of 30-50 day oscillation is quite obvious in the mid-hi...In this part, the temporal evolution and interaction across the equator of 30-50 day oscillation in the atmosphere are investigated further. The annual variation of 30-50 day oscillation is quite obvious in the mid-high latitudes. In the tropical atmosphere, the obvious interannual variation is an important property for temporal evolution of 30-50 day oscillation. The low-frequency wavetrain across the equator over the central Pacific and central Atlantic area, the movement of the long-lived low-frequency system across the equator and the meridional wind component across the equator will obviously show the interaction of 30-50 day oscillation in the atmosphere across the equator.展开更多
BACKGROUND Frailty is a complex aging-related syndrome characterized by a cumulative loss of physiological reserve and increased vulnerability to adverse clinical outcomes,including falls,disability,incapacity and dea...BACKGROUND Frailty is a complex aging-related syndrome characterized by a cumulative loss of physiological reserve and increased vulnerability to adverse clinical outcomes,including falls,disability,incapacity and death.While an increasing number of studies suggest that the gut microbiota may play a key role in the pathophy-siology of frailty,direct evaluation of the association between gut microbiome alterations and frailty in older adults remains limited.AIM Seven electronic databases(China National Knowledge Infrastructure,VIP,SinoMed,Wanfang,PubMed,Web of Science and EMBASE)were searched for articles published before October 31,2023 to identify observational studies that compared the microbiomes of older adults with and without frailty.The diversity and composition of the gut microbiota were the main outcomes used to analyze the associations of changes in the gut microbiota with frailty in older adults.The quality of the included studies was assessed via the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality.RESULTS Eleven observational studies with 912 older adults were included in this review.Consistent results revealed a significant difference in the gut microbiota composition between frail and non-frail older adults,with a significant decrease inαdiversity and a significant increase inβdiversity in frail older adults.The pooled results revealed that at the phylum level,four microbiota(Actinobacteria,Proteo-bacteria,Verrucomicrobia and Synergistetes)were significantly enriched,and two microbiota(Firmicutes and Fusobacteria)were significantly depleted in frail older adults.At the family level,the results consistently revealed that the abundances of 6 families,most of which belong to the Actinobacteria or Proteo-bacteria phylum,were greater in frail than in non-frail older adults.At the genus or species level,consistent results from more than two studies revealed that the abundances of the genera Prevotella,Faecalibacterium,and Roseburia were significantly lower in frail older adults;individual studies revealed that the abundances of some genera or species(e.g.,Megamonas,Blautia,and Megasphaera)were significantly lower,whereas those of other genera or species(e.g.,Bifidobacterium,Oscillospira,Ruminococcus and Pyramidobacter)were significantly greater in frail older adults.CONCLUSION This systematic review suggests that changes in the gut microbiota are associated with frailty in older adults,which is commonly reflected by a reduction in beneficial species and an increase in pathogenic species.However,further studies are needed to confirm these findings.展开更多
Identifying the causal impact of＇ some intervention challenging when one is faced with correlated binary end-points in observational studies is a challenging task, and it is even more The statistical literature on an...Identifying the causal impact of＇ some intervention challenging when one is faced with correlated binary end-points in observational studies is a challenging task, and it is even more The statistical literature on analyzing such data is well documented. Dependence between observations from the same study subject in correlated data renders invalid the usual chi-square tests of independence and inflates the variance ofparameter estimates. Disaggregated approaches such as hierarchical linear models which are able to adjust for individual level covariate：s are favoured in the analysis of such data, thereby gaining power over aggregated and individual-level analyses. In this article the authors, therefore, address the issue of analyzing correlated data with dichotomous end-points by using hierarchical logistic regression, a generalization of the standard logistic regression model for independent outcomes.展开更多
Objective To investigate the relationships between erythrocyte membrane n-6：n-3 PUFAs ratio and blood lipids and high sensitivity C-reactive protein （hs-CRP）. Methods The Chinese and a observational study consisted...Objective To investigate the relationships between erythrocyte membrane n-6：n-3 PUFAs ratio and blood lipids and high sensitivity C-reactive protein （hs-CRP）. Methods The Chinese and a observational study consisted of a population-based cross-sectiona subsequent 1-year follow-up study of 171 subjects with the fasting cholesterol of 5.13-8.00 mmol/L. study of 456 plasma total Results In the cross-sectional analysis, plasma low-density lipoprotein cholesterol （LDL-c） had a significant and negative association with the erythrocyte membrane n-6：n-3 PUFAs ratio （P for trend=0.019） after adjusting for sex, age and total PUFA percentage. In the follow-up study, 171 subjects were categorized into quartiles by the changes of n-6：n-3 ratio in erythrocyte membrane （△=month 12-month 0）. In the top quartile whose ratios of n-6：n-3 increased by an average of 1.25 during the follow-up, the LDL-c-lowering extent was 3.3 times of that in the lowest quartile whose ratios of n-6：n-3 decreased by an average of 1.13 （-1.07 mmol/L v.s. -0.32 mmol/L）. The hsCRP decreased by 0.11 mg/dL in the lowest quartile while increasing by 0.10 mg/dL in the top quartile （P for difference=0.052）. Conclusion Our results suggested that the balance between n-6 and n-3 fatty acids may optimize the cardiovascular benefits from dietary PUFAs.展开更多
Recently we read the article entitled“Outcomes of different minimally invasive surgical treatments for vertebral compression fractures:An observational study”.This was an observational study that reviewed the safety...Recently we read the article entitled“Outcomes of different minimally invasive surgical treatments for vertebral compression fractures:An observational study”.This was an observational study that reviewed the safety and efficacy of different cement augmentation modalities for vertebral compression fractures under osteoporotic condition.Overall,this is a valuable study that can provide a reference for clinical practice.On the other hand,we also noticed some points in the article and are willing to share our views.Further studies with a higher level of evidence can add more knowledge regarding relevant concerns.展开更多
Demographics, access to new treatment, altruistic motivations and continuity of care have been shown to influence motivation to participate in clinical trials. Less is known however, about factors that motivate resear...Demographics, access to new treatment, altruistic motivations and continuity of care have been shown to influence motivation to participate in clinical trials. Less is known however, about factors that motivate research participants to agree to take part in observational studies and provide a biologic specimen. This study evaluates and quantitates factors that motivate participation in observational studies and provide a biospecimen among cancer patients, their family members, and controls. An online survey was completed by 450 participants from a cancer genetics registry, including cancer patients, their relatives, and controls. Overall, the benefit to society and the research institution reputation were the most important motivators for participation. Cancer cases were significantly more likely to endorse personal meaningfulness as a factor for participation compared to those without cancer and women were 50% more likely than men to believe that a family benefit is an important determinant of research participation. Researcher and institutional trustworthiness as well as security of stored data were most important when deciding whether to provide a biological sample, with differences seen by gender and history of cancer. This study demonstrated which factors are most important to participants when considering participation in an observational study and donating a biospecimen. Motivational factors significantly differed by gender as well as history and stage of cancer. The application of these study results may improve participation rates in cohort studies.展开更多
Objective: To characterize the methods of design and analysis currently adopted in survey research of school-based observational studies for smoking, and to identify the common pitfalls made by researchers. Methods: T...Objective: To characterize the methods of design and analysis currently adopted in survey research of school-based observational studies for smoking, and to identify the common pitfalls made by researchers. Methods: The systematic review was conducted in 2009 and consisted of observational studies in school settings published between January 2005 and January 2009. Smoking status was the main outcome of interest. Following Cochrane style, five steps were followed: setting selection criteria for studies and conducting a literature search;review of abstracts;review of complete articles;data extraction and quality assessment of included studies;and, finally, synthesis of studies. Results: Of the 292 abstracts retrieved, 45 (15.4%) articles were selected for the final review. Inconsistencies were found in the definition of smoking behaviour which impeded generalisability. Individual-level factors had importance, but environmental level factors were also important in studying the aetiology of smoking. Results showed that studies inappropriately reported sample size estimation and important confounding factors. Hierarchical linear modelling, random effects modelling and structural equation modelling were employed in comparatively few studies. Conclusions: There were concerns regarding data analysis of complex surveys. Fifty five percent of reviewed studies ignored environmental effects which may have produced unreliable inferences. Multi-level analysis assisted in understanding school-level effects.展开更多
Background Patients undergoing intensive care are exposed to risk factors for hearing impairment.This study assessed the worse changes in pure tone average(PTA)thresholds after intensive care and identified the factor...Background Patients undergoing intensive care are exposed to risk factors for hearing impairment.This study assessed the worse changes in pure tone average(PTA)thresholds after intensive care and identified the factors associated with worse hearing function.Methods We conducted a single-centre retrospective study,and included adult patients admitted to the intensive care unit(ICU)of Kurashiki Central Hospital between January 2014 and September 2019,who had regular pure tone audiometry performed before and after ICU admission.Correlations between changes in PTA threshold and patient characteristics,were evaluated.The included ears were classified as those with worse hearing(>10 dB increase in the PTA threshold)and those without worse hearing,and the baseline characteristics were compared.Results During the study period,125 ears of 71 patients(male:female ratio,35:36;mean age,72.5±12.3 years)met the eligibility criteria.Age,sex,and the use of furosemide were not correlated with changes in PTA threshold.Univariate analysis showed that ears with worse hearing were associated with a lower serum platelet count than ears without worse hearing(153±85×10^(9)/L vs.206±85×10^(9)/L,respectively;P=0.010),and the rate of planned ICU admission(elective surgery)was higher in the worse hearing group(57.1% vs.28.8%,respectively;p=0.011).Conclusions Age,sex,and the use of furosemide did not have adversely affect hearing function.Low serum platelet count and planned admission appear to be risk factors for worse hearing.展开更多
基金supported by the China Postdoctoral Science Foundation(Grant No.2021M703366)Shenzhen Science and Technology Program(Grant No.KQTD20190929172835662).
文摘Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.
文摘Objective:To investigate the distribution of health literacy(HL)levels and the association of HL with proactive personality in patients with permanent colostomy.Methods:A cross-sectional study was conducted to measure proactive personality and HL using validated scales.A total of 172 patients with permanent colostomy were selected from January 2021 to May 2022 in Yantai City,China.Descriptive statistics,t-test,ANOVA,Pearson correlation analysis,and multiple linear regression analysis techniques were used.Results:The results obtained from the study showed that the HL status of the participants was moderate.The correlation between participants’total HL scores and proactive personality scores was 0.417(P-value<0.001).In addition,HL showed statistically significant differences according to education level,place of residence,profession,and average monthly household income.Conclusions:This study showed that patients with higher proactive personality scores had higher HL.The key stakeholders require several positive strategies to improve the HL of patients with permanent colostomy by cultivating their proactive personalities,and these important policies will help to improve patient health and quality of life.
文摘Objective To introduce the design of observational trials under real-world study(RWS),and to provide guidance for clinical development of new research trials and reference for real-world researchers.Methods Relevant literature of RWS and observational experiments at home and abroad were reviewed and analyzed,and then the design of observational studies was summarized under RWS.Results and Conclusion The data and information provided in observational studies not only help to further verify the clinical study results obtained by randomized controlled trial(RCT)in clinical practice,but also objectively reflect the real situation in the process of clinical research and application.
基金Supported by International Cooperation Project of the Guangzhou Science and Technology Bureau, No. 2011J5200017Guangdong Provincial Science and Technology Development Program, No. 2011B031800207
文摘AIM: To investigate if there is an association between hepatitis B virus (HBV) or hepatitis C virus (HCV) infection and the risk of pancreatic cancer. METHODS: All relevant studies published before 11 October, 2012 were identified by a systematic search of MEDLINE, EMBASE, BIOSIS Previews and the Cochrane Library databases and with cross-referencing. The observational studies that reported RR or OR estimates with 95%CIs for the association between HBV or HCV and pancreatic cancer were included. A random-effects model was used to summarize meta-analytic estimates. The Newcastle-Ottawa quality assessment scale was applied to assess the quality of the methodology in the included studies. RESULTS: A total of 8 eligible studies were selected for meta-analysis. Overall, chronic hepatitis B and inactive hepatitis B surface antigen (HBsAg) carrier state (HBsAg positive) had a significantly increased risk of pancreatic cancer with OR of 1.20 (95%CI: 1.01-1.39), especially in the Chinese population (OR = 1.30, 95%CI: 1.05-1.56). Past exposure to HBV (possible occult HBV infection) had an increased OR of pancreatic cancer risk (OR = 1.24, 95%CI: 1.05-1.42), especially among those patients without natural immunity [anti hepatitis B core (HBc) positive/hepatitis B surface antibody (anti HBs) negative], with OR of 1.67 (95%CI: 1.13-2.22). However, past exposure to HBV with natural immunity (anti-HBc positive/anti-HBs positive) had no association with pancreatic cancer development, with OR 0.98 (95%CI: 0.80-1.16), nor did the HBV active replication (hepatitis B e antigen positive status), with OR 0.98 (95%CI: 0.27-1.68). The risk of pancreatic cancer among anti-HBs positive patients was significantly lower than among anti-HBs negative patients (OR = 0.54, 95%CI: 0.46-0.62). Past exposure to HCV also resulted in an increased risk of pancreatic cancer (OR = 1.26, 95%CI: 1.03-1.50). Significant between-study heterogeneity was observed. Evidence of publication bias for HBV/HCV infection-pancreatic cancer association was not found. CONCLUSION: Chronic HBV and HCV infection increases pancreatic cancer risk. Our findings underscore the need for more studies to confirm this potential relationship.
基金supported by a grant to Dr Ulvi Bayraktutan from The Dunhill Medical Trust(R459/0216)
文摘Ischemic stroke is a devastating,life altering event which can severely reduce patient quality of life.Despite years of research there have been minimal therapeutic advances.Endothelial progenitor cells(EPCs),stem cells involved in both vasculogenesis and angiogenesis,may be a potential therapeutic target.After a stroke,EPCs migrate to the site of ischemic injury to repair cerebrovascular damage,and their numbers and functional capacity may determine patients'outcome.This study aims to determine whether the number of circulating EPCs and their functional aspects may be used as biomarkers to identify the type(cortical or lacunar)and/or severity of ischemic stroke.The study will also investigate if there are any differences in these characteristics between healthy volunteers over and under 65 years of age.100 stroke patients(50 lacunar and 50 cortical strokes)will be recruited in this prospective,observational case-controlled study.Blood samples will be taken from stroke patients at baseline(within 48 hours of stroke)and days 7,30 and90.EPCs will be counted with flow cytometry.The plasma levels of pro-and anti-angiogenic factors and inflammatory cytokines will also be determined.Outgrowth endothelial cells will be cultured to be used in tube formation,migration and proliferation functional assays.Primary outcome is disability or dependence on day 90 after stroke,assessed by the modified Rankin Scale.Secondary outcomes are changes in circulating EPC numbers and/or functional capacity between patient and healthy volunteers,between patient subgroups and between elderly and young healthy volunteers.Recruitment started in February 2017,167 participants have been recruited.Recruitment will end in November 2019.West Midlands-Coventry&Warwickshire Research Ethics Committee approved this study(REC number:16/WM/0304)on September8,2016.Protocol version:2.0.The Bayraktutan Dunhill Medical Trust EPC Study was registered in ClinicalTrials.gov(NCT02980354)on November 15,2016.This study will determine whether the number of EPCs can be used as a prognostic or diagnostic marker for ischemic strokes and is a step towards discovering if transplantation of EPCs may aid patient recovery.
文摘Based on the long-term marine ship observation data, records of meteorological stations and High-Reflective Cloud(HRC) data by satellite remote sensing , this paper has studied the circulation patterns and variability in elements during onset and the established periods of the South China Sea(SCS) southwest(SW) monsoon. The averaged date of the onset SW monsoon in the SCS occurs in the middle of May climatologically. The corresponding date for the northern part is little earlier (May 12) and those for the southern parts are little later (May 20). The interannual range of the onset dates is about one month. Following the onset of the SW monsoon, the cloud amount and the precipitation increase while the convection activities enhance over the SCS. But there is a strong spatial heterogeneity within the domain. After onset of the SW monsoon the strong convective area moves northwards, while the SCS rain band moves to the center and north. Sea surface temperature(SST) increases rapidly before the onset and the leading time is about one month. The increment of SST supplies heat and vapor for the onset. From April to May the surface heat fluxes display obvious changes, e.g., latent heat exchange and evaporation enhancement. It is one of the reasons why the SW monsoon bursts firstly in the SCS.
文摘Features of structure and propagation of the 30 to SO day atmospheric oscillations are investigated using the ECMWF analysis of 1980-1983. Evidence is provided to confirm the characteristics of the oscillation in the equatorial region. Those in the mid-high latitudes, however, are revealed to be very different from the tropics and pose a strong barotropic structure. Horizontal coherence shows teleconnection patterns which can be identified as EAP and PNA. The wind field of the specified time scale of the oscillation appears as long-lived vortices and vortex pairs. Mid-latitude perturbations propagate clearly westwards, especially during the winter season. In the high latitudes, they propagate westwards in the winter but eastwards in the summer. Meridional propagations are rather different from region to region.
基金Supported by the National Natural Science Foundation of China(11501578,11701571)
文摘To estimate the true treatment effect on a censored outcome in observational studies, potential confounding effect and complex heterogeneity in the treatment assignment have to be properly adjusted. In this article, we demonstrate that the partial least squares method could be a valuable tool in this regard. It is showed that the partial least squares method not only can adequately account for the heterogeneity in treatment assignment, but also be robust to treatment assignment model misspecifications. Numerical results show that the partial least squares estimator is more efficient and robust. A real data set is analyzed to illustrate the proposed method.
文摘BACKGROUND Osteoporosis with vertebral compression fractures is increasingly common in the elderly population.Cement augmentation is one of the effective surgical treatments for these patients.Currently,there are several different types of cement augmentation treatments.No studies have compared the safety and efficacy of different cement augmentation types for the treatment of such fractures;thus,we retrospectively compared vertebroplasty,balloon kyphoplasty,and kyphoplasty with SpineJack or an intravertebral expandable pillar.AIM To compare the postoperative safety and efficacy of each surgical intervention in treating vertebral compression fractures.METHODS We retrospectively analyzed 354 patients with acute vertebral compression fractures,defined as signal changes in the T1 weighted magnetic resonance imaging,and randomly divided the patients into five groups.Their visual analog scale scores for pain,kyphotic angle,average body height,rate of cement leakage,and occurrence of adjacent vertebral compression fractures were followed for 1 year.One-way analysis of variance,the post hoc Bonferroni test,and Fisher exact probability test were used for statistical analyses.RESULTS All pain scores significantly improved 12 mo postoperatively;however,there was no significant difference between the groups(P=0.325).Kyphoplasty with SpineJack significantly reduced the kyphotic angle(P=0.028)and restored the height of the vertebral body(P=0.02).The rate of adjacent compression fractures was the highest in the vertebroplasty group,with a statistically significant difference according to the Fisher exact probability test(P=0.02).The treatment with the lowest cement leakage rate cannot be identified because of the small sample size;however,kyphoplasty with SpineJack,an IVEP,and vesselplasty resulted in lower rates of cement leakage than balloon kyphoplasty and vertebroplasty.CONCLUSION Kyphoplasty with SpineJack has good outcomes in kyphotic angle reduction and body height restoration.Vertebroplasty has the highest cement leakage rate and adjacent compression fracture occurrence.
基金Supported by A grant of the Korean Health Technology R and D Project,Ministry of Health and Welfare,Republic of Korea,No.HI12C0050
文摘AIM:To evaluate whether red meat intake is related to the risk of endometrial cancer(EC) using meta-analysis.METHODS:We searched Pub Med,EMBASE,and the Cochrane Library up to June 2013,using common keywords related to red meat and EC.Case-control studies and cohort studies comparing the risk of endometrial cancer among categories by the amount of intake were included.Eleven case-control studies and five cohort studies met our criteria.We performed a conventional and a dose-response meta-analysis of case-control studies using the Der Simonian-Laird method for random-effects.For cohort studies we performed a conventional meta-analysis.Publication bias was evaluated using Egger's test.RESULTS:In the meta-analysis of 11 case-control studies including 5419 cases and 12654 controls,higher red meat consumption was associated with an increased risk of EC [summary relative risk(SRR) = 1.43,95%CI:1.15-1.79;I2 = 73.3% comparing extreme intake categories).In a dose-response analysis,for red meat intake of 100 g/d,SRR was 1.84(95%CI:1.64-2.05).In contrast,in the meta-analysis of five prospective studies including a total of 2549 cases among 247746 participants,no significant association between red meat intake and EC risk(SRR = 0.97,95%CI:0.85-1.11;I2 = 4.9% comparing extreme intake categories) was observed.CONCLUSION:Our meta-analysis found a significantlinear association between red meat intake and EC risk based on case-control studies but this was not confirmed in prospective studies.
文摘Discontinuation of antipsychotic therapy has been a significant clinical issue among patients with schizophrenia, since the patients who discontinued antipsychotic treatment showed worse clinical and functional outcomes, and higher risks of relapse of schizophrenia symptoms and hospitalization. We conducted a post-hoc analysis of a post-marketing research with a 12-month follow-up period to identify the predictors for discontinuation of antipsychotic monotherapy in Japan. This is a prospective, naturalistic multicenter observational study, designed to evaluate the discontinuation rates of olanzapine monotherapy and non-olanzapine antipsychotic monotherapy in Japanese adult patients with acute schizophrenia. Patients were treatment-naive, or had switched from other antipsychotics or from poly-pharmacotherapy to oral antipsychotic monotherapy. We analyzed the correlation of discontinuation of antipsychotic monotherapy with baseline characteristics of patients. A total of 1089 patients (578 patients treated with olanzapine and 511 with non-olanzapine antipsychotics) were eligible for analysis. By the end of the 12-month study period, 614 patients (56.4%) discontinued antipsychotic therapy. Multivariate logistic regression analyses indicated significantly lower discontinuation rates in all patients treated with antipsychotics: older age (Odds ratio [OR], 0.871;95% confidence interval [CI], 0.797 to 0.953;p = 0.003), outpatient status (OR, 0.508;95% CI, 0.383 to 0.675;p < 0.001), prior use of antipsychotics (OR, 0.693;95% CI, 0.516 to 0.930;p = 0.015), and olanzapine group showed lower discontinuation rate than that of non-olanzapine group (OR, 1.416;95% CI, 1.086 to 1.846;p = 0.010). The present study indicated that the outpatient status, older age, and prior use of antipsychotics have better adherence to antipsychotic treatment. In addition to these factors, use of anti-parkinson agents showed lower discontinuation rates in the olanzapine monotherapy group.
文摘Background: 70% of all gynecological consultations are for abnormal uterine bleeding. Any approach to optimal management begins with an appropriate diagnosis. 40% of premenopausal women with abnormal uterine bleeding were found to have some intrauterine pathology. This study aims to compare the diagnostic value of transvaginal ultrasonography in comparison to hysteroscopy in detecting uterine abnormalities in patients with abnormal uterine bleeding. Methods: Retrospective observational cross sectional study of 250 women presented with abnormal uterine bleeding. The patients who fulfilled the selection criteria and have been sequentially investigated by transvaginal ultrasound (TVS) and hysteroscopy were included. Results: 90% of patients were from 35 - 49 yrs. 81.2% of patients have body mass index above 25 kg/m2. Transvaginal ultrasound (TVS) compared well with high sensitivity as regards normal endometrium. (TVS) missed 4 patients of endometrial polyps and one patient of sub mucous fibroid. Three patients of adenomyosis were only diagnosed by (TVS);they were reported as being normal by hysteroscopy. Conclusion: (TVS) is considered as an excellent approach to the initial evaluation of uterine pathologies in patients with abnormal uterine bleeding.
基金This study was supported in part by National Natural Science Foundation of China
文摘In this part, the temporal evolution and interaction across the equator of 30-50 day oscillation in the atmosphere are investigated further. The annual variation of 30-50 day oscillation is quite obvious in the mid-high latitudes. In the tropical atmosphere, the obvious interannual variation is an important property for temporal evolution of 30-50 day oscillation. The low-frequency wavetrain across the equator over the central Pacific and central Atlantic area, the movement of the long-lived low-frequency system across the equator and the meridional wind component across the equator will obviously show the interaction of 30-50 day oscillation in the atmosphere across the equator.
文摘BACKGROUND Frailty is a complex aging-related syndrome characterized by a cumulative loss of physiological reserve and increased vulnerability to adverse clinical outcomes,including falls,disability,incapacity and death.While an increasing number of studies suggest that the gut microbiota may play a key role in the pathophy-siology of frailty,direct evaluation of the association between gut microbiome alterations and frailty in older adults remains limited.AIM Seven electronic databases(China National Knowledge Infrastructure,VIP,SinoMed,Wanfang,PubMed,Web of Science and EMBASE)were searched for articles published before October 31,2023 to identify observational studies that compared the microbiomes of older adults with and without frailty.The diversity and composition of the gut microbiota were the main outcomes used to analyze the associations of changes in the gut microbiota with frailty in older adults.The quality of the included studies was assessed via the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality.RESULTS Eleven observational studies with 912 older adults were included in this review.Consistent results revealed a significant difference in the gut microbiota composition between frail and non-frail older adults,with a significant decrease inαdiversity and a significant increase inβdiversity in frail older adults.The pooled results revealed that at the phylum level,four microbiota(Actinobacteria,Proteo-bacteria,Verrucomicrobia and Synergistetes)were significantly enriched,and two microbiota(Firmicutes and Fusobacteria)were significantly depleted in frail older adults.At the family level,the results consistently revealed that the abundances of 6 families,most of which belong to the Actinobacteria or Proteo-bacteria phylum,were greater in frail than in non-frail older adults.At the genus or species level,consistent results from more than two studies revealed that the abundances of the genera Prevotella,Faecalibacterium,and Roseburia were significantly lower in frail older adults;individual studies revealed that the abundances of some genera or species(e.g.,Megamonas,Blautia,and Megasphaera)were significantly lower,whereas those of other genera or species(e.g.,Bifidobacterium,Oscillospira,Ruminococcus and Pyramidobacter)were significantly greater in frail older adults.CONCLUSION This systematic review suggests that changes in the gut microbiota are associated with frailty in older adults,which is commonly reflected by a reduction in beneficial species and an increase in pathogenic species.However,further studies are needed to confirm these findings.
文摘Identifying the causal impact of＇ some intervention challenging when one is faced with correlated binary end-points in observational studies is a challenging task, and it is even more The statistical literature on analyzing such data is well documented. Dependence between observations from the same study subject in correlated data renders invalid the usual chi-square tests of independence and inflates the variance ofparameter estimates. Disaggregated approaches such as hierarchical linear models which are able to adjust for individual level covariate：s are favoured in the analysis of such data, thereby gaining power over aggregated and individual-level analyses. In this article the authors, therefore, address the issue of analyzing correlated data with dichotomous end-points by using hierarchical logistic regression, a generalization of the standard logistic regression model for independent outcomes.
基金supported by research grants from the National Natural Science Foundation of China (30872102)the Diet Nutrition Research & Communication Grant of Danone Institute China (DIC2008‐12)
文摘Objective To investigate the relationships between erythrocyte membrane n-6：n-3 PUFAs ratio and blood lipids and high sensitivity C-reactive protein （hs-CRP）. Methods The Chinese and a observational study consisted of a population-based cross-sectiona subsequent 1-year follow-up study of 171 subjects with the fasting cholesterol of 5.13-8.00 mmol/L. study of 456 plasma total Results In the cross-sectional analysis, plasma low-density lipoprotein cholesterol （LDL-c） had a significant and negative association with the erythrocyte membrane n-6：n-3 PUFAs ratio （P for trend=0.019） after adjusting for sex, age and total PUFA percentage. In the follow-up study, 171 subjects were categorized into quartiles by the changes of n-6：n-3 ratio in erythrocyte membrane （△=month 12-month 0）. In the top quartile whose ratios of n-6：n-3 increased by an average of 1.25 during the follow-up, the LDL-c-lowering extent was 3.3 times of that in the lowest quartile whose ratios of n-6：n-3 decreased by an average of 1.13 （-1.07 mmol/L v.s. -0.32 mmol/L）. The hsCRP decreased by 0.11 mg/dL in the lowest quartile while increasing by 0.10 mg/dL in the top quartile （P for difference=0.052）. Conclusion Our results suggested that the balance between n-6 and n-3 fatty acids may optimize the cardiovascular benefits from dietary PUFAs.
文摘Recently we read the article entitled“Outcomes of different minimally invasive surgical treatments for vertebral compression fractures:An observational study”.This was an observational study that reviewed the safety and efficacy of different cement augmentation modalities for vertebral compression fractures under osteoporotic condition.Overall,this is a valuable study that can provide a reference for clinical practice.On the other hand,we also noticed some points in the article and are willing to share our views.Further studies with a higher level of evidence can add more knowledge regarding relevant concerns.
文摘Demographics, access to new treatment, altruistic motivations and continuity of care have been shown to influence motivation to participate in clinical trials. Less is known however, about factors that motivate research participants to agree to take part in observational studies and provide a biologic specimen. This study evaluates and quantitates factors that motivate participation in observational studies and provide a biospecimen among cancer patients, their family members, and controls. An online survey was completed by 450 participants from a cancer genetics registry, including cancer patients, their relatives, and controls. Overall, the benefit to society and the research institution reputation were the most important motivators for participation. Cancer cases were significantly more likely to endorse personal meaningfulness as a factor for participation compared to those without cancer and women were 50% more likely than men to believe that a family benefit is an important determinant of research participation. Researcher and institutional trustworthiness as well as security of stored data were most important when deciding whether to provide a biological sample, with differences seen by gender and history of cancer. This study demonstrated which factors are most important to participants when considering participation in an observational study and donating a biospecimen. Motivational factors significantly differed by gender as well as history and stage of cancer. The application of these study results may improve participation rates in cohort studies.
文摘Objective: To characterize the methods of design and analysis currently adopted in survey research of school-based observational studies for smoking, and to identify the common pitfalls made by researchers. Methods: The systematic review was conducted in 2009 and consisted of observational studies in school settings published between January 2005 and January 2009. Smoking status was the main outcome of interest. Following Cochrane style, five steps were followed: setting selection criteria for studies and conducting a literature search;review of abstracts;review of complete articles;data extraction and quality assessment of included studies;and, finally, synthesis of studies. Results: Of the 292 abstracts retrieved, 45 (15.4%) articles were selected for the final review. Inconsistencies were found in the definition of smoking behaviour which impeded generalisability. Individual-level factors had importance, but environmental level factors were also important in studying the aetiology of smoking. Results showed that studies inappropriately reported sample size estimation and important confounding factors. Hierarchical linear modelling, random effects modelling and structural equation modelling were employed in comparatively few studies. Conclusions: There were concerns regarding data analysis of complex surveys. Fifty five percent of reviewed studies ignored environmental effects which may have produced unreliable inferences. Multi-level analysis assisted in understanding school-level effects.
文摘Background Patients undergoing intensive care are exposed to risk factors for hearing impairment.This study assessed the worse changes in pure tone average(PTA)thresholds after intensive care and identified the factors associated with worse hearing function.Methods We conducted a single-centre retrospective study,and included adult patients admitted to the intensive care unit(ICU)of Kurashiki Central Hospital between January 2014 and September 2019,who had regular pure tone audiometry performed before and after ICU admission.Correlations between changes in PTA threshold and patient characteristics,were evaluated.The included ears were classified as those with worse hearing(>10 dB increase in the PTA threshold)and those without worse hearing,and the baseline characteristics were compared.Results During the study period,125 ears of 71 patients(male:female ratio,35:36;mean age,72.5±12.3 years)met the eligibility criteria.Age,sex,and the use of furosemide were not correlated with changes in PTA threshold.Univariate analysis showed that ears with worse hearing were associated with a lower serum platelet count than ears without worse hearing(153±85×10^(9)/L vs.206±85×10^(9)/L,respectively;P=0.010),and the rate of planned ICU admission(elective surgery)was higher in the worse hearing group(57.1% vs.28.8%,respectively;p=0.011).Conclusions Age,sex,and the use of furosemide did not have adversely affect hearing function.Low serum platelet count and planned admission appear to be risk factors for worse hearing.
