LOGIT: a program for dose-response analysis.

We describe a FORTRAN computer program for fitting the logistic distribution function: (formula: see text) Where x represents dose or time, to dose-response data. The program determines both weighted least squares and maximum likelihood estimates for the parameters alpha and beta. It also calculates the standard errors of alpha and beta under both estimation methods, as well as the median lethal dose (LD50) and its standard error. Dose--response curves found by both fitting methods can be plotted as well as the 95% confidence bands for these lines.     

Bovine Spongiform Encephalopathy (BSE) – Infectious,Contagious, Zoonotic or Production Disease?

The aim of the work was to collect, evaluate, summarize and compare heat resistance data reported for Campylobacter, Enterococcus, Escherichia, Listeria, Salmonella and Yersinia spp. The work was limited to resistance in liquids with pH values 6–8. Results obtained under similar experimental conditions were sought. Thermal destruction lines for the various bacterial groups studied were constructed using log₁₀ D values and treatment temperatures. There was a good linear relationship between log₁₀ D and temperature with Escherichia coli, listerias and salmonellas. For campylobacters, enterococci and yersinias the relationships were weaker but, nevertheless, present. Using the slopes of the lines and their 95% confidence limits, z values and their 95% confidence limits were calculated. z values were compared with z values obtained from reports. The equations for the lines were also used for calculation of predicted means of D values at various treatment temperatures. 95% confidence limits on predicted means of D values and on predicted individual D values were also calculated. Lines and values are shown in figures and tables. Differences in heat resistance noted between and within the bacterial groups studied are discussed.     

Retinal vessel diameters and obesity: a population-based study in older persons

Objective: Obesity is linked with large vessel atherosclerosis and diabetes. Its association with microvascular changes is less clear. We investigated the associations among retinal vessel diameters, vessel wall signs, and BMI in an older population. Research Methods and Procedures: Retinal photographs were taken on 3654 persons aged 49+ years at baseline of the Blue Mountains Eye Study in Australia. Arteriolar and venular diameters were measured from digitized retinal photographs of the right eyes. BMI was calculated as weight (kilograms)/height (meters²). Incident obesity was defined in persons with BMI ≤ 30 at baseline but >30 after 5 years. A significant weight gain was defined as an increase in BMI of 2+ SDs (4 or more units) over the 5‐year period. Results: At baseline, mean BMI was 26.1 (±4.6) in this population. At 5‐year examinations, 177 (10.0% of 1773 at risk) developed incident obesity, and 136 (6.4% of 2143 at risk) had significant weight gain. After adjusting for age, sex, smoking, triglyceride levels, and mean arterial blood pressure, persons with wider retinal venular diameters had a higher risk of incident obesity (odds ratio, 1.8; 95% confidence interval, 1.0 to 3.1, comparing the highest with lowest venular diameter quintiles) and significant weight gain (odds ratio, 1.7; 95% confidence interval, 0.9 to 3.2). These associations were attenuated with further adjustment for baseline BMI. Arteriolar diameter was unrelated with baseline or change in BMI. Discussion: Wider retinal venular diameter is associated with risk of obesity, independent of hypertension, diabetes, lipids, and cigarette smoking. These data may support a role for impaired microvascular function in the course of weight gain.     

Confidence Intervals in Qtl Mapping by Bootstrapping

The determination of empirical confidence intervals for the location of quantitative trait loci (QTLs) was investigated using simulation. Empirical confidence intervals were calculated using a bootstrap resampling method for a backcross population derived from inbred lines. Sample sizes were either 200 or 500 individuals, and the QTL explained 1, 5, or 10% of the phenotypic variance. The method worked well in that the proportion of empirical confidence intervals that contained the simulated QTL was close to expectation. In general, the confidence intervals were slightly conservatively biased. Correlations between the test statistic and the width of the confidence interval were strongly negative, so that the stronger the evidence for a QTL segregating, the smaller the empirical confidence interval for its location. The size of the average confidence interval depended heavily on the population size and the effect of the QTL. Marker spacing had only a small effect on the average empirical confidence interval. The LOD drop-off method to calculate empirical support intervals gave confidence intervals that generally were too small, in particular if confidence intervals were calculated only for samples above a certain significance threshold. The bootstrap method is easy to implement and is useful in the analysis of experimental data.     

Magnetic fields of high voltage power lines and risk of cancer in Finnish adults: nationwide cohort study.

OBJECTIVE: To investigate the risk of cancer in association with magnetic fields in Finnish adults living close to high voltage power lines. DESIGN: Nationwide cohort study. SUBJECTS: 383,700 people who lived during 1970-89 within 500 metres of overhead power lines of 110-400 kV in a magnetic field calculated to be > or = 0.01 microT. Study subjects were identified by record linkages of nationwide registers. MAIN OUTCOME MEASURES: Numbers of observed and expected cases of cancer, standardised incidence ratios, and incidence rate ratios adjusted for sex, age, calendar year, and social class--for example, by continuous cumulative exposure per 1 microT year with 95% confidence intervals from multiplicative models for all cancers combined and 21 selected types. RESULTS: Altogether 8415 cases of cancer were observed (standardised incidence ratio 0.98; 95% confidence interval 0.96 to 1.00) in adults. All incidence rate ratios for both sexes combined were non-significant and between 0.91 and 1.11. Significant excesses were observed in multiple myeloma in men (incidence rate ratio 1.22) and in colon cancer in women (1.16). CONCLUSIONS: Typical residential magnetic fields generated by high voltage power lines do not seem to be related to the risk of overall cancer in adults. The previously suggested associations between extremely low frequency magnetic fields and tumours of the nervous system, lymphoma, and leukaemia in adults and breast cancer in women were not confirmed.     

Evaluation of the iPhone with an acrylic sleeve versus the Scoliometer for rib hump measurement in scoliosis

ABSTRACT: BACKGROUND: Vertebral rotation found in structural scoliosis contributes to trunkal asymmetry which is commonly measured with a simple Scoliometer device on a patient's thorax in the forward flexed position. The new generation of mobile 'smartphones' have an integrated accelerometer, making accurate angle measurement possible, which provides a potentially useful clinical tool for assessing rib hump deformity. This study aimed to compare rib hump angle measurements performed using a Smartphone and traditional Scoliometer on a set of plaster torsos representing the range of torsional deformities seen in clinical practice. METHODS: Nine observers measured the rib hump found on eight plaster torsos moulded from scoliosis patients with both a Scoliometer and an Apple iPhone on separate occasions. Each observer repeated the measurements at least a week after the original measurements, and were blinded to previous results. Intra-observer reliability and inter-observer reliability were analysed using the method of Bland and Altman and 95% confidence intervals were calculated. The Intra-Class Correlation Coefficients (ICC) were calculated for repeated measurements of each of the eight plaster torso moulds by the nine observers. RESULTS: Mean absolute difference between pairs of iPhone/Scoliometer measurements was 2.1 degrees, with a small (1 degrees) bias toward higher rib hump angles with the iPhone. 95% confidence intervals for intra-observer variability were +/- 1.8 degrees (Scoliometer) and +/- 3.2 degrees (iPhone). 95% confidence intervals for inter-observer variability were +/- 4.9 degrees (iPhone) and +/- 3.8 degrees (Scoliometer). The measurement errors and confidence intervals found were similar to or better than the range of previously published thoracic rib hump measurement studies. CONCLUSIONS: The iPhone is a clinically equivalent rib hump measurement tool to the Scoliometer in spinal deformity patients. The novel use of plaster torsos as rib hump models avoids the variables of patient fatigue and discomfort, inconsistent positioning and deformity progression using human subjects in a single or multiple measurement sessions.     

Hirschsprung's disease prevalence in Europe: A register based study

Background: Hirschsprung's disease is a congenital gut motility disorder, characterised by the absence of the enteric ganglion cells along the distal gut. The aim of this study was to describe the epidemiology of Hirschsprung's disease, including additional congenital anomalies, total prevalence, trends, and association with maternal age. Methods: Cases of Hirschsprung's disease delivered during 1980 to 2009 notified to 31 European Surveillance of Congenital Anomaly registers formed the population‐based case‐series. Prevalence rates and 95% confidence intervals were calculated as the number of cases per 10,000 births. Multilevel Poisson regression was performed to investigate trends in prevalence, geographical variation and the association with maternal age. Results: There were 1,322 cases of Hirschsprung's disease among 12,146,210 births. The total prevalence was 1.09 (95% confidence interval, 1.03–1.15) per 10,000 births and there was a small but significant increase in prevalence over time (relative risk = 1.01; 95% credible interval, 1.00–1.02; p = 0.004). There was evidence of geographical heterogeneity in prevalence (p < 0.001). Excluding 146 (11.0%) cases with chromosomal anomalies or genetic syndromes, there were 1,176 cases (prevalence = 0.97; 95% confidence interval, 0.91–1.03 per 10,000 births), of which 137 (11.6%) had major structural anomalies. There was no evidence of a significant increased risk of Hirschsprung's disease in cases born to women aged ≥35 years compared with those aged 25 to 29 (relative risk = 1.09; 95% credible interval, 0.91–1.31; p = 0.355). Conclusion: This large population‐based study found evidence of a small increasing trend in Hirschsprung's disease and differences in prevalence by geographic location. There was also no evidence of an association with maternal age. Birth Defects Research (Part A), 100:695–702, 2014. © 2014 Wiley Periodicals, Inc.     

Genetic polymorphism of heme oxygenase 1 promoter in the occurrence and severity of chronic obstructive pulmonary disease: a meta‐analysis

Heme oxygenase 1 (HMOX1) plays an important role in the development of chronic obstructive pulmonary disease (COPD). However, the association of HMOX1 length polymorphism in promoter region to the risk and severity of COPD has not been well studied. In this study, we searched the databases including PubMed, EMBASE, Cochrane Library and China National Knowledge Infrastructure (CNKI) and extracted the information from related articles. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to study the effect of HMOX1 polymorphism on the risk and severity of COPD. As a result, nine studies were included for this meta‐analysis. Higher frequencies of L allele and type I genotype (containing at least one L allele) were found in patients with COPD (for L allele, OR 2.02, 95% CI: 1.32–3.11, P = 0.001; for type I genotype, OR 1.82, 95% CI: 1.28–2.61, P = 0.001), especially in Asian population (for L allele, OR 2.23, 95% CI: 1.68–2.95, P < 0.001; for type I genotype, OR 2.02, 95% CI: 1.51–2.70, P < 0.001). Genotyping method, source of control subjects, literature quality and language also affected the results to some extent. However, there was little difference in HMOX1 genotypes distribution in patients with COPD with different severity. Our study indicated L allele and type I genotype were related to the susceptibility but not the severity of COPD.     

Habitat loss and possible effects on local species richness in a species-poor system: a case study of southern Baltic Sea macrofauna

The effects of habitat loss on local species richness depend on the characteristics of the endangered system (including its total species pool and the distribution of species among the habitats). The present study focuses on the species-poor southern Baltic marine benthic biota. Macrobenthic samples were collected in three habitats: (1) soft bottom covered with vegetation; (2) stony reefs; (3) unvegetated sands. Fourty one percent of 54 observed macrozoobenthic species were habitat specific, while 30% occurred in all three habitats. There were no significant differences in total species richness among the three habitats. The accumulation curves plotted for subsets of data with selected habitats excluded lay below the curve plotted for the whole dataset, but only in one case the 95% confidence intervals of the subset curve did not overlap with those plotted for the whole dataset. The exclusion of samples from selected habitats produced a species richness drop ranging from 9 to 13%. The present study showed that habitat loss in a species-poor area with a relatively large ratio of generalist species cannot produce local species richness declines similar to those predicted for diverse marine systems. However, it must be emphasized that in species-poor systems, the loss of ecological function accompanying habitat loss could be disproportionally higher than that predicted based on decreases in species richness, as some functions are performed by a single species.     

RFLP studies of genetic relationships among inbred lines of the cultivated sunflower,Helianthus annuus L.: evidence for distinct restorer and maintainer germplasm pools

One-hundred-and-eighty-one nuclear DNA probes were used to examine restriction-fragment length polymorphism in inbred lines of the cultivated sunflower (Helianthus annuus L.). The probes were from six libraries: two genomic libraries — one made with PstI and the other with HindIII, and four cDNA libraries — from etiolated plantlets, green leaves, ovaries, petals and anthers. Total DNA from 17 inbred lines representing an overview of the genetic stocks of sunflower, including restorer and maintainer lines of the classical cytoplasmic male sterility, was digested with four different restriction enzymes and probed in 331 probe-enzyme combinations. Of 181 clones analysed, 73 probes were found to be polymorphic. Genetic distances between inbreds were calculated from the resultant proportion of shared bands and submitted to principal component analysis and the UPGMA tree-making method. The RFLP analysis allowed a clear differentiation between restorer and maintainer lines of the cytoplasmic male sterility, together with a grouping of some of the genotypes from the same origin. The analysis of the accuracy of distance estimation as a function of the number of probe-enzyme combinations used, indicates that 40–50 combinations ensure a confidence level of near 95%. Considering the inbreds as representatives of the range of cultivated inbreds, estimates of gene diversity, as well as estimates of average gene diversity between and within the sets of restorer and maintainer lines, were calculated. Estimation of gene diversity showed that the available genetic variability in cultivated sunflower, based on allelic frequencies, is lower than that of other plants (H=0.20). Moreover, we show that the proportion of genetic variability due to the difference between maintainer and restorer lines (D_m) is about 2%.     

Anthelmintic efficacy on UK Thoroughbred stud farms

Anthelmintic drugs have been applied indiscriminately to control horse nematodes for over 40 years. We undertook a comprehensive study to investigate efficacy of the four available broad-spectrum anthelmintic drugs on 16 Thoroughbred stud farms using the faecal egg count reduction test. Efficacy against strongyles was determined by calculating the percentage of reduction in faecal egg count between the group mean at Day 0 and Days 14–17 post-treatment and the 95% lower confidence intervals estimated by non-parametric bootstrapping. Individual strongyle faecal egg count reduction tests (n = 429) were performed in which 179, 131, 89 and 30 horses were administered ivermectin, moxidectin, pyrantel and fenbendazole, respectively. Moxidectin was efficacious in all tests (faecal egg count reduction range: 99.8–100%; 95% lower confidence intervals range: 96.8–100%) and reduced efficacy of ivermectin (faecal egg count reduction range: 85.7–100%; 95% lower confidence intervals range: 65–100%) was observed in one group of yearlings. Reduced pyrantel efficacy was observed in five groups of yearlings (faecal egg count reduction range: 0–73%; 95% lower confidence intervals range: 0–59.5%), but pyrantel was found to be efficacious when administered to mares (faecal egg count reduction range: 98–99.4%; 95% lower confidence intervals range: 91.8–99.3%). Low efficacy of fenbendazole was always observed (faecal egg count reduction range: 0.4–41%; 95% lower confidence intervals not calculable). Two further methods for estimating efficacy were applied and outputs obtained using all methodologies were in agreement. Efficacy against Parascaris equorum was assessed on four farms: fenbendazole had acceptable efficacy (faecal egg count reduction range: 97.5–99.9%; 95% lower confidence intervals range: 96.3–99.1%), but reduced efficacy of ivermectin was observed (faecal egg count reduction range: 25.5–91.2%; 95% lower confidence intervals range: 6.7–82.4%). Strongyle faecal egg count were analysed at approximately 2 week intervals for up to 12 weeks after anthelmintic drug administration to determine the egg reappearance period for moxidectin, ivermectin and pyrantel. The egg reappearance period for all three anthelmintic drugs was shorter than previously observed. Overall, our results indicate that ivermectin and moxidectin administration provided acceptable efficacy at 14 days; however, egg reappearance period results suggest that these products are working less effectively than measured previously. As shortened egg reappearance period is believed to be an early indicator of resistance, this highlights the issue of impending multi-drug resistance in strongyles on stud farms.     

Length-weight relationships of 11 fish species from the Min River Estuary and its adjacent waters,Fujian Province,China

Length-weight relationships (LWRs) were estimated for 11 fish species from the Min River Estuary and its adjacent waters, Fujian Province, China. All samples were collected using gillnets (mesh size 45 mm) and bottom trawls (mesh sizes 45 mm at the main webbing and 25 mm at the cod end) seasonally in 2017 and 2018. The parameters for the LWRs were estimated, along with the basic Statistical analyses for total length and weight ranges as well as the 95% confidence intervals for the intercept (a) and the slope (b) of the regression lines. Further, the coefficient of correlation indicated that the LWRs were highly significant (all r² > .95, p < .001). This study provides the new maximum total lengths (TL_max) for Coilia grayii (33.0 cm), Johnius taiwanensis (20.9 cm), Johnius trewavasae (22.0 cm) and Cynoglossus sibogae (22.0 cm).     

Marked increase in breast cancer incidence in young women: A 10-year study from Northern Iran, 2004–2013

IntroductionBreast cancer is the most frequent cancer among women worldwide. Breast cancer incidence in young women is a health issue of concern, especially in middle-income countries such as Iran. The aim of this study is to report the breast cancer incidence variations in Golestan province, Iran, over a 10-year period (2004–2013).MethodsWe analyzed data from the Golestan Population-based Cancer Registry (GPCR), which is a high-quality cancer registry collecting data on primary cancers based on standard protocols throughout the Golestan province. Age-standardized incidence rates (ASRs) and age-specific incidence rates per 100,000 person-years were calculated. Time trends in ASRs and age-specific rates were evaluated using Joinpoint regressions. The average annual percentage change (AAPC) with correspondence 95% confidence intervals (95%CIs) were calculated.ResultsA total of 2106 new breast cancer cases were diagnosed during the study period. Most cases occurred in women living in urban areas: 1449 cases (68%) versus 657 cases (31%) in rural areas. Statistically significant increasing trends were observed over the 10-year study period amongst women of all ages (AAPC = 4.4; 95%CI: 1.2–7.8) as well as amongst women in the age groups 20–29 years (AAPC = 10.0; 95%CI: 1.7–19.0) and 30–39 years (AAPC = 5.1; 95%CI: 1.4–9.0).ConclusionThe incidence of breast cancer increased between 2004 and 2013 in Golestan province amongst all age groups, and in particular amongst women aged 20–39 years. Breast cancer should be considered a high priority for health policy making in our community.     

Comparing a bioenergetics model with feeding rates of caged European starlings

We tested a bioenergetics model integrated within a mortality model that estimates numbers of European starlings (Sturnus vulgaris) poisoned with the avicide, Compound DRC-1339 Concentrate. The bioenergetics model predicted daily metabolic rate. Accuracy and reliability of this variable is critical because other algorithms (e.g., toxicity regressions, feeding behavior) in the mortality model depend on metabolic rate to calculate the amount of DRC-1339 ingested per bird. We tested the bioenergetics model by comparing its estimates of metabolic rate with those generated from measuring feeding rates of caged starlings during a feeding trial conducted outdoors during January 2008. Over the 12-day feeding trial, daily feeding rates of caged starlings indicated that metabolic rates ranged from 157 kJ/bird per day to 305 kJ/bird per day. The bioenergetics model predicted metabolic rates ranging from 208 kJ/bird per day to 274 kJ/bird per day. There was no difference between these 2 independently derived estimates of daily metabolic rate (paired t-test: t₍₁₁₎ = 1.4, P = 0.18). Using 95% confidence intervals calculated from variation of feeding rates among cages (n = 4, 6 birds/cage), the bioenergetics model's estimates were within 95% confidence intervals on 9 of 12 days and greater than the upper 95% confidence interval on 3 days. Daily estimates of metabolic rate were directly correlated between the bioenergetics model and the feeding-rate model (r₁₂ = 0.57, P = 0.05). A broad range of temperatures (−17°C to 14°C), wind speeds (0–40 km/hr), and percent cloud cover (0–100%) were encountered during the feeding trial. The bioenergetics model's predictions appeared robust to varying meteorological conditions typical of winters in middle latitudes of the interior United States. Compound DRC-1339 Concentrate is used by USDA Wildlife Services to manage chronic infestations of starlings at livestock facilities, which occur mainly during fall and winter. Compared to other methods used for estimating DRC-1339 mortality (e.g., counting birds pre- and posttreatment), bioenergetics modeling should improve the mortality model's overall accuracy and precision. © The Wildlife Society, 2011     

Accuracy of Monoclonal Stool Tests for Determining Cure of Helicobacter pylori Infection After Treatment

Background: Studies comparing new monoclonal fecal tests for evaluating cure of Helicobacter pylori infection after treatment are scarce. The objective was to compare the diagnostic accuracy of three monoclonal stool tests: two rapid in‐office tools –RAPID Hp StAR and ImmunoCard STAT! HpSA – and an EIA test – Amplified IDEIA Hp StAR. Materials and methods: Diagnostic reliability of the three tests was evaluated in 88 patients at least 8 weeks after H. pylori treatment. Readings of immunochromatographic tests were performed by two different observers. Sensitivity, specificity, positive and negative predictive values and 95% confidence intervals were calculated. Results: All tests presented similar performance for post‐eradication testing. Sensitivity for detecting persistent infection was 100% for both Amplified IDEIA and RAPID Hp StAR and 90% for ImmunoCard STAT! HpSA. Respective specificities were 94.9%, 92.3–93.6% and 94.9%. Negative predictive values were very high (100%, 100% and 98.7% respectively). But positive predictive values were lower, ranging from 62.5 to 71.4%. Conclusion: All monoclonal fecal tests in this series presented similar performance in the post‐treatment setting. A negative test after treatment adequately predicted cure of the infection. However, nearly a third of tests were false positive, showing a poor predictive yield for persistent infection.     

A fluorescent PCR assay for the codominant interpretation of a dominant SCAR marker linked to the virus resistance allele bc-1 2 in common bean

Our objective was to develop a rapid and accurate procedure to genotype common bean plants for the bc-1 ² allele, which conditions resistance to bean common mosaic and bean common mosaic necrosis viruses. A segregating F₂ population was derived from the cross between pinto bean breeding lines P94207-43 (bc-1 ²//bc-1 ²) and P94207-189 (bc-1//bc-1). A quantitative PCR assay based on the detection of fluorescent labeled amplicons was developed to distinguish between homozygous (bc-1 ²//bc-1 ²), heterozygous (bc-1 ²//bc-1) and null (bc-1//bc-1) F₂ genotypes. Remnant F₁ plants were used as a comparative reference sample. PCR results among this sample fit a normal distribution, and 99% and 95% confidence intervals for heterozygotes were determined. F₂ plants for which no amplification was detected were classified as null (bc-1//bc-1) genotypes. F₂ plants that fell within the confidence intervals for heterozygotes were classified as heterozygotes (bc-1 ²//bc-1), while plants that fell outside the right tail of the heterozygote confidence intervals were classified as homozygotes (bc-1 ²//bc-1 ²). F₂ plants were also genotyped for the bc-1 ² allele by performing F₃ family progeny tests for virus resistance. Agreement between the two methods for genotyping plants was 100% (59/59) when PCR genotyping was based on a 99% heterozygote confidence interval, and 98.3% (58/59) when based on a 95% heterozygote confidence interval. This assay will accelerate breeding for virus resistance in bean by facilitating discrimination among plants that are heterozygous or homozygous for the bc-1 ² allele. The experimental design may be generally applicable towards developing other assays for the codominant interpretation of dominant markers in diploid plants.     

Cytochrome P450 1A1 gene polymorphisms and digestive tract cancer susceptibility: a meta‐analysis

Cytochrome P450 1A1 (CYP1A1) is a phase I enzyme that regulates the metabolism of environmental carcinogens and alter the susceptibility to various cancers. Many studies have investigated the association between the CYP1A1 MspI and Ile462Val polymorphisms and digestive tract cancer (DTC) risk in different groups of populations, but their results were inconsistent. The PubMed and Embase Database were searched for case–control studies published up to 30th September, 2015. Data were extracted and pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the relationship. Totally, 39 case–control studies (9094 cases and 12,487 controls) were included. The G allele in Ile/Val polymorphism was significantly associated with elevated DTC risk with per‐allele OR of 1.24 (95% CI = 1.09–1.41, P = 0.001). Similar results were also detected under the other genetic models. Evidence was only found to support an association between MspI polymorphism and DTC in the subgroups of caucasian and mixed individuals, but not in the whole population (the dominant model: OR = 1.19, 95% CI = 0.94–1.91, P = 0.146). In conclusion, our results suggest that the CYP1A1 polymorphisms are potential risk factors for DTC. And large sample size and well‐designed studies with detailed clinical information are needed to more precisely evaluate our founding.     

Recognition of Childhood Overweight during Health Supervision Visits: Does BMI Help Pediatricians?

Objective: To assess, in diverse pediatric practices, the frequency of overweight/obesity (OW/OB) identification during health supervision visits and its association with BMI curve use. Research Methods and Procedures: Pediatricians in public and private practice in St. Louis, MO, participated in a study of the care of chronic conditions during health supervision visits. Requested information from 30 visits per pediatrician of children 6 to 17 years of age included the visit note, the growth chart, and a one‐page questionnaire about patient demographics and visit content. Pediatricians indicated the presence and discussion of common chronic conditions, including OW/OB. Identification was compared with patient BMI category, and associations between identification and patient and visit characteristics, including BMI curve use, were examined. Results: Twenty‐one (40%) of contacted pediatricians returned information from 557 visits. Pediatricians identified OW/OB in 27% of children with a BMI at the 85th to 94th percentile and 86% of children with a BMI at or above the 95th percentile. Identification was higher in adolescents but was not associated with patient sex or race, practice setting, insurance type, or visit length. Only 41% of growth charts were current, and 6.1% had BMI plotted. BMI plotting was associated with OW/OB identification when the BMI was at the 85th to 94th percentile but not when the BMI was at or above the 95th percentile. After controlling for BMI percentile, OW/OB identification was significantly associated with diet counseling (odds ratio, 7.46; 95% confidence interval, 3.42 to 16.24) and exercise counseling (odds ratio, 5.57; 95% confidence interval, 2.61 to 11.90). Discussion: Despite low BMI curve use, pediatricians recognized most overweight/obese children with a BMI at or above the 95th percentile. BMI plotting may increase recognition in mildly overweight children.     

Prognostic value of pre-treatment red blood cell distribution width in lung cancer: a meta-analysis

Abstract

Objective: In recent years, increasing studies found that pre-treatment red blood cell distribution width (RDW) could predict clinical outcomes in various cancers. However, the prognostic value of pre-treatment RDW in lung cancer was inconsistent. Therefore, we performed a meta-analysis to determine prognostic value of pre-treatment RDW in lung cancer.

Methods: We performed a search in PubMed, The Cochrane Library, EMBASE (via OVID), Web of Science, CNKI, Wanfang, VIP, SinoMed databases, then we identified all records up to February 15, 2019. Outcomes of interest were overall survival (OS) and disease-free survival (DFS). Hazard ratios (HRs) and corresponding 95% confidence intervals (95% CIs) were calculated to assess the relevance of pre-treatment RDW to OS in lung cancer.

Results: We included ten articles in total. Pooled results revealed that elevated pre-treatment RDW was significantly associated with poor OS (HR?=?1.55, 95% CI: 1.26–1.92, p?<?0.001) and DFS (HR?=?1.53, 95% Cl: 1.15–2.05; p?=?0.004) in lung cancer. Further subgroup analysis manifested that lung cancer patients with elevated pre-treatment RDW had worse prognosis.

Conclusions: A higher value of pre-treatment RDW indicated worse survival of patients with lung cancer. RDW may serve as a reliable and economical marker for prediction of lung cancer prognosis.     

LTBP-2 acts as a novel marker in human heart failure – a preliminary study

Background: We have observed increased expression of latent TGF-β binding protein (LTBP)-2 mRNA in human failing hearts. This study was aimed to further confirm LTBP-2 act as a novel marker in human acute heart failure.

Methods and results: We demonstrated that median level of LTBP-2 in myocardial samples from heart failure patients was significantly elevated, and TGF-β1 significantly promoted LTBP-2 expression in neonatal rat cardiomyocytes. To investigate the potential of LTBP-2 as a biomarker to diagnose heart failure with reduced ejection fraction (HFREF), another cohort of 133 consecutive patients with dyspnea were enrolled. In receiver operating characteristic (ROC) curve analyses to detect HFREF, LTBP-2 achieved an area under curve (AUC) of 0.67 (95% confidence intervals (CI) 0.58–0.75), comparable to the diagnostic ability of NT-proBNP 0.68 (95% CI 0.59–0.77).

Conclusion: The serum LTBP-2 levels might act as a promising biomarker in HFREF.