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Rural and Remote Health Jun 2024Physical activity and lifestyle programs are scarce for people with hereditary ataxias and neurodegenerative diseases. Aboriginal families in the Top End of Australia...
INTRODUCTION
Physical activity and lifestyle programs are scarce for people with hereditary ataxias and neurodegenerative diseases. Aboriginal families in the Top End of Australia who have lived with Machado-Joseph disease (MJD) for generations co-designed a physical activity and lifestyle program called the Staying Strong Toolbox. The aim of the present study was to explore feasibility and impact of the program on walking and moving around.
METHODS
A mixed-methods, multiple case study design was used to pilot the Staying Strong Toolbox. Eight individuals with MJD participated in the program for 4 weeks. Participants tailored their own program using the Toolbox workbook. Families, support workers and researchers facilitated each individual's program. Feasibility was determined through program participation, adherence, coinciding or serious adverse events, participant acceptability and cost. Impact was determined through measures of mobility, ataxia, steps, quality of life, wellbeing and goal attainment, assessed before and after the program.
RESULTS
All participants completed the program, averaging five activity sessions per week, 66 minutes per session, of walking (63.5%), strengthening/balance-based activities (16%), cycling (11.4%) and activities of daily living, cultural and lifestyle activities (10.5%). Seven participants were assessed on all measures on three occasions (baseline, pre-program and post-program), while one participant could not complete post-program measures due to ceremonial responsibilities. All had significant improvements in mobility, steps taken and ataxia severity (p<0.05) after the program. Quality of life and wellbeing were maintained.
CONCLUSION
The program helped participants remain 'strong on the inside and outside'. Participants recommended implementation in 4-week blocks and for the program to be shared internationally. The Staying Strong Toolbox program was feasible for families with MJD. The program had a positive impact on walking and moving around, with participants feeling stronger on the outside (physically) and inside (emotionally, spiritually, psychosocially). The program could be adapted for use by other families with MJD.
Topics: Humans; Machado-Joseph Disease; Male; Female; Native Hawaiian or Other Pacific Islander; Adult; Exercise; Australia; Middle Aged; Life Style; Feasibility Studies; Quality of Life; Walking; Activities of Daily Living
PubMed: 38909987
DOI: 10.22605/RRH8376 -
BMC Pregnancy and Childbirth Jun 2024Differential exposure to chronic stressors by race/ethnicity may help explain Black-White inequalities in rates of preterm birth. However, researchers have not...
BACKGROUND
Differential exposure to chronic stressors by race/ethnicity may help explain Black-White inequalities in rates of preterm birth. However, researchers have not investigated the cumulative, interactive, and population-specific nature of chronic stressor exposures and their possible nonlinear associations with preterm birth. Models capable of computing such high-dimensional associations that could differ by race/ethnicity are needed. We developed machine learning models of chronic stressors to both predict preterm birth more accurately and identify chronic stressors and other risk factors driving preterm birth risk among non-Hispanic Black and non-Hispanic White pregnant women.
METHODS
Multivariate Adaptive Regression Splines (MARS) models were developed for preterm birth prediction for non-Hispanic Black, non-Hispanic White, and combined study samples derived from the CDC's Pregnancy Risk Assessment Monitoring System data (2012-2017). For each sample population, MARS models were trained and tested using 5-fold cross-validation. For each population, the Area Under the ROC Curve (AUC) was used to evaluate model performance, and variable importance for preterm birth prediction was computed.
RESULTS
Among 81,892 non-Hispanic Black and 277,963 non-Hispanic White live births (weighted sample), the best-performing MARS models showed high accuracy (AUC: 0.754-0.765) and similar-or-better performance for race/ethnicity-specific models compared to the combined model. The number of prenatal care visits, premature rupture of membrane, and medical conditions were more important than other variables in predicting preterm birth across the populations. Chronic stressors (e.g., low maternal education and intimate partner violence) and their correlates predicted preterm birth only for non-Hispanic Black women.
CONCLUSIONS
Our study findings reinforce that such mid or upstream determinants of health as chronic stressors should be targeted to reduce excess preterm birth risk among non-Hispanic Black women and ultimately narrow the persistent Black-White gap in preterm birth in the U.S.
Topics: Humans; Female; Premature Birth; Pregnancy; Machine Learning; White People; Black or African American; Stress, Psychological; Adult; Risk Factors; United States; Young Adult; Risk Assessment
PubMed: 38909177
DOI: 10.1186/s12884-024-06613-w -
BMJ Open Jun 2024In trials, subgroup analyses are used to examine whether treatment effects differ by important patient characteristics. However, which subgroups are most commonly... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
In trials, subgroup analyses are used to examine whether treatment effects differ by important patient characteristics. However, which subgroups are most commonly reported has not been comprehensively described.
DESIGN AND SETTINGS
Using a set of trials identified from the US clinical trials register (ClinicalTrials.gov), we describe every reported subgroup for a range of conditions and drug classes.
METHODS
We obtained trial characteristics from ClinicalTrials.gov via the Aggregate Analysis of ClinicalTrials.gov database. We subsequently obtained all corresponding PubMed-indexed papers and screened these for subgroup reporting. Tables and text for reported subgroups were extracted and standardised using Medical Subject Headings and WHO Anatomical Therapeutic Chemical codes. Via logistic and Poisson regression models we identified independent predictors of result reporting (any vs none) and subgroup reporting (any vs none and counts). We then summarised subgroup reporting by index condition and presented all subgroups for all trials via a web-based interactive heatmap (https://ihwph-hehta.shinyapps.io/subgroup_reporting_app/).
RESULTS
Among 2235 eligible trials, 23% (524 trials) reported subgroups. Follow-up time (OR, 95%CI: 1.13, 1.04-1.24), enrolment (per 10-fold increment, 3.48, 2.25-5.47), trial starting year (1.07, 1.03-1.11) and specific index conditions (eg, hypercholesterolaemia, hypertension, taking asthma as the reference, OR ranged from 0.15 to 10.44), predicted reporting, sponsoring source and number of arms did not. Results were similar on modelling any result reporting (except number of arms, 1.42, 1.15-1.74) and the total number of subgroups. Age (51%), gender (45%), racial group (28%) were the most frequently reported subgroups. Characteristics related to the index condition (severity/duration/types etc) were frequently reported (eg, 69% of myocardial infarction trials reported on its severity/duration/types). However, reporting on comorbidity/frailty (five trials) and mental health (four trials) was rare.
CONCLUSION
Other than age, sex, race ethnicity or geographic location and characteristics related to the index condition, information on variation in treatment effects is sparse.
PROSPERO REGISTRATION NUMBER
CRD42018048202.
Topics: Humans; Chronic Disease; Clinical Trials as Topic; Epidemiologic Studies; Research Design
PubMed: 38908852
DOI: 10.1136/bmjopen-2023-081315 -
BMJ Open Jun 2024Globally, transgender ('trans') women experience extreme social and economic marginalisation due to intersectional stigma, defined as the confluence of stigma that...
Reducing intersectional stigma among transgender women in Brazil to promote uptake of HIV testing and PrEP: study protocol for a randomised controlled trial of Manas por Manas.
INTRODUCTION
Globally, transgender ('trans') women experience extreme social and economic marginalisation due to intersectional stigma, defined as the confluence of stigma that results from the intersection of social identities and positions among those who are oppressed multiple times. Among trans women, gender-based stigma intersects with social positions such as engagement in sex work and substance use, as well as race-based stigma to generate a social context of vulnerability and increased risk of HIV acquisition. In Brazil, trans women are the 'most at-risk' group for HIV, with 55 times higher estimated odds of HIV infection than the general population; further, uptake of HIV testing and pre-exposure prophylaxis (PrEP) among trans women is significantly lower than other at-risk groups. Through extensive formative work, we developed Manas por Manas, a multilevel intervention using HIV prevention strategies with demonstrated feasibility and acceptability by trans women in Brazil, to address intersectional stigma and increase engagement in the HIV prevention continuum.
METHODS AND ANALYSIS
We are conducting a two-arm randomised wait-list controlled trial of the intervention's efficacy in São Paulo, Brazil, to improve uptake of HIV testing and PrEP among transgender women (N=400). The primary outcomes are changes in HIV testing (self-testing and clinic based), changes in PrEP uptake and changes in PrEP persistence at baseline and follow-up assessment for 12 months at 3-month intervals.
ETHICS AND DISSEMINATION
This study was approved by University of California, San Francisco Institutional Review Board (15-17910) and Comissão Nacional de Ética em Pesquisa (Research Ethics National Commission, CAAE: 25215219.8.0000.5479) in Brazil. Participants provided informed consent before enrolment. We are committed to collaboration with National Institutes of Health officials, other researchers, and health and social services communities for rapid dissemination of data and sharing of materials. The results will be published in peer-reviewed academic journals and scientific presentations.
TRIAL REGISTRATION NUMBER
NCT03081559.
Topics: Humans; Transgender Persons; Brazil; Female; HIV Infections; Pre-Exposure Prophylaxis; Social Stigma; Male; Adult; HIV Testing; Randomized Controlled Trials as Topic; Young Adult; Adolescent; Patient Acceptance of Health Care
PubMed: 38908840
DOI: 10.1136/bmjopen-2023-076878 -
Plant Disease Jun 2024In 2023, an outbreak of bacterial canker disease (BCD) in sweet cherry orchards caused significant economic losses to growers and nurseries in the Pacific Northwest, USA...
In 2023, an outbreak of bacterial canker disease (BCD) in sweet cherry orchards caused significant economic losses to growers and nurseries in the Pacific Northwest, USA (Fig. S1). The cherry industry in Washington State alone is valued at over $800 million (USDA NASS, 2022). BCD poses a recurring threat to the state's sweet cherry [Prunus avium (L.) L.] orchards, especially young and newly planted orchards. Three Pseudomonas species, including P. syringae pv. syringae (Pss), P. amygdali pv. morsprunorum (Pam) (formerly P. syringae pv. morsprunorum Race 1, Psm1), and P. avellanae pv. morsprunorum (formerly P. syringae pv. morsprunorum Race 2, Psm2), have been reported to be associated with BCD in sweet cherries (Hulin et al. 2019). While Pss is widely prevalent in the United States, Pam has only been reported in Michigan (Renick et al., 2008) as well as in Europe, Central America, South Africa and Australia (Hulin et al. 2019) . In 2023, we surveyed more than 60 cherry orchards and collected hundreds of canker samples from newly planted up to 8-year-old trees. BCD prevalence ranged from 40-100% in cherry orchards, leading to the removal of hundreds of thousands of trees. Affected cherry trees exhibited characteristic bacterial canker symptoms, including dead bud, canker, and gummosis (Fig. S1). Bacteria were isolated from canker tissues or ooze on King's B (KB) agar plates (King et al., 1954) and more than 300 fluorescent Pseudomonas isolates were obtained from 12 symptomatic sweet cherry cultivars. PCR results using Pss- and Pam- specific primers (SyrB and Psm1, Table S1) (Sorensen et al., 1998; Kałużna et al., 2016) revealed that 91.9% and 8% isolates were tested positive for SyrB and Psm1, indicating that these isolates potentially belong to Pss and Pam, respectively. Pathogenicity tests using immature cherries cv. Sentina showed that all isolates caused typical necrotic lesions and could be re-isolated and re-identified as Pss and Pam, thus completing Koch's postulates. The identity of three Pam representative isolates (S79, S158, S202) was further confirmed by comparing gyrD and rpoD housekeeping genes as well as 16S rRNA gene sequence with other Pam strains in GenBank (Parkinson et al., 2010; Gomila et al., 2017). Blast searches against GenBank using gyrB (GenBank accession numbers PP357444-PP357446), rpoD (PP357447-PP357449) and 16S rRNA (GenBank accession numbers PP421223-PP421225) gene sequences, ranging from 520 to 859bp, matched those of the Pam isolates (GenBank accession numbers CP026558 or PP218075) with 100% homology and 100% query coverage, further indicating that these isolates are indeed Pam. This represents the first documented record of Pam causing BCD in the Pacific Northwest, USA, suggesting the complexity of the disease, which underscores the need for effective management strategies for cherry growers in the region.
PubMed: 38907520
DOI: 10.1094/PDIS-04-24-0718-PDN -
Respiratory Research Jun 2024Idiopathic pulmonary fibrosis (IPF) is a devastating interstitial lung disease (ILD) with a high mortality rate. The antifibrotic medications pirfenidone and nintedanib...
BACKGROUND
Idiopathic pulmonary fibrosis (IPF) is a devastating interstitial lung disease (ILD) with a high mortality rate. The antifibrotic medications pirfenidone and nintedanib have been in use since 2014 for this disorder and are associated with improved rate of lung function decline. Less is known about their long-term outcomes outside of the clinical trial context.
METHODS
The Pulmonary Fibrosis Foundation Patient Registry was used for this study. Patients with an IPF diagnosis made within a year of enrollment were included. The treated group was defined as patients receiving either pirfenidone or nintedanib for at least 180 days. The untreated group did not have any record of antifibrotic use. Demographic data, comorbidities, serial lung function, hospitalization, and vital status data were collected from the registry database. The primary outcomes were transplant-free survival, time to first respiratory hospitalization, and time to 10% absolute FVC decline. Time-to-event analyses were performed utilizing Cox proportional hazards models and the log-rank test. Model covariates included age, gender, smoking history, baseline lung function, comorbidities, and oxygen use.
RESULTS
The registry contained 1212 patients with IPF; ultimately 288 patients met inclusion criteria for the treated group, and 101 patients were designated as untreated. Patients treated with antifibrotics were significantly younger (69.8 vs. 72.6 years, p = 0.008) and less likely to have smoked (61.1% ever smokers vs. 72.3% never smokers, p = 0.04). No significant differences were seen in race, gender, comorbidities, or baseline pulmonary function between groups. The primary outcome of transplant-free survival was not significantly different between the two groups (adjusted HR 0.799, 95% CI 0.534-1.197, p = 0.28). Time to respiratory hospitalization was significantly shorter in the treated group (adjusted HR 2.12, 95% CI 1.05-4.30, p = 0.04). No significant difference in time to pulmonary function decline was seen between groups.
CONCLUSIONS
This multicenter study demonstrated 63% of newly diagnosed IPF patients had continuous antifibrotic usage. Antifibrotics were not associated with improved transplant-free survival or pulmonary function change but was associated with an increased hazard of respiratory hospitalization. Future studies should further investigate the role of antifibrotic therapy in clinically important outcomes in real-world patients with IPF and other progressive ILDs.
Topics: Humans; Male; Registries; Female; Idiopathic Pulmonary Fibrosis; Aged; Middle Aged; Antifibrotic Agents; Treatment Outcome; Pyridones; Indoles; Time Factors
PubMed: 38907239
DOI: 10.1186/s12931-024-02883-2 -
BMC Women's Health Jun 2024Breast imaging clinics in the United States (U.S.) are increasingly implementing breast cancer risk assessment (BCRA) to align with evolving guideline recommendations...
BACKGROUND
Breast imaging clinics in the United States (U.S.) are increasingly implementing breast cancer risk assessment (BCRA) to align with evolving guideline recommendations but with limited uptake of risk-reduction care. Effectively communicating risk information to women is central to implementation efforts, but remains understudied in the U.S. This study aims to characterize, and identify factors associated with women's interest in and preferences for breast cancer risk communication.
METHODS
This is a cross-sectional survey study of U.S. women presenting for a mammogram between January and March of 2021 at a large, tertiary breast imaging clinic. Survey items assessed women's interest in knowing their risk and preferences for risk communication if considered to be at high risk in hypothetical situations. Multivariable logistic regression modeling assessed factors associated with women's interest in knowing their personal risk and preferences for details around exact risk estimates.
RESULTS
Among 1119 women, 72.7% were interested in knowing their breast cancer risk. If at high risk, 77% preferred to receive their exact risk estimate and preferred verbal (52.9% phone/47% in-person) vs. written (26.5% online/19.5% letter) communications. Adjusted regression analyses found that those with a primary family history of breast cancer were significantly more interested in knowing their risk (OR 1.5, 95% CI 1.0, 2.1, p = 0.04), while those categorized as "more than one race or other" were significantly less interested in knowing their risk (OR 0.4, 95% CI 0.2, 0.9, p = 0.02). Women 60 + years of age were significantly less likely to prefer exact estimates of their risk (OR 0.6, 95% CI 0.5, 0.98, p < 0.01), while women with greater than a high school education were significantly more likely to prefer exact risk estimates (OR 2.5, 95% CI 1.5, 4.2, p < 0.001).
CONCLUSION
U.S. women in this study expressed strong interest in knowing their risk and preferred to receive exact risk estimates verbally if found to be at high risk. Sociodemographic and family history influenced women's interest and preferences for risk communication. Breast imaging centers implementing risk assessment should consider strategies tailored to women's preferences to increase interest in risk estimates and improve risk communication.
Topics: Humans; Female; Breast Neoplasms; Cross-Sectional Studies; Middle Aged; Patient Preference; United States; Adult; Mammography; Risk Assessment; Aged; Communication; Surveys and Questionnaires; Tertiary Care Centers; Health Knowledge, Attitudes, Practice
PubMed: 38907193
DOI: 10.1186/s12905-024-03197-7 -
JAMA Health Forum Jun 2024Young people and historically marginalized racial and ethnic groups are poorly represented in the democratic process. Addressing voting inequities can make policy more...
IMPORTANCE
Young people and historically marginalized racial and ethnic groups are poorly represented in the democratic process. Addressing voting inequities can make policy more responsive to the needs of these communities.
OBJECTIVE
To assess whether leveraging health care settings as venues for voter registration and mobilization is useful, particularly for historically underrepresented populations in elections.
DESIGN, SETTING, AND PARTICIPANTS
In 2020, nonpartisan nonprofit Vot-ER partnered with health care professionals and institutions to register people to vote. This cross-sectional study analyzed the demographics and voting behavior of people mobilized to register to vote in health care settings, including hospitals, community health centers, and medical schools across the US. The age and racial and ethnic identity data of individuals engaged through Vot-ER were compared to 2 national surveys of US adults, including the 2020 Cooperative Election Study (CES) and the 2020 American National Election Study (ANES).
EXPOSURE
Health care-based voter registration.
MAIN OUTCOMES AND MEASURES
The main outcomes were age composition, racial and ethnic composition, and voting history.
RESULTS
Of the 12 441 voters contacted in health care settings, 41.9% were aged 18 to 29 years, 15.9% were identified as African American, 9.6% as Asian, 12.7% as Hispanic, and 60.4% as White. This distribution was significantly more diverse than the racial and ethnic distribution of the ANES (N = 5447) and CES (N = 39 014) samples, of which 72.5% and 71.19% self-identified as White, respectively. Voter turnout among health care-based contacts increased from 61.0% in 2016 to 79.8% in 2020, a turnout gain (18.8-percentage point gain) that was 7.7 percentage points higher than that of the ANES sample (11.1-percentage point gain). Demographically, the age distribution of voters contacted in health care settings was significantly different from the ANES and CES samples, with approximately double the proportion of young voters aged 18 to 29 years.
CONCLUSION AND RELEVANCE
This cross-sectional study suggests that health care-based voter mobilization reaches a distinctly younger and more racially and ethnically diverse population relative to those who reported contact from political campaigns. This analysis of the largest health care-based voter mobilization effort points to the unique impact that medical professionals may have on voter registration and turnout in the 2024 US elections. In the long term, health equity initiatives should prioritize expanding voting access to address the upstream determinants of health in historically marginalized communities.
Topics: Humans; Cross-Sectional Studies; Male; Female; Adult; Politics; Middle Aged; United States; Adolescent; Young Adult; Aged; Ethnicity; Voting
PubMed: 38904953
DOI: 10.1001/jamahealthforum.2024.1563 -
JAMA Health Forum Jun 2024The 2018 Veterans Affairs Maintaining Internal Systems and Strengthening Integrated Outside Networks (VA MISSION) Act was implemented to increase timely access to care...
IMPORTANCE
The 2018 Veterans Affairs Maintaining Internal Systems and Strengthening Integrated Outside Networks (VA MISSION) Act was implemented to increase timely access to care by expanding veterans' opportunities to receive Veterans Affairs (VA)-purchased care in the community (community care [CC]). Because health equity is a major VA priority, it is important to know whether Black and Hispanic veterans compared with White veterans experienced equitable access to primary care within the VA MISSION Act.
OBJECTIVE
To examine whether utilization of and wait times for primary care differed between Black and Hispanic veterans compared with White veterans in rural and urban areas after the implementation of the VA MISSION Act.
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional study used VA and CC outpatient and consult data from the VA's Corporate Data Warehouse for fiscal years 2021 to 2022 (October 1, 2020, to September 30, 2022). Separate fixed-effects multivariable models were run to predict CC utilization and wait times. Each model was run twice, once comparing Black and White veterans and then comparing Hispanic and White veterans. Adjusted risk ratios (ARRs) were calculated for Black and Hispanic veterans compared with White veterans within rurality status for both outcomes.
MAIN OUTCOMES AND MEASURES
VA and CC primary care utilization as measured by primary care visits (utilization cohort); VA and CC primary care access as measured by mean wait times (access cohort).
RESULTS
A total of 5 046 087 veterans (994 517 [19.7%] Black, 390 870 [7.7%] Hispanic, and 3 660 700 [72.6%] White individuals) used primary care from fiscal years 2021 to 2022. Utilization increased for all 3 racial and ethnicity groups, more so in CC than VA primary care. ARRs were significantly less than 1 regardless of rurality status, indicating Black and Hispanic veterans compared with White veterans were less likely to utilize CC for primary care. There were 468 246 primary care consultations during the study period. The overall mean (SD) wait time was 33.3 (32.4) days. Despite decreases in wait times over time, primary care wait times remained longer in CC than in VA. Black veterans compared with White veterans had significantly longer wait times in CC (ARRs >1) but significantly shorter wait times in VA (ARRS <1) regardless of rurality status in VA and CC. CC wait times for Hispanic veterans compared with White veterans were longer in rural areas only and in VA rural and urban areas (ARRs >1).
CONCLUSION AND RELEVANCE
The results of this cross-sectional study suggest that additional research should explore the determinants and implications of utilization differences among Black and Hispanic veterans compared with White veterans. Efforts to promote equitable primary care access for all veterans are needed so that policy changes can be more effective in ensuring timely access to care for all veterans.
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Access to Primary Care; Black or African American; Cross-Sectional Studies; Ethnicity; Health Services Accessibility; Healthcare Disparities; Hispanic or Latino; Primary Health Care; Rural Population; United States; United States Department of Veterans Affairs; Veterans; White
PubMed: 38904952
DOI: 10.1001/jamahealthforum.2024.1568 -
Frontiers in Immunology 2024To explore the relationship between serum calcium levels and the prognosis of severe acute osteomyelitis, and to assess the effectiveness of calcium levels in prognostic...
OBJECTIVE
To explore the relationship between serum calcium levels and the prognosis of severe acute osteomyelitis, and to assess the effectiveness of calcium levels in prognostic evaluation.
METHODS
Relevant patient records of individuals diagnosed with severe acute osteomyelitis were obtained for this retrospective study from the Medical Information Mart for Intensive Care (MIMIC-IV). The study aimed to assess the impact of different indicators on prognosis by utilizing COX regression analysis. To enhance prognostic prediction for critically ill patients, a nomogram was developed. The discriminatory capacity of the nomogram was evaluated using the Area Under the Curve (AUC) of the Receiver Operating Characteristic (ROC) curve, in addition to the calibration curve.
RESULT
The study analyzed a total of 1,133 cases of severe acute osteomyelitis, divided into the survivor group (1,025 cases) and the non-survivor group (108 cases). Significant differences were observed between the two groups in terms of age, hypertension, sepsis, renal injury, and various laboratory indicators, including WBC, PLT, Ca2+, CRP, hemoglobin, albumin, and creatinine (P<0.05). However, no significant differences were found in race, gender, marital status, detection of wound microbiota, blood sugar, lactate, and ALP levels. A multivariate COX proportional hazards model was constructed using age, hypertension, sepsis, Ca2+, creatinine, albumin, and hemoglobin as variables. The results revealed that hypertension and sepsis had a significant impact on survival time (HR=0.514, 95% CI 0.339-0.779, P=0.002; HR=1.696, 95% CI 1.056-2.723, P=0.029). Age, hemoglobin, Ca2+, albumin, and creatinine also showed significant effects on survival time (P<0.05). However, no statistically significant impact on survival time was observed for the other variables (P>0.05). To predict the survival time, a nomogram was developed using the aforementioned indicators and achieved an AUC of 0.841. The accuracy of the nomogram was further confirmed by the ROC curve and calibration curve.
CONCLUSION
According to the findings, this study establishes that a reduction in serum calcium levels serves as a distinct and standalone predictor of mortality among individuals diagnosed with severe acute osteomyelitis during their stay in the Intensive Care Unit (ICU) within a span of two years.
Topics: Humans; Male; Female; Osteomyelitis; Prognosis; Middle Aged; Calcium; Retrospective Studies; Aged; Nomograms; Adult; Acute Disease; Severity of Illness Index; Biomarkers; ROC Curve; Critical Illness
PubMed: 38903514
DOI: 10.3389/fimmu.2024.1378730