scholarly journals Application of a Ridden Horse Pain Ethogram and Its Relationship with Gait in a Convenience Sample of 60 Riding Horses

Animals ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 1044 ◽  
Author(s):  
Sue Dyson ◽  
Danica Pollard
Keyword(s):  
Musculoskeletal Pain ◽  
Multivariable Analysis ◽  
Skill Score ◽  
Continuous Variable ◽  
Convenience Sample ◽  
Video Recordings ◽  
Type Test ◽  
Gait Abnormalities ◽  
Regular Work ◽  
Epaxial Muscle

A Ridden Horse Pain Ethogram (RHpE) comprising 24 behaviours has been developed to facilitate the identification of musculoskeletal pain. The aim was to further test the RHpE by its application to a convenience sample (n = 60) of sports horses and riding school horses in regular work and assumed by their owners to be working comfortably. All horses performed a purpose-designed dressage-type test of 8.5 min duration in walk, trot and canter, with their normal rider. The RHpE was applied retrospectively to video recordings acquired in a standardised fashion. Seventy-three percent of horses were lame (≤ grade 2/8) on one or more limbs; 47% had gait abnormalities in canter. Ridden Horse Pain Ethogram scores ranged from 3 to 16/24 (median 9); rider skill score ranged from 2.5 to 8/10 (median 4.75). The effect of horse age, breed, sex, work-discipline, epaxial muscle hypertonicity or pain, an ill-fitting saddle, rider skill score, the presence of lameness or gait abnormalities in canter on the RHpE score was assessed using Poisson regression. Two variables were retained in the final multivariable analysis, rider skill score as a continuous variable (p < 0.001), and lameness (p = 0.008). A RHpE score ≥8 was a good indicator of the presence of musculoskeletal pain.

scholarly journals Impact of Surgical Table Orientation on Flow Disruptions and Movement Patterns during Pediatric Outpatient Surgeries

2021 ◽  
Vol 18 (15) ◽  
pp. 8114
Author(s):  
Anjali Joseph ◽  
David Neyens ◽  
Sahar Mihandoust ◽  
Kevin Taaffe ◽  
David Allison ◽  
...  
Keyword(s):  
Ambulatory Surgery ◽  
Surgical Team ◽  
Scrub Nurse ◽  
Work Zones ◽  
Convenience Sample ◽  
Operational Strategies ◽  
Team Members ◽  
Video Recordings ◽  
Safety Risks ◽  
Flow Disruptions

(1) Background: The surgical table within a typical ambulatory surgery operating room is frequently rotated and placed in different orientations to facilitate surgery or in response to surgeon preferences. However, different surgical table orientations can impact access to different work zones, areas and equipment in the OR, potentially impacting workflow of surgical team members and creating patient safety risks; (2) Methods: This quantitative observational study used a convenience sample of 38 video recordings of the intraoperative phase of pediatric outpatient surgeries to study the impacts of surgical table orientation on flow disruptions (FDs), number of contacts between team members and distance traveled; (3) Results: This study found that the orientation of the surgical table significantly influenced staff workflow and movement in the OR with an angled surgical table orientation being least disruptive to surgical work. The anesthesia provider, scrub nurse and circulating nurse experienced more FDs compared to the surgeon; (4) Conclusions: The orientation of the surgical table matters, and clinicians and architects must consider different design and operational strategies to support optimal table orientation in the OR.

Impact of wait times on survival of women with uterine cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5586-5586
Author(s):  
Lorraine Elit ◽  
Erin O'Leary ◽  
Hsien Seow ◽  
Gregory Russell Pond
Keyword(s):  
Uterine Cancer ◽  
Multivariable Analysis ◽  
Wait Time ◽  
Continuous Variable ◽  
Cox Proportional Hazards ◽  
Wait Times ◽  
Endometrioid Adenocarcinoma ◽  
Multivariable Model ◽  
Histologic Diagnosis ◽  
Definitive Surgery

5586 Background: Reducing cancer wait times have been a priority investment for Cancer Care Ontario since 2005. Our objective was to determine whether wait time from histologic diagnosis of uterine cancer to time of definitive surgery by hysterectomy impacted on all cause survival. Methods: Cases were identified in the Ontario Cancer Registry using ICD-09 codes 179 and 182. Excluded were women without histologic/cytologic confirmation of cancer prior to surgery, with no definitive surgery, or with wait times of ≤14 days or >2 years. Survival was calculated using the Kaplan-Meier method from the day of hysterectomy. Factors were evaluated for their prognostic ability on survival using Cox proportional hazards regression. Wait time was evaluated as a continuous variable and dichotomized at selected cutpoints in the univariable analyses and in a multivariable model adjusting for significant patient factors identified using forward stepwise selection. Results: The final study population included 8,744 women. 51.9% had surgery by a gynaecologist and 69.9% had endometrioid adenocarcinoma. The optimal model is shown below. Multivariable analysis of factors prognostic for survival. Longer wait times remained a statistically significant negative prognostic factor for survival regardless of definition, univariably (p<0.002) and multivariably after adjusting for other significant factors (p<0.001). The final multivariable model is shown. 5-year (95%CI) survival for women with more than 12 week wait times was 61.4 (57.8-64.8)% versus 71.9 (69.9-73.8)% for women with less than 6 week wait time. Conclusions: The longer a woman waits from diagnosis of uterine cancer to definitive surgery negatively impacts her overall survival. [Table: see text]

Prognostic relevance of neutrophil to lymphocyte ratio (NLR) before anti-PD1 therapy in metastatic melanoma patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21045-e21045
Author(s):  
Daniel Vilarim Araujo ◽  
Rafael Vanin de Moraes ◽  
Victor Aurelio Ramos Sousa ◽  
Mauro Daniel Spina Donadio ◽  
Aline Fusco Fares ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Metastatic Melanoma ◽  
Proportional Hazards ◽  
Checkpoint Inhibitors ◽  
Prognostic Significance ◽  
Multivariable Analysis ◽  
Continuous Variable ◽  
Cox Proportional Hazards ◽  
Rank Test ◽  
Melanoma Patients

e21045 Background: Biomarkers to select the patients most likely to benefit from checkpoint inhibitors are urged. NLR is a simple way of measuring systemic inflammation and is an independent predictor of survival before Anti-CTLA4 therapy. We hypothesized if NLR is also a predictor of survival before Anti-PD1 therapy. Methods: We performed a retrospective review of the medical records of all consecutive metastatic melanoma patients who received Nivolumab treatment from January/2014 – February/2017, including 53 patients prospectively collected from an Expanded Access Program. Of 86 patients, 83 patients were included for demographic and efficacy analysis, and 74 had information about baseline pre-treatment NLR. We analyzed NLR as a continuous variable and categorised ≥ 5 vs. < 5. Kaplan-Meier method was used for survival analysis. Long-rank test compared categories and Cox proportional hazards regression model was used to assess the prognostic significance of baseline NLR in univariate and multivariable analysis. Results: Median PFS for the entire population was 6,407 months (3,28 – 9,52) and median OS was not reached (NR) with a median FU of 10,74 months. The median NLR ratio was 3,11 (0,87 – 19). 18 patients (24,3%) had a ≥ 5 NLR vs. 56 (75,7%) < 5. Median PFS for NLR ≥ 5 was: 2,3 (1,75 – 2,84) vs. 12,02 (5,11 – 18,93) for < 5 (HR = 3,11; IC95% 1,52 – 6,27; p = 0,001). Median OS ≥ 5: 3,05 (2,06 – 4,04) vs. NR for < 5 (HR = 5,88; IC95% 2,60 – 13,29; p = 0,001). NLR categorised remained statistically significant in multivariate analysis for PFS and NLR as a continuous variable remained statistically significant for both PFS and OS in multivariate analysis (Table 1). Conclusions: Baseline NLR is a rapid, simple, and cost-free predictor of survival before Anti-PD1 therapy. These results should be validated in a larger cohort of patients. [Table: see text]

Management of bronchopulmonary carcinoid: NCDB database analysis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e21007-e21007
Author(s):  
Mojun Zhu ◽  
Harry E Fuentes ◽  
Gustavo Figueiredo Marcondes Westin ◽  
Mohamad Bassam Sonbol ◽  
Konstantinos Leventakos ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Mediastinal Lymph Node ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Continuous Variable ◽  
Older Age ◽  
Typical Carcinoid ◽  
Reasonable Approach ◽  
Bronchopulmonary Carcinoid ◽  
The Impact

e21007 Background: There is a lack of data to guide the management of resectable bronchopulmonary carcinoid tumors (BCTs). Methods: The NCDB database was retrospectively reviewed to analyze the roles of surgery, chemotherapy and radiation. Patients with a diagnosis of clinically staged T1-2/N0-1 typical carcinoid (TC) and atypical carcinoid (AC) between 2004-2012 were included. Kaplan-Meier methods and multivariable analysis were performed. Results: A total of 2148 patients (TC 1874 & AC 274; T1/1648 & T2/500) were identified. The median age was 59 (range 18-89). There was a female (69.7%) and right lung (56.9%) predominance. Fifty-three patients received pneumonectomy, 68 chemotherapy, and 84 radiation therapy. The impact of age, histology (TC vs. AC), medical comorbidities (Charlson/Deyo score 0 vs. ≥1) and type of surgery [sublobar resection (SR) vs. lobectomy vs. lobectomy with mediastinal lymph node dissection (L/MLND)] were subsequently examined. AC, older age, and comorbidities were associated with shorter overall survival (OS) by both univariate and multivariable analysis. Patients who underwent lobectomy had longer OS (119 months) than those with SR (109 months) or L/MLND (115 months). However, this association was not significant by multivariable analysis with age incorporated as either a categorical ( < 60 vs. ≥60) or a continuous variable (Table). In the subgroup analysis of patients with T1, T2, TC and AC respectively, type of surgical resection was not significantly associated with OS by multivariable analysis. Conclusions: Patients with resectable BCTs have excellent OS. Atypical histology, older age, and comorbidities predicted inferior OS. There were insufficient data to support the use of perioperative chemotherapy or radiation therapy. Lobectomy was associated with prolonged OS by univariate analysis but this was not significant in the multivariable model, suggesting that SR is a reasonable approach for patients who cannot tolerate lobectomy. MLND did not seem to provide additional survival benefits. [Table: see text]

Musculoskeletal Pain, Job Satisfaction, Depression, and Anxiety Among Spanish Podiatric Physicians

2014 ◽  
Vol 104 (2) ◽  
pp. 191-197 ◽  
Author(s):  
Marta Elena Losa Iglesias ◽  
Ricardo Becerro de Bengoa Vallejo
Keyword(s):  
Job Satisfaction ◽  
Musculoskeletal Pain ◽  
Single Women ◽  
Job Dissatisfaction ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Convenience Sample ◽  
High Prevalence ◽  
Physical Consequences ◽  
High Level

Background There is a high prevalence of musculoskeletal complaints related to day-to-day work among podiatric physicians. We sought to determine the relationships among musculoskeletal pain, job satisfaction, depression, and anxiety in Spanish podiatric physicians. Methods A convenience sample of 421 Spanish podiatric physicians was administered a survey that included questions about sociodemographic variables, musculoskeletal pain, job satisfaction, depression, and anxiety. Results On average, respondents were found to have a high level of pain, a moderate level of job satisfaction, and low-to-moderate levels of depression and anxiety. Young single women had the highest levels of pain and anxiety. Analysis with the Student t test indicated significant differences between the sexes for levels of pain (P &lt; .0001) and anxiety (P &lt; .014). Job satisfaction was inversely related to depression and anxiety. Conclusions These findings, particularly the increased levels of pain, job dissatisfaction, anxiety, and depression in young single female podiatrists, indicate a need for strategies to reduce the risks posed by the work environment in podiatric medicine, thus minimizing the negative psychological and physical consequences of participating in the profession.

scholarly journals Validation of Dietary Antioxidant Index (DAI) and investigating the relationship between DAI and the odds of Gastric Cancer

2019 ◽  
Author(s):  
Farhad Vahid ◽  
Seyed Hosein Davoodi
Keyword(s):  
Gastric Cancer ◽  
Multivariable Analysis ◽  
Continuous Variable ◽  
Equal Weight ◽  
Dietary Intakes ◽  
Dietary Antioxidants ◽  
Dietary Antioxidant ◽  
Incidence And Mortality ◽  
Total Antioxidant ◽  
Total Fat

Abstract Background Gastric Cancer (GC) incidence and mortality are rapidly growing. The necessity of the design and validation of the Dietary Antioxidant Index (DAI) was to examine the total antioxidant content of the diet. The present study examined the validity of DAI and its association with the odds of GC. Methods In this hospital-based case-control study, 82 patients with GC and 95 healthy controls were examined. We have used a 168 item FFQ to assess dietary intakes. The DAI was calculated based on the intake of vitamin A, C, E, and selenium, manganese, and zinc. To calculate DAI, we standardized each of the six vitamins and minerals by subtracting the global mean and dividing by the global standard deviation. We then calculated the DAI by summing the standardized intakes of these vitamins and minerals with equal weight. Results We observed a significant and acceptable correlation between DAI and TAC after controlling for age, BMI, energy intake, and smoking and FBS, education, total fat intake, H.pylori infection, total cholesterol, and SFA intakes. Results obtained from modeling DAI as a continuous variable in relation to GC showed a negative association after adjustment for age and in the multivariable analysis (OR=0.64, CI=0.43-0.95). Conclusion DAI is a valid indicator of dietary antioxidants assessments, and it can be used as a predictor of antioxidant status due to its correlation with serum antioxidants levels. The results of this study showed that dietary antioxidants have a significant relationship with GC, which indicates the importance of antioxidants in preventing this cancer.

scholarly journals Heavy load carrying and musculoskeletal health: An exploratory study of sand miners in Pokhara, Kaski District, Nepal

2020 ◽  
Author(s):  
Aybüke Koyuncu ◽  
Michael N. Bates ◽  
Ziva Petrin ◽  
Myles Cope ◽  
Sandra I. McCoy ◽  
...  
Keyword(s):  
Musculoskeletal Pain ◽  
Construction Materials ◽  
Health And Safety ◽  
Cross Sectional Study ◽  
Epidemiologic Studies ◽  
Body Region ◽  
Heavy Load ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Load Carrying

ABSTRACTBackgroundTrends in urbanization contribute to the growing global demand for raw construction materials. The health effects of load carrying among occupational groups that mine and carry sand and stone used for construction of roads and buildings remains poorly understood.MethodsWe conducted an exploratory cross-sectional study among a convenience sample of sand miners working at an excavation site on the Seti River in Pokhara, Nepal. Load carrying weight, duration, and frequency were used to categorize miners as having “low” or “high” load-carrying exposures. Probable musculoskeletal disorders (MSDs) were identified using self-reported symptoms of moderate to severe musculoskeletal pain, as well as physical examinations.ResultsThe average loads carried by female and male sand miners weighed 66.3 kg and 87.3 kg, respectively. Among all participants (N=42), 45.2% reported moderate to severe musculoskeletal pain in at least one body region and 16 (38.1%) had probable MSDs identified using specified case criteria. The prevalence of MSDs was lower among miners carrying, on average, heavier loads compared to those carrying lighter loads (ORa=0.29; 95% CI: 0.05, 1.8), possibly indicative of the healthy worker survival effect. Miners carrying loads for longer durations and frequencies had higher odds of MSDs compared with those carrying for shorter durations and frequencies.ConclusionDespite the pervasiveness of load carrying as an income generating activity throughout the developing world, these populations remain largely excluded from global occupational health agendas. Larger epidemiologic studies are needed to justify action to protect the health and safety of these unrecognized and understudied groups.

Assessment of age as its own risk factor in AML.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6610-6610
Author(s):  
Thomas Buchner ◽  
Wolfgang E. Berdel ◽  
Claudia Haferlach ◽  
Susanne Schnittger ◽  
Matthias Stelljes ◽  
...  
Keyword(s):  
Risk Factor ◽  
Remission Rate ◽  
Standard Dose ◽  
Multivariable Analysis ◽  
Continuous Variable ◽  
Treatment Intensity ◽  
High Dose ◽  
High Dose Cytarabine ◽  
Baseline Characteristics ◽  
The Difference

6610 Background: Patients’ age is an important issue in treatment decisions for AML, while its role in this disease remains poorly explained. Methods: In the AMLCG 1999 trial 1223 patients (pts) were 16-59y and 1470 pts were 60-85y of age. Their treatment was randomized between TAD-HAM vs HAM-HAM induction (TAD, standard dose thioguanine, cytarabine, daunorubicin 60mg/m² x 3; HAM, high-dose cytarabine 3g/m² x 6, mitoxantrone 10mg/m² x 3), TAD consolidation and monthly maintenance vs autologous SCT, any chemotherapy + vs - G-CSF priming. All randomization was done upfront. Pts of <60y received routine double induction and full dose HAM while pts of 60+y preferentially received only one course induction and HAM at 1g instead of 3g cytarabine /m² x 6. Results: With little differences according randomizations, pts <60y and 60+y achieved a complete remission rate (CR) of 70.2% and 53.5% (p<.001), overall survival (OS) at 5y of 41.3% and 12.9% (p<.001) and a relapse rate (RR) of 49.0 and 72.0% (p<.001). We also focussed on pts around 60y of age and compared the 172 pts of 57-59y with the 261 pts of 60-62y excluding pts undergoing allogeneic stem cell transplantation. According to their similar age the two groups showed similar baseline characteristics. In contrast and due to the cut-off point for age adaption at 60y they differed considerably in treatment. Expressed by the cumulative dosage of cytarabine, the difference between the two groups was by factor 2.9. This difference, however, did not translate into a different outcome being 62% vs 60% CR, 28% vs 21% 5y OS (p=0.25), and 73% vs 73% RR at 5y. A multivariable analysis in all pts between 16 and 85y of age identified cytogenetik/ molecular risk and age as a continuous variable, to be risk factors predicting CR, OS, as well as RR. In pts of 16-60y those below and above the median age of 47y differed in their CR rate by 75% vs 66% (p<.001), their OS by 49% vs 35% (p<.001) and in their RR by 45% vs 53% (p=.007). In pts of 60-85y those below and above the median age of 67y differed in their CR rate by 57% vs 51% (p=.023), and their OS by 16% vs 11% (p<.001), while their RR was similarly 71%. Conclusions: The outcome in pts with AML is substantially determined by patients’ age as its own risk factor, and not by treatment intensity.

Association of prostate specific-antigen doubling time (PSADT) with metastasis-free survival (MFS) and overall survival (OS) in non-metastatic castration-resistant prostate cancer (nmCRPC).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e16525-e16525 ◽  
Author(s):  
Jennifer H Lin ◽  
Brian Macomson ◽  
Ozgur Tunceli ◽  
Chris Pericone ◽  
Ajay S. Behl ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Linear Trend ◽  
Multivariable Analysis ◽  
Specific Antigen ◽  
Continuous Variable ◽  
Castration Resistant Prostate Cancer ◽  
Increased Risk ◽  
Bone Scans ◽  
Practice Methods

e16525 Background: For optimal nmCRPC management, it is important to assess the rate of disease progression and its predictors. MFS and OS endpoints are likely to be important determinants in evaluating the relative impact of treatments in nmCRPC patients. This study assessed the association of PSADT with MFS and OS in real world practice. Methods: A retrospective cohort study of men ≥18 years old was conducted using the Optum electronic health record (EHR) database (2007-2016). nmCRPC was defined as a prostate cancer diagnosis, no ICD-9/10 code or therapy indicating metastatic disease, a testosterone (T) level < 50 ng/dL (castrate level) and 2 rising PSAs (relative rise ≥25%; absolute rise ≥2 ng/mL above nadir) ≥1 week apart. Baseline PSADT, calculated from the PSA nadir until 2nd rise of PSA, was grouped into < 6, 6-18 or > 18 months. A Cox proportional hazard model was used to assess the association of baseline PSADT with MFS and OS, comparing PSADT < 6 and 6-18 months against PSADT > 18 months. Multivariable analysis was adjusted for age, race, comorbidity index score, T levels, therapy and bone scans before nmCRPC. A linear trend was tested by taking PSADT as a continuous variable (median value in each group) in the model. Results: A total of 901 patients were identified. Mean nmCRPC onset age was 76 years and mean follow-up time was 2 years. The median PSADT was 7 months, ranging from 0.5 to 267 months. During follow-up, 477 patients developed metastasis and 384 died. MFS was 89%, 60%, and 47% at year 1, 3 and 5, respectively. Men with PSADT < 6 and 6-18 months had ≥50% increased risk of shorter MFS than men with PSADT > 18 months; hazard ratios (HR) were 1.87 (95% confidence interval [CI]: 1.39-2.54) and 1.50 (95%CI: 1.11-2.04), respectively. OS was 87%, 64% and 57% at year 1, 3 and 5, respectively. Shorter PSADT was associated with shorter OS (p for trend < 0.001). Men with a PSADT < 6 months had a 2-fold increased risk for decreased OS (HR = 2.04, 95% CI: 1.44-2.90). Conclusions: Patients with nmCPRC with shorter PSADT had significantly shorter MFS and OS compared to those with longer PSADT. Baseline PSADT may serve as a predictor for nmCRPC progression.

Validation of the Immunoscore prognostic value in stage III colon cancer patients treated with oxaliplatin in the prospective IDEA France cohort study (PRODIGE-GERCOR).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 3513-3513 ◽  
Author(s):  
Franck Pages ◽  
Thierry Andre ◽  
Julien Taieb ◽  
Dewi Vernerey ◽  
Julie Henriques ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Cohort Study ◽  
Multivariable Analysis ◽  
Digital Pathology ◽  
Disease Free Survival ◽  
Continuous Variable ◽  
Primary Objective ◽  
Stage Iii ◽  
Cox Models ◽  
N Stage

3513 Background: The Immunoscore (IS), which has been shown to prognostically classify Stage I-III colon cancer (CC) patients, was assessed in the IDEA France cohort study evaluating 3 versus 6 months of oxaliplatin-based adjuvant chemotherapy in Stage III CC patients. Methods: Densities of CD3+ and cytotoxic CD8+ T cells in the tumor and invasive margin of each patient were quantified by digital pathology and converted to IS using pre-defined published cut-off. The performance of IS to predict disease-free survival (DFS) was assessed in the modified intention-to-treat population, in each study arm, and was adjusted with relevant clinical features in multivariable Cox models. Harrell’s C-statistics was used to investigate the IS performance. Results: 1322 patients were included; 82 were excluded due to pre-analytical non-conformity. IS was successfully analyzed in 1062 (85.6%) eligible patients. In a 2-category IS analysis, Low and (Int+High) IS were observed in n=599 (43.6%) and n=463 (56.4%) patients, respectively. IS was significantly correlated with T stage, T/N stage (T1-3 and N1 versus T4 and/or N2), and microsatellite instability status. The study met its primary objective of validating that Low IS identifies patients with higher-risk of relapse or death [HR=1.54; 95%CI 1.24-1.93, p=0.0001]. The 3-year DFS rates were 66.80% [95%CI 62.23-70.95] and 77.14% [95%CI 73.50-80.35] for Low IS and (Int+High) IS, respectively. In multivariable analysis, IS remained independently associated with DFS (p<0.0012) when combined with T/N stage. The addition of IS to the T/N stage significantly improved the model discrimination capacity [bootstrap C index mean difference, 0.022; 95%CI 0.005-0.04]. In addition, IS in 3 categories (Low, Int, High) and as a continuous variable were also both significantly associated with DFS (all p<0.001). In univariable analysis, IS was also associated with DFS in 6 months arm (p<0.0001); a similar trend was observed in 3 months arm (p=0.09). Conclusions: IS was confirmed as a prognostic factor of DFS in Stage III CC patients in the prospective IDEA France cohort study. Clinical trial information: NCT03422601.

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