Category: Statistics

Neurogenetics. 2024 Dec 6;26(1):15. doi: 10.1007/s10048-024-00792-6.

ABSTRACT

To investigate the causal relationships between cerebrospinal fluid (CSF) metabolites and various neurodegenerative diseases (NDDs), we conducted a two-sample Mendelian randomization (MR) analysis. This study utilized summary statistics from genome-wide association studies (GWAS) of CSF metabolites and four common neurodegenerative diseases: Alzheimer’s disease (AD), Parkinson’s disease (PD), multiple sclerosis (MS), and amyotrophic lateral sclerosis (ALS). MR methods were employed to determine causal associations, with the inverse variance weighted method as the primary approach. Additionally, different GWAS summary data for NDDs were used to validate the initial results and perform sensitivity analyses to enhance the robustness of the findings. Finally, reverse MR analyses were conducted to assess the possibility of reverse causation. Combining results from the initial and replication phases of MR analysis, we identified potential causal relationships between various CSF metabolites and different NDDs. Specifically, we found potential causal relationships between five CSF metabolites and AD, six CSF metabolites and MS, and thirteen CSF metabolites and ALS. Further sensitivity analyses confirmed the robustness of these associations. Reverse MR analysis indicated causal effects of AD on glucuronate and ALS on acetylcarnitine (C2). Our study, through genetic means, demonstrates close causal associations between the specific types of CSF metabolites and the risk of NDDS (AD, PD, MS, and ALS), providing useful guidance for future clinical researches.

PMID:39641862 | DOI:10.1007/s10048-024-00792-6

Acta Neurochir (Wien). 2024 Dec 6;166(1):494. doi: 10.1007/s00701-024-06341-2.

ABSTRACT

BACKGROUND: Gamma Knife radiosurgery (GKRS) is a well-established treatment for residual or growing pituitary adenomas (PAs) post-partial resection. However, some PAs grow even after initial GKRS, for which the efficacy of repeat GKRS is unclear. The primary objective of this study was to determine long-term progression-free survival (PFS) following repeated GKRS in patients with PA. The secondary objective was to determine predictors of tumor progression in these patients.

METHODS: Single-center, population-based consecutive cohort study of patients with recurrent PAs treated with repeated GKRS due to tumor progression between 1999 and 2022 at the Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden. PFS and predictors of tumor growth were assessed.

RESULTS: 23 patients were included, with a median follow-up time of 6.3 years. The 5-year PFS rate was 57%, and the median duration from repeat GKRS to tumor progression was 2.6 years. Tumor growth after repeat GKRS occurred exclusively within the first three years post-treatment. Older age at the time of repeat GKRS was a significant predictor of continued tumor growth (OR 1.09, p = 0.036).

CONCLUSION: Repeat GKRS is a feasible treatment alternative for PAs that exhibit growth following initial GKRS.

PMID:39641851 | DOI:10.1007/s00701-024-06341-2

Environ Sci Pollut Res Int. 2024 Dec 6. doi: 10.1007/s11356-024-35702-8. Online ahead of print.

ABSTRACT

The study analyzes the impact of environmental regulations on carbon emissions in countries with different levels of emissions, utilizing two measures of carbon emissions based on: production (PBA) and consumption (CBA) accounting. Environmental regulations are measured by means of three components of the Environmental Policy Stringency (EPS) index: market-based and non-market-based instruments, and technology support. The Moments-Quantile Regression method is employed to assess the effectiveness of these policies across countries with varying levels of emissions-high, medium, and low within the Environmental Kuznets Curve. The findings indicate that increased stringency in environmental regulations correlates with reduced carbon emissions per capita. Notably, the EPS index has a more significant effect on reducing PBA emissions compared to CBA emissions. A key finding is that the EPS index is more effective in countries with lower pollution per capita (i.e., lower quantiles) than in those with higher pollution per capita. Among the three components, market-based instruments are identified as the most effective in reducing carbon emissions. Additionally, in countries where per capita emissions are relatively low, the combination of market and non-market instruments proves to be the most effective in reducing emissions. In contrast, the highest carbon emitters per capita tend to achieve emissions reductions primarily through technological support.

PMID:39641842 | DOI:10.1007/s11356-024-35702-8

Oral Maxillofac Surg. 2024 Dec 6;29(1):17. doi: 10.1007/s10006-024-01312-4.

ABSTRACT

INTRODUCTION: This study aimed to explore the predictive and prognostic value of tumor-stromal ratio (TSR) and tumor budding (TB) in the recurrence and outcome of patients with Oral tongue squamous cell carcinoma (OTSCC).

METHODS: All patients with OTSCC who underwent glossectomy with or without neck dissection in a tertiary center between 2010 and 2020 were included. The pathology slides of all patients were reviewed by a consulting pathologist. All pathologic features including tumor size, tumor grade, tumor thickness, surgical margin status, lymphovascular- and perineural invasion, T-stage, number of dissected, TB, TSR, and involved, tumor budding and tumor-stromal ratio were defined, we categorized the tumors as stroma-rich (low TSR) and stroma-poor (high TSR); as well as TB as low (0-4 buds) and high (≥ 5 buds). The inter-observer reliability of TB and TSR was assessed using the Kappa statistics analysis.

RESULTS: A total of 109 patients, with a median age of 62 (range 19-88) years, were included. There was a significant correlation between TSR and tumor budding with other adverse pathologic features and prognostic factors. In univariate analysis, both stromal-rich tumors and tumor budding were poor prognostic factors for disease-free survival (DFS) and overall survival (OS). However, on multivariate analysis, N-stage, adjuvant radiotherapy, tumor size, depth of invasion (DOI) and tumor budding emerged as independent prognostic factors for DFS. Likewise, N-stage, and DOI were recognized as independent prognostic factors for OS.

CONCLUSION: Both TSR and TB are important histopathological parameters strongly linked to other pathologic prognostic indicators. Additionally, they play key roles in predicting tumor behavior, recurrence, and patient survival.

PMID:39641832 | DOI:10.1007/s10006-024-01312-4

Clin Oral Investig. 2024 Dec 6;29(1):3. doi: 10.1007/s00784-024-06081-8.

ABSTRACT

OBJECTIVE: To compare the efficacy of silver diamine fluoride (SDF) and atraumatic restorative treatment (ART) in arresting caries lesions. Variables such as treatment time, adverse effects/parental aesthetic perception, anxiety and patients’ behavior were also evaluated.

MATERIALS AND METHODS: Children (3.53 ± 1.03 years) with dentin caries lesions on the occlusal surface of primary molars were randomized into test (SDF) and control (ART) groups. To determine the presence of caries, dmf-t and ICDAS indexes were used. Caries lesions were also classified according to activity (active or inactive). The time required to perform treatments was recorded and the children’s anxiety was assessed by a Facial Image Scale. The adverse events/aesthetic perception were registered by the operator and caregivers. The Frankl Behavioral Scale assessed patients’ behavior. The chi-square/Fisher’s exact and Mann-Whitney tests were used for comparisons between the groups.

RESULTS: Of the 118 participants who received treatment (SDF, n = 59; ART, n = 59), after 12-month follow-up, 91.5% (43/47) of caries lesions in the SDF and 90.2% (46/51) in the ART group were arrested (p = 1.000). After 24 months, 72% (18/25) were arrested in the SDF group and 95.2% (20/21) in the ART. The treatment times were 6.08 ± 1.72 and 13.58 ± 4.83, for SDF and ART, respectively (p < 0.001). No statistically significant difference of adverse effects, aesthetic perception, anxiety, and patients’ behavior were found between the groups.

CONCLUSIONS: SDF was similar to ART in arresting caries lesion but required less time for treatment. The anxiety, adverse effects/aesthetic perception and patients’ behavior were also similar between the groups. CLINICAL RELEVANCE: The use of SDF may be a faster and less invasive alternative for the treatment of caries lesions. Clinical trial registration number and date of registration: NCT03063307. September 2016.

PMID:39641816 | DOI:10.1007/s00784-024-06081-8

Clin Oral Investig. 2024 Dec 6;29(1):2. doi: 10.1007/s00784-024-06080-9.

ABSTRACT

OBJECTIVES: The study aimed to evaluate the use of oral exfoliative cytology and highlight its limited effectiveness in diagnosing oral diseases.

MATERIALS AND METHODS: A total of 1000 consecutive cases of oral cytology were retrieved from the files of an Oral Pathology Service, comprising the period between January 2002 and December 2022. Patient data and clinical details of the lesions were collected, and all slides were reviewed. Categorical data were presented in absolute and relative frequency (%), while numerical data were expressed as the median with minimum and maximum values. The Chi-square (X²) test was employed for frequency comparisons, with a significance level of 5%.

RESULTS: Men constituted 64.6% (n = 646) of the cases, with a statistically significant predominance of white individuals (69.4%; n = 694). Of the 1000 evaluated cases, 87.8% (n = 878) were graded using Papanicolaou staining. Regarding provisional diagnoses, most clinicians (79.1%) suspected fungal lesions (n = 817). Analysis of the agreement between provisional and final cytological diagnoses revealed a statistically significant disagreement.

CONCLUSIONS: This work reinforces the limited use of exfoliative cytology in diagnosing oral lesions.

CLINICAL RELEVANCE: Exfoliative oral cytology should be restricted to specific cases, particularly for diagnosing fungal disease, and occasionally when oral cancer is suspected, but a biopsy cannot be performed at that time.

PMID:39641812 | DOI:10.1007/s00784-024-06080-9

Eur J Pediatr. 2024 Dec 6;184(1):66. doi: 10.1007/s00431-024-05893-w.

ABSTRACT

The purpose of this study is to compare the effects of two different ways of stopping incubator humidification on episodes of hypothermia, hyperthermia, hyponatraemia, hypernatraemia, or skin injury. The design is a single site, two-armed, parallel, randomised, clinical trial conducted between April 2019 and March 2022. The setting was a quaternary referral and teaching hospital in Queensland, Australia. There were 140 extremely preterm infants, born < 28 weeks gestational age (GA). Intervention groups were (1) cease humidity: incubator humidification turned from 80% to off at 00.01am on day 8 of life (n = 70); or (2) gradually reduce humidity: incubator humidification reduced by 5% at 00:01 of each day from day 8 until ceased on day 14 (n = 70). The primary outcome was episodes of temperature instability: defined as either hypothermia < 36.5 °C or hyperthermia > 37.5 °C. Secondary outcomes included episodes of hyponatraemia: hypernatraemia or skin injury. One hundred forty infants were enrolled, 70 in each group. No statistically significant differences for any outcomes. Hyperthermia: 77% (n = 54) in the cease group and 73% (n = 51) in the gradual reduction group (P = 0.70). Hypothermia: 53% (n = 37) in the cease group and 37% (n = 26) in the gradual reduction group (P = 0.09). The number of hyponatraemic events was similar for both groups (P = 0.73), as for hypernatraemic events (P = 0.3). Skin injury in week 2 of life: 63% in the cease group and 67% in the gradual reduction group (P = 0.72).

CONCLUSIONS: Ceasing or gradually reducing incubator humidification after day 7 of life had no effect on the number of episodes of hypothermia or hyperthermia in this cohort of extremely preterm infants (EPTI). There was also no effect on the number of episodes of hyponatraemia or hypernatraemia.

TRIAL REGISTRATION: ANZCTR.org.au (Australia New Zealand Clinical Trials Registry). ACTRN 1261 9000 266167 Registered 21/2/2019.

WHAT IS KNOWN: • Incubator humidification is a widely accepted and routine practice in the management of EPTI as it influences transepidermal water loss (TEWL) and supports thermoregulation. However, weaning practices remain varied and inconsistent across the globe. • There remains a paucity of data to inform specific evidenced-based humidification practices.

WHAT IS NEW: • Ceasing or gradually reducing incubator humidification after 7 days had no effect on temperature stability, serum sodium levels, or frequency of skin injury in this cohort of EPTI between day 8 and day 14. • There is no apparent benefit in prolonging incubator humidity beyond day 7 of life in these EPTI.

PMID:39641809 | DOI:10.1007/s00431-024-05893-w

Strahlenther Onkol. 2024 Dec 6. doi: 10.1007/s00066-024-02339-y. Online ahead of print.

ABSTRACT

PURPOSE: The association of cardiac dosimetric parameters with survival in lung cancer patients is well established. However, most research has concentrated on patients undergoing definitive treatment. This study aims to investigate the relationship between cardiac dosimetric parameters and survival in patients receiving postoperative radiotherapy (PORT).

METHODS: Sixty patients who received PORT between 2011 and 2021 were retrospectively evaluated. The substructures of the heart were delineated on the simulation computed tomography scans of the patients. Univariate and multivariate Cox regression analyses were conducted to investigate the correlation between dosimetric parameters and overall survival. The Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM Corp., Armonk, NY, USA) was utilized for statistical analyses.

RESULTS: Right atrium (RA) maximum dose (Dmax) was the only variable that was significantly associated with a shorter OS. Further receiver operating characteristic (ROC) analysis revealed that the optimum cut-off value for RA Dmax was 43.6 Gy, with a sensitivity of 69% and a specificity of 62%. In addition, inclusion of the upper right paratracheal (2R), lower right paratracheal (4R), left pulmonary ligament (9L), and right hilus (10R) lymphatic stations in the treatment field led to an increase in RA Dmax.

CONCLUSION: The results of this retrospective study show that RA Dmax appears to have an impact on overall survival in patients undergoing PORT. Limiting the RA Dmax dose to below 43.6 Gy and avoiding elective nodal irradiation might potentially enhance survival in this patient cohort.

PMID:39641790 | DOI:10.1007/s00066-024-02339-y

Abdom Radiol (NY). 2024 Dec 6. doi: 10.1007/s00261-024-04722-w. Online ahead of print.

ABSTRACT

PURPOSE: Percutaneous ultrasound-guided renal biopsy is essential for diagnosing medical renal disorders in transplant kidneys. A variety of techniques have been advocated. The purpose of this study is to evaluate the safety and efficacy of two different coaxial techniques and biopsy devices.

METHODS: This single-center dual-arm, observation study cohort included 1831 consecutive transplant kidney biopsies performed over a 68-month period. Two coaxial techniques were used, distinguished by whether the 17 gauge (G) coaxial needle was advanced into the renal cortex (intracapsular technique; IC) or to the edge of the cortex (extracapsular technique; EC). One of two needle types could be used with either technique: an 18G side-cutting (Bard Max-Core or Mission) or an 18G end-cutting (Biopince Ultra) needle. In all cases, the cortical tangential technique was used to reduce the risk of central artery transgression and unnecessary medullary sampling. Patients were monitored for 30 days post-procedurally and complications were evaluated using the SIR adverse event classification.

RESULTS: Of the 1831 patients included in the study cohort, 13 suffered severe bleeding complications requiring operative intervention. Of these patients, 8 underwent biopsy with side-cutting needle and IC, 2 with side-cutting needle and approach not specified, 2 with end-cutting needle and IC, and 1 with end-cutting needle and EC. There was no statistically significant difference in the risk of bleeding complications between different coaxial techniques and needle types. However, there was a significantly increased chance of inadequate sampling when comparing the side-cutting needle (1.0%) to the end-cutting needle (0.1%).

CONCLUSIONS: Transplant kidney biopsy performed with two different coaxial techniques and needle types did not show differences in bleeding complications. There is an increased risk of inadequate sampling when using side-cutting relative to end-cutting biopsy devices.

PMID:39641782 | DOI:10.1007/s00261-024-04722-w

Afr J Reprod Health. 2024 Oct 31;28(10s):358-367. doi: 10.29063/ajrh2024/v28i10s.38.

ABSTRACT

Parents often perceive that stunting, wasting, and being underweight in their children are solely influenced by nutritional intake. In reality, various factors contribute to these outcomes. The objective of this study was to identify the factors associated with stunting, wasting, and being underweight in Indonesia. The design was a systematic literature review using the PRISMA procedure. The researchers applied a keyword search to databases collected via Science Direct, PubMed, ProQuest, SAGE and Emerald to find relevant articles published in English from 2016 to 2021. The results of the study found 17 relevant articles and revealed several factors associated with stunting, wasting and being underweight in Indonesia. All factors related to stunting, wasting, and underweight do not stand alone as the only predictors. Instead, they interact and contribute collectively to the occurrence of these conditions.

PMID:39641260 | DOI:10.29063/ajrh2024/v28i10s.38