Category: Statistics

Clin Epigenetics. 2024 Nov 2;16(1):152. doi: 10.1186/s13148-024-01763-2.

ABSTRACT

Inflammation underlies many conditions causing excess morbidity and mortality among people with HIV (PWH). A handful of single-trait epigenome-wide association studies (EWAS) have suggested that inflammation is associated with DNA methylation (DNAm) among PWH. Multi-trait EWAS may further improve statistical power and reveal pathways in common between different inflammatory markers. We conducted single-trait EWAS of three inflammatory markers (soluble CD14, D-dimers and interleukin-6) in the Veterans Aging Cohort Study (n = 920). The study population was all male PWH with an average age of 51 years, and 82.3% self-reported as Black. We then applied two multi-trait EWAS methods-CPASSOC and OmniTest-to combine single-trait EWAS results. CPASSOC and OmniTest identified 189 and 157 inflammation-associated DNAm sites, respectively, of which 112 overlapped. Among the identified sites, 56% were not significant in any single-trait EWAS. Top sites were mapped to inflammation-related genes including IFITM1, PARP9 and STAT1. These genes were significantly enriched in pathways such as “type I interferon signaling” and “immune response to virus.” We demonstrate that multi-trait EWAS can improve the discovery of inflammation-associated DNAm sites, genes and pathways. These DNAm sites might hold the key to addressing persistent inflammation in PWH.

PMID:39488703 | DOI:10.1186/s13148-024-01763-2

J Cardiothorac Surg. 2024 Nov 2;19(1):619. doi: 10.1186/s13019-024-03119-6.

ABSTRACT

OBJECTIVES: This study aims to examine the relationship between left atrial appendage closure (LAAC) and post-operative atrial fibrillation (POAF) in cardiac surgery patients with no pre-operative atrial fibrillation (AF).

METHODS: We analyzed a cohort of 2059 adult patients in our Society of Thoracic Surgery (STS) database who underwent at least one of the following procedures between 2018 and 2021: coronary artery bypass grafting (CABG), aortic valve replacement, or mitral valve replacement. All patients had no pre-operative AF, and 169 (8.2%) of them received a left atrial appendage closure (LAAC). Primary outcome was new-onset POAF and secondary outcomes included 1-year mortality, 30-day readmission, 1-year incident stroke, and post-operative hospital length of stay (LOS). Patients without an LAAC were matched to patients with LAAC using a 1:1 nearest neighbor propensity score method to reduce the bias due to potential confounding. Associations between LAAC and postoperative adverse outcomes were assessed using appropriate statistical tests for matched analyses.

RESULTS: The matched cohort included 162 pairs. LAAC was associated with elevated risk of new-onset POAF (41.4% vs. 25.3%, p = 0.003), and postoperative hospital LOS (142.1 vs. 120.5 h, p = 0.001). The LAAC did not significantly impact all-cause 1-year mortality, 30-day readmission, and 1-year incident stroke.

CONCLUSIONS: In cardiac surgery patients with no pre-operative history AF, LAAC was associated with substantially higher rates of new-onset POAF, without a corresponding impact on risk of 1-year incident stroke, 30-day readmission, or 1-year mortality.

PMID:39488696 | DOI:10.1186/s13019-024-03119-6

Environ Microbiome. 2024 Nov 2;19(1):84. doi: 10.1186/s40793-024-00628-8.

ABSTRACT

BACKGROUND: Interactions between plants and diverse root-associated fungi are essential drivers of forest ecosystem dynamics. The symbiosis is potentially dependent on multiple ecological factors/processes such as host/symbiont specificity, background soil microbiome, inter-root dispersal of symbionts, and fungus-fungus interactions within roots. Nonetheless, it has remained a major challenge to reveal the mechanisms by which those multiple factors/processes determine the assembly of root-associated fungal communities. Based on the framework of joint species distribution modeling, we examined 1,615 root-tips samples collected in a cool-temperate forest to reveal how root-associated fungal community structure was collectively formed through filtering by host plants, associations with background soil fungi, spatial autocorrelation, and symbiont-symbiont interactions. In addition, to detect fungi that drive the assembly of the entire root-associated fungal community, we inferred networks of direct fungus-fungus associations by a statistical modeling that could account for implicit environmental effects.

RESULTS: The fine-scale community structure of root-associated fungi were best explained by the statistical model including the four ecological factors/processes. Meanwhile, among partial models, those including background soil fungal community structure and within-root fungus-fungus interactions showed the highest performance. When fine-root distributions were examined, ectomycorrhizal fungi tended to show stronger associations with background soil community structure and spatially autocorrelated patterns than other fungal guilds. In contrast, the distributions of root-endophytic fungi were inferred to depend greatly on fungus-fungus interactions. An additional statistical analysis further suggested that some endophytic fungi, such as Phialocephala and Leptodontidium, were placed at the core positions within the web of direct associations with other root-associated fungi.

CONCLUSION: By applying emerging statistical frameworks to intensive datasets of root-associated fungal communities, we demonstrated background soil fungal community structure and fungus-fungus associations within roots, as well as filtering by host plants and spatial autocorrelation in ecological processes, could collectively drive the assembly of root-associated fungi. We also found that basic assembly rules could differ between mycorrhizal and endophytic fungi, both of which were major components of forest ecosystems. Consequently, knowledge of how multiple ecological factors/processes differentially drive the assembly of multiple fungal guilds is indispensable for comprehensively understanding the mechanisms by which terrestrial ecosystem dynamics are organized by plant-fungal symbiosis.

PMID:39488693 | DOI:10.1186/s40793-024-00628-8

BMC Womens Health. 2024 Nov 2;24(1):586. doi: 10.1186/s12905-024-03421-4.

ABSTRACT

BACKGROUND: Breast cancer is the most commonly diagnosed cancer among women worldwide, and it is associated with significant number of metabolic and reproductive risk factors. Despite the overlap between hormonal and metabolic factors involved in the development of PCOS and many known risk factors for breast cancer, the relationship between PCOS and breast cancer, the most common type of cancer among women, remains unknown. This study was conducted with the aim of determining the relationship between breast cancer and clinical symptoms of PCOS.

METHODS: This case-control study was conducted on 285 women with breast cancer and 285 healthy women referred to three centers in Tehran in 2023. Both the case and control groups were matched in terms of age and body mass index. The data collection tool in this study was a researcher-made data registration form, that was completed in person by qualified individuals. A history of PCOS was identified according to the Rotterdam criteria. Women aged 15-49 years who were able to read and write were included in the study. The case group had a history of breast cancer, while the control group did not. Participants who did not consent to having their data use in the analysis were excluded. Data was analyzed using an independent t-test, a chi-square test and a logistic regression model.

RESULTS: The mean age of the participants in the case group was 43.05 ± 4.92 years and that of the control group was 42.78 ± 5.06 years. The two groups showed a statistically significant difference in terms of PCOS history (p < 0.001). After adjusting for confounding variables, the logistic regression model showed that women with PCOS had a significantly higher chance of developing breast cancer (0R: 3.677, 95%CI: 1.529-8.840, P = 0.004). Among PCOS symptoms, women with a history of hirsutism had a higher chance of developing breast cancer (OR: 2.188, 95% CI: 1.014-4.720, P = 0.046).

CONCLUSION: The findings of the present study suggest that PCOS is a risk factor for breast cancer. Well-designed further studies are highly recommended to determine the role of PCOS in predicting breast cancer.

PMID:39488687 | DOI:10.1186/s12905-024-03421-4

BMC Surg. 2024 Nov 2;24(1):343. doi: 10.1186/s12893-024-02643-5.

ABSTRACT

BACKGROUND: The purposes of this retrospective study were to determine the efficacy of interventional methods in control of intraoperative blood losses and investigate the perioperative complications.

METHODS: The cases of 44 patients in whom a giant upper extremity tumor had been operated between 2008 and 2022 were analyzed retrospectively. Of these, 29 patients were treated with interventional methods (Group A) and 15 were treated without (Group B). Group A was further divided based on the intervention methodss: Group C (combination of balloon occlusion and transarterial embolization [TAE], n = 11) and Group D (single TAE, n = 18). Within Group D, patients were categorized based on the timing of TAE relative to surgery into Group E (TAE on the same day as surgery) and Group F (TAE performed days before surgery). We compared demographic features, blood loss, ICU admission rates, and use of vasopressors during surgery.

RESULTS: We collected clinical records from 44 patients diagnosed with a giant upper extremity tumor who underwent surgery. Group sizes were as follows: A (29), B (15), C (11), D (18), E (7), and F (11). Tumor volumes in the interventional and non-interventional groups were similar (704.19 ± 812.77 cm³ vs. 1224.53 ± 1414.01 cm³, P = 0.127). Blood plasma transfusion was significantly higher in Group B compared to Group A (425.33 ± 476.20 ml vs. 155.90 ± 269.67 ml, P = 0.021). Although overall blood loss did not significantly differ between Group A and Group B (467.93 ± 302.08 ml vs. 1150 ± 1424.15 ml, P = 0.087), the rate of massive bleeding (defined as blood loss over 1000 ml) was lower in Group A (6.9% vs. 46.47%, P = 0.004). The proportion of minors (patients aged less than 18) in Group C was significantly higher than in Group D (27.7% vs. 0.00%, P = 0.045). The amount of RBC transfusion was also significantly higher in Group C compared to Group D (458.18 ± 292.22 ml vs. 164.44 ± 224.03 ml, P = 0.021). No significant perioperative complications were observed.

CONCLUSIONS: Interventional techniques have been shown to reduce both blood loss and the necessity for blood transfusions in patients with large upper extremity tumors. Furthermore, no significant perioperative complications have been observed.

PMID:39488685 | DOI:10.1186/s12893-024-02643-5

BMC Public Health. 2024 Nov 2;24(1):3040. doi: 10.1186/s12889-024-20402-2.

ABSTRACT

BACKGROUND: While there is growing evidence highlighting the prevalence of mental health concerns among university faculty, few studies have examined mental health interventions in this population. The objective of this systematic review and meta-analysis was to collect and critically appraise the available evidence about the effectiveness of interventions designed to improve the mental health of faculty.

METHODS: A systematic search was conducted by searching PubMed, EMBASE, Scopus, Web of Science, and CINAHL to identify relevant studies published in English language from January 1st, 2000 until October 1st, 2023. The search focused on studies done on academic faculty to describe interventions or support programs aimed at improving mental health outcomes, with comparison of mental health data before and after the intervention and an improvement in mental health as study outcome. A random effect meta-analysis method was used to estimate the effectiveness of interventions on faculty mental health.

RESULTS: Ten publications with 891 participants from 2,217 retrieved records were included. The random effect model showed substantial heterogeneity (I² = 84.8%, 95% CI: 73.8 – 91.2%, p < 0.001). The pooled SMD was – 1.41 (95% CI: -2.81-0.004) showing a large effect, and it significantly favors the use of intervention for reducing mental health issues among faculty members. The effect size estimates for all included studies ranged from small to large, showing the positive effect of intervention on faculty mental health. Multimodal inference analysis showed that, of the many studied factors for faculty mental health, the region was the most important predictor of intervention effectiveness. However, when the significance of quantitative moderators was tested using meta-regression, age (p = 0.9491) and duration of intervention (p = 0.1284) were not statistically significant.

CONCLUSION: Interventions aimed at enhancing the mental health of university faculty were overall significant; however, individual studies showed heterogeneous results. Making efforts to enhance the mental health of faculty is crucial and has been proven effective; nevertheless, the existing evidence necessitates further research in this area. For interventions to be effective, it is imperative to tailor them to the specific environment and to the unique characteristics of faculty members.

PROSPERO REGISTRATION NUMBER: CRD42023490388.

PMID:39488684 | DOI:10.1186/s12889-024-20402-2

Cardiovasc Diabetol. 2024 Nov 2;23(1):393. doi: 10.1186/s12933-024-02470-1.

ABSTRACT

BACKGROUND: Dysglycemia and insulin resistance increase type 2 diabetes (T2D) and cardiovascular disease (CVD) risk, yet associations with specific glucose-insulin homeostatic biomarkers have been inconsistent. Vitamin D and marine omega-3 fatty acids (n-3 FA) may improve insulin resistance. We sought to examine the association between baseline levels of insulin, C-peptide, HbA1c, and a novel insulin resistance score (IRS) with incident cardiometabolic diseases, and whether randomized vitamin D or n-3 FA modify these associations.

METHODS: VITamin D and OmegA-3 TriaL (NCT01169259) was a randomized clinical trial testing vitamin D and n-3 FA for the prevention of CVD and cancer over a median of 5.3 years. Incident cases of T2D and CVD (including cardiovascular death, myocardial infarction, stroke, and coronary revascularization) were matched 1:1 on age, sex, and fasting status to controls. Conditional logistic regressions adjusted for demographic, clinical, and adiposity-related factors were used to assess the adjusted odds ratio (aOR) per-standard deviation (SD) and 95%CI of baseline insulin, C-peptide, HbA1c, and IRS (Insulin×0.0295 + C-peptide×0.00372) with risk of T2D, CVD, and coronary heart disease (CHD).

RESULTS: We identified 218 T2D case-control pairs and 715 CVD case-control pairs including 423 with incident CHD. Each of the four biomarkers at baseline was separately associated with incident T2D, aOR (95%CI) per SD increment: insulin 1.46 (1.03, 2.06), C-peptide 2.04 (1.35, 3.09), IRS 1.72 (1.28, 2.31) and HbA1c 7.00 (3.76, 13.02), though only HbA1c remained statistically significant with mutual adjustments. For cardiovascular diseases, we only observed significant associations of HbA1c with CVD (1.19 [1.02, 1.39]), and IRS with CHD (1.25 [1.04, 1.50]), which persisted after mutual adjustment. Randomization to vitamin D and/or n-3 FA did not modify the association of these biomarkers with the endpoints.

CONCLUSIONS: Each of insulin, C-peptide, IRS, and HbA1c were associated with incident T2D with the strongest association noted for HbA1c. While HbA1c was significantly associated with CVD risk, a novel IRS appears to be associated with CHD risk. Neither vitamin D nor n-3 FA modified the associations between these biomarkers and cardiometabolic outcomes.

PMID:39488682 | DOI:10.1186/s12933-024-02470-1

BMC Sports Sci Med Rehabil. 2024 Nov 2;16(1):224. doi: 10.1186/s13102-024-01010-4.

ABSTRACT

OBJECTIVE: The influence of the menstrual cycle on practical power performance such as barbell back squats and jumping performance in women has not yet been fully investigated. In addition, the performance level of athletes has not been considered in previous studies. This study aimed to investigate the influence of different cycle phases on acute back squat performance, jumping ability and psychological state concerning the performance level.

METHODS: 24 female strength athletes (age: 25.2 ± 3.3 years; height: 169.5 ± 3.4 cm; body weight: 67.7 ± 7.3 kg) were recruited for the study. Level of performance was classified according to Santos et al. (intermittent (n = 13), advanced (n = 6), highly advanced (n = 5)). Participants were tested for 1RM barbell back squat and jumping performance (countermovement and squat jump) as well as two questionnaires assessing their psychological states in the menses (M), late follicular phase (FP) and mid-luteal phase (LP) in three MC. Saliva estradiol and progesterone concentrations with a menstrual cycle diary were used to confirm a normal MC. A principal components analysis for power performance, well-being, relaxation and alertness was carried out and a linear mixed model was used for statistical evaluation.

RESULTS: No significant differences were found between the MC phases in performance scores (p > 0.05), readiness (p > 0.05) and alertness (p > 0.05). However, a high correlation between MC phases, performance level and back squat performance was detected. Correlation analyses indicate that a higher performance level results in a higher variation depending on the MC of the squat performance. For well-being, a significantly lower score was detected in M than in FP and LP.

CONCLUSION: In general the performance score of the lower body is not influenced by the MC. If strength performance and jumping ability are considered separately, there are indications that strength capability is influenced at a higher performance level. In addition, individual variance was also observed, so this should also be considered. However, further studies are needed to confirm this assumption due to the small sample sizes of the individual performance levels.

TRIAL REGISTRATION: German registry for clinical studies (DRKS00034816, Date: 08/01/2024).

PMID:39488680 | DOI:10.1186/s13102-024-01010-4

Biochem Genet. 2024 Nov 3. doi: 10.1007/s10528-024-10950-y. Online ahead of print.

ABSTRACT

Successful embryo implantation relies on a receptive endometrium and a maternofetal dialogue. Abnormal receptivity is a common cause of implantation failure in assisted reproductive techniques. This study aimed to develop a novel transcriptomic-based diagnostic assay, Adhesio, for assessing endometrial receptivity and guiding personalized embryo transfer. Adhesio was developed based on an initial dataset of 74 endometrial biopsies. Two types of biopsy samples were involved: 45 endometrial biopsies collected during the optimal theoretical window of implantation (WOI) and 29 endometrial biopsies which cells have been cultured with or without an autologous embryo. Microarray analysis was performed to identify differentially expressed genes associated with endometrial receptivity and selected candidate genes were assessed using quantitative real-time polymerase chain reaction (RT-qPCR) on biopsy samples. Statistical analyses were conducted to assess the performance and accuracy of Adhesio. The microarray analysis identified three distinct clusters of endometrial samples with differential gene expression patterns. Cluster 1 exhibited 1717 differentially expressed genes involved in biological processes associated with endometrial receptivity. A specific transcriptomic signature of 60 genes associated with endometrial co-culture was obtained using class prediction approach. Thereafter, an original panel of 10 genes was selected as potential biomarkers for endometrial receptivity based on their expression profiles in both endometrial biopsies and co-cultured cells. This article outlines the methodology employed to develop Adhesio, a test that assesses endometrial receptivity using an original panel of 10 genes. These genes are not only involved during the WOI but are also influenced by the maternal-fetal dialogue.

PMID:39488671 | DOI:10.1007/s10528-024-10950-y

Pediatr Surg Int. 2024 Nov 2;40(1):287. doi: 10.1007/s00383-024-05869-9.

ABSTRACT

PURPOSE: Practice patterns of same-day discharge for pediatric laparoscopic appendectomy for non-perforated appendicitis are not well-analyzed. Our aim is to evaluate current practice patterns and outcomes of same-day discharge for these patients.

METHODS: NSQIP-P retrospective registry identified patients (2017-2021) who underwent laparoscopic appendectomy for non-perforated appendicitis. Annual same-day discharge (SDD) rate was determined. SDD patients were compared to those discharged postoperative days 1-2 (non-SDD). Sub-group analysis was performed on ICD-10 code K35.30. Regression was performed.

RESULTS: Overall, 67,214 patients were identified. The SDD rate increased from 33.3% (2017) to 52.5% (2021) with decreased 30-day readmissions between SDD and non-SDD (1.3% vs 2.1%, p < 0.001). Sub-group analysis identified 7,330 patients with SDD rates from 50.7% (2019) to 60.4% (2021) with decreased 30-day readmissions (1.3% vs 2.1%, p < 0.001) for SDD versus non-SDD. No increase in adverse events for SDD occurred in either analysis. Regression identified esophageal/gastric/intestinal diseases increased odds of early readmission or reoperation (OR 1.85, p = 0.042).

CONCLUSION: Same-day discharge after pediatric laparoscopic appendectomy for non-perforated acute appendicitis continues to increase in frequency without a significant increase in adverse outcomes. SDD rates are 20-30% lower than previously published single-center studies, indicating there is a likely a larger percentage of patients that could discharge same-day.

LEVEL OF EVIDENCE (I-V): Level III.

PMID:39488659 | DOI:10.1007/s00383-024-05869-9