Category: Statistics

Acta Otolaryngol. 2023 Oct 30:1-7. doi: 10.1080/00016489.2023.2269255. Online ahead of print.

ABSTRACT

BACKGROUND: To determine the anatomical proximity of the vestibular nuclei to the respiratory nuclei and the effect of susceptibility of the posterior labyrinth to a hypoxic state on the vestibular system.

OBJECTIVE: It was aimed to evaluate the possible effects of periodic hypoxia on vestibular reflexes and proprioceptive perception in patients with obstructive sleep apnea syndrome (OSAS).

MATERIAL AND METHODS: The study was conducted with 40 patients diagnosed with moderate and severe OSAS and 21 healthy individuals. All individuals were evaluated with Dizziness Handicap Inventory, ocular vestibular evoked myogenic potential (oVEMP), cervical vestibular evoked myogenic potential (cVEMP), video head impulse test (vHIT), videonystagmography (VNG) and sportKAT 3000.

RESULTS: In the vHIT, a statistically significant difference was found between the groups in terms of anterior and posterior semicircular canal vestibulo-ocular reflex gains (p < .05). A negative correlation was found between the lateral gain asymmetry and RALP gain asymmetry and the awake blood oxygen level in the OSAS groups. There was a statistically significant difference between the groups in terms of wave response rates cVEMP 100 dB nHL and oVEMP 100-110 dB nHL (p < .05).

CONCLUSION AND SIGNIFICANCE: It was concluded that vestibular reflexes and proprioceptive perception were affected due to periodic/chronic hypoxia in patients with moderate and severe OSAS.

PMID:37902611 | DOI:10.1080/00016489.2023.2269255

J Physiol. 2023 Oct 30. doi: 10.1113/JP284958. Online ahead of print.

ABSTRACT

Critical torque (CT) represents the highest oxidative steady state for intermittent knee extensor exercise, but the extent to which it is influenced by skeletal muscle mitochondria and sex is unclear. Vastus lateralis muscle biopsy samples were collected from 12 females and 12 males -matched for relative maximal oxygen uptake normalized to fat-free mass (FFM) (F: 57.3 (7.5) ml (kg FFM)^-1 min^-1 ; M: 56.8 (7.6) ml (kg FFM)^-1 min^-1 ; P = 0.856) – prior to CT determination and performance fatiguability trials. Males had a lower proportion of myosin heavy chain (MHC) I isoform (40.6 (18.4)%) compared to females (59.5 (18.9)%; P = 0.021), but MHC IIa and IIx isoform distributions and protein markers of mitochondrial content were not different between sexes (P > 0.05). When normalized to maximum voluntary contraction (MVC), the relative CT (F: 42.9 (8.3)%; M: 37.9 (9.0)%; P = 0.172) and curvature constant, W’ (F: 26.6 (11.0) N m s (N m)^-1 ; M: 26.4 (6.5) N m s (N m)^-1 ; P = 0.962) were not significantly different between sexes. All protein biomarkers of skeletal muscle mitochondrial content, as well as the proportion of MHC I isoform, positively correlated with relative CT (0.48 < r < 0.70; P < 0.05), and the proportion of MHC IIx isoform correlated positively with relative W’ (r = 0.57; P = 0.007). Indices of performance fatiguability were not different between males and females for MVC- and CT-controlled trials (P > 0.05). Greater mitochondrial protein abundance was associated with attenuated declines in potentiated twitch torque for exercise at 60% MVC (P < 0.05); however, the influence of mitochondrial protein abundance on performance fatiguability was reduced when exercise was prescribed relative to CT. Whether these findings translate to whole-body exercise requires additional research. KEY POINTS: The quadriceps critical torque represents the highest intensity of intermittent knee extensor exercise for which an oxidative steady state is attainable, but its relationship with skeletal muscle mitochondrial protein abundance is unknown. Matching males and females for maximal oxygen uptake relative to fat-free mass facilitates investigations of sex differences in exercise physiology, but studies that have compared critical torque and performance fatiguability during intermittent knee extensor exercise have not ensured equal aerobic fitness between sexes. Skeletal muscle mitochondrial protein abundance was correlated with critical torque and fatigue resistance for exercise prescribed relative to maximum voluntary contraction but not for exercise performed relative to the critical torque. Differences between sexes in critical torque, skeletal muscle mitochondrial protein abundance and performance fatiguability were not statistically significant. Our results suggest that skeletal muscle mitochondrial protein abundance may contribute to fatigue resistance by influencing the critical intensity of exercise.

PMID:37902588 | DOI:10.1113/JP284958

J Cogn Neurosci. 2023 Oct 30:1-24. doi: 10.1162/jocn_a_02080. Online ahead of print.

ABSTRACT

Web-based experiments are gaining momentum in motor learning research because of the desire to increase statistical power, decrease overhead for human participant experiments, and utilize a more demographically inclusive sample population. However, there is a vital need to understand the general feasibility and considerations necessary to shift tightly controlled human participant experiments to an online setting. We developed and deployed an online experimental platform modeled after established in-laboratory visuomotor rotation experiments to serve as a case study examining remotely collected data quality for an 80-min experiment. Current online motor learning experiments have thus far not exceeded 60 min, and current online crowdsourced studies have a median duration of approximately 10 min. Thus, the impact of a longer-duration, web-based experiment is unknown. We used our online platform to evaluate perturbation-driven motor adaptation behavior under three rotation sizes (±10°, ±35°, and ±65°) and two sensory uncertainty conditions. We hypothesized that our results would follow predictions by the relevance estimation hypothesis. Remote execution allowed us to double (n = 49) the typical participant population size from similar studies. Subsequently, we performed an in-depth examination of data quality by analyzing single-trial data quality, participant variability, and potential temporal effects across trials. Results replicated in-laboratory findings and provided insight on the effect of induced sensory uncertainty on the relevance estimation hypothesis. Our experiment also highlighted several specific challenges associated with online data collection including potentially smaller effect sizes, higher data variability, and lower recommended experiment duration thresholds. Overall, online paradigms present both opportunities and challenges for future motor learning research.

PMID:37902584 | DOI:10.1162/jocn_a_02080

Trauma Violence Abuse. 2023 Oct 30:15248380231204887. doi: 10.1177/15248380231204887. Online ahead of print.

ABSTRACT

Gender-based violence (GBV) is a pervasive public health issue that harms victims. Bystanders’ interventions are crucial in preventing the risks of GBV; however, numerous barriers impede their willingness and behaviors to intervene. As a part of efforts to thwart these barriers, this study used a systematic review and meta-analysis to identify such barriers and assess their impact on bystanders’ engagement to intervene. The researchers explored academic databases and included 38 studies in the analysis; we extracted and coded the identified barriers (e.g., lack of responsibility, rape myth) and allocated them to six domains: failure to notice, failure to perceive risk, failure to take responsibility for engaging, lack of bystander efficacy/competency, failure to take an action, and failure of previous intervention attempts. We calculated the overall and domain-specific effect sizes (ES) and performed moderator analysis. The overall ES of the barriers identified in the review were small but statistically significant. The most potent bystander intervention barrier domain was failed previous intervention attempts; the greatest specific barriers therein were negative emotions and feelings of uncertainty after engaging in bystander behaviors. University/college populations were more vulnerable to barriers to intervention than community members. Moreover, the barriers were more prohibitive in incidents of violence against women and sexual assaults than in intimate partner violence. Bystander-focused programs that address negative emotions and feelings arising from prior intervention experiences are needed to foster continued bystander engagement and assistance in GBV; moreover, tailored program content should also be provided for groups most vulnerable to intervention barriers.

PMID:37902582 | DOI:10.1177/15248380231204887

J Cardiovasc Imaging. 2023 Oct;31(4):200-206. doi: 10.4250/jcvi.2023.0055.

ABSTRACT

BACKGROUND: Right ventricular (RV) dysfunction is a significant risk of major adverse cardiac events in patients with acute heart failure (AHF). In this study, we evaluated RV-pulmonary artery (PA) coupling, assessed by tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) and assessed its prognostic significance, in AHF patients.

METHODS: We measured the TAPSE/PASP ratio and analyzed its correlations with other echocardiographic parameters. Additionally, we assessed its prognostic role in AHF patients.

RESULTS: A total of 1147 patients were included in the analysis (575 men, aged 70.81 ± 13.56 years). TAPSE/PASP ratio exhibited significant correlations with left ventricular (LV) ejection fraction(r = 0.243, p < 0.001), left atrial (LA) diameter(r = -0.320, p < 0.001), left atrial global longitudinal strain (LAGLS, r = 0.496, p < 0.001), mitral E/E’ ratio(r = -0.337, p < 0.001), and right ventricular fractional area change (RVFAC, r = 0.496, p < 0.001). During the median follow-up duration of 29.0 months, a total of 387 patients (33.7%) died. In the univariate analysis, PASP, TAPSE, and TAPSE/PASP ratio were significant predictors of mortality. After the multivariate analysis, TAPSE/PASP ratio remained a statistically significant parameter for all-cause mortality (hazard ratio [HR], 0.453; p = 0.037) after adjusting for other parameters. In the receiver operating curve analysis, the optimal cut-off level of TAPSE/PASP ratio for predicting mortality was 0.33 (area under the curve = 0.576, p < 0.001), with a sensitivity of 65% and a specificity of 47%. TAPSE/PASP ratio < 0.33 was associated with an increased risk of mortality after adjusting for other variables (HR, 1.306; p = 0.025).

CONCLUSIONS: In AHF patients, TAPSE/PASP ratio demonstrated significant associations with RVFAC, LA diameter and LAGLS. Moreover, a decreased TAPSE/PASP ratio < 0.33 was identified as a poor prognostic factor for mortality.

PMID:37901999 | DOI:10.4250/jcvi.2023.0055

ACS Nano. 2023 Oct 30. doi: 10.1021/acsnano.3c08377. Online ahead of print.

ABSTRACT

An electron-hole pair in a cube-shaped CdSe/CdS core/shell nanocrystal exists in the form of dynamic excitons across the strongly and weakly confined regimes under ambient temperatures. Photochemical doping is applied to distinguish the band-edge electron and hole levels, confirming an effective mass model with universal constants. Reduction of the optical bandgap upon epitaxy of the CdS shells is caused by lowering the band-edge electron level and barely affecting the band-edge hole level. Similar shifts of the electron levels, yet retaining the hole levels, can switch the order in energy of the three lowest-energy transitions. Thermal distribution of 1-4 electrons among the two thermally accessible electron levels follows number-counting statistics, instead of Fermi-Dirac distribution.

PMID:37901990 | DOI:10.1021/acsnano.3c08377

Circulation. 2023 Oct 30. doi: 10.1161/CIRCULATIONAHA.123.066017. Online ahead of print.

ABSTRACT

Background: Climate change is causing an increase in extreme heat. Individuals with cardiovascular disease are at high risk of heat-related adverse health effects. How the burden of extreme heat-associated cardiovascular deaths in the United States will change with the projected rise in extreme heat is unknown. Methods: We obtained data on cardiovascular deaths among adults and the number of extreme heat days (maximum heat index ≥90 °F [32.2 °C]) in each county in the contiguous United States from 2008 to 2019. Based on representative concentration pathway trajectories that model greenhouse gas emissions and shared socioeconomic pathways (SSP) that model future socioeconomic scenarios and demographic projections, we obtained county-level projected numbers of extreme heat days and populations under 2 scenarios for the midcentury period 2036 to 2065: SSP2-4.5 (representing demographic projections from a “middle-of-the-road” socioeconomic scenario and an intermediate increase in emissions) and SSP5-8.5 (demographic projections in an economy based on “fossil-fueled development” and a large increase in emissions). The association of cardiovascular mortality with extreme heat was estimated with a Poisson fixed-effects model. Using estimates from this model, the projected number of excess cardiovascular deaths associated with extreme heat was calculated. Results: Extreme heat was associated with 1651 (95% CI, 921-2381) excess cardiovascular deaths per year from 2008 to 2019. By midcentury, extreme heat is projected to be associated with 4320 (95% CI, 2369-6272) excess deaths annually, which is an increase of 162% (95% CI, 142-182) under SSP2-4.5, and 5491 (95% CI, 3011-7972) annual excess deaths, which is an increase of 233% (95% CI, 206-259) under SSP5-8.5. Elderly adults are projected to have a 3.5 (95% CI, 3.2- 3.8) times greater increase in deaths in the SSP2-4.5 scenario compared with nonelderly adults. Non-Hispanic Black adults are projected to have a 4.6 (95% CI, 2.8-6.4) times greater increase compared with non-Hispanic White adults. The projected change in deaths was not statistically significantly different for other race and ethnicity groups or between men and women. Conclusions: By midcentury, extreme heat is projected to be associated with a significantly greater burden of excess cardiovascular deaths in the contiguous United States.

PMID:37901952 | DOI:10.1161/CIRCULATIONAHA.123.066017

Nucl Med Commun. 2023 Oct 30. doi: 10.1097/MNM.0000000000001761. Online ahead of print.

ABSTRACT

OBJECTIVE: Human epidermal growth factor receptor 2 (HER2) is an important biomarker for targeted gastric cancer (GC) immunotherapy. However, heterogeneous HER2 overexpression in GC, loss of HER2 expression during therapy, and inability to non-invasively identify HER2 overexpressing tumors impede effective targeting therapies. Improved HER2-specific functional imaging can address these challenges. Trastuzumab is a HER2-directed mAb to treat HER2 overexpressing cancers. The 64Cu-DOTA-trastuzumab radiotracer is used to detect HER2+ metastatic breast cancer. We aimed to develop 64Cu-DOTA-trastuzumab PET-CT to detect and characterize tumor uptake in HER2+ or – GC patients.

METHODS: We conducted a single-arm phase II pilot study exploring the feasibility of 64Cu-DOTA-trastuzumab for PET imaging of HER2 overexpressing GC compared to HER2 non-expressing tumors. Eight patients with biopsy-confirmed gastric adenocarcinoma were included. Immunohistochemistry was used to evaluate primary tumor biopsies for HER2 overexpression. Patients were injected with 45 mg of cold trastuzumab followed by 5 mg of 64Cu-DOTA-trastuzumab. PET-CT scans were performed 24-48 h post radiotracer injection and compared to standard staging CT scans.

RESULTS: We observed limited toxicity following 64Cu-DOTA-trastuzumab injections. While there was uptake of the radiotracer in portions of HER2+ lesions, there was no statistically significant distinction between tumor and background by standardized uptake value analysis.

CONCLUSION: Despite the potential of 64Cu-DOTA-trastuzumab PET imaging of HER2+ metastatic breast cancer, a 5 mg dose of this radiotracer injected 24-48 h before imaging was insufficient to identify HER2+ GC. These results inform future GC imaging studies to optimize biomarker-targeted therapies based on dosage and timing for more clinically relevant imaging.

PMID:37901917 | DOI:10.1097/MNM.0000000000001761

Am J Clin Pathol. 2023 Oct 30:aqad119. doi: 10.1093/ajcp/aqad119. Online ahead of print.

ABSTRACT

OBJECTIVES: Several alternative lymph node staging systems have recently been described for gastric cancer. The log odds of positive lymph nodes (LODDS) system may be superior to the pN stage (American Joint Committee on Cancer) and lymph node ratio systems in predicting outcomes for patients with gastric cancers, as indicated by some researchers. Most studies, however, have been conducted in Asian countries, and conflicting results have been reported by other investigators.

METHODS: We conducted a retrospective study of all 377 cases of gastric cancer resected at a tertiary hospital in Spain between 2000 and 2019. Clinicopathologic features were collected, LODDS were calculated and categorized into 5 groups (S1-S5), and statistical analysis was performed.

RESULTS: The cases included (n = 315) were classified as S1 (25.6%), S2 (18.4%), S3 (21.3%), S4 (20.3%), and S5 (14.4%). The LODDS classification was significantly associated with tumor size, Laurén subtype, presence of signet ring cells, tumor grade, perineural infiltration, lymphovascular invasion, growth pattern, pT, tumor recurrence, and death. Kaplan-Meier analysis based on the LODDS classification demonstrated improved patient stratification compared with the pN stage for both overall survival (OS) and disease-free survival (DFS). Area under the curve values for recurrence and death were superior for the LODDS classification, and this classification was independently related to OS and DFS. In addition, the LODDS classification successfully divided patients without lymph node metastases (pN0) into subgroups with distinct prognoses.

CONCLUSIONS: For our cohort, the LODDS system showed better prognostic performance than pN stage; it was an independent predictor of OS and DFS, and it provided valuable prognostic information in cases without lymph node metastases. Its prognostic accuracy, however, decreased in cases with fewer than 16 lymph nodes resected.

PMID:37901915 | DOI:10.1093/ajcp/aqad119

Eur J Ophthalmol. 2023 Oct 30:11206721231210693. doi: 10.1177/11206721231210693. Online ahead of print.

ABSTRACT

PURPOSE: To investigate best corrected visual acuity (BCVA), subretinal fluid (SRF) absorption time or ellipsoid zone (EZ) restoration time and various variables in patients with persistent SRF after successful primary repair of rhegmatogenous retinal detachment (RRD).

METHODS: This retrospective multicenter study allowed independent analysis of the healing pattern by two observers based on composite of serial cross-sectional macular optical coherence tomography (OCT) scans. Univariate and multivariate analyses were implemented.

RESULTS: One hundred and three cases had persistent SRF after pars plana vitrectomy, scleral buckling, or pneumatic retinopexy. By univariate analysis, SRF resolution time correlated positively with the number of retinal breaks (p < 0.001) and with increased myopia (p = 0.011). Using multivariate analysis, final BCVA (log MAR) correlated positively with age, duration of RRD, initial BCVA (OR = 3.28; [95%CI = 1.44-7.47]; p = 0.015), and SRF resolution time (OR = 0.46 [95%CI 0.21-1.05]; p = 0.049). EZ restoration time was longer with increasing number of retinal tears (OR = 0.67; [95%CI 0.29-1.52]; p = 0.030), worse final BCVA, and presence of macula-off RRD (OR = 0.26; [95%CI 0.08-0.88]; p = 0.056). SRF resolution time correlated marginally with prone position.

CONCLUSIONS: Residual posterior SRF is more common in eyes with multiple breaks or in myopic eyes. Final BCVA is better in younger subjects and in eyes with shorter duration of RRD. Persistent SRF is a self-limited disorder with a mean resolution of 11.2 months with good visual prognosis improving from a mean baseline logMAR of 1.08 to 0.25 at one year.

PMID:37901895 | DOI:10.1177/11206721231210693