Category: Statistics

Eur J Radiol. 2021 Mar 13;138:109657. doi: 10.1016/j.ejrad.2021.109657. Online ahead of print.

ABSTRACT

PURPOSE: With the help of quantitative computed tomography (QCT), it is possible to identify smoking-associated airway remodeling. However, there is currently little information on whether QCT-based airway metrics are sensitive to early airway wall remodeling in subclinical phases of smoking-associated airway disease. This study aimed to evaluate a predictive model that normalized airway parameters and investigate structural airway alterations in smokers with normal-looking CT using the normalization scheme.

METHODS: In this retrospective analysis, 222 non-smokers (male 97, female 125) and 69 smokers (male 66, female 3) from January 2014 to December 2016 were included, and airway parameters were quantitatively analyzed. To control inter-subject variability, multiple linear regressions of tracheal wall thickness (WT), diameter (D), and luminal area (LA) were performed, adjusted for age, sex, and height. Using this normalization scheme, airway parameters with matched generation were compared between smokers and non-smokers.

RESULTS: Using the normalization scheme, it was possible to assess generation-based structural alterations of the airways in subclinical smokers. Smokers showed diffuse luminal narrowing of airways for most generations (P < 0.05, except 3rd generation), no change in wall thickness of the proximal bronchi (1st-3rd generation), and a thinning of distal airways (P <0.05, ≥4th generation).

CONCLUSION: QCT assessment for subclinical smokers can help identify minimal structural changes in airways induced by smoking.

PMID:33773402 | DOI:10.1016/j.ejrad.2021.109657

Clin Imaging. 2021 Mar 20;78:98-103. doi: 10.1016/j.clinimag.2021.03.011. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the diagnostic performance of Prostate Imaging-Reporting and Data System version 2.0 (PI-RADSv2.0) for differentiating clinically significant prostate cancer (csPCa) from benign prostate disease on prebiopsy multiparametric MRI stratified by total prostate specific antigen (PSA) concentration.

MATERIALS AND METHODS: 150 patients who had prebiopsy mpMRI, serum PSA concentration and subsequent biopsy were retrospectively analyzed. Patients were stratified by PSA concentration (Group1 ≥ 10 ng/mL; Group2 4.0-<10 ng/mL). MRI findings were assessed using PI-RADSv2.0 by two blinded radiologists. Lesions were graded histopathologically using the International Society of Urological Pathology (ISUP) score. Diagnostic performance of PI-RADSv2.0 was evaluated and compared to PSA and PSA Density (PSAD). The performance of the radiologists was compared including inter-observer agreement for PI-RADSv2.0. The correlation between imaging and histopathological biopsy results was analyzed.

RESULTS: The differences in total PSA, free/total PSA ratio and PSAD between benign (n = 78) and malignant (n = 72) groups were significant (p < 0.05). The PI-RADSv2.0 scores of the radiologists were strongly correlated (r = 0.912, p < 0.001) with excellent agreement, κ = 0.97 (95%CI: 0.90-1.03; p < 0.005). Receiver operating characteristics curve analysis showed significantly high predictive power for PI-RADSv2.0, total PSA and PSAD alone. Comparison of age, prostate volume, PSAD, free/total PSA ratio and total PSA values between ISUP1 and ISUP ≥ 2 cases revealed significantly increased PSAD (p < 0.001) and total PSA (p = 0.001) in the ISUP ≥ 2 group.

CONCLUSION: PI-RADSv2.0 had high diagnostic accuracy in both PSA groups. PI-RADSv2.0, PSAD and total PSA alone had significant high predictive power to detect csPCa. However, the combination of PI-RADSv2.0 and PSAD or total PSA for each reader showed no statistically significant improvement when compared to PI-RADSv2.0 alone.

PMID:33773450 | DOI:10.1016/j.clinimag.2021.03.011

J Hum Evol. 2021 Mar 24;154:102976. doi: 10.1016/j.jhevol.2021.102976. Online ahead of print.

ABSTRACT

Identifying when hominins first produced Lomekwian, Oldowan, and Acheulean technologies is vital to multiple avenues of human origins research. Yet, like most archaeological endeavors, our understanding is currently only as accurate as the artifacts recovered and the sites identified. Here we use optimal linear estimation (OLE) modelling to identify the portion of the archaeological record not yet discovered, and statistically infer the date of origin of the earliest flaked stone technologies. These models provide the most accurate framework yet for understanding when hominins first produced these tool types. Our results estimate the Oldowan to have originated 2.617 to 2.644 Ma, 36,000 to 63,000 years earlier than current evidence. The Acheulean’s origin is pushed back further through OLE, by at least 55,000 years to 1.815 to 1.823 Ma. We were unable to infer the Lomekwian’s date of origin using OLE, but an upper bound of 5.1 million years can be inferred using alternative nonparametric techniques. These dates provide a new chronological foundation from which to understand the emergence of the first flaked stone technologies, alongside their behavioral and evolutionary implications. Moreover, they suggest there to be substantial portions of the artifact record yet to be discovered.

PMID:33773284 | DOI:10.1016/j.jhevol.2021.102976

Value Health Reg Issues. 2021 Mar 24;25:57-63. doi: 10.1016/j.vhri.2020.12.003. Online ahead of print.

ABSTRACT

INTRODUCTION: There are increasing demands for studies of cost-effectiveness to allocate resources for disease prevention and treatment strategies. The aim of this study is to measure quality of life in migraineurs, based on the Migraine-Specific Questionnaire (MSQ) and EQ-5D-5L, and thereafter map an algorithm to estimate health-state utility values from the MSQ in individuals with migraine.

METHODS: In this cross-sectional study conducted between May and July 2018 in a tertiary headache clinic in Tehran, Iran, migraineurs diagnosed based on International Classification of Headache Disorders (ICHD)-3β were enrolled and were asked to complete the MSQ questionnaire and EQ-5D questionnaire. The Spearman correlation coefficient (ρ) was calculated to measure the correlation between the EQ-5D-5L and MSQ v2.1 domains’ score. A P value of <.05 was considered statistically significant. After statistical analysis, several regression models were presented to map the results of the MSQ domains to the utility index, and the preferred model was achieved based on goodness of fit and the model’s predictive performance.

RESULTS: The preferred MSQ algorithm had approximately the same prediction errors in all migraineurs, episodic and chronic migraine (root mean square error 0.24, 0.24, and 0.23, respectively). The preferred MSQ model explained a variance of 0.26 (R²) in episodic and 0.38 in chronic migraine in the EQ-5D-5L questionnaire.

CONCLUSION: The preferred MSQ mapping algorithm will be suitable in estimating health state utilities in trials of patients with migraine that contain MSQ scores but lack utility values.

PMID:33773328 | DOI:10.1016/j.vhri.2020.12.003

Eur J Cancer. 2021 Feb 27;148:328-339. doi: 10.1016/j.ejca.2021.02.024. Online ahead of print.

ABSTRACT

BACKGROUND: Coronavirus disease (COVID-19) is interfering heavily with the screening, diagnosis and treatment of cancer patients. Better knowledge of the seroprevalence and immune response after Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in this population is important to manage them safely during the pandemic.

METHODS: 922 cancer patients, 100 non-cancer patients and 94 health care workers (HCW) attending the Multidisciplinary Oncology Unit of Antwerp University Hospital from 24th of March 2020 till 31st of May 2020, and the Oncology Unit of AZ Maria Middelares Hospital, Ghent, from 13th of April 2020 till 31st of May 2020 participated in the study. The Alinity® (A; Abbott) and Liaison® (D; DiaSorin) commercially available assays were used to measure SARS-CoV-2 IgG, while total SARS-CoV-2 Ig was measured by Elecsys® (R; Roche).

RESULTS: In the overall study population IgG/total SARS-CoV-2 antibodies were found in respectively 32/998 (3.2%), 68/1020 (6.7%), 37/1010 (3.7%) and of individuals using the A, D or R test. Forty-six out of 618 (7.4%) persons had a positive SARS-CoV-2 polymerase chain reaction (RT-PCR) test. Seroprevalence in cancer patients (A:2.2%, D:6.2%, R:3.0%), did not significantly differ from that in non-cancer patients (A:1.1%, D:5.6%, R:0.0%), but was lower than the HCW (A:13%, D:12%, R:12%; respectively Fisher’s exact test p = 0.00001, p = 0.046, p = 0.0004). A positive SARS-CoV-2 RT-PCR was found in 6.8% of the cancer patients, 2.3% of the non-cancer patients and 28.1% of the HCW (Fisher’s exact test p = 0.0004). Correlation between absolute values of the different Ig tests was poor in the cancer population. Dichotomising a positive versus negative test result, the A and R test correlated well (kappa 0.82 p McNemar test = 0.344), while A and D and R and D did not (respectively kappa 0.49 and 0.57; result significantly different p McNemar test = <0.0001 for both). The rate of seroconversion (>75%) and median absolute antibody levels (A: 7.0 versus 4.7; D 74.0 versus 26.6, R: 16.34 versus 7.32; all >P Mann Whitney U test = 0.28) in cancer patients and HCW with a positive RT-PCR at least 7 days earlier did not show any differences. However, none (N = 0/4) of the patients with hematological tumours had seroconversion and absolute antibody levels remained much lower compared to patients with solid tumours (R: 0.1 versus 37.6, p 0.003; D 4.1 versus 158, p 0.008) or HCW (all p < 0.0001).

CONCLUSION: HCW were at high risk of being infected by SARS-CoV-2 during the first wave of the pandemic. Seroprevalence in cancer patients was low in the study period. Although Ig immune response in cancer patients with solid tumours does not differ from healthy volunteers, patients with hematological tumours have a very poor humoral immune response. This has to be taken into account in future vaccination programmes in this population. SARS-CoV-2 antibody tests have divergent results and seem to have little added value in the management of cancer patients.

PMID:33773276 | DOI:10.1016/j.ejca.2021.02.024

J Hazard Mater. 2021 Mar 11;415:125631. doi: 10.1016/j.jhazmat.2021.125631. Online ahead of print.

ABSTRACT

The exposure of soil to metals and to antibiotic resistant bacteria may lead to the progressive deterioration of soil quality. The persistence of antibiotic resistant bacteria or antibiotic resistance genes in soil can be influenced by the microbial community or by soil amendments with metal salts. This work assessed the effect of soil amendment with copper and zinc, as sulfate or nitrate salts, on the fate of a carbapenem-resistant (bla_VIM⁺) hospital effluent isolate of Pseudomonas aeruginosa (strain H1FC49) and on the variations of the microbial community composition. Microcosms with soil aged or not with copper and zinc salts (20 mM), and inoculated with P. aeruginosa H1FC49 were monitored at 0, 7, 14 and/or 30 days, for community composition (16S rRNA gene amplicon) and strain H1FC49 persistence. Data on culturable P. aeruginosa, quantitative PCR of the housekeeping gene ecf, and the presumably acquired genes bla_VIM⁺ and integrase (intI1), and community composition were interpreted based on descriptive statistics and multivariate analysis. P. aeruginosa and the presumably acquired genes, were quantifiable in soil for up to one month, in both metal-amended and non-amended soil. Metal amendments were associated with a significant decrease of bacterial community diversity and richness. The persistence of P. aeruginosa and acquired genes in soils, combined with the adverse effect of metals on the bacterial community, highlight the vulnerability of soil to both types of exogenous contamination.

PMID:33773246 | DOI:10.1016/j.jhazmat.2021.125631

Eur J Obstet Gynecol Reprod Biol. 2021 Mar 20;260:131-136. doi: 10.1016/j.ejogrb.2021.03.025. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the performance of uterocervical angle (UCA) and cervical length (CL) measurement at 20 weeks of pregnancy for prediction of spontaneous preterm birth (sPTB) in twin pregnancies.

STUDY DESIGN: We conducted a retrospective cohort study of 424 twin pregnancies who delivered in our center from October 2014 to December 2018 and who underwent transvaginal ultrasound between 19⁺⁰-22⁺⁰ weeks to measure CL during routine second trimester scan. Recorded ultrasound images of CL were reassessed to evaluate UCA. Medical and obstetric data were also collected for statistical analysis.

RESULTS: A total of 424 women were included. The rates of sPTB rate below 28, 32 and 34 weeks of gestation were 2.8 %, 5.4 % and 10.4 %, respectively. ROC curves showed a better area under the curve (AUC) for UCA at all gestational ages compared with CL (AUC for sPTB <28 weeks 0.902 (p < 0.001) vs 0.620 (p 0.175); AUC for sPTB <32 weeks 0.740 (p 0.001) vs 0.620 (p 0.058); AUC for sPTB <34 weeks 0.676 (p 0.001) vs 0.632 (p 0.047). UCA > 120 degrees was significantly associated with sPTB <28 weeks (p < 0.001; OR 39.17; CI 4.81-319.23; NPV, 99.65 %), <32 weeks (OR 4.23; p 0.002) and <34 weeks of gestation (OR 2.66; p 0.01).

CONCLUSION: In our study, an UCA > 120 degrees allowed to identify those women with twin pregnancies at risk of sPTB and performed better than CL measurement.

PMID:33773259 | DOI:10.1016/j.ejogrb.2021.03.025

Int Immunopharmacol. 2021 Mar 24;95:107575. doi: 10.1016/j.intimp.2021.107575. Online ahead of print.

ABSTRACT

BACKGROUND: Metformin (MET) may exert anti-rheumatic effects and reduce cartilage degradation through its immunomodulatory and anti-inflammatory actions.

METHODS: This was a double-blind placebo-controlled study, 120 adult patients with active rheumatoid arthritis (RA) were randomized to receive MET (1000 mg) or placebo daily with methotrexate (MTX, 7.5 mg/week) for 12 weeks. American College of Rheumatology (ACR)20, ACR50, and ACR70 response rates, Disease Activity Score in 28 joints (DAS-28), and drug safety were the efficacy endpoints. Serum levels of TNF-α, IL-1β, IL-6, IL-10, IL-17A, NF-κB, TGG-β1, MDA together with gene expression of AMPK and IGF-IR were assessed before and after the therapy.

RESULTS: A total of 80.8% of the patients in the MET group, compared with 54.7% in placebo group, met the criteria of ACR20 response after 12 weeks (P = 0.001). Statistically significant enhancements in the DAS28-3 (CRP) were observed after 4 and 8 weeks for the MET group compared with placebo and were sustained after 12 weeks. MET group showed statistically significant increase in percentage of patients achieving DAS remission after 12 weeks (P = 0.015). Significant improvements in ACR50, ACR70, Health Assessment Questionnaire Disability Index (HAQ-DI), and DAS28-3 (CRP) were also reported. MET was well-tolerated, and no serious adverse effects were reported in both groups. Furthermore, the MET group was superior in improving the measured parameters compared to the placebo.

CONCLUSIONS: MET improved the anti-rheumatic effect of MTX; suggesting it to be a beneficial adjuvant in patients with RA. Trial registration ID: NCT04068246.

PMID:33773207 | DOI:10.1016/j.intimp.2021.107575

J Environ Manage. 2021 Mar 24;288:112368. doi: 10.1016/j.jenvman.2021.112368. Online ahead of print.

ABSTRACT

A better knowledge of surface ozone variations and the relevant influential factors is of great significance for controlling frequent ozone pollution events. In this study, we first examined the primary variation patterns of surface ozone in space and time across China via a clustering analysis on the basis of daily maximum 8h average surface ozone (MDA8) between 2015 and 2018. Statistical models were then established between MDA8 and a set of influential factors to pinpoint dominant factors contributing to regional MDA8 variations. The clustering results revealed four typical variation patterns of MDA8 in China given distinct pollution levels, seasonality, and long-term trends. Statistical modeling results indicated that the seasonal variability of MDA8 was closely associated with UV radiation and meteorological factors like boundary layer height, temperature and relative humidity. In contrast, the long-term trends of MDA8 were largely linked to ozone precursors and meteorological variables including temperature, relative humidity, and total cloud cover. Moreover, the phenomenal increasing trends of MDA8 in North China were found to be statistically associated with the depletion of nitrogen dioxide (NO₂) and carbon monoxide (CO). Specifically, substantial increases in volatile organic compounds (VOCs) along with depletions in NO₂ and CO significantly boosted the photochemical ozone formation chain process in a VOC-limited regime like the North China plain. Overall, the inferred linkage in this study provides evidence and clues to help control increasing ozone pollution events in North China.

PMID:33773209 | DOI:10.1016/j.jenvman.2021.112368

J Environ Manage. 2021 Mar 24;288:112384. doi: 10.1016/j.jenvman.2021.112384. Online ahead of print.

ABSTRACT

Groundwater resources in South Asian cities are facing immense stress due to over-extraction leading to environmental, social and economic instabilities. The perennial mega rivers of Himalayas form the lifeline for South Asia, underpinning food and water security for a large population both directly and indirectly through exchange with groundwater systems. The present study delineates the spatio-temporal variation in patterns and processes of sub-hourly to annual-scale hydrological exchanges between the Ganges and its adjoining highly exploited aquifer in a urban-peri urban reach. Multivariate statistical analyses established river water-groundwater interaction in this region with ~40% loading of first principal component, i.e river water during monsoon on the shallow aquifer. The part of the aquifer detached from the main confined aquifer show an influence of precipitation (the second principal component) with loading of ~90%. Again the part of the aquifer suffering infiltration of local surface water bodies show effect of precipitation with a second principal loading of ~80%. Fourier transformation is used in the hydrograph to remove influence of heavy urbanization on the hydrographs. This study proves that the phenomenon of infiltrating river water during monsoon plays a primary role in controlling aquifer storage although contaminating the aquifer simultaneously. However, during pre and post-monsoon the flow path reversal helps in maintaining river baseflow. Cross-correlation between the river and piezometric series show increased delay of pressure head propagation of the infiltrating river waterfront, with increasing distance. These observations are also substantiated by stable isotope signatures. The present study provides an understanding of potential groundwater vulnerability resulting from waste water and irrigational contamination through river water intrusion which would eventually lead the government to implement proper water and environmental management policies towards availability of long-term sustainable water resources for the residents.

PMID:33773213 | DOI:10.1016/j.jenvman.2021.112384