Category: Statistics

Intern Med J. 2021 Feb;51(2):189-198. doi: 10.1111/imj.15106.

ABSTRACT

BACKGROUND: The first case of corona virus disease (COVID-19) was detected in South Australia on 1 February 2020. The Royal Adelaide Hospital (RAH) is the state’s designated quarantine hospital.

AIM: To determine the characteristics, outcomes and predictors of outcomes for hospitalised patients with coronavirus disease (COVID-19) within the RAH.

METHODS: We performed a retrospective audit of 103 patients diagnosed with COVID-19 who were discharged from the RAH between 14 February and 21 May 2020. We collected demographic, clinical and laboratory data through an audit of electronic medical records. The main outcome measures were: (i) the need for oxygen supplementation; (ii) need for intensive care unit (ICU) care; and (iii) death in hospital.

RESULTS: The median age of patients was 60 years (range 19-85). A total of 55 (53%) patients was male. All patients were independent at baseline; 37 (36%) patients suffered from hypertension. Cardiovascular disease, respiratory disease and diabetes were present in fewer than 19 (18%) patients. Obesity was present in 24 (23%) patients; 39 (38%) patients required supplemental oxygen, 18 (17%) required ICU care and 4 (4%) patients died. Older patients were significantly more at risk of oxygen requirement (median 68 vs 57.5 years, P < 0.01), ICU admission (median 66.5 vs 60 years, P = 0.04) and death (median 74.5 vs 60 years, P = 0.02). We did not find a statistically significant association between gender, body mass index and poor outcomes. Lactate dehydrogenase (LDH) was the only parameter at admission associated with oxygen requirement, ICU care and death. Peak LDH, aspartate aminotransferase, alanine aminotransferase, C-reactive protein and neutrophil lymphocyte ratio were significantly associated with oxygen requirement, ICU admission and death (P < 0.05 for all of the above laboratory markers).

CONCLUSIONS: Although our sample size was small, we found that certain comorbidities and laboratory values were associated with poor outcomes. This occurred in a setting where care was not influenced by limited hospital and intensive care beds.

PMID:33631864 | DOI:10.1111/imj.15106

Acta Cytol. 2021 Feb 25:1-7. doi: 10.1159/000512868. Online ahead of print.

ABSTRACT

PURPOSE: For anaplastic lymphoma kinase (ALK) gene detection, the centrifugal sedimentation method (CSM) and cell block method (CBM) are commonly used to process samples of bloody pleural effusions (BPEs). However, in practice, the impurity content in the processed samples often affects the results and even leads to the detection failure. The purpose of this study was to establish a cell enrichment method (CEM) by using a disposable membrane cell collector to remove blood and inflammatory cells and enrich lung adenocarcinoma cells in BPE for more efficient RNA extraction and ALK gene detection.

MATERIALS AND METHODS: CEM proposed in this study and the traditional CSM and CBM were used to treat BPE samples collected from 37 lung adenocarcinoma patients. A DeNovix DS-11 ultraviolet spectrophotometer was used to measure the concentration and purity of extracted RNA. Amplification refractory mutation systems (ARMS) and ABI 7500 fluorescence qPCR were used to detect ALK gene. Through statistical analysis, the CEM was compared with the CSM and CBM in RNA concentration, purity, and ALK gene detection results.

RESULTS: The concentration of RNA extracted by using the CEM was significantly higher than that extracted by using the CBM and CSM (p < 0.001). The purity of RNA extracted by using the CEM was significantly higher than that by the other 2 methods (p = 0.011, p = 0.005). ALK gene testing with PCR was successful in all the samples using the CEM, but 2 cases by the CSM and 1 case by the CBM failed.

CONCLUSIONS: Using the disposable membrane cell collector to process BPE of lung adenocarcinoma patients for RNA extraction and ALK gene detection is more effective and successful compared with the traditional methods, and it is suggested to be further applied and popularized in clinical practice.

PMID:33631757 | DOI:10.1159/000512868

Brain Lang. 2021 Feb 22;215:104930. doi: 10.1016/j.bandl.2021.104930. Online ahead of print.

ABSTRACT

Conventional metaphor, irony, and literal language processing were compared. Thirty right-handed participants (21-34 years) performed a sequential-statement ERP-paradigm. A left-frontal Late Anterior Negative Slow Wave (LANSW, 450-1000 ms) was significantly greater for metaphors and by visual tendency greater for irony, compared to literal statements. A centroparietal N400 (300-450 ms) and a centroparietal right-dominant “Late N400” (450-600 ms) were by statistical and visual tendency greater for metaphors. Left PCC and left lingual gyrus activity was significantly higher in metaphors compared to literal statements (eLORETA; 450-1000 ms). A statistical trend indicated higher parahippocampal gyrus activity in metaphors and ironies. N400 results are discussed considering changing processing techniques and a renewed semantic conflict. The Late N400 was associated with the construct of “associativeness”. The LANSW was related to metaphorical mapping, frame-shifting processes, integration of meanings, and memory processes. eLORETA results were discussed considering metaphorical mapping, creation of mental images, conventionality, valence, memory processes, and divergent thinking.

PMID:33631658 | DOI:10.1016/j.bandl.2021.104930

J Biomech. 2021 Feb 12;119:110316. doi: 10.1016/j.jbiomech.2021.110316. Online ahead of print.

ABSTRACT

Understanding gait differences in context of group differences is dependent on statistical testing methods and time normalization techniques (TN). The method induces a relationship of both with one another. As to our knowledge, there has been no investigation into their relation so far. To show empirically what effects may be of importance, we use SPM with linear time interpolation (LI) and Dynamic Time Warping (DTW) separately for data of a study on stair ascent kinematics between two groups. There is a slight difference in statistical significance for the comparison of LI and DTW. LI-uniquely significant time highlight differences due to in-group time-variations, whereas DTW-uniqueness is tied to qualitative differences of homogeneous events. The comparison of stair ascent kinematics with DTW shows more pronounced evidence for backlift-like strategies for the older group, although trunk angles are kept more extended as to ensure stabilty. Thus, the difference in SPM from TN is slight but important, if there is need to mirror said effects methodically.

PMID:33631663 | DOI:10.1016/j.jbiomech.2021.110316

Sex Reprod Healthc. 2020 Dec 23;28:100588. doi: 10.1016/j.srhc.2020.100588. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aims at exploring the present situation of the delivery place and the impact of social networks on the choice of delivery place among the ethnic women in Bangladesh.

METHODS: Data were collected through face to face interviews using a structured questionnaire from a sample of 205 married ethnic – Garo and Mandai – women in Madhupur Upazilla of Tangail district. A stepwise binary logistic regression analysis is run to explain the impact of social networks on the choice of delivery place (the place where the women actually did deliver a baby) of ethnic women in Bangladesh.

RESULTS: Descriptive statistics show that of the total deliveries 37.7% among Garo- and 13% among Mandai women take place in institutions (hospitals and clinics). The regression model reveals that next to ethnicity and husband’s occupation, network size has a significant positive relationship, while reproductive health-related constraints have a significant negative relationship with the choice of delivery place of ethnic women. Based on these, this study suggests that if the social networks of ethnic women increase, the probability of their institutional delivery may increase.

CONCLUSION: The personal social networks of ethnic women may motivate them on their choice of institutional delivery in Bangladesh. This finding may contribute to the development of pathways to stimulate ethnic women’s reproductive health behaviour in the developing countries context.

PMID:33631702 | DOI:10.1016/j.srhc.2020.100588

Curr Probl Cardiol. 2021 Feb 15;46(5):100819. doi: 10.1016/j.cpcardiol.2021.100819. Online ahead of print.

ABSTRACT

OBJECTIVES AND METHODS: the current understanding of the interplay between cardiovascular (CV) risk and Covid-19 is grossly inadequate. CV risk-prediction models are used to identify and treat high risk populations and to communicate risk effectively. These tools are unexplored in Covid-19. The main objective is to evaluate the association between CV scoring systems and chest X ray (CXR) examination (in terms of severity of lung involvement) in 50 Italian Covid-19 patients. Results only the Framingham Risk Score (FRS) was applicable to all patients. The Atherosclerotic Cardiovascular Disease Score (ASCVD) was applicable to half. 62% of patients were classified as high risk according to FRS and 41% according to ASCVD. Patients who died had all a higher FRS compared to survivors. They were all hypertensive. FRS≥30 patients had a 9.7 higher probability of dying compared to patients with a lower FRS. We found a strong correlation between CXR severity and FRS and ASCVD (P < 0.001). High CV risk patients had consolidations more frequently. CXR severity was significantly associated with hypertension and diabetes. 71% of hypertensive patients’ CXR and 88% of diabetic patients’ CXR had consolidations. Patients with diabetes or hypertension had 8 times greater risk of having consolidations.

CONCLUSIONS: High CV risk correlates with more severe CXR pattern and death. Diabetes and hypertension are associated with more severe CXR. FRS offers more predictive utility and fits best to our cohort. These findings may have implications for clinical practice and for the identification of high-risk groups to be targeted for the vaccine precedence.

PMID:33631706 | DOI:10.1016/j.cpcardiol.2021.100819

Physiol Meas. 2021 Feb 25. doi: 10.1088/1361-6579/abe9ff. Online ahead of print.

ABSTRACT

OBJECTIVES: The human skeletal muscle responds immediately under electrical muscle stimulation (EMS), and there be an immediate physiological response in human skeletal muscle. Response muscle areas of human calf muscles under electrical muscle stimulation (EMS) have been detected by frequency difference electrical impedance tomography (fd-EIT).

APPROACH: The experimental protocol consists of four parts: pre-training (pre), training (tra), post-training (post), and relaxation (relax) parts. The relaxation part has three types of relaxation conditions which are massage relaxation (MR), cold pack relaxation (CR) and hot pack relaxation (HR).

MAIN RESULTS: From the experimental results, conductivity distribution images σp (p means protocol = pre, tra, post, or relax) are clearly reconstructed by fd-EIT as response muscle areas, which are called M1 response area composed of gastrocnemius muscle and M2 response area composed of tibialis anterior muscle, extensor digitorum longus muscle, and peroneus longus muscle. Paired samples t-test was conducted to elucidate the statistical significance of spatial-mean conductivities <σp>M1 and <σp>M2 in M1 and M2 with reference of conventional extracellular water ratio ꞵp by bioelectrical impedance analysis (BIA).

SIGNIFICANCE: From the t-test results, <σp>M1 and <σp>M2 have good correlations with ꞵp. In the post-training part, the <σpost> and ꞵpost were significantly higher than those in the pre-training part (n = 24, p < 0.001). The relax-pre difference ratios of spatial-mean conductivity Δ<σrelax-pre> and the relax-pre difference ratios of extracellular water ratio Δꞵrelax-pre in both MR and CR were lower; on the contrary, the Δ<σrelax-pre> and Δꞵrelax-pre in HR were significantly higher than those in post-pre difference ratios of spatial-mean conductivity Δ<σpost-pre> (n = 8, p < 0.05). The reason for changes in <σp>M1 and <σp>M2 is caused by the changes in muscle extracellular volumes. In conclusion, fd-EIT satisfactorily evaluates the effectiveness of human calf muscles under EMS.

PMID:33631732 | DOI:10.1088/1361-6579/abe9ff

Health Place. 2021 Feb 22;68:102529. doi: 10.1016/j.healthplace.2021.102529. Online ahead of print.

ABSTRACT

In the 1930s United States, urban neighborhoods were graded on their desirability for investment (often based on race), a process known as “redlining.” This study examined how historical redlining relates to current disparities in an important health determinant: tobacco retailer density. Analyses were conducted for thirteen Ohio cities using negative binomial models that accounted for retailer spatial dependence and controlled for present-day sociodemographic characteristics. Findings indicated that as grades increased from “Best” to “Still Desirable” to “Definitely Declining” and “Hazardous,” retailer density increased monotonically. These results highlight the persisting impacts of redlining and how disparities, once intentionally created, can be perpetuated over time.

PMID:33631601 | DOI:10.1016/j.healthplace.2021.102529

Ecotoxicol Environ Saf. 2021 Feb 22;213:112074. doi: 10.1016/j.ecoenv.2021.112074. Online ahead of print.

ABSTRACT

Synthetic musks (SMs) have drawn worldwide attention, as they are persistent, bioaccumulative, and toxic to many organisms. There is not enough information on the bioaccumulation and trophodynamic behavior of SMs in freshwater food webs to reliably understand the associated ecological risks. In this study, the concentrations of six SM congeners in fifteen aquatic species from Lake Chaohu, China, was investigated. The total concentrations of the six SMs ranged from 0.29 to 59.7 ng/g dry weight (median, 4.41) in fish muscle tissue and in the whole body tissues of small fish species and shrimps. Galaxolide (HHCB) and tonalide (AHTN) were the predominant congeners, accounting for 65.0% and 28.5% of the total SM concentration, respectively. On the whole, the total concentrations of SMs in livers and gills were 0.18-32.8 and 0.84-254 times higher than those in muscle tissues in fish species, respectively. In the food web of Lake Chaohu, cashmeran (DPMI) and HHCB showed a trend towards trophic magnification, and AHTN tended to show trophic dilution, but these trends were not statistically significant. This suggested that the trophic transfer of these chemicals through the food web was strongly influenced by many factors, including tissue-specific distribution within individuals at higher trophic levels. More investigation into the trophic transfer of SMs in aquatic ecosystems and the factors influencing uptake is needed.

PMID:33631637 | DOI:10.1016/j.ecoenv.2021.112074

J Neurol Sci. 2021 Jan 7;422:117310. doi: 10.1016/j.jns.2021.117310. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the value of next-generation sequencing (NGS) technology in early diagnosis of patients with tuberculous meningitis (TBM).

METHODS: 56 patients with clinically suspected TBM who came to Shandong Provincial Chest Hospital from February 2, 2018 to August 2, 2018 were prospectively included, and the clinical diagnosis and treatment outcomes were followed up. NGS was performed for the cerebrospinal fluid specimens submitted for test on the BGISEQ-100 platform of Tianjin Huada Gene Research Institute and the obtained pathogen sequences were compared with the pathogen data to get the final results. The NGS results were positive for detecting the unique matching sequence of the Mycobacterium tuberculosis (MTB) complex and negative for no unique matching sequence. Patients confirmed with TBM should have at least one of the following four items: cerebrospinal fluid MTB culture positive, smear positive, Xpert MTB/RIF test positive, or MTB nucleic acid polymerase chain reaction (PCR) test positive; clinically diagnosed patients were those with clinically suspected TBM and effective anti-tuberculosis treatment; non-TBM patients were those with other pathogenic basis or clinical exclusion of TBM. The sensitivity and specificity of NGS in early diagnosis of TBM were analyzed.

RESULTS: 22 patients were confirmed with TBM, of which 13 were positive for Xpert MTB/RIF test, 6 were positive for cerebrospinal fluid MTB culture, 5 were positive for MTB nucleic acid PCR test, 12 patients were clinically diagnosed with TBM, and there were 16 cases of non-TBM patients. Among confirmed and clinically diagnosed patients, 20 cases of MTB complex were detected by NGS technology, with a sensitivity of 58.8% (20/34) and specificity of 100% (16/16). Among confirmed patients, the sensitivity of NGS was 63.6% (14/22). Of the 50 specimens that were simultaneously subjected to traditional methods, Xpert MTB/RIF test and NGS, the specificity of the three methods was 100% (16/16) based on clinical diagnosis, and the sensitivity was 29.4% (10/34), 38.2% (13/34), and 58.8% (20/34) respectively. The difference of sensitivity between the first two detection methods and NGS was statistically significant (McNemar test, p = 0.013, x² = 5.786 and p = 0.065, x² = 3.273). The sensitivity of traditional methods combined with NGS was as high as 82.4% (28/34).

CONCLUSIONS: NGS technology could rapidly detect the MTB complex in cerebrospinal fluid with significant sensitivity and specificity, which could be used as an early diagnosis index of TBM. NGS combined with MTB culture could increase the detection rate.

PMID:33631643 | DOI:10.1016/j.jns.2021.117310