Category: Statistics

Se Pu. 2022 Aug;40(8):736-745. doi: 10.3724/SP.J.1123.2021.12024.

ABSTRACT

Deep vein thrombosis (DVT) is a venous thromboembolic disease characterized by high incidence, mortality, and sequelae. Therefore, the effective prevention of DVT has become a critical public health concern. However, due to its complexity, the pathophysiological mechanism of DVT remains unclear. Metabolomics can be employed to analyze disease characteristics and provide scientific evidence on the underlying mechanisms. In this study, an established left femoral vein ligation rat model of DVT (n=10) was used and compared with sham surgery controls (n=10). In the DVT group, rats were anesthetized using an intraperitoneal injection of 10% chloral hydrate (300 mg/kg), after which the hair was shaved and the groin disinfected. A 2-cm longitudinal incision was made along the midpoint of the left groin area, and then the left femoral vein was separated. The vein was partially ligated at its proximal end to shrink the blood vessel lumen to approximately half. Then, 0.4 mL of 10% hypertonic saline was slowly injected from the distal end of the left femoral vein. At the same time, the femoral vein turned dark red, which indicated the formation of thrombosis. Finally, the incision was sutured after verifying bleeding in the surrounding tissue. Keeping all other procedures the same as the DVT group, the vein in the control group was not ligated or stimulated using hyper-tonic saline. The abdominal aorta plasma from rats in each group was collected seven days later. Untargeted metabolomics analysis based on ultra-high performance liquid chromatography-electrostatic field orbitrap high resolution mass spectrometry (UHPLC-Orbitrap HRMS) was conducted to investigate the plasma metabolic profiles of the sham surgery control and DVT groups. Principal component analysis (PCA) and orthogonal to partial least squares discrimi-nant analysis (OPLS-DA) on metabolome data for multivariate statistical analysis were employed to assess differences in the metabolic profile between the two groups. The results revealed distinct profiles for the DVT and control groups. The selection criteria for the differential metabolites were the variable importance in the projection (VIP) values of OPLS-DA (VIP>1) and fold changes (FC) in the DVT group (FC≤0.5 or FC≥2, P<0.05). The resulting 27 differential metabolites reflecting a metabolic disorder in the DVT group were selected and analyzed. Of these, the levels of 17 metabolites significantly increased in the DVT group, including trimethylamine N-oxide (TMAO), 4-amino-2-methyl-1-naphthol, chenodeoxycholic acid, and 7-ketocholesterol, whereas the levels of 10 metabolites decreased, including 3-dehydroxycarnitine, phosphatidylcholine 22∶6/20∶2 (PC 22∶6/20∶2), diglyceride 18∶3/20∶4 (DG 18∶3/20∶4) and anserine. To identify the changes in the metabolic pathway reflected by these differential metabolites, a differential abundance (DA) analysis based on the Kyoto Encyclopedia of Genes and Genomes metabolic pathway was conducted. The results showed that the differences in the metabolic pathways between the DVT and control groups were mainly manifested in the primary bile acid biosynthesis, bile secretion, histidine metabolism, linoleic acid metabolism, glycerophospholipid metabolism, and β-alanine metabolism pathways. Among them, the primary bile acid biosynthesis and bile secretion pathways were upregulated in the DVT group, whereas the glycerophospholipid metabolism, linoleic acid metabolism, and β-alanine metabolism pathways were downregulated. The histidine metabolism pathway contained upregulated as well as downregulated metabolites, resulting in a DA score of 0. In conclusion, these results indicate that the plasma metabolic profiling of the DVT group was significantly altered, while the disordered metabolites and metabolic pathways could provide a reference to further understand the pathological mechanism of DVT and identify new drug targets.

PMID:35903841 | DOI:10.3724/SP.J.1123.2021.12024

Hepatol Commun. 2022 Jul 28. doi: 10.1002/hep4.2044. Online ahead of print.

ABSTRACT

Nonalcoholic steatohepatitis (NASH) is a prevalent chronic disease that is associated with a spectrum of liver fibrosis and can lead to cirrhosis. Patients with NASH report lower health-related quality of life (HRQoL) than the general population. It remains uncertain how changes in histologic severity are associated with changes in HRQoL. This is a secondary analysis of the Farnesoid X Receptor Ligand Obeticholic Acid in NASH Treatment (FLINT) and Pioglitazone, Vitamin E, or Placebo for Nonalcoholic Steatohepatitis (PIVENS) randomized controlled trials in patients with biopsy-proven NASH. HRQoL was assessed using short form-36 at baseline and at follow-up biopsy (at 72 and 96 weeks, respectively). Adjusted linear regression models were used to examine the association between changes in liver fibrosis (primary analysis), nonalcoholic fatty liver disease (NAFLD) activity score (secondary analysis), and changes in HRQoL scores. Compared with stable fibrosis, improvement of fibrosis by at least one stage was significantly associated with improvements only in the physical function component by 1.8 points (95% confidence interval, 0.1, 3.5). Worsening of fibrosis by at least one stage was not associated with statistically significant changes in any HRQoL domain compared with stable fibrosis. Associations between HRQoL and NAFLD disease activity score in the secondary analysis were of similar magnitude. Weight loss was associated with small improvements in physical function, general health, and energy levels. Conclusion: Improvements in fibrosis stage were associated with improvements in the physical component of HRQoL, but the clinical impact was modest. As improving fibrosis may not meaningfully improve well-being, treatment for NASH will be cost effective only if it prevents long-term hepatic and cardiovascular disease.

PMID:35903833 | DOI:10.1002/hep4.2044

Open Access Emerg Med. 2022 Jul 21;14:347-354. doi: 10.2147/OAEM.S368324. eCollection 2022.

ABSTRACT

BACKGROUND: Studies showed that each year people lose their life on the road and many people are disabled. The majority of this disability was caused by orthopedic injury related to road traffic accidents. However, in the context of Ethiopia, studies ascribed to orthopedic injuries related to road traffic accidents are limited. The study aimed to assess the pattern of orthopedic injuries related to road traffic accidents among patients managed at the emergency department of Black Lion Hospital.

METHODS: An institutional-based cross-sectional study was conducted on 354 victims of road traffic accidents with orthopedic injuries who were visiting the Emergency department of Black Lion Hospital. Patient charts were selected by systematic random sampling technique and the data was entered into Epi-data version 4.4.2.2 and exported to the static package for social science window version 26, and descriptive statistics were used for analysis.

RESULTS: The study reveals that males were mostly injured persons (71.7%) with the age group of 13-24 were the most injured. Passenger car accounts 36.3% of causes of injury followed by motorbikes (27.4%) and lower limbs were the most common anatomic site of injuries (47.9). Of all injury types, a fracture is the most common one with 71.1%, especially lower limb fracture (42.1%). More than half victims (59.5%) had open wounds, and almost half of the study subjects (51.8%) experience Road traffic accidents while they are crossing or walking along the way.

CONCLUSION: Orthopedic injuries related to road traffic accidents are the main cause of death and disability in many individuals, especially in reproductive age groups. Therefore, policy-makers should be aware of different patterns of orthopedic injuries associated with a victim of road traffic accidents to have an appropriate and sustainable capacity to manage the orthopedic injuries.

PMID:35903799 | PMC:PMC9314752 | DOI:10.2147/OAEM.S368324

Front Hum Neurosci. 2022 Jul 12;16:902757. doi: 10.3389/fnhum.2022.902757. eCollection 2022.

ABSTRACT

BACKGROUND: Exercise is one of the effective ways to improve cognition. Different forms of exercises, such as aerobic exercise, resistance exercise, and coordination exercise, have different effects on the improvement of cognitive impairment. In recent years, exergames based on Non-Immersive Virtual Reality (NIVR-Exergames) have been widely used in entertainment and have gradually been applied to clinical rehabilitation. However, the mechanism of NIVR-Exergames on improving motor cognition has not been clarified. Therefore, the aim of this study is to find whether NIVR-Exergames result in a better neural response mechanism to improve the area of the cerebral cortex related to motor cognition under functional near-infrared spectroscopy (fNIRS) dynamic monitoring in comparison with resistance exercise (resistance band stretching).

METHODS: A cross-over study design was adopted in this study, and 15 healthy young subjects (18-24 years old) were randomly divided into group A (n = 8) and group B (n = 7) according to a computerized digital table method. Task 1 was an NIVR-Exergame task, and Task 2 was resistance band stretching. Group A first performed Task 1, rested for 30 min (i.e., a washout period), and then performed Task 2. Group B had the reverse order. The fNIRS test was synchronized in real time during exercise tasks, and heart rate measurements, blood pressure measurements, and 2-back task synchronization fNIRS tests were performed at baseline, Post-task 1, and Post-task 2. The primary outcomes were beta values from the general linear model (GLM) in different regions of interest (ROIs), and the secondary outcomes were heart rate, blood pressure, reaction time of 2-back, and accuracy rate of 2-back.

RESULTS: The activation differences of Task 1 and Task 2 in the right premotor cortex (PMC) (P = 0.025) and the left PMC (P = 0.011) were statistically significant. There were statistically significant differences in the activation of the right supplementary motor area (SMA) (P = 0.007), left dorsolateral prefrontal cortex (DLPFC) (P = 0.031), left and right PMC (P = 0.005; P = 0.002) between baseline and Post-task 1. The differences in systolic pressure (SBP) between the two groups at three time points among women were statistically significant (P1 = 0.009, P2 < 0.001, P3 = 0.044).

CONCLUSION: In this study, we found that NIVR-Exergames combined with motor and challenging cognitive tasks can promote the activation of SMA, PMC and DLPFC in healthy young people compared with resistance exercise alone, providing compelling preliminary evidence of the power for the rehabilitation of motor and cognitive function in patients with central nervous system diseases.

PMID:35903784 | PMC:PMC9314640 | DOI:10.3389/fnhum.2022.902757

J Family Reprod Health. 2022 Mar;16(1):67-77. doi: 10.18502/jfrh.v16i1.8596.

ABSTRACT

Objective: It is a fact that coronavirus disease of 2019 (COVID-19) infection mortality rate is high, but the question is “what is the role of other factors in maternal death with COVID-19?” The present study aimed to understand the factors that prevent women from timely use of healthcare services and also the potential weaknesses of the healthcare system that cause the lack of quality healthcare services for women. Materials and methods: This case-series study was performed in the southeast of Iran. In total, 12 cases of maternal deaths attributed to COVID-19 were identified through the Iranian Maternal Mortality Surveillance System. The required information was collected through existing verbal autopsy data sets. In some cases, the family members had to be re-contacted and healthcare workers were asked to supply the missing information. The root cause analysis method was employed for data analysis. Results: From March 2020 to March 2021, the deaths of 12 women were attributed to COVID-19. The majority of these women lived in rural areas (58%) and had a secondary school education level or less (83.3%). The contributing factors were divided into three categories: barriers at the community level (no prenatal care, lack of trust, lack of recognition of the severity of disease, and attribution of symptoms to something else), at the primary health system level, and at the hospital level (fear of staff of being infected, non-compliance with guidelines, lack of team working, and problem with telehealth). Conclusion: The socio-cultural context and unmet healthcare needs hinder the utilization of available services. Moreover, factors at the level of the healthcare system prevent the timely detection and referral of women with COVID-19 to receive quality healthcare services. Using telehealth also did not help to appropriately triage pregnant women.

PMID:35903768 | PMC:PMC9287121 | DOI:10.18502/jfrh.v16i1.8596

J Water Health. 2022 Jul;20(7):1091-1101. doi: 10.2166/wh.2022.065.

ABSTRACT

Water quality improvement, sanitation, and hygiene have been demonstrated to have positive impacts on health, social, and economic development. However, global understanding of water quality, sanitation, and hygiene is limited. The study extracted data from the Joint Monitoring Programme (WHO/UNICEF) and the Demographic and Health Surveys (DHS) to estimate global water, sanitation, and hygiene (WASH) levels. Statistical tools of univariate and multivariate analyses were used to process global access to WASH. Results show that men (53%) had access to safe water compared to women. Women (67%), on the other hand, demonstrated better hygiene practices than men (33%). In addition, adults had access to safe water compared to children, the elderly, and strangers. Globally, there is low water quality in landlock developing countries compared to small island developing states. The categorisation of countries into economic states of low, upper-middle, and high-income countries directly affects water quality, sanitation, and hygiene. Continentally, Africa recorded the least water quality, sanitation, and hygiene levels. Thus, African countries must learn from the best practice in governmental policies and management systems from other continents regarding water improvement, sanitation, and hygiene.

PMID:35902991 | DOI:10.2166/wh.2022.065

J Water Health. 2022 Jul;20(7):1051-1063. doi: 10.2166/wh.2022.030.

ABSTRACT

The aim of the present study was to detect free-living amoeba (FLA) in the water resources of Arak, Iran using molecular tools. A total of 154 samples were collected from different water supplies. Molecular analyses, sequencing, and phylogenetic study were conducted to confirm the species and genotypes of FLA. Fisher exact test was used to determine the significance. Of 154 water samples, 19 (12.3%) samples were tested positive for FLA. Three genotypes of Acanthamoeba including T4, subtype D, and T5 were identified among the isolates. The pathogenicity assay showed that the isolate of Acanthamoeba in drinking water was highly pathogenic. Three species of Naegleria, including N. australiensis, N. pagei, and N. gruberi were found among the samples. Six isolates of Vermamoeba were identified as V. vermiformis. Meanwhile, three other species including Vannella sp., Vahlkampfia avara, and Stenamoeba polymorpha were also recovered from the water samples. Statistical analysis showed a significant difference between the various water resources contaminated with FLA. This is the first study to reveal the presence of S. polymorpha in water sources in Iran. According to the findings of the present study, health officials should be beware of potential public health impacts of FLA in water resources.

PMID:35902987 | DOI:10.2166/wh.2022.030

J Cheminform. 2022 Jul 28;14(1):50. doi: 10.1186/s13321-022-00629-0.

ABSTRACT

In virtual screening for drug discovery, hit enrichment curves are widely used to assess the performance of ranking algorithms with regard to their ability to identify early enrichment. Unfortunately, researchers almost never consider the uncertainty associated with estimating such curves before declaring differences between performance of competing algorithms. Uncertainty is often large because the testing fractions of interest to researchers are small. Appropriate inference is complicated by two sources of correlation that are often overlooked: correlation across different testing fractions within a single algorithm, and correlation between competing algorithms. Additionally, researchers are often interested in making comparisons along the entire curve, not only at a few testing fractions. We develop inferential procedures to address both the needs of those interested in a few testing fractions, as well as those interested in the entire curve. For the former, four hypothesis testing and (pointwise) confidence intervals are investigated, and a newly developed EmProc approach is found to be most effective. For inference along entire curves, EmProc-based confidence bands are recommended for simultaneous coverage and minimal width. While we focus on the hit enrichment curve, this work is also appropriate for lift curves that are used throughout the machine learning community. Our inferential procedures trivially extend to enrichment factors, as well.

PMID:35902962 | DOI:10.1186/s13321-022-00629-0

J Intensive Care. 2022 Jul 28;10(1):37. doi: 10.1186/s40560-022-00630-7.

ABSTRACT

The 5A score predicts in-hospital mortality of patients suffering from accidental hypothermia, including those not in cardiac arrest. The HOPE score was specifically developed to predict survival for the subgroup of hypothermic patients in cardiac considered for extracorporeal life support rewarming. The C-statistic in the external validation study of the HOPE score was 0.825 (95% CI: 0.753-0.897), confirming its excellent discrimination. In addition, its good calibration allows for a reliable interpretation of the corresponding survival probability after rewarming. The HOPE score should be used for predicting outcome and selecting hypothermic patients in cardiac arrest for rewarming.

PMID:35902949 | DOI:10.1186/s40560-022-00630-7

Med J Malaysia. 2022 Jul;77(4):462-467.

ABSTRACT

BACKGROUND: Nasopharyngeal carcinoma (NPC) is the most common head and neck cancer in Malaysia. The gold standard treatment of NPC is radiotherapy (RT), as NPC is a radiosensitive tumour. Although RT is successful in treating NPC, patients cannot avoid the resulting RT complications. Oral mucositis is the most frequently encountered debilitating complication of RT and has no specific preventive treatment. The aim of this study was to evaluate the efficacy and safety of a 2.5% propolis mouthwash for preventing RT-induced mucositis in patients with NPC.

MATERIALS AND METHODS: The study was a prospective, double-arm, randomised control trial with intervention. The patients were randomly divided into an experimental group receiving propolis mouthwash and a placebo group receiving normal saline mouthwash. All patients were instructed to rinse their mouths with 7mL mouthwash three times daily for six weeks. The severity of oral mucositis was then evaluated by the World Health Organization Oral Toxicity Scale at the second, fourth, and sixth weeks of the study.

RESULTS: In total, 17 patients completed the study: 10 patients used the propolis mouthwash and seven used the placebo mouthwash. The mean mucositis scores for the propolis mouthwash compared to the placebo at the second, fourth, and sixth weeks were 0.10 vs. 1.14, 0.50 vs. 2.00, and 1.20 vs. 2.86, respectively, and the differences between the two groups were statistically significant (p<0.001).

CONCLUSION: A 2.5% propolis mouthwash was both safe and effective for reducing the severity of oral mucositis following RT for NPC.

PMID:35902936