Category: Statistics

PM R. 2021 Nov 27. doi: 10.1002/pmrj.12741. Online ahead of print.

ABSTRACT

INTRODUCTION: Better tools are needed to predict functional decline and oncologic prognosis in inpatient cancer rehabilitation. The Karnofky Performance Status (KPS) is a widely used scale of functional performance in oncology, although the scale differs from current rehabilitation terminology. Use of the KPS in inpatient rehabilitation may support a shared method of communication between cancer rehabilitation providers and the primary oncology teams.

OBJECTIVE: To establish interrater reliability for translation of the KPS for use in inpatient cancer rehabilitation.

DESIGN: Retrospective interrater reliability review.

SETTING: A large inpatient rehabilitation hospital system.

PARTICIPANTS: Fifty randomized charts were chosen for review from a larger database of all patients admitted to an inpatient cancer rehabilitation program in 2020.

INTERVENTION: Not applicable.

MAIN OUTCOME MEASURES: The KPS scale was translated into common inpatient rehabilitation grading consistent with the Continuity and Assessment Record and Evaluation (CARE) Item Set to support its use in this specialty area. Additionally, a list of best practice guidelines and scoring instructions were created to assist raters in determining appropriate levels within the scale. Members of the inpatient cancer rehabilitation team scored all patients within the larger database (n=424) throughout 2020. A blinded rater completed retrospective chart reviews to score the 50- chart sample. A two-way random effects model was used to calculate an intraclass correlation coefficient (ICC) for the KPS scores at each of three time points (premorbid, admission, and discharge).

RESULTS: The KPS interpretation for rehabilitation proved to be statistically reliable for the 50- chart sample. The premorbid KPS interrater reliability was acceptable (ICC=0.67, 95% CI: 0.40, 0.82), admission KPS reliability was good (ICC=0.88, 95% CI: 0.78, 0.93), and discharge reliability was excellent (ICC= 0.96, 95% CI: 0.91, 0.98).

CONCLUSION: The KPS translation at three time points (pre-morbid, admission and discharge) during the inpatient rehabilitation continuum has acceptable interrater reliability. This article is protected by copyright. All rights reserved.

PMID:34837660 | DOI:10.1002/pmrj.12741

J Esthet Restor Dent. 2021 Nov 27. doi: 10.1111/jerd.12848. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate effect of distilled alcoholic beverages on surface hardness, roughness, and erosion of bulk-fill resin composites.

MATERIALS AND METHODS: Sixty eight specimens of each bulk-fill resin composite (Filtek One Bulk Fill Restorative, SonicFill 2, and Tetric N-Ceram Bulk Fill) were prepared. Baseline data of surface hardness and roughness value were recorded. The specimens were divided into five groups: vodka, whisky, tequila, brandy, and deionized water (served as a control). Specimens were then alternately immersed in 25 ml of a storage agent for 5 s and in 25 ml of artificial saliva for 5 s over 10 cycles. This process was repeated for 14 days. After immersion, specimens were subjected to evaluation of surface hardness, roughness, and erosion on days 7 and 14. The data were statistically analyzed by two-way repeated analysis of variance, Tukey’s honestly significant difference, and a t test (p < 0.05).

RESULTS: Distilled alcoholic beverages caused significant hardness decrement, roughness and erosion increment (p < 0.05), where the greatest degradation was found in brandy group. Tetric N-Ceram Bulk Fill had the most significant decrement in hardness and increment in roughness and erosion than the other resin composites (p < 0.05).

CONCLUSION: Distilled alcoholic beverages affected hardness, roughness, and erosion of all the bulk-fill resin composites.

CLINICAL SIGNIFICANCE: Regarding the bulk-fill resin composites tested, Filtek One Bulk Fill Restorative was the most appropriate restorative material in patients who consume distilled alcoholic beverages.

PMID:34837668 | DOI:10.1111/jerd.12848

Environ Sci Pollut Res Int. 2021 Nov 27. doi: 10.1007/s11356-021-17644-7. Online ahead of print.

ABSTRACT

Metallothionein-like protein concentrations (MT) and three functionally defined fractions of cholinesterase activity (ChE) were quantified in gill and digestive gland homogenates of tropical cup oysters from 5 nearshore locations in the Colombian Caribbean and correlated with sediment and tissue metal (9 metals) and pesticide (22 organophosphates, OPs, and 20 organochlorines-OCPs), as well as water physical-chemical parameters (salinity, pH, temperature, and dissolved oxygen). Tissue and sediment pesticide concentrations were below detection limits in all samples, whereas sediment and tissue metal concentrations exceeded environmental thresholds at several locations. Tissue MT and ChE biomarkers varied by a factor of 5-6 between locations. Inhibition of cholinesterase activity was negligible for all 5 sites, despite spatial-temporal variation in ChE activity, consistent with below-detection OP concentrations. Tissue MT and ChE biomarkers correlated with tissue and metal sediment concentrations, yet, statistically significant covariance between biomarkers and water chemistry parameters was also observed, indicating that both, metal concentrations and physical-chemical variables, are likely to be responsible for generating the observed spatial-temporal variations in biomarker patterns.

PMID:34837617 | DOI:10.1007/s11356-021-17644-7

Environ Sci Pollut Res Int. 2021 Nov 27. doi: 10.1007/s11356-021-17794-8. Online ahead of print.

ABSTRACT

A growing number of epidemiologic studies have estimated the associations between endocrine-disrupting chemicals and gestational diabetes mellitus (GDM). However, reports on the association between bisphenol A (BPA) substitutes and GDM are limited. This investigation aimed to explore the associations of maternal serum BPA, bisphenol B (BPB), bisphenol F (BPF), bisphenol S (BPS), and tetrabromobisphenol A (TBBPA) with the risk of GDM. A nested case-control study was performed among 500 pregnant women. In conditional logistic regression models, the OR for BPS was significantly increased in the medium exposure groups (OR = 1.77; 95% CI: 1.01, 3.13) compared with the reference group, while BPA (OR: 0.38, 95%CI: 0.29, 0.50) and TBBPA (OR: 0.67, 95%CI: 0.54, 0.85) were negatively associated with the risk of GDM. In the Bayesian kernel machine regression (BKMR) analysis, the joint effect of bisphenols was positively associated with the risk of GDM. BPS showed positively relationship, while BPA and TBBPA showed negatively relationship, respectively. The quantile g-computation revealed a statistically significant and negative joint effect of the five bisphenols on the risk of GDM (OR: 0.57; 95% CI: 0.46, 0.72) with BPA (70.2%), TBBPA (21.3%), and BPB (8.5%) had positive contribution to the overall effect. These findings suggested that BPS had a positive effect on the risk of GDM, while BPA and TBBPA had negative effect on the risk of GDM. Moreover, exposure to the mixture of the five bisphenols was negatively associated with the risk of GDM.

PMID:34837624 | DOI:10.1007/s11356-021-17794-8

J Robot Surg. 2021 Nov 27. doi: 10.1007/s11701-021-01337-x. Online ahead of print.

NO ABSTRACT

PMID:34837594 | DOI:10.1007/s11701-021-01337-x

Biomech Model Mechanobiol. 2021 Nov 27. doi: 10.1007/s10237-021-01533-6. Online ahead of print.

ABSTRACT

Evaluation of the bony anatomy of the glenohumeral joint is frequently required for surgical planning and subject-specific computational modeling and simulation. The three-dimensional geometry of bones is traditionally obtained by segmenting medical image datasets, but this can be time-consuming and may not be practical in the clinical setting. The aims of this study were twofold. Firstly, to develop and validate a statistical shape modeling approach to rapidly reconstruct the complete scapular and humeral geometries using discrete morphometric measurements that can be quickly and easily measured directly from CT, and secondly, to assess the effectiveness of statistical shape modeling in reconstruction of the entire humerus using just the landmarks in the immediate vicinity of the glenohumeral joint. The most representative shape prediction models presented in this study achieved complete scapular and humeral geometry prediction from seven or fewer morphometric measurements and yielded a mean surface root mean square (RMS) error under 2 mm. Reconstruction of the entire humerus was achieved using information of only proximal humerus bony landmarks and yielding mean surface RMS errors under 3 mm. The proposed statistical shape modeling facilitates rapid generation of 3D anatomical models of the shoulder, which may be useful in rapid development of personalized musculoskeletal models.

PMID:34837584 | DOI:10.1007/s10237-021-01533-6

Int Urol Nephrol. 2021 Nov 27. doi: 10.1007/s11255-021-03075-3. Online ahead of print.

ABSTRACT

PURPOSE: The main purpose of this study was to analyze the characteristics of dyspepsia and contributing factors in Montenegrin maintenance hemodialysis patients.

METHODS: The study included 43 patients undergoing hemodialysis with symptoms of dyspepsia and 40 control dyspeptic subjects with preserved kidney function. All subjects underwent an interview about dyspeptic symptoms, physical and biochemical examination, and upper gastrointestinal endoscopy with pathohistological analysis of biopsy specimens.

RESULTS: Early satiety, bloating and heartburn were the most common symptoms in hemodialysis patients but without significant difference in frequency in relation to controls. Chronic kidney disease patients had statistically lower concentration of total proteins and albumin (p < 0.001), as well lower BMI values (p = 0.002). Despite this, no significant correlation of laboratory parameters with dyspeptic symptoms was found. Pathohistological examination indicated that the most common finding in hemodialysis patients was chronic active gastritis (58%), while chronic atrophic gastritis was significantly more common in dialytic patients (p = 0.032). Patients on hemodialysis had more frequently atrophy of corpus mucosa, which was positively related to dialysis duration (p = 0.001) and negatively related to pH values (p = 0.004) and bicarbonate concentration (p = 0.049). Helicobacter pylori was considerably more common in patients who underwent shorter time on hemodialysis (p < 0.001) and had higher values of bicarbonate (p = 0.037).

CONCLUSION: Maintenance hemodialysis patients are at risk for chronic gastric diseases that correlated with both dialysis vintage and duration.

PMID:34837575 | DOI:10.1007/s11255-021-03075-3

Clin Oral Investig. 2021 Nov 27. doi: 10.1007/s00784-021-04309-5. Online ahead of print.

ABSTRACT

OBJECTIVES: To three-dimensionally evaluate deviations of full-arch intraoral (IO) scans from reference desktop scans in terms of translations and rotations of individual teeth and different types of (mal)occlusion.

MATERIALS AND METHODS: Three resin model pairs reflecting different tooth (mal)positions were mounted in the phantom head of a dental simulation unit and scanned by three dentists and three non-graduate investigators using a confocal laser IO scanner (Trios 3®). The tooth-crown surfaces of the IO scans and reference scans were superimposed by means of best-fit alignment. A novel method comprising the measurement of individual tooth positions was used to determine the deviations of each tooth in the six degrees of freedom, i.e., in terms of 3D translation and rotation. Deviations between IO and reference scans, among tooth-(mal)position models, and between dentists and non-graduate investigators were analyzed using linear mixed-effects models.

RESULTS: The overall translational deviations of individual teeth on the IO scans were 76, 32, and 58 µm in the lingual, mesial, and intrusive directions, respectively, resulting in a total displacement of 114 µm. Corresponding rotational deviations were 0.58° buccal tipping, 0.04° mesial tipping, and 0.14° distorotation leading to a combined rotation of 0.78°. These deviations were the smallest for the dental arches with anterior crowding, followed by those with spacing and those with good alignment (p < 0.05). Results were independent of the operator’s level of education.

CONCLUSIONS: Compared to reference desktop scans, individual teeth on full-arch IO scans showed high trueness with total translational and rotational deviations < 115 µm and < 0.80°, respectively.

CLINICAL RELEVANCE: Available confocal laser IO scanners appear sufficiently accurate for diagnostic and therapeutic orthodontic applications. Results indicate that full-arch IO scanning can be delegated to non-graduate dental staff members.

PMID:34837565 | DOI:10.1007/s00784-021-04309-5

Int Urol Nephrol. 2021 Nov 27. doi: 10.1007/s11255-021-03068-2. Online ahead of print.

ABSTRACT

PURPOSE: To assess the impact of preoperative chronic kidney disease (CKD) on perioperative morbidity and mortality in a contemporary cohort undergoing renal surgery in an era of increased prevalence of minimally invasive surgery and partial nephrectomy.

METHODS: The National Surgery Quality Improvement Program dataset was queried to identify patients undergoing radical nephrectomy (RN) or partial nephrectomy (PN) between 2010 and 2018. CKD staging was assigned based on creatinine clearance calculated using the Cockcroft-Gault formula. Multivariable logistic regression was performed to assess the effect of preoperative CKD stage on postoperative outcomes, including a composite variable encompassing multiple major complications.

RESULTS: We analyzed 19,545 patients with CKD undergoing renal surgery. CKD stage ≥ 2 predicted an increase in major perioperative complications, OR 1.54 (95% CI 1.46-1.63); p < 0.01. The risk of perioperative morbidity increased linearly with increasing CKD stage. Patients with CKD stage > 2 also demonstrated increased 30-day mortality, OR 1.87 (95% CI 1.26-2.48); p < 0.01. Adjusting for surgery type, CKD staging predicted perioperative mortality in patients undergoing RN only, and perioperative morbidity in RN and PN.

CONCLUSIONS: Here, we demonstrate a statistically significant increase in the risk of major postoperative complications following RN and PN with increasing CKD stage. Amongst patients undergoing RN, we also demonstrate increasing 30-day mortality with increasing CKD stage. Importantly, we highlight the ability of CKD staging to predict major perioperative outcomes with greater magnitude of effect than surgery type alone. Thus, we provide a model for translating CKD staging into operative risk amongst patients undergoing surgery for a renal mass.

PMID:34837574 | DOI:10.1007/s11255-021-03068-2

Metabolomics. 2021 Nov 27;17(12):105. doi: 10.1007/s11306-021-01857-5.

ABSTRACT

INTRODUCTION: Gestational diabetes mellitus (GDM) significantly increases maternal and fetal health risks, but factors predictive of GDM are poorly understood.

OBJECTIVES: Plasma metabolomics analyses were conducted in early pregnancy to identify potential metabolites associated with prediction of GDM.

METHODS: Sixty-eight pregnant women with overweight/obesity from a clinical trial of a lifestyle intervention were included. Participants who developed GDM (n = 34; GDM group) were matched on treatment group, age, body mass index, and ethnicity with those who did not develop GDM (n = 34; Non-GDM group). Blood draws were completed early in pregnancy (10-16 weeks). Plasma samples were analyzed by UPLC-MS using three metabolomics assays.

RESULTS: One hundred thirty moieties were identified. Thirteen metabolites including pyrimidine/purine derivatives involved in uric acid metabolism, carboxylic acids, fatty acylcarnitines, and sphingomyelins (SM) were different when comparing the GDM vs. the Non-GDM groups (p < 0.05). The most significant differences were elevations in the metabolites’ hypoxanthine, xanthine and alpha-hydroxybutyrate (p < 0.002, adjusted p < 0.02) in GDM patients. A panel consisting of four metabolites: SM 14:0, hypoxanthine, alpha-hydroxybutyrate, and xanthine presented the highest diagnostic accuracy with an AUC = 0.833 (95% CI: 0.572686-0.893946), classifying as a “very good panel”.

CONCLUSION: Plasma metabolites mainly involved in purine degradation, insulin resistance, and fatty acid oxidation, were altered in early pregnancy in connection with subsequent GDM development.

PMID:34837546 | DOI:10.1007/s11306-021-01857-5