Category: Statistics

Am J Otolaryngol. 2021 Mar 29;42(5):103010. doi: 10.1016/j.amjoto.2021.103010. Online ahead of print.

ABSTRACT

PURPOSE: Chronic rhinosinusitis (CRS) is one of the most common chronic diseases seen worldwide. Endoscopic sinus surgery (ESS) has become a widely accepted procedure for medically refractory chronic rhinosinusitis and nasal polyps. Prevention of revision surgery often depends on good wound healing and less adhesion formation. In recent years, the effects of platelet-rich fibrin (PRF) on tissue healing have been addressed in many surgical branches, especially for dental implant surgery and plastic surgery.

METHODS: This prospective study was conducted with 50 patients who underwent endoscopic sinus surgery for the diagnosis of nasal polyposis. While the middle meatus in one nasal cavity was filled with PRF and supported with Nasopore, only Nasopore was used in the other nasal cavity middle meatus. The patients were followed up clinically at weeks 1, 2, 3, 4, 8, and 12 postoperatively. The assessor determined the presence of adhesion, crusting, bleeding, frontal ostium stenosis, granulation, and infection, and if present, the grades of these complications were scored according to a questionnaire.

RESULTS: In our study, adhesion, infection, bleeding, granulation, and frontal ostium stenosis were less common in the PRF group, and a statistically significant difference was found between the groups.

CONCLUSION: In our study, better results were obtained in terms of adhesion, infection, bleeding, granulation, and frontal ostium stenosis after ESS as a result of the effects of PRF on wound healing. The application of PRF is an inexpensive and easy procedure. PRF can be a good alternative to other types of tampons after ESS.

PMID:33862565 | DOI:10.1016/j.amjoto.2021.103010

Clin Imaging. 2021 Apr 5;79:3-7. doi: 10.1016/j.clinimag.2021.03.020. Online ahead of print.

ABSTRACT

The increase in risk for acute ischemic stroke (AIS) with age is well established. If not treated properly and promptly, AIS can result in permanent neurological damage and even death. This literature review assesses the clinical outcomes of AIS patients treated with both intravenous thrombolysis (IVT) prior to mechanical thrombectomy (MT) compared to those treated solely with mechanical thrombectomy. Randomized controlled trials (RCTs) and meta-analyses published from 2015 to 2020 and available on PubMed were selected for review, and their quantitative and qualitative findings were extrapolated and summarized. Post-hoc analyses from ASTER and ETIS trials were reviewed as well as the impact of combined therapy and monotherapy on large vessel occlusions (LVO). Clinical outcomes in all examined trials demonstrated significant successful reperfusion as well as a higher rate of functional independence at 90 days for IVT prior to MT. Concerns of thrombus fragility, safety and cost effectiveness of dual therapy are also addressed. Based on these findings, we recommend the use of IVT as a pretreatment procedure to MT for AIS when eligible for IVT. Recent articles further strengthen this recommendation and provide new insights that IVT prior to MT is especially beneficial for patients presenting with multiple LVOs localized to the anterior intracranial circulation. Additional multi-center RCTs are necessary for further analysis of statistical outcomes demonstrating mixed effects.

PMID:33862545 | DOI:10.1016/j.clinimag.2021.03.020

Int Immunopharmacol. 2021 Apr 13;96:107620. doi: 10.1016/j.intimp.2021.107620. Online ahead of print.

ABSTRACT

Histamine is released from mast cells when tissues are inflamed or stimulated by allergens. Activation of histamine receptors and calcium influx via TRPV1 could be related to histamine-induced itch and skin inflammation. Quercetin is known to have anti-inflammatory and anti-itching effects. This study aims to understand whether quercetin can directly affect histamine-induced calcium influx in human keratinocyte. In it, we investigated quercetin, which acts on histamine-induced intracellular free calcium ([Ca²⁺]i) elevation in human keratinocyte. Changes in [Ca²⁺]i were measured using spectrofluorometry and confocal Imaging. We detected the expression of IL-8 after treatment of quercetin using qRT-PCR and evaluated its anti-itching effect in BALB/c mice. We also performed a docking study to estimate the binding affinity of quercetin to H4 receptors. We found that quercetin pretreatment decreased histamine-induced [Ca²⁺]i elevation in a concentration-dependent manner. The inhibitory effect of quercetin on histamine-induced [Ca²⁺]i elevation was blocked by JNJ7777120, a selective H₄ antagonist, as well as by U73122, a PLC inhibitor, and by GF109203X, a PKC inhibitor. We also found that H4 agonist (4-methylhistamine)-induced [Ca²⁺]i elevation could be inhibited by quercetin. Moreover, the selective TRPV1 blocker capsazepine significantly suppressed the quercetin-mediated inhibition of histamine-induced [Ca²⁺]i elevation, whereas the TRPV4 blocker GSK2193874 had no effect. Last, quercetin decreased histamine and H4 agonist-induced IL-8 expression in keratinocyte and inhibited the scratching behavior-induced compound 48/80 in BALB/c mice. The molecular docking study also showed that quercetin exhibited high binding affinities with H4 receptors (autodock scores for H4 = -8.7 kcal/mol). These data suggest that quercetin could decrease histamine 4 receptor-induced calcium influx through the TRPV1 channel and could provide a molecular mechanism of quercetin in anti-itching, anti-inflammatory, and unpleasant sensations.

PMID:33862555 | DOI:10.1016/j.intimp.2021.107620

Int J Hyg Environ Health. 2021 Apr 13;234:113748. doi: 10.1016/j.ijheh.2021.113748. Online ahead of print.

ABSTRACT

BACKGROUND: Acute respiratory infections (ARIs) are among the most common human illnesses globally. Previous studies that examined the associations between climate variability and ARIs or ARI pathogens have reported inconsistent findings. Few studies have been conducted in Southeast Asia to date, and the impact of climatic factors are not well-understood. This study aimed to investigate the short-term associations between climate variability and ARIs in Singapore.

METHODS: We obtained reports of ARIs from all government primary healthcare services from 2005 to 2019 and analysed their dependence on mean ambient temperature, minimum temperature and maximum temperature using the distributed lag non-linear framework. Separate negative binomial regression models were used to estimate the association between each temperature (mean, minimum, maximum temperature) and ARIs, adjusted for seasonality and long-term trend, rainfall, relative humidity, public holidays and autocorrelations. For temperature variables and relative humidity we reported cumulative relative risks (RRs) at 10th and 90th percentiles compared to the reference value (centered at their medians) with corresponding 95% confidence intervals (CIs). For rainfall we reported RRs at 50th and 90th percentiles compared to 0 mm with corresponding 95% CIs.

RESULTS: Statistically significant inverse S-curve shaped associations were observed between all three temperature variables (mean, minimum, maximum) and ARIs. A decrease of 1.1 °C from the median value of 27.8 °C to 26.7 °C (10th percentile) in the mean temperature was associated with a 6% increase (RR: 1.06, 95% CI: 1.03 to 1.09) in ARIs. ARIs also increased at 23.9 °C (10th percentile) compared to 24.9 °C of minimum temperature (RR: 1.11, 95% CI: 1.07 to 1.16). The effect of maximum temperature for the same comparison (30.5 °C vs 31.7 °C) was non-significant (RR: 1.02, 95% CI: 0.99 to 1.05). An increase in ambient temperature to 28.9 °C (90th percentile) was associated with an 18% decrease (RR: 0.82, 95% CI: 0.80 to 0.83) in ARIs. Similarly, ARIs decreased with the same increase to 90th percentile in minimum (RR: 0.84, 95% CI: 0.80 to 0.87) and maximum (RR: 0.89, 95% CI: 0.86 to 0.93) temperatures. Rainfall was inversely associated with ARIs and displayed similar shape in all three temperature models. Relative humidity, on the other hand, exhibited a U-shaped relationship with ARIs.

CONCLUSION: Our findings suggest that lower temperatures increase the risk of ARIs. Anticipated extreme weather events that reduce ambient temperature can be used to inform increased healthcare resource allocation for ARIs.

PMID:33862488 | DOI:10.1016/j.ijheh.2021.113748

J Pharm Biomed Anal. 2021 Apr 6;199:114064. doi: 10.1016/j.jpba.2021.114064. Online ahead of print.

ABSTRACT

Major depressive disorder (MDD) is a prevalent complex psychiatric disorder, and there are no effective biomarkers for clinical diagnosis. Urine is not subjected to homeostatic control, allowing it to reflect the sensitive changes that occur in various diseases. In this study, we examined the urine proteome changes in a chronic unpredictable mild stress mouse model of MDD. Male C57BL/6 mice were subjected to chronic unpredictable mild stress for 5 weeks. The tail suspension test and sucrose consumption test were then applied to evaluate depression-like behaviors. The urine proteomes on day 0 and day 36 in the CUMS group were profiled by liquid chromatography coupled with tandem mass spectrometry (LCMS/MS). A total of 36 differential proteins were identified, 19 of which have been associated with the pathogenic mechanisms of MDD. There was an average of two differential proteins that were identified through 1,048,574 random combination statistical analyses, indicating that at least 95 % of the differential proteins were reliable. The differential proteins were mainly associated with blood coagulation, inflammatory responses and central nervous system development. Our preliminary results indicated that the urine proteome can reflect changes associated with MDD in the CUMS model, which provides potential clues for the diagnosis of MDD.

PMID:33862505 | DOI:10.1016/j.jpba.2021.114064

Waste Manag. 2021 Apr 13;126:597-607. doi: 10.1016/j.wasman.2021.03.035. Online ahead of print.

ABSTRACT

The paper contributes to the debate concerning the management of municipal solid waste by providing an analysis of two key aspects of waste management – namely, waste separation and dispatch to treatment plants. Our analysis aims at detecting the extent to which actual behavior in (close-by) municipalities is similar with respect to those two aspects. To pursue our scope, a complex network approach is followed. In particular, we conceptualize, explore and compare two networks, whose nodes are the municipalities, while weights synthesize in one network the percentage of sorted waste that is collected at a municipal level, and in the other one the distance from the waste processing plants used by each municipality. The theoretical network models are implemented through an empirical study based on a high quality dataset referred to Italian municipalities. In this regard, the detection of communities of municipalities and their geospatial contextualization are introduced as devices for a complete description of current practices of municipal waste separation and transfers in Italy.

PMID:33862511 | DOI:10.1016/j.wasman.2021.03.035

Eur J Oncol Nurs. 2021 Mar 27;52:101950. doi: 10.1016/j.ejon.2021.101950. Online ahead of print.

ABSTRACT

PURPOSE: The overall aim of this study was to describe perceptions of the decision-making process in relation to participation/non-participation in ethics discussions among healthcare professionals in paediatric oncology.

METHODS: Healthcare professionals, working at three paediatric units where ethics discussions where performed answered a study-specific questionnaire focusing on perceptions of involvement, influence, responsibility and understanding of ethics decision-making. Statistical analyses included descriptive statistics, non-parametric paired t-tests and correlation tests.

RESULTS: Participation in ethics discussions was related to perceptions of greater involvement and the possibility of influencing decisions, as well as formal/shared responsibility for the ethics decisions related to patient care. Medical doctors and registered nurses perception of involvement in decisions, possibility to influence and responsibility decreased when they were not present during the ethics discussion or when no ethics discussion was conducted at all. Healthcare professionals had a generally good understanding of the ethical issues and the ethics decisions. The whole group considered medical doctors to be the most important participants in the ethics discussions, followed by patients/family. Healthcare professionals wanted more teamwork and viewed ethics discussions as very helpful for teamwork when dealing with ethical issues in paediatric oncology.

CONCLUSIONS: Ethics discussions in paediatric oncology practice increases the involvement within and the understanding of the decision-making process about ethical decisions. The understanding is not always dependent on participation, indicating a great trust in team members. Based on these findings the implementation of a structure for ethics support in paediatric oncology where patients/families are integrated is recommended.

PMID:33862416 | DOI:10.1016/j.ejon.2021.101950

Eur J Obstet Gynecol Reprod Biol. 2021 Apr 1;260:212-217. doi: 10.1016/j.ejogrb.2021.03.035. Online ahead of print.

ABSTRACT

OBJECTIVE: Laparoscopic high uterosacral ligament suspension (l-HUSLS) is a laparoscopic-transposed vaginal technique for the treatment of pelvic organ prolapse. Nowadays data regarding quality of life and sexual functions in patients who underwent l-HUSLS for pelvic organ prolapse are few and generic with most of the study investigating the anatomical outcome. For these reasons, the aim of our study is to evaluate these subjective outcomes in women undergoing this surgical procedure with the support of validated questionnaires.

STUDY DESIGN: This is a retrospective study with the primary aim of analysing the quality of life, sexual function, patient satisfaction rates and anatomical outcome among patients who underwent l-HUSLS in our institution. The SPSS Version 26.0 for Windows (Statistical package for the social studies, Chicago, IL, USA) was used for the statistical analysis.

RESULTS: A total of 60 patients underwent l-HUSLS between 2016 and 2018. All patients had a high grade of apical prolapse. No intraoperative and major postoperative complications were registered. The median follow-up was 24 months (24-48). PGI-I score was 1-2 in 55 (91.6 %) women. We observed a significant improvement of EQ-5D index and VAS scores from the baseline to the 2 years follow-up: from 0.72 (0.67-1) to 0.91 (0.79-1) and from 50 (30-90) to 70 (50-100) respectively (p = 0.000). All women showed a statistically significant amelioration of FSDS and ICIQ-SF scores. Anatomical success rate after 24 months was 83.7 %.

CONCLUSIONS: l-HUSLS appears to be a safe, feasible and effective treatment for advanced pelvic organ prolapse with high rates of patient self-reported cure.

PMID:33862432 | DOI:10.1016/j.ejogrb.2021.03.035

Rev Chil Pediatr. 2020 Dec;91(6):917-923. doi: 10.32641/rchped.vi91i6.1831. Epub 2020 Dec 12.

ABSTRACT

INTRODUCTION: There is a close relationship between chronic kidney disease (CKD) and cardiovascular disease. One of its clinical manifestations is left ventricular hypertrophy (LVH), expressed as Left Ventricular Mass Index (LVMI gr/m27). In CKD patients with growth retardation, the LVMI calculation should be adjusted by correcting age for length/height.

OBJECTIVE: To compare the age-corrected LVMI for length/height with the value calculated by chronological age in CKD children on dialysis.

PATIENTS AND METHOD: Cross-sectional study. We analyzed echocardiographies of CKD children on dialysis aged between 1 and 18, from January 2016 to July 2017. LVMI was evaluated by adjusting the value expressed in gr/m27 to the percentile for the chronological child’s age, and then the value was adjusted to the age-corrected length/height. We used descriptive statistics and concordance study for LVMI assessments calculating by chronological age and for age-corrected length/height.

RESULTS: 26 patients were included and 75 echocardiograms. 56% had left ventricular hypertrophy using chronological age versus 46.6% age-corrected LVMI for length/height. When comparing the percentile groups of LVMI-chronological age vs. age-adjusted LVMI for actual length/height, it was observed that 18.6% of the sample changed percentile groups, 100% of them to a lower percentile group. The agreement evaluated based on the Kappa coefficient was 0.72 (perfect agreement > 0.8), confirming differences when adjusting the LVMI for age-corrected length/height.

CONCLUSION: Calculating LVMI by chro nological age overestimates the cardiovascular involvement in children with CKD who are charac teristically stunted. The results suggest that the age-adjusted, length/height-corrected calculation of LVMI gives greater accuracy to the diagnosis of left ventricular hypertrophy in this group of patients.

PMID:33861828 | DOI:10.32641/rchped.vi91i6.1831

Addiction. 2021 Apr 16. doi: 10.1111/add.15511. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) questionnaire screens for harmful drinking using a 12-month timeframe. A score of 0 is assigned to individuals who report abstaining from alcohol in the past year. However, many middle-aged individuals reporting current abstinence are former drinkers (FDs). Because FDs may be more genetically prone to harmful alcohol use than life-long abstainers (LAs) and are often combined with LAs, we evaluated the impact of differentiating them on the identification of genetic association.

DESIGN AND SETTING: The UK Biobank (UKBB) includes AUDIT-C and alcohol drinker status.

PARTICIPANTS: 131,510 Europeans, including 5,135 FDs.

MEASUREMENTS: We compared three genome-wide association (GWAS) analyses to explore the effects of removing FDs: the full AUDIT-C data, AUDIT-C data without FDs, and data from a random sample numerically matched to the data without FDs. Because prior studies show a consistent association of the ADH1B polymorphism rs1229984 with both alcohol consumption and alcohol use disorder, we compared allele frequencies for rs1229984 stratified by AUDIT-C value and FD versus LA status. Additionally, we calculated polygenic risk scores (PRS) of related diseases.

FINDINGS: The rs1229984 allele frequencies among FDs were numerically comparable to those with high AUDIT-C scores and very different from those of LAs. Removing FDs from GWAS yielded a stronger association with rs1229984 (p-value after removal: 1.9 x10^-70 versus 1.7×10^-65 and 2.5 x10^-62 ), more statistically significant single nucleotide polymorphisms (SNPs) (after removal: 11 versus 9 and 8), and genomic loci (after removal: 11 versus 9 and 7). Additional independent SNPs were identified after removal of FDs: rs2817866 (PTGER3), rs7105867 (ANO3), and rs17601612 (DRD2). For PRS of alcohol use disorder and major depressive disorder, there are statistically significant differences between FDs and LAs.

CONCLUSIONS: Differentiating between former drinkers and life-long abstainers can improve Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) genome-wide association results.

PMID:33861876 | DOI:10.1111/add.15511