Category: Statistics

Eur Surg Res. 2021 Apr 7:1-8. doi: 10.1159/000515459. Online ahead of print.

ABSTRACT

INTRODUCTION: Intraductal papillary mucinous neoplasms (IPMNs) represent the most common precancerous cystic lesions of the pancreas. The aim of our study was to investigate if resection for non-invasive IPMNs alters quality of life (QoL) in a long-term follow-up.

METHODS: Patients (n = 50) included in the analysis were diagnosed and resected from 2010 to 2016. QoL was assessed at a median of 5.5 years after resection. At that point in time, the current QoL as well as the QoL before resection was evaluated retrospectively. The standardised European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire for Pancreatic Cancer (EORTC QLQ – PAN26) was applied for the QoL assessment.

RESULTS: After a median of 66 months postoperatively, the total QoL score significantly worsened (92.13 vs. 88.04, p = 0.020, maximum achievable score = 100) for patients (median age at surgery 68.0 years), mostly due to digestive symptoms. During the same follow-up period, median Eastern Cooperative Oncology Group (ECOG) performance status did not worsen (p = 0.003).

CONCLUSIONS: Long-term QoL statistically significantly worsened after pancreatic resection for IPMN. The extent of worsening, however, was small, and QoL still remained excellent. Therefore, resection in cases of IPMN is appropriate, if indicated carefully.

PMID:33827087 | DOI:10.1159/000515459

Med Princ Pract. 2021 Apr 7. doi: 10.1159/000516342. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this retrospective study was to investigate the effect of photobiomodulation therapy on postoperative pain provoked by thermal stimulation in direct pulp capping.

SUBJECT AND METHODS: A retrospective study was performed using the records of patients who received direct pulp capping using mineral trioxide aggregate. Teeth irradiated with a laser were assigned as the photobiomodulation therapy group and non-irradiated teeth were considered as the control group. Before treatment and 6 hours, 1 day and 7 days after treatment, tooth sensitivity to a cold stimulus was recorded using a visual analog scale.

RESULTS: From a total of 123 documented direct pulp capping procedures, only 72 directly capped permanent teeth met the inclusion criteria. Age, gender, and tooth location were comparable between the groups. A statistically significant difference was found in sensitivity to cold stimulus between groups on day 7 (p=.007), but no difference was found at the preoperative, 6 hour, and day 1 time points (p=.055, p=.132, p=.100, respectively). In the intragroup evaluation, a significantly greater decrease was detected in the photobiomodulation therapy group compared to the control group, although both groups showed a reduction in discomfort throughout the follow-up period (p=.000).

CONCLUSION: Photobiomodulation therapy is an effective method for enhancing patient comfort by reducing thermal sensitivity following direct pulp capping procedures.

PMID:33827095 | DOI:10.1159/000516342

Eur Neurol. 2021 Apr 7:1-6. doi: 10.1159/000514828. Online ahead of print.

ABSTRACT

INTRODUCTION: The primary aim of the present study was to evaluate the long-term efficacy of fingolimod in patients with multiple sclerosis (MS); secondary aims were to describe the safety of fingolimod with the evaluation of treatment satisfaction and impact on the quality of life in real life.

METHODS: We collected clinical, demographical, neuroradiological, and treatment data, including pre- and posttreatment status health-related quality of life from 286 MS patients consecutively treated with fingolimod. Clinical assessment was based on the Expanded Disability Status Scale (EDSS), and quality of life assessment was performed with MS-related quality of life inventory (MSQOLI). The data were recorded at baseline and every 6 months for 2 years.

RESULTS: One hundred and fourteen males and 172 females were enrolled. The annualized relapse rate and EDSS showed a statistically significant reduction during the observation period (p < 0.001). The patients also demonstrated substantial improvements in magnetic resonance imaging (MRI) outcomes (p < 0.001). Health-related quality of life scores improved significantly between baseline and 24-month visit (p < 0.001). No serious adverse events occurred.

CONCLUSION: In our cohort, fingolimod treatment was associated with reduced relapse, MRI activity, and improved EDSS and MSQOLI scores. Additionally, fingolimod has been able to maintain its effectiveness over a considerable long period of treatment.

PMID:33827097 | DOI:10.1159/000514828

Anesth Prog. 2020 Mar 1;68(1):19-25. doi: 10.2344/anpr-67-03-12.

ABSTRACT

The aim of this study was to analyze the use of dental local anesthetics in Germany compared with international data. The type and distribution of dental local anesthetics and added vasoconstrictors based on a representative sample of German dentists itemized over a period of 7 years (2011 to 2017) were evaluated and statistically analyzed. The results were compared with international dental local anesthetic consumption data published since 2005. With a consistent market share of nearly 98%, articaine was the first-line local dental anesthetic agent in Germany. During the investigation period, German dental local anesthetics with epinephrine 1:200,000 had ∼50% market shares, whereas formulations with epinephrine 1:100,000 had 40% to 45% market shares. Articaine, with market shares between 38% and 81%, was also the preferred anesthetic agent in various other countries, with the notable exceptions of the United Kingdom and the United States, where lidocaine was the preferred local anesthetic agent. Epinephrine was the preferred vasoconstrictor internationally, similar to Germany. The larger market share of higher concentrated epinephrine 1:100,000 was remarkable, considering the increasing number of medically compromised patients. Increased consideration for using agents with reduced dosages of epinephrine (1:200,000) is generally recommended.

PMID:33827123 | DOI:10.2344/anpr-67-03-12

Adv Med Sci. 2021 Mar 30;66(2):237-245. doi: 10.1016/j.advms.2021.03.005. Online ahead of print.

ABSTRACT

PURPOSE: We analyzed the SARS-CoV-2 genome using our integrated genome analysis system and present the concept of a comprehensive approach to monitoring and surveillance of emerging variants.

MATERIAL/METHODS: A total of 69 SARS-CoV-2 positive samples (with Ct value ​≤ ​28) were tested. Samples included in this study were selected from 7 areas of eastern Poland. All samples were sequenced on an Illumina MiSeq platform using a 300-cycle MiSeq Reagent Kit v2. BWA was used for reads mapping on the reference SARS-CoV-2 sequence. SAMTools were used for post-processing of reads to genome assembly. Pango lineage and Nexstrain were used to identify variants and amino acid mutations. Statistical analysis was performed with R 4.0.2.

RESULTS: This study shows the first confirmed case of SARS-CoV-2 in Poland with the lineage B.1.351 (known as 501Y.V2 South African variant), as well as another 18 cases with epidemiologically relevant lineage B.1.1.7, known as British variant. Supplementary analysis of SARS-CoV-2 sequences deposited in GISAID shows that the share of a new variant can change rapidly within one month. In addition, we show a complete, integrated concept of a networked system for analyzing the variability of the SARS-CoV-2 genome, which, used in the present study, generated data and a variant report within 6 days.

CONCLUSION: The analyzed viral genomes showed considerable variability with simultaneous clear distinction of local clusters of genomes showing high similarity. Implementing real-time monitoring of new SARS-CoV-2 variants in Poland is urgently needed, and our developed system is available to be implemented on a large scale.

PMID:33827042 | DOI:10.1016/j.advms.2021.03.005

Phys Biol. 2021 Apr 7. doi: 10.1088/1478-3975/abf5b3. Online ahead of print.

ABSTRACT

The number of motors carrying cargos in biological cells is not well-defined, instead varying from cargo to cargo about a statistical mean. Predictive understanding of motility in cells therefore requires quantitative insights into mixed ensembles of cargos. Toward this goal, here we employed Monte Carlo simulations to investigate statistical ensembles of cargos carried by a Poisson-distributed number of motors. Focusing on the key microtubule-based motor kinesin-1, our simulations utilized experimentally determined single-kinesin characteristics and alterations in kinesin’s on- and off-rates caused by cellular factors and/or physical load. We found that a fractional increase in mean kinesin number enhances the ensemble-averaged cargo run length and amplifies run-length sensitivity to changes in single-kinesin on-rate and off-rate. These tuning effects can be further enhanced as solution viscosity increases over the range reported for cells. Together, our data indicate that the physiological range of kinesin number sensitively tunes the motility of mixed cargo populations. These effects have rich implications for quantitative and predictive understanding of cellular motility and its regulation.

PMID:33827070 | DOI:10.1088/1478-3975/abf5b3

Am J Nephrol. 2021 Apr 7:1-11. doi: 10.1159/000515232. Online ahead of print.

ABSTRACT

INTRODUCTION: Use of certain antihypertensive medications has been an area of interest during the COVID-19 pandemic, and several hypotheses have been developed regarding the effects of renin-angiotensin system blockers as well as calcium channel blockers in those infected with COVID-19. We seek to determine the association between exposure to ACEI, ARB, and CCB and outcomes in those admitted to the hospital with COVID-19 infection.

METHODS: This retrospective cohort study included 841 adult patients hospitalized with COVID-19 infection at the University of Chicago Medical Center between March 25 and June 22, 2020. Out of these 841, 453 patients had a personal history of hypertension. For the first part, we evaluated primary outcomes of in-hospital mortality and ICU admission in hospitalized COVID-19 patients based on their exposure to particular medications regardless of a personal history of hypertension and compared them with those who were not on these medications. For the second part, we evaluated the aforementioned outcomes in 453 patients with a personal history of hypertension based on their medication exposure. Secondary outcomes of length of stay, readmission rate, and new-onset dialysis requirement were also compared across the study groups.

RESULTS: Out of 841 patients, 111 (13.19%) were on ACEI/ARB (median age: 66.1, SD 15.4; 52.25% females) and 730 (86.80%) were not on them (median age: 56.6, SD 20.3; 50.14% females), while 277 (32.93%) used CCB (median age: 64.6, SD 15.2; 57.04% females) and 564 (67.06%) did not use CCB (median age: 54.6, SD 21.2; 47.16% females). After adjusting for demographics and covariates, neither ACEI/ARB nor CCB exposure was associated with any effect on mortality, but ACEI/ARB exposure was associated with 42% reduction in risk of ICU admissions (OR 0.58, 95% CI [0.35, 0.95], p value 0.03). In addition, combined use of ACEI/ARB and CCB was associated with statistically significant (45%) reduction in ICU admission (OR 0.55, 95% CI [0.32, 0.94], p value 0.029). Out of 453 patients with a personal history of hypertension, 85 (18.76%) were taking ACEI/ARB (median age 65, SD 15.6; 56.47% females) and 368 (81.24%) were not on ACEI/ARB (median age 62.8, SD 16.4; 54.89% females), while 208 (45.92%) out of 453 were on CCB (median age 65; SD 14.8; 60.1% females) and 245 (54.08%) were not on CCB (median age 61.7, SD 17.3; 51.02% females). In the fully adjusted model in this group, ACEI use was associated with 71% reduction in in-house mortality (OR 0.29, 95% CI [0.09, 0.93], p value 0.03).

DISCUSSION/CONCLUSION: Among all hospitalized patients with COVID-19 infection, exposure to ACEI/ARB, as well as combined exposure to ACEI/ARB and CCB, were associated with reduced incidence of ICU admissions. In those admitted patients who had a personal history of hypertension, there was a trend towards reduced in-hospital mortality in those exposed to ACEI.

PMID:33827074 | DOI:10.1159/000515232

J Environ Manage. 2021 Mar 31;288:112456. doi: 10.1016/j.jenvman.2021.112456. Online ahead of print.

ABSTRACT

The present study describes the development of a web-based flood risk information system ‘WebFRIS’ for Jagatsinghpur district, a severely flood-prone region in Eastern India. The WebFRIS is designed by using various readily available open-source web tools and packages such as Google Map, PHP, MySQL, and JSON. Special emphasis is directed towards designing the layout and architecture, to be easily accessible by any end-user irrespective of any technical know-how. The WebFRIS illustrates spatial maps of flood hazard, socio-economic vulnerability, and flood risk at the village level for two-time scenarios. While analyzing a set of graphical statistics depicting the changes in flood risk components, a significant increase in high and very-high categories of both flood hazard (~140%) and socio-economically vulnerable villages (~68%) is noticed during Scenario-I. The number of villages facing compound risk (contributed equally by flood hazard and socio-economic vulnerability) nearly doubled in Scenario-I. A spatial analysis of diametric changes in flood risk shows that a large proportion of villages in Balikuda, Ersama, and Tirtol tehsils have undergone radical changes. Following these observations, a set of possible engineering, social, and policy measures are proposed, whose implementation in the near future is expected to reinforce flood management in the study area. The WebFRIS architecture is flexible, easy-to-use; it is expected to provide crucial lessons to the local bodies, town-planners, water professionals, flood experts, and also the citizens, a precious knowledge on flood risk management. The WebFRIS may be considered as a precious cartographic product for environmental management. The proposed web platform is generic, as it can be applied to study other inter-related systems such as environmental protection, land-use planning, coastal habitat restoration, and community resilience building.

PMID:33827018 | DOI:10.1016/j.jenvman.2021.112456

Int Immunopharmacol. 2021 Apr 4;96:107606. doi: 10.1016/j.intimp.2021.107606. Online ahead of print.

ABSTRACT

Patients with Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) have a poor prognosis. This study investigated the efficacy of rituximab-containing immuno-chemotherapy regimens for EBV-HLH. In this study, 15 patients were treated with rituximab-containing regimens. The treatment efficacy and adverse events were evaluated. In 10 patients, EBV DNA became negative after the first course of treatment. The lymphocyte types infected by EBV in the 10 patients were only infected with B cells and mainly infected with B cells. In the other 5 patients, the EBV DNA of peripheral blood mononuclear cells (PBMC) before and after treatment with the regimens had no statistical difference (P = 0.111). In addition, in these 5 patients, EBV mainly infected T and NK cells. Among the 5 patients without a significant decline in EBV DNA of PBMC, 2 patients received allogeneic hematopoietic stem cell transplantation and turned negative for EBV DNA. This study suggests that rituximab-containing regimens are effective therapy for EBV-HLH with only and mainly B lymphocytes infected by EBV, especially for eliminating EBV.

PMID:33826999 | DOI:10.1016/j.intimp.2021.107606

J Contam Hydrol. 2021 Mar 2;240:103792. doi: 10.1016/j.jconhyd.2021.103792. Online ahead of print.

ABSTRACT

Groundwater samples from 61 randomly selected tube-wells in densely residential (DR) and sparse residential (SR) parts of Aba, Nigeria were analysed to elucidate the influence of urban land-use on the quality and characterize the hydrochemistry of the groundwater. Twelve water quality indicators: temperature, pH, EC, and TDS (physicochemical), as well as HCO₃, Cl, SO₄, NO₃, Na, K, Ca, and Mg (major ions) were analysed for each well. The results of the analyses were grouped based on the influence of land-use on the wells. The descriptive statistics, Piper, Chadha’s, and bivariate scattered plots, as well as index of base ion-exchange, and Friedman nonparametric statistical test were used to delineate and ascertain the significance of the urban impact on the quality of the groundwater wells. The results showed that the groundwater pH is acidic (3.7-5.6), and the mineralization low, with TDS ranging between 6.5 mg/l – 365 mg/l. The statistical mean and standard deviation (x¯±S.D) of the remaining quality indicators were found within the limits set by WHO in all the wells. The Piper and Chadha’s plots revealed four dominant water-types with spatial differentiation in the area. Though there are several mixed water-types in the SR area, the Na-HCO₃ water-type is dominant and represents the background hydrochemistry of the groundwater in the area. Whereas, Mg, Ca-Cl, water-types predominates in the DR wells. Other dominant water-types found between the SR and DR areas are Na-Cl and Ca-HCO₃ types. The rapid compositional change and local alteration in the hydrochemistry of the groundwater were impacted by some identified urban land-use practices, which introduce additional major ions in the groundwater solution. The mixed water-types found in the SR wells were influenced by factors such as the direction of flow and mixing of the groundwater reservoirs impacted by the hydrochemistry of the DR groundwater, which were upstream to the SR wells. The results of indicators such as EC, TDS, Cl, and NO₃, when compared showed observable local deterioration moving from wells in the SR to wells in the DR area. This was supported by the Friedman statistical test which revealed statistical significance of some urban practices on the quality of the groundwater. These results highlight the current quality status and harmonize the reports of previous studies which have characterized the hydrochemistry of the groundwater in the study area.

PMID:33827000 | DOI:10.1016/j.jconhyd.2021.103792