Category: Statistics

J Public Health Res. 2021 Sep 24. doi: 10.4081/jphr.2021.2132. Online ahead of print.

ABSTRACT

BACKGROUND: Developmental dental anomalies are seen as abnormalities in tooth size, shape, position, and structure due to multiple reasons during various stages of tooth development. These anomalies can create disturbances in dental arch lengths and occlusions. Hence, it is very important to treat, recognise and perform proper treatment. The purpose of this study was to find out the prevalence and distribution of selected developmental anomalies in shape, size and position of teeth in the Saudi population of Taif Region.

DESIGN AND METHODS: The study was based on the clinical examination of 2481 adults who are Saudi nationals came for dental treatment from September 2019 to February 2020, at Taif University Dental Hospital, Saudi Arabia. These patients were examined clinically for developmental dental anomalies affecting shape, size and position.

RESULTS: We found that a total of 512 individuals (20.63%) had developmental anomalies and out of which 386 persons (15.56%) had at least one developmental dental anomaly. The frequency and distribution of anomalies of shape and size, number and position were 46.8%, 26.9% and 42.9% respectively. In the present study, 15.56% individuals exhibited at least one anomaly, 8.54% subjects had more than one anomalies and 79.36%.did not any developmental anomaly. On comparison, statistical significant results were seen between different groups of anomalies.

CONCLUSIONS: The present study had varying results for the prevalence rate of selected dental anomalies. This variation in results might be due racial differences or discrepancy in sample size or/and diagnostic or inclusion criteria. Treatment of developmental anomalies necessitates a multidisciplinary approach and mostly may comprise of orthodontic correction or prosthetic replacement.

PMID:34558880 | DOI:10.4081/jphr.2021.2132

Hepatol Commun. 2021 Aug 24. doi: 10.1002/hep4.1796. Online ahead of print.

ABSTRACT

Physical frailty and impaired cognition are common in patients with cirrhosis. Physical frailty can be assessed using performance-based tests, but the extent to which impaired cognition may impact performance is not well characterized. We assessed the relationship between impaired cognition and physical frailty in patients with cirrhosis. We enrolled 1,623 ambulatory adult patients with cirrhosis waiting for liver transplantation at 10 sites. Frailty was assessed with the liver frailty index (LFI; “frail,” LFI ≥ 4.4). Cognition was assessed at the same visit with the number connection test (NCT); continuous “impaired cognition” was examined in primary analysis, with longer NCT (more seconds) indicating worse impaired cognition. For descriptive statistics, “impaired cognition” was NCT ≥ 45 seconds. Linear regression associated frailty and impaired cognition; competing risk regression estimated subhazard ratios (sHRs) of wait-list mortality (i.e., death/delisting for sickness). Median NCT was 41 seconds, and 42% had impaired cognition. Median LFI (4.2 vs. 3.8) and rates of frailty (38% vs. 20%) differed between those with and without impaired cognition. In adjusted analysis, every 10-second NCT increase associated with a 0.08-LFI increase (95% confidence interval [CI], 0.07-0.10). In univariable analysis, both frailty (sHR, 1.63; 95% CI, 1.43-1.87) and impaired cognition (sHR, 1.07; 95% CI, 1.04-1.10) associated with wait-list mortality. After adjustment, frailty but not impaired cognition remained significantly associated with wait-list mortality (sHR, 1.55; 95% CI, 1.33-1.79). Impaired cognition mediated 7.4% (95% CI, 2.0%-16.4%) of the total effect of frailty on 1-year wait-list mortality. Conclusion: Patients with cirrhosis with higher impaired cognition displayed higher rates of physical frailty, yet frailty independently associated with wait-list mortality while impaired cognition did not. Our data provide evidence for using the LFI to understand mortality risk in patients with cirrhosis, even when concurrent impaired cognition varies.

PMID:34558844 | DOI:10.1002/hep4.1796

Hepatol Commun. 2021 Sep 1. doi: 10.1002/hep4.1813. Online ahead of print.

ABSTRACT

The benefit of endoscopic retrograde cholangiopancreatography (ERCP) for the treatment of primary sclerosing cholangitis (PSC) remains controversial. To identify predictors of jaundice resolution after ERCP and whether resolution is associated with improved patient outcomes, we conducted a retrospective cohort study of 124 patients with jaundice and PSC. These patients underwent endoscopic biliary balloon dilation and/or stent placement at an American tertiary center, with validation in a separate cohort of 102 patients from European centers. Jaundice resolved after ERCP in 52% of patients. Median follow-up was 4.8 years. Independent predictors of jaundice resolution included older age (P = 0.048; odds ratio [OR], 1.03 for every 1-year increase), shorter duration of jaundice (P = 0.059; OR, 0.59 for every 1-year increase), lower Mayo Risk Score (MRS) (P = 0.025; OR, 0.58 for every 1-point increase), and extrahepatic location of the most advanced biliary stricture (P = 0.011; OR, 3.13). A logistic regression model predicted jaundice resolution with area under the receiver operator characteristic curve of 0.67 (95% confidence interval, 0.5-0.79) in the validation set. Independent predictors of death or transplant during follow-up included higher MRS at the time of ERCP (P < 0.0001; hazard ratio [HR], 2.33 for every 1-point increase), lower total serum bilirubin before ERCP (P = 0.031; HR, 0.91 for every 1 mg/dL increase), and persistence of jaundice after endoscopic therapy (P = 0.003; HR, 2.30). Conclusion: Resolution of jaundice after endoscopic treatment of biliary strictures is associated with longer transplant-free survival of patients with PSC. The likelihood of resolution is affected by demographic, hepatic, and biliary variables and can be predicted using noninvasive data. These findings may refine the use of ERCP in patients with jaundice with PSC.

PMID:34558848 | DOI:10.1002/hep4.1813

Hepatol Commun. 2021 Jun 12. doi: 10.1002/hep4.1752. Online ahead of print.

ABSTRACT

Hepatocellular carcinoma (HCC) is a malignant cancer with one of the highest mortality rates. Des-γ-carboxyprothrombin (DCP) is an HCC serologic surveillance marker that can complement the low sensitivity of alpha-fetoprotein (AFP). DCP exists in the blood as a mixture of proteoforms from an impaired carboxylation process at glutamic acid (Glu) residues within the N-terminal domain. The heterogeneity of DCP may affect the accuracy of measurements because DCP levels are commonly determined using an immunoassay that relies on antibody reactivity to an epitope in the DCP molecule. In this study, we aimed to improve the DCP measurement assay by applying a mass spectrometry (MS)-based approach for a more inclusive quantification of various DCP proteoforms. We developed a multiple-reaction monitoring-MS (MRM-MS) assay to quantify multiple noncarboxylated peptides included in the various des-carboxylation states of DCP. We performed the MRM-MS assay in 300 patients and constructed a robust diagnostic model that simultaneously monitored three noncarboxylated peptides. The MS-based quantitative assay for DCP had reliable surveillance power, which was evident from the area under the receiver operating characteristic curve (AUROC) values of 0.874 and 0.844 for the training and test sets, respectively. It was equivalent to conventional antibody-based quantification, which had AUROC values at the optimal cutoff (40 mAU/mL) of 0.743 and 0.704 for the training and test sets, respectively. The surveillance performance of the MS-based DCP assay was validated using an independent validation set consisting of 318 patients from an external cohort, resulting in an AUROC value of 0.793. Conclusion: Due to cost effectiveness and high reproducibility, the quantitative DCP assay using the MRM-MS method is superior to antibody-based quantification and has equivalent performance.

PMID:34558815 | DOI:10.1002/hep4.1752

Pharmacoepidemiol Drug Saf. 2021 Sep 24. doi: 10.1002/pds.5361. Online ahead of print.

ABSTRACT

PURPOSE: Our objective was to calculate the positive predictive value (PPV) of the ICD-9 diagnosis code for angioedema when physicians adjudicate the events by electronic health record review. Our secondary objective was to evaluate the inter-rater reliability of physician adjudication.

METHODS: Patients from the Cardiovascular Research Network previously diagnosed with heart failure who were started on angiotensin-converting enzyme inhibitors (ACEI) during the study period (July 1, 2006 through September 30, 2015) were included. A team of two physicians per participating site adjudicated possible events using electronic health records for all patients coded for angioedema for a total of five sites. The PPV was calculated as the number of physician-adjudicated cases divided by all cases with the diagnosis code of angioedema (ICD-9-CM code 995.1) meeting the inclusion criteria. The inter-rater reliability of physician teams, or kappa statistic, was also calculated.

RESULTS: There were 38 061 adults with heart failure initiating ACEI in the study (21 489 patient-years). Of 114 coded events that were adjudicated by physicians, 98 angioedema events were confirmed for a PPV of 86% (95% CI: 80%, 92%). The kappa statistic based on physician inter-rater reliability was 0.65 (95% CI: 0.47, 0.82).

CONCLUSIONS: ICD-9 diagnosis code of 995.1 (Angioneurotic edema, not elsewhere classified) is highly predictive of angioedema in adults with heart failure exposed to ACEI. This article is protected by copyright. All rights reserved.

PMID:34558760 | DOI:10.1002/pds.5361

Mol Ecol Resour. 2021 Sep 24. doi: 10.1111/1755-0998.13513. Online ahead of print.

ABSTRACT

In the last five years, interest in close-kin mark-recapture (CKMR), a variant of mark-recapture that uses genetically inferred kin as “recaptures,” has grown dramatically. However, understanding the basis of CKMR, and properly implementing it, remains challenging. This paper describes an R package, CKMRpop, for simulating age-structured populations with user-specified demography, reproductive dispersion (allowing for different ratios of effective to census size), and random sampling of individuals. Using compiled code for the simulation makes it feasible to simulate populations of millions of individuals. From the simulation output, pairs of sampled individuals related within a user-specified number of generations are found. Such pairs form the foundation for CKMR inference, and simulating them provides insight for understanding the statistical basis for CKMR and for assessing the feasibility of CKMR in different scenarios. We predict that CKMRpop will serve as an important tool for researchers contemplating CKMR estimation of population size. Further more, the methods presented here for identifying and categorizing relationships beyond half-siblings allow a more complete picture of the wide variety of kin pairs encountered in populations. This identifies the fraction of kin pairs that may not be the target of a CKMR experiment, but may be inadvertently mistaken for a more closely related “target” kin pair. Additionally, as more distant kin categories will likely be accurately inferred from increasingly available and inexpensive whole genome resequencing, understanding the distributions of more distant relationships in populations is a first step toward broadening the scope of CKMR to include them.

PMID:34558810 | DOI:10.1111/1755-0998.13513

Anat Histol Embryol. 2021 Sep 24. doi: 10.1111/ahe.12741. Online ahead of print.

ABSTRACT

Kidney diseases are the most common illness for cats with a prevalence seven times higher than in dogs. Metanephros is the last of three renal systems to be formed during the embryonic period, which then becomes the permanent kidney. The current work aimed to analyse the morphology and to quantify the structures present in the development of metanephros from domestic cat (Felis catus) embryos and foetuses. For this purpose, the evaluation of the biometric parameters of metanephros from cat embryos and foetuses was performed in addition to the quantification of renal corpuscles and volume of cortical and medullary layers by stereological analysis. The evaluated biometric parameters were weight, width, height, thickness and volume. The values of the measured biometric parameters increased throughout the gestational stages. The quantity of renal corpuscles gradually increased following the embryo-foetal development, mainly during the middle of the gestational stage. It was during this phase that morphologically, a complete corticomedullary division was observed. Although the difference in the quantity of renal corpuscles between the middle and the end of the gestational stages was not statistically significant, there was an increase in the volume of the medullary layer and a decrease in the volume of the cortical layer between these two stages. These findings suggest that the metanephros presents a progressive growth with the renal corpuscles following this development until the middle of the gestational stage. Starting from this phase, the differentiation of the corticomedullary layers can be seen with a significant increase in the medullary layer.

PMID:34558727 | DOI:10.1111/ahe.12741

J Clin Apher. 2021 Sep 24. doi: 10.1002/jca.21940. Online ahead of print.

ABSTRACT

BACKGROUND: Transplantation of peripheral blood stem cells (PBSCs) mobilized by cytokines is increasingly applied to treat patients with hematologic diseases, such as lymphoma, multiple myeloma, leukemia, etc. Successful hematopoietic stem cell transplantation (HSCT) increasingly depends on the collection of hematopoietic stem cells (HSCs) from peripheral blood. Peripheral vein (PV) is the most common type of blood access. When the blood vessels are not well filled and the blood flow is insufficient, the machine will appear repeated low pressure alarm or pipeline coagulation, which seriously affects the collection efficiency. A peripheral artery (PA) is utilized for drawing blood, while a peripheral vein is used for blood return, that is a way to perform apheresis. The advantages of PA are that it ensures adequate extracorporeal circulation blood flow, stable blood flow rate, simple operation, and relatively low price. However, there are very few studies on the efficacy of peripheral arterial access for HSCs collection. Therefore, this retrospective study was conducted to assess the effectiveness of PA and PV access for PBSCs collection.

METHODS: We performed a retrospective analysis of 150 apheresis procedures on 26 patients and 95 healthy donors collected by PV or PA access from March 1, 2020 to March 1, 2021. We compared the CD34+ cell count, collection efficiency (CE), duration of processing a single blood volume, number of low-pressure alarms, average blood flow rate and number of punctures between the two groups. Also, we analyzed adverse events.

RESULTS: There was no significant difference in the quality of apheresis blood components between the PA group and the PV group. The CD34+ cells collected was 274.16 ± 216.31 × 10⁶ in the PV group and 246.63 ± 127.94 × 10⁶ in the PA group. The CE in the PA group was 49.50 ± 9.88%, higher than 42.39 ± 14.62% in the PV group. The duration of processing a single blood volume was 90.67 ± 15.35 min in the PV group and 79.68 ± 10.28 min in the PA group. The number of low-pressure alarms in the PA group was 0.38 ± 0.98, <2.42 ± 1.76 in the PV group, and the average blood flow rate in the PA group was 59.27 ± 2.18, higher than 54.21 ± 3.41 in the PV group. The difference was statistically significant (P < .05). The Number of punctures was 1.35 ± 0.75 in the PA group and 1.41 ± 1.01 in the PV group. There was no statistically significant difference.

CONCLUSION: Peripheral artery is a safe, reliable, economical, convenient, and fast vascular access, which opens a new way to the establishment of vascular access for PBSCs collection.

PMID:34558738 | DOI:10.1002/jca.21940

J Clin Lab Anal. 2021 Sep 24:e23951. doi: 10.1002/jcla.23951. Online ahead of print.

ABSTRACT

BACKGROUND: N-6 methylation (m6A) pushes forward an immense influence on the occurrence and development of lung adenocarcinoma (LUAD). However, the methylation on non-coding RNA in LUAD, especially long non-coding RNA (lncRNA), has not been received sufficient attention.

METHODS: Spearman correlation analysis was used to screen lncRNA correlated with m6A regulators expression from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) repositories, respectively. Then, the least absolute shrinkage and selection operator (LASSO) was applied to build a risk signature consisting m6A-related lncRNA. Univariate and multivariate independent prognostic analysis were applied to evaluate the performance of signature in predicting patients’ survival. Next, we applied Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and gene set enrichment analysis (GSEA) to conduct pathway enrichment analysis of 3344 different expression genes (DEGs). Finally, we set up a competing endogenous RNAs (ceRNA) network to this lncRNA.

RESULTS: A total of 85 common lncRNAs were selected to acquire the components related to prognosis. The final risk signature established by LASSO regression contained 11 lncRNAs: ARHGEF26-AS1, COLCA1, CRNDE, DLGAP1-AS2, FENDRR, LINC00968, TMPO-AS1, TRG-AS1, MGC32805, RPARP-AS1, and TBX5-AS1. M6A-related lncRNA risk score could predict the prognostic of LUAD and was significantly associated with clinical pathological. And in the evaluation of lung adenocarcinoma tumor microenvironment (TME) by using ESTIMATE algorithm, we found a statistically significant correlation between risk score and stromal/immune cells.

CONCLUSION: M6A-related lncRNA was a potential prognostic and therapy target for lung adenocarcinoma.

PMID:34558724 | DOI:10.1002/jcla.23951

Semin Dial. 2021 Sep 24. doi: 10.1111/sdi.13022. Online ahead of print.

ABSTRACT

INTRODUCTION: Arterial blood gas analysis is a minimally invasive technique used in our daily practice but is not a complication free technique. The aim of this study was to validate results from blood gas analysis obtained from the arteriovenous fistula (AVF)/graft as a surrogate marker of the arterial blood gas analysis.

METHODS: A prospective observational study was made in 45 patients. We performed arterial and AVF/graft blood gas analysis and results were compared by a paired sample t Student test.

RESULTS: Most of our subjects was male (68.9%) and the mean age was 67 years (±14). Hemodialysis vintage was 63 months (±66), and vascular access age was 62 months (±56). The more prevalent vascular access was left radiocephalic AVF (n = 16; 35.6%) and the main puncture artery was right radial artery (n = 27; 60.0%). There were no statistically significant differences between the samples collected.

CONCLUSIONS: Our results suggest a possible alternative of arterial blood gas analysis in AVF/graft for hemodialysis patients. This could result in making an uncomfortable procedure almost painless and reducing complications. Future research should take place to include anatomical characteristics of the AVF or the circulation of recirculation.

PMID:34558726 | DOI:10.1111/sdi.13022