Category: Statistics

Am J Ind Med. 2021 Oct;64(10):827-836. doi: 10.1002/ajim.23271. Epub 2021 Jul 19.

ABSTRACT

BACKGROUND: Few studies have examined the association between disaster-related factors and stroke by subtype or number. We investigated the association between 9/11-related posttraumatic stress disorder (PTSD), dust exposure, and stroke subtype as well as recurrent strokes.

METHODS: The study included 29,012 individuals enrolled in the World Trade Center Health Registry. Stroke cases were obtained by matching Registry enrollees to the New York State Department of Health’s discharge records for inpatient visits between 2000 and 2016. Cox proportional hazards regression models were performed to examine the association between 9/11-related risk factors and stroke by subtype. Multinomial logistic regression models were conducted to assess the associations between the same risk factors and the number of stroke hospitalizations.

RESULTS: Having PTSD significantly increased the risk of developing ischemic and hemorrhagic stroke, with adjusted hazards ratios (AHRs) of 1.64 (95% confidence interval [CI]: 1.28-2.10) and 1.73 (95% CI: 1.10-2.71), respectively. The point estimate for dust cloud exposure, although not significant statistically, suggested an increased risk of ischemic stroke (AHR = 1.20, 95% CI: 0.96-1.50). PTSD was significantly associated with recurrent strokes with an adjusted odds ratio of 1.79 (95% CI: 1.09-2.95).

CONCLUSIONS: PTSD is a risk factor for both ischemic and hemorrhagic stroke and is associated with recurrent strokes. Dust exposure on 9/11 is a possible risk factor for ischemic stroke but not for hemorrhagic stroke, and was not associated with recurrent strokes. Our findings warrant additional research on stroke-morbidity and mortality associated with 9/11-related PTSD and dust exposure.

PMID:34558721 | DOI:10.1002/ajim.23271

Turk Patoloji Derg. 2021 Sep 24. doi: 10.5146/tjpath.2021.01555. Online ahead of print.

ABSTRACT

OBJECTIVE: Diffuse gliomas, the most common primary malignant brain tumors, have been classified by the World Health Organization as class II-IV gliomas. After 2016, two mutations in the promoter region of the telomerase reverse transcriptase (TERT) gene were identified in addition to the IDH, 1p / 19q, and ATRX status.

MATERIAL AND METHOD: We identified 84 patients with grade II-IV glioma with IDH, ATRX, 1p / 19q and TERT status. All tumor samples were subjected to molecular genetic screening (Sanger sequencing for IDH and TERT mutations, fluorescence in situ hybridization for 1p/19q status) after histological diagnosis (immunohistochemistry for IDH1 R132H, ATRX, and p53) for a more precise molecular diagnosis. The confidence intervals were calculated at the 95% confidence level, and differences at p < 0.05 were considered statistically significant.

RESULTS: Primary glioblastomas had the highest frequency of TERT promoter mutations (25 of 28, 89.2%, p=0.006) followed by oligodendrogliomas (29 of 35, 82.8%, p < 0.001) while astrocytomas showed the lowest frequency (3 of 15, 20%, p=0.107), and the positivity significantly differed among these three groups (p < 0.001). TERT promoter mutations were more frequent in patients older than 55 years of age at diagnosis (p=0.023). The group with TERT promoter mutations, and without IDH mutations showed the worst overall survival. However, the presence of both TERT promoter and IDH mutations, which resembled oligodendroglial progression, showed best overall survival (p=0.042).

CONCLUSION: The discovery of TERT promoter mutations in numerous gliomas has opened the door for a better molecular classification of gliomas, and TERT status is associated with survival. Further studies will help in elucidating the value of TERT promoter mutations as biomarkers in clinical practice, and eventual therapeutic targets.

PMID:34558656 | DOI:10.5146/tjpath.2021.01555

Parasite Immunol. 2021 Sep 24:e12880. doi: 10.1111/pim.12880. Online ahead of print.

ABSTRACT

BACKGROUND: Visceral leishmaniasis (VL) is a serious public health problem. The factors that can determine whether VL develops and progresses to severe form have not been fully identified, but a specific cellular immune response appears to play a key role. Therefore, understanding immunopathogenesis can be useful in preventing a serious clinical outcome.

MATERIALS AND METHODS: Bone marrow samples were collected from patients with severe (SVL) or non-severe VL (NSVL). Cytokine levels and parasitic load were analyzed by RT-qPCR. There is a statistically significant difference in the leukocyte parameter in patients with SVL and NSVL compared to the control patients (p=0.006 and p=0.014, respectively).

RESULTS: Urea, alanine transaminase and albumin parameters had a significant difference p=0.036, p=0.039 and p=0.017, respectively, between SVL and NSVL. Although high levels of IFN-γ, IL-10, IL-6 and TNF-α were present in all groups of individuals with VL, they were not statistically associated with severity. In patients with active VL, IFN-γ and IL-10 were associated, respectively, with a reduction and increase in the parasite load, strong and significant positive association between IFN-γ and IL-10 (rho=0.627 and p=0.003).

CONCLUSION: This study demonstrates that VL stimulates an non-dichotomized inflammatory response between Th1/Th2 and that bone marrow is an important tissue for immune regulation.

PMID:34558674 | DOI:10.1111/pim.12880

Eur Heart J Qual Care Clin Outcomes. 2021 Sep 24:qcab068. doi: 10.1093/ehjqcco/qcab068. Online ahead of print.

ABSTRACT

AIMS: The PRECISE-DAPT score is recommended by guidelines for predicting out-of-hospital bleeding in patients after percutaneous coronary intervention (PCI). However, the long-term prognostic value of the PRECISE-DAPT score in patients after PCI remains unclear.

METHODS AND RESULTS: We performed a prospective study of 10,724 patients who underwent PCI throughout 2013 in Fuwai hospital. The bleeding endpoint was Bleeding Academic Research Consortium 2, 3, or 5 bleeding. The ischaemic endpoints were all-cause death and major adverse cardiovascular and cerebrovascular events (MACCE). After a 5-year follow-up, 10,109 patients were finally analysed. A total of 415 (4.11%) patients experienced bleeding, 364 (3.60%) experienced all-cause death, and 2049 (20.27%) had MACCE. Using Cox regression, the risk of bleeding (hazard ratio [HR]: 1.721, 95% confidence interval [CI]: 1.180-2.511, P = 0.005), MACCE (HR: 1.607, 95% CI: 1.347-1.917, P < 0.001), and all-cause-death (HR: 3.902, 95% CI: 2.916-5.221, P < 0.001) in patients with a high score were significantly higher than those in patients with a low score. The PRECISE-DAPT score showed prognostic value for 5-year events of bleeding (C statistic: 0.566, 95% CI: 0.537-0.594), MACCE (C statistic: 0.540, 95% CI: 0.527-0.553), and all-cause-death (C statistic: 0.673, 95% CI: 0.644-0.702).

CONCLUSION: After 5 years of follow-up, the PRECISE-DAPT score has a statistically significant predictive value for long-term bleeding events in Chinese PCI population, and also had some prognostic value for death and MACCE.

PMID:34558620 | DOI:10.1093/ehjqcco/qcab068

Nicotine Tob Res. 2021 Sep 24:ntab194. doi: 10.1093/ntr/ntab194. Online ahead of print.

ABSTRACT

INTRODUCTION: Standardised packaging on tobacco products was required in Norway July 1, 2018. We report pre-registered analyses of the potential impact on daily smoking and on daily snus use among women and men.

METHODS: Interrupted time series (segmented regression) on repeated cross-sectional surveys (2012 to 2019) from two sources: probability samples (Registry Sample, N=46,957) and market research samples (Market Research Sample, N=64,465) of Norwegian adults aged 16 to 79. Self-reported daily smoking and snus use were regressed on a step change impact variable, controlled for trend and demographics (sex, age, region, and education based on national registers in the Registry Sample, and self-reported in the Market Research Sample).

RESULTS: There were tendencies of a decline in smoking (Odds Ratio [OR]=0.94; 95% confidence interval [CI]=0.87, 1.02; lower-tail p-value [Plower]=0.07), and women’s snus use (OR= 0.89; CI=0.77, 1.03; Plower=0.06), but not men’s snus use (OR=1.01; CI=0.92, 1.11; Plower=0.59). Analyses using only the Registry Sample did not detect declines in smoking (OR=0.99; CI=0.88, 1.11; Plower=0.43) or women’s snus use (OR=0.99; CI=0.80, 1.24]; Plower=0.48), and indicated no decline in men’s snus use (OR=1.18; CI=1.03, 1.35; Plower=0.99). Exploratory analyses suggested potential acceleration of the declining trend in smoking (change in trends, OR=0.97) and of the increasing trend in men’s snus use (OR=1.03).

CONCLUSIONS: The analyses indicate that standardised packaging in Norway did not produce a decline in men’s snus use. Results are inconclusive regarding smoking and women’s snus use. Exploratory analyses indicated a decrease in smoking and an increase in men’s snus use.

IMPLICATIONS: -We could not confirm or disconfirm whether standardised packaging is an effective tobacco control measure in a Norwegian context.-According to our analyses, standardized packaging may have effects on smoking prevalence and women’s snus use, but is unlikely to reduce men’s snus use.-The present results may reflect higher effectiveness of standardised packaging for products with stronger health warnings.-As the results varied according to samples and outcomes, the study underlines the importance of pre-registering future analyses on this topic.-Future confirmatory research should test models of gradual impact of standardised packaging.

PMID:34558626 | DOI:10.1093/ntr/ntab194

Analyst. 2021 Sep 24. doi: 10.1039/d1an90083h. Online ahead of print.

ABSTRACT

Correction for ‘Spatiotemporal distribution and speciation of silver nanoparticles in the healing wound’ by Marco Roman et al., Analyst, 2020, 145, 6456-6469, DOI: 10.1039/D0AN00607F.

PMID:34558571 | DOI:10.1039/d1an90083h

Food Funct. 2021 Sep 24. doi: 10.1039/d1fo02033a. Online ahead of print.

ABSTRACT

Despite the high human interindividual variability in response to (poly)phenol consumption, the cause-and-effect relationship between some dietary (poly)phenols (flavanols and olive oil phenolics) and health effects (endothelial function and prevention of LDL oxidation, respectively) has been well established. Most of the variables affecting this interindividual variability have been identified (food matrix, gut microbiota, single-nucleotide-polymorphisms, etc.). However, the final drivers for the health effects of (poly)phenol consumption have not been fully identified. At least partially, these drivers could be (i) the (poly)phenols ingested that exert their effect in the gastrointestinal tract, (ii) the bioavailable metabolites that exert their effects systemically and/or (iii) the gut microbial ecology associated with (poly)phenol metabolism (i.e., gut microbiota-associated metabotypes). However, statistical associations between health effects and the occurrence of circulating and/or excreted metabolites, as well as cross-sectional studies that correlate gut microbial ecologies and health, do not prove a causal role unequivocally. We provide a critical overview and perspective on the possible main drivers of the effects of (poly)phenols on human health and suggest possible actions to identify the putative actors responsible for the effects.

PMID:34558584 | DOI:10.1039/d1fo02033a

NPJ Breast Cancer. 2021 Sep 23;7(1):128. doi: 10.1038/s41523-021-00332-7.

ABSTRACT

The vast majority of studies investigating immune checkpoint inhibition (ICI) in patients with breast cancer have focused on triple-negative breast cancer (TNBC). In this study, we compared the tumor immune microenvironment (TIME) between TNBC and hormone receptor-negative HER2-positive breast cancer based on a selection of immune markers at the protein level in an institutional retrospective series. Additionally, we performed a similar comparison using publicly available transcriptomics data. Altogether, the results show a comparable TIME in both groups, with possible implications for the use of ICI in patients with hormone receptor-negative HER2-positive breast tumors.

PMID:34556657 | DOI:10.1038/s41523-021-00332-7

Korean J Orthod. 2021 Sep 25;51(5):355-362. doi: 10.4041/kjod.2021.51.5.355.

ABSTRACT

OBJECTIVE: This study aimed to establish the prevalence and patterns of nonsyndromic tooth agenesis in patients referred to a tertiary health care facility.

METHODS: The intraoral records and panoramic radiographs of 9,874 patients aged 12-22 years were evaluated. The study group included 716 patients (371 male, 345 female) with non-syndromic agenesis of at least one tooth (except the third molars). The study data were assessed using descriptive statistics, chisquare test, and Mann-Whitney U test, while patterns were evaluated using a tooth agenesis code (TAC) tool.

RESULTS: A total of 1,627 congenitally missing teeth, were found in patients with non-syndromic tooth agenesis, with an average of 2.27 missing teeth per patient. The prevalence of tooth agenesis was 7.25%, and the most commonly missing teeth were the left mandibular second premolars (10.17%). The age group comparison revealed no significant difference in the median number of missing teeth per patient according to the cutoff values for ages between 12 and 22 years. When the missing teeth were examined separately according to quadrants, 114 different tooth agenesis patterns (upper right quadrant = 28, upper left quadrant = 27, lower left quadrant = 31, and lower right quadrant = 28) were identified, and 81 of these patterns appeared only once.

CONCLUSIONS: This study highlights the benefits of applying the TAC tool in a large sample population. The application of the TAC tool in such studies will enable the development of template treatment plans by determining homogenous patterns of tooth agenesis in certain populations.

PMID:34556590 | DOI:10.4041/kjod.2021.51.5.355

Med Sci Monit. 2021 Sep 24;27:e932724. doi: 10.12659/MSM.932724.

ABSTRACT

BACKGROUND This retrospective study from a single center aimed to compare patient outcomes following TiRobot-assisted sacroiliac screw fixation and bone grafting with traditional screw fixation without bone grafting in 33 patients with unstable osteoporotic sacral fracture (UOSF). MATERIAL AND METHODS Patients with UOSF were included and divided into 2 groups: a TiRobot-assisted surgical group with 18 patients (robot-aided sacroiliac screw fixation and bone grafting) and a standard surgical group with 15 patients (free-hand screw fixation without bone grafting). T values of bone mineral density (BMD) £-2.5 standard deviation (SD) were diagnosed as osteoporosis. Screw positioning and fracture healing time were evaluated. Functional outcomes were investigated at the final follow-up. RESULTS There were no statistically significant differences in screw positioning; however, there were satisfactory positioning rates in 94.4% (17/18) of patients in the TiRobot-assisted surgical group and 73.3% (11/15) in the standard surgical group. The advantages with TiRobot on surgical time of screw placement, fluoroscopy frequency, and total drilling times were noted (P=0.000). The nonunion rates were 5.6% (1/18) in the TiRobot-assisted surgical group and 33.3% (5/15) in the standard group (P=0.039). Healing time in the union cases had a significant difference (P=0.031). Functional outcome scores in the TiRobot-assisted surgical group were superior to that in the standard group (P=0.014). CONCLUSIONS The findings showed that TiRobot-assisted sacroiliac screw fixation and bone grafting was a safe and effective surgical treatment option that had a reduced radiation dose and improved fracture healing, when compared with standard screw fixation without bone grafting.

PMID:34556623 | DOI:10.12659/MSM.932724