Category: Statistics

Hu Li Za Zhi. 2021 Dec;68(6):43-52. doi: 10.6224/JN.202112_68(6).07.

ABSTRACT

BACKGROUND: Night-shift work affects the physical and mental health of employees. Early identification of relevant high-risk groups may be referenced in health promotion, job analysis, and job design.

PURPOSE: To explore the differences in workplace fatigue, physiological index of metabolic syndrome, and risk of cardiovascular disease between long-term and non-long-term night-time working nursing staff.

METHODS: The health examination data of 91 long-term and 119 non-long-term night-shift nurses were collected. A sub-data analysis approach was used and t-test, chi-square, Pearson`s correlation, and hierarchical multiple regression were used to conduct statistical analysis.

RESULTS: A positive correlation between cardiovascular risk and workplace fatigue was found in the long-term night-shift working group. Moreover, a lower average duration of sleep was found in the non-long-term night-shift working group. Finally, the participants with workplace fatigue and metabolic syndrome were found to have higher levels of cardiovascular risk.

CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Nursing staff who work night shifts for long-term and non-long-term periods should all receive regular health check-ups and practice healthy eating, exercise, and sleep habits. Employers should provide regular health checkups to their nursing staff and implement measures to identify health hazards in accordance with laws on labor standards, occupational safety, and health and labor health protection regulations, and then adopt appropriate plans and necessary safety and health measures to achieve a mutually beneficial result for both employers and employees in the healthcare industry.

PMID:34839490 | DOI:10.6224/JN.202112_68(6).07

Am J Perinatol. 2021 Nov 28. doi: 10.1055/s-0041-1740062. Online ahead of print.

ABSTRACT

OBJECTIVE: In 2014, the leading obstetric societies published an executive summary of a joint workshop to establish obstetric interventions to be considered for periviable births. Antenatal corticosteroid administration between 22^0/7 and 22^6/7 weeks was not recommended given existing evidence. We sought to evaluate whether antenatal steroid exposure was associated with improved survival among resuscitated newborns delivered between 22 and 23 weeks of gestation.

STUDY DESIGN: We conducted a population-based cohort study of all resuscitated livebirths delivered between 22^0/7 and 23^6/7 weeks of gestation in the United States during 2009 to 2014 utilizing National Center for Health Statistics data. The primary outcome was rate of survival to 1 year of life (YOL) between infant cohorts based on antenatal steroid exposure. Multivariable logistic regression estimated the association of antenatal steroid exposure on survival outcomes.

RESULTS: In the United States between 2009 and 2014, there were 2,635 and 7,992 infants who received postnatal resuscitation after delivery between 22^0/7 to 22^6/7 and 23^0/7 to 23^6/7 weeks of gestation, respectively. Few infants born at 22 (15.9%) and 23 (26.0%) weeks of gestation received antenatal corticosteroids (ANCS). Among resuscitated neonates, survival to 1 YOL was 45.2 versus 27.8% (adjusted relative risk [aRR]: 1.6, 95% confidence interval [CI]: 1.2-2.1) and 57.9 versus 47.7% (aRR: 1.3, 95% CI: 1.1-1.5) for infants exposed to ANCS compared with those not exposed at 22 and 23 weeks of gestation, respectively. When stratified by 100 g birth weight category, ANCS were associated with survival among neonates weighing 500 to 599 g (aRR: 1.9, 95% CI: 1.3-2.9) and 600 to 699 g (aRR: 1.7, 95% CI: 1.1-2.6) at 22 weeks.

CONCLUSION: Exposure to ANCS was associated with higher survival rates to 1 YOL among resuscitated infants born at 22 and 23 weeks. National guidelines recommending against ANCS utilization at 22 weeks should be re-evaluated given emerging evidence of benefit.

KEY POINTS: · Exposure to antenatal steroids was associated with higher survival rates at 22 and 23 weeks of gestation.. · Women exposed to antenatal steroids were more likely to have an adverse outcome.. · The association between steroids and survival was observed among infants with birth weights > 500 g..

PMID:34839472 | DOI:10.1055/s-0041-1740062

Sleep Breath. 2021 Nov 27. doi: 10.1007/s11325-021-02535-5. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the association of sleep duration with type 2 diabetes mellitus (T2DM) in a rural Chinese population.

METHODS: A 1:1 matched nested case-control study was performed based on a cohort that had been established in rural communities in Henan Province, China. T2DM patients and healthy controls (550 pairs) were included in this study.

RESULTS: Abnormal sleep duration significantly increased the risk of T2DM with an approximate U-shaped association (sleep duration ≤ 6 h, OR = 1.742, 95% CI = 1.007-3.011, P = 0.047; sleep duration 8-9 h, OR = 1.462, 95% CI = 1.038-2.060, P = 0.030) compared with participants with a night sleep duration of 7-8 h, after adjusting for multiple confounders. When stratified by gender, only women were sensitive to shorter sleep duration (OR = 2.483, 95% CI = 1.149-5.366, P = 0.021). Abnormal sleep duration (too short or too long) had adverse effects on homeostasis model assessment (HOMA) and blood metabolites, and the effect was more noticeable in people with longer sleep durations.

CONCLUSION: In a rural Chinese population, both too short and too long sleep duration increased the risk of T2DM. Especially women with less sleep duration have a higher risk of T2DM. Abnormal sleep also affects the HOMA index and metabolites; the relationship between HOMA-IR, total cholesterol, and LDL-Cholesterol with sleep duration was U-shaped, while fasting plasma glucose, body mass index, waist circumference, and triglyceride levels increased significantly only with longer sleep duration.

PMID:34839464 | DOI:10.1007/s11325-021-02535-5

Asian Pac J Cancer Prev. 2021 Nov 1;22(11):3705-3709. doi: 10.31557/APJCP.2021.22.11.3705.

ABSTRACT

OBJECTIVE: Obesity is known to be a preoperative risk factor for rectal cancer surgery. This study aimed to investigate the influence of obesity on the surgical outcomes of laparoscopic surgery for rectal cancer.

METHODS: The clinical data of 356 patients with rectal cancer from Jan 2012 to Dec 2015 were analyzed retrospectively. Perioperative outcomes were compared between 48 patients with a BMI (body mass index) ≥30 kg/m2 [obese group ] and 308 patients with a BMI≥30 kg/m2 [non-obese group] who underwent laparoscopic surgery.

RESULTS: Operation times were significantly longer for the obese group than for the non-obese group (125.2±30.5 min vs. 180.5±58.2 min, P=0.021). There were no statistically significant differences between two groups in terms of intraoperative blood loss, the number of retrieved lymph nodes, postoperative recovery and postoperative complications (P≥0.05). During the follow-up period, the overall survival rates were not significantly different between the two groups [66.7% (32/48) vs 67.2% (207/308), P=0.787]. The differences in recurrence and metastasis between the two groups were not statistically significant.

CONCLUSION: Our analysis revealed that laparoscopic surgery can be safely performed in patients with BMI≥30. The procedure was considered to be difficult but sufficiently feasible.

PMID:34837930 | DOI:10.31557/APJCP.2021.22.11.3705

Asian Pac J Cancer Prev. 2021 Nov 1;22(11):3663-3670. doi: 10.31557/APJCP.2021.22.11.3663.

ABSTRACT

BACKGROUND: Leukemia is a major concern for children worldwide. Around 30% of malignancies in children (ages 0-14) are caused by leukemia.

OBJECTIVE: This study aims to explore the time trends in the incidence of childhood leukemia (aged 0-14 years) in Iraq between 2000 and 2019.

METHODS: Poisson regression with a log link function was used to analyze the long-term trends of incidence related to childhood leukemia cancer based on published data from the Iraqi cancer registry between 2000 and 2019. Annual estimates of the population, by 5-year age groups and by gender obtained from the United Nations, population Division.

RESULTS: A total of 8,570 cases of leukemia children in Iraq between 2000 and 2019 were recorded, the boys to girl ratio were 1.32 to 1. The most diagnosed type of leukemia was Acute lymphoblastic leukemia, accounting for about 33.56%, followed by Leukemia Not specify (NOS) (17.3%) with a relatively equal proportion of stated instances between boys and girls in these subsets. The age-standardized incidence rates, aged 0-14 years, from 2000-2019 were 3.45/100,000 for both genders. The Joinpoint regression ASRs analysis of childhood leukemia from 2000-2019 among 0 -14 age group for both genders indicate that there was an overall significant increasing trend at 1.23% per year, while no one joinpoint was identified during the entire study period. Among boys, there was an overall insignificant increasing trend at 0.77% per year. Among girls, there was an overall significant increasing trend at 1.93% per year, while one joinpoint was identified during the entire study period. Conclusions: The overall (both genders) incidence rate of childhood leukemia has been increasing significantly in Iraq. The test for trends was insignificant among boys, while it was significant among girls. The increasing trend of leukemia requires further epidemiological studies to describe incidence by geography in Iraq.

PMID:34837925 | DOI:10.31557/APJCP.2021.22.11.3663

Asian Pac J Cancer Prev. 2021 Nov 1;22(11):3685-3692. doi: 10.31557/APJCP.2021.22.11.3685.

ABSTRACT

BACKGROUND: The association between ABO blood group and the prognosis of hepatocellular carcinoma (HCC) remains unclear. We investigated the impact of ABO blood groups as a prognostic factor in HCC patients treated with transarterial chemoembolization (TACE).

MATERIALS AND METHODS: We revisited records of all HCC patients who underwent TACE between January 2007 and December 2019 at a tertiary care hospital. The inclusion criteria were HCC patients, Child-Pugh score A5-B7, and treated with TACE monotherapy. The baseline characteristics of each patient were compared against their blood group and the survival analysis was carried out using Cox’s regression. With Bonferroni adjustment for multiple comparisons, P-values <.0125 were considered statistically significant.

RESULTS: Of 211 eligible patients, the frequencies of blood groups O, A, B, and AB were 89, 54, 56, and 12, respectively. Their respective months of median survival were 41, 20, 21, and 42. After adjustments in the six-and-twelve criteria and Child-Pugh scores, and using blood group O as the referent group, the coefficients (SE) of groups A, B, and AB were 0.69 (0.24), 0.47 (0.23), and 0.49 (0.49), respectively. A significant difference in survival was found only between patients with blood group O vs A (hazard ratio, 2.00; confidence interval, 1.25-3.21).

CONCLUSIONS: ABO blood group is associated with the prognosis of HCC patients treated with TACE monotherapy. In our data, patients with blood group O tended to have the best survival. However, only blood group A patients had a significantly shorter survival rate comparing to blood group O.

PMID:34837928 | DOI:10.31557/APJCP.2021.22.11.3685

Asian Pac J Cancer Prev. 2021 Nov 1;22(11):3601-3606. doi: 10.31557/APJCP.2021.22.11.3601.

ABSTRACT

OBJECTIVE: Cancer-associated venous thromboembolism (CAT) is a common disease or complication which is associated with reduced survival and incurring a substantial health-care cost. Low molecular weight heparin (LMWH) remained the gold standard treatment option available. Direct oral anticoagulants (DOACs) have recently become more popular in the guidelines, they are still few and inconsistent across the current literature. The aim of this study was to evaluate rivaroxaban in treatment of CAT.

METHODS: In this prospective real-world study, we recruited and followed up patients diagnosed with CAT treated with rivaroxaban or standard of care as a control for 12 months or until death. Baseline characteristics were collected at the study entry. The primary outcomes were recurrent DVT or PE and death within 12 months after treatment initiation. Safety outcomes were composite outcomes of major and minor bleeding. Results: A total of 80 patients confirm CAT with radiological imaging were recruited; 39 patients were evaluated in the control arm and 41 patients in the rivaroxaban arm. The 12 months cumulative CAT recurrence rate was 46.2% in control and 39% in rivaroxaban (p=0.519). The 12-month death was not a statistically significant difference between both arms (20.5% vs. 31.7%, p=0.255). The cumulative rate of composite safety outcomes was similar in both groups (17.9% vs. 12.2%, p=0.471).

CONCLUSION: The result of this small but important real-world evidence proofs that rivaroxaban is an effective and safe alternative to the standard of care for CAT in Malaysia’s cancer population.

PMID:34837918 | DOI:10.31557/APJCP.2021.22.11.3601

Asian Pac J Cancer Prev. 2021 Nov 1;22(11):3615-3621. doi: 10.31557/APJCP.2021.22.11.3615.

ABSTRACT

OBJECTIVE: This study aimed to compare the patients’ satisfaction level after fibroadenoma surgery with Video-Assisted Breast Surgery (VABS) and Vacuum-Assisted Breast Biopsy (VABB) techniques.

METHODS: Patients who underwent VABS or VABB for a diagnosis of fibroadenoma mammae at the Oncology Clinic in Solo, Indonesia were included in this study. Clinical and demographic data were obtained from medical records. Direct or telephone interviews were performed and the patients were asked to complete Universitas Sebelas Maret Breast Satisfaction Questionnaire 8 (UNS-BsQ8) questionnaire.

RESULTS: A total sample of 16 patients with VABS and 26 patients with VABB were recruited. All the patients were confirmed to have fibroadenoma based on the pathological result. The mean total scores for VABS and VABB were 34.50 ± 2.094 and 31.57 ± 3.081, respectively (P= 0.137). Out of 8 questions, only 3 items had statistically significant differences. VABS had higher mean score than VABB in terms of surgery cost (P = 0.002), pain in surgery site (P = 0.006), and pain in shoulder (P = 0.013).

CONCLUSION: There was no significant difference in terms of overall patients’ satisfaction level between both groups. However, VABS had a higher mean score than VABB in terms of cost and pain.

PMID:34837920 | DOI:10.31557/APJCP.2021.22.11.3615

Asian Pac J Cancer Prev. 2021 Nov 1;22(11):3561-3568. doi: 10.31557/APJCP.2021.22.11.3561.

ABSTRACT

BACKGROUND: Chemotherapy as part of colorectal cancer management can cause death to immunologically active tumor cell, but also it has immune suppressive effect. Phyllanthus niruri Linn is known to has immunomodulatory effect. This study was intended to prove P. niruri Linn effect on infiltrating dendritic cells and Neutrophil/lymphocyte ratios (NLRs) in Sprague-Dawley rats with colorectal cancer which were given capecitabine chemotherapy.

METHODS: The study was randomized post-test only control group design. The samples were 39 Sprague-Dawley male rats, with body weight around 170-220 grams, induced by 1,2-dimetylhydrazine (DMH) 30 mg/kgBW once per week subcutaneously. On 9th,11th and 13th week, there were four induced rats sacrificed each week to detect colorectal cancer (CRC) development. On the 13th week, all of the 4 sacrificed rats developed colon cancer, so the induction had to be stopped. The rest of 27 induced rats were randomly divided into three groups: control-group (K) were left untreated (9 rats), group P1 (9 rats) were given Capecitabine and group P2 (9 rats) were given Capecitabine with combination of P. niruri Linn extract 13.5 mg/kgBW orally. After 17th week, all rats were terminated and tumor lesion of colon were processed to be paraffin blocks and were stained with HE for evaluating the NLRs, and immunohistochemistry (S100) for evaluating infiltrating dendritic cells. Data was analyzed by using Oneway-Anova-test and post-Hoc LSD-test. Considered significant if p was <0.05.

RESULTS: The mean±standard deviation of infiltrating dendritic cells showed increasing value in group P2 (62.11±31.35) compared to group P1 (52.78±29.24) though not statistically significant. The mean of NLRs also showed statistically significant elevation of value in group P2 (0.13±0.05) compared to group P1 (0.04±0.01).

CONCLUSION: Extract of Phyllanthus niruri Linn increasing immunologic status through elevation of infiltrating dendritic cells and NLRs in animal model colorectal cancer with Capecitabine chemotherapy.

PMID:34837913 | DOI:10.31557/APJCP.2021.22.11.3561

Asian Pac J Cancer Prev. 2021 Nov 1;22(11):3513-3520. doi: 10.31557/APJCP.2021.22.11.3513.

ABSTRACT

OBJECTIVE: MicroRNAs (MiRNAs) regulate mammalian cell growth, differentiation, and apoptosis by altering the expression of other genes and serve multiple roles in tumorigenesis and progression. Proto-oncogene serine/threonine-protein kinase (RAF-1) functions as a part of the MAPK/ERK signal transduction pathway. The present study aim was to prospectively evaluate MicroRNA 106a (MiR-106a) and RAF-1 as a diagnostic and prognostic factor in early prediction of breast cancer (BC), recurrence and early detection of distant metastasis as well as to analyses the statistical correlation between MiR-106a and RAF-1 levels and clinical-pathological parameters including tumor size, lymph node, histological type and grading.

METHODS: Sera and plasma of 30 normal women and 50 women with breast carcinoma were assayed for MiR-106a by RT-qPCR as well as levels of Hb, WBCs and platelets count and RAF-1 by solid phase enzyme-linked immunosorbent assay (ELISA).

RESULTS: The patients’ characteristics, they were classified according to grade into 8% grade I, 66% grade II, 22% grade III and 4% grade IV. The stages were classified according to the TNM system as stage II was the highest percentage 66%, while the lowest percentage was 10% for stage I and 24% for stage III. Also, Hb% and RAF-1 levels were significantly decreased in breast cancer patients as compared with healthy control. On the other hand, MiRNA-106a gene expression was non-significantly increased in positive lymph node metastasis patients (FC=3.66) when compared to patients with negative lymph node metastasis (FC=3.51). In addition, MiR-106a was significantly up-regulated in breast cancer patients with a fold of change 3.63 when compared to control samples.

CONCLUSION: Expression of MiR-106a gene can be used as a diagnostic and prognostic noninvasive biomarker which can stimulates breast cancer cell invasion and proliferation through downregulation of Raf-1 levels.<br />.

PMID:34837907 | DOI:10.31557/APJCP.2021.22.11.3513