Category: Statistics

J Natl Cancer Inst. 2022 Apr 19:djac085. doi: 10.1093/jnci/djac085. Online ahead of print.

ABSTRACT

BACKGROUND: Paradoxically, Helicobacter pylori-positive (HP+) advanced gastric cancer patients have a better prognosis than those who are HP-negative (HP-). Immunologic and statistical analyses can be used to verify whether systemic mechanisms modulated by HP are involved in this more favorable outcome.

METHODS: A total of 658 advanced gastric cancer patients who underwent gastrectomy were enrolled. HP infection, mismatch repair, programmed death-ligand 1 (PD-L1), and CD4/CD8 proteins, and microsatellite instability were analyzed. Overall survival (OS) and relapse free survival (RFS) rates were analyzed after stratifying clinicopathological factors. Cox proportional hazards regression analysis was performed to identify independent prognostic factors.

RESULTS: Among 491 cases that were analyzed, 175 (36%) and 316 (64%) cases were HP+ and HP⁻, respectively. Analysis of RFS indicated an interaction of HP status among the subgroups for S-1 dose (Pinteraction=0.0487) and PD-L1 (P = .016). HP+ patients in the PD-L1⁻ group had significantly higher five-year OS and RFS than HP- patients (81% vs. 68%; P = .0011; HR 0.477; 95% CI, 0.303-0.751 and 76% vs. 63% P = .0011; HR 0.508; 95% CI, 0.335-0.771, respectively). The five-year OS and RFS was also significantly higher for HP+ compared to HP- patients in the PD-L1-/S-1-reduced group (86% vs. 46%; P = .0014; HR 0.205; 95% CI, 0.07-0.602 and 83% vs. 34%; P = .001; HR 0.190; 95% CI, 0.072-0.498, respectively). Thus, HP status was identified as one of the most potentially important independent factors to predict prolonged survival.

CONCLUSION: This retrospective study suggests that an HP-modulated host immune system may contribute to prolonged survival in the absence of immune escape mechanisms of gastric cancer.

PMID:35437596 | DOI:10.1093/jnci/djac085

Ann Work Expo Health. 2022 Apr 19:wxac019. doi: 10.1093/annweh/wxac019. Online ahead of print.

ABSTRACT

The factors influencing transfer of chemicals or other contaminants to and from the surface of the skin are often poorly understood. Previous research has indicated that environmental conditions, skin hydration, and repeated contacts may all influence the quantity of dermal transfer. The aim of this analysis was to evaluate the influence of skin hydration and condition on quantitative chemical transfer in a series of systematic measurements using human subjects for 5 and 10 repeated contacts. Elemental metallic lead was used as the exemplar test substance for the measurements collected. Skin hydration index (HI) was assessed using a corneometer and skin condition and barrier function were measured using an open-chamber transepidermal water loss (TEWL) instrument. Results indicated that for the palmar surface of the index finger where sampling was conducted, the relative hydration level of the skin was higher for males (n = 6) versus females (n = 4) (mean HI = 4.0 for females; mean HI = 5.5 for males) but this difference was not statistically significant. Overall, the skin hydration level was not significantly associated with dermal loading for either the 5 contact scenario (Pearson correlation = 0.27; R2 = 0.07; P = 0.45) or the 10 contact scenario (Pearson correlation = 0.26; R2 = 0.07; P = 0.47). When the results were stratified by higher versus lower hydration levels (HI = 1-5 versus HI = 5-10), for the higher hydration levels (HI = 5-10; mean HI = 7), there was a moderately positive association between skin hydration and loading, but this was not statistically significant for either the 5 contact scenario (Pearson correlation = 0.75; R2 = 0.56; P = 0.15) or the 10 contact scenario (Pearson correlation = 0.6; R2 = 0.36; P = 0.28). No clear relationship was observed between the lower hydration levels (HI = 1-5) and dermal loading. For the palmar index finger, there was a negative correlation between the TEWL measurements and both the 5 contact (Pearson correlation = -0.45; R2 = 0.2; P = 0.19) and 10 contact (Pearson correlation = -0.3; R2 = 0.09; P = 0.4) scenarios, but this was not statistically significant. The results of this study are consistent with the limited results of other analyses, which have suggested that there may be nuances with respect to the effects of skin hydration on the quantitative dermal transfer to and from the skin, although additional data are needed to better understand these potential differences.

PMID:35437588 | DOI:10.1093/annweh/wxac019

Health Promot Int. 2022 Apr 19:daac042. doi: 10.1093/heapro/daac042. Online ahead of print.

ABSTRACT

The progression of diabetes-related complications can be delayed with multifactorial interventions that support healthy behaviours. However, many initiatives have focused on educational or individual-level activities and observed limited or modest sustained improvements in healthy behaviours. A multicomponent approach to behaviour change, which simultaneously considers numerous social determinants of health across multiple socio-ecological model levels, may be required to achieve meaningful health outcomes for people with Type 2 diabetes. Applying a multicomponent method of inquiry, this integrative review aimed to synthesize the evidence on interventions using multifactorial interventions to promote healthy behaviours in adults with Type 2 diabetes. Interventions promoting healthy behaviours in adults with Type 2 diabetes were considered for the review. A total of 7205 abstracts retrieved from eight databases were screened for inclusion. Thirteen articles were included, of these 11 achieved statistically significant clinical and/or behavioural changes in outcomes such as glycated haemoglobin, blood pressure, cholesterol, diet and physical activity. The multifactorial components utilized included the coordination of multi-disciplinary health care teams, in-person self-care classes, group activities, incorporation of peer-leaders, the development of community partnerships, economic relief and built-environment support. The proportion of included studies published within recent years indicates a trend towards multicomponent interventions and the growing recognition of this approach in promoting public health. Our findings provide early support for the potential of extending intervention components beyond educational, individual-level and health care system-level focus to incorporate multiple socio-ecological model components that contribute to the system of influence affecting the health of people with diabetes.

PMID:35437595 | DOI:10.1093/heapro/daac042

Zhonghua Yi Xue Za Zhi. 2022 Apr 19;102(15):1100-1107. doi: 10.3760/cma.j.cn112137-20211105-02457.

ABSTRACT

Objectives: To explore the risk factors associated with septic cardiomyopathy and establish a predictive model of the disease based on left ventricular global longitudinal strain (LV GLS). Methods: Data from sepsis patients without a history of cardiac dysfunction who were treated in the Critical Care Department of the Northern Jiangsu People’s Hospital from September, 2019 to January, 2021 were included in the analysis. The LV GLS was measured by echocardiography within 72 hours and the patients were divided into a septic myocardiopathy group (LV GLS>-17%) and a normal cardiac function group (LV GLS≤-17%). Clinical data from two groups of patients were collected for univariate analysis. The receiver operating characteristic (ROC) curves of the factors that were statistically different were drawn for exploring the diagnostic and cut-off values. The continuous variable was converted to a dichotomous variable according to the cut-off value. Multivariate logistic regression analysis of sepsis cardiomyopathy was performed to screen the risk factors and create a predictive model. The predictive model was evaluated by ROC curve analysis and the Bootstrap method and shown as a nomograph. Results: Patients in the sepsis cardiomyopathy group had higher levels of high sensitive troponin I (Hs-TnI), procalcitonin (PCT), lactate (Lac), N-terminal pro-brain atriuretic peptide (NT-proBNP), vasopressor dosing intensity (VDI) and sequential organ failure assessment (SOFA) when compared to those in the normal cardiac function group (all P<0.05). The multivariate logistic regression analysis showed that Hs-TnI≥0.131 μg/L (OR=6.71, 95%CI:2.67-16.88, P<0.001), PCT≥40 μg/L (OR=3.08, 95%CI:1.10-8.59, P=0.032), Lac≥4.2 mmol/L (OR=2.80, 95%CI:1.02-7.69, P=0.045), NT-proBNP≥3 270 ng/L (OR=2.67, 95%CI:1.06-6.74, P=0.038) were independent risk factors for septic myocardiopathy. The area under the ROC curve of the predictive model based on the four indexes up-mentioned was 0.838 (95%CI:0.766-0.910), and the C-index was 0.822 (95%CI:0.750-0.894) which indicated the utility of the nomogram. The model had a good predictive ability, accuracy and discrimination. Conclusions: Hs-TnI≥0.131 μg/L, PCT≥40 μg/L, Lac≥4.2 mmol/L and NT-proBNP≥3 270 ng/L are independent risk factors for septic myocardiopathy, and the septic cardiomyopathy predictive model constructed based on these factors has a good diagnostic performance.

PMID:35436809 | DOI:10.3760/cma.j.cn112137-20211105-02457

Zhonghua Yi Xue Za Zhi. 2022 Apr 19;102(15):1093-1099. doi: 10.3760/cma.j.cn112137-20211018-02304.

ABSTRACT

Objective: To investigate the application value of relaxation time quantitative technique from synthetic magnetic resonance imaging (MRI) in the diagnosis and invasion assessment of prostate cancer. Methods: A total of 119 patients with prostate diseases [122 regions of interest(ROI)] who underwent routine MRI scan and magnetic resonance image compilation (MAGiC) sequence of prostate from March 2020 to March 2021 in General Hospital of Ningxia Medical University were retrospectively collected, they were divided into prostate cancer group(58 cases, 61 ROI) and non-prostate cancer group(61 cases, 61 ROI) according to the pathological results. In the prostate cancer group, those patients with an age of 48 to 85(69.8±5.9) years, and further divided into two subgroups according to the location of occurrence: peripheral zone cancer group (43 cases, 45 ROI) and transitional zone cancer group (15 cases, 16 ROI). The non-prostate cancer group consisted of patients with benign prostatic hyperplasia or complicated with chronic prostatitis, with an age of 41 to 81(68.6±7.0) years, and they were further divided into two subgroups according to the location of occurrence: non-cancerous peripheral zone group (45 cases, 45 ROI) and transitional zone benign prostatic hyperplasia group(16 cases, 16 ROI). Prostate cancer lesions were classified as low risk (Gleason score ≤6) or intermediate/high risk (Gleason score ≥7). After the post-processing of MAGiC images, T₁, T₂ and proton density(PD) values of prostate cancer group and non-prostate cancer group were obtained. At the same time, relevant software were used for image post-processing to generate apparent diffusion coefficient (ADC) value, the data between the two groups were analyzed by the Independent sample t-test or Mann-Whitney U-test, and the diagnostic effectiveness of each quantitative parameter in diagnosing prostate cancer and discriminating low risk prostate cancer from intermediate/high risk prostate cancer was analyzed by using receiver operating characteristic curve (ROC) analysis, the correlation between each quantitative parameter and Gleason score were assessed by Spearman correlation analysis. Results: The T₁ value and T₂ value of the peripheral zone cancer group were lower than those in non-cancerous peripheral zone group [1 201.3 (1 103.5, 1 298.2) ms vs 2 274.0 (1 620.9, 2 776.5) ms; 78.0 (74.0, 83.8) ms vs (160.6±54.9) ms] (all P<0.001), there was no statistically significant in PD value between the two groups (P>0.05). The T₁ value and T₂ value of the transitional zone cancer group were lower than those in transitional zone benign prostatic hyperplasia group [1 073.3 (1 003.9, 1 164.9) ms vs 1 340.8 (1 208.5, 1 502.8) ms; 76.9 (74.8, 82.8) ms vs 95.1(82.8, 103.4) ms] (all P<0.001), there was no statistically significant in PD value between the two groups (P>0.05). The area under the curve (AUC) of T₂ value was similar with the ADC value in discriminating peripheral zone cancer group from non-cancerous peripheral zone group(0.963 vs 0.991, P=0.105), while in discriminating transitional zone cancer group from transitional zone benign prostatic hyperplasia group, the AUC of T₂ value、T₁ value and ADC value were similar(0.867, 0.930 vs 0.938, all P>0.05). ADC value, T₂ value all were negatively correlated with Gleason score (r=-0.747,-0.453, all P<0.001). T₂ value and ADC value demonstrated equivalent diagnostic performance in discriminating low risk from intermediate/high risk prostate cancer, and there were no statistically significant (AUC: 0.787 vs 0.943, P=0.069). Conclusions: Quantitative relaxation time T₁ and T₂ values derived from synthetic MRI can discriminate prostate cancer from other benign pathologies, and T₂ value have the equivalent diagnostic performance compared to ADC value. Synthetic MRI has high clinical application value, and T₂ value can distinguish low risk prostate cancer from intermediate/high risk prostate cancer.

PMID:35436808 | DOI:10.3760/cma.j.cn112137-20211018-02304

Zhonghua Yi Xue Za Zhi. 2022 Apr 19;102(15):1086-1092. doi: 10.3760/cma.j.cn112137-20211030-02406.

ABSTRACT

Objective: To explore the value of enhanced magnetic resonance imaging nomogram model in the prediction of dual-phenotype hepatocellular carcinoma(DPHCC). Methods: Data of 116 patients of hepatocellular carcinoma (HCC) confirmed by postoperative pathology, who underwent preoperative enhanced MRI between January 2016 and March 2021 in the First Affiliated Hospital of Soochow University were retrospectively evaluated, of these, there are 87 males and 28 females, aged 30-79 (59±10) years, including 31 patients with DPHCC and 85 patients with non-DPHCC. The patients were randomly divided into training set(51 cases of non-DPHCC,19 cases of DPHCC)and validation set(34 cases of non-DPHCC, 12 cases of DPHCC) in a ratio of 6∶4, according to random number table,clinical and imaging characteristics of the two groups were compared. The statistically significant parameters were included in multivariate logistic regression to identify the independent predictors and for the establishment of the nomogram model. The receiver operating characteristic curves were used to evaluate the prediction ability of the models, the corrected curve was used to validate the model. Results: In the training group, the proportions of rim arterial phase hyperenhancement in the DPHCC was significantly higher than that of the non-DPHCC [47.4%(9/19)vs 7.8%(4/51),P<0.001]. Rim arterial phase hyper-enhancement and enhanced capsule were significant predictors for DPHCC[OR=10.17(1.70-60.80),0.17(0.03-0.93),all P<0.05]. In the training group, the area under curve (AUC), sensitivity and specificity of the nomogram were 0.888 (95%CI: 0.806-0.969), 78.9% and 86.3%. In the validation group, the above three indicators were 0.811(95%CI: 0.655-0.968), 75.0% and 82.4%. Conclusion: Enhanced MRI nomogram model has certain value in prediction of DPHCC, with high sensitivity and specificity.

PMID:35436807 | DOI:10.3760/cma.j.cn112137-20211030-02406

Eur J Dent. 2022 Apr 18. doi: 10.1055/s-0042-1743149. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to investigate the size and shape variations of soft-tissue patterns in different sagittal skeletal patterns using the geometric morphometrics method (GMM) obtained from lateral cephalograms.

MATERIALS AND METHODS: This is a retrospective study, where the sample comprised of 188 Malaysian Malay subjects aged between 18 and 40 years and with different sagittal skeletal patterns. Overall, 71 males and 117 females were gathered for all size and shape analyses. This study incorporated 11 soft-tissue landmarks, which underwent landmark application using tpsDig2 software version 2.31, while the shape analysis was done using MorphoJ software version 1.07a.

STATISTICAL ANALYSIS: Statistical analyses were performed using IBM SPSS Statistics 26. The result of the analysis of variance (ANOVA) test showed significant differences in some of the parameters between the landmarks. Length D, Length E, Length F, Length H, and Length I showed significant differences (p < 0.05), while other parameters showed no difference (p > 0.05).

RESULTS: The shape variation of soft-tissue landmarks in different skeletal patterns existed in 18 different dimensions which showed by 18 principal components (PCs). Procrustes ANOVA and canonical variate analysis showed the size and shape differences of soft-tissue patterns between Class II and III and gender groups (p < 0.0001). In discriminant function analysis for Class II subjects, the classification accuracy was 98.4%, whereas subsequent to cross-validation, the classification accuracy was 90.6%. For Class III subjects, the classification accuracy was 96.6%, while after cross-validation, the classification accuracy was 90%.

CONCLUSION: Different sagittal skeletal patterns demonstrated different soft-tissue shape variations. Class III showed the most protrusive upper and lower lips, while Class II demonstrated the most retrusive lower lip.

PMID:35436793 | DOI:10.1055/s-0042-1743149

Am J Perinatol. 2022 Apr 18. doi: 10.1055/a-1827-7518. Online ahead of print.

ABSTRACT

Objective To evaluate the utility of brain natriuretic peptide (BNP), troponin, galectin-3 and miRNA-126a-5p as screening biomarkers for persistent pulmonary hypertension of the newborn (PPHN) by comparing expression in serum of infants with hypoxic-ischemic injury that develop PPHN to those that do not. Study design This was a prospective, observational pilot study including neonates with hypoxic-ischemic injury undergoing therapeutic hypothermia (TH) at two regional perinatal medical centers. PPHN in this population was diagnosed clinically and confirmed by ECHO. Serial measurements of biomarkers were performed from 6-96 hours post-TH initiation in 40 patients. Results Of 40 infants in study, 10 (25%) developed PPHN and 30 (75%) did not. Baseline demographics and hemodynamics were similar between the groups. Patients with PPHN had significantly higher need for vasopressors compared to patients without PPHN (70% vs. 27%, p=0.007). Mean serum BNP and troponin levels were significantly higher in PPHN group peaking at 12-24 hours and decreasing following PPHN treatment initiation. MiRNA-126a-5p expression was increased in patients with PPHN compared to patients without, with statistical significance detected at 12 hours (p=0.005) and 96 hours (p=0.01). Mean circulating Gal-3 levels were not statistically different between the two groups; however, Gal-3 was elevated in all patients with hypoxic-ischemic injury on TH compared to healthy infants from prior studies. Conclusion BNP and troponin are readily available, low-cost biomarkers that showed significant serial elevations in PPHN group of study, thus may have value in screening for PPHN in the setting of HIE. Galectin-3 was elevated in all patients with HIE and may be a useful biomarker of hypoxic injury in infants being evaluated for TH. Elevations in MiRNA-126a-5p were not consistently seen in this study. Larger studies are required to establish an association between PPHN and these biomarkers in patients with and without HIE.

PMID:35436801 | DOI:10.1055/a-1827-7518

Eur J Dent. 2022 Apr 18. doi: 10.1055/s-0041-1742125. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to analyze the antibiofilm effectiveness of cinnamon (Cinnamomum burmanii) ethanol extract against Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans in vitro.

MATERIAL AND: METHODS: Phytochemical tests were done to identify the cinnamon extract active substances. Furthermore, a crystal violet biofilm assay was used to analyze biofilm detachment after treatment with different concentrations (15, 10, 7.5, 5, and 2.5%) of cinnamon. Biofilm turbidity was measured at 595-nm wavelength using a microplate reader. Additionally, MTT assay was done to analyze the toxicity level of cinnamon extract on fibroblast cells.

STATISTICAL ANALYSIS: The obtained data were analyzed for normality using the Kolmogorov-Smirnov test. The differences between each group were analyzed using a one-way analysis of variance statistical test, with a significance level of p <0.05.

RESULTS: The results showed that the ethanol extract of cinnamon contains active compounds of flavonoids, alkaloids, saponins, tannins, quinones, and terpenoids. MTT result showed the cinnamon extract to be nontoxic. The biofilm assay results showed that all cinnamon concentrations exhibited an antibiofilm effect against P. gingivalis and A. actinomycetemcomitans in all incubation time compared with a negative control (p <0.05).

CONCLUSIONS: Cinnamon extracts were effective in inhibiting biofilm of periodontal pathogens. Cinnamon extract might be useful as an alternative therapy for periodontal diseases. Future studies are still needed to confirm this result in vivo to analyze the efficacy of this extract as mouthwash.

PMID:35436792 | DOI:10.1055/s-0041-1742125

Eur J Dent. 2022 Apr 18. doi: 10.1055/s-0042-1743152. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine (1) the level of knowledge regarding COVID-19 and dental emergency (DE) along with the factors that might be associated (2) with the effect of educational video on the level of knowledge among nondental students.

MATERIALS AND METHODS: This online pre-experimental study used an educational video regarding COVID-19 and DE with a one-group pretest-posttest design toward the undergraduate nondental students (n = 363) from six public universities in West Java Province, Indonesia, aged 18 to 22 years. A Google Form was used and convenience sampling was undertaken.

STATISTICAL ANALYSIS: The chi-squared, Mann-Whitney, Wilcoxon, and Spearman correlation tests were performed. Cohen’s d effect size was used to assess the effect of videos.

RESULTS: Most of the respondents were females around 20.36 ± 0.94 years. There is a statistically significant difference between the pre- and posttest knowledge score for COVID-19 (p <0.001) and DE (p <0.001). The “with dental school” group had a significantly higher pretest score in DE literacy than the “without dental school” group. There is a significantly positive linear relationship between the frequency of watching videos and the posttest score. The effect size was 1.03 and 0.8 for COVID-19 and DE, respectively. The majority of students agreed (agree and very agree) with all statements regarding video education.

CONCLUSIONS: The level of knowledge regarding COVID-19 and DE increased from 5.30 to 6.75 and 6.58 to 8.02, respectively. The associated factors were the type of university and the frequency of watching videos. Educational intervention seems to have a great effect in increasing the knowledge of nondental students.

PMID:35436791 | DOI:10.1055/s-0042-1743152