Category: Statistics

Support Care Cancer. 2022 May 6. doi: 10.1007/s00520-022-07109-z. Online ahead of print.

ABSTRACT

OBJECTIVES: This systematic review aimed to analyze the use of telehealth in monitoring patients with head and neck cancer regarding the application used, user adherence to technology, user satisfaction, and user quality of life.

MATERIALS AND METHODS: A search strategy was developed using the PICO acronym and the terms “Head and Neck Cancer,” “Telehealth,” “Mobile Application,” and “Supportive Care.” A broad literature search was performed on PubMed, Cochrane Library, Scopus, Web of Science, Lilacs, and Embase databases and on grey literature through Open Grey, Google Scholar, and Jstor, for studies comparing the monitoring of head and neck cancer patients with telehealth apps to the monitoring performed in a traditional way at health units. No study design, publication status, publication time, or language restrictions were applied. Pairs of reviewers worked independently for study selection and risk of bias assessment. The protocol was registered in PROSPERO and the PRISMA checklist used for reporting the review.

RESULTS: We found 393 references in the databases, 325 after duplicate removal; 19 met the criteria for full-text reading; 08 studies were included for qualitative synthesis. Although there was heterogeneity regarding the technology used, the studies included showed that remote monitoring and/or self-management of symptoms through mobile applications was feasible for most patients, with satisfactory degrees of acceptability, satisfaction, usability, and adherence. The health-related quality of life improved with the use of remote technologies for telehealth, associated with low to moderate self-efficacy, higher personal control, and higher knowledge of health with clinically acceptable levels of accuracy compared to traditional clinical evaluation. Even when the data presented were not statistically significant, patients reported improvement in health-related quality of life after the intervention.

CONCLUSIONS: Telehealth monitoring through the use of remote technologies presents itself as an alternative way of educating and supporting patients during the treatment of Head and Neck Cancer (HNC). There is the need for a more user-friendly interface, adequate user experience assessment, and the concrete applicability of telehealth technologies for monitoring patients with HNC in order to legitimize the cost-effectiveness of developing long-term multicenter longitudinal studies term.

PMID:35524146 | DOI:10.1007/s00520-022-07109-z

Food Funct. 2022 May 6. doi: 10.1039/d1fo03795a. Online ahead of print.

ABSTRACT

Evidence suggests a role of serum cholesterol in prostate cancer (PCa) development and of lipid lowering medications in PCa risk reduction. We developed a score for adherence to an established cholesterol-lowering diet and evaluated its association with PCa risk in a multicentric hospital-based case-control study (1294 cases; 1451 matched controls) in Italy (1992-2001). The score was derived from seven dietary indicators which have been reported to lower cholesterol levels: high intake of non-cellulosic polysaccharides (viscous fibres), monounsaturated fatty acids, legumes, seeds/corn oil; low intake of saturated fatty acids, dietary cholesterol, and glycaemic index. Odds ratios (ORs) and corresponding confidence intervals (CIs) were calculated through the unconditional logistic regression model. Although most of the dietary indicators alone were not significantly associated with reduced PCa risk, men who fulfilled 5 to 7 dietary indicators (187 cases and 281 controls) showed a 43% reduction in PCa risk compared to those with 0 to 2 indicators (OR: 0.57; 95% CI: 0.43-0.77). This association was not modified by socio-demographic characteristics or lifestyle factors. In conclusion, adherence to a cholesterol-lowering diet is a favourable factor against the risk of PCa, providing support to dietary guidelines that promote cholesterol reduction through plant-based diets.

PMID:35522943 | DOI:10.1039/d1fo03795a

Wiad Lek. 2022;75(3):735-741.

ABSTRACT

OBJECTIVE: The aim: Multiple sclerosis (MS) is a disease of the central nervous system (CNS) characterized by inflammation and demyelination, which leads to chronic progressive disability. Fingolimod is the first registered oral disease-modifying drug (DMD) approved for the treatment of highly active relapsing-remitting multiple sclerosis (RRMS). Fingolimod statistically significantly reduced the number of relapses, clinical and radiological disease activity and disability progression. However, fingolimod can be associated with an increased risk of cancer. This study is aimed to underline how important is regular specialist follow-up during fingolimod therapy.

PATIENTS AND METHODS: Materials and methods: The literature review was conducted using the key words: “fingolimod”, “multiple sclerosis”, “fingolimod and cancer”, “relapsing-remitting multiple sclerosis”, “fingolimod adverse effects”, “basal cell carcinoma fingolimod”, “squamous cell carcinoma fingolimod”. The study is based on the case report of a 67-year-old male patient with metachronous skin cancer treated with fingolimod. The drug had an influence on the inhibition of clinical and radiological activity of the disease. Despite the control of the underlying disease, skin cancers occurred during treatment. Basal cell carcinoma and squamous cell carcinoma were diagnosed at an early stage when complete resection was possible and negative (R0) margin resection was achieved.

CONCLUSION: Conclusions: Dermatological examination should be performed at the beginning and during treatment with fingolimod. Patients need to be informed about the risk of malignancy. Patient education are crucial during treatment, which allows achieving a good therapeutic effect, thus minimizing the risk of malignancy and enabling its early detection and cure.

PMID:35522887

Wiad Lek. 2022;75(3):670-677.

ABSTRACT

OBJECTIVE: The aim: To analyse the structure of sensory impairments, associated with COVID-19. To identify terms of recovery periods depending on severity of disease, age and gender of the patients.

PATIENTS AND METHODS: Materials and methods: Within two weeks, 2225 patients with confirmed COVID-19 completed a questionnaire, created by Google Forms. General complaints, peculiarities of sensory impairments and recovery time were specified. After exclusion criteria application, data of 2108 patients were analyzed by R Statistics Package, Student’s t-test, Wilcoxon rank-sum test, Fisher’s exact test, Spearman’s rank test.

RESULTS: Results: Among patients enrolled (973 males and 1135 females, mean age 28.6±0.18) the most frequent were olfactory (91.32%) and gustatory (66.03%) dysfunctions. Olfactory manifestations were usually accompanied by gustatory disorders (73.72%). Average duration of olfactory dysfunction was 15.46±0.45 days, gustatory – 11.3±0.33, hearing – 4.3±0.16, and visual – 6.53±0.23 days. It was found a correlation between duration of olfactory and gustatory impairments (r=0.65; p < 0.001), hearing and visual disorders (r=0.49; p < 0.05).

CONCLUSION: Conclusions: Olfactory and gustatory disorders are prevalent symptoms in Ukrainian population. 7.87% of respondents who had impairment of all four sensory functions had the longest recovery time. Duration of sensory impairments did not depend on age, type of treatment and severity of disease, which rises the question about the neurogenic pathway of virus.

PMID:35522877

J Plast Surg Hand Surg. 2022 May 6:1-14. doi: 10.1080/2000656X.2022.2070177. Online ahead of print.

ABSTRACT

Local anesthesia is an effective method to perform digital nerve blocks. In this study, we compare the effectiveness of single-volar subcutaneous and double-dorsal injection through a systematic review and meta-analysis of randomized controlled trials (RCTs). A systematic search of PubMed, Embase, and the Cochrane Library from inception to 7 April 2021 was performed. RCTs with the effects of single-volar subcutaneous and double-dorsal injection were eligible. Meta-analysis was performed using random effect models with pooled standardized mean differences (SMDs) and 95% confidence intervals (CI). RoB 2.0 and GRADE of Recommendation Assessment, Development, and Evaluation criteria were applied for evaluating the bias. A total of 2484 studies were initially identified, with 11 eligible RCTs finally included in the meta-analysis (1363 patients). The pooled data of nine studies showed single-volar injection had a statistically significantly lower pain score (pooled SMD: 0.20, 95% CI, 0.01 to 0.39, p = 0.041, I2 = 58%, N = 1187) and higher patient preference but invalid anesthesia at the dorsal proximal digit. No significant differences were observed in the onset of anesthesia, adjacent digit invalid numbness, distal phalanx invalid anesthesia, additional injection rate, and adverse effects. In conclusion, this meta-analysis of RCTs showed that the single-volar injection was associated with a lower pain sensation during injection and higher patient satisfaction with a reduced anesthetic effect over the proximal dorsal phalanx. Further high-quality RCTs with a higher number of cases are needed to validate our results.

PMID:35522838 | DOI:10.1080/2000656X.2022.2070177

Wiad Lek. 2022;75(3):645-648.

ABSTRACT

OBJECTIVE: The aim: To assess the impact of complex metabolic therapy of primary osteoarthritis and type 2 diabetes mellitus under conditions of comorbidity on the course and progression of these pathologies. Patients with comorbidities of primary osteoarthritis and diabetes mellitus are a special group of patients because the importance of these comorbidities is the additional difficulty in diagnosing and conducting adequate therapy, given the close etiopathogenetic links of these conditions, which leads to poor quality of life, increased costs of diagnosis and treatment, increasing the frequency and duration of hospital stay.

PATIENTS AND METHODS: Materials and methods: We examined 67 patients with primary osteoarthritis in comorbidity with diabetes mellitus. Patients were comparable by clinical, gender criteria, the severity of primary osteoarthritis, and treatment received and were divided into two groups: 1st group (n=32) – patients received treatment for OA and diabetes mellitus in accordance with international recommendations; 2nd group (n=35) – patients received treatment as in group 1 + drug alpha-lipoic acid. Determination of the level of the studied parameters was performed before and after treatment.

RESULTS: Results: The analysis of the obtained results revealed statistically significant positive dynamics after treatment for symptoms of primary osteoarthritis in both study groups of patients (p<0.05), but the therapeutic effect in the 2nd group was more significant (p<0.05). There was a statistically significant positive dynamics on the scale of VAS at rest and movement (p<0,05), WOMAC index for pain, stiffness, and functional insufficiency (p<0,05), and Leken index in the 2nd group after treatment compared with the 1st (p<0.05).

CONCLUSION: Conclusions: The obtained results indicate a statistically significant positive effect of alpha-lipoic acid on the course and progression of primary osteoarthritis under conditions of comorbidity with diabetes mellitus.

PMID:35522872

Prim Care Companion CNS Disord. 2022 May 5;24(3):21m03230. doi: 10.4088/PCC.21m03230.

ABSTRACT

Objective: To assess psychological resilience, coping, and related psychological distress in admitted COVID-19 patients. Predictors of subsequent development of posttraumatic stress symptoms (PTSS) and disability were also studied.

Methods: Stable inpatients with COVID-19 (aged > 18 years with mild symptoms) admitted to a tertiary care hospital from April 2020 to December 2020 were recruited for the study. During admission, the patients were assessed for resilience, coping, and psychological distress using the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), Brief COPE (Coping Orientation to Problems Experienced), and 4-item Patient Health Questionnaire (PHQ-4). Similarly, they were assessed at 4 weeks after discharge using the PTSD Checklist for DSM-5 and World Health Organization Disability Assessment Schedule.

Results: A total of 176 patients were recruited for the study and assessed during their admission, and 102 were reassessed during follow-up. Of the patients, 17.6% during admission and 58.8% at follow-up had significant psychological distress (PHQ-4 score > 2). The mean ± SD CD-RISC-10 score was 27.94 ± 5.82. The most used coping strategies were emotional support, religion, and acceptance. Increased resilience was associated with better education (rs[100] = 0.265, P = .007), less psychological distress (r[100] = -0.596, P = .001), and healthy coping strategies. PHQ-4, PCL-5, and disability scores at follow-up were positively correlated (Pearson correlation). The multiple regression model statistically significantly predicted PTSS (F_{7, 94} = 2.660, P < .015, adjusted R² = 0.103).

Conclusions: COVID-19 patients with better resilience are associated with reduced psychological distress. Better resilient traits and reduced psychological distress may prevent ensuing PTSS and disability.

PMID:35522834 | DOI:10.4088/PCC.21m03230

Int J Audiol. 2022 May 6:1-11. doi: 10.1080/14992027.2022.2071345. Online ahead of print.

ABSTRACT

OBJECTIVE: One challenge in extracting the scalp-recorded frequency-following response (FFR) is related to its inherently small amplitude, which means that the response cannot be identified with confidence when only a relatively small number of recording sweeps are included in the averaging procedure.

DESIGN: This study examined how the non-negative matrix factorisation (NMF) algorithm with a source separation constraint could be applied to improve the efficiency of FFR recordings. Conventional FFRs elicited by an English vowel/i/with a rising frequency contour were collected. Study sample: Fifteen normal-hearing adults and 15 normal-hearing neonates were recruited.

RESULTS: The improvements of FFR recordings, defined as the correlation coefficient and root-mean-square differences across a sweep series of amplitude spectrograms before and after the application of the source separation NMF (SSNMF) algorithm, were characterised through an exponential curve fitting model. Statistical analysis of variance indicated that the SSNMF algorithm was able to enhance the FFRs recorded in both groups of participants.

CONCLUSIONS: Such improvements enabled FFR extractions in a relatively small number of recording sweeps, and opened a new window to better understand how speech sounds are processed in the human brain.

PMID:35522832 | DOI:10.1080/14992027.2022.2071345

Prim Care Companion CNS Disord. 2022 May 3;24(3):21m03177. doi: 10.4088/PCC.21m03177.

ABSTRACT

Objective: A range of psychiatric morbidities such as persistent depression, anxiety, insomnia, and posttraumatic stress disorder (PTSD) has been observed in coronavirus disease 2019 (COVID-19) survivors. The objective of this study was to explore the psychological status of health care workers after recovery from COVID-19 and to examine the sociodemographic and clinical factors associated with psychiatric morbidity.

Methods: A cross-sectional study was conducted among health care workers of a tertiary care hospital in South India. The study included health care workers who tested positive for COVID-19 according to the provisional guidelines of the World Health Organization. The data were collected after they tested negative for COVID-19 from September 2020 to October 2020. The study used a semistructured proforma and rating scales such as the 9-item Patient Health Questionnaire, 7-item Generalized Anxiety Disorder Scale, and Posttraumatic Stress Disorder Checklist for DSM-5 to assess for depression, anxiety, and PTSD.

Results: The results indicate that the prevalence of depression, anxiety, and PTSD among 107 post-COVID patients was 26.2%%, 12.1%, and 3.7%%, respectively. Female sex (P = .017), patients with post-COVID persistent physical symptoms (P = .05), and the duration of fever during the acute phase of COVID-19 infection (P = .005) were found to have a statistically significant association with a higher rate of depression among the study population.

Conclusions: The study findings indicate that all COVID-19 survivors working in the health care sector should be screened for depression and anxiety disorders regularly for early detection and effective management.

PMID:35522828 | DOI:10.4088/PCC.21m03177

PLoS Genet. 2022 May 6;18(5):e1010170. doi: 10.1371/journal.pgen.1010170. Online ahead of print.

ABSTRACT

Polygenic scores link the genotypes of ancient individuals to their phenotypes, which are often unobservable, offering a tantalizing opportunity to reconstruct complex trait evolution. In practice, however, interpretation of ancient polygenic scores is subject to numerous assumptions. For one, the genome-wide association (GWA) studies from which polygenic scores are derived, can only estimate effect sizes for loci segregating in contemporary populations. Therefore, a GWA study may not correctly identify all loci relevant to trait variation in the ancient population. In addition, the frequencies of trait-associated loci may have changed in the intervening years. Here, we devise a theoretical framework to quantify the effect of this allelic turnover on the statistical properties of polygenic scores as functions of population genetic dynamics, trait architecture, power to detect significant loci, and the age of the ancient sample. We model the allele frequencies of loci underlying trait variation using the Wright-Fisher diffusion, and employ the spectral representation of its transition density to find analytical expressions for several error metrics, including the expected sample correlation between the polygenic scores of ancient individuals and their true phenotypes, referred to as polygenic score accuracy. Our theory also applies to a two-population scenario and demonstrates that allelic turnover alone may explain a substantial percentage of the reduced accuracy observed in cross-population predictions, akin to those performed in human genetics. Finally, we use simulations to explore the effects of recent directional selection, a bias-inducing process, on the statistics of interest. We find that even in the presence of bias, weak selection induces minimal deviations from our neutral expectations for the decay of polygenic score accuracy. By quantifying the limitations of polygenic scores in an explicit evolutionary context, our work lays the foundation for the development of more sophisticated statistical procedures to analyze both temporally and geographically resolved polygenic scores.

PMID:35522704 | DOI:10.1371/journal.pgen.1010170