Category: Statistics

PLoS One. 2021 Sep 10;16(9):e0257099. doi: 10.1371/journal.pone.0257099. eCollection 2021.

ABSTRACT

Screening plans for prevention and containment of SARS-CoV-2 infection should take into account the epidemic context, the fact that undetected infected individuals may transmit the disease and that the infection spreads through outbreaks, creating clusters in the population. In this paper, we compare through simulations the performance of six screening plans based on poorly sensitive individual tests, in detecting infection outbreaks at the level of single classes in a typical European school context. The performance evaluation is done by simulating different epidemic dynamics within the class during the four weeks following the day of the initial infection. The plans have different costs in terms of number of individual tests required for the screening and are based on recurrent evaluations on all students or subgroups of students in rotation. Especially in scenarios where the rate of contagion is high, at an equal cost, testing half of the class in rotation every week appears to be better in terms of sensitivity than testing all students every two weeks. Similarly, testing one-fourth of the students every week is comparable with testing all students every two weeks, despite the first one is a much cheaper strategy. In conclusion, we show that in the presence of natural clusters in the population, testing subgroups of individuals belonging to the same cluster in rotation may have a better performance than testing all the individuals less frequently. The proposed simulations approach can be extended to evaluate more complex screening plans than those presented in the paper.

PMID:34506536 | DOI:10.1371/journal.pone.0257099

J Popul Ther Clin Pharmacol. 2021 Sep 2;28(1):35-45. doi: 10.15586/jptcp.2021.v28i1.837. eCollection 2021.

ABSTRACT

OBJECTIVES: The purpose of this study was to evaluate the knowledge and perceptions of Arabian dental students on geriatric dentistry.

MATERIALS AND METHODS: A cross-sectional survey was conducted with a total of 100 participants belonging to Group I (25 each from third- and fourth-year students) and Group II (50 fifth-year students and interns ). All participants had completed a three-part questionnaire related to geriatric dentistry: Part I (knowledge), Part II (cognitive evaluation), and Part III (awareness and attitude of psychosocial and health problems). Comparisons were made between the groups, and the data were analyzed using SPSS software.

RESULTS: The responses on the Part I were not statistically significant among the groups (P > 0.05). The knowledge mean scores comparison showed an evident significant relationship among the groups (P < 0.05). Overall the Group II participants achieved the highest scores for all the Parts (all P > 0.05).

CONCLUSIONS: The students belong to Group II, and the interns achieved higher scores than the Group I students. Dental students and interns in Saudi Arabia lack positive approaches in providing primary health care to geriatric individuals despite a rapidly growing geriatric population.

PMID:34505759 | DOI:10.15586/jptcp.2021.v28i1.837

Transpl Infect Dis. 2021 Sep 10. doi: 10.1111/tid.13729. Online ahead of print.

ABSTRACT

BACKGROUND: The management of active tuberculosis (TB) in solid organ transplantation (SOT) recipients is challenging given the pharmacological interaction and the potential delays in diagnosis due to atypical presentation. The incidence rates (IRs) of post-SOT TB from whole recipients’ cohort in high-endemic country have not been evaluated.

METHODS: We established SOT cohort (n = 15,598) and confirmed cases of TB between 2011 and 2015 from the Korean National Health Insurance Database using ICD-10 codes. After excluding 1,302 and 180 SOT-recipients due to age (< 18 years) and presence of pre-SOT TB and/or treatment for latent TB during wash-out period between 2006 and cohort entry, we analyzed 14,116 SOT recipients and 70,580 individuals with no history of SOT matched by age and sex. The hazard ratios (HRs) of IRs were adjusted for age, sex, low-income status, diabetes mellitus, chronic co-morbidities, and anti-TNF-α therapy.

RESULTS: The IR of TB was significantly higher (adjusted HR [aHR]: 6.1, 95% confidence interval [CI]: 4.5-7.6) in SOT recipients (4.9/1,000 person-years) than in non-SOT individuals (0.8/1,000 person-years). Of the transplanted organs, pancreas (pancreas alone and simultaneous pancreas-kidney) and lung had the highest IR (aHR: 16.3 [6.1-42.2] and 16.1 [5.9-43.8], respectively). The use of anti-thymocyte globulin and azathioprine was associated with a higher IR (aHR: 1.53 [1.01-2.43] and 3.92 [1.21-12.47], respectively), but basiliximab was associated with a lower IR (aHR: 0.67 [0.48-0.98]).

CONCLUSION: The IR of TB in SOT recipients, especially in pancreas and lung, was significantly higher than that in non-SOT population. This article is protected by copyright. All rights reserved.

PMID:34505751 | DOI:10.1111/tid.13729

Biomed Chromatogr. 2021 Sep 10:e5241. doi: 10.1002/bmc.5241. Online ahead of print.

ABSTRACT

Spontaneous intracerebral hemorrhage (ICH) accounts for 10-20% of all strokes, and contributes to higher mortalities and severe disabilities. The objectives of this study were therefore to characterize novel biomarkers, metabolic disruptions, and the mechanisms involving ICH. A total 30 ICH patients and 30 control subjects were enrolled in the study, followed by analyses of their clinical characteristics. Non-targeted metabolomic analysis was conducted using ultra-performance liquid chromatography quadrupole time-of-flight tandem mass spectrometry (UPLC/Q-TOF MS). Multivariate statistical analysis and receiver operating characteristic curve analysis were used for screening and evaluating the predictive ability of biomarkers. ICH patients showed significantly higher systolic blood pressure, diastolic blood pressure, blood glucose levels, white blood cell counts, neutrophil count, Percentage of neutrophils, globulin, and a lower albumin/globin ratio, when compared with control subjects. In total, 11 important metabolites were identified, which were associated with disruption of fatty acid oxidation, sphingolipid and phospholipid metabolism, as well as increased inflammation, oxidative stress, and vascular pathologies. Further multiple logistic regression analyses of these metabolites showed that L-carnitine and phosphatidylcholine (PC) (20:3/22:6) have potential as biomarkers of ICH, and the area under the curve and the sensitivity and specificity were 0.974, 90%, and 93%, respectively. These findings provide insights into the pathogenesis, early prevention, and diagnosis of ICH.

PMID:34505712 | DOI:10.1002/bmc.5241

Macromol Rapid Commun. 2021 Sep 10:e2100473. doi: 10.1002/marc.202100473. Online ahead of print.

ABSTRACT

The combination of complementary, non-covalent interactions is a key principle for the design of multi-stimuli responsive hydrogels. In this work, we report an amphiphilic peptide, supramacromolecular hydrogelator which combines metal-ligand coordination induced gelation and thermoresponsive toughening. Following a modular approach, the incorporation of the triphenylalanine sequence FFF into a structural (C₃^EG ) and a terpyridine-functionalized (C₃^Tpy ) C₃ -symmetric monomer enables their statistical copolymerization into self-assembled, 1D nanorods in water, as investigated by circular dichroism (CD) spectroscopy and transmission electron microscopy (TEM). In the presence of a bis(terpyridine) functionalized telechelic PEG crosslinker, complex formation upon addition of different transition metal ions (Fe²⁺ , Zn²⁺ , Ni²⁺ ) induces the formation of soft, reversible hydrogels at a solid weight content of 1 wt% as observed by linear shear rheology. The viscoelastic behavior of Fe²⁺ and Zn²⁺ crosslinked hydrogels are basically identical, while the most kinetically inert Ni²⁺ coordinative bond leads to significantly weaker hydrogels, suggesting that the most dynamic rather than the most thermodynamically stable interaction supports the formation of robust and responsive hydrogel materials. This article is protected by copyright. All rights reserved.

PMID:34505725 | DOI:10.1002/marc.202100473

Euro Surveill. 2021 Sep;26(36). doi: 10.2807/1560-7917.ES.2021.26.36.2100054.

ABSTRACT

BackgroundCohort studies on vaccine effectiveness are prone to confounding bias if the distribution of risk factors is unbalanced between vaccinated and unvaccinated study subjects.AimWe aimed to estimate influenza vaccine effectiveness in the elderly population in Finland by controlling for a sufficient set of confounders based on routinely available register data.MethodsFor each of the eight consecutive influenza seasons from 2012/13 through 2019/20, we conducted a cohort study comparing the hazards of laboratory-confirmed influenza in vaccinated and unvaccinated people aged 65-100 years using individual-level medical and demographic data. Vaccine effectiveness was estimated as 1 minus the hazard ratio adjusted for the confounders age, sex, vaccination history, nights hospitalised in the past and presence of underlying chronic conditions. To assess the adequacy of the selected set of confounders, we estimated hazard ratios of off-season hospitalisation for acute respiratory infection as a negative control outcome.ResultsEach analysed cohort comprised around 1 million subjects, of whom 37% to 49% were vaccinated. Vaccine effectiveness against laboratory-confirmed influenza ranged from 16% (95% confidence interval (CI): 12-19) to 48% (95% CI: 41-54). More than 80% of the laboratory-confirmed cases were hospitalised. The adjusted off-season hazard ratio estimates varied between 1.00 (95% CI: 0.94-1.05) and 1.08 (95% CI: 1.01-1.15), indicating that residual confounding was absent or negligible.ConclusionSeasonal influenza vaccination reduces the hazard of severe influenza disease in vaccinated elderly people. Data about age, sex, vaccination history and utilisation of hospital care proved sufficient to control confounding.

PMID:34505568 | DOI:10.2807/1560-7917.ES.2021.26.36.2100054

Anal Methods. 2021 Sep 10. doi: 10.1039/d1ay01372f. Online ahead of print.

ABSTRACT

A high-performance liquid chromatography tandem mass spectrometry cubed (HPLC/MS³) method was developed and validated to quantify lamotrigine in human plasma with carbamazepine as an internal standard. The HPLC/MS/MS system is composed of a Shimadzu UFLC XR high-performance liquid chromatograph coupled with a hybrid linear ion trap triple quadrupole mass spectrometer. Following simple protein precipitation with methanol, the separation of lamotrigine and carbamazepine was performed on an Agilent Poroshell 120 SB-C18 column (4.6 × 50 mm, 2.7 μm) using gradient elution with 0.1% formic acid in water (solvent I) and 0.1% formic acid in methanol (solvent II) at a flow rate of 0.8 mL min^-1. The total run time for each sample was 5 min. The method was validated for accuracy, precision, linearity, lower limit of quantification (LLOQ), selectivity, and other parameters. The LC/MS³ method was linear in the concentration range of 0.50-50.0 μg mL^-1 (R² ≥ 0.995). The LLOQ was 0.5 μg mL^-1, requiring only 30 μL of human plasma. Intra- and inter-day accuracies were <6.17% and precisions were <11.4% at all concentrations. The absolute recoveries (%) and matrix effect (%) for lamotrigine in human plasma were between 83.8 and 90.7. The developed and validated LC-MS³ assay was successfully applied to monitor the lamotrigine levels in human plasma after the administration of lamotrigine.

PMID:34505603 | DOI:10.1039/d1ay01372f

Mol Med Rep. 2021 Nov;24(5):789. doi: 10.3892/mmr.2021.12429. Epub 2021 Sep 10.

ABSTRACT

Inhibin βA (INHBA) serves a prognostic and tumor‑promoting role in numerous types of cancer. The present study aimed to determine the clinical significance of INHBA in non‑small cell lung cancer (NSCLC) and the mechanisms underlying its potential tumor‑promoting effect. INHBA expression was detected in clinical NSCLC samples using immunohistochemistry. In vivo loss‑ and gain‑of‑function studies were performed to determine the effects of INHBA on NSCLC invasion. In addition, protein and mRNA expression levels of INHBA, yes‑associated protein (YAP), large tumor suppressor 1/2 kinase (LATS1/2), connective tissue growth factor, cysteine rich angiogenic inducer 61 and Merlin were assessed using western blotting and reverse transcription‑quantitative PCR, respectively, to investigate the mechanism by which INHBA may affect the invasion of NSCLC. The present study revealed that INHBA was significantly upregulated in 238 clinical NSCLC samples compared with its expression levels in paired adjacent non‑cancerous tissues, and in metastatic nodules compared with in primary tumors. Notably, high INHBA expression was statistically associated with clinicopathological features, including poor differentiation and advanced tumor stage. INHBA positivity was statistically related to decreased 5‑year overall survival, for which INHBA was an independent prognostic factor. Furthermore, INHBA promoted NSCLC invasion in vitro. In NSCLC, INHBA expression was associated with the nuclear levels of YAP and INHBA overexpression enhanced the invasive abilities of NSCLC cells via inhibiting the Hippo pathway. Mechanistically, INHBA inhibited l LATS1/2 phosphorylation and induced YAP nuclear translocation by downregulating the protein expression levels of Merlin. In conclusion, INHBA may negatively regulate the Hippo pathway to act as a tumor promotor, and could represent a marker of prognosis in NSCLC.

PMID:34505633 | DOI:10.3892/mmr.2021.12429

Physiol Res. 2021 Sep 10. Online ahead of print.

ABSTRACT

Diabetic foot ulcer (DFU) is a serious complication of diabetes and hyperbaric oxygen therapy (HBOT) is also considered in comprehensive treatment. The evidence supporting the use of HBOT in DFU treatment is controversial. The aim of this work was to introduce a DFU model in ZDF rat by creating a wound on the back of an animal and to investigate the effect of HBOT on the defect by macroscopic evaluation, quantitative histological evaluation of collagen (types I and III), evaluation of angiogenesis and determination of interleukin 6 (IL6) levels in the plasma. The study included 10 rats in the control group (CONT) and 10 in the HBOT group, who underwent HBOT in standard clinical regimen. Histological evaluation was performed on the 18th day after induction of defect. The results show that HBOT did not affect the macroscopic size of the defect nor IL6 plasma levels. A volume fraction of type I collagen was slightly increased by HBOT without reaching statistical significance (1.350.49 and 1.94+/-0.67 %, CONT and HBOT, respectively). In contrast, the collagen type III volume fraction was ~120 % higher in HBOT wounds (1.41+/-0.81 %) than in CONT ones (0.63+/-0.37 %; p=0.046). In addition, the ratio of the volume fraction of both collagens in the wound ((I+III)w) to the volume fraction of both collagens in the adjacent healthy skin ((I+III)h) was ~65 % higher in rats subjected to HBOT (8.9+/-3.07 vs. 5.38+/-1.86 %, HBOT and CONT, respectively; p=0.028). Vessels density (number per 1 mm2) was found to be higher in CONT vs. HBOT (206.5+/-41.8 and 124+/-28.2, respectively, p<0.001). Our study suggests that HBOT promotes collagen III formation and decreases the number of newly formed vessels at the early phases of healing.

PMID:34505531

Ophthalmic Epidemiol. 2021 Sep 10:1-7. doi: 10.1080/09286586.2021.1976805. Online ahead of print.

ABSTRACT

PURPOSE: This study was undertaken to evaluate the complication rates and visual outcomes of outreach cataract surgeries done in makeshift operating rooms.

METHOD: In this retrospective study, surgical outcomes of consecutive Manual Small Incision Cataract Surgeries (MSICS) done in 11 rural camps in Nepal were compared with the results of consecutive hospital surgeries (MSICS and phacoemulsification) done by the same surgeon. Surgeries were done from September 2018 to March 2020.

RESULTS: Out of 1034 study population in each group, a significantly higher number (p < .001) of camp patients (27%, n = 279) were either blind or had severe visual impairment when compared to hospital patients (18.6%, n = 192). Around 88.9% (n = 919) of cases operated in camps and 85.7% (n = 886) in the hospital achieved uncorrected visual acuity (VA) of 6/18 or better on the first postoperative day. Poor outcome (VA<6/60) was seen in 3.7% (n = 38) of cases in camps and 3.9% (n = 40) in the hospital. The difference in visual outcomes was not significant (p = .162) when the results were controlled for other associated variables. There was no significant difference (p = .126) between complication rates in camps (1.9%, n = 20) and hospital surgeries (3.5%, n = 36) when preoperative conditions were statistically controlled. No cases of endophthalmitis were reported.

CONCLUSIONS: Makeshift operating rooms can be used for cataract surgeries in rural areas where no standard operating rooms are available. If appropriate patient selection criteria and standard surgical protocols are followed, good surgical outcomes can be achieved in camps by an experienced surgical team.

PMID:34505552 | DOI:10.1080/09286586.2021.1976805