Category: Statistics

Pathol Res Pract. 2021 Oct 26;228:153668. doi: 10.1016/j.prp.2021.153668. Online ahead of print.

ABSTRACT

Synovial sarcoma (SS) is a malignant soft tissue neoplasm harboring SS18-SSX fusion gene and is histologically characterized by spindle cells and epithelial components. Some investigations have demonstrated that desmoplastic reaction (DR) is an independent prognostic factor of cancers. However, it remains unknown whether DR is of predictive value for the prognosis of synovial sarcoma patients. Here, we reviewed the clinical and histological findings of 88 patients with SS. We defined DR as hyalinized collagenous structures and classified the degree of DR as follows: none, mild, moderate, and severe. Overall, 23 SS cases (24%) showed moderate or severe DR histologically. Statistically, the cases with moderate or severe degree of DR showed poorer prognosis than those with no or mild DR (local recurrence: P = 0.0059, distant metastasis: P = 0.0002, tumor death: P = 0.0382). The findings of the study suggest that the DR of synovial sarcoma could be an important prognostic factor.

PMID:34773915 | DOI:10.1016/j.prp.2021.153668

Clin Nutr. 2021 Oct 9;40(12):5771-5780. doi: 10.1016/j.clnu.2021.10.002. Online ahead of print.

ABSTRACT

BACKGROUND: High blood pressure (BP) constitutes a common and serious medical condition which is rising globally, and is among preventable factors for cardiovascular, renal, brain and other diseases. Modifiable risk factors of high BP include unhealthy dietary patterns, presence of obesity, excess alcohol consumption and lack of physical activity. Data in regard to the different types of diets show that Mediterranean diet (MD) is associated with healthy levels of BP. In this study we aimed to investigate the impact of the level of adherence to MD in BP.

AIMS-METHODS: A systematic literature search (up to 08.2021) in PubMed, Scopus, Embase, Web of Science, Cochrane and Google Scholar databases was conducted, and 54 observational studies were included.

RESULTS: Systolic blood pressure (SBP) was found to be lower in the high adherence to MD group SMD: -0.08, (95%CI: -0.15, -0.02) whereas no differences regarding diastolic blood pressure (DBP) were observed between the high and low adherence to MD groups [SMD: -0.07, (95%CI: -0.13, 0.00)]. Mean DBP of all included studies for both high and low adherence groups were in healthy levels (<90 mmHg).

CONCLUSIONS: Higher adherence to MD could positively influence SBP, but further research is needed in this field due to the heterogeneous definitions of low/high adherence and the type of studies used (observational).

PMID:34773865 | DOI:10.1016/j.clnu.2021.10.002

J Clin Anesth. 2021 Nov 10;76:110579. doi: 10.1016/j.jclinane.2021.110579. Online ahead of print.

NO ABSTRACT

PMID:34773870 | DOI:10.1016/j.jclinane.2021.110579

Child Abuse Negl. 2021 Nov 10;123:105377. doi: 10.1016/j.chiabu.2021.105377. Online ahead of print.

ABSTRACT

BACKGROUND: Childhood sexual abuse (CSA) contributes to increased risk of substance use and mental health disorders in the general population.

OBJECTIVE: To assess the prevalence and associations of CSA and suicide attempts, substance use, and mental health disorders as a function of sex (female, male) and sexual orientation (lesbian, gay, bisexual, heterosexual-identified with same-sex attraction and/or behavior, heterosexual-identified without same-sex attraction and/or behavior, and unsure).

PARTICIPANTS AND SETTING: Data were collected using structured diagnostic face-to-face interviews in a nationally representative sample of 36,309 US adults.

METHODS: We used descriptive statistics and logistic regression modeling to analyze data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III).

RESULTS: Childhood sexual abuse was most prevalent among sexual minorities, especially bisexual females. Nearly one-third of bisexual females (30.6%) reported experiencing two or more types of CSA, p < .001. Among all participants, exposure to one or more types of CSA was associated with greater odds of lifetime suicide attempts, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) alcohol, tobacco or other drug use disorder, and mental health disorders, after adjusting for other childhood adversity/maltreatment and general life stressors.

CONCLUSIONS: Sexual minority females and males in the US are more likely than their heterosexual counterparts to report CSA. Higher risk of suicide attempts and DSM-5 alcohol, tobacco, other drug use, and mental health disorders in adulthood was directly associated with CSA, particularly among bisexual females. Health professionals working with individuals who have experienced CSA should assess these risks and intervene as needed.

PMID:34773839 | DOI:10.1016/j.chiabu.2021.105377

Forensic Sci Int. 2021 Nov 4;329:111093. doi: 10.1016/j.forsciint.2021.111093. Online ahead of print.

ABSTRACT

Over the last few years there has been a dramatic increase in the amount of “Fantasy” type drugs seized in New Zealand, with gamma-butyrolactone (GBL) being by far the most prevalent. In 2018, N-methyl-2-pyrrolidone (NMP) was detected in a liquid, along with GBL, for the first time in New Zealand. Since this seizure, the number of seizures containing mixtures of GBL and NMP that have been submitted for analysis by New Zealand authorities have significantly increased, with 82% of submitted samples containing GBL also containing NMP. Analysis of these liquids showed that the majority had GBL and NMP purities of approximately 60-70% and 30-40%, respectively. Subsequent investigations by New Zealand authorities revealed a potential source of these liquids being a diverted legitimate industrial product. The health and psychoactive effects of NMP, along with GBL and NMP mixtures, are unknown. Health statistics in New Zealand have indicated increased harm from GBL use over the last few years.

PMID:34773817 | DOI:10.1016/j.forsciint.2021.111093

Forensic Sci Int. 2021 Nov 4;329:111094. doi: 10.1016/j.forsciint.2021.111094. Online ahead of print.

ABSTRACT

INTRODUCTION: In the field of forensic toxicology, many unexpected deaths are investigated as to whether toxicological substances may have caused or contributed to someone’s death. One of the factors that makes interpretation of the results of quantitative analysis in postmortem toxicology challenging, is that measured postmortem drugs levels may vary according to the sampling site and the interval between death and specimen collection. These site- and time-dependent variations are caused by ‘postmortem redistribution’ (PMR). Literature shows that there are several factors that determine the degree of PMR, such as cell and tissue changes after death, decomposition and the physicochemical characteristics of drugs. Blood from peripheral sites seems to be less affected by PMR than cardiac blood. Therefore, the ratio of cardiac blood concentration/peripheral blood concentration (C/P) of a drug is often used as a marker of the extent of postmortem redistribution. In this study, we investigated the relationship between different potentially important variables and the C/P ratio of morphine in humans in order to provide new insights that might assist in the interpretation of quantitative results in forensic casework.

METHOD: Toxicological results of all morphine positive postmortem cases investigated by the Netherlands Forensic Institute between January 1, 2010 and July 31, 2020 were reviewed. Morphine was quantified in both femoral and cardiac blood in a total of 103 cases. The C/P ratios were determined for all selected cases. To collect data for this study, all corresponding files were reviewed. C/P ratios were compared between subgroups by performing either a Mann-Whitney U test or a Kruskal-Wallis test, followed by a post-hoc Mann-Whitney U test. Bonferroni correction was performed to correct for the likelihood of a significant result by chance due to multiple testing. After Bonferroni correction, a p-value< 0.004 was considered statistically significant.

RESULTS: The data suggests a relationship between grade of decomposition at autopsy, position of the corpse at discovery, route of administration, attempted resuscitation and the C/P ratio of morphine with p-values of 0.010, 0.026, 0.035 and 0.046, respectively.

CONCLUSION: Grade of decomposition at autopsy, position of the corpse at discovery, route of administration and attempted resuscitation seem to be influencing the C/P ratio of morphine. Of these four variables, the route of administration seems to have the greatest impact.

PMID:34773819 | DOI:10.1016/j.forsciint.2021.111094

J Environ Manage. 2021 Nov 10;302(Pt B):114062. doi: 10.1016/j.jenvman.2021.114062. Online ahead of print.

ABSTRACT

Environmental impact associated with production and consumption of pulses in the United States was evaluated using life cycle assessment (LCA). The system boundary was set to cradle-to-grave with a functional unit of 60 g (dry basis) of pulses consumed in a US household. Varieties of pulses modeled in the study included field pea (Pisum sativum), lentil (Lens culinaris), chickpea (Cicer arietinum), and dry bean. Three methods of cooking pulses at the consumer stage tested in the study were cooking in open vessel on electric cooking range (OVC), cooking in stovetop pressure cooker on electric cooking range (SPC), and cooking in electric pressure cooker (EPC). OVC formed the base scenario against which all other scenarios were compared. The environmental impact of pulses varied with type of pulse crop, cooking method, and the batch size. Consumption of approximately 60 g of dry pulses resulted in the greatest environmental impact for OVC. The consumer stage contributed at least 83, 81, 76, 75, and 87 percent for global warming potential (GWP), fossil resource scarcity (FRS), water consumption (WC), freshwater eutrophication (FE), and marine eutrophication (ME), respectively for this scenario. EPC resulted in the greatest decrease in the environmental impact, compared to OVC, for GWP, FRS, FE, and ME for all pulse varieties, which was validated in the uncertainty analysis. SPC, on the other hand, decreased the impact across these categories only for chickpea and dry bean. The uncertainty analysis suggested that the differences associated with cooking methods in the mean land use and water consumption scores of pulses were statistically non-significant. The impact categories were also highly sensitive to the mass of pulses cooked in a batch. Increasing the reference flow in OVC to 1 kg decreased the environmental impact of pulses by 49-87 percent for all impact categories, excluding land use. Overall, the study identified the consumer stage as the hotspot for environmental impact in the supply chain of pulses in the United States. The large contribution of the consumer stage to the overall environmental impact of pulses was attributed to electricity consumption for cooking and associated upstream emissions.

PMID:34773783 | DOI:10.1016/j.jenvman.2021.114062

Epilepsy Res. 2021 Oct 26;178:106794. doi: 10.1016/j.eplepsyres.2021.106794. Online ahead of print.

ABSTRACT

INTRODUCTION: Epilepsy affects almost 1% of people and is characterized by sudden seizures. To date, no reliable biomarker has been found to diagnose or predict the outcomes of epilepsy. Brain-derived neurotrophic factor (BDNF) levels have recently been shown to differ between patients with certain neurologic disorders and normal population, and it is unknown whether this is the case for epilepsy. In this study, we mainly aim to answer this question.

METHODS: We searched three databases for studies comparing BDNF levels between patients with epilepsy and controls. Quality assessment of included studies was performed using the Newcastle-Ottawa scale and statistical analyses were carried out in STATA software version 16.

RESULTS: Final analyses included 10 studies involving 403 patients with epilepsy. BDNF levels were statistically similar between patients and controls (standardized mean difference (SMD) = – 0.30, 95% CI = – 1.32 to 0.71, p = 0.56). When categorized by epilepsy subtype, patients with partial epilepsy showed lower BDNF measures than controls (95% CI = – 1.42 to – 0.32, p < 0.01), while the difference was not significant in patients with generalized epilepsy (95% CI = – 2.81 to 1.65, p = 0.61). Subgroup analyses indicated that BDNF was lower in patients than controls when age or sex matching was not present. Patient samples acquired in the morning also showed significantly lower BDNF levels than controls, unlike afternoon samples. Meta-regression identified no predictor for the difference in BDNF levels.

CONCLUSION: Generally, patients with epilepsy had BDNF levels similar to general population, although patients with partial epilepsy showed lower BDNF levels. Taking into account the sub-group analyses, further studies with higher qualities are required to evaluate the role and utility of BDNF in epilepsy.

PMID:34773766 | DOI:10.1016/j.eplepsyres.2021.106794

Cancer Epidemiol. 2021 Nov 10;75:102054. doi: 10.1016/j.canep.2021.102054. Online ahead of print.

ABSTRACT

Comorbidities and advanced stage diagnosis (ASD) are both associated with poorer cancer outcomes, but the association between comorbidities and ASD is poorly understood. We summarized epidemiological evidence on the association between comorbidities and ASD of selected cancers in a systematic review and meta-analysis. We searched PubMed and Web of Science databases up to June 3rd, 2021 for studies assessing the association between comorbidities and ASD of lung, breast, colorectal, or prostate cancer. Summary odds ratios (ORs) and 95% confidence intervals (95%CIs) were calculated using random-effects models. Also, potential variations in the associations between comorbidities and ASD by cancer type were investigated using random-effects meta-regression. Thirty-seven studies were included in this review, including 8,069,397 lung, breast, colorectal, and prostate cancer patients overall. The Charlson comorbidity index score was positively associated with ASD (stages III-IV) of breast cancer but was inversely associated with ASD of lung cancer (p_interaction = 0.004). Regarding specific comorbidities, diabetes was positively associated with ASD (OR = 1.17, 95%CI = 1.09-1.26), whereas myocardial infarction was inversely associated with ASD (OR = 0.84, 95%CI = 0.75-0.95). The association between renal disease and ASD differed by cancer type (p_interaction < 0.001). A positive association was found with prostate cancer (OR = 2.02, 95%CI = 1.58-2.59) and an inverse association with colorectal cancer (OR = 0.84, 95%CI = 0.70-1.00). In summary, certain comorbidities (e.g., diabetes) may be positively associated with ASD of several cancer types. It needs to be clarified whether closer monitoring for early cancer signs or screening in these patients is reasonable, considering the problem of over-diagnosis particularly relevant in patients with short remaining life expectancy such as those with comorbidities. Also, evaluation of the cost-benefit relationship of cancer screening according to the type and severity of comorbidity (rather than summary scores) may be beneficial for personalized cancer screening in populations with chronic diseases.

PMID:34773768 | DOI:10.1016/j.canep.2021.102054

Respir Med. 2021 Nov 2;190:106676. doi: 10.1016/j.rmed.2021.106676. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: The main target of inspiratory muscle training (IMT) is to improve diaphragm function in patients with COPD who have inspiratory muscle weakness. Ventilatory demand is already increased during quiet breathing in patients with COPD, and whether threshold load imposed by IMT would active more accessory muscle remained to be determined. The purpose of this study was to examine diaphragm and sternocleidomastoid (SCM) activation during IMT with intensities of 30% and 50% maximal inspiratory pressure (P_Imax).

METHODS: Patients with COPD and a P_Imax lower than 60 cmH₂O were recruited for the study. Surface electromyography (EMG) was used to measure diaphragm and SCM activation, and group-based trajectory modeling (GBTM) was used to identify activation patterns during IMT. The generalized estimating equation (GEE) was then used to detect differences of variables between various breathing tasks. Statistical significance was established at p < 0.05.

RESULTS: A total of 30 patients with COPD participated in this study. All patients demonstrated significant increases in diaphragm and SCM activation during 30% and 50% P_Imax of IMT than during quiet breathing (all p < 0.001). Diaphragm demonstrated two distinct patterns in response to IMT: low activation (n = 8) and high activation (n = 22) group using GBTM analysis.

CONCLUSION: Diaphragm and SCM were substantially activated during IMT in patients with COPD who had inspiratory muscle weakness. Regardless of whether diaphragm activation was high or low, SCM was activated to a greater extent in response to IMT.

PMID:34773734 | DOI:10.1016/j.rmed.2021.106676