Category: Statistics

Phys Med Biol. 2021 Jul 12. doi: 10.1088/1361-6560/ac1366. Online ahead of print.

ABSTRACT

Microdosimetry is an important tool for assessing energy deposition distributions from ionizing radiation at cellular and cellular nucleus scales. It has served as an input parameter for multiple common mathematical models, including evaluation of relative biological effectiveness (RBE) of carbon ion therapy. The most common detector used for microdosimetry is the tissue-equivalent proportional counter (TEPC). Although widely applied, the TEPC has various inherent uncertainties. Therefore, this work quantified the magnitude of TEPC measurement uncertainties and their impact on RBE estimates for therapeutic carbon beams. Microdosimetric spectra and frequency-, dose-, and saturation-corrected dose-mean lineal energy (y_F,y_D,y^∗) were calculated using the Monte Carlo toolkit Geant4 for five monoenergetic and three SOBP carbon beams in water at every millimeter along the central beam axis. We simulated the following influences on these spectra from eight sources of uncertainty: wall effects, pulse pile-up, electronics, gas pressure, W-value, gain instability, low energy cut-off, and counting statistics. statistic uncertainty was quantified as the standard deviation of perturbed values for each source. Bias was quantified as the difference between default lineal energy values and the mean of perturbed values for each systematic source. Uncertainties were propagated to RBE using the modified microdosimetric kinetic model (MKM). Variance introduced by statistic sources iny_Fandy_Daveraged 3.8% and 3.4%, respectively, and 1.5% iny^∗across beam depths and energies. Bias averaged 6.2% and 7.3% iny_Fandy_D, and 4.8% iny^∗. These uncertainties corresponded to 1.2±0.9% on average in RBE_MKM. The largest contributors to variance and bias were pulse pile-up and wall effects. This study established an error budget for microdosimetric carbon measurements by quantifying uncertainty inherent to TEPC measurements. It is necessary to understand how robust the measurement of RBE model input parameters are against this uncertainty in order to verify clinical model implementation.

PMID:34252894 | DOI:10.1088/1361-6560/ac1366

Meat Sci. 2021 Jul 7;182:108621. doi: 10.1016/j.meatsci.2021.108621. Online ahead of print.

ABSTRACT

The objective of this study was to determine whether the addition of different pollen powder concentrations (0.0, 0.5, 1.0 and 1.5 g/100 g) to frankfurters had an influence on antioxidant potential and oxidative changes during storage, without detrimental effect on the quality of sausages. After cold storage of frankfurters, significant (P < 0.05) reductions of psychrotrophic bacteria populations were achieved with higher amounts of pollen (1.0 and 1.5 g/100 g). Good antioxidant properties and maintained TBARS values were accomplished by incorporating pollen into the frankfurters. In terms of quality parameters, statistically significant changes were obtained regarding the color, but sensory characteristics of the products were not disturbed. Also, the incorporation of pollen did not cause changes in terms of texture profile analyses of frankfurters. It can be concluded that the natural component, bee pollen powder, can be used as an antioxidant in frankfurter formulations, but further research is needed to estimate whether it can be an adequate replacement for synthetic antioxidants.

PMID:34252842 | DOI:10.1016/j.meatsci.2021.108621

Early Hum Dev. 2021 Jul 4;160:105423. doi: 10.1016/j.earlhumdev.2021.105423. Online ahead of print.

ABSTRACT

BACKGROUND: The number of children with prenatal polysubstance exposure is increasing. Supportive mother-child interaction is a protective factor, which can ameliorate adverse effects of prenatal polysubstance exposure on developmental outcomes.

AIM: To examine the role of maternal verbal scaffolding on cognitive and language development in children with prenatal polysubstance exposure.

STUDY DESIGN: Pregnant women were recruited, and we prospectively followed mother-child dyads to 20 months of age. This analysis included 66 dyads (33 healthy controls and 33 with prenatal polysubstance exposure). Multivariable linear regression modelling was used to examine the cross-sectional association between maternal scaffolding and Bayley Scales of Infant and Toddler Development (BSID-III) score, as well as an interaction between the study group and scaffolding score.

OUTCOME MEASURES: The BSID-III cognitive and language score was used. Videotaped mother-child play was coded to obtain a maternal verbal scaffolding score. Effect sizes were measured using average differences in scores between groups.

RESULTS: There was no evidence of an association between study group and maternal scaffolding scores. Children in the polysubstance exposure group had lower cognitive and language scores compared to controls, but this association was not statistically significant after controlling for maternal education. Maternal scaffolding was predictive of language scores, with scores increasing by 1.24 points on average (95% CI: 0.42, 2.06) for every 1-point increase in scaffolding score after adjustment for covariates. There was no evidence of a study group-by-scaffolding interaction with respect to the language or cognitive scores.

CONCLUSIONS: Maternal scaffolding during play was associated with language development in children with and without prenatal polysubstance exposure.

PMID:34252844 | DOI:10.1016/j.earlhumdev.2021.105423

Neuromodulation. 2021 Jul 12. doi: 10.1111/ner.13495. Online ahead of print.

ABSTRACT

OBJECTIVES: The efficacy of repetitive transcranial magnetic stimulation (rTMS) in clinically relevant neuroplasticity research depends on the degree to which stimulation induces robust, reliable effects. The high degree of interindividual and intraindividual variability observed in response to rTMS protocols, such as continuous theta burst stimulation (cTBS), therefore represents an obstacle to its utilization as treatment for neurological disorders. Brain-derived neurotrophic factor (BDNF) is a protein involved in human synaptic and neural plasticity, and a common polymorphism in the BDNF gene (Val66Met) may influence the capacity for neuroplastic changes that underlie the effects of cTBS and other rTMS protocols. While evidence from healthy individuals suggests that Val66Met polymorphism carriers may show diminished or facilitative effects of rTMS compared to their homozygous Val66Val counterparts, this has yet to be demonstrated in the patient populations where neuromodulatory therapies are most relevant.

MATERIALS AND METHODS: We examined the effects of BDNF Val66Met polymorphism on cTBS aftereffects in stroke patients. We compared approximately 30 log-transformed motor-evoked potentials (LnMEPs) obtained per time point: at baseline and at 0, 10, 20, and 30 min after cTBS-600, from 18 patients with chronic stroke using single TMS pulses. We used linear mixed-effects regression with trial-level data nested by subject for higher statistical power.

RESULTS: We found a significant interaction between BDNF genotype and pre-/post-cTBS LnMEPs. Val66Val carriers showed decrease in cortical excitability, whereas Val66Met carriers exhibited a modest increase in cortical excitability for 20 min poststimulation, followed by inhibition 30 min after cTBS-600.

CONCLUSIONS: Our findings strongly suggest that BDNF genotype differentially affects neuroplastic responses to TMS in individuals with chronic stroke. This provides novel insight into potential sources of variability in cTBS response in patients, which has important implications for optimizing the utility of this neuromodulation approach. Incorporating BDNF polymorphism genetic screening to stratify patients prior to use of cTBS as a neuromodulatory technique in therapy or research may optimize response rates.

PMID:34252254 | DOI:10.1111/ner.13495

Mycoses. 2021 Jul 12. doi: 10.1111/myc.13352. Online ahead of print.

ABSTRACT

BACKGROUND: Detection of galactomannan (GM) from bronchoalveolar lavage fluid (BALF) or serum is broadly used for diagnosis of invasive aspergillosis (IA), although the sensitivity of GM from serum is lower in non-neutropenic patients. We evaluated the Aspergillus galactomannan lateral flow assay (LFA) with digital readout from serum in a mixed cohort of patients.

METHODS: We performed a retrospective two-center study evaluating the LFA from serum of patients with clinical suspicion of IA obtained between 2015 and 2021 at the University of California San Diego (UCSD) and the Medical University of Graz. The sensitivity and specificity was calculated for proven/probable aspergillosis versus no aspergillosis. Correlation with same-sample GM was calculated using Spearman correlation analysis and kappa statistics.

RESULTS: In total, 122 serum samples from 122 patients were analyzed, including proven IA (n=1), probable IA or coronavirus-associated pulmonary aspergillosis (CAPA) (n=27), and no IA/CAPA/non-classifiable (n=94). At a 0.5 ODI cutoff, the sensitivity and specificity of the LFA was 78.6% and 80.5%. Spearman correlation analysis showed a strong correlation between serum LFA ODI and serum GM ODI (rho 0.459, p<0.0001). Kappa was 0.611 when both LFA and GM were used with a 0.5 ODI cutoff, showing substantial agreement (p<0.001).

DISCUSSION: The LFA with digital read out from serum showed good performance for the diagnosis of probable/proven aspergillosis, with substantial agreement to GM from serum. Like the LFA from BALF, the LFA from serum may serve as a more rapid test compared to conventional GM, particularly in settings where GM is not readily available.

PMID:34252244 | DOI:10.1111/myc.13352

Cancer Sci. 2021 Jul 12. doi: 10.1111/cas.15060. Online ahead of print.

ABSTRACT

In Japan, the age-adjusted incidence of cervical cancer has been increasing constantly and rapidly among younger women. We set out to accurately confirm the effectiveness of the HPV vaccine in Japan. Data was collected for women born in the fiscal year (FY) 1990 to 1997, who became eligible for their 20-year-old cervical cancer screening between the FY 2010 to 2017. The adjusted incidence of CIN1+ in women born in FY 1990 to 1993, i.e., those who reached the national vaccination target age prior to the introduction of publicly-subsidized HPV vaccinations, referred here after as ‘the pre-introduction generation’, was 1.42% (242/17,040). The incidence in the ‘vaccination generation’ (women born in FY 1994 to 1997, i.e., those who were heavily vaccinated as a group when they were of the nationally targeted age of 13-16) was 1.66% (135/8,020). There was no significant difference between these incidence rates. However, our FY birth year-by-year analysis revealed that the incidence of CIN1+ was obviously lower than that predicted based on just the tendency for CIN1+ seen in the pre-introduction generation. Our analysis revealed that the incidence of CIN3+ was obviously lower in the vaccinated generation than in the pre-introduction generation (p=0.0008) . The incidence of CIN was already tending to increase in both the pre-introduction and vaccination generations. The changes in CIN incidence by individual birth FY must be examined to accurately determine the actual affects of the HPV vaccine for reducing mild cervical lesions.

PMID:34252250 | DOI:10.1111/cas.15060

Neurourol Urodyn. 2021 Jul 12. doi: 10.1002/nau.24737. Online ahead of print.

ABSTRACT

AIMS: To investigate the clinical characteristics of health care-seeking men presenting with lower urinary tract symptoms (LUTS) in China and to reveal risk factors for symptom severity.

METHODS: This multicenter, hospital-based, cross-sectional study recruited 1477 eligible male subjects, who were at least 45 years, seeking health care at 9 participating hospitals across the mainland China. The general medical information and subjective symptoms were recorded, followed by the measurement of prostate volume, urodynamic indices, and laboratory tests for kidney function, plus glucose/lipid metabolism. Univariate and multivariate linear regression were employed for the detection of risk factors for symptom severity.

RESULTS: The proportion of mild, moderate, and severe LUTS was 14.6%, 32.6%, and 52.8%, respectively, with 62.2% reporting the triple combination of storage, voiding, and postmicturition symptoms. Median prostate volume was 44.6 ml, and 71.1% were experiencing comorbidities. Thirteen independent risk factors for LUTS severity were identified, namely, nocturnal voiding episodes and the presence of straining and weak steam; the triple combination of symptom subtypes; general and nocturia quality of life; Q_max and bladder outlet obstruction index; and numbers of comorbidities, hypertension, estimated glomerular filtration rate, and cholesterol and glycosylated hemoglobin.

CONCLUSIONS: The majority of health care-seeking LUTS men present with moderate-to-severe and overlapping symptoms, with a high prevalence of both lower urinary tract dysfunction and systemic comorbidities. The evidence from both urological and nonurological independent risk factors demonstrate the multifactorial nature of LUTS, for which a multidisciplinary management is essential.

PMID:34252243 | DOI:10.1002/nau.24737

J Am Geriatr Soc. 2021 Jul 12. doi: 10.1111/jgs.17363. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the age-related differences in the association between level of acculturation and perceptions about change in health status after migration in mid- to late-life immigrants.

DESIGN: Cross-sectional study.

SETTING: Nationally representative cohort of legal U.S. immigrants.

PARTICIPANTS: Legal immigrants ≥50 years of age.

MEASUREMENTS: The outcome was perceived change in health status, determined by the survey question, “compared with your health right before you most recently came to the United States to live, would you say that your health is better now, about the same or worse?” The main predictor included age group (50-64, 65-74, and ≥75 years) and secondary variable of interest was level of acculturation. Analyses were adjusted for demographic characteristics, medical, and functional comorbidities.

RESULTS: Immigrants age ≥75 years were more likely to report worse health after migration [RRR 1.93, 95% CI (1.17, 3.17), p < 0.01] compared with immigrants of 50-64 years, but this difference was not statistically significant in the adjusted model. Acculturation level was associated with increased likelihood of reporting worse health status, [RRR 2.10, (1.02, 4.35), p < 0.05] for somewhat acculturated and [RRR 2.55, (1.10, 5.88), p < 0.05] for most acculturated, compared with participants who were not acculturated.

CONCLUSION: The oldest immigrant group (≥75 years) was more likely to report worse health after migration, but this association was no longer significant after accounting for acculturation level and other covariates. Future work should be undertaken to identify specific health needs across older immigrant age groups and identify acculturative stressors that negatively impact health.

PMID:34252200 | DOI:10.1111/jgs.17363

Acta Anaesthesiol Scand. 2021 Jul 12. doi: 10.1111/aas.13949. Online ahead of print.

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) is a common complication of cardiopulmonary bypass (CPB), associated with increased mortality in surgical patients. It is well proven that Th17 and its hallmark cytokine, IL-17, contribute to AKI development. Since the RAR-related orphan receptor C (RORC) gene is a master regulator of the Th17 differentiation, we aimed to evaluate the association between its polymorphisms, CPB-AKI and plasma IL-17 levels among Iranian patients undergoing cardiopulmonary bypass.

METHOD: Totally, 138 patients undergoing cardiopulmonary bypass in Bandar Abbas, Iran, were enrolled. The allele and genotype frequencies of the selected SNPs were determined using PCR-SSP. IL-17 serum level was determined using an enzyme-linked immunosorbent assay.

RESULTS: Rs9017 GG genotype and G allele were associated with increased risk of CPB-AKI (OR=3, 95% CI=1.4-6.6 and OR=2.3, 95% CI=1.3-3.9 respectively) while A allele was protective against the disease (OR=0.4, 95% CI=0.3-0.7, P=0.02). There was not a statistically significant interaction between the three genotypes of rs9017 and AKI disease with IL-17 serum level before (P=0.9) and after (P=0.6) the operation. The IL-17 serum level before surgery was significantly higher in patients carrying GG genotype compared to GA genotype (P=0.017).

CONCLUSION: Our results showed that the rs9017 GG genotype was associated with an increased level of IL-17 and risk of CBP-AKI in the Iranian population. Our current results suggest that the rs9017 GG genotype could be a probable predictor of AKI after cardiac surgery.

PMID:34252205 | DOI:10.1111/aas.13949

Sleep. 2021 Jul 12:zsab175. doi: 10.1093/sleep/zsab175. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: Sleep problems and problematic internet use have important implications for adolescent health; however, there have been no large-scale surveys using comprehensive measures. We examined the association between internet use duration and sleep problems among Japanese adolescents.

METHODS: We used data from the Lifestyle Survey of Adolescents collected in 2012, 2014, and 2017. We calculated the change in sleep status (insomnia, sleep duration, bedtime, and sleep quality) and internet usage (screen time and services such as internet surfing, social media use, streaming such as YouTube, and online gaming). A binary logistic model was estimated for insomnia. Generalized ordered logit models were employed for the ordinal outcomes (sleep duration, bedtime, sleep quality, and multidimensional sleep health). Sampling weights were constructed based on participation rate on survey years and selection rates from population statistics.

RESULTS: We analyzed data from 248,983 adolescents. Sleep status was unchanged; however, many adolescents used more internet services and for longer durations. The odds ratio of internet screen time for all sleep problems (insomnia, shorter sleep duration, later bedtime, and worse sleep quality) gradually declined. Longer internet screen time (> 5 hours) was strongly associated with all sleep problems. Internet services were also associated with sleep problems; particularly, social media use and online gaming were linked to later bedtimes.

CONCLUSIONS: Despite the decreased strength in the association between internet usage and sleep problems, longer internet time was strongly associated with sleep problems. Public health interventions should consider internet use as an intervention target to improve adolescents’ health.

PMID:34252182 | DOI:10.1093/sleep/zsab175