Category: Statistics

Nat Commun. 2021 Jun 29;12(1):4013. doi: 10.1038/s41467-021-24250-1.

ABSTRACT

Future warming in the Mediterranean is expected to significantly exceed global values with unpredictable implications on the sea-level rise rates in the coming decades. Here, we apply an empirical-Bayesian spatio-temporal statistical model to a dataset of 401 sea-level index points from the central and western Mediterranean and reconstruct rates of sea-level change for the past 10,000 years. We demonstrate that the mean rates of Mediterranean industrial-era sea-level rise have been significantly faster than any other period since ~4000 years ago. We further highlight a previously unrecognized variability in Mediterranean sea-level change rates. In the Common Era, this variability correlates with the occurrence of major regional-scale cooling/warming episodes. Our data show a sea-level stabilization during the Late Antique Little Ice Age cold event, which interrupted a general rising trend of ~0.45 mm a^-1 that characterized the warming episodes of the Common Era. By contrast, the Little Ice Age cold event had only minor regional effects on Mediterranean sea-level change rates.

PMID:34188029 | DOI:10.1038/s41467-021-24250-1

J Hypertens. 2021 Aug 1;39(8):1602-1610. doi: 10.1097/HJH.0000000000002822.

ABSTRACT

BACKGROUND: Guidelines recommend to start blood pressure (BP)-lowering drugs also according to cardiovascular risk including history of cardiovascular events. We hypothesized that in patients with a history of myocardial infarction (MI), stroke, both or none of those, the index events predict the next event and have different SBP risk associations to different cardiovascular outcomes.

DESIGN AND MEASUREMENTS: In this pooled posthoc, nonprespecified analysis, we assessed outcome data from high-risk patients aged 55 years or older with a history of cardiovascular events or proven cardiovascular disease, randomized to the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial and to Telmisartan Randomized Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease Trial investigating telmisartan, ramipril and their combination with a median follow-up of 56 months. Standardized office BP was measured every 6 months. Associations of mean achieved BP on treatment were investigated on MI, stroke and cardiovascular death. We identified patients with previous MI (N = 13 487), stroke (N = 4985), both (N = 1509) or none (N = 10 956) of these index events. Analyses were done by Cox regression, analysis of variance and Chi2-test. 30 937 patients with complete data were enrolled between 1 December 2001 and 31 July 2003, and followed until 31 July 2008. Data of both trials were pooled as the outcomes were similar.

RESULTS: Patients with MI as index event had a higher risk to experience a second MI [hazard ratio 1.42 (confidence interval (CI) 1.20-1.69), P < 0.0001] compared with patients with no events but no increased risk for a stroke as a next event [hazard ratio 0.95 (CI 0.73-1.23), n.s.]. The risk was roughly doubled when they had both, MI and stroke before [hazard ratio 2.07 (CI 1.58-2.71), P < 0.0001]. Patients with a stroke history had a roughly three-fold higher likelihood to experience a second stroke [hazard ratio 2.89 (CI 2.37-3.53) P < 0.0001] but not MI [hazard ratio 1.07 (CI 0.88-1.32), n.s.]. Both types of index events increased roughly three-fold the risk of a second stroke compared with no previous events. The SBP-risk relationship was not meaningfully altered by the event history. After MI and stroke the risk for subsequent events and cardiovascular death was increased over the whole SBP spectrum. A J-shape relationship between BP and outcome was only observed for cardiovascular death.

CONCLUSION: Previous MI and previous stroke are associated with increased risk for the same event in the future, independent of achieved SBP. Thus, secondary prevention may also be chosen according to the event history of patients.

CLINICAL TRIAL REGISTRATION: http://clinicaltrials.gov. Unique identifier: NCT00153101.

PMID:34188004 | DOI:10.1097/HJH.0000000000002822

J Hypertens. 2021 Aug 1;39(8):1726-1727. doi: 10.1097/HJH.0000000000002877.

NO ABSTRACT

PMID:34188008 | DOI:10.1097/HJH.0000000000002877

Med Sci Monit. 2021 Jun 30;27:e929454. doi: 10.12659/MSM.929454.

ABSTRACT

BACKGROUND COVID-19 (coronavirus disease 2019) broke out in China. This study was to investigate the situation of mental health status among medical staff following COVID-19. MATERIAL AND METHODS A cross-sectional study was conducted through structured questionnaires to collect the demographical information of the participating medical staff via WeChat following COVID-19 crisis. The Center for Epidemiologic Studies-Depression Scale (CES-D), impact of events scale revised (IES-R), and Pittsburgh Sleep Quality Index (PSQI) scale were used to evaluate depression, post-traumatic stress disorder (PTSD) symptoms, and sleep quality, respectively. 95% confidence intervals (CI) were calculated. RESULTS A total of 597 medical staff’s information was included for the statistical analysis, and found 45.23% of subjects had PTSD symptoms, the mean PSQI score was 6.320±3.587. The results of multivariable analysis implied that medical workers who did not participate in the Hubei aid program (ß=4.128; 95% CI, 0.983-7.272; P=0.010) and PTSD symptoms (ß=7.212; 95% CI, 4.807-9.616; P<0.001) were associated with a higher tendency to depression. The PSQI score was linearly related to the CES-D score (ß=1.125; 95% CI, 0.804-1.445; P<0.001). Subgroup analysis showed that medical workers who did not participate in the Hubei aid program, no traumatic experience before COVID-19 outbreaks, and PTSD symptoms may affect the tendency to depression in females, but not in males. PSQI score was linearly related to the CES-D score both in males and females. CONCLUSIONS The medical staff with PTSD symptoms and higher PSQI score may have a higher tendency to depression following COVID-19 outbreaks.

PMID:34188013 | DOI:10.12659/MSM.929454

J Korean Assoc Oral Maxillofac Surg. 2021 Jun 30;47(3):197-208. doi: 10.5125/jkaoms.2021.47.3.197.

ABSTRACT

OBJECTIVES: The purpose of this retrospective study was to evaluate the variables associated with length of stay (LOS), hospital costs, intensive care unit (ICU) use, and treatment outcomes in patients hospitalized for maxillofacial infections at a tertiary medical center in South Korea.

MATERIALS AND METHODS: : A retrospective chart review was conducted for patients admitted for treatment of maxillofacial infections at Dankook University Hospital from January 1, 2011 through September 30, 2020. A total of 390 patient charts were reviewed and included in the final statistical analyses.

RESULTS: : Average LOS and hospital bill per patient of this study was 11.47 days, and ₩4,710,017.25 ($4,216.67), respectively. Of the 390 subjects, 97.3% were discharged routinely following complete recovery, 1.0% expired following treatment, and 0.8% were transferred to another hospital. In multivariate linear regression analyses to determine variables associated with LOS, admission year, infection side, Flynn score, deep neck infection, cardiovascular disease, admission C-reactive protein (CRP) and glucose levels, number and length of surgical interventions, tracheostomy, time elapsed from admission to first surgery, and length of ICU stay accounted for 85.8% of the variation. With regard to the total hospital bill, significantly associated variables were age, type of insurance, Flynn score, number of comorbidities, admission CRP, white blood cell, and glucose levels, admission temperature, peak temperature, surgical intervention, the length, type, and location of surgery, tracheostomy, time elapsed from admission to first surgery, and length of ICU use, which accounted for 90.4% of the variation. Age and ICU use were the only variables significantly associated with unfavorable discharge outcomes in multivariate logistic regression analysis.

CONCLUSION: For successful and cost-effective management of maxillofacial infections, clinicians to be vigilant about the decision to admit patients with maxillofacial infections, perform appropriate surgery at an adequate time, and admit them to the ICU.

PMID:34187960 | DOI:10.5125/jkaoms.2021.47.3.197

J Hypertens. 2021 Aug 1;39(8):1586-1593. doi: 10.1097/HJH.0000000000002802.

ABSTRACT

OBJECTIVE: Data are sparse regarding the impact of sodium and potassium intakes on serial blood pressure (BP) levels during long-term follow-up.

METHODS: Among 1007 Coronary Artery Risk Development in Young Adults participants (mean age, 30.2 years; 53% blacks; 57% women) who had at least two 24-h urine samples collected at year 5 (Y5) examination, we assessed associations of urinary sodium and potassium excretions with BP trends and incident hypertension in the subsequent 25 years. Participants were classified by sex-specific medians for averaged 24-h urinary excretions: lower sodium and higher potassium (Na-Lo-K-Hi); higher sodium and lower potassium (Na-Hi-K-Lo); and others.

RESULTS: In the adjusted generalized estimating equation model, SBP and DBP greatly increased in the Na-Hi-K-Lo group (n = 185) compared with the Na-Lo-K-Hi group (n = 185), with statistically significant BP differences at Y20, Y25, and Y30 (mean SBP, 3.93, 4.94, and 4.88 mmHg, respectively; and mean DBP, 4.70, 4.95, and 4.59 mmHg, respectively). During 25-year follow-up, among 926 participants without prevalent hypertension by Y5, 381 (41.1%) developed hypertension. In the adjusted Cox proportional hazards model, the Na-Hi-K-Lo group had hazard ratio (95% confidence interval), 1.45 (1.00-2.10) for incident hypertension compared with the Na-Lo-K-Hi group. The association with incident hypertension was predominant in blacks and white women (race–sex interaction, P = 0.03). Sodium-to-potassium ratio and sodium excretion were positively, whereas potassium excretion was inversely, associated with incident hypertension (all P trend <0.05).

CONCLUSION: Our findings highlight the importance of dietary sodium reduction and higher potassium intake for hypertension prevention among young adults.

PMID:34188003 | DOI:10.1097/HJH.0000000000002802

Ortop Traumatol Rehabil. 2021 Jun 30;23(3):157-165. doi: 10.5604/01.3001.0014.9152.

ABSTRACT

BACKGROUND: Adhesive Capsulitis of shoulder (AdCS) is a treatment dilemma for surgeons. Intraarticular Corticosteroid Injection (IACI) has shown only short-term benefit in improving shoulder-related disability. Suprascapular nerve block (SSNB) has shown promise in trials in reducing chronic shoulder pain. Thus a RCT was conducted to compare the efficacy of SSNB versus IACI in the treatment of AdCS.

MATERIAL AND METHODS: 86 patients with AdCS were divided into SSNB and IACI groups by block randomization. SSNB group received single Suprascapular Nerve Block with 10ml of 0.5% Bupivacaine while IACI group received single injection of 40mg Triamcinolone and 1ml 2% Lignocaine in the shoulder; both followed by physiotherapy and followed-up and evaluated with SPADI and modified Constant scores at 1, 6 and 12 weeks.

RESULTS: Statistically significant improvements occurred in both groups. At 12 weeks, the SPADI and Con-stant score for SSNB improved to 9.62±10.07 and 36.95±3.43 respectively (p&lt;0.001); and for IACI improved to 11.65±5.56 and 35.07±3.32 respectively (p &lt;0.001). The difference in the scores between the 2 groups at 1st and 6th week was insignificant, but was statistically significant in favour of SSNB at 12 weeks (p=0.002).

CONCLUSIONS: 1. Thus, from the present study it can be concluded that both Suprascapular Nerve Block and Intra-articular Corticosteroid injection are effective mo-dalities of treatment for Adhesive Capsulitis of the shoulder. 2. Suprascapular Nerve Block increased patients’ pain tolerability for effective mobilization, the effect be-ing persistent even at 12 weeks following injection. 3. It was safer than Intra-articular Corticosteroid in-jection with less incidence of adverse effects in our study and the literature. 4. It is an easy-to-perform outpatient procedure, with minimal chance of infection and other complications. 5. In light of the above, we may recommend Su-prascapular Nerve Block as the initial procedure of choice in patients with Adhesive Capsulitis of Shoulder.

PMID:34187937 | DOI:10.5604/01.3001.0014.9152

Ortop Traumatol Rehabil. 2021 Jun 30;23(3):193-203. doi: 10.5604/01.3001.0014.9157.

ABSTRACT

BACKGROUND: The aim of the study was to assess the activity of the vastus lateralis (VAL) and vastus medialis (VAM) within 3-5 years after anterior cruciate ligament (ACL) reconstruction with a LARS synthetic ligament (the Ligament Advanced Reinforcement System) compared to muscle activity in the non-operated limb and in the limbs of the controls during selected functional tests.

MATERIAL AND METHODS: 20 men after ACL reconstruction using LARS synthetic ligament were qualified to the study group. The control group included 20 healthy men. Lysholm scale used to assess the functionality of the knee joint. To test muscle activity, TELEMYO DTS surface electromyography (sEMG) recording kit by Noraxon was used. The examined muscles on both limbs were the VAL and the VAM. The subjects were asked to perform the test-movements (dynamic ascent and descent from 25 cm step and slowly squats).

RESULTS: Statistically significant differences were noted only for the values of VAL SA_SD (the quotients of mean sEMG values of the VAL muscle during step ascent – SA and descent -SD; Z=2.83; p=0.0047) and VAM SA_SD (Z=1.98; p=0.0401) parameters. In each analyzed parameter higher values were recorded among people from the control group. Weak but significant correlations were found between the VAL and VAM: SA_SD and the results obtained on the Lysholm Scale.

CONCLUSIONS: 1. In the group of patients after LARS, quadriceps activity disorders persisted in tested dynamic activities. 2. In the therapy planning or sports training in the distant period after ACL reconstruction with LARS, emphasis should be placed on quadriceps muscle training, and the sEMG test may be helpful in optimizing the management strategy.

PMID:34187938 | DOI:10.5604/01.3001.0014.9157

Saudi Med J. 2021 Jul;42(7):728-734. doi: 10.15537/smj.2021.42.7.20200797.

ABSTRACT

OBJECTIVES: To estimate the prevalence mono-resistant tuberculosis (MR-TB) and multidrug resistant TB (MDR-TB), and evaluate the risk factors associated with the drug-resistant tuberculosis (DR-TB).

METHODS: A descriptive, retrospective study was applied, utilizing the TB patients’ medical records at King Fahd Armed Forces Hospital (KFAFH), Jeddah, Saudi Arabia. The records of patients notified between 2000 and 2018 were reviewed and culture positive cases for Mycobacterium tuberculosis species were included. Moreover, the risk factors included were age, gender, smoking history, renal disease, liver disease, hyperbilirubinemia, diabetes mellitus, and human immunodeficiency virus (HIV).

RESULTS: Nine hundred and one cases in entirety were involved in the research, out of which 193 had drug-resistant tuberculosis (DR-TB) (21.4%). Out of the 21.4% DR-TB, 91.7% were MR-TB and 8.3% were MDR-TB. The highest MR prevalence was for pyrazinamide at 33.4%, while the lowest resistance was for ethambutol at 7.1%. For the risk factors of drug-resistant TB, only age depicted a statistically significant (p<0.01) but weak negative (r= -0.145) correlation with anti-TB drug resistance.

CONCLUSION: Rates of DR-TB reported in the study are considered higher compared to the recently reported national and international rates. According to the results, only younger people are at risk of developing DR-TB. Moreover, genetic mutation may play a role in drug resistance among our cases specifically for pyrazinamide monoresistance.

PMID:34187916 | DOI:10.15537/smj.2021.42.7.20200797

Saudi Med J. 2021 Jul;42(7):769-775. doi: 10.15537/smj.2021.42.7.20200750.

ABSTRACT

OBJECTIVES: To compare the clinicopathological, histological and immunohistochemical features of breast cancer (BC) in between young (≤40 years) and older (>40 years) patients.

METHODS: This retrospective study included histopathological reports of all patients with primary BC diagnose at the King Fahad Hospital, Madinah, Saudi Arabia between January 2006 and November 2020.

RESULTS: During the study period, a total of 708 patients with BC were identified; 173 cases (24.4%) were ≤40 years old and 535 (75.6%) were above 40 years. There were significant differences in tumor size (p=0.046), tumor grade (p<0.0001), tumor stage (p=0.047), lymphovascular invasion (p<0.0001), and distant metastasis (p<0.0001) between the 2 groups. Comparing the status of the hormone receptors and molecular subtypes between the 2 age groups, BCs in the younger patients were triple-negative (p=0.008) in majority of the cases and less likely to be estrogen receptor (ER) and progesterone receptor (PR) hormone receptors-positive (p=0.0001, p<0.0001). Young patients exhibited the HER2/neu type with more frequent statistical significance (p=0.016) and the tumor type luminal A (p=0.002) with less frequent statistical significance compared to old patients.

CONCLUSION: Although BC in young women is uncommon, it may be different with regards to poor prognostic outcomes, which are attributed to more aggressive histopathological features and less favorable receptor status when compared to the cases diagnosed in older women.

PMID:34187921 | DOI:10.15537/smj.2021.42.7.20200750