Category: Statistics

J Magn Reson Imaging. 2022 Feb 25. doi: 10.1002/jmri.28131. Online ahead of print.

ABSTRACT

BACKGROUND: Early detection and grading of liver inflammation are important for the management of nonalcoholic fatty liver disease (NAFLD) patients. There is still lack of a noninvasive way for the inflammation characterization in NAFLD.

PURPOSE: To assess liver inflammation grades by water specific T1 (wT1) in a rat model.

STUDY TYPE: Prospective.

ANIMAL MODEL: A total of 65 male rats with methionine-choline-deficient diet-induced NAFLD and 15 male normal rats as control.

FIELD STRENGTH/SEQUENCE: A 3 T; multiecho variable flip angle gradient echo sequence.

ASSESSMENT: The wT1 and proton density fat fraction were quantified. Inflammation and fibrosis were assessed histologically with H&E and Sirius red stained slices according to the nonalcoholic steatohepatitis scoring system. Inflammation grade was scored with G0/G1/G2/G3 as none/mild/moderate/severe inflammation in NALFD rats. G0 + G1 and G2 + G3 were combined as none-to-mild grade (GL) and moderate-to-severe grade (GH) inflammation groups.

STATISTICAL TESTS: Analysis of variance (ANOVA), Mann-Whitney U test, Spearman’s correlation, and receiver operating characteristic (ROC) analysis were performed. The areas under ROC (AUROC) was used for the diagnostic performance of wT1 in discriminating GH and GL. A P value < 0.01 was considered statistically significant.

RESULTS: Seventy-six rats were included in the analysis. The numbers in G0-G3 groups were 5, 16, 13, and 27. wT1 of G0-G3 was 568.55 ± 63.93 msec, 582.53 ± 62.98 msec, 521.21 ± 67.31 msec, and 508.79 ± 60.53 msec. A moderate but significant negative correlation between wT1 and histopathological inflammation grades was observed (r_s = -0.42). The wT1 of GH (512.80 ± 62.22 msec) was significantly lower than GL (579.20 ± 61.89 msec). The AUROC of wT1 was 0.79, and the optimal cut-off of wT1 was 562.64 msec (sensitivity: 90%, specificity: 76%), for the discrimination of GL and GH. DATA CONCLUSIONS: wT1 could differentiate none-to-mild inflammation from moderate-to-severe inflammation in the early stage of the NAFLD rat model.

EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 1.

PMID:35212074 | DOI:10.1002/jmri.28131

Pediatr Allergy Immunol. 2022 Feb;33(2):e13740. doi: 10.1111/pai.13740.

ABSTRACT

BACKGROUND: Human milk oligosaccharides (HMOs) have several biological functions. Yet, very few studies have investigated the effect of HMOs on the development of allergies and even fewer on their specific associations with atopic dermatitis (AD) during early childhood.

OBJECTIVE: This study investigated whether individual HMO concentrations, measured at two time points of lactation, were associated with reported diagnosis of AD in children up to two years of age.

METHOD: Outcome data were available for HMOs measured in human milk samples collected at 6 weeks (n = 534) and 6 months (n = 356) of lactation. Associations of HMOs with AD, ascertained from parents and pediatricians at ages one and two years, were assessed in crude and adjusted logistic regression models.

RESULTS: Few associations were statistically significant at the conventional level (p < .05), for example, 6-week Lacto-N-neotetraose with 2-year AD [OR 95%CI: 0.82 (0.66, 1.00)] and 6-month 3′-sialyllactose among non-secretor mothers with 1-year AD [2.59 (1.53, 6.81)]. Importantly, accounting for multiple testing, these and all further associations were not statistically significant (all p > .0031, which is the threshold for statistical significance after correction for multiple testing).

CONCLUSION: Our findings suggest that the intake of different levels (or even absence) of the individual HMOs measured at 6 weeks and 6 months of lactation, in the current study, is not significantly associated with the development of AD in early childhood. Given the exploratory nature of our study and the limited sample size, these results should be interpreted with caution. The specific HMOs for which we show plausible associations at conventional level may warrant further research and investigation.

PMID:35212042 | DOI:10.1111/pai.13740

Mycoses. 2022 Feb 25. doi: 10.1111/myc.13435. Online ahead of print.

ABSTRACT

BACKGROUND: The second COVID-19 wave in India has been associated with an unprecedented increase in cases of COVID-19 associated mucormycosis (CAM), mainly Rhino-orbito-cerebral mucormycosis (ROCM).

METHODS: This retrospective cohort study was conducted at Noble hospital and Research Centre (NHRC), Pune, India between 1^st April 2020 and 1^st August 2021 to identify CAM patients and assess their management outcomes. The primary endpoint was incidence of all-cause mortality due to CAM.

RESULTS: 59 patients were diagnosed with CAM. Median duration from the first positive COVID-19 RT PCR test to diagnosis of CAM was 17 (IQR: 12,22) days. 90% patients were diabetic with 89% having uncontrolled sugar level (HbA1c >7%). All patients were prescribed steroids during treatment for COVID-19. 56% patients were prescribed steroids for non-hypoxemic, mild COVID-19 (irrational steroid therapy) while in 9%, steroids were prescribed in inappropriately high dose. Patients were treated with a combination of surgical debridement (94%), intravenous liposomal Amphotericin B (91%) and concomitant oral Posaconazole (95.4%). 74.6% patients were discharged after clinical and radiologic recovery while 25.4% died. On Relative risk analysis, COVID-19 CT severity index ≥ 18 (p=0.017), presence of orbital symptoms (p=0.002), presence of diabetic ketoacidosis (p=0.011) and cerebral involvement (p=0.0004) were associated with increased risk of death.

CONCLUSIONS: CAM is a rapidly progressive, angio-invasive, opportunistic fungal infection which is fatal if left untreated. Combination of surgical debridement and antifungal therapy leads to clinical and radiologic improvement in majority of cases.

PMID:35212032 | DOI:10.1111/myc.13435

J Med Virol. 2022 Feb 24. doi: 10.1002/jmv.27677. Online ahead of print.

ABSTRACT

In the current study, the relationship between viral load, demographic characteristics, and disease information in 1007(48.5%) patients with Delta variant (B.1.617.2), and 1070 (51.5%) patients with Alpha variant (B1.1.7) mutations was investigated. We found that there was a significant difference in viral load between patients who died from the Alpha variant and those who were discharged (p<0.05). Nevertheless, no significant difference was observed in patients with Delta variant. The viral load in patients who died from the Alpha variant was significantly higher than those who were discharged (p<0.05). The viral load was found to be higher in females in patients with Delta variant, whereas it was very close in males and females in patients with Alpha variant (p>0.05). No significant difference was detected between the cycle threshold values (Ct) and disease severity. In terms of the mean Ct values, statistical differences were observed in patients with Delta and Alpha variant. The Alpha variant was found to have a higher viral load than the Delta variant. Furthermore, Delta variant was found to be higher in the 40-year-old and under-age group than in the Alpha variant, whereas the Alpha variant was higher in the 40-year-old and older group. While the rate of moderate and severe patients in Alpha variant was found to be higher, the rate of mild survivors was found to be higher in Delta variant. In conclusion, The increase in vaccination prior to the appearance of the Delta variant in our region may have influenced the viral load and clinical status of the patients. This article is protected by copyright. All rights reserved.

PMID:35212012 | DOI:10.1002/jmv.27677

Rev Neurol. 2022 Mar 1;74(5):156-162. doi: 10.33588/rn.7405.2021385.

ABSTRACT

INTRODUCTION: Patients who have suffered a chronic cerebrovascular accident or a stroke need long-term physiotherapy treatments. However, they have had to be stopped due to the COVID-19 pandemic. To be able to offer these patients an online functional assessment, a proposal was put forward to design an adaptation of the Spanish version of the Fugl Meyer assessment scale and to test its viability.

PATIENTS AND METHODS: The adapted online scale, based on the Fugl Meyer assessment scale. The motor function, balance and pain domains were kept, and items requiring assistance for the patient were removed. This scale was administered to 13 patients with a chronic cerebrovascular accident from the Salamanca Acquired Brain Injury Association (Asociacion de Dano Cerebral Adquirido) via different web platforms. The procedure followed was the same as for the original scale and lasted from 30 to 45 minutes.

RESULTS: All the patients completed the Fugl Meyer assessment scale, online version. The greatest difficulty was encountered in the assessment of the lower limbs. Patients and physiotherapists highlighted how easy it was to complete the items in the scale. On comparing the versions, statistically significant positive correlations were found with the original version (p < 0.001) and the correlation coefficients indicated a strong association. The difference between the equivalent sections of the scale in each instrument was no greater than 5%, except for balance.

CONCLUSION: The Fugl Meyer assessment scale, online version, is a feasible, useful and easy to apply scale that allows assessment of the functional status of stroke patients and can help meet the current needs during the COVID-19 pandemic.

PMID:35211949 | DOI:10.33588/rn.7405.2021385

Ann N Y Acad Sci. 2022 Feb 24. doi: 10.1111/nyas.14746. Online ahead of print.

ABSTRACT

Statistics plays a key role in many areas of modern society, including technology, social and behavior studies, economics, and the sciences. Statistics anxiety (SA) has a detrimental impact on academic experiences in university populations, although the mediating factors remain underexplored. We conducted the first systematic review and meta-analysis focused on SA in university students in the context of statistical performance, individual differences in statistical learning, self-perceptions regarding the statistics course and instructor, and sociodemographic factors. Searches were carried out in the PsycINFO, PubMed, Scielo, and Web of Science databases according to our preregistration. Forty studies were selected for systematic review. Seventeen were included in a series of six meta-analyses concerning academic achievement, attitudes, self-perception, procrastination, and gender. The findings reveal learning strategies, procrastination, self-efficacy, and self-awareness as predictors of SA. However, the impact of sociodemographic data in these moderators is still uncharted. We conclude with a critical appraisal of the selected studies and present future directions for research in SA.

PMID:35211989 | DOI:10.1111/nyas.14746

Rofo. 2022 Feb 24. doi: 10.1055/a-1740-4310. Online ahead of print.

ABSTRACT

PURPOSE: Classifications were created to facilitate radiological evaluation of the novel coronavirus disease 2019 (COVID-19) on computed tomography (CT) images. The categorical CT assessment scheme (CO-RADS) categorizes lung parenchymal changes according to their likelihood of being caused by SARS-CoV-2 infection. This study investigates the diagnostic accuracy of diagnosing COVID-19 with CO-RADS compared to the Thoracic Imaging Section of the German Radiological Society (DRG) classification and Radiological Society of North America (RSNA) classification in an anonymized patient cohort. To mimic advanced disease stages, follow-up examinations were included as well.

METHOD: This study includes all patients undergoing chest CT in the case of a suspected SARS-CoV-2 infection or an already confirmed infection between March 13 and November 30, 2020. During the study period, two regional lockdowns occurred due to high incidence values, increasing the pre-test probability of COVID-19. Anonymized CT images were reviewed retrospectively and in consensus by two radiologists applying CO-RADS, DRG, and RSNA classification. Afterwards, CT findings were compared to results of sequential real-time reverse transcriptase polymerase chain reaction (qPCR) test performed during hospitalization to determine statistical analysis for diagnosing COVID-19.

RESULTS: 536 CT examinations were included. CO-RADS, DRG and RSNA achieved an NPV of 96 %/94 %/95 % (CO-RADS/DRG/RSNA), PPV of 83 %/80 %/88 %, sensitivity of 86 %/76 %/80 %, and specificity of 96 %/95 %/97 %. The disease prevalence was 20 %.

CONCLUSION: All applied classifications can reliably exclude a SARS-CoV-2 infection even in an anonymous setting. Nevertheless, pre-test probability was high in our study setting and has a great influence on the classifications. Therefore, the applicability of the individual classifications will become apparent in the future with lower prevalence and incidence of COVID-19.

KEY POINTS: · CO-RADS, DRG, and RSNA classifications help to reliably detect infected patients in an anonymized setting. · Pre-test probability has a great influence on the individual classifications. · Difficulties in an anonymized study setting are severe pulmonary changes and residuals..

CITATION FORMAT: · Valentin B, Steuwe A, Wienemann T et al. Applicability of CO-RADS in an Anonymized Cohort Including Early and Advanced Stages of COVID-19 in Comparison to the Recommendations of the German Radiological Society and Radiological Society of North America. Fortschr Röntgenstr 2022; DOI: 10.1055/a-1740-4310.

PMID:35211925 | DOI:10.1055/a-1740-4310

Mem Cognit. 2022 Feb 24. doi: 10.3758/s13421-021-01272-0. Online ahead of print.

ABSTRACT

The present study aimed to investigate the mechanism underlying the development of level 2 visual perspective taking (VPT2). Specifically, we examined the role of working memory capacity (WMC) and mental rotation (MR) in the developmental change of VPT2 among early school-aged children. Children aged between 6 and 8 years (N = 150) completed measures to assess WMC, MR, and VPT2. Results showed that WMC, the ability of MR, and VPT2 developed progressively from 6 to 8 years old. The ability of VPT2 was significantly correlated with WMC and MR, even when age was statistically controlled for. Mediation analyses further revealed that both age-related changes in WMC and MR partially mediated the development of VPT2. Furthermore, age-related development in MR mediated the relationship between changes of WMC and VPT2. Our findings suggest the importance of WMC and MR in the early development of VPT2 and provide preliminary support for the developmental cascade hypothesis. That is, as children grow up, their WMC increases, leading to better capability of MR, which in turn results in the improvement of VPT2.

PMID:35211866 | DOI:10.3758/s13421-021-01272-0

Langenbecks Arch Surg. 2022 Feb 25. doi: 10.1007/s00423-022-02434-7. Online ahead of print.

ABSTRACT

PURPOSE: To clarify the efficacy of perioperative chemotherapy for the patients with resectable colorectal liver metastases (CLM), we conducted a multicenter randomized phase III trial to compare surgery followed by postoperative FOLFOX regimen with perioperative FOLFOX regimen plus cetuximab in patients with KRAS wild-type resectable CLM.

METHODS: Patients who had KRAS wild-type resectable CLM having one to eight liver nodules without extrahepatic disease were randomly assigned to the postoperative chemotherapy group, wherein up-front hepatectomy was performed followed by 12 cycles of postoperative modified FOLFOX6, and the perioperative chemotherapy group (experimental), wherein six cycles of preoperative modified FOLFOX6 plus cetuximab were performed followed by hepatectomy and six cycles of postoperative modified FOLFOX6 plus cetuximab. The primary endpoint was progression-free survival (PFS).

RESULTS: There were 37 patients in postoperative chemotherapy group and 40 patients in the perioperative chemotherapy group who were analyzed. Baseline characteristics were well-balanced between groups. The PFS and overall survival (OS) showed no significant difference (PFS, hazard ratio 1.18 [95% confidence interval 0.69-2.01], P = 0.539: OS, 1.03 [0.46-2.29], P = 0.950). In the postoperative chemotherapy group, 35.1% had a 3-year PFS, and 86.5% had a 3-year OS. Meanwhile, in the perioperative chemotherapy group, 30.0% had a 3-year PFS, and 74.4% had a 3-year OS.

CONCLUSION: There was no difference in survival found between the group of the perioperative chemotherapy plus cetuximab and that of the postoperative chemotherapy in the cohort of our study. The study was registered in the University Hospital Medical Information Network (UMIN000007787).

PMID:35211831 | DOI:10.1007/s00423-022-02434-7

Ann Surg Oncol. 2022 Feb 24. doi: 10.1245/s10434-022-11444-0. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the prognostic value of the percentage of high-grade patterns (micropapillary, solid, and complex glands) in early-stage lung adenocarcinoma (LUAD).

METHODS: A total of 1049 patients undergoing radical surgery with pathological T1-2N0M0 LUAD were screened retrospectively, and 191 patients were involved in the final analysis. Disease-free survival (DFS) was evaluated using the Kaplan-Meier curve and Cox regression analysis. The optimal cut-off value was determined using maximally selected rank statistics.

RESULTS: The entire cohort was divided into quartile groups based on the percentage of high-grade patterns: Group 1 (≤ 30%), Group 2 (31-55%), Group 3 (56-85%), and Group 4 (≥ 86%). There were significant differences in smoking history (P = 0.041), EGFR mutations (P < 0.001), and ALK rearrangement (P = 0.010) between the four groups, but no significant differences in other clinicopathological features. Kaplan-Meier analysis showed that a higher percentage of high-grade patterns predicted worse DFS (P = 0.001), and multivariate analysis indicated that the percentage of high-grade patterns was an independent predictor (Group 2 vs. Group 1, HR = 2.136, P = 0.228; Group 3 vs. Group 1, HR = 3.355, P = 0.035; Group 4 vs. Group 1, HR = 5.147, P = 0.003, respectively). A cut-off value of 20% (P = 0.048) and 50% (P <0.001) for high-grade patterns were tested, and both revealed a significant difference in distinguishing DFS between subgroups.

CONCLUSIONS: The percentage of high-grade patterns is associated with the prognosis of early-stage invasive LUAD. A higher percentage indicates a worse prognosis.

PMID:35211858 | DOI:10.1245/s10434-022-11444-0