Category: Statistics

Eur J Surg Oncol. 2021 Jun 1:S0748-7983(21)00535-7. doi: 10.1016/j.ejso.2021.05.040. Online ahead of print.

ABSTRACT

BACKGROUND: Surgical intervention presents a fundamental therapeutic choice in the management of colorectal malignancies. Complications, the most serious one being anastomotic leak (AL), still have detrimental effects upon patients’ morbidity and mortality. We aimed to assess whether NSAIDs, and their sub-categories, increase AL in colonic anastomoses and to identify whether this affects specific anastomotic sites.

MATERIALS AND METHODS: A systematic search of MEDLINE, Cochrane Library, ClinicalTrials.gov, Web of Science, Science Direct, Google Scholar was conducted between January 1, 1999 till the October 30, 2020. Cohort studies and randomized control trials examining AL events in NSAID-exposed, colorectal cancer patients were included. NSAIDs were grouped according to the 2019 NICE guidelines in non-specific (NS-NSAIDs) and specific COX-2 inhibitors. The primary outcome was AL events in NSAID-exposed patients undergoing operations with either ileocolic, colocolic or colorectal anastomoses. Secondary outcomes included NSAID category-specific AL events and demographic confounding factors increasing AL risk in this patient population.

RESULTS: Fifteen studies involving 25,395 patients were included in the systematic review and meta-analysis. Of all anastomoses, colocolic anastomoses were found to be statistically more prone to AL events in the NS-NSAID-exposed population [OR 3.24 (95% CI 0.98-10.72), p = 0.054]. Male gender was an independent confounder increasing AL rate regardless of NSAID exposure.

CONCLUSION: The association between NSAID exposure and AL in oncology patients remains undetermined. Whilst in present work, colocolic anastomoses appear to be more sensitive to AL events, the observed association may be anastomotic site and NSAID-category dependent.

PMID:34099356 | DOI:10.1016/j.ejso.2021.05.040

Chin J Traumatol. 2021 May 18:S1008-1275(21)00087-0. doi: 10.1016/j.cjtee.2021.05.003. Online ahead of print.

ABSTRACT

PURPOSE: Posttraumatic stress disorder (PTSD) is a significant global mental health concern, especially in the military. This study aimed to estimate the efficacy of mindfulness meditation in the treatment of military-related PTSD, by synthesizing evidences from randomized controlled trials.

METHODS: Five electronic databases (Pubmed, EBSCO Medline, Embase, PsychINFO and Cochrane Library) were searched for randomized controlled trials focusing on the treatment effect of mindfulness meditation on military-related PTSD. The selection of eligible studies was based on identical inclusion and exclusion criteria. Information about study characteristics, participant characteristics, intervention details, PTSD outcomes, as well as potential adverse effects was extracted from the included studies. Risk of bias of all the included studies was critically assessed using the Cochrane Collaboration’s tool. R Statistical software was performed for data analysis.

RESULTS: A total of 1902 records were initially identified and screened. After duplicates removal, 834 records were screened for title and abstract. Then, full-text of 115 related articles were retrieved and assessed for eligibility. Among them, 96 articles were excluded for no random assignment, article type of commentary, editorial, review, case report, etc. Finally, 19 articles in English language with 1326 participants were included through strict inclusion and exclusion criteria. The results revealed that mindfulness meditation had a significantly larger effect on alleviating military-related PTSD symptoms compared with control conditions, such as treatment as usual, present-centered group therapy and PTSD health education (standardized mean difference (SMD) = -0.33; 95% CI [-0.45, -0.21]; p < 0.0001). Mindfulness interventions with different control conditions (active or non-active control, SMD = -0.33, 95% CI [-0.46, -0.19]; SMD = -0.49, 95% CI [-0.88, -0.10], respectively), formats of delivery (group-based or individual-based, SMD = -0.30, 95% CI [-0.42, -0.17], SMD = -0.49, 95% CI [-0.90, -0.08], respectively) and intervention durations (short-term or standard duration, SMD = -0.27, 95% CI [-0.46, -0.08], SMD = -0.40, 95% CI [-0.58, -0.21], respectively) were equally effective in improving military-related PTSD symptoms.

CONCLUSION: Findings from this meta-analysis consolidate the efficacy and feasibility of mindfulness meditation in the treatment of military-related PTSD. Further evidences with higher quality and more rigorous design are needed in the future.

PMID:34099359 | DOI:10.1016/j.cjtee.2021.05.003

J Arthroplasty. 2021 May 4:S0883-5403(21)00409-5. doi: 10.1016/j.arth.2021.04.037. Online ahead of print.

ABSTRACT

BACKGROUND: Although the number of total hip arthroplasty and total knee arthroplasty (THA and TKA) increases, individuals of color continue to be less likely to undergo these procedures. Socioeconomic status may be a key influencer of THA and TKA utilization and outcomes. We explore the influence of net worth and race on THA and TKA utilization and outcomes of length of stay and readmissions using a large patient database.

METHODS: The StrataSphere data set, an aggregation of 49 health systems representing 209 hospitals, was used for primary THA and TKA procedures performed in the calendar year 2019. Net worth was determined from Market Vue Partners’ data sources. Statistical analyses were performed to investigate relationships between net worth and patients undergoing THA or TKA.

RESULTS: When comparing our overall patient cohorts with the US population using Census data, we found differences in the utilization pattern indicated by index ratios most clearly in the lowest net worth categories. In the <$10K net worth category, THA and TKA index ratios were 0.51 and 0.54, respectively. In addition, we found that patients in the $100-250 and $250-500K net worth categories had increased utilization of both THA (index ratios of 1.39, 1.53) and TKA (index ratios of 1.45, 1.47) surgeries.

CONCLUSION: Net worth is a strong driver of disparities in utilization of THA and TKA with lower utilization of these surgeries in patients with net worth <$10K and increased utilization in patients with net worth from $100-250 and $250-500K.

PMID:34099350 | DOI:10.1016/j.arth.2021.04.037

J Dairy Sci. 2021 Jun 4:S0022-0302(21)00644-5. doi: 10.3168/jds.2020-20077. Online ahead of print.

ABSTRACT

In a return to tradition, the popularity of caprine milk is on the rise. However, particularly in countries with developed dairy industries based on bovine milk, there is the risk of adulteration with bovine milk, which is a cheaper alternative. Thus, a rapid, robust, and simple method for the detection of bovine milk added to caprine milk is necessary, and ¹H nuclear magnetic resonance spectroscopy appears to provide a solution. A matrix of 115 pure and artificially adulterated pasteurized milk samples was prepared and used to discover biomarkers of bovine milk that are independent of chemical and biological variation caused by factors such as genetics, diet, or seasonality. Principal component analysis and orthogonal projections to latent structures discriminant analysis of pure bovine milk and pure caprine milk revealed spectral features that were assigned to the resonances of 4 molecules. Of these, the peaks corresponding to protons in the N-acetylglucosamine and N-acetylgalactosamine acetyl moieties showed significant applicability for our method. Receiver operating characteristic curve analysis was used to evaluate the performance of the peak integrals as biomarkers of adulteration. This approach was able to distinguish caprine milk adulterated with 5% of bovine milk with 84.78% accuracy and with 10% of bovine milk an excellent 95.65% accuracy. This study demonstrates that N-acetyl carbohydrates could be used as biomarkers for the detection of bovine milk in caprine milk and could help in protecting caprine milk authenticity.

PMID:34099301 | DOI:10.3168/jds.2020-20077

Gynecol Oncol. 2021 Jun 5:S0090-8258(21)00447-9. doi: 10.1016/j.ygyno.2021.06.001. Online ahead of print.

ABSTRACT

BACKGROUND: Endometrial cancer is strongly associated with obesity and dysregulation of metabolic factors such as estrogen and insulin signaling are causal risk factors for this malignancy. To identify additional novel metabolic pathways associated with endometrial cancer we performed metabolomic analyses on pre-diagnostic plasma samples from 853 case-control pairs from the European Prospective Investigation into Cancer and Nutrition (EPIC).

METHODS: A total of 129 metabolites (acylcarnitines, amino acids, biogenic amines, glycerophospholipids, hexoses, and sphingolipids) were measured by liquid chromatography-mass spectrometry. Conditional logistic regression estimated the associations of metabolites with endometrial cancer risk. An analysis focusing on clusters of metabolites using the bootstrap lasso method was also employed.

RESULTS: After adjustment for body mass index, sphingomyelin [SM] C18:0 was positively (OR_1SD: 1.18, 95% CI: 1.05-1.33), and glycine, serine, and free carnitine (C0) were inversely (OR_1SD: 0.89, 95% CI: 0.80-0.99; OR_1SD: 0.89, 95% CI: 0.79-1.00 and OR_1SD: 0.91, 95% CI: 0.81-1.00, respectively) associated with endometrial cancer risk. Serine, C0 and two sphingomyelins were selected by the lasso method in >90% of the bootstrap samples. The ratio of esterified to free carnitine (OR_1SD: 1.14, 95% CI: 1.02-1.28) and that of short chain to free acylcarnitines (OR_1SD: 1.12, 95% CI: 1.00-1.25) were positively associated with endometrial cancer risk. Further adjustment for C-peptide or other endometrial cancer risk factors only minimally altered the results.

CONCLUSION: These findings suggest that variation in levels of glycine, serine, SM C18:0 and free carnitine may represent specific pathways linked to endometrial cancer development. If causal, these pathways may offer novel targets for endometrial cancer prevention.

PMID:34099314 | DOI:10.1016/j.ygyno.2021.06.001

Rev Colomb Psiquiatr (Engl Ed). 2021 Apr-Jun;50(2):74-81. doi: 10.1016/j.rcpeng.2020.01.003.

ABSTRACT

INTRODUCTION: Multiple investigations have revealed that patients with behavioral variant of frontotemporal dementia (bvFTD) experience difficulty recognizing emotional signals in multiple processing modalities (e.g., faces, prosody). Few studies have evaluated the recognition of musical emotions in these patients. This research aims to evaluate the ability of subjects with bvFTD to recognize musical stimuli with positive and negative emotions, in comparison with healthy subjects.

METHODS: bvFTD (n=12) and healthy control participants (n=24) underwent a test of musical emotion recognition: 56 fragments of piano music were randomly reproduced, 14 for each of the emotions (happiness, sadness, fear, and peacefulness).

RESULTS: In the subjects with bvFTD, a mean of correct answers of 23.6 (42.26%) was observed in contrast to the control subjects, where the average number of correct answers was 36.3 (64.8%). Statistically significant differences were found for each of the evaluated musical emotions and in the total score on the performed test (P<.01). The within-group analysis showed greater difficulty for both groups in recognizing negative musical emotions (sadness, fear), with the subjects with bvFTD exhibiting worse performance.

CONCLUSIONS: Our results indicate that the recognition of musical stimuli with positive (happiness, peacefulness) and negative (sadness, fear) emotions are compromised in patients with bvFTD. The processing of negative musical emotions is the most difficult for these individuals.

PMID:34099256 | DOI:10.1016/j.rcpeng.2020.01.003

J Dairy Sci. 2021 Jun 4:S0022-0302(21)00656-1. doi: 10.3168/jds.2021-20241. Online ahead of print.

ABSTRACT

The aim of this study was to analyze time-lagged heat stress (HS) effects during late gestation on genetic co(variance) components in dairy cattle across generations for production, female fertility, and health traits. The data set for production and female fertility traits considered 162,492 Holstein Friesian cows from calving years 2003 to 2012, kept in medium-sized family farms. The health data set included 69,986 cows from calving years 2008 to 2016, kept in participating large-scale co-operator herds. Production traits were milk yield (MKG), fat percentage (fat%), and somatic cell score (SCS) from the first official test-day in first lactation. Female fertility traits were the nonreturn rate after 56 d (NRR56) in heifers and the interval from calving to first insemination (ICFI) in first-parity cows. Health traits included clinical mastitis (MAST), digital dermatitis (DD), and endometritis (EM) in the early lactation period in first-parity cows. Meteorological data included temperature and humidity from public weather stations in closest herd distance. The HS indicator was the temperature-humidity index (THI) during dams’ late gestation, also defined as in utero HS. For the genetic analyses of production, female fertility, and health traits in the offspring generation, a sire-maternal grandsire random regression model with Legendre polynomials of order 3 for the production and of order 2 for the fertility and health traits on prenatal THI, was applied. All statistical models additionally considered a random maternal effect. THI from late gestation (i.e., prenatal climate conditions), influenced genetic parameter estimates in the offspring generation. For MKG, heritabilities and additive genetic variances decreased in a wave-like pattern with increasing THI. Especially for THI >58, the decrease was very obvious with a minimal heritability of 0.08. For fat% and SCS, heritabilities increased slightly subjected to prenatal HS conditions at THI >67. The ICFI heritabilities differed marginally across THI [heritability (h²) = 0.02-0.04]. For NRR56, MAST, and DD, curves for heritabilities and genetic variances were U-shaped, with largest estimates at the extreme ends of the THI scale. For EM, heritability increased from THI 25 (h² = 0.13) to THI 71 (h² = 0.39). The trait-specific alterations of genetic parameters along the THI gradient indicate pronounced genetic differentiation due to intrauterine HS for NRR56, MAST, DD, and EM, but decreasing genetic variation for MKG and ICFI. Genetic correlations smaller than 0.80 for NRR56, MAST, DD, and EM between THI 65 with corresponding traits at remaining THI indicated genotype by environment interactions. The lowest genetic correlations were identified when considering the most distant THI. For MKG, fat%, SCS, and ICFI, genetic correlations throughout were larger than 0.80, disproving concerns for any genotype by environment interactions. Variations in genetic (co)variance components across prenatal THI may be due to epigenetic modifications in the offspring genome, triggered by in utero HS. Epigenetic modifications have a persistent effect on phenotypic responses, even for traits recorded late in life. However, it is imperative to infer the underlying epigenetic mechanisms in ongoing molecular experiments.

PMID:34099290 | DOI:10.3168/jds.2021-20241

Mol Ecol Resour. 2021 Jun 7. doi: 10.1111/1755-0998.13443. Online ahead of print.

ABSTRACT

With the advent of chromatin-interaction maps, chromosome-level genome assemblies have become a reality for a wide range of organisms. Scaffolding quality is, however, difficult to judge. To explore this gap, we generated multiple chromosome-scale genome assemblies of an emerging wild animal model for carcinogenesis, the California sea lion (Zalophus californianus). Short-read assemblies were scaffolded with two independent chromatin interaction mapping data (Hi-C and Chicago), and long-read assemblies with three data types (Hi-C, optical maps, and 10X linked reads) following the ‘Vertebrate Genomes Project (VGP)’ pipeline. In both approaches, 18 major scaffolds recovered the karyotype (2n=36), with scaffold N50s of 138 Mb and 147 Mb, respectively. Synteny relationships at the chromosome-level with other pinniped genomes (2n=32-36), ferret (2n=34), red panda (2n=36) and domestic dog (2n=78) were consistent across approaches and recovered known fissions and fusions. Comparative chromosome painting and multicolor chromosome tiling with a panel of 264 genome-integrated single-locus canine bacterial artificial chromosome (BAC) probes provided independent evaluation of genome organization. Broad-scale discrepancies between the approaches were observed within chromosomes, most commonly in translocations centered around centromeres and telomeres, which were better resolved in the VGP assembly. Genomic and cytological approaches agreed on near-perfect synteny of the X chromosome, and in combination allowed detailed investigation of autosomal rearrangements between dog and sea lion. This study presents high-quality genomes of an emerging cancer model and highlights that even highly fragmented short-read assemblies scaffolded with Hi-C can yield reliable chromosome level scaffolds suitable for comparative genomic analyses.

PMID:34097816 | DOI:10.1111/1755-0998.13443

PLoS One. 2021 Jun 7;16(6):e0251914. doi: 10.1371/journal.pone.0251914. eCollection 2021.

ABSTRACT

Active contour models driven by local binary fitting energy can segment images with inhomogeneous intensity, while being prone to falling into a local minima. However, the segmentation result largely depends on the location of the initial contour. We propose an active contour model with global and local image information. The local information of the model is obtained by bilateral filters, which can also enhance the edge information while smoothing the image. The local fitting centers are calculated before the contour evolution, which can alleviate the iterative process and achieve fast image segmentation. The global information of the model is obtained by simplifying the C-V model, which can assist contour evolution, thereby increasing accuracy. Experimental results show that our algorithm is insensitive to the initial contour position, and has higher precision and speed.

PMID:34097693 | DOI:10.1371/journal.pone.0251914

PLoS One. 2021 Jun 7;16(6):e0252238. doi: 10.1371/journal.pone.0252238. eCollection 2021.

ABSTRACT

BACKGROUND: To investigate the excess of deaths by specific causes, in the first half of 2020 in the city of São Paulo-Brazil, during the COVID-19 pandemic.

METHODS: Ecological study conducted from 01/01 to 06/30 of 2019 and 2020. Population and mortality data were obtained from DATASUS. The standardized mortality ratio (SMR) by age was calculated by comparing the standardized mortality rate in 2020 to that of 2019, for overall and specific mortality. The ratio between the standardized mortality rate due to COVID-19 in men as compared to women was calculated for 2020. Crude mortality rates were standardized using the direct method.

RESULTS: COVID-19 was responsible for 94.4% of the excess deaths in São Paulo. In 2020 there was an increase in overall mortality observed among both men (SMR 1.3, 95% CI 1.17-1.42) and women (SMR 1.2, 95% CI 1.06-1.36) as well as a towards reduced mortality for all cancers. Mortality due to COVID-19 was twice as high for men as for women (SMR 2.1, 95% CI 1.67-2.59). There was an excess of deaths observed in men above 45 years of age, and in women from the age group of 60 to 79 years.

CONCLUSION: There was an increase in overall mortality during the first six months of 2020 in São Paulo, which seems to be related to the COVID-19 pandemic. Chronic health conditions, such as cancer and other non-communicable diseases, should not be disregarded.

PMID:34097694 | DOI:10.1371/journal.pone.0252238