Category: Statistics

J Minim Invasive Gynecol. 2021 Oct 2:S1553-4650(21)01178-X. doi: 10.1016/j.jmig.2021.09.714. Online ahead of print.

ABSTRACT

STUDY OBJECTIVE(S): In this study, we describe trends of all three routes of hysterectomy, patient demographics, and perioperative morbidity among women undergoing surgery for benign indications between 2007-2017. We also sought to compare the rates of ELOS and readmission rates among the laparoscopic, abdominal, and transvaginal routes.

STUDY DESIGN: Retrospective cohort study STUDY SETTING: National Database study PATIENTS: American College of Surgeons- National Surgical Quality Improvement Program (ACS-NSQIP) database to identify patients who underwent an elective hysterectomy for benign indication between 2007-2017.

INTERVENTIONS: Patients were identified using Current Procedural Terminology (CPT) codes and excluded if their indication for surgery included cancer and pelvic organ prolapse diagnoses based on International Classification of Disease (ICD) codes. Collected variables of interest included age, Body Mass Index (BMI), American Society of Anesthesiologists (ASA) classification, uterine weight > 250 grams, and operative time. Our outcomes of interest included ELOS and readmission within thirty days. ELOS was defined as a hospital admission of two days or more after laparoscopic and transvaginal hysterectomy, and greater than three days for an abdominal hysterectomy. Summary statistics were used to evaluate shifts in patient characteristics and postoperative outcomes by hysterectomy route and year of surgery. Multivariable logistic regression analysis, stratified by year, comparing laparoscopic to transvaginal and abdominal hysterectomies, was performed.

MEASUREMENTS AND MAIN RESULTS: 224,357 patients that met the inclusion and exclusion criteria. Of those, 132,567 (59.1%) underwent a laparoscopic hysterectomy; 30,105 (13.4%) a vaginal hysterectomy; and 61,685 (27.5%) an abdominal hysterectomy. The rate of laparoscopic hysterectomy increased by more than 200% between 2007-2017, while the rates of transvaginal and abdominal hysterectomies steadily decreased (-58%, -42%, respectively]). The mean age, median obesity, and ASA classification increased amongst women undergoing hysterectomy across all routes with the sharpest increase within the laparoscopic hysterectomy group (% increase in mean age [2.1%, 1.3%, 0.7%] and mean BMI [9.1%, 4.3%, 3.7%] for laparoscopic, transvaginal and abdominal routes, respectively). In 2017 the odds of ELOS were 29% lower for those who received laparoscopic compared to those who received abdominal hysterectomy (P<0.001). Comparing the rates of readmission between the laparoscopic and abdominal hysterectomy groups shows that the odds of readmission is significantly lower for patients who receive a laparoscopic hysterectomy across all eleven years (P<0.001).

CONCLUSION(S): The rates of laparoscopic hysterectomy have been steadily increasing over the past eleven years. This large retrospective study confirms the lowest rates of readmission and extended length of stay within the laparoscopic hysterectomy group despite the rising medical complexity of the patients.

PMID:34610464 | DOI:10.1016/j.jmig.2021.09.714

J Psychiatr Res. 2021 Sep 24;144:102-109. doi: 10.1016/j.jpsychires.2021.09.050. Online ahead of print.

ABSTRACT

AIMS: Interventions to decrease readmissions in psychiatric patients are urgently needed. In Switzerland therapeutic leave (TL) composes a cornerstone of inpatient treatment. TL is a planned time-limited absence from the inpatient ward giving patients the opportunity to test their resilience in their usual environment. Evidence of its applicability as an intervention reducing readmissions is lacking. Therefore, our objective was to examine the association between TL and readmission risk.

METHODS: Using the Kaplan-Meier curve we compared the time to readmission of 3’302 inpatients at the UPK Basel with and without TL. Cox regression was applied, integrating other covariates associated with readmission.

RESULTS: The Kaplan-Meier curve indicated longer cumulative survival in patients with TL. The log-rank test implied statistical significance (χ²(1) = 18.8, p < .05). The Cox regression showed a reduced hazard for patients with TL (HR = 0.735, CI 95% = [0.639, 0.846], p < .001) and for involuntarily hospitalized patients (HR = 0.760, CI 95% = [0.618, 0.934], p < .01). A higher readmission risk was found for a history of psychiatric admissions (HR = 1.005, CI 95% = [1.004, 1.005], p < .001), higher severity of symptoms at admission (HR = 1.029, CI 95% = [1.018, 1.040], p < .001), comorbidity (HR = 1.178, CI 95% [1.024, 1.355], p = .022), and a diagnosis with schizophrenia-spectrum disorders (HR = 1.401, CI 95% [1.164, 1.687], p = .001).

CONCLUSION: Linking TL with readmission risk, our results imply an easy way to improve quality of care, with possible implications for practice, policies and quality interventions. TL might be suitable to enhance recovery, reduce readmissions and health care costs. RCTs are needed for validation.

PMID:34610513 | DOI:10.1016/j.jpsychires.2021.09.050

Neuroimage. 2021 Oct 2:118625. doi: 10.1016/j.neuroimage.2021.118625. Online ahead of print.

ABSTRACT

Graph models of the brain hold great promise as a framework to study functional and structural brain connectivity across scales and species. The network-based statistic (NBS) is a well-known tool for performing statistical inference on brain graphs, which controls the family-wise error rate in a mass univariate analysis by combining the cluster-based permutation technique and the graph-theoretical concept of connected components. As the NBS is based on group-level inference statistics, it does not inherently enable informed decisions at the level of individuals, which is, however, necessary for the realm of precision medicine. Here we introduce NBS-Predict, a new approach that combines the powerful features of machine learning (ML) and the NBS in a user-friendly GUI. By combining ML models with connected components in a cross-validation (CV) structure, the new methodology provides a fast and convenient tool to identify generalizable neuroimaging-based biomarkers. The purpose of this paper is to (i) introduce NBS-Predict and evaluate its performance using two sets of simulated data with known ground truths, (ii) demonstrate the application of NBS-Predict in a real case-control study, including resting-state functional magnetic resonance imaging (rs-fMRI) data acquired from patients with schizophrenia, (iii) evaluate NBS-Predict using rs-fMRI data from the Human Connectome Project 1200 subjects release. We found that: (i) NBS-Predict achieved good statistical power on two sets of simulated data; (ii) NBS-Predict classified schizophrenia with an accuracy of 90% using subjects’ functional connectivity matrices and identified a subnetwork with reduced connections in the group with schizophrenia, mainly comprising brain regions localized in frontotemporal, visual, and motor areas, as well as in the subcortex; (iii) NBS-Predict also predicted general intelligence scores from resting-state fMRI connectivity matrices with a prediction score of r = 0.2 and identified a large-scale subnetwork associated with general intelligence. Overall results showed that NBS-Predict performed comparable to or better than pre-existing feature selection algorithms (lasso, elastic net, top 5%, p-value thresholding) and connectome-based predictive modeling (CPM) in terms of identifying relevant features and prediction accuracy. Network-based statistic, machine learning, graph theory, biomarkers, functional connectivity, connectome-based prediction.

PMID:34610435 | DOI:10.1016/j.neuroimage.2021.118625

Infect Genet Evol. 2021 Oct 2:105091. doi: 10.1016/j.meegid.2021.105091. Online ahead of print.

ABSTRACT

BACKGROUND: Norovirus is a leading cause of viral gastroenteritis outbreaks worldwide. Histo-blood group antigens (HBGAs) are important host attachment factors in susceptibility to norovirus. In this study, the association of FUT2 gene, which participates in the biosynthesis of HBGAs, with norovirus infection has been investigated.

METHODS: All relevant studies on the associations of FUT2 gene with norovirus were retrieved from PubMed, Web of Science, Embase, and Cochrane Library databases. Odds ratios (ORs) and 95% confidence interval (CI) were used to analyze the extracted data. I² statistic, sensitivity analysis and publication bias analysis were used to confirm the findings. Subgroup analyses were performed for races, genotypes, development degree of the countries, publication years, age and setting when heterogeneity was recorded.

RESULTS: Twenty studies including 4066 participants were included for the meta-analysis. This analysis showed that there is a significant association between FUT2 gene and norovirus infection (OR = 3.02, 95%CI = 2.00-4.55, P < 0.001). Additionally, the ORs of norovirus infection among Chinese (OR = 4.49, 95%CI = 2.37-8.50, P < 0.001) were higher than those among Caucasian (OR = 3.23, 95%CI = 2.20-4.74, P < 0.001).

CONCLUSIONS: The meta-analysis suggested that FUT2 gene is associated with susceptibility to norovirus infection.

PMID:34610432 | DOI:10.1016/j.meegid.2021.105091

J Ethnopharmacol. 2021 Oct 2:114699. doi: 10.1016/j.jep.2021.114699. Online ahead of print.

ABSTRACT

ETHNOPHARMACOLOGICAL RELEVANCE: Danggui Buxue Decoction (DBT) is classical prescriptions, which contains two Traditional Chinese Medicines of Angelicae sinensis radix and Astragali radix. According to the preliminary work of our laboratory and numerous studies, it has been found that DBT has a therapeutic effect on diabetic nephropathy (DN). However, the mechanisms underlying its action remain unclear.

AIM OF THE STUDY: The aim of this study was to evaluate the impact of DBT on kidney disease in diabetic mice and further explore its protective mechanism.

METHODS: DN mice model was induced by high-fat fodder and streptozotocin (STZ). Qualitative and quantitative analysis of 6 compounds in DBT was carried out by HPLC, including calycosin-7-glucoside, ferulic acid, ononin, calycosin, formononetin, and levostilide A. Hematoxylin-Eosin (HE) staining was used to determine the degree of kidney pathological damage. The UPLC-Q Exactive MS technique was used to analyze the lipids metabolism profile of kidneys samples and multiple statistical analysis methods were used to screen and identify biomarkers. Transcriptomics analyses were carried out using RNAseq. The possible molecular mechanism was unraveled by network pharmacology.

RESULTS: Thirty-one significantly altered lipid metabolites were identified in the model group comparing with the control group. DBT improved aberrant expression of several pathways related to lipidomics, including glycerophospholipid metabolism and sphingolipid metabolism. Comprehensive analysis indicated that DBT intervention reduced the content of Cers, phosphatidylethanolamines and phosphatidylcholines in mouse kidneys by downregulating the transcription level of Degs2 and Cers, reducing lipid accumulation and promoting Akt phosphorylation by upregulating the expression of Acers and Pdk1. Network pharmacology analysis showed that components in DBT, such as kaempferol, ferulic acid and astragaloside IV, could be responsible for the pharmacological activity of DN by regulating the AGE-RAGE, PI3K/Akt, MAPK and NF-κB signaling pathways in diabetic complications.

CONCLUSIONS: These results showed that DBT may improve DN by affecting insulin resistance, chronic inflammation and lipid accumulation.

PMID:34610419 | DOI:10.1016/j.jep.2021.114699

J Vasc Interv Radiol. 2021 Oct 2:S1051-0443(21)01389-0. doi: 10.1016/j.jvir.2021.09.019. Online ahead of print.

ABSTRACT

PURPOSE: To assess the safety and efficacy of Genicular Artery Embolization (GAE) compared with a sham procedure in the treatment of knee pain secondary to mild-moderate grade Osteoarthritis (OA).

MATERIALS AND METHODS: A multicenter, single-blinded, randomized controlled trial was conducted to evaluate knee OA symptom reduction after GAE vs sham procedure. Subjects (n=21) with mild to moderate OA and intractable knee pain were randomized 2:1 to either GAE or a sham procedure. Subjects who were randomized to the sham procedure and did not report minimal clinical improvement in both total WOMAC and VAS scores were unblinded and able to crossover to treatment at 1 month. Longitudinal data were collected for 12 months, and subjects were excluded if they required additional analgesics at follow-up. Comparisons of reductions in VAS and Total WOMAC scores were performed using mixed effects linear regression models.

RESULTS: All subjects in the sham group failed to show significant improvements at 1 month and crossed over to the treatment arm.There was a statistically significant greater pain reduction in treatment group vs sham at 1 month (50.1mm VAS; SE=10.6, 95% CI: [29.0, 72.3], p<0.01). Disability improvement was also significantly greater in the treatment group (24.7 points WOMAC; SE=10.4, 95% CI: [3.5, 45.9], p=0.02). Only minor adverse events were reported.5 subjects were excluded after increased analgesic use. Sensitivity analysis with all excluded patients confirmed significant improvements at 1 and 12 months.

CONCLUSION: In patients with mild to moderate knee OA, GAE results in symptomatic improvement greater than sham procedure with clinically significant reduction in pain and disability.

PMID:34610422 | DOI:10.1016/j.jvir.2021.09.019

Appetite. 2021 Oct 2:105731. doi: 10.1016/j.appet.2021.105731. Online ahead of print.

NO ABSTRACT

PMID:34610394 | DOI:10.1016/j.appet.2021.105731

Am J Infect Control. 2021 Oct 2:S0196-6553(21)00640-4. doi: 10.1016/j.ajic.2021.09.020. Online ahead of print.

ABSTRACT

INTRODUCTION: The purpose of this study is to assess the impact of a germicidal ultraviolet light-emitting diode (LED) on the contamination level of a back table in the operating room (OR) during total joint arthroplasty (TJA) procedures.

METHODS: Eight Tryptic Soy Agar (TSA) petri plates were placed on a table located near the operative field and exposed to air. One plate was removed on the hour over an 8-hour time span. The back table had either an UV-LED for disinfection or a sham UV-LED. This process was repeated in 12 different ORs (6 with UV light, 6 with sham device). The plates were then incubated for 48 hours at 36° +/- 1° C. Colony forming units (CFU) were recorded 24 and 48 hours after incubation.

RESULTS: There was a statistically significant difference in total CFUs between the intervention vs. sham at 24-hours (27 vs. 95, p=0.0001) and 48-hours (38 vs. 122, p<0.0001). The multivariate analysis revealed that the 24-hour and 48-hour count, the predictors UV light (p=0.002) and hour of plate removal (p=0.050) were statistically significantly associated with CFU counts. Together, the predictor variables explained 15.8% and 23.0% of the variance in CFU counts at 24- and 48-hours, respectively.

CONCLUSIONS: A back table UV-LED may decrease environmental contamination near the operative field. This has potential to lead to a decrease in joint infection.

PMID:34610393 | DOI:10.1016/j.ajic.2021.09.020

Q J Exp Psychol (Hove). 2021 Oct 5:17470218211053472. doi: 10.1177/17470218211053472. Online ahead of print.

ABSTRACT

By leveraging Phonology-to-Semantics Consistency (PSC, Amenta, Marelli & Sulpizio, 2017), which quantifies form-meaning systematicity as the semantic similarity between a target word and its phonological nearest neighbors, wedocument a unique effect of systematicity on Age of Acquisition (AoA). This effect is also found after controlling for theeffect of neighbourhood density measured for word forms and lexical semantics and several other standard predictorsof AoA. Moreover, we show that the effect of systematicity is not reducible to iconicity. Finally, we extensively probethe reliability of this finding by testing different statistical models, analyzing systematicity in phonology and orthographyand implementing random baselines, reporting a robust, unique negative effect of systematicity on AoA, such thatmore systematic words tend to be learned earlier. We discuss the findings in the light of studies on non-arbitrary form-meaning mappings and their role in language learning, focusing on the analogical process at the interface of form andmeaning upon which PSC is based and how it could help children infer the semantics of novel words when context isscarce or uninformative, ultimately speeding up word learning.

PMID:34609218 | DOI:10.1177/17470218211053472

Acta Radiol. 2021 Oct 5:2841851211043835. doi: 10.1177/02841851211043835. Online ahead of print.

ABSTRACT

BACKGROUND: Rapid and accurate quantification of the supraspinatus outlet view (SOV) is a clinical challenge.

PURPOSE: To quantify the X-ray beam angle of the SOV using the horizontal angle of the subscapular spine line (SSSL) and to further verify the feasibility of this method.

MATERIAL AND METHODS: A total of 119 patients who underwent shoulder computed tomography (CT) examination were enrolled in the retrospective study. Three-dimensional (3D) CT reconstruction was performed and manually adjusted to provide the position similar to SOV. The rotation angle of the 3D image along the long axis of the human body (marked as β) was obtained. The horizontal angle of SSSL (marked as α) was measured on the anteroposterior localizer image of shoulder CT. Pearson correlation and linear regression correlation analysis were performed. In addition, the first-time success rate between the experience-based group and the measurement-based group were compared to verify the novel method.

RESULTS: We found a linear correlation between α and β (r = 0.962; P = 0.000). There was no significant correlation between the experience-based group and the measurement-based group in terms of age (P = 0.500), sex (P = 0.397), and side (P = 0.710), but there was a significant statistical difference in the first success rate between the two validation groups (χ² = 5.808^a, P = 0.016).

CONCLUSION: This novel quantitative measurement method for determining the X-ray beam angle of SOV using the horizontal angle of SSSL is feasible.

PMID:34609193 | DOI:10.1177/02841851211043835