Category: Statistics

Klin Monbl Augenheilkd. 2021 May 17. doi: 10.1055/a-1333-2723. Online ahead of print.

ABSTRACT

AIM: This retrospective investigated the impact of donor age, recipient age, donor endothelial cell density, vis-à-tergo, and additional intraoperative lens exchange (triple-procedure) on overall early and late phase postoperative endothelial cell density (ECD) following penetrating keratoplasty (PKP) in various diagnosis groups.

PATIENTS AND METHODS: In 590 cases with diagnosed keratoconus (KC), Fuchs dystrophy (FD) and herpes simplex virus infection (HSV) who underwent PKP or triple surgery, the ECD in cells/mm² was analysed, both preoperatively, with all-sutures-in (early postoperative stage), and after last suture removal. The factors were tested by Mann-Whitney U-test, correlation analysis and linear regression analysis.

OUTCOME: Correlation analysis demonstrated a weak negative correlation between the patient’s ECD and donor age (early postoperative stage: r = – 0.25, p < 0.001; after last suture removal: r = – 0.16; p = 0.003). Regression analysis revealed that donor age did not impact postoperative patient ECD. There was a weak negative correlation between postoperative ECD and recipient age (early postoperative stage: r = – 0.31, p < 0.001; after last suture removal: r = – 0.34, p < 0.001). Regression analysis confirmed the negative impact of recipient age on patient ECD (early postoperative stage: β = – 13.2, p = 0.001; after last suture removal: β = – 4.6, p < 0.001). Correlation analysis determined a weak positive correlation between postoperative ECD and donor endothelial cell density (early postoperative stage: r = 0.37, p < 0.001; after last suture removal: r = 0.32, p < 0.001). Regression analysis also determined that donor endothelial cell density had a positive impact on postoperative ECD following last suture removal (β = 0.4, p < 0.001). Vis-à-tergo and additional lens exchange (triple procedure) had no significant effect on postoperative ECD (p > 0.05). This was also confirmed by the results of the regression analysis after last suture removal.

CONCLUSION: Recipient age and donor endothelial cell density have a significant impact on postoperative ECD following PKP. Not all of the statistical tests proved donor age to be a significant influencing factor. Vis-à-tergo and additional lens exchange (triple procedure) had no significant effect on postoperative ECD following PKP.

PMID:34000746 | DOI:10.1055/a-1333-2723

Klin Monbl Augenheilkd. 2021 May 17. doi: 10.1055/a-1384-1020. Online ahead of print.

ABSTRACT

PURPOSE: Minimally invasive glaucoma surgery (MIGS), like Xen45 gel stents, is known as effective therapy in lowering intraocular pressure (IOP); however, fibrotic reactions are a common problem in postoperative management. It was the aim of this study to investigate the therapeutic success of Xen45 gel stents as a stand-alone technique (Xen) and combined with cataract surgery (XenPhaco), and with antimetabolites (mitomycin C, MMC) in open-angle glaucoma patients.

METHODS: Retrospective analysis was performed of 199 eyes of 177 glaucoma patients of the Department of Ophthalmology, University of Erlangen Nürnberg, and from the Erlangen Glaucoma Registry (NCT00494923; ISSN 2191-5008, CS-2011) who underwent implantation of a Xen45 gel stent. Therapeutic success was defined as IOP reduction of ≥ 20% on the same or less anti-glaucomatous medication after 12 months compared to preoperative and without any additional glaucoma-related surgery (except bleb needling). IOP reduction, reduction in local anti-glaucomatous eye drops, and intra- and postoperative complications were monitored.

RESULTS: Stand-alone Xen45 gel stent: therapeutic success was reached in 39% (-MMC) and 55% (+MMC). Failure rate was 61% (-MMC) and 45% (+MMC). XenPhaco: therapeutic success was achieved in 57% (-MMC) and 46% (+MMC). Failure rate was 43% (-MMC) and 54% (+MMC). Data were not different for group and subgroup analyses (p > 0.05).

CONCLUSIONS: The use of MMC seemed to increase the therapeutic success rate after stand-alone Xen45 gel stent implantation and combined with cataract surgery, yet statistical significant was not reached.

PMID:34000747 | DOI:10.1055/a-1384-1020

Diabetes Metab Syndr. 2021 May 8;15(3):1017-1022. doi: 10.1016/j.dsx.2021.05.006. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: Understanding people’s attitudes towards Covid-19 vaccination is crucial to the successful implementation of a vaccination program. Hence this research study seeks to identify critical factors influencing Indian people’s attitudes and intentions to take up Covid-19 vaccinations.

METHODS: An online questionnaire was administered to a sample (n = 254) drawn from Indian population, to assess the impact of perceived benefits, risk perceptions, social media exposure, social norms, and trust associated with Covid-19 vaccines on people’s attitudes towards Covid-19 vaccines and their intentions to take up the Covid-19 vaccinations.

RESULTS: The findings showed that the perceived benefits, social norms, and trust correlated significantly with people’s attitudes towards Covid-19 vaccinations. In contrast, risk perceptions and social media exposure showed an insignificant influence on people’s attitudes towards Covid-19 vaccinations. Social norms, trust, and people’s attitudes towards the Covid-19 vaccinations are significantly correlated with their intentions to take up Covid-19 vaccinations. On the contrary, social media exposure was found to have an insignificant influence on people’s intentions to take up Covid-19 vaccinations.

CONCLUSION: Participants’ intentions to take up Covid-19 vaccinations was influenced mainly by their attitudes and perceptions of Covid-19 vaccines in general, which strongly confirms the importance of various dimensions (perceived benefits, trust, social norms) of Covid-19 vaccines in cultivating Covid-19 vaccination acceptance among participants’.

PMID:34000711 | DOI:10.1016/j.dsx.2021.05.006

Int Arch Allergy Immunol. 2021 May 17:1-7. doi: 10.1159/000513810. Online ahead of print.

ABSTRACT

INTRODUCTION: While there exists considerable evidence for efficacy of sublingual immunotherapy (SLIT), its impact on the improvement of nasal signs in allergic rhinitis (AR) patients remains quite unclear. In this study, the endoscopic examination and the modified Lund-Kennedy (MLK) scoring system were performed to describe and evaluate the therapeutic effect of SLIT.

METHODS: A total of 105 patients with AR induced by house dust mites were enrolled and treated with standardized Dermatophagoides farinae (D. farinae) drops for 1 year. The total nasal symptoms score (TNSS), total medication score (TMS), visual analog scale (VAS), and MLK scores were assessed at baseline and 6 and 12 months. The MLK score was also compared for its correlation with TNSS, TMS, and VAS.

RESULTS: The TNSS, TMS, and VAS scores statistically decreased after SLIT compared to baseline (all p < 0.05). After 12 months of treatment, the rates of well-controlled, partial controlled, and uncontrolled AR patients were 42, 49.5, and 8.5%, respectively. The nasal endoscopy findings showed significant improvement in nasal signs, which mainly included color change of turbinate mucosa, reduction of nasal secretions, and improvement of nasal edema. A significant decrease was observed in MLK scores, and there was a positive correlation between MLK and VAS scores.

CONCLUSIONS: In addition to commonly utilized subjective assessments (TMS, TNSS, and VAS), our results of endoscopic examination and the MLK scores consistently confirmed that SLIT is an effective therapeutic modality for AR patients. The MLK scores might be considered as an auxiliary tool to evaluate efficacy of SLIT in clinical practice and outcomes research.

PMID:34000723 | DOI:10.1159/000513810

Oncology. 2021 May 17:1-8. doi: 10.1159/000515280. Online ahead of print.

ABSTRACT

INTRODUCTION: This study compared clinical outcomes of 2nd- and 3rd-line regorafenib in patients with unresectable hepatocellular carcinoma.

METHODS: In this retrospective cohort study, 48 patients were treated with regorafenib for unresectable hepatocellular carcinoma. Thirty-five and 13 patients were initiated on 2nd- and 3rd-line therapy, respectively. We assessed the responses to and safety of the therapy.

RESULTS: There were no statistically significant differences in clinical characteristics at the start of 2nd- or 3rd-line regorafenib therapy. The overall response rate of 2nd- and 3rd-line regorafenib was 20 and 8%, respectively. The disease control rate was 57 and 54%, respectively. Median overall survival (mOS) from the start of 2nd-line regorafenib was 17.5 months. mOS from the start of 3rd-line regorafenib was not obtained. Median progression-free survival of 2nd- and 3rd-line regorafenib was 4.9 and 2.3 months, respectively. mOS from 1st-line therapy with tyrosine kinase inhibitor plus sorafenib-regorafenib-lenvatinib was 29.5 months; that with lenvatinib-sorafenib-regorafenib was not obtained. Patients on 3rd-line therapy tended to have better Child-Pugh scores and tumor factors at the start of 1st-line therapy than other patients.

CONCLUSION: Patients on 2nd- and 3rd-line regorafenib showed favorable responses. Good Child-Pugh scores and tumor factors may be associated with a better response rate and OS.

PMID:34000725 | DOI:10.1159/000515280

Neuroimage Clin. 2021 May 3;31:102690. doi: 10.1016/j.nicl.2021.102690. Online ahead of print.

ABSTRACT

In recent years, there has been increasing evidence of cerebellar involvement in emotion processing. Difficulties in the recognition of emotion from voices (i.e., emotional prosody) have been observed following cerebellar stroke. However, the interplay between sensory and higher-order cognitive dysfunction in these deficits, as well as possible hemispheric specialization for emotional prosody processing, has yet to be elucidated. We investigated the emotional prosody recognition performances of patients with right versus left cerebellar lesions, as well as of matched controls, entering the acoustic features of the stimuli in our statistical model. We also explored the cerebellar lesion-behavior relationship, using voxel-based lesion-symptom mapping. Results revealed impairment of vocal emotion recognition in both patient subgroups, particularly for neutral or negative prosody, with a higher number of misattributions in patients with right-hemispheric stroke. Voxel-based lesion-symptom mapping showed that some emotional misattributions correlated with lesions in the right Lobules VIIb and VIII and right Crus I and II. Furthermore, a significant proportion of the variance in this misattribution was explained by acoustic features such as pitch, loudness, and spectral aspects. These results point to bilateral posterior cerebellar involvement in both the sensory and cognitive processing of emotions.

PMID:34000647 | DOI:10.1016/j.nicl.2021.102690

Cancer Epidemiol. 2021 May 14;73:101934. doi: 10.1016/j.canep.2021.101934. Online ahead of print.

ABSTRACT

BACKGROUND: The diagnosis of Lynch syndrome-associated endometrial cancer patients is significant for early warning of their relatives. The purpose of this study was to provide diagnostic indicators of Lynch syndrome-associated endometrial cancer by screening the differential clinical and genetic characteristics.

METHODS: Clinical information and hysterectomy specimens were collected from 377 eligible patients with endometrial cancer. The MLH1 methylation level was detected by an EZ DNA Methylation-Gold Kit. According to the above experimental results, the patients were then divided into sporadic endometrial cancer and suspected Lynch syndrome-associated endometrial cancer groups. A total of 62 samples were randomly selected for whole-exome sequencing. IBM SPSS Statistics 21 was used to compare the clinical data between the sporadic and suspected Lynch syndrome-associated endometrial cancer groups, and the relationship between the specific high-frequency-mutation genes and the clinical data.

RESULTS: According to the results of MMR immunohistochemistry and MLH1 methylation, the sporadic endometrial cancer group included 361 patients and the suspected Lynch syndrome-associated endometrial cancer group included 16 patients in this study. In the clinical analysis, the average age of the suspected Lynch syndrome-associated endometrial cancer patients was 45.50 ± 11.50 years, which was significantly younger than the 51.17 ± 10.03 years of the sporadic endometrial cancer patients (P = 0.028). The average BMI of the suspected Lynch syndrome-associated endometrial cancer patients was 23.43 kg/m² (CI: 20, 30), which was lower than the 26.50 kg/m² of the sporadic endometrial cancer patients (P = 0.028). Combined with the WES data, MASP2, NADK and RNF223 were identified as three specific mutation sites related to age, FIGO stage and histology.

CONCLUSIONS: Compared with the suspected endometrial cancer patients, the Lynch syndrome-associated endometrial cancer patients were younger and less obese. Mutations in MASP2, NADK and RNF223 might be regarded as genetic endometrial cancer features related to clinical characteristics.

PMID:34000661 | DOI:10.1016/j.canep.2021.101934

Cognition. 2021 May 14;214:104764. doi: 10.1016/j.cognition.2021.104764. Online ahead of print.

ABSTRACT

This study investigated how the experience of different reward distributions would shape the utility functions that can be inferred from economic choice. Despite the generally accepted notion that utility functions are not insensitive to external references, the exact way in which such changes take place remains largely unknown. Here we benefitted from the capacity to engage in thorough and prolonged empirical tests of economic choice by one of our evolutionary cousins, the rhesus macaque. We analyzed data from thousands of binary choices and found that the animals’ preferences changed depending on the statistics of rewards experienced in the past (up to weeks) and that these changes could reflect monkeys’ adapting their expectations of reward. The utility functions we elicited from their choices stretched and shifted over several months of sequential changes in the mean and range of rewards that the macaques experienced. However, this adaptation was usually incomplete, suggesting that – even after months – past experiences held weight when monkeys’ assigned value to future rewards. Rather than having stable and fixed preferences assumed by normative economic models, our results demonstrate that rhesus macaques flexibly shape their preferences around the past and present statistics of their environment. That is, rather than relying on a singular reference-point, reference-dependent preferences are likely to capture a monkey’s range of expectations.

PMID:34000666 | DOI:10.1016/j.cognition.2021.104764

Accid Anal Prev. 2021 May 14;157:106188. doi: 10.1016/j.aap.2021.106188. Online ahead of print.

ABSTRACT

OBJECTIVES: Research on the deterrent effects of driving-under-the-influence (DUI) laws has been limited in China, which has criminalized drunk driving since May 2011 yet the effectiveness of this legislation remains unclear. Primary studies are needed to confirm whether government reports of reductions in DUI rates since then can indeed match changes in driver perceptions of DUI risk, and if so, be attributed to what specific components of the DUI legal environments. Based on the classical theory of deterrence and recent advances in differential deterrence, this study adopted a conjoint experiment from a previous US study that simulated the decision-making process of potential drinking drivers, and evaluated how DUI sanctions and enforcement practices contributed differentially to the three components of deterrence (i.e., certainty, swiftness, and severity of punishment). Key individual characteristics and nonlegal factors, as suggested by differential deterrence research to moderate the impact of DUI laws, were also considered.

METHODS: A Web-based conjoint experiment was conducted on a sample of 109 college students from two major universities in Shenzhen, China. Participants were randomly assigned to blocks of hypothetical scenarios composed of different levels of DUI enforcement and penalties, and asked to choose from a pair of scenarios each time, in which they were more likely to drink and drive. They also answered questions adapted from previous studies that measured key individual factors in relation to differential deterrence, such as informal sanction threat, moral inhibition, and personal and vicarious experiences with punishment. Such individual differences were accounted for in both a conventional two-level mixed logit aggregate model and a Hierarchical Bayes model.

RESULTS: Consistent with prior findings in Western countries, DUI enforcement intensity, was found to be the strongest deterrent to potential drinking drivers in China. License suspension, as an administrative punishment that can be swiftly implemented, was also effective in deterring the Chinese drivers, who however were much more likely to fear the revocation of their licenses rather than a 6-month suspension only. Meanwhile, they were notably deterred by the possibility of being in jail for 1-3 days, let alone for 1-2 months. Altogether, enforcement, license suspension and jail penalties accounted for more than 75 percent of attribute impact on drivers’ decision to drink and drive, whereas fine penalty and license points had almost no effect. On the other hand, nonlegal factors such as informal sanction threat and vicarious experiences were found to have significantly moderated the deterrent effects of DUI laws.

CONCLUSIONS: Overall, this study quantified the unique effects of perceived certainty, swiftness, and severity of DUI punishment in the Chinese context, and supported the usefulness of conjoint experiments for examining risk perceptions and DUI decisions in different legal environments. It also provided new empirical evidence on differential deterrence and pointed out the need of determining for which subsets of individuals and under what conditions can legal sanctions successfully deter potential offenders. Such research will help researchers and policy makers better understand the role of deterrence, for more effective policy development related to DUI as well as other important traffic safety issues.

PMID:34000676 | DOI:10.1016/j.aap.2021.106188

J Surg Res. 2021 May 14;266:160-167. doi: 10.1016/j.jss.2021.03.051. Online ahead of print.

ABSTRACT

BACKGROUND: The incidence of thyroid cancer is increasing at a rapid rate. Prior studies have demonstrated financial burden and decreased quality of life in patients with thyroid cancer. Here, we characterize patient-reported financial burden in patients with thyroid cancer over a 28y period.

MATERIALS AND METHODS: Patients who underwent thyroidectomy for thyroid cancer from 1990-2018 completed a phone survey assessing financial burden and its related psychological financial hardship. Descriptive statistics were performed to characterize these outcomes and correlation with sociodemographic data was assessed.

RESULTS: Respondents (N = 147) were 73% female, 75% white, and had a median follow up of 7 y. The majority had a full-time job (59%) and private insurance (81%) at the time of diagnosis. Overall, 16% of respondents reported financial burden and 50% reported psychological financial hardship. Those reporting financial burden were disproportionately impacted by psychological financial hardship (87% versus 43%, P < 0.001). One in four (25%) respondents reported not being adequately informed about costs.

CONCLUSIONS: Financial burdens are important outcomes of thyroid cancer which occur even among patients with protective financial factors, suggesting an even greater impact on the general population of patients with thyroid cancer. Further research is needed to explore the intersection of financial burden, cost, and quality of life.

PMID:34000639 | DOI:10.1016/j.jss.2021.03.051