Category: Statistics

Accid Anal Prev. 2021 Apr 21;156:106144. doi: 10.1016/j.aap.2021.106144. Online ahead of print.

ABSTRACT

Road anger is an increasing problem that does not only lead to discomfort but is also associated with aggressive driving and an increased risk of crash involvement. Based on a cognitive-behavioural approach, we developed and tested a short group intervention (90 min) that aimed at decreasing road anger among drivers. We used a before-after control group design, surveying people who did (EG) and who did not (CG) participate in the group intervention. The sample (n = 126) consisted of 80 men and 46 women with a mean age of 54 years (SD = 13). In addition, a sub-sample (n = 37) participated in a driving simulator study before and after the intervention. To enrich the survey- and simulator-based findings, we conducted a focus group discussion about post-intervention experiences in traffic. Comparisons of pre and post survey results showed that constructive expression as measured by a slightly revised sub-scale of the Driving Anger Expression Inventory (DAX-short), increased significantly for EG participants but not within the CG. In addition, the involvement in milder forms of road anger (e.g., yelling) decreased significantly in the EG but not in the CG. In the simulator study, we observed that EG participants decreased the extent of aggressive driving, commenting and gesturing – however, none of these differences were statistically significant. EG participants self-assessed the intervention overall positive and 44 % reported that they had changed their way of thinking or reacting in traffic. Overall, results indicate a positive effect of the cognitive-behavioural group intervention. Study limitations, possibilities to improve the intervention and different areas of application are discussed.

PMID:33894475 | DOI:10.1016/j.aap.2021.106144

J Hazard Mater. 2021 Apr 12;416:125866. doi: 10.1016/j.jhazmat.2021.125866. Online ahead of print.

ABSTRACT

Perfluorooctanoic acid (PFOA) is widely concerned because its serious toxicity to the environment and ecosystems. In order to effectively and conveniently remove PFOA from aqueous solutions, reduced graphene oxide aerogel modified by Cu nanoparticles and fluorine (Cu/F-rGA) was prepared by the microbubble template method as an electrode in electrosorption. The removal capacity of Cu/F-rGA electrode to PFOA was 489% and 45.9% higher at + 0.8 V than that of open circuit and unmodified electrode, respectively. These significant improvements can be attributed to the advantages of Cu/F-rGA in ligand exchange reaction and electrostatic attraction under voltage assistance. The regeneration of Cu/F-rGA electrode maintained 75.51% capacity after 10 times electrosorption-desorption by applying reverse voltage. These properties provided potential for the reuse and application of Cu/F-rGA electrode. The electrosorption isotherm and model results showed that PFOA tended to be parallel to the adsorption site at low temperature and perpendicular at high temperature. The number of PFOA molecules connected to each adsorption site was 0.72-1.76, and the number of adsorption layers of PFOA on the electrode was between 1.46 and 2.87. Findings from this study provide a green and effective strategy to remove PFOA from aqueous solutions with low energy consumption.

PMID:33894436 | DOI:10.1016/j.jhazmat.2021.125866

Liver Int. 2021 Apr 24. doi: 10.1111/liv.14905. Online ahead of print.

ABSTRACT

BACKGROUND: Data concerning the impact of hepatitis C virus (HCV) cure on type 2 diabetes mellitus (T2DM) are controversial. The aim of the study was to evaluate the effects of anti-HCV direct-acting antiviral (DAA) treatments on long-term glucose control in HCV/T2DM patients with chronic hepatitis C (CHC) or with cirrhosis.

METHODS: One hundred and eighty-two consecutive HCV/T2DM patients who achieved a viral clearance by DAA treatment were enrolled. Seventy/182 of them had CHC, and 112 had cirrhosis. Clinical, biochemical and instrumental parameters were recorded at baseline and at 48, 96, and 120 weeks (48w, 96w, 120w, respectively) after stopping DAA therapy.

RESULTS: At baseline, the overall study population had a mean of glycated haemoglobin (HbA1c) value of 7.2% (ranging from 5 to 11.2), without any significant differences between CHC and cirrhosis [7.1 and 7.2, respectively]. Evaluation over time of HbA1c variations showed a significant improvement of glucose control at all post-treatment time points compared to baseline in CHC patients (p=0.001). In cirrhotic patients a significant decrease of HbA1c levels was only found when comparing HbA1c values between baseline and 48w time-point (p=0.001), whereas this improvement disappeared at both 98w and 120w (p=0.8 and p=0.3, respectively). Multivariate logistic regression analysis showed that patients with chronic hepatitis have a 2.5 (CI 1,066-5,945) times greater chance of achieving an improvement of glycaemic values than patients with liver cirrhosis (p=0.035).

CONCLUSION: DAA-based HCV cure induces a significant and persistent amelioration of glycaemic control in HCV/diabetic patients with chronic hepatitis, whereas cirrhotic HCV/diabetic subjects have only a transient benefit from the virus elimination.

PMID:33894103 | DOI:10.1111/liv.14905

Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2021 Apr 23;42(1):53-66. doi: 10.2478/prilozi-2021-0004.

ABSTRACT

Aims: The aim of this paper is to indicate if carotid stenosis is predictive for the prognosis of coronary artery disease.Method and materials: Our study is a prospective cohort study. 1031 patients with proven coronary artery disease (CAD) were recruited consecutively. Carotid ultrasound was used to assess IMT, plaque, or stenosis. They were followed for 24 months for adverse cardiovascular events. Selected demographic date such as smoking history, dyslipidemia, hypertension, laboratory values, and clinical data (associated diseases and risk) were collected from each patient. Total cardiovascular events and mortality rate were followed up for the study population. The results were collected prospectively and retrospectively. The study was organized as a clinical, cross-sectional study and comparative study.From the data collected with the clinical research, a file was formed in the statistical program with the help of which the data were statistically analyzed.From the methods of descriptive statistics, absolute frequencies, percentages, arithmetic mean, median, measures of variability, minimum, maximum, standard deviation and logistic regression models were used.Result: Of the total number of patients 1026 had arterial hypertension (HTA). Data on hyperlipidemia (HLP) had been reported in 895 patients. 1.023 patients had peripheral artery disease (PAB). 1031 patients were presented with multivessel coronary artery disease (CAD). There were 1,029 patients with diabetes mellitus (DM), while 1,013 patients had coronary artery by-pass (CABG), and 1,012 had stroke (CVI). Elevated systolic blood pressure was reported in 966 patients. 184 patients had elevated triglycerides and 187 had elevated cholesterol. 1,008 patients have had a history of myocardial infarction. Carotid artery stenosis (CAS) has been found in 1,009 patients, increased body mass index (BMI) in 270 patients.1.031 patients were followed for 24 months. Cardiovascular events were reported in 54 patients (or 5.2%). Revascularization was performed in 28 (4.1%) patients, while 12 (1.8%) of patients died. Diabetes mellitus (OR 1.878 95% CI 0.491 7.184) and Carotid stenosis (OR 2.185 95% CI 0.731 6.53) were found to be predictive factors for future cardiovascular events.Conclusion: Due to our results carotid ultrasound may be a useful tool for risk stratification of coronary artery disease pts.

PMID:33894121 | DOI:10.2478/prilozi-2021-0004

J Cosmet Dermatol. 2021 Apr 24. doi: 10.1111/jocd.14171. Online ahead of print.

ABSTRACT

BACKGROUND: Oxidative stress parameters have been reported to be significantly higher than controls in diverse disorders of pigmentation but no such data seems to be extant for IGH.

OBJECTIVES: To verify if heightened oxidative stress levels are seen in patients with IGH (compared with matched controls), and quantify the same in blood using appropriate bio-chemical markers. Further, to attempt determining if there might be any correlation between the amount of oxidative stress and the severity of the disease.

METHODOLOGY: This prospective case-control study was conducted in Northern India. Thirty Indian patients (Fitzpatrick skin phototype (SPT) IV-V) were included. The diagnosis of IGH lesions was confirmed based on characteristic clinical, and dermoscopic characteristics, and confirmed on histopathological examination (H & E) of one of the lesions.

RESULTS: The oxidative stress enzyme level were significantly higher among the cases compared to controls which were statistically significant (P < 0.05). A positive correlation was also observed between the levels of these markers and number of lesions; but this finding was statistically not significant [p>0.05] Assessment of melanin level by Dopa staining method in the IGH lesions revealed irregularly distributed melanin with areas of high and low melanin content and greater accumulation in the basement layer.

CONCLUSION: The results of this probably the first study evaluating oxidative stress in IGH show that the oxidative stress is increased in patients with IGH. Level of oxidative stress seems to be correlates with both age of the patient (more in the elderly) and number of lesions.

PMID:33894101 | DOI:10.1111/jocd.14171

J Magn Reson Imaging. 2021 Apr 24. doi: 10.1002/jmri.27659. Online ahead of print.

ABSTRACT

BACKGROUND: Recent studies suggest that macromolecular fraction (MMF) derived from three-dimensional ultrashort echo time magnetization transfer (UTE-MT) imaging is insensitive to the magic angle effect. However, its clinical use in osteoarthritis (OA) remains to be investigated.

PURPOSE: To investigate the feasibility of 3D UTE-MT-derived MMF in differentiating normal from degenerated cartilage.

STUDY TYPE: Prospective.

SUBJECTS: Sixty-two participants (54.8 ± 16.7 years, 30 females) with and without OA, plus two healthy volunteers (mean age 35.0 years) for reproducibility test.

FIELD STRENGTH/SEQUENCE: 3 T/UTE-MT sequence.

ASSESSMENT: A 3D UTE-MT sequence was employed to calculate MMF based on a two-pool model. Kellgren-Lawrence (KL) grade and Whole-Organ Magnetic Resonance Imaging Score (WORMS) were evaluated by three experienced musculoskeletal radiologists. KL grade was condensed into three groups: KL0, KL1-2, and KL3-4. WORMS was regrouped based on extent of lesion (extent group) and depth of lesion (depth group), respectively. The performance of MMF at evaluating the degeneration of cartilage was assessed via Spearman’s correlation coefficient and the area under the curve (AUC) calculated according to the receiver-operating characteristic curve.

STATISTICAL TESTS: After normality check, one-way analysis of variance was used to evaluate the performance. Tukey-Kramer test was performed for post hoc testing.

RESULTS: MMF showed significant negative correlations with KL grade (r = -0.53, P < 0.05) and WORMS (r = -0.49, P < 0.05). Significantly lower MMFs were found in subjects with greater KL grade (11.8 ± 0.8% for KL0; 10.9 ± 0.9% for KL1-2; 10.6 ± 1.1% for KL3-4; P < 0.05) and in cartilage with greater extent (12.1 ± 1.6% for normal cartilage; 10.9 ± 1.6% for regional lesions; 9.6 ± 1.7% for diffuse lesions; P < 0.05) and depth (12.1 ± 1.6% for normal cartilage; 10.6 ± 1.6% for partial-thickness lesions; 8.8 ± 1.7% for full-thickness lesions; P < 0.05) of lesions. AUC values of MMF for doubtful-minimal OA (KL1-2) and mild cartilage degradation (WORMS1-2) were 0.8 and 0.7, respectively.

DATA CONCLUSION: This study highlights the clinical potential of MMF in the detection of early OA.

LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 2.

PMID:33894091 | DOI:10.1002/jmri.27659

J Magn Reson Imaging. 2021 Apr 24. doi: 10.1002/jmri.27654. Online ahead of print.

ABSTRACT

BACKGROUND: Current registration methods for diffusion-MRI (dMRI) data mostly focus on white matter (WM) areas. Recently, dMRI has been employed for the characterization of gray matter (GM) microstructure, emphasizing the need for registration methods that consider all tissue types.

PURPOSE: To develop a dMRI registration method based on GM, WM, and cerebrospinal fluid (CSF) tissue probability maps (TPMs).

STUDY TYPE: Retrospective longitudinal study.

POPULATION: Thirty-two healthy participants were scanned twice (legacy data), divided into a training-set (n = 16) and a test-set (n = 16), and 35 randomly-selected participants from the Human Connectome Project.

FIELD STRENGTH/SEQUENCE: 3.0T, diffusion-weighted spin-echo echo-planar sequence; T1-weighted spoiled gradient-recalled echo (SPGR) sequence.

ASSESSMENT: A joint segmentation-registration approach was implemented: Diffusion tensor imaging (DTI) maps were classified into TPMs using machine-learning approaches. The resulting GM, WM, and CSF probability maps were employed as features for image alignment. Validation was performed on the test dataset and the HCP dataset. Registration performance was compared with current mainstream registration tools.

STATISTICAL TESTS: Classifiers used for segmentation were evaluated using leave-one-out cross-validation and scored using Dice-index. Registration success was evaluated by voxel-wise variance, normalized cross-correlation of registered DTI maps, intra- and inter-subject similarity of the registered TPMs, and region-based intra-subject similarity using an anatomical atlas. One-way ANOVAs were performed to compare between our method and other registration tools.

RESULTS: The proposed method outperformed mainstream registration tools as indicated by lower voxel-wise variance of registered DTI maps (SD decrease of 10%) and higher similarity between registered TPMs within and across participants, for all tissue types (Dice increase of 0.1-0.2; P < 0.05).

DATA CONCLUSION: A joint segmentation-registration approach based on diffusion-driven TPMs provides a more accurate registration of dMRI data, outperforming other registration tools. Our method offers a “translation” of diffusion data into structural information in the form of TPMs, allowing to directly align diffusion and structural images.

LEVEL OF EVIDENCE: 1 Technical Efficacy Stage: 1.

PMID:33894095 | DOI:10.1002/jmri.27654

J Magn Reson Imaging. 2021 Apr 24. doi: 10.1002/jmri.27655. Online ahead of print.

ABSTRACT

BACKGROUND: There is increasing interest in noncontrast-enhanced MRI due to safety concerns for gadolinium contrast agents.

PURPOSE: To investigate the clinical feasibility of MR-based conductivity imaging for breast cancer detection and lesion differentiation.

STUDY TYPE: Prospective.

SUBJECTS: One hundred and ten women, with 112 known cancers and 17 benign lesions (biopsy-proven), scheduled for preoperative MRI.

FIELD STRENGTH/SEQUENCE: Non-fat-suppressed T2-weighted turbo spin-echo sequence (T2WI), dynamic contrast-enhanced MRI and diffusion-weighted imaging (DWI) at 3T.

ASSESSMENT: Cancer detectability on each imaging modality was qualitatively evaluated on a per-breast basis: the conductivity maps derived from T2WI were independently reviewed by three radiologists (R1-R3). T2WI, DWI, and pre-operative digital mammography were independently reviewed by three other radiologists (R4-R6). Conductivity and apparent diffusion coefficient (ADC) measurements (mean, minimum, and maximum) were performed for 112 cancers and 17 benign lesions independently by two radiologists (R1 and R2). Tumor size was measured from surgical specimens.

STATISTICAL TESTS: Cancer detection rates were compared using generalized estimating equations. Multivariable logistic regression analysis was performed to identify factors associated with cancer detectability. Discriminating ability of conductivity and ADC was evaluated by using the areas under the receiver operating characteristic curve (AUC).

RESULTS: Conductivity imaging showed lower cancer detection rates (20%-32%) compared to T2WI (62%-71%), DWI (85%-90%), and mammography (79%-88%) (all P < 0.05). Fatty breast on MRI (odds ratio = 11.8, P < 0.05) and invasive tumor size (odds ratio = 1.7, P < 0.05) were associated with cancer detectability of conductivity imaging. The maximum conductivity showed comparable ability to the mean ADC in discriminating between cancers and benign lesions (AUC = 0.67 [95% CI: 0.59, 0.75] vs. 0.84 [0.76, 0.90], P = 0.06 (R1); 0.65 [0.56, 0.73] vs. 0.82 [0.74, 0.88], P = 0.07 (R2)).

DATA CONCLUSION: Although conductivity imaging showed suboptimal performance in breast cancer detection, the quantitative measurement of conductivity showed the potential for lesion differentiation.

EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 2.

PMID:33894088 | DOI:10.1002/jmri.27655

Pediatr Allergy Immunol. 2021 Apr 24. doi: 10.1111/pai.13526. Online ahead of print.

ABSTRACT

BACKGROUND: Exposure to indoor moisture damage and visible mould has been found to be associated with asthma and respiratory symptoms in several questionnaire-based studies by self-report. We aimed to define the prospective association between the early life exposure to residential moisture damage or mould and fractional exhaled nitric oxide (FeNO) and lung function parameters as objective markers for airway inflammation and asthma in 6-year old children.

METHODS: Home inspections were performed in children’s homes when infants were on average 5 months old. At age 6 years, data on FeNO (n=322) as well as lung function (n=216) measurements were collected. Logistic regression and generalized additive models were used for statistical analyses.

RESULTS: Early age major moisture damage and moisture damage or mould in the child’s main living areas was significantly associated with increased FeNO levels (>75th percentile) at the age of 6 years (adjusted Odds Ratios, 95% Confidence Intervals, aOR (95%CI): 3.10 (1.35-7.07)) and 3.16 (1.43-6.98), respectively). Effects were more pronounced in those who did not change residential address throughout the study period. For lung function, major structural damage within the whole home was associated with reduced FEV1 and FVC, but not with FEV1/FVC. No association with lung function was observed with early moisture damage or mould in the child’s main living areas.

CONCLUSION: These results underline the importance of prevention and remediation efforts of moisture and mould damaged buildings in order to avoid harmful effects within the vulnerable phase of the infants and children’s immunological development.

PMID:33894090 | DOI:10.1111/pai.13526

J Dermatol. 2021 Apr 24. doi: 10.1111/1346-8138.15908. Online ahead of print.

ABSTRACT

Dermoscopy is an efficient and non-invasive technique which has been widely used in the diagnosis of nail disorders including nail psoriasis (NP). Many nail dermoscopic features are considered as clues to NP. The aim of this study was to investigate specific dermoscopic features of fingernail psoriasis and the correlation between the severity of nail lesions or systemic inflammation, and psoriasis severity of skin and nail. This observational study recruited 135 patients with fingernail psoriasis (1186 fingernails) and 30 patients with onychomycosis (80 fingernails). All of the involved fingernails were examined with a handheld dermatoscope. The Nail Psoriasis Severity Index score (NAPSI) score, Psoriasis Area and Severity Index (PASI) score, body surface area (BSA), and detailed history of patients with psoriasis were recorded. Mann-Whitney U-test, χ² -test, Spearman’s correlation, and Kruskal-Wallis H-test were used for statistical analysis, and the significance threshold was p < 0.05. The trial registration number was 2020-SR-045. We identified onycholysis as the most common feature (93.3%) of fingernail psoriasis. Red lunula, longitudinal fissures, transverse grooves, nail plate crumbling, trachyonychia, oil-dropping sign, erythematous border of an onycholytic area, subungual hyperkeratosis, and dilated streaky capillaries were relevant to NP severity (p < 0.05). Red lunula, transverse grooves, nail plate crumbling, trachyonychia, oil-dropping sign, erythematous border of an onycholytic area, splinter hemorrhages, and dilated streaky capillaries were relevant to systemic inflammation severity (p < 0.05). The total NAPSI score was positively associated with the PASI score and BSA (p < 0.0001). The thumb had a higher NAPSI score than the other fingers (p < 0.05). In conclusion, dermoscopic features can improve the accuracy of diagnosis of nail psoriasis, and have correlations with psoriasis severity.

PMID:33894071 | DOI:10.1111/1346-8138.15908