Category: Statistics

Arch Dermatol Res. 2021 Apr 23. doi: 10.1007/s00403-021-02233-y. Online ahead of print.

ABSTRACT

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin condition that substantially reduces patient quality of life. Many HS patients ask their dermatologist about potential lifestyle modifications, such as following particular diets or avoiding specific products, in an attempt to alleviate their symptoms. However, insufficient research has been conducted to support well-informed lifestyle modification counseling, and patients frequently defer to anecdotal endorsements of various interventions found on social media support groups. Therefore, we sought to clarify what lifestyle modifications were capable of improving HS symptoms.

METHODS: We conducted a survey-based study to examine modifiable risk factors and their association with the severity of HS. Five hundred and ninety-one patients with HS participated in an online survey detailing the severity of their HS symptoms before and after various lifestyle interventions. Average improvements in both subjective and objective ratings of symptom severity were calculated and statistical differences between the levels of improvement seen among various categories of lifestyle interventions were determined.

RESULTS: Numerous lifestyle interventions including substantial weight loss, smoking cessation, use of gentle skin and depilatory products, and menstrual regulation were associated with both subjective and objective improvements in symptom severity.

CONCLUSIONS: Our results suggest that patients affected by HS may experience clinically significant improvement from a variety of lifestyle modifications.

PMID:33893517 | DOI:10.1007/s00403-021-02233-y

Aesthetic Plast Surg. 2021 Apr 23. doi: 10.1007/s00266-021-02289-1. Online ahead of print.

ABSTRACT

BACKGROUND: Previous data were not conclusive on the safety of gestation in patients whose abdominal flaps were earlier harvested. We performed a meta-analysis to evaluate the abdominal wall complications and birth mode of pregnancy in post-TRAM or post-DIEP harvested individuals.

METHODS: A literature search was performed using the PubMed, Embase, Scopus, and Google scholar database. Heterogeneity was statistically analyzed, and random effect models were applied. Publication bias was assessed by funnel plot.

RESULTS: We included 25 papers that captured 56 patients giving birth to 69 healthy babies after elevation of abdominally based flaps, with a pooled abdominal complication rate of 0.00-0.09. The complication incidence in TRAM group was 0.01 (95% CI = [0.00-0.14%]) while 0.00 in the DIEP group (95% CI = [0.00-0.26%]). Discrepancies in incidence following unilaterally or bilaterally based TRAM flaps, following free or pedicled TRAM flaps, following primary sutured or mesh strengthened fascia, following MS free TRAM or conventional free TRAM could not be calculated as statistically significant. TRAM group and DIEP group patients had identical birth modes.

CONCLUSIONS: The present meta-analysis did not detect evidence that abdominal walls with the prior harvest of abdominal flaps could affect the process of pregnancy or contraindicate vaginal delivery. No abdominal hernia or bulge occurred with post-DIEP pregnancies. However, such conclusions need to be substantiated by larger sample studies.

LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .

PMID:33893518 | DOI:10.1007/s00266-021-02289-1

Dis Esophagus. 2021 Apr 24:doab021. doi: 10.1093/dote/doab021. Online ahead of print.

ABSTRACT

INTRODUCTION: The prognostic value of histomorphologic regression in primary esophageal cancer has been previously established, however the impact of lymph node (LN) response on survival still remains unclear. The aim of this review was to assess the prognostic significance of LN regression or downstaging following neoadjuvant therapy for esophageal cancer.

METHODS: An electronic search was performed to identify articles evaluating LN regression or downstaging after neoadjuvant therapy. Random effects meta-analyses were performed to assess the influence of regression in the LNs and nodal downstaging on overall survival. Histomorphologic tumor regression in LNs was defined by the absence of viable cells or degree of fibrosis on histopathologic examination. Downstaged LNs were defined as pN0 nodes by the tumor, node, and metastasis classification, which were positive prior to treatment neoadjuvant.

RESULTS: Eight articles were included, three of which assessed tumor regression (number of patients = 292) and five assessed downstaging (number of patients = 1368). Complete tumor regression (average rate of 29.1%) in the LNs was associated with improved survival, although not statistically significant (hazard ratio [HR] = 0.52, 95% confidence interval [CI] = 0.26-1.06; P = 0.17). LNs downstaging (average rate of 32.2%) was associated with improved survival compared to node positivity after neoadjuvant treatment (HR = 0.41, 95%CI = 0.22-0.77; P = 0.005).

DISCUSSION: The findings of this meta-analysis have shown a survival benefit in patients with LN downstaging and are suggestive for considering LN downstaging to ypN0 as an additional prognostic marker in staging and in the comparative evaluation of differing neoadjuvant regimens in clinical trials. No statistically significant effect of histopathologic regression in the LNs on long-term survival was seen.

PMID:33893494 | DOI:10.1093/dote/doab021

Soc Psychiatry Psychiatr Epidemiol. 2021 Apr 24. doi: 10.1007/s00127-021-02076-y. Online ahead of print.

ABSTRACT

PURPOSE: Honest, Open, Proud (HOP; formerly “Coming Out Proud”/COP) is a peer-led group program to support people with mental illness in their disclosure decisions and in their coping with stigma. The aims of this study were to provide (i) a conceptual review of HOP, including versions for different target groups and issues related to outcome measurement and implementation; and (ii) a meta-analysis of program efficacy.

METHODS: Conceptual and empirical literature on disclosure and the HOP program was reviewed. Controlled trials of HOP/COP were searched in literature databases. A meta-analysis of HOP efficacy in terms of key outcomes was conducted.

RESULTS: HOP program adaptations for different target groups (e.g. parents of children with mental illness; veterans or active soldiers with mental illness) exist and await evaluation. Recruitment for trials and program implementation may be challenging. A meta-analysis of five HOP RCTs for adults or adolescents with mental illness or adult survivors of suicide attempts found significant positive effects on stigma stress (smd = – 0.50) as well as smaller, statistically non-significant effects on self-stigma (smd = – 0.17) and depression (smd = – 0.11) at the end of the HOP program. At 3- to 4-week follow-up, there was a modest, not statistically significant effect on stigma stress (smd = – 0.40, 95%-CI -0.83 to 0.04), while effects for self-stigma were small and significant (smd = – 0.24). Long-term effects of the HOP program are unknown.

CONCLUSION: There is initial evidence that HOP effectively supports people with mental illness in their disclosure decisions and in their coping with stigma. Implementation issues, future developments and public health implications are discussed.

PMID:33893512 | DOI:10.1007/s00127-021-02076-y

Sci Rep. 2021 Apr 23;11(1):8812. doi: 10.1038/s41598-021-87956-8.

ABSTRACT

The current research explores incremental effect of thermal radiation on heat transfer improvement corresponds to Darcy-Forchheimer (DF) flow of carbon nanotubes along a stretched rotating surface using RSM. Casson carbon nanotubes’ constructed model in boundary layer flow is being investigated with implications of both single-walled CNTs and multi-walled CNTs. Water and Ethylene glycol are considered a basic fluid. The heat transfer rate is scrutinized via convective condition. Outcomes are observed and evaluated for both SWCNTs and MWCNTs. The Runge-Kutta Fehlberg technique of shooting is utilized to numerically solve transformed nonlinear ordinary differential system. The output parameters of interest are presumed to depend on governing input variables. In addition, sensitivity study is incorporated. It is noted that sensitivity of SFC via SWCNT-Water becomes higher by increasing values of permeability number. Additionaly, sensitivity of SFC via SWCNT-water towards the permeability number is higher than the solid volume fraction for medium and higher permeability levels. It is also noted that sensitivity of SFC (SWCNT-Ethylene-glycol) towards volume fraction is higher for increasing permeability as well as inertia coefficient. Additionally, the sensitivity of LNN towards the Solid volume fraction is higher than the radiation and Biot number for all levels of Biot number. The findings will provide initial direction for future device manufacturing.

PMID:33893354 | DOI:10.1038/s41598-021-87956-8

Sci Rep. 2021 Apr 23;11(1):8871. doi: 10.1038/s41598-021-88266-9.

ABSTRACT

In this paper, we analyse the seismic noise at Ischia Island (Italy) with the objective of detecting the hydrothermal source signals taking advantage of the Covid-19 quiescence due to lockdown (strong reduction of anthropogenic noise). We compare the characteristics of the background noise in pre-, during and post-lockdown in terms of spectral content, energy release (RMS) and statistical moments. The continuous noise is decomposed into two independent signals in the 1-2 Hz and 2-4 Hz frequency bands, becoming sharpened around 1 Hz and 3 Hz respectively in lockdown. We propose a conceptual model according to which a dendritic system of fluid-permeated fractures plays as neighbour closed organ pipes, for which the fundamental mode provides the persistent whisper and the first higher mode is activated in concomitance with energy increases. By assuming reasonable values for the sound speed in low vapor-liquid mass fraction for a two-phase fluid and considering temperatures and pressures of the shallow aquifer fed by sea, meteoric and deep hydrothermal fluids, we estimate pipe lengths in the range 200-300 m. In this scheme, Ischia organ-like system can play both continuous whisper and transients, depending on the energy variations sourced by pressure fluctuations in the hydrothermal fluids.

PMID:33893368 | DOI:10.1038/s41598-021-88266-9

Eur J Clin Nutr. 2021 Apr 23. doi: 10.1038/s41430-021-00910-9. Online ahead of print.

ABSTRACT

OBJECTIVES: We aimed to investigate the predictive potential of early pregnancy factors such as lifestyle, gestational weight gain (GWG) and mental well-being on gestational diabetes mellitus (GDM) beyond established risk factors.

METHODS: GDM risk was investigated in the cohort of the German ‘Gesund leben in der Schwangerschaft’/healthy living in pregnancy study. Women were recruited up to the 12^th week of gestation. GDM was diagnosed with a 75 g oral glucose tolerance test between the 24^th and 28^th weeks of gestation. Pre-pregnancy age and weight, mental health and lifestyle were assessed via questionnaires. Maternal weight was measured throughout pregnancy. Early excessive GWG was defined based on the guidelines of the Institute of Medicine. The association between several factors and the odds of developing GDM was assessed using multiple logistic regression analyses.

RESULTS: Of 1694 included women, 10.8% developed GDM. The odds increased with pre-pregnancy BMI and age (women with obesity: 4.91, CI 3.35-7.19, p < 0.001; women aged 36-43 years: 2.84, CI 1.45-5.56, p = 0.002). Early excessive GWG, mental health and general lifestyle ratings were no significant risk factors. A 31% reduction in the odds of GDM was observed when <30% of energy was consumed from fat (OR 0.69, CI 0.49-0.96, p = 0.026). Vigorous physical activity tended to lower the odds without evidence of statistical significance (OR 0.59 per 10 MET-h/week, p = 0.076).

CONCLUSIONS: Maternal age and BMI stand out as the most important drivers of GDM. Early pregnancy factors like dietary fat content seem to be associated with GDM risk. Further evaluation is warranted before providing reliable recommendations.

PMID:33893447 | DOI:10.1038/s41430-021-00910-9

Nat Commun. 2021 Apr 23;12(1):2463. doi: 10.1038/s41467-021-22613-2.

NO ABSTRACT

PMID:33893282 | DOI:10.1038/s41467-021-22613-2

Nat Commun. 2021 Apr 23;12(1):2435. doi: 10.1038/s41467-021-22757-1.

ABSTRACT

Antibiotic resistance spreads among bacteria through horizontal transfer of antibiotic resistance genes (ARGs). Here, we set out to determine predictive features of ARG transfer among bacterial clades. We use a statistical framework to identify putative horizontally transferred ARGs and the groups of bacteria that disseminate them. We identify 152 gene exchange networks containing 22,963 bacterial genomes. Analysis of ARG-surrounding sequences identify genes encoding putative mobilisation elements such as transposases and integrases that may be involved in gene transfer between genomes. Certain ARGs appear to be frequently mobilised by different mobile genetic elements. We characterise the phylogenetic reach of these mobilisation elements to predict the potential future dissemination of known ARGs. Using a separate database with 472,798 genomes from Streptococcaceae, Staphylococcaceae and Enterobacteriaceae, we confirm 34 of 94 predicted mobilisations. We explore transfer barriers beyond mobilisation and show experimentally that physiological constraints of the host can explain why specific genes are largely confined to Gram-negative bacteria although their mobile elements support dissemination to Gram-positive bacteria. Our approach may potentially enable better risk assessment of future resistance gene dissemination.

PMID:33893312 | DOI:10.1038/s41467-021-22757-1

J Contemp Dent Pract. 2020 Dec 1;21(12):1374-1378.

ABSTRACT

AIM AND OBJECTIVE: The present study compared the fracture strength and failure pattern of endodontically treated, bi-rooted, maxillary premolars with different number of coronal walls and postendodontic restoration (one vs double post).

MATERIALS AND METHODS: 105 premolars were divided into 3 groups according to the number of residual walls: control group (intact teeth; n = 15), group 1 (3 residual walls; n = 45), group 2 (2 residual walls; n = 45). Each test group was then divided into 3 subgroups (n = 15 each) according to postendodontic restoration: no post (A), 1 post (B) or 2 posts (C). A load was applied parallel to the longitudinal axis of the teeth, thus simulating physiological occlusion. ANOVA and Tukey’s tests were used to detect fracture strength differences among groups, while Chi-square test was used to check differences in fracture pattern.

RESULTS: No significant differences were observed between control group (intact teeth) and groups A1 (p = 0.999), B1 (p = 0.997) and C1 (p = 1.000); statistically significant differences were detected between control group and groups A2 (p < 0.001), B2 (p < 0.001) and C2 (p < 0.05). Different post placement techniques were non-significantly associated with fracture pattern in both groups 1 (p = 0.666) and 2 (p = 0.143) while, irrespective of the number of posts, the presence of the post was significantly associated with the fracture pattern in teeth with two residual walls. The double-post technique did not further improve the fracture resistance of hardly damaged endodontically treated maxillary bi-rooted premolars compared to single-post technique. Therefore, the insertion of a single post in the palatal canal could be a safer and more conservative choice.

CLINICAL SIGNIFICANCE: The double-post technique did not further improve the fracture resistance of severely structurally compromised endodontically treated maxillary premolars with two roots compared to the single-post technique. Therefore, the safer and less invasive treatment is the placement of a single post in the palatal canal.

PMID:33893261