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Nevin Manimala Statistics

Dental Injuries on Garden Trampolines

Swiss Dent J. 2021 Mar 25;131(10). Online ahead of print.

ABSTRACT

Garden trampolines are very popular in Switzerland. Most trampoline related accidents result in fractures and soft tissue injuries of the extremities. While these types of injuries have been well investigated in numerous studies, there has been no study on dental injuries on trampolines. The aim of the present study was to investigate dental accidents on garden trampolines in Switzerland and to analyze possible influencing factors. Data collection was carried out by analyzing aerial photographs and a questionnairebased survey. Out of 1212 questionnaires sent out, 637 could be included in the study. The data were evaluated in terms of accident, type of trampoline (inground or onground), and whether a safety net was present. A total of 105 trampoline accidents (16.5%) occurred, of which 23 were dental injuries (23.2%). 39.1% (n=9) were tooth fractures, 30.4% (n=7) were concussions, 17.4% (n=4) were avulsions, and 13.0% (n=3) were dislocation injuries. Teeth were predominantly impacted on the trampoline frame (26.2%, n=6) or on a person’s own knee (26%, n=6). Dental accidents occurred 3.6 times more frequently when the trampoline was used by more than one person at a time. Dental accidents occurred 2.4 times more frequently on inground trampolines than on onground trampolines. Statistically, only the diameter of the trampoline had an influence on the frequency of accidents: Larger trampolines led more frequently to accidents. The present study showed that trampolining poses a risk of dental injury like other sports such as kick scooter or skiing. It is therefore important to increase parental and public awareness regarding the potential dangers of trampoline use.

PMID:33764032

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Nevin Manimala Statistics

Impact of Non-Vitamin K Antagonist Oral Anticoagulants on the Change of Antithrombotic Regimens in Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention

Korean Circ J. 2021 Jan 25. doi: 10.4070/kcj.2020.0407. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Antithrombotic therapy after percutaneous coronary intervention (PCI) in patients with atrial fibrillation (AF) has changed in recent years with new data from large randomized trials and updates to clinical guidelines. This study aimed to investigate the trends in periprocedural antithrombotic regimens in Korean patients with AF undergoing PCI with non-vitamin K antagonist oral anticoagulants (NOACs).

METHODS: Using the claims database of the Health Insurance Review and Assessment during 2013-2018, 27,594 patients with AF undergoing PCI were identified. The annual prevalence of PCI and prescriptions of each antithrombotic agent, including antiplatelet agents and oral anticoagulants, within 30 days after PCI were investigated.

RESULTS: During 2013-2018, the number of patients with AF undergoing PCI increased up to 1.3-fold (from 3,913 to 5,075 patients per year). After the introduction of NOACs, the proportion of dual antiplatelet therapy (DAPT) decreased from 71.9% to 49.8% but still occupied the largest proportion among antithrombotic regimens. Triple antithrombotic therapy (TAT) use increased from 25.4% to 46.0%, and NOAC has rapidly replaced warfarin as the oral anticoagulant of choice. TAT was preferred to DAPT for patients with CHA₂DS₂-VASc score ≥2. Among various factors, prior intracranial hemorrhage was the most powerful predictor of favoring DAPT use over TAT.

CONCLUSION: Since the introduction of NOACs, the patterns of periprocedural antithrombotic regimens have changed rapidly toward more use of TAT, specifically with NOAC-based regimen. Appropriate stroke prevention with oral anticoagulants is still underutilized in patients with AF undergoing PCI in Korea.

PMID:33764010 | DOI:10.4070/kcj.2020.0407

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Nevin Manimala Statistics

Log-ratio analysis of microbiome data with many zeroes is library size dependent

Mol Ecol Resour. 2021 Mar 24. doi: 10.1111/1755-0998.13391. Online ahead of print.

ABSTRACT

Microbiome composition data collected through amplicon sequencing are count data on taxa in which the total count per sample (the library size) is an artefact of the sequencing platform and as a result such data are compositional. To avoid library size dependency, one common way of analyzing multivariate compositional data is to perform a principal component analysis (PCA) on data transformed with the centered log-ratio, hereafter called a log-ratio PCA. Two aspects typical of amplicon sequencing data are the large differences in library size and the large number of zeroes. In this paper we show on real data and by simulation that, applied to data that combines these two aspects, log-ratio PCA is nevertheless heavily dependent on the library size. This leads to a reduction in power when testing against any explanatory variable in log-ratio redundancy analysis. If there is additionally a correlation between the library size and the explanatory variable, then the type 1 error becomes inated. We explore putative solutions to this problem.

PMID:33763959 | DOI:10.1111/1755-0998.13391

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Nevin Manimala Statistics

Natural History of Hepatitis C Virus Infection in a Large National Seroconversion Cohort in the Direct Acting Antiviral Agent Era: Results from ERCHIVES

J Viral Hepat. 2021 Mar 24. doi: 10.1111/jvh.13507. Online ahead of print.

ABSTRACT

Hepatitis C virus (HCV) natural history studies are limited by not knowing the time of infection, small numbers and non-representative populations. No studies are available from the direct acting antiviral agents (DAA) era. We created the largest known cohort of persons with HCV with a known window of seroconversion in the DAA era. We compared the annual cumulative incident events and incidence rate/1,000 person-years of follow-up for liver cirrhosis, hepatic decompensation, hepatocellular carcinoma (HCC) and mortality from the time of seroconversion among untreated and those treated and attaining a sustained virologic response (SVR). Among 12,881 persons in the final analyses, 10,417 had never been treated for HCV, 2,464 (23.6%) were treated with a DAA regimen and 1,836 (74.5%) attained SVR. After 9 years of follow-up, cirrhosis was diagnosed in 17.4% of untreated and 13.6% of the SVR group. Overall, 29.5% in the untreated vs. 3.5% in the SVR group died. Incidence rates/1,000 person-years of follow-up (95% CI) for untreated vs. SVR group were 22.7(21.6,23.9) vs. 19.5(17.0,21.9) for cirrhosis (P=0.03), 0.1(0.03,0.2) vs. 0.07(-0.07,0.2) for HCC (P=0.74) and 35.4(34.0,36.8) vs. 4.53(3.4,5.7) for mortality (P<0.0001). After excluding those with alcohol related diagnoses at baseline, the difference in cirrhosis was not statistically significant. Cirrhosis and mortality occur early and steadily increase over the first decade after acquiring HCV infection, while HCC is rarely observed. Those treated with a DAA regimen have sharply lower cirrhosis and mortality rates, particularly among those without alcohol abuse or dependence.

PMID:33763947 | DOI:10.1111/jvh.13507

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Nevin Manimala Statistics

Factor structure of the Fear of Cancer Recurrence Inventory (FCRI): Comparison of international FCRI factor structure data and factor analysis of the Dutch FCRI-NL using three predominantly breast cancer samples

Eur J Cancer Care (Engl). 2021 Mar 25:e13431. doi: 10.1111/ecc.13431. Online ahead of print.

ABSTRACT

OBJECTIVE: Factor structure results of Fear of Cancer Recurrence Inventory (FCRI) translations are inconclusive. Through investigating the factor structure, this study aimed to improve the FCRI and its usability. Therefore, we did a comprehensive comparison of the factor structure results of all translations, by exploring and improving the structure of the Dutch FCRI-NL and by testing this new factor structure in two patient samples.

METHODS: To compare factor structure results of FCRI translations, we did a literature search using PubMed and Google Scholar. We performed exploratory factor analysis (EFA) in a mixed cancer sample. The confirmatory factor analyses (CFAs) were secondary analyses performed in two randomized controlled trial samples: consecutive breast cancer patients and distressed, mainly breast cancer patients.

RESULTS: All translations showed comparable and reasonable factor structure results; however, the FCRI factor structure can be improved. The EFA resulted in a four-factor solution: fear of cancer recurrence (FCR) severity, cognitive coping, impact of FCR on functioning and behavioural coping. However, the 4-factor CFAs did not fit the sample 2 and 3 data well.

CONCLUSION: Further exploring the FCRI-NL factor structure did not result in a psychometrically stronger FCRI-NL. Therefore, we recommend retaining the 7-factor FCRI-NL.

PMID:33763943 | DOI:10.1111/ecc.13431

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Effect of microsurgical varicocelectomy on fertility outcome and treatment plans of patients with severe oligozoospermia: An original report and meta-analysis

Andrologia. 2021 Mar 24:e14059. doi: 10.1111/and.14059. Online ahead of print.

ABSTRACT

Varicocele ligation has been proven to restore semen parameters and improve pregnancy rates in men with clinical disease. However, its effect in men with severe oligozoospermia (SO) is less clearly elucidated. This original report and meta-analysis examined the impact of subinguinal microsurgical varicocelectomy on semen parameters and fertility outcomes of men with SO. A retrospective chart review of 85 patients was conducted on patients with SO who underwent microsurgical subinguinal varicocelectomy. A literature search was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 8 studies investigating the effects of varicocele ligation in men with SO were included for the meta-analysis. The original study reported significant improvements in semen parameters following surgery. 78 patients had a pre-operative TMSC < 5 million. Following surgery, 9 (11.5%) patients had a total motile sperm count (TMSC) between 5 and 9 million, while 14 (17.9%) patients had a TMSC > 9 million. Furthermore, the meta-analysis demonstrated a statistically significant increase in sperm count, total motility and TMSC following surgery. The reported natural pregnancy rate was 27.5%. Varicocelectomy does present as an important treatment option for SO patients because improvements in TMSC can broaden their fertility treatment options.

PMID:33763931 | DOI:10.1111/and.14059

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Nevin Manimala Statistics

Effects of the Competitive Season and Off-Season on Knee Articular Cartilage in Collegiate Basketball Players Using Quantitative MRI: A Multicenter Study

J Magn Reson Imaging. 2021 Mar 24. doi: 10.1002/jmri.27610. Online ahead of print.

ABSTRACT

BACKGROUND: Injuries to the articular cartilage in the knee are common in jumping athletes, particularly high-level basketball players. Unfortunately, these are often diagnosed at a late stage of the disease process, after tissue loss has already occurred.

PURPOSE/HYPOTHESIS: To evaluate longitudinal changes in knee articular cartilage and knee function in National Collegiate Athletic Association (NCAA) basketball players and their evolution over the competitive season and off-season.

STUDY TYPE: Longitudinal, multisite cohort study.

POPULATION: Thirty-two NCAA Division 1 athletes: 22 basketball players and 10 swimmers.

FIELD STRENGTH/SEQUENCE: Bilateral magnetic resonance imaging (MRI) using a combined T and T2 magnetization-prepared angle-modulated portioned k-space spoiled gradient-echo snapshots (MAPSS) sequence at 3T.

ASSESSMENT: We calculated T2 and T relaxation times to compare compositional cartilage changes between three timepoints: preseason 1, postseason 1, and preseason 2. Knee Osteoarthritis Outcome Scores (KOOS) were used to assess knee health.

STATISTICAL TESTS: One-way variance model hypothesis test, general linear model, and chi-squared test.

RESULTS: In the femoral articular cartilage of all athletes, we saw a global decrease in T2 and T relaxation times during the competitive season (all P < 0.05) and an increase in T2 and T relaxation times during the off-season (all P < 0.05). In the basketball players’ femoral cartilage, the anterior and central compartments respectively had the highest T2 and T relaxation times following the competitive season and off-season. The basketball players had significantly lower KOOS measures in every domain compared with the swimmers: Pain (P < 0.05), Symptoms (P < 0.05), Function in Daily Living (P < 0.05), Function in Sport/Recreation (P < 0.05), and Quality of Life (P < 0.05).

CONCLUSION: Our results indicate that T2 and T MRI can detect significant seasonal changes in the articular cartilage of basketball players and that there are regional differences in the articular cartilage that are indicative of basketball-specific stress on the femoral cartilage. This study demonstrates the potential of quantitative MRI to monitor global and regional cartilage health in athletes at risk of developing cartilage problems.

LEVEL OF EVIDENCE: 2 Technical Efficacy Stage: 2.

PMID:33763929 | DOI:10.1002/jmri.27610

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A Prospective, Longitudinal Magnetic Resonance Imaging Evaluation of Cerebrovascular Reactivity and Infarct Development in Patients With Intracranial Stenosis

J Magn Reson Imaging. 2021 Mar 24. doi: 10.1002/jmri.27605. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with symptomatic atherosclerotic and non-atherosclerotic (i.e., moyamoya) intracranial steno-occlusive disease experience high 2-year infarct rates.

PURPOSE: To investigate whether cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) measures may provide biomarkers of 1-to-2-year infarct risk.

STUDY TYPE: Prospective, longitudinal study.

SUBJECTS: Adult participants (age = 18-85 years) with symptomatic intracranial atherosclerotic disease (N = 26) or non-atherosclerotic (i.e., moyamoya; N = 43) and stenosis ≥50% of a major intracranial artery were initially scanned within 45 days of stroke. Follow-up imaging (target = 1.5 years) was acquired for new infarct assessment.

FIELD STRENGTH/SEQUENCE: 3.0 Tesla with normocapnic arterial spin labeling (ASL) and blood oxygenation level-dependent (BOLD) imaging acquired during an interleaved hypercapnic (3 minutes) and normocapnic (3 minutes) respiratory stimulus.

ASSESSMENT: CBF, maximum CVR, and time-to-maximum CVR (i.e., CVRDELAY ) were calculated. Laterality indices (difference between infarcted and contralesional hemispheres divided by sum of absolute values) of metrics at enrollment were contrasted between participants with vs. without new infarcts on follow-up.

STATISTICAL TESTS: Laterality indices were compared using non-parametric Wilcoxon tests (significance: two-sided P < 0.05) and effect sizes as Cohen’s d. Continuous variables are presented as mean ± SD.

RESULTS: New infarcts were observed on follow-up in 15.0% of participants. The laterality index of the CVRDELAY was elevated (P = 0.01) in participants with atherosclerosis with new infarcts (index = 0.13) compared to participants without new infarcts (index = 0.05).

DATA CONCLUSION: Elevated CVRDELAY may indicate brain parenchyma at increased risk for new infarcts in patients with symptomatic intracranial atherosclerotic disease treated with standard-of-care medical management.

LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 3.

PMID:33763922 | DOI:10.1002/jmri.27605

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Nevin Manimala Statistics

Informative array testing with multiplex assays

Stat Med. 2021 Mar 24. doi: 10.1002/sim.8954. Online ahead of print.

ABSTRACT

High-volume testing of clinical specimens for sexually transmitted diseases is performed frequently by a process known as group testing. This algorithmic process involves testing portions of specimens from separate individuals together as one unit (or “group”) to detect diseases. Retesting is performed on groups that test positively in order to differentiate between positive and negative individual specimens. The overall goal is to use the least number of tests possible across all individuals without sacrificing diagnostic accuracy. One of the most efficient group testing algorithms is array testing. In its simplest form, specimens are arranged into a grid-like structure so that row and column groups can be formed. Positive-testing rows/columns indicate which specimens to retest. With the growing use of multiplex assays, the increasing number of diseases tested by these assays, and the availability of subject-specific risk information, opportunities exist to make this testing process even more efficient. We propose specific specimen arrangements within an array that can reduce the number of retests needed when compared with other array testing algorithms. We examine how to calculate operating characteristics, including the expected number of tests and the SD for the number of tests, and then subsequently find a best arrangement. Our methods are illustrated for chlamydia and gonorrhea detection with the Aptima Combo 2 Assay. We also provide R functions to make our research accessible to laboratories.

PMID:33763901 | DOI:10.1002/sim.8954

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The alcohol advertising ban in Norway: Effects on recorded alcohol sales

Drug Alcohol Rev. 2021 Mar 24. doi: 10.1111/dar.13289. Online ahead of print.

ABSTRACT

INTRODUCTION: Although bans or restrictions on alcohol advertising are recommended as one of the three most effective and cost-effective policies to curb alcohol consumption, the best evidence to support this is indirect. The aim of this study was to examine whether the complete ban on alcohol advertising in Norway in 1975 had any effect on total alcohol sales.

METHODS: Annual time series of recorded alcohol sales (1960-2006) were analysed. Autoregressive integrated moving average interrupted time series techniques were used to model the effect of the advertising ban, adjusting for alcohol prices and wages.

RESULTS: The autoregressive integrated moving average analyses showed a negative and statistically significant effect of the ban on total recorded alcohol sales, suggesting an immediate and lasting reduction of 7.4% (P = 0.002).

DISCUSSION AND CONCLUSIONS: The complete ban on alcohol advertising in 1975 in Norway reduced recorded alcohol sales. This suggests that the ban had a protective effect by reducing total alcohol consumption. The conclusion remains tentative because of possible effects of unrecorded alcohol consumption and marketing on social media and satellite TV channels.

PMID:33763886 | DOI:10.1111/dar.13289