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Nevin Manimala Statistics

Towards a Vulnerability Model for Major Depressive Episodes

Psychiatr Danub. 2021 Dec;33(Suppl 11):5-9.

ABSTRACT

BACKGROUND: While many studies have investigated depression risk factors, few attempts have been made to weight, and compare them. Therefore, we conducted a prospective comparison of a sample of subjects suffering from major depressive disorder and a group of healthy subjects. We compared classic risk factors with internal elements such as personality, family dynamics and health locus of control. We also looked for prognostic factors.

METHODS: Forty people with major depressive disorder (the MDD group) were randomly assigned to different treatment groups and followed for two years. In parallel, we followed a group of 21 healthy subjects (healthy group). At the beginning of the study, sociodemographic data were recorded and all subjects were asked to complete the Multidimensional Health Locus of Control (MHLC) scale, the NEO Five-Factor Inventory (NEO-FFI), and the Family Adaptation and Cohesion Scale (FACES III). During the study, subjects were regularly assessed using the Hamilton Depression Scale (HDS) and the Short Form Health Survey (SF-12).

RESULTS: Of the 23 explanatory variables, 13 were statistically different (p≤0.05): age, gender, number of people living together, income, extravert personality and neuroticism, Internal HLC, Powerful others HLC, Adaptability of the current couple and the family of origin, and Cohesion of the ideal and nuclear family and family of origin. The accumulation of risk factors doubles the chances of suffering from MDD (odds ratio 1.905**). Independent of treatment, among the 13 variables, the first nine explain 34.1% of change in depression measured on the HDS scale (p<0.001).

CONCLUSION: While the size of our sample limits the robustness of our results, our study suggests that some risk factors are also prognostic. The respective weights of these factors vary as a function of age group. Finally, some, such as health locus of control, family dynamics or extraversion, can be modified as an adjunct to pharmacological treatment.

PMID:34862881

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Combined anti-cancer effects of curcumin and oxaliplatin on colon carcinoma colo205 cells using transplanted nude mice

Pak J Pharm Sci. 2021 Sep;34(5(Special)):2021-2025.

ABSTRACT

The objective of this study was to investigate the effects of curcumin combined with oxaliplatin on human colon carcinoma Colo205 cells and to analyze the anti-cancer mechanism. Sixty nude mice were inoculated with Colo205 cells as tumor transplanted models which were randomly divided into control group, curcumin group, oxaliplatin group and curcumin plus oxaliplatin group (n=15 in each group). The volume of tumor and the tumor suppressor rate was calculated after continuous administration of the curcumin or oxaliplatin for 10 times. The routine blood tests, the liver function and kidney tests were performed. The cell cycle, apoptosis rate and the pathological morphology of tumor tissues was observed. The expression of Bcl-2 and Bax related to apoptosis was detected. The turned out degree of tumor inhibition varied when compared to the control group while the curcumin plus oxaliplatin group served for highest inhibition rate. Statistically insignificant difference (P>0.05) was observed among the groups in routine blood, liver and kidney function tests. The tumor apoptosis rate was significantly increased in other three groups when compared to the control group. There was insignificant difference (P>0.05) in Bax expression of tumor tissue of control group, curcumin group and oxaliplatin group while in curcumin plus oxaliplatin group, it was significantly increased. The expression of Bcl-2 in oxaliplatin group was significantly lower and the value of Bcl-2/Bax in curcumin plus oxaliplatin group was decreased most obviously.

PMID:34862868

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Diet drinks and dental caries among U.S. adults: cluster analysis

Community Dent Health. 2021 Nov 8. doi: 10.1922/CDH_00154Samman07. Online ahead of print.

ABSTRACT

BACKGROUND: In recent years, the consumption of sugar sweetened beverages has been declining, while low calorie sweetener and diet beverage consumption is increasing. Evidence about the effect of diet drinks on dental caries is insufficient, and has not accounted for the complexity of beverage consumption patterns. Therefore, the aim of this study is to examine the association between consuming diet drinks and dental caries among US adults.

METHODS: We analyzed 2011-2014 NHANES dietary data of adults using cluster analysis, with individuals grouped based on their beverage consumption. Clusters were identified based on the R-square statistic and the local peak of the pseudo F statistic. Survey procedure and sample weights were used to account for the complex NHANES sampling design.

RESULTS: Four beverage consumption patterns were identified: “high soda”, “high diet drinks”, “high coffee/tea” and “high water”. The “High soda” cluster was the only one associated with higher DMFT after controlling for confounders (β=1.02, 95% CI=0.42 – 1.63), whereas DT was associated with “high soda” (β=0.45, 95% CI=0.25 – 0.64) and “high coffee/tea” (β=0.24, 95% CI=0.01 – 0.47). On the other hand, the “high diet drinks” cluster was neither associated with DMFT (β=0.69, 95% CI=0.51 – -0.35) nor DT (β=0.07, 95% CI=-0.21 – 0.35).

CONCLUSION: Diet drinks consumption may not be associated with increased risk of dental caries. However, more studies should be conducted in order to confirm this finding.

PMID:34862864 | DOI:10.1922/CDH_00154Samman07

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Evaluation of Various Polishing Systems for Lithium Disilicate Glass-Ceramics

Eur J Prosthodont Restor Dent. 2021 Nov 30. doi: 10.1922/EJPRD_2332Lee12. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to investigate the surface roughness of lithium disilicates (LS2s) polished using various polishing systems.

MATERIALS AND METHODS: Two types of LS2 (A, Amber Mill and E, IPS e.max CAD) were polished using LS2-specific polishing systems (L-Edenta, L-Jota), a zirconia-specific polishing system (Z-Jota), and a conventional ceramic polishing system (P-Shofu) (n = 8 per group). The compositions of different polishing systems were analyzed using EDS. Surface roughness was measured using confocal laser scanning microscopy and analyzed using EDS and SEM. ANOVA and Tukey’s tests were used for the statistical analyses (p = 0.05).

RESULTS: The polishing systems were mainly composed of C, O, and Si. The L-Jota group exhibited rougher surfaces than the other groups. Amber Mill exhibited higher surface roughness than IPS e.max CAD (p⟨0.001). Among the polishing systems, the L-Jota group presented the highest roughness value (pp⟨0.001). The surface roughness of the AL-Jota group was higher than that of the other groups.

CONCLUSIONS: A sufficiently smooth surface can be achieved without a LS2-specific polishing system. Further, the same polishing system can have different effects depending on the type of LS2.

PMID:34862863 | DOI:10.1922/EJPRD_2332Lee12

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Correlation between clinicopathological characteristics of lung adenocarcinoma and the risk of venous thromboembolism

Thorac Cancer. 2021 Dec 4. doi: 10.1111/1759-7714.14260. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with primary lung adenocarcinoma are at increased risk of venous thromboembolism (VTE). However, lung adenocarcinoma characteristics differ across histological subtypes. Therefore, we performed comprehensive analyses on the clinicopathological characteristics of lung adenocarcinoma and risk of VTE.

METHODS: A total of 952 surgically resected lung adenocarcinoma cases were reviewed and classified according to criteria of the International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS) /European Respiratory Society (ERS). The correlation between this classification and VTE risk was retrospectively analyzed. The risks of other clinicopathological features including pleural invasion, vascular invasion and associated surgical intervention risks were also assessed.

RESULTS: Of the 952 patients, 100 (10.4%) cases experienced VTE events during the follow-up period. Among those with VTE, 28 (28%) were found before surgery, 47 (47%) were found within 1 month after surgery, and 91 (91%) were found in hospital. Univariate analysis revealed that ages, extent of resection and presence of micropapillary features were predictive of VTE risk. Furthermore, multivariable analysis demonstrated that the presence of micropapillary features (subdistribution hazard ratio [SHR] 1.560, 95% CI: 1.043-2.330) and age >60 (SHR: 2.270, 95% CI:1.491-3.470) were associated with increased risk of VTE. After one year, the probability of developing VTE was 13.1% and 8.3% in patients with micropapillary features and those without, respectively.

CONCLUSIONS: VTE is a common complication for lung adenocarcinoma patients who undergo surgery, especially during the perioperative process and hospitalization. Presence of micropapillary subtype and age are positively associated with VTE risk.

PMID:34862856 | DOI:10.1111/1759-7714.14260

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Relaxation time of brain tissue in the elderly assessed by synthetic MRI

Brain Behav. 2021 Dec 4:e2449. doi: 10.1002/brb3.2449. Online ahead of print.

ABSTRACT

BACKGROUND: Synthetic MRI (SyMRI) is a quantitative technique that allows measurements of T1 and T2 relaxation times (RTs). Brain RT evolution across lifespan is well described for the younger population. The aim was to study RTs of brain parenchyma in a healthy geriatric population in order to define the normal value of structures in this group population. Normal values for geriatric population could help find biomarker for age-related brain disease.

MATERIALS AND METHODS: Fifty-four normal-functioning individuals (22 females, 32 males) with mean age of 83 years (range 56-98) underwent SyMRI. RT values in manually defined ROIs (centrum semiovale, middle cerebellar peduncles, thalamus, and insular cortex) and in segmented whole-brain components (brain parenchyma, gray matter, white matter, myelin, CSF, and stromal structures) were extracted from the SyMRI segmentation software. Patients’ results were combined into the group age. Main ROI-based and whole-brain results were compared for the all dataset and for age group results as well.

RESULTS: For white matter, RTs between ROI-based analyses and whole-brain results for T2 and for T1 were statistically different and a trend of increasing T1 in centrum semiovale and cerebellar peduncle was observed. For gray matter, thalamic T1 was statistically different from insular T1. A difference was also found between left and right insula (p < .0001). T1 RTs of ROI-based and whole-brain-based analyses were statistically different (p < .0001). No significant difference in T1 and T2 was found between age groups on ROI-based analysis, but T1 in centrum semiovale and thalamus increased with age. No statistical difference between age groups was found for the various segmented volumes except for myelin between 65-74 years of age and the 95-105 years of age groups (p = .038).

CONCLUSIONS: SyMRI is a new tool that allows faster imaging and permits to obtain quantitative T1 and T2. By defining RT values of different brain components of normal-functioning elderly individuals, this technique may be used as a biomarker for clinical disorders like dementia.

PMID:34862855 | DOI:10.1002/brb3.2449

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Parallel age-related cognitive effects in autism: A cross-sectional replication study

Autism Res. 2021 Dec 4. doi: 10.1002/aur.2650. Online ahead of print.

ABSTRACT

Findings on age-related cognitive effects in autism in adulthood are inconsistent across studies. As these studies substantially differ in their methodology, replication studies are needed. In this replication study frequentist (i.e., null-hypothesis significance testing), and Bayesian statistics were used to investigate the hypothesis that in autistic adults compared to non-autistic adults mostly parallel, but also protective age-related cognitive effects can be observed. Participants were 88 autistic adults, and 88 non-autistic matched comparisons (age range: 30-89 years, mean age: 55 years). Cognitive measures were administered on the following six domains: verbal memory, visual memory, working memory, Theory of Mind (ToM), verbal fluency, and processing speed, and self-reported cognitive failures. Non-autistic adults outperformed autistic adults on ToM, verbal fluency, and verbal memory, but only the first two were confirmed with Bayesian replication analyses. Also, more cognitive failures were reported by autistic adults. No interactions between group and age were observed, suggesting a parallel age-related effect on all cognitive domains. In sum, previously observed difficulties in ToM and verbal fluency were replicated which seem to persist at older age. Previously reported parallel age-related cognitive patterns were replicated, yet no evidence for protective age-related patterns was found. LAY SUMMARY: We investigated whether our previous findings on cognitive aging in autism could be confirmed in a new study measuring the cognitive effects of age in autistic and non-autistic adults. As expected, tasks that younger autistic adults had difficulties with (theory of mind, fluency) were also difficult for older autistic adults, and the effect of age itself was similar in autistic and non-autistic adults. Unexpectedly, we observed no protective effects (less cognitive aging) in autism.

PMID:34862853 | DOI:10.1002/aur.2650

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Benchmarking Cesarean Delivery Rates using Machine Learning-Derived Optimal Classification Trees

Health Serv Res. 2021 Dec 4. doi: 10.1111/1475-6773.13921. Online ahead of print.

ABSTRACT

OBJECTIVE: To establish a case-adjusted hospital-specific performance evaluation tool using machine learning methodology for cesarean delivery.

DATA SOURCES: Secondary data were collected from patients between 1/1/2015-2/28/2018 using a hospital’s “Electronic Data Warehouse” database from Illinois, USA.

STUDY DESIGN: The machine learning methodology of Optimal Classification Trees (OCT’s) was used to predict cesarean delivery rate by physician group, thereby establishing the case-adjusted benchmarking standards in comparison to the overall hospital cesarean delivery rate. Outcomes of specific patient populations of each participating practice were predicted, as if each were treated in the overall hospital environment. The resulting OCTs estimate physician group expected cesarean delivery outcomes, both aggregate and in specific clinical situations.

DATA COLLECTION/EXTRACTION METHODS: 12,841 singleton, vertex, term deliveries, cared for by practices with ≥50 births.

PRINCIPAL FINDINGS: The overall rate of cesarean delivery was 18.6% (n = 2384), with a range of 13.3%-33.7% amongst 22 physician practices. An optimal decision tree was used to create a prediction model for the overall hospital which defined 23 patient cohorts, divided by 46 nodes. The model’s performance for prediction of cesarean delivery is as follows: area under the curve- 0.73, sensitivity- 98.4%, specificity- 16.1%, positive predictive value 83.7%, negative predictive value 70.6%. Comparisons with the overall hospital’s specific-case adjusted benchmark groups revealed that several groups outperformed the overall hospital and some practice groups underperformed in comparison to the overall hospital.

CONCLUSIONS: OCT benchmarking can assess physician practice specific case-adjusted performance, both overall and clinical situation specific, and can serve as a valuable tool for hospital self-assessment and quality improvement. This article is protected by copyright. All rights reserved.

PMID:34862801 | DOI:10.1111/1475-6773.13921

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Anticoagulant treatment regimens in patients with Covid-19: a meta-analysis

Clin Pharmacol Ther. 2021 Dec 4. doi: 10.1002/cpt.2504. Online ahead of print.

ABSTRACT

Coronavirus disease 2019 (Covid-19) is associated with a hypercoagulable state. It has been hypothesized that higher-dose anticoagulation, including therapeutic-dose and intermediate-dose anticoagulation, is superior to prophylactic-dose anticoagulation in the treatment of Covid-19. This meta-analysis evaluated the efficacy and safety of higher-dose anticoagulation compared with prophylactic-dose anticoagulation in patients with Covid-19. Ten randomized controlled open-label trials with a total of 5,753 patients were included. The risk of death and net adverse clinical events (including death, thromboembolic events, and major bleeding) were similar between higher-dose and prophylactic-dose anticoagulation (risk ratio (RR) 0.96, 95%CI, 0.79-1.16, P=0.66 and RR 0.87, 95%CI, 0.73-1.03, P=0.11, respectively). Higher-dose anticoagulation, compared with prophylactic-dose anticoagulation, decreased the risk of thromboembolic events (RR 0.63, 95%CI, 0.47-0.84, P=0.002) but increased the risk of major bleeding (RR 1.76, 95%CI, 1.19-2.62, P=0.005). The risk of death showed no statistically significant difference between higher-dose anticoagulation and prophylactic-dose anticoagulation in non-critically ill patients (RR 0.87, 95%CI, 0.50-1.52, P=0.62) and in critically ill patients with Covid-19 (RR 1.04, 95%CI, 0.93-1.17, P=0.5). The risk of death was similar between therapeutic-dose versus prophylactic-dose anticoagulation (RR 0.92, 95%CI 0.69-1.21, P=0.54) and between intermediate-dose versus prophylactic-dose anticoagulation (RR 1.01, 95%CI 0.63-1.61, P=0.98). In patients with markedly increased d-dimer levels, higher-dose anticoagulation was also not associated with a decreased risk of death as compared with prophylactic-dose anticoagulation (RR 0.86, 95%CI, 0.64-1.16, P=0.34). Without any clear evidence of survival benefit, these findings do not support the routine use of therapeutic-dose or intermediate-dose anticoagulation in critically or non-critically ill patients with Covid-19.

PMID:34862791 | DOI:10.1002/cpt.2504

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Design and Application of Intelligent Management System of Artificial Airway Airbag Pressure in Intensive Care

Zhongguo Yi Liao Qi Xie Za Zhi. 2021 Nov 30;45(6):645-649.

ABSTRACT

In order to solve the problem of continuous monitoring and automatic regulation of patient airbag pressure in intensive care unit, the study designed an intelligent management system of artificial airway airbag pressure. It can realize real-time monitoring and automatic control of airbag pressure. Its pressure data was sent to the PC in real time by the serial port. It can realize the display, store, review and analysis of pressure data. Its clinical application effect was discussed. Experiments showed that the system can monitor airbag pressure in real time and control the pressure to stabilize at 25~30 cmH2O. Compared with the control group, the experimental group had a statistically significant difference in the operation time of monitoring patients’ airbag pressure, changes in airbag pressure, the instantaneous maximum value during nursing operation, and the number of aspiration and reflux cases. The clinical application of the system can reduce the workload of medical staff greatly, effectively reduce the number of patients with aspiration and reflux, reduce the incidence of ventilator pneumonia.

PMID:34862778