Tag: pubmed

Neurol Res. 2022 Oct 8:1-7. doi: 10.1080/01616412.2022.2132459. Online ahead of print.

ABSTRACT

OBJECTIVES: Endovascular treatment (EVT) of basilar tip aneurysms (BTAs) is arduous because of the lesions’ angioarchitecture and the relatively high recanalization rate after EVT. In this study, we aimed to report the clinical characteristics of BTAs and evaluate the incidence of and risk factors for recanalization.

METHODS: One hundred twenty-five patients with BTAs (11 ruptured, 114 unruptured) treated with EVT between 2009 and 2019 at one institution were retrospectively reviewed. Among them, 113 patients were included in statistical analyses. The anatomical parameters of the aneurysms and clinical data were analyzed. Univariate (chi-square test and t-test) and multivariate (multiple logistic regression) analyses were performed to identify risk factors for recanalization.

RESULTS: Recanalization of the BTA occurred in 15 patients (13.3%). One patient (0.9%) was retreated endovascularly. The mean follow-up duration was 49.8 months. Neck size, posterior cerebral artery (PCA) angle, maximum diameter, and the rupture rate differed significantly between the recanalization and non-recanalization groups (P=.007, P<.001, P=.006, and P=.048, respectively). The maximum diameter (odds ratio, 1.483 per mm; 95% confidence interval, 1.145-1.919; P=.003) and PCA angle (odds ratio, 1.020 per degree; 95% confidence interval, 1.001-1.039; P=.036) were independently associated with recanalization.

CONCLUSIONS: Of all investigated BTAs, 96.8% were wide-neck aneurysms. The recanalization rate of BTAs after EVT was 13.3%. The PCA angle and maximal aneurysmal diameter were independently associated with recanalization; no associations were observed regarding vertebral artery dominance or modality of treatment. As such, BTA patients with wide PCA angles should be carefully monitored over time.

PMID:36208455 | DOI:10.1080/01616412.2022.2132459

J Neurosurg. 2022 Oct 7:1-10. doi: 10.3171/2022.8.JNS221329. Online ahead of print.

ABSTRACT

OBJECTIVE: Cerebellopontine angle (CPA) meningiomas present many surgical challenges depending on their volume, site of dural attachment, and connection to surrounding neurovascular structures. Assuming that systematic radical resection of large CPA meningiomas carries a high risk of permanent morbidity, the authors adopted an alternative strategy of optimal resection followed by radiosurgery or careful observation of the residual tumor and assessed the efficiency and safety of this approach to meningioma treatment management.

METHODS: This single-center retrospective cohort study included 50 consecutive patients who underwent surgery for meningioma between January 2003 and February 2020.

RESULTS: The most common main dural attachments of the meningiomas were posterior (42%) and superior (26%) to the internal auditory meatus. The suboccipital retrosigmoid route was the most routinely used (92%). At the last follow-up examination, 93% of the patients with normal preoperative facial nerve (FN) function retained good House-Brackmann (HB) grades of I and II, whereas 3 patients (7%) displayed intermediate HB grade III FN function. Hearing preservation was achieved in 86% of the patients who presented with preoperative serviceable hearing, and recovery after surgery was achieved in 19% of the patients experiencing preoperative hearing loss. In order to preserve all cranial nerve function, gross-total resection was obtained in 26% of patients. Of the 35 patients who had undergone subtotal resection, 20 (57%) had been allocated into a wait-and-rescan treatment approach and 15 (43%) underwent upfront Gamma Knife surgery (GKS). The mean postoperative tumor volume was 1.20 cm3 in the upfront GKS group and 0.73 cm3 in the wait-and-rescan group (p = 0.08). Tumor control was achieved in 87% and 55% of cases (p < 0.001), with a mean follow-up of 85 and 69 months in the GKS and wait-and-rescan groups, respectively. The 1-, 5-, and 7-year tumor progression-free survival rates were 100%, 100%, and 89% in the GKS group and 95%, 59%, and 47% in the wait-and-rescan group, respectively (p < 0.001).

CONCLUSIONS: Optimal nonradical resection of large CPA meningiomas provides favorable long-term tumor control and functional preservation. Adjuvant GKS does not carry additional morbidity and appears to be an efficient adjuvant treatment.

PMID:36208440 | DOI:10.3171/2022.8.JNS221329

J Neurosurg. 2022 Oct 7:1-9. doi: 10.3171/2022.8.JNS22597. Online ahead of print.

ABSTRACT

OBJECTIVE: Growing intracranial aneurysms (IAs) are prone to rupture. Previous cross-sectional studies using postrupture morphology have shown the morphological or hemodynamic features related to IA rupture. Yet, which morphological or hemodynamic differences of the prerupture status can predict the growth and rupture of smaller IAs remains unknown. The purpose of this longitudinal study was to investigate the effects of morphological features and the hemodynamic environment on the growth of IAs at middle cerebral artery (MCA) bifurcations during the follow-up period.

METHODS: One hundred two patients with MCA M1-2 bifurcation saccular IAs who underwent follow-up for more than 2 years at the authors’ institutions between 2011 and 2019 were retrospectively identified. During the follow-up period, cases involving growth of MCA IAs were assigned to the event group, and those with MCA IAs unchanged in size were assigned to the control group. The morphological parameters examined were aneurysmal neck length, dome height, aspect ratio and volume, M1 and M2 diameters and their ratio, and angle configurations among M1, M2, and the aneurysm. Hemodynamic parameters were flow rate and wall shear stress in M1, M2, and the aneurysm, including the aneurysmal inflow rate coefficient (AIRC), defined as the ratio of the aneurysmal inflow rate to the M1 flow rate. Those parameters were compared statistically between the two groups. Correlations between morphological and hemodynamic parameters were also examined.

RESULTS: Eighty-three of 102 patients were included: 25 with growing MCA IAs (event group) and 58 with stable MCA IAs (control group). The median patient age at initial diagnosis was 66.9 (IQR 59.8-72.3) years. The median follow-up period was 48.5 (IQR 36.5-65.6) months. Both patient age and the AIRC were significant independent predictors of the growth of MCA IAs. Moreover, the AIRC was strongly correlated with sharper bifurcation and inflow angles, as well as wider inclination angles between the M1 and M2 arteries.

CONCLUSIONS: The AIRC was a significant independent predictor of the growth of MCA IAs. Sharper bifurcation and inflow angles and wider inclination angles between the M1 and M2 arteries were correlated with the AIRC. MCA IAs with such a bifurcation configuration are more prone to grow and rupture.

PMID:36208434 | DOI:10.3171/2022.8.JNS22597

J Am Geriatr Soc. 2022 Oct 8. doi: 10.1111/jgs.18025. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the cognitive effectiveness and safety of tau-targeting drugs for Alzheimer’s disease (AD) METHODS: The MEDLINE, Embase, Cochrane Library, PsycINFO, ClinicalTrials.gov, and WHO International Clinical Trials Registry Platform databases were searched from inception to 22 November 2021. A systematic review and meta-analysis of randomized controlled trials were performed RESULTS: Thirty-four randomized controlled trials comprising 5549 participants, of which fifteen (51.7%) had a low risk of bias, were included. The meta-analysis showed no differences in the cognitive subscale of the AD: Assessment Scale (ADAS-Cog) between anti-tau drugs and placebo (mean difference [MD]: -0.77, 95% CI: -1.64 to 0.10; minimal important difference 3.1-3.8 points, moderate certainty evidence). For ADAS-Cog, the results subgroup analysis suggested a statistical effect of tau posttranslational modifications on drug inhibition (MD: -0.80, 95% CI: -1.43 to -0.17), which was not seen with tau aggregation inhibitors or immunotherapy (interaction p = 0.24). A total of 11.0%, 5.2%, and 4.8% of drugs inhibiting tau aggregation, immunotherapy, and drugs targeting posttranslational modifications, respectively, had a reduced risk of dropouts due to adverse events (AEs).

DISCUSSION: Current evidence suggests that anti-tau drugs are unlikely to have an important impact on slowing cognitive impairment. Although the subgroup analysis suggested that inhibition of tau posttranslational modifications is statistically effective and generally safer because of reduced dropouts due to AEs, the analysis has limited credibility. Additional large-scale and well-designed randomized and placebo-controlled trials will be necessary to explore the benefit of a certain type of anti-tau drug for AD.

PMID:36208415 | DOI:10.1111/jgs.18025

Sports Med. 2022 Oct 8. doi: 10.1007/s40279-022-01766-0. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Meta-analysis and meta-regression are often highly cited and may influence practice. Unfortunately, statistical errors in meta-analyses are widespread and can lead to flawed conclusions. The purpose of this article was to review common statistical errors in meta-analyses and to document their frequency in highly cited meta-analyses from strength and conditioning research.

METHODS: We identified five errors in one highly cited meta-regression from strength and conditioning research: implausible outliers; overestimated effect sizes that arise from confusing standard deviation with standard error; failure to account for correlated observations; failure to account for within-study variance; and a focus on within-group rather than between-group results. We then quantified the frequency of these errors in 20 of the most highly cited meta-analyses in the field of strength and conditioning research from the past 20 years.

RESULTS: We found that 85% of the 20 most highly cited meta-analyses in strength and conditioning research contained statistical errors. Almost half (45%) contained at least one effect size that was mistakenly calculated using standard error rather than standard deviation. In several cases, this resulted in obviously wrong effect sizes, for example, effect sizes of 11 or 14 standard deviations. Additionally, 45% failed to account for correlated observations despite including numerous effect sizes from the same study and often from the same group within the same study.

CONCLUSIONS: Statistical errors in meta-analysis and meta-regression are common in strength and conditioning research. We highlight five errors that authors, editors, and readers should check for when preparing or critically reviewing meta-analyses.

PMID:36208412 | DOI:10.1007/s40279-022-01766-0

J Dig Dis. 2022 Oct 8. doi: 10.1111/1751-2980.13136. Online ahead of print.

ABSTRACT

BACKGROUND: Population-based prospective studies on the associations of cigarette smoking, alcohol drinking and primary liver cancer are still limited in mainland China, our study was designed to evaluate such relationships in middle-aged Chinese men.

METHODS: Self-reported habits of smoking and alcohol drinking were obtained from all cohort members at the baseline survey. The outcomes were identified through in-person follow-up and annual record linkage to multiple statistics of vital and cancer registration. Age-adjusted and multivariable-adjusted hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were estimated utilizing the Cox regression model.

RESULTS: After a median follow-up time of 12.31 years, 329 incident cases of primary liver cancer occurred among 45 266 male participants. Compared with never smokers, former smoking was positively associated with liver cancer risk, with a multivariable-adjusted HR of 1.42 (95% CI, 1.02-1.98). Individuals who have smoked for more than 40 years have an increased risk of liver cancer by 49% (HR_{>40 years} = 1.49, 95% CI, 1.04-2.14). The association of alcohol drinking with liver cancer did not show any statistical significance.

CONCLUSION: Our study provided evidence that cigarette smoking was positively associated with an increased liver cancer risk among Chinese men. Attention to such non-viral modifiable risk factors to prevent liver cancer effectively is needed.

PMID:36208410 | DOI:10.1111/1751-2980.13136

Environ Monit Assess. 2022 Oct 8;194(12):857. doi: 10.1007/s10661-022-10543-5.

ABSTRACT

Heavy metals in indoor dust are associated with health risks in humans. However, in Shijiazhuang, a city in northern China with severe haze, no research has been published on this topic. To determine the content, distribution characteristics, and sources of heavy metals in indoor dust in the city of Shijiazhuang, indoor dust samples from 33 sampling points in the main urban area of Shijiazhuang were collected and tested. Concentrations of Cu, Ni, Cr, Zn, Cd, and Pb were 87.0, 35.1, 104.4, 568.0, 1.980, and 187.6 mg·kg^-1, respectively; their levels have been discussed statistically in comparison with the reported values in other cities in China. The sources of heavy metals were analyzed using enrichment factor, correlation coefficient, and principal component analysis. The results showed that the levels of all six elements in indoor dust in Shijiazhuang exceeded the background values of soil in Hebei Province. Among these, Cd, Pb, and Zn were significantly enriched. The enrichment factors of Cu, Ni, and Cr were below 10, and their levels at different sampling points were similar, indicating their geogenic source. The corresponding pollution levels of Cd, Pb, and Zn were relatively high, and their levels at different points were significantly different and correlated, indicating that they were derived mainly from transportation. Additionally, the level of Zn was significantly affected by the indoor environment. Our findings provide a basis for conducting health risk assessments in the future.

PMID:36208397 | DOI:10.1007/s10661-022-10543-5

Forensic Sci Med Pathol. 2022 Oct 8. doi: 10.1007/s12024-022-00536-8. Online ahead of print.

ABSTRACT

Identifying charred human remains poses a challenge to forensic laboratories. High temperature completely incinerates the superficial tissues and partially destroys bones, forcing the forensics to seek an alternative, for bones and teeth, forensic material that should quickly and cheaply deliver DNA of sufficient quantity and quality. We sought, other than rib cartilage, types of cartilages that could serve as a DNA source. DNA was isolated from the fibrous cartilage of a fibrous ring of intervertebral L1-L2 discs sampled from charred cadavers or charred body fragments: 5 victims of car fires, 1 victim of combustion during a residential house gas explosion, and 3 victims of nitroglycerin explosion. DNA was isolated by the column method. DNA quality and concentration were assessed by RT-PCR and multiplex PCR for 23 autosomal and 17 Y chromosome STR loci. STR polymorphism results obtained by capillary electrophoresis served for likelihood ratio (LR) calculations. DNA concentration in relation to the cadaver’s age and post-mortem interval (PMI) were analyzed. All samples (n = 9) yielded good-quality DNA in quantities (0.57-17.51 ng/µL for T. Large autosomal sequence) suitable for STR-based amplification. The isolated DNA characterized a low degradation index (0.80-1.99), and we were able to obtain complete genetic profiles. In each of the nine cases, the genotyping results allowed identifying the victims based on comparative material from the immediate family. The results demonstrate the usefulness of human intervertebral disc fibrocartilage as an alternative DNA source for the genetic identification of charred bodies or charred torso fragments.

PMID:36208368 | DOI:10.1007/s12024-022-00536-8

Lifetime Data Anal. 2022 Oct 8. doi: 10.1007/s10985-022-09579-z. Online ahead of print.

ABSTRACT

The proportional hazards (PH) model is, arguably, the most popular model for the analysis of lifetime data arising from epidemiological studies, among many others. In such applications, analysts may be faced with censored outcomes and/or studies which institute enrollment criterion leading to left truncation. Censored outcomes arise when the event of interest is not observed but rather is known relevant to an observation time(s). Left truncated data occur in studies that exclude participants who have experienced the event prior to being enrolled in the study. If not accounted for, both of these features can lead to inaccurate inferences about the population under study. Thus, to overcome this challenge, herein we propose a novel unified PH model that can be used to accommodate both of these features. In particular, our approach can seamlessly analyze exactly observed failure times along with interval-censored observations, while aptly accounting for left truncation. To facilitate model fitting, an expectation-maximization algorithm is developed through the introduction of carefully structured latent random variables. To provide modeling flexibility, a monotone spline representation is used to approximate the cumulative baseline hazard function. The performance of our methodology is evaluated through a simulation study and is further illustrated through the analysis of two motivating data sets; one that involves child mortality in Nigeria and the other prostate cancer.

PMID:36208362 | DOI:10.1007/s10985-022-09579-z

J Relig Health. 2022 Oct 8. doi: 10.1007/s10943-022-01666-7. Online ahead of print.

ABSTRACT

The Yule-Simpson paradox indicates contradicting statistical outcomes for the pooled sample and for each stratified group separately. The objective of the current study is to demonstrate this paradox. The sample is based on a 2015-2016 longitudinal survey carried out by the Israeli Central Bureau of Statistics. The sample includes 1194 individuals, where the responses of 1140 individuals were assessed twice (in 2015 and 2016) and the responses of 54 individuals were recorded only once. This gives a total sample of 2334 observations × years. The sample includes 609 females and 585 males. We use the limited dependent binary probit regression model. The dependent variable is a dummy variable that equals 1 if the individual is obese (BMI ≥ 30, where BMI = WEIGHT ÷ (HEIGHT²), WEIGHT is measured in kilograms and HEIGHT is measured in meters) and zero otherwise. The independent variables are the denomination (secular vs. ultra-Orthodox) and age in years. Findings suggest that on the one hand, for the pooled sample of 21-50-year-old females and males, results clearly support the conclusion that compared with secular Israeli Jews, projected probability of obesity (BMI ≥ 30) among ultra-Orthodox Israeli Jews is higher (p = 0.0128). On the other hand, when stratified by gender, one cannot reject the opposite conclusion, according to which projected probability of obesity is equal for all cohorts among ultra-Orthodox and secular Israeli Jews. Research findings thus stress the importance of cautious and rigorous statistical analysis and robustness tests prior to statistical inference.

PMID:36208353 | DOI:10.1007/s10943-022-01666-7