Tag: statistics

J Surg Res. 2023 Jan 9;284:303-311. doi: 10.1016/j.jss.2022.12.007. Online ahead of print.

ABSTRACT

INTRODUCTION: Nephrotoxicity is a significant side effect of thoracic transplantation. Many lung transplant patients will require subsequent renal transplantation (KAL). Recently, simultaneous lung/kidney transplants (SLuK) have become an attractive option for patients with end-stage renal disease at the time of lung transplantation. This article explores SLuK outcomes compared to conventional KAL, as well as outcomes among KAL patients against those were KAL listed but never transplanted.

MATERIALS AND METHODS: The United Network for Organ Sharing/the Organ Procurement and Transportation Network database was used to identify SLuK patients (n = 74), KAL transplants (n = 456), and patients who were listed for KAL but were never transplanted (n = 626). Significance was determined by chi², Wilcoxon rank sum test, or independent t-tests. Death-censored graft survival for subgroups was estimated using Kaplan-Meier with log-rank for significance. Analyses were completed using SPSS Statistics 28.

RESULTS: The SLuK cohort was older (P = 0.04), more likely diabetic (P < 0.001), and had shorter life expectancies (P < 0.001) than KAL patients. Of those SLuK transplants within 5 y, 84% of patients were alive 1 y post transplant and 82% were alive 3 y post-transplant (compared to 74.6% and 60.3% of overall SLuK). Patients who did undergo KAL were younger and had a lower body mass index (both P < 0.001) compared to those who did not. Those who received a kidney had increased survival times compared to WL patients (P < 0.001).

CONCLUSIONS: Conventional KAL transplants are still favorable for average lung recipients. However, recent improvements have made SLuK an option for patients with renal dysfunction. Those patients who were able to receive KAL transplants were better surgical candidates than those who remained on the waitlist.

PMID:36628916 | DOI:10.1016/j.jss.2022.12.007

J Surg Res. 2023 Jan 9;284:296-302. doi: 10.1016/j.jss.2022.12.009. Online ahead of print.

ABSTRACT

INTRODUCTION: Despite a favorable risk-benefit profile, inpatient admission postoperatively for minimally invasive adrenalectomy (MIA) has remained common. Prior studies have shown that outpatient MIA was not associated with an increased 30-day complications or readmission. However, this has not been explored in-depth by adrenalectomy indication. We aimed to examine whether the safety profile of outpatient MIA varies by adrenal indication.

MATERIALS AND METHODS: Clinicopathologic parameters were examined for all MIAs entered into an adrenal database at our institution from 2012 to 2021. Predictor variables included patient demographics, surgical indication, and operative time. Outcomes were 30-day emergency department visit, readmission, and complication rates between surgical indications, comparing outpatient and inpatient groups. Statistical analyses were performed using Kruskal-Wallis, Wilcoxon, Mann-Whitney, and Chi-squared tests, as appropriate.

RESULTS: A total of 185 MIA patients were included. Outpatient MIA was performed in 53 patients (28.6%). Outpatient discharge post-MIA was related to both surgical indication and operative time. Pheochromocytoma (PC) patients were less likely to be discharged as an outpatient postoperatively when compared to all other indications (13.0% versus 33.8%, P = 0.007). Among all patients with operations 2-3 h in length, PC patients were less likely to be discharged home as an outpatient (10% versus 33.3%, P = 0.040). No significant differences were identified between outpatient and inpatient MIA groups for complications, emergency department visits, or readmission (P > 0.05 for all). Only six outpatient MIA patients had any complication (11.3%) and six were readmitted (11.3%).

CONCLUSIONS: Outpatient MIA was demonstrated to be associated with similar, low complication and readmission rates compared to inpatient MIA, although it was used less often for patients with PC or prolonged operative times. Our study highlights potential evidence that outpatient MIA can be safely used in selected patients across all indications for adrenal surgery.

PMID:36628915 | DOI:10.1016/j.jss.2022.12.009

Am J Otolaryngol. 2022 Dec 23;44(2):103762. doi: 10.1016/j.amjoto.2022.103762. Online ahead of print.

ABSTRACT

BACKGROUND: To analyze the impact of facility volume on survival for human papilloma virus positive oropharyngeal squamous cell carcinoma (HPV+ OPSCC) patients.

METHODS: Patients treated for HPV+ OPSCC from 2010 to 2017 were queried from the National Cancer Database. Facilities of average annual case volume <50th percentile were categorized as low-volume (LV) and >95th percentile as high-volume (HV).

RESULTS: 11,546 were included, with 10,305 patients (89.3 %) treated at LV and 1241 (10.7 %) at HV facilities. A greater proportion of cases involving resection of base of tongue and lingual tonsil were treated at HV (30.3 %) compared to LV (22.3 %) facilities (p < 0.001). Patients treated at a HV facility had greater percentage of clinical T4 (11.2 % vs. 8.6 %, p = 0.001) and N+ disease (90.5 % vs. 85.7 %, p < 0.001) patients. Survival analysis showed no statistically significant difference between five-year overall survival rates by facility volume (p = 0.388) for all patients. On multivariable analysis, facility volume was not associated with survival (HR: 0.968 [0.758-1.235], p = 0.791). These trends were found for both patients undergoing primary surgery or chemoradiotherapy.

CONCLUSION: Our data indicates that patients with HPV+ OPSCC do not experience a survival benefit with treatment at HV facility, suggesting these patients may be adequately treated at LV centers.

PMID:36628908 | DOI:10.1016/j.amjoto.2022.103762

J Hazard Mater. 2023 Jan 3;446:130722. doi: 10.1016/j.jhazmat.2023.130722. Online ahead of print.

ABSTRACT

Widespread soil contamination endangers public health and undermines global attempts to achieve the United Nations Sustainable Development Goals. Due to the lack of relevant studies and low precision of spaceborne spectroscopy, estimating soil heavy metal concentrations is challenging. In this study, we developed a coupled retrieval to qualify the heavy metal nickel (Ni) concentration in agricultural soil from spaceborne hyperspectral imagery. The retrieval couples spectral feature extraction from multi-scale discrete wavelet transform (DWT) and dimension reduction (DR), optimal band combination algorithm to five machine learning retrieval models using tree-based ensemble learning, neural network-based, and kernel-based. The comparison between the retrievals and Ni measurements shows that the DWT combined with t-distributed stochastic neighbor embedding (tSNE) coupled extreme gradient boosting (XGboost) retrieval model exhibited the best prediction for the validation dataset. Moreover, due to the integration of six statistical indicators of model performance and the fitted slope of the regression line, the retrieval framework can produce more robust and accurate predictions than those that rely on correlation coefficients. The demonstrated potential of spaceborne hyperspectral remote sensing to provide accurate quantitative measurements of soil heavy metal concentrations will serve as a reference for agricultural plot applications worldwide.

PMID:36628862 | DOI:10.1016/j.jhazmat.2023.130722

J Pediatr Urol. 2022 Dec 29:S1477-5131(22)00590-3. doi: 10.1016/j.jpurol.2022.12.013. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to quantify end-stage kidney disease (ESKD) risk after infancy in individuals with myelomeningocele (MMC) followed by urology in the modern medical era and to assess if ESKD risk was higher after surgery related to a hostile bladder.

METHODS: We retrospectively reviewed patients with MMC followed by urology at our institution born ≥ 1972 (when clean intermittent catheterization was introduced) past 1 year of age (when mortality is highest, sometimes before establishing urology care). ESKD was defined as requiring permanent peritoneal/hemodialysis or renal transplantation. Early surgery related to hostile bladder included incontinent vesicostomy, bladder augmentation, detrusor Botulinum A toxin injection, ureteral reimplantation, or nephrectomy for recurrent urinary tract infections. Survival analysis and proportional hazards regression were used. Sensitivity analyses included: risk factor analysis with only vesicostomy, timing of surgery, including the entire population without minimal follow-up (n = 1054) and only patients with ≥ 5 years of follow-up (n = 925).

RESULTS: Overall, 1029 patients with MMC were followed for a median of 17.0 years (49% female, 76% shunted). Seven patients (0.7%) developed ESKD at a median 24.3 years old (5 hemodialysis, 1 peritoneal dialysis, 1 transplantation). On survival analysis, the ESKD risk was 0.3% at 20 years old and 2.1% at 30 years old (Figure). This was ∼100 times higher than the general population (0.003% by 21 years old, p < 0.001). Patients who underwent early surgery for hostile bladder had higher ESKD risk (HR 8.3, p = 0.001, 6% vs. 1.5% at 30 years). On exploratory analyses, gender, birth year, shunt status and wheelchair use were not associated with ESKD risk (p ≥ 0.16). Thirty-year ESKD risk was 10% after early vesicostomy vs. 1.4% among children without one (p = 0.001). Children undergoing bladder surgery between 1.5 and 5 years old had a higher risk of ESKD. No other statistically/clinically significant differences were noted.

COMMENT: Patients with MMC remain at risk of progressive renal damage throughout life. We relied on the final binary ESKD outcome to quantify this risk, rather than imprecise glomerular filtration rate formulas. Analysis was limited by few people developing ESKD, inconsistent documentation of early urodynamic findings and indications for bladder-related surgery.

CONCLUSIONS: While ESKD is relatively uncommon in the MMC population receiving routine urological care, affecting 2.1% of individuals in the first 3 decades, it is significantly higher than the general population. Children with poor bladder function are likely at high risk, underlining the need for routine urological care, particularly in adulthood.

PMID:36628830 | DOI:10.1016/j.jpurol.2022.12.013

Explore (NY). 2023 Jan 7:S1550-8307(23)00001-0. doi: 10.1016/j.explore.2023.01.001. Online ahead of print.

ABSTRACT

BACKGROUND: Magnetic resonance imaging examinations frequently cause anxiety and fear in children. The objective of this study was to investigate the effects of listening to music sound, the mother’s voice, and sound isolation on the depth of sedation and need for sedatives in pediatric patients who would undergo MRI.

METHODS: Ninety pediatric patients aged 3 to 12 years who were planned for imaging in the MRI unit were randomly assigned to isolation group (Group I), musical sound group (Group II), and mother’s voice group (Group III). We evaluated patients’ anxiety and sedation levels via the Observer’s Assessment of Alertness/Sedation (OAA/S) RESULTS: Heart rate, oxygen saturation, OAA/S, and Ramsey scores during the procedure were not significantly different among the groups (p>0.05). The mean amount of propofol and total propofol consumption was statistically lower in the mother’s voice group than in the isolation and music sound groups (p<0.001). Mean propofol amount and total propofol consumption were not significantly different in isolation and music sound groups (p>0.05). No difference was found between the groups regarding the time it took for the patients’ Modified Aldrete score to reach 9 (p>0.05).

CONCLUSIONS: In pediatric patients, listening to the mother’s voice during MRI decreased the total sedative requirement consumed without increasing the depth of sedation.

PMID:36628804 | DOI:10.1016/j.explore.2023.01.001

Acad Radiol. 2023 Jan 9:S1076-6332(22)00662-6. doi: 10.1016/j.acra.2022.12.021. Online ahead of print.

ABSTRACT

RATIONALE AND OBJECTIVES: The recently developed ultrasound based tools using attenuation coefficient (AC) and scatter distribution coefficient (SDC) values can be used to quantify hepatic fat content in patients with non-alcoholic fatty liver disease (NAFLD). However, currently the impact of respiratory phase on these measurements is not known. The purpose of this study is to compare AC and SDC measurements acquired at peak inspiration and end expiration phases.

MATERIALS AND METHODS: AC and SDC measurements were obtained in 50 patients with NAFLD. Tissue Attenuation Imaging (TAI) and Tissue Scatter Distribution Imaging (TSI) tools were utilized to measure AC and SDC values, respectively. Five measurements were performed at respiratory phases using TAI and TSI tools and the median values were noted. Subgroup analyses were performed and Wilcoxon signed rank test was used for comparison of the measurements.

RESULTS: The median values of the AC measurements at peak inspiration and end expiration phases were 0.87 dB/cm/MHz and 0.89 dB/cm/MHz, respectively. The median values of the SDC measurements at peak inspiration and end expiration phases were 97.91 and 96.62, respectively. There were no statistically significant differences in AC and SDC measurements between the respiratory phases except for AC measurements in BMI <30 kg/m² subgroup.

CONCLUSION: Our results revealed that respiratory phases have no impact on SDC measurements. However, while the AC measurements in BMI ≥30 kg/m² subgroup showed no significant difference, there was a significant difference in AC measurements in BMI <30 kg/m² subgroup between the respiratory phases.

PMID:36628802 | DOI:10.1016/j.acra.2022.12.021

Anal Chim Acta. 2023 Jan 25;1239:340704. doi: 10.1016/j.aca.2022.340704. Epub 2022 Dec 7.

ABSTRACT

This work describes the analysis of formaldehyde using a 96-well microplate as multiple headspaces for the separation of sulfur dioxide gas generated from the sulfite remaining after its reaction with the formaldehyde in the sample. The quantitation of the gas is by colorimetric detection of an indicator paper placed over the microplate. The samples are aqueous extracts of various foods that are possibly adulterated with formaldehyde. A known excess amount of sulfite is added to the extract solution aliquoted in the well. The remaining sulfite is acidified with hydrochloric acid to generate sulfur dioxide gas which diffuses through the headspace above the solution to be absorbed at the moist strip of the indicator paper placed over the mouth of the wells. Anthocyanins extracted from the butterfly pea flower is used as the pH indicator giving a color change from the increase of hydrogen ions by hydrolysis of the absorbed sulfur dioxide gas. The exposed paper strip is scanned, and the digital images of the colored region analyzed using ImageJ software. The optimized method has a linear range of 200-1000 mg L^-1 formaldehyde with limit of detection ((2.57*SD of intercept)/(slope of calibration line)) of the aqueous extract of 40 mg L^-1 and coefficient of determination (r²) > 0.9979. Samples of fresh produce, such as seafood, meat, and vegetables, and various processed food were analyzed for their possible formaldehyde content. The results obtained from the headspace paper-based colorimetric detection are not statistically different from the values obtained from the titration method by paired t-tests.

PMID:36628712 | DOI:10.1016/j.aca.2022.340704

Anal Chim Acta. 2023 Jan 25;1239:340648. doi: 10.1016/j.aca.2022.340648. Epub 2022 Nov 21.

ABSTRACT

Glycated albumin (GA) in human serum is tested clinically as a short-term indicator for glucose monitoring. Here, we evaluated a candidate serum reference material (RM) at three different GA concentrations to help standardize serum GA measurements. Both albumin and GA were quantitatively determined using isotope-dilution liquid chromatography/tandem mass spectrometry with lysine-4,4,5,5-D₄·2HCl (D₄-lysine) and N^ε–^l3C₆-(l-deoxy-d-fructose-1-yl)-l-lysine (¹³C₆-DOF-lysine) as internal standards and lysine and synthetic DOF-lysine as calibration standards. The method was evaluated with the RM, JCCRM611-1, from the Reference Material Institute for Clinical Chemistry Standards. The homogeneity and stability of the candidate RMs were examined using a commercial biochemical analyzer. Fifteen units were randomly selected, and statistical analysis showed no inhomogeneity. The candidate RMs were stable for at least 6 months at -80 °C. The coefficients of variation (CVs) for the JCCRM611-1 RM ranged from 3.2% to 2.3%, and the biases ranged from 4.12% to -1.84%. GA was tested at low, medium, and high concentrations, which were quantified as 249.53 ± 13.29, 408.02 ± 11.70, and 637.22 ± 17.03 mmol/mol, respectively. The overall CVs ranged from 0.99% to 2.51%. The candidate RMs can potentially be used to develop a traceability chain to improve the accuracy of GA measurements.

PMID:36628699 | DOI:10.1016/j.aca.2022.340648

Arthroscopy. 2022 Dec 8:S0749-8063(22)00762-9. doi: 10.1016/j.arthro.2022.11.018. Online ahead of print.

ABSTRACT

PURPOSE: To report minimum 10-year follow-up survivorship, defined as non-conversion to total hip arthroplasty (THA), and patient-reported outcome scores (PROS) after primary hip arthroscopy with acetabular microfracture in the setting of femoroacetabular impingement syndrome (FAIS) and acetabular chondral lesions, respectively.

METHODS: Data were prospectively collected and retrospectively analyzed on all patients who underwent a primary hip arthroscopy and received an acetabular microfracture between June 2009 and January 2011. Patients with a minimum 10-year follow-up for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and the visual analog scale (VAS) for pain were included. If available, the minimum 10-year follow-up for the Hip Outcome Score-Sport-Specific Subscale was reported. The demographics, intraoperative findings, surgical procedures, PROS, rate of achieving the minimal clinical important difference (MCID), and secondary surgeries were analyzed and reported.

RESULTS: Twenty-two hips (20 patients) were included in the study, and the mean follow-up time was 124.5 ± 2.2 months. There were 17 hips (77.3%) from males and 5 hips (22.7%) from females. The average patient age at the time of surgery was 42.3 years ± 9.6. All patients on average experienced statistically significant improvement (P < .05) between preoperative and minimum 10-year follow-up scores for all PROs. In total, 77.3% of the patients did not require conversion to THA. Additionally, 83.3% of the patients achieved the MCID for the mHHS, NAHS, and VAS for pain.

CONCLUSION: At a minimum 10-year follow-up, survivorship of 77.3% was reported for patients who underwent primary hip arthroscopy with acetabular microfracture for the treatment of FAIS and focal/full-thickness acetabular cartilage lesions. Further, in the patients that did not require THA conversion, significant improvement in all PROS was demonstrated.

LEVEL OF EVIDENCE: IV, case-series study.

PMID:36628692 | DOI:10.1016/j.arthro.2022.11.018