Tag: statistics

Indian J Tuberc. 2023 Jul;70(3):303-310. doi: 10.1016/j.ijtb.2022.05.012. Epub 2022 Jun 1.

ABSTRACT

BACKGROUND: Drug induced liver injury (DILI) is a serious adverse effect caused by first-line anti-TB (ATT) drugs, limiting the TB-treatment. The tissue inflammation induced by free radical burst and poor dietary intake in TB induces oxidative stress, which was proposed as one of the mechanisms responsible for ATT induced DILI. N-acetylcysteine (NAC) exerts a hepato-protective effect by enhancing the cellular antioxidant defense mechanism. There are few studies evaluating the effect of NAC on ATT induced DILI in Indian-population.

METHODS: This is a prospective, randomized, double-blind, placebo-controlled, parallel-group study. Thirty-eight newly diagnosed TB patients on first-line ATT with normal liver function test (LFT) were recruited and randomized to receive either NAC 600 mg tablet or placebo twice daily for 4 weeks and followed-up for next 4 weeks. LFT [AST, ALT, ALP and Total bilirubin] was assessed at baseline, 2, 4 and 8 weeks. Oxidative-stress biomarkers [Malondialdehyde (MDA), Nitric Oxide (NO), Glutathione (GSH)] and quality of life (QOL) by SF-36 questionnaire were assessed at baseline, 4 and 8 weeks. Adverse Drug Reactions (ADRs) were monitored at every visit. Compliance was assessed by pill-count method.

RESULTS: Baseline characteristics were homogenous among both the groups. In the NAC group, there was significant reduction in ALT (p < 0.01), ALP (p < 0.01), total bilirubin (p < 0.001) at 4 weeks compared to baseline. AST, MDA and NO showed a reduction of 19%, 21.6% and 5.5% respectively from baseline and GSH at showed an increase of 2.6% from baseline at 4 weeks in the NAC group, however these were not statistically significant. These effects in LFT and oxidative biomarkers persisted even at the end of 8 weeks. Significant improvement from baseline in QOL was observed in both the groups (p < 0.05). Between group analysis showed, significant reduction in ALT (p < 0.05) and AST (p < 0.05) in NAC group at 4 weeks, whereas bilirubin, MDA, NO and GSH showed improvement at 4 weeks compared to placebo in NAC group, however it was not statistically significant. This improvement in the LFT and oxidative biomarkers continued even at the end of 8 weeks. Itching and rashes were the most common ADRs, with similar incidence in both the groups. Compliance to treatment was good in both the groups.

CONCLUSION: Significant improvement in liver function parameters is suggestive of hepatoprotective effect of NAC. This observed effect at 4 weeks was found to be persistent at 8 weeks, which signifies prolonged hepato-protective effect of NAC. Long duration studies with large sample size are required for further confirmation of hepato-protective action of NAC.

PMID:37562904 | DOI:10.1016/j.ijtb.2022.05.012

Handb Clin Neurol. 2023;195:271-286. doi: 10.1016/B978-0-323-98818-6.00016-9.

ABSTRACT

Electromyography (EMG) focuses on assessment of the motor unit (MU), and a given muscle has several hundred MUs, each innervating hundreds of muscle fibers. Assessment is limited by the recording radius of electrodes, 1-2 fibers with single-fiber electrodes and 7-15 fibers with concentric or monopolar electrodes. Routine qualitative EMG studies rely on observing MUs in free-run mode and qualitatively estimating common metrics. In contrast, quantitative EMG (QEMG) applied to routine studies includes assessment of individual MUs by software available in modern EMG machines with extraction of discrete values for common metrics, and also derived metrics. This results in greater precision and statistical interpretation. Other QEMG techniques assess muscle fiber density within the MU and time variability at the neuromuscular junction. The interference pattern can also be assessed. The number of MUs innervating a muscle can be estimated. Advanced signal processing, called near-fiber EMG, allows for extraction of underlying muscle fiber contributions to MU waveforms. It is also possible to use QEMG to make statistical probabilities of the state of a muscle as to whether normal, myopathic, or neuropathic. Time to acquire QEMG data is minimal. QEMG is most useful in situations where pathology is uncertain.

PMID:37562872 | DOI:10.1016/B978-0-323-98818-6.00016-9

J Neurointerv Surg. 2023 Aug 10:jnis-2023-020686. doi: 10.1136/jnis-2023-020686. Online ahead of print.

ABSTRACT

BACKGROUND: To assess the frequency, imaging appearances, and risk factors of brain microemboli following pediatric neuroangiography, as assessed by early diffusion-weighted MRI imaging (DWI).

METHODS: This single-center, retrospective analysis investigated early DWI post-pediatric neuroangiography. Patients aged 0-18 years who had diagnostic neuroangiography and DWI within a week postprocedure were included. Data on clinical and procedural parameters and MRI findings were recorded. Univariate and multivariate analyses were performed on the following risk factors: age, weight, vasculopathy, antiplatelet drug use, access type, intraprocedural heparin, procedure duration, neck arteries catheterized, and angiographic runs. A p-value<0.05 indicated statistical significance.

RESULTS: Eighty-two children were included (40.2% female), mean age 10.1±4.5 years (range: 7 months-17 years). There were no intraprocedural thromboembolic complications recognized. DWI positivity was seen following 3.6% (3/82) procedures: two with transient symptoms, and one instance of silent microemboli. There were no territorial infarcts or clinical stroke. Children with underlying vasculopathy had a higher risk of microemboli from angiography than children without vasculopathy (OR 31.6, p=0.02), and the OR of microemboli following transradial angiography was 79.1 (p=0.005) as compared with transfemoral angiography. Univariate and multivariate analysis showed a significant association between microemboli and number of angiographic runs (p=0.004). Follow-up MRI in all three patients showed no residual abnormal signal.

CONCLUSIONS: Cerebral microemboli are unusual following uncomplicated neuroangiography in children. However, in the presence of underlying vasculopathy and with transradial technique, the incidence approaches that reported in the adult literature. An increased association with the number of angiographic runs is an important and controllable factor.

PMID:37562819 | DOI:10.1136/jnis-2023-020686

J Am Vet Med Assoc. 2023 Aug 9:1-5. doi: 10.2460/javma.23.05.0273. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare long-term outcomes of lower lid entropion surgery performed in juvenile dogs versus adult dogs and evaluate the success rate of temporary tacking procedures in dogs < 1 year of age.

ANIMALS: 116 client-owned dogs.

METHODS: A retrospective study was performed evaluating dogs younger than 3 years old diagnosed with primary lower lid entropion between 2010 and 2020. Recurrence of entropion following temporary tacking sutures was evaluated. Surgical outcomes were evaluated of entropion surgery in dogs < and > 1 year of age.

RESULTS: 44 dogs with entropion (71 eyes) had a temporary tacking procedure. The entropion resolved in 36.6% of eyes, requiring no further therapy. The median age of dogs successfully treated with a temporary tacking procedure was younger than those that failed. Forty-seven dogs (75 eyes) had entropion surgery at maturity, and 52 dogs (79 eyes) were juvenile. Twenty-seven dogs had temporary tacking procedure prior to surgery, accounting for the difference in number. There was no statistically significant difference in the recurrence rate of entropion between eyes of adult (6/75 [8%]) and juvenile dogs (10/79 [12.7%]) following surgery.

CLINICAL RELEVANCE: Entropion surgery in juvenile dogs is not associated with a higher risk of recurrence and need not be delayed until dogs are older than 1 year of age.

PMID:37562785 | DOI:10.2460/javma.23.05.0273

J Acad Nutr Diet. 2023 Aug 8:S2212-2672(23)01309-6. doi: 10.1016/j.jand.2023.08.003. Online ahead of print.

ABSTRACT

BACKGROUND: Childhood diet can impact health outcomes over the life course. Few studies have assessed dietary quality among infants and children in the U.S.-Affiliated Pacific (USAP) region.

OBJECTIVE: The aim of this study was to examine the differences in diet quality among Pacific children in the Children’s Healthy Living (CHL) program by Pacific jurisdiction and by their World Bank Income Group (WBIG) level.

DESIGN: This cross-sectional study used dietary records collected from 2012 to 2015.

PARTICIPANTS: /Setting: Data were collected on two- to eight-year-old children (n=3,529) enrolled in the Children’s Healthy Living Program for Remote Underserved Minority Populations in the Pacific region, conducted in the USAP jurisdictions of Alaska, Hawai’i, American Samoa, Commonwealth of the Northern Mariana Islands (CNMI), Guam, Federated States of Micronesia (FSM islands include Chuuk, Kosrae, Pohnpei, Yap), Republic of the Marshall Islands (RMI), and Republic of Palau.

MAIN OUTCOME MEASURE: Diet quality was assessed using the Healthy Eating Index-2005 (HEI-2005). This HEI version was commensurate with the time of dietary data collection for the CHL project and previous studies, thus allowing cross study comparisons.

STATISTICAL ANALYSIS PERFORMED: Means of total HEI-2005 scores between jurisdictions and their WBIG level were compared using linear models, with and without adjustment for age, sex, and dietary energy.

RESULTS: Differences in mean HEI-2005 scores among children were found between jurisdictions and their WBIG level. Alaska had the highest adjusted mean score (63.3). RMI had the lowest adjusted mean score (50.1). By WBIG, lower-middle income jurisdictions had the lowest adjusted mean HEI-2005 score (56.0) whereas high income jurisdictions had the highest adjusted mean HEI-2005 score (60.5).

CONCLUSIONS: Variation in children’s diet quality was found between USAP jurisdictions, notably between jurisdictions of different WBIG levels. Future research is needed to deepen understanding of these differences in diet quality by WBIG level, such as whether differences may be due to the jurisdictions’ varying food systems, and possibly explained by the nutrition transition. Understanding childhood diet quality in this region can inform approaches for nutrition programs in the Pacific region.

PMID:37562772 | DOI:10.1016/j.jand.2023.08.003

Gastroenterol Hepatol. 2023 Aug 8:S0210-5705(23)00379-5. doi: 10.1016/j.gastrohep.2023.08.001. Online ahead of print.

ABSTRACT

INTRODUCTION: portal vein thrombosis (PVT) is the most frequent cause of portal hypertension in paediatric population. Baveno VI Consensus considers endoscopic variceal ligation (EVL) as the second therapeutic option after Meso-Rex bypass (surgical shunt).

AIM: analyse the diagnostic profitability of non-invasive scales in order to predict the risk of oesophageal varices (OV) in children with PVT.

MATERIALS AND METHODS: descriptive retrospective study where every upper gastrointestinal endoscopy (UGE) carried on patients <15 years old with non-cirrhotic PVT were included. There were divided according to the presence of OV and sex, cause, age, previous gastrointestinal bleeding or treatments, results of UGE and scales (Clinical Prediction Rule-CPR), Varices Prediction Rule-VPR), King’s Variceal Prediction Score-K-VaPS) and Platelet count / Spleen diameter Ratio-PSR). Qualitative variables were expressed as absolute frequency and percentage, and quantitative variables as median and intercuartilic range. U Man-Whitney and Hanley-McNeil tests were used for comparisons.

RESULTS: 45 UGE were analysed. 80%(n=36) presented OV: median of 3(2 – 3) and 33,3%(n=12) required EVL. Statistical differences were demonstrated between both groups: CPR (142,39 (132,22 – 166,53) vs. 122,75 (115,24 – 133,15); p=0,003), VPR (9,91 (9,36 – 11,75) vs. 5,6 (3,34 – 8,39) p=0,001), K-VaPS (117,86 (99,66 – 126,58) vs. 99,64 (94,88 – 110,18) p=0,019), PSR (2384,62 (1902,22 – 3201,63) vs. 1252,5 (579,6 – 2144,42) p=0,05), with and area under the curve AUROC>75%, without statistical differences between scales.

CONCLUSIONS: in paediatric patients with non-cirrotic PVT non-invasive scales can be used as a tool to predict the presence of OV and raise the indication of UGE.

PMID:37562768 | DOI:10.1016/j.gastrohep.2023.08.001

Environ Res. 2023 Aug 8:116859. doi: 10.1016/j.envres.2023.116859. Online ahead of print.

ABSTRACT

The characterization of a rainfall simulator provides an excellent opportunity to study the potential of soil erosivity without waiting for natural rain. But, precise instrumentation is required to estimate the parameters, which is seldom available. To overcome this problem, the empirical and conceptual relationships obtained through physically-based modeling help to correlate the rain parameters contributing to soil erosion. The present laboratory study used five pressurized nozzles of different capacities and a Laser Precipitation Monitor (LPM) to generate different rain intensities (21.0-79.0 mm h^-1) and to register drop size distribution, respectively. The sediment transportation induced by rain and runoff was measured with an erosion flume of 2.50 × 1.25 × 0.56 m with an adjustable longitudinal slope. The spatial uniformity, drop size distribution, drop velocity, and kinetic energy were used to evaluate the simulator’s performance. The different rain erosivity parameters were correlated and tested statistically using linear and non-linear regression analysis. The rain simulation experiments of different intensities at different pressure ranges were performed on flat, 5, 10, and 15% slopes of the erosion flume to evaluate rain characteristics and record the surface runoff and sediment yield. The median drop sizes produced during the simulator ranged from 0.38 to 2.11 mm, coinciding with natural rain. The empirical relationships were developed to correlate surface discharge and sediment yield with rain intensity by optimizing the parameters for further study of experimental field plots of different slopes. The observed and estimated rain erosivity parameters showed a significant relationship (R² = 0.75 to 0.93; P < 0.001) in multiple regression analysis, and the metrics used to test the developed regression equations showed lower MAE, MSE, and RMSE errors indicating the adequacy of the relationships. The results indicated that the simulator helps to understand the complex task of soil erosion with hydrologic and geomorphic processes in laboratory experimentation with sufficient accuracy in measuring sediment transport events.

PMID:37562739 | DOI:10.1016/j.envres.2023.116859

Toxicol Lett. 2023 Aug 8:S0378-4274(23)00238-2. doi: 10.1016/j.toxlet.2023.08.001. Online ahead of print.

ABSTRACT

Arsenic is among the most critical environmental toxicants associated with many human disorders. However, its effect on type 2 diabetes mellitus (T2DM) is contradictory. This systematic review and dose-response meta-analysis aim to update information on the association between arsenic exposure and the risk of T2DM. The sample type (drinking water, urine, blood, and nails) conducted the subgroup analysis. Evaluation of the high vs. low arsenic concentrations showed a significant association between drinking water arsenic (OR: 1.58, 95% CI: 1.20-2.08) and urinary arsenic (OR: 1.37, 95% CI: 1.24-1.51) with the risk of T2DM. The linear dose-response meta-analysis showed that each 1μg/L increase in levels of drinking water arsenic (OR: 1.01, 95% CI: 1.00-1.01) and urinary arsenic (OR: 1.01, 95% CI: 1.00-1.02) was associated with a 1% increased risk of T2DM. The non-linear dose-response analysis indicated that arsenic in urine was associated with the risk of T2DM (_{Pnon-linearity}<0.001). However, this effect was not statistically significant for arsenic in drinking water (_{Pnon-linearity}=0.941). Our findings suggest that blood arsenic was not significantly linked to the increased risk of T2DM in high vs. low (OR: 1.21, 95% CI: 0.85-1.71), linear (OR: 1.04, 95% CI: 0.99-1.09), and non-linear (P_{non-linearity}=0.365) analysis. Also, nail arsenic was not associated with the risk of T2DM in this meta-analysis (OR: 1.33, 95% CI: 0.69-2.59). This updated dose-response meta-analysis indicated that arsenic exposure was significantly correlated with the risk of T2DM.

PMID:37562716 | DOI:10.1016/j.toxlet.2023.08.001

Clin Microbiol Infect. 2023 Aug 8:S1198-743X(23)00365-8. doi: 10.1016/j.cmi.2023.08.003. Online ahead of print.

ABSTRACT

OBJECTIVES: We aimed to explore the impact of social distancing on the incidence and microbiology of peritonsillar abscess (PTA).

METHODS: We performed a cross-sectional analysis of all PTA patients and their microbiological findings in the two years preceding versus the two years following the COVID-19 lockdown in Denmark (March 11, 2020), who were admitted to the Ear-Nose-Throat Department, Aarhus University Hospital. Age-stratified population data for the catchment area were obtained from Statistics Denmark.

RESULTS: The annual incidence rate was significantly higher in the two-years period before (21.8 cases/100,000 inhabitants) compared to after (14.9 cases/100,000) the lockdown (p<0.001). The number of cases with growth of S. pyogenes was significantly higher in the period before (n=67) compared to after (n=28) the lockdown (p<0.001), while the number of cases positive for F. necrophorum (n=60 vs n=64) and streptococcus anginosus group (SAG) (n=37 vs n=43) were stabile (p=0.79 and p=0.58, respectively). The relative prevalence of S. pyogenes was significantly higher in the period before (67/246 cultures, 27%) compared to after (28/179, 16%) the lockdown (p=0.007). On the contrary, the relative prevalence of F. necrophorum and SAG were significantly lower before (60/246, 24% and 37/246, 15%) compared to after (64/179, 36% and 43/179, 24%) the lockdown (p=0.013 and p=0.023).

CONCLUSIONS: Social distancing had a significant impact on the incidence and microbiology of PTA. Our findings suggest that S. pyogenes-positive PTA is highly related to direct social interaction, and represents a contagious pathogen. By contrast, PTA development caused by F. necrophorum and SAG are unrelated to direct social interaction and may be derived from flora imbalance.

PMID:37562694 | DOI:10.1016/j.cmi.2023.08.003

World Neurosurg. 2023 Aug 8:S1878-8750(23)01109-9. doi: 10.1016/j.wneu.2023.08.007. Online ahead of print.

ABSTRACT

BACKGROUND: The decision for treatment for unruptured intracranial aneurysms (UIAs) is often difficult. Innovation in endovascular devices have improved the benefit-to-risk profile for especially elderly patients, however the treatment guidelines from the past decade often recommend conservative management. It is unknown how these changes have affected the overall age of the patients selected for treatment. Herein, we aimed to study potential changes in the average age of the patients that are being treated over time.

METHODS: A systematic search of the literature was performed to identify all studies describing the age of the UIAs that were treated by any modality. Scatter diagrams with trend lines were used to plot the age of the patients treated over time and assess the presence of a potential significant trend via statistical correlation tests.

RESULTS: A total of 280 studies including 83,437 UIAs treated between 1987-2021 met all eligibility criteria and were entered in the analysis. Mean age of the patients was 55.5 years and 70.7% were females. There was a significant increasing trend in the age of the treated patients over time (Spearman’s r: 0.250; p < 0.001), with a 1-year increase in the average age of the treated patients every 5 years since 1987.

CONCLUSIONS: The present study indicates that based on the treated UIA patient data published in the literature, older UIAs are being treated over time. This trend is likely driven by safer treatments while suggesting that reevaluation of certain UIA treatment decision scores may be of great interest.

PMID:37562685 | DOI:10.1016/j.wneu.2023.08.007