Tag: statistics

J Cosmet Dermatol. 2022 Dec 27. doi: 10.1111/jocd.15568. Online ahead of print.

ABSTRACT

BACKGROUND: The experience of pain during microfocused ultrasound with visualization (MFU-V) treatment is common and crucial for dictating patient satisfaction and retention.

OBJECTIVE: To compare the pain perception during the MFU-V procedure between two pain reduction methods (topical anesthesia alone versus combined topical anesthesia with forced air cooling).

MATERIALS AND METHODS: This was a prospective, single-blinded, randomized controlled trial. A square area on the inner side of both arms of healthy volunteers was marked as an experimental site and randomly assigned to receive each pain reduction method: topical anesthesia or combined topical anesthesia with forced air cooling. Thereafter, MFU-V was performed with a 4.5 MHz, 4.5 mm transducer (10 lines, 0.9 J) followed by a 7 MHz, 3.0 mm transducer (10 lines, 0.3 J). The visual analog scale (VAS) for pain was measured immediately after 4.5 mm transducer (T1a), immediately after 3.0 mm transducer (T1b), and after the entire procedure (T2).

RESULTS: Twenty-one participants with a mean (SD) age of 34.67 (±6.18) years were enrolled. The mean (±SD) pain score of combined topical anesthesia with forced air cooling-treated area was 5.40 (±1.64), 4.80 (±1.63), and 5.40 (±1.56) at T1a, T1b, and T2, respectively. The mean pain score for topical anesthesia-treated areas was 5.89 (±1.45), 5.00 (±1.72), and 5.76 (±1.67) at T1a, T1b, and T2, respectively. There were no statistically significant differences in the pain perception between the two methods.

CONCLUSION: The addition of forced air cooling is not beneficial for pain reduction during the MFU-V procedure because its temperature reduction effect cannot be delivered to the deep parts of the skin, which is the target site of MFU-V.

PMID:36575874 | DOI:10.1111/jocd.15568

Int J Urol. 2022 Dec 27. doi: 10.1111/iju.15137. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to investigate the utility of uroflowmetry in predicting anatomical success following urethroplasty based on real-world clinical data.

METHODS: Data from 100 male patients who underwent urethroplasty for urethral strictures at our institute were analyzed. Postoperative anatomical success was determined as the passage of a 16.2 Fr flexible endoscope after approximately 4 months following the procedure. Sensitivity and specificity of the maximal flow rate (Q_max ), average flow rate (Q_ave ), and Q_max – Q_ave for anatomical success were determined, along with receiver operating characteristic analysis. The optimal cutoff was set using Youden’s index.

RESULTS: Anatomical success was observed in 67%. Voided volumes in the success and failure groups were equivalent: 252 ± 121 versus 242 ± 91 ml, respectively. In 18 cases, voided volumes were <150 ml. Parameters of uroflowmetry were all significantly higher in the anatomical success group when compared to those in the failure group: the mean value of Q_max was 26.1 versus 15.0 ml/s; Q_ave , 14.2 versus 9.1 ml/s; and Q_max – Q_ave , 11.9 versus 5.9 ml/s, respectively (p < 0.0001 for each parameter). The area under the curve was 0.8082 for Q_max , 0.7727 for Q_ave , and 0.8186 for Q_max – Q_ave . Optimal cutoff values for Q_max and Q_max – Q_ave were 20 and 6 ml/s, which predicted anatomical success with 86% and 87% positive predictive value, respectively.

CONCLUSION: This analysis presents statistically valid cutoffs by which uroflowmetry can be used as a viable surrogate of anatomical success following urethroplasty in clinical practice.

PMID:36575864 | DOI:10.1111/iju.15137

CNS Neurosci Ther. 2022 Dec 27. doi: 10.1111/cns.14073. Online ahead of print.

ABSTRACT

BACKGROUND: Alzheimer’s disease (AD), the most prevalent form of dementia, affects 6.5 million Americans and over 50 million people globally. Clinical, genetic, and phenotypic studies of dementia provide some insights of the observed progressive neurodegenerative processes, however, the mechanisms underlying AD onset remain enigmatic.

AIMS: This paper examines late-onset dementia-related cognitive impairment utilizing neuroimaging-genetics biomarker associations.

MATERIALS AND METHODS: The participants, ages 65-85, included 266 healthy controls (HC), 572 volunteers with mild cognitive impairment (MCI), and 188 Alzheimer’s disease (AD) patients. Genotype dosage data for AD-associated single nucleotide polymorphisms (SNPs) were extracted from the imputed ADNI genetics archive using sample-major additive coding. Such 29 SNPs were selected, representing a subset of independent SNPs reported to be highly associated with AD in a recent AD meta-GWAS study by Jansen and colleagues.

RESULTS: We identified the significant correlations between the 29 genomic markers (GMs) and the 200 neuroimaging markers (NIMs). The odds ratios and relative risks for AD and MCI (relative to HC) were predicted using multinomial linear models.

DISCUSSION: In the HC and MCI cohorts, mainly cortical thickness measures were associated with GMs, whereas the AD cohort exhibited different GM-NIM relations. Network patterns within the HC and AD groups were distinct in cortical thickness, volume, and proportion of White to Gray Matter (pct), but not in the MCI cohort. Multinomial linear models of clinical diagnosis showed precisely the specific NIMs and GMs that were most impactful in discriminating between AD and HC, and between MCI and HC.

CONCLUSION: This study suggests that advanced analytics provide mechanisms for exploring the interrelations between morphometric indicators and GMs. The findings may facilitate further clinical investigations of phenotypic associations that support deep systematic understanding of AD pathogenesis.

PMID:36575854 | DOI:10.1111/cns.14073

Front Biosci (Elite Ed). 2022 Sep 28;14(4):26. doi: 10.31083/j.fbe1404026.

ABSTRACT

BACKGROUND: The aim of this work was the study of the proximate composition and profile of fatty acids, minerals, and some microbiological aspects of four edible seaweed species (Chondrus crispus, Palmaria palmata, Porphyra sp., and Ulva sp.) available in the Portuguese market for food consumption, and produced in a national Integrated Multi-Trophic System (IMTA).

METHODS: Moisture, ash, and total lipids were determined gravimetrically. Crude protein was analysed by Duma’s combustion procedures. The total carbohydrate content was assayed by the phenol/sulphuric acid method. The assessment of the fatty acids methyl esters (FAMEs) was determined through GC-MS. Characterization of elemental analysis was performed by ICP-AES. Different standard microbiological methods were applied for microorganisms. Statistics were performed using the non-parametric Mann-Whitney U test to assess significant differences between samples.

RESULTS: Lipid contents (n = 3) were very low (1.6-2.3%), particularly in Palmaria palmata, and Chondrus crispus (1.6-1.7%). The protein content (n = 4) varied from 14.4% in P. palmata to 23.7% in Porphyra sp. Carbohydrates (n = 3) were the major constituent of most seaweeds (31-34%), except in Porphyra sp., with higher content in proteins than carbohydrates. Regarding the fatty acid content (n = 4), in general, saturated fatty acids (SFAs) were the most abundant followed by polyunsaturated fatty acids (PUFAs) and monounsaturated fatty acids (MUFAs). Among macro and trace elements (n = 3), Chondrus crispus shows the highest average content in Zn (71.1 mg ⋅ kg – 1 D.W.), Palmaria palmata the highest average content in K (124.8 g ⋅ kg – 1 D.W.), Porphyra sp. the highest average content in P (2.1 g ⋅ kg – 1 D.W.), and Ulva sp. the highest average content of Ca (5.5 g ⋅ kg – 1 D.W.), Mg (55.8 g ⋅ kg – 1 D.W.), and Fe (336.3 mg ⋅ kg – 1 D.W.). In general, Na and K were the most abundant elements among analysed seaweed. Additionally, the microbiological results (n = 4) comply with the Portuguese guidelines (subgroup 2D) on the application of general principles of food hygiene in ready-to-eat foods.

CONCLUSIONS: Overall, the results highlight the potential of using these seaweeds as an alternative and sustainable source of elements and bioactive compounds to produce enriched food products with a beneficial potential for human nutrition.

PMID:36575846 | DOI:10.31083/j.fbe1404026

Brief Bioinform. 2022 Dec 28:bbac568. doi: 10.1093/bib/bbac568. Online ahead of print.

ABSTRACT

Aberrant DNA methylation is the most common molecular lesion that is crucial for the occurrence and development of cancer, but has thus far been underappreciated as a clinical tool for cancer classification, diagnosis or as a guide for therapeutic decisions. Partly, this has been due to a lack of proven algorithms that can use methylation data to stratify patients into clinically relevant risk groups and subtypes that are of prognostic importance. Here, we proposed a novel Bayesian model to capture the methylation signatures of different subtypes from paired normal and tumor methylation array data. Application of our model to synthetic and empirical data showed high clustering accuracy, and was able to identify the possible epigenetic cause of a cancer subtype.

PMID:36575828 | DOI:10.1093/bib/bbac568

Eur J Clin Invest. 2022 Dec 27:e13942. doi: 10.1111/eci.13942. Online ahead of print.

ABSTRACT

BACKGROUND: The association of aspartate aminotransferase to alanine aminotransferase ratio (De Ritis ratio) with clinical outcome in patients with chronic coronary syndromes (CCS) remains unclear. This study aims to assess the association of De Ritis ratio with adverse cardiovascular events in patients with CCS.

MATERIALS AND METHODS: The study included 5020 patients with CCS undergoing percutaneous coronary intervention. Patients were categorized in groups according to tertiles of the De Ritis ratio: tertile 1 (De Ritis ratio: <0.75; n=1688 patients), tertile 2 (De Ritis ratio: 0.75-1.08; n=1666 patients) and tertile 3 (De Ritis ratio: >1.08; n=1666 patients). The primary endpoint was 3-year mortality.

RESULTS: At 3 years, there were 384 deaths, 176 myocardial infarctions and 61 strokes. In groups with De Ritis in the 1st, 2nd and 3rd tertiles deaths occurred in 5.0%, 7.5% and 14.5% of the patients, respectively (adjusted hazard ratio =1.09, 95% confidence interval 1.06 to 1.12], P<0.001); myocardial infarctions occurred in 2.6%, 3.5% and 5.1% of the patients, respectively (P<0.001); strokes occurred in 1.0%, 1.2% and 1.9% of the patients, respectively (P=0.030); bleeding at 30 days (n=112) occurred in 1.4%, 1.6% and 3.7% of the patients, respectively (P<0.001). The C-statistic of the Cox proportional hazards model for all-cause mortality with baseline data without the De Ritis ratio was 0.815 [0.794-0.836] and 0.818 [0.797-0.838] after inclusion of the De Ritis ratio (delta C-statistic =0.003; P=0.005).

CONCLUSIONS: In patients with CCS undergoing percutaneous coronary intervention an elevated De Ritis ratio was associated with long-term major cardiovascular adverse events.

PMID:36575818 | DOI:10.1111/eci.13942

BMJ Open. 2022 Sep 1;12(9):e055031. doi: 10.1136/bmjopen-2021-055031.

ABSTRACT

INTRODUCTION: EHealth can help health service users take a more active role in decision-making and help health professionals guide the patient in this process. A digital tool has been designed to support maternal education (ME), and it is organised into four areas: (1) information, (2) communication, (3) health self-management and (4) clinical data. The main objective of the study is to evaluate the effectiveness of the EMAeHealth digital tool, and assess its usability and acceptability under routine conditions.

METHODS AND ANALYSIS: Hybrid implementation-effectiveness design: (1) A cluster randomised, prospective, longitudinal, multicentre clinical trial to evaluate the effectiveness of EMAeHealth in (A) improving health-related quality of life (primary outcome), (B) improving self-efficacy for labour and childbirth and self-efficacy in breast feeding and (C) reducing the number of visits to the obstetric emergency services and health centre in situations of ‘non-pathological pregnancy’, ‘false labour pains’ and ‘non-pathological puerperium’. The EMAeHealth intervention plus usual care will be compared with receiving only usual care, which includes traditional ME. N=1080 participants, 540 for each study arm. Two measurements will be made throughout the pregnancy and three in the first 16 weeks post partum. (2) A mixed-method study to evaluate the usability and acceptability of the tool, barriers and facilitators for its use, and implementation in our health system: focus groups (women, professionals and agents involved) and a quantitative analysis of implementation indicators.

ANALYSIS: It will be carried out by intention to treat, using mixed models taking into account the hierarchical structure of the data and per protocol to evaluate the effectiveness of the express use of the digital tool.

ETHICS AND DISSEMINATION: Clinical Research Ethics Committee of Euskadi, Spain, (Ref: PI2020044) approved this study. The results will be actively disseminated through manuscript publications and conference presentations.

TRIAL REGISTRATION NUMBER: NCT04937049.

PMID:36575817 | DOI:10.1136/bmjopen-2021-055031

J Chest Surg. 2022 Dec 28. doi: 10.5090/jcs.22.110. Online ahead of print.

ABSTRACT

BACKGROUND: We analyzed our experience with descending necrotizing mediastinitis (DNM) treatment and investigated the efficacy of video-assisted thoracoscopic surgery (VATS) for mediastinal drainage.

METHODS: This retrospective analysis included patients who underwent surgical drainage for DNM at our hospital from 2005 to 2020. We analyzed patients’ baseline characteristics, surgical data, and perioperative outcomes and compared them according to the mediastinal drainage approach among patients with type II DNM.

RESULTS: Twenty-five patients (male-to-female ratio, 18:7) with a mean age of 54.0±12.9 years were enrolled in this study. The most common infection sources were pharyngeal infections (60%). Most patients had significantly increased white blood cell counts, elevated C-reactive protein levels, and decreased albumin levels on admission. The most common DNM type was type IIB (n=16, 64%), while 5 and 4 patients had types I and IIA, respectively. For mediastinal drainage, the transcervical approach was used in 15 patients and the transthoracic approach (VATS) in 10 patients. The mean length of hospital stay was 26.5±23.8 days, and the postoperative morbidity and in-hospital mortality rates were 24% and 12%, respectively. No statistically significant differences were found among patients with type II DNM between the transcervical and VATS groups. However, the VATS group showed shorter mean antibiotic therapy duration, drainage duration, and hospital stay length than the transcervical group.

CONCLUSION: DNM manifested as severe infection requiring long-term inpatient treatment, with a mortality rate of 12%. Thus, active treatment with a multidisciplinary approach is crucial, and mediastinal drainage using VATS is considered relatively safe and effective.

PMID:36575811 | DOI:10.5090/jcs.22.110

Nurs Open. 2022 Dec 27. doi: 10.1002/nop2.1573. Online ahead of print.

ABSTRACT

AIM: To identify the factors affecting Emergency Department Length of Stay for transferred critically ill patients.

BACKGROUND: The Length of Stay of the transferred patients is an important indicator of Emergency Department service quality; thus, understanding the factors affecting the Emergency Department Length of Stay of transferred critically ill patients is essential.

METHODS: Using the electronic medical records of 968 transferred critically ill Emergency Department patients of a tertiary hospital in Korea, prediction models for Emergency Department Length of Stay were built using various machine learning algorithms.

RESULTS: The logistic regression (AUROC 0.85) models showed the best performance, followed by random forest (AUROC 0.83) and Naive Bayes (AUROC 0.83). The logistic regression model indicated that fewer consultations, the highest acuity level, need for an emergency operation or angiography, need for ICU admission, severe emergency disease and fewer diagnoses were the statistically significant predictors for Emergency Department Length of Stay of 6 h or less.

CONCLUSIONS: The transferred critically ill patients analysed in this study who required immediate or specialized care tended to receive needed care on time at the study site.

IMPLICATIONS FOR NURSING MANAGEMENT: Understanding the factors affecting the Emergency Department Length of Stay of transferred critically ill patients is crucial for developing strategies to manage the nursing resource of Emergency Department successfully.

PMID:36575810 | DOI:10.1002/nop2.1573

Brief Bioinform. 2022 Dec 27:bbac579. doi: 10.1093/bib/bbac579. Online ahead of print.

ABSTRACT

Long noncoding ribonucleic acids (RNAs; LncRNAs) endowed with both protein-coding and noncoding functions are referred to as ‘dual functional lncRNAs’. Recently, dual functional lncRNAs have been intensively studied and identified as involved in various fundamental cellular processes. However, apart from time-consuming and cell-type-specific experiments, there is virtually no in silico method for predicting the identity of dual functional lncRNAs. Here, we developed a deep-learning model with a multi-head self-attention mechanism, LncReader, to identify dual functional lncRNAs. Our data demonstrated that LncReader showed multiple advantages compared to various classical machine learning methods using benchmark datasets from our previously reported cncRNAdb project. Moreover, to obtain independent in-house datasets for robust testing, mass spectrometry proteomics combined with RNA-seq and Ribo-seq were applied in four leukaemia cell lines, which further confirmed that LncReader achieved the best performance compared to other tools. Therefore, LncReader provides an accurate and practical tool that enables fast dual functional lncRNA identification.

PMID:36575567 | DOI:10.1093/bib/bbac579