Tag: statistics

Eur J Cardiothorac Surg. 2022 Dec 26:ezac576. doi: 10.1093/ejcts/ezac576. Online ahead of print.

ABSTRACT

OBJECTIVES: This retrospective observational study aimed to assess the geometrical features, including diameters, length and angulation, of the ascending aorta with bicuspid and tricuspid aortic valve and to identify imaging markers potentially predicting whether aortopathy is likely to evolve chronically or to complicate with acute type A dissection.

METHODS: Angio-computed-tomography scans of 354 patients (from 3 Centers) with non-dilated (n = 97), aneurysmal (n = 100) or dissected aorta (n = 157) were reviewed. Diameters were measured at root, sinotubular junction, ascending, brachio-cephalic trunk origin; centerline lengths of the root and tubular tract, and ascending-arch angle (between the ascending tubular tract axis and the proximal arch axis) were also measured. For 12 dissection patients, pre-dissection scans were available to investigate predisposing aortic geometry. Statistical analysis included: tricuspid versus bicuspid comparisons in each subgroup; univariate and multivariate analysis of the predictors of ascending-arch angle narrowing; estimation of diagnostic accuracy of the angle parameter.

RESULTS: Diameters and lengths were similar between aneurysms and dissections, whereas dissections showed a significant ascending-arch angle narrowing (117°±13 in tricuspid, 115°±14 in bicuspid) compared to non-dilated and aneurysmal aortas (all p < 0.001). The best angle cut-off to discriminate dissection patients was 131° (96% sensitivity). In patients with a pre-dissection scan, Asc-Arch narrowing was already present before dissection. In non-dissected aortas over-angulation was predicted by root phenotype dilatation both in bicuspid and tricuspid patients. Bicuspid patients with non-dilated aorta showed elongated root (p = 0.027), a feature significantly correlated with Asc-Arch angle narrowing (p = 0.008).

CONCLUSIONS: The ascending-arch angle is promising as a risk marker for dissection to be used along with diameter. Its narrowing seems to be associated with elongation of the root, a feature that bicuspid patients can show even without significant dilatation. Root-phenotype aortopathy may be at higher risk also with tricuspid aortic valve.

PMID:36571506 | DOI:10.1093/ejcts/ezac576

Aust Endod J. 2022 Dec 26. doi: 10.1111/aej.12734. Online ahead of print.

ABSTRACT

This study aimed to evaluate the amount of apically extruded debris caused by different NiTi files. One hundred mandibular premolars were included in this study. The specimens were divided into five groups (n = 20): (i) TruNatomy, (ii) WaveOne Gold, (iii) 2Shape, (iv) ProTaper Next and (v) Reciproc Blue. The extruded debris was collected into preweighed Eppendorf tubes. These tubes were weighed again, and the net weight of debris was calculated. Data were statistically analysed, and the significance level was set at 5%. The least amount of extruded debris was observed in the TruNatomy group (p < 0.05). Statistically significant differences were not found among (iii), (iv) and (v) groups (p > 0.05). However, these groups resulted in significantly higher amounts of debris when compared to (i) and (ii) groups (p < 0.05). The results lead us to conclude that all instrumentation systems caused apical extrusion of debris at varying weights.

PMID:36571483 | DOI:10.1111/aej.12734

Zhen Ci Yan Jiu. 2022 Dec 25;47(12):1041-7. doi: 10.13702/j.1000-0607.20220586.

ABSTRACT

OBJECTIVE: To observe the effect of electroacupuncture (EA) of “Xiusanzhen” ［bilateral “Yingxiang”(LI20)+”Yintang”(GV24⁺)］ on synaptophysin (SYN), postsynaptic density protein-95 (PSD-95), Iba-1⁺ CD68⁺ microglia and complement C related protein expression of hippocampus in Parkinson’s disease dementia (PDD) mice, so as to explore its mechanism in improving memory impairment of PDD.

METHODS: Male C57BL/6 mice were randomly divided into control, sham operation, model and EA groups, with 10 mice in each group. The PDD model was established by injecting 6-OHDA into the medial forebrain tract. EA (2 Hz, 1 mA) was applied to unilateral LI20 and GV29 for 20 min once daily for consecutive 14 days. Morris water maze and new object recognition test were used to evaluate the learning and memory ability. Western blot was used to detect the expression of SYN and PSD-95 proteins in hippocampus. Immunofluorescence was used to label Iba-1⁺ CD68⁺ microglia and C1q positive cells in hippocampal CA1 region. The content of C3 protein in hippocampus was detected by ELISA.

RESULTS: Compared with the control group, there was no statistical significance in all the observed indexes in the sham operation group. Compared with the sham operation group, the average escape latency (AEL) prolonged significantly (P<0.01), the target platform crossing times (TPCT) and new object recognition index (NORI) decreased remarkably (P<0.01); the expressions of SYN and PSD-95 proteins in hippocampal CA1 region were significantly decreased (P<0.01); the rate of Iba-1+CD68+ microglia, the rate of C1q positive cells and the content of C3 protein were significantly increased (P<0.01) in the model group. In comparison with the model group, the AEL was shortened (P<0.01), the TPCT and NORI were increased (P<0.05) remarkably; the expressions of SYN and PSD-95 proteins in hippocampal CA1 region were increased (P<0.01, P<0.05); the rate of Iba-1⁺ CD68⁺ microglia, the rate of C1q positive cells and the content of C3 protein were significantly decreased (P<0.01) in the EA group.

CONCLUSION: “Xiusanzhen” can alleviate the learning and memory impairment of PDD model mice, and improve the synaptic plasticity of hippocampal CA1 area. The mechanism may be related to the reduction of C1q and C3 deposition in hippocampal CA1 region and the reduction of microglia phagocytosis.

PMID:36571217 | DOI:10.13702/j.1000-0607.20220586

Free Radic Res. 2022 Dec 26:1-12. doi: 10.1080/10715762.2022.2162392. Online ahead of print.

ABSTRACT

BACKGROUND: Vitamin B₁₂ is involved in biochemical metabolic pathways. B₁₂ deficiency is common in childhood when the need for the vitamin increases and growth and development occur. Various hematological, neurological, psychiatric, and gastrointestinal disorders are observed in its deficiency. In addition, B₁₂ deficiency is associated with oxidative stress and DNA damage.

AIM: Therefore, the aim of our study is to evaluate oxidative stress, thiol/disulfide homeostasis, and DNA damage pre and post-treatment in children diagnosed with B₁₂ deficiency.

METHODS: A total of 40 children with B₁₂ deficiency were included in the study after the consent form was approved. Blood was drawn from children pre and post-treatment. Hemoglobin (HGB), hematocrit (HCT), and red blood cells (RBC) were measured by autoanalyzer; total antioxidant status (TAS), total oxidant status (TOS), total thiol (TT), and native thiol (NT) were measured by the photometric method, and DNA damage was analyzed by the comet assay method. Oxidative stress index (OSI) and disulfide (DIS) values were calculated.

RESULTS: As a result of the experiments, HGB, HCT, and RBC increased with treatment. While TAS, TT, and NT as antioxidant parameters increased; TOS, OSI, and DIS decreased with treatment compared to pretreatment. DNA damage was also found to decrease with treatment. Additionally, these data were statistically significant (p < 0.001).

CONCLUSIONS: It was found that oxidative stress and DNA damage decreased with oral B₁₂ treatment in children with B₁₂ deficiency, and clinical parameters were also improved.

PMID:36571212 | DOI:10.1080/10715762.2022.2162392

Hip Int. 2022 Dec 26:11207000221146116. doi: 10.1177/11207000221146116. Online ahead of print.

ABSTRACT

BACKGROUND: Total hip arthroplasty (THA) is an orthopaedic procedure that improves the quality of life in patients suffering from hip pain related to osteoarthritis, fractures, and avascular osteonecrosis of the femoral head. Different surgical approaches can be used for THA leading to different recovery times. Because of the lowering medium age of people undergoing THA, it is important to focus on the earlier return of physiological activity after surgery.

AIM: To evaluate the best approach for THA in terms of earlier return to activity.

METHOD: Studies comparing the postoperative outcomes in patients who underwent THA through different approaches were analysed focusing on patients’ self-reported outcomes, ADL score and UCLA activity score with a short follow-up.

RESULTS: A total of 1990 articles were identified in the search, and 14 met the inclusion criteria. The Review Manager software version 5.4 was used to conduct a meta-analysis to compare the direct anterior (DAA) and posterior (PA) approaches, which are the most adopted approaches. An earlier return to walk without aids and to independent ADLs were reported with DAA, but without statistical significance (respectively p = 0.06 and p = 0.10). The time to return to drive was similar among the 2 groups (p = 0.88). The return to work was faster with PA, but no statistical significance was reported (p = 0.47).

CONCLUSIONS: Further studies are needed with a larger number of patients, that present homogeneous outcomes, follow-ups and rehabilitation programmes, and that compare similar surgical approaches to assess the early return to activity of daily living after THA.

PMID:36571209 | DOI:10.1177/11207000221146116

J Obstet Gynaecol. 2022 Dec 26:2158315. doi: 10.1080/01443615.2022.2158315. Online ahead of print.

ABSTRACT

The aim of this study was to explore provider practices and attitudes towards routine follow-up counselling after prescription of contraceptives. An anonymous 16-item survey was pilot-tested and sent to providers of the Internal Medicine, Family Medicine, Pediatrics, and OBGYN departments of Thomas Jefferson University Hospitals (TJUH), an urban academic medical centre in Philadelphia, PA, USA. Frequency and descriptive statistics were used to analyse quantitative data while a framework analysis approach was applied to open-ended questions. Fifty percent of providers said they typically follow up with patients regarding a newly prescribed contraceptive. Only 15.3% said they do for an existing prescription. Eighty-three percent reported that it is important though only 30% believed follow-up guidelines were clear. Ultimately, there is a gap between providers’ interest in delivering follow-up care and established direction on how to do so.Impact StatementWhat is already known on the subject? Prescription contraceptive adherence is suboptimal. However, it is known that proactive follow-up has positive effects on prescription contraceptive adherence.What do the results of the study add? Most respondents believe that patients take their prescription contraception as prescribed. In light of this finding, providers are less likely to follow up with an existing prescription contraceptive. Interestingly, most respondents do believe that follow-up is important for patients using prescribed contraception but endorse that guidelines about follow-up are neither established nor clear.What are the implications of these findings for clinical practice and/or further research? Patient adherence to prescription contraceptives can be improved through optimised routine patient follow-up after initial prescription. This must be done in ways that minimise burdens to both patients and providers. Providers could benefit from clear guidelines regarding best practices. Future research is needed to understand how providers can best support patients on their contraceptive journey.

PMID:36571208 | DOI:10.1080/01443615.2022.2158315

Ann Palliat Med. 2022 Dec 12:apm-22-783. doi: 10.21037/apm-22-783. Online ahead of print.

ABSTRACT

BACKGROUND: Data is lacking as to the clinical presentation of erosive esophagitis (EE) in neurologically impaired children compared to non-neurologically impaired children (non-NIC). To determinate the clinical presentation, associations, management, and outcomes of EE in neurologically impaired children compared to children without neurologic impairment.

METHODS: Retrospective chart review of all esophagogastroduodenoscopies performed in pediatric patients at the University of Mississippi Medical Center from 1998 to 2020 with the diagnosis of EE. Fisher’s exact test was used to compare results from neurologically impaired children group and non-NIC. A probability <0.05 was considered statistically significant.

RESULTS: Forty-seven patients were diagnosed with EE and met study criteria. Twenty-six patients were neurologically impaired children, and 21 were non- neurologically impaired children. No significant difference was seen between age at diagnosis, sex, or hematologic markers of anemia. The most common indication for esophagogastroduodenoscopies in neurologically impaired children was hematemesis (65.4%), whereas abdominal pain (33.3%) was the most common in non-NIC. Neurologically impaired children were more likely to be treated with acid-blockade. Nine neurologically impaired children had gastrostomy tubes prior to diagnosis as opposed to 0 non-neurologically impaired children. After diagnosis, 8 neurologically impaired children underwent gastrostomy tube placement compared to 0 non-neurologically impaired children, and fundoplication was performed in 11 neurologically impaired children as compared to 1 non-NIC. The sensitivity of fecal occult blood test for detecting EE was higher for neurologically impaired children (91.7%) than for non-NIC (33.3%).

CONCLUSIONS: EE in neurologically impaired children presents differently than in non-neurologically impaired children with blood loss being the most common presentation in neurologically impaired children. Neurologically impaired children are more likely to be treated with acid-blockade prior to diagnosis, likely due to heightened risk for gastroesophageal reflux disease (GERD). Additionally, they are more likely to undergo surgical management of EE than non- neurologically impaired children.

PMID:36571169 | DOI:10.21037/apm-22-783

Ann Palliat Med. 2022 Dec 12:apm-22-826. doi: 10.21037/apm-22-826. Online ahead of print.

ABSTRACT

BACKGROUND: The occurrence of portal vein system thrombosis (PVST) after splenectomy in patients with Wilson disease (WD) can lead to serious complications. The early identification of high-risk patients can help improve patient prognosis. This study aimed to establish and validate a personalized nomogram for assessing the risk of PVST after splenectomy in patients with WD and hypersplenism.

METHODS: We retrospectively collected the data from 81 patients with WD and hypersplenism who underwent splenectomy. Based on whether PVST occurred within a month after the operation, they were divided into the PVST group and the non-PVST group. The clinical data of the 2 groups were compared, and univariate analysis was used to select the statistically significant features and incorporated into the least absolute shrinkage and selection operator (LASSO) regression model for optimization. Multivariate logistic regression analysis was used to determine the independent risk factors for PVST after splenectomy, which were then applied to establish a personalized nomogram. We calculated the concordance (C)-index and drew the receiver operating characteristic (ROC) curve, the model calibration curve, and the clinical decision analysis (DCA) curve to evaluate the accuracy, calibration, and clinical applicability of the model, respectively. We used bootstrapping for internal validation of the model.

RESULTS: Univariate analysis showed that the differences in preoperative portal vein diameter and velocity of portal blood flow, postoperative mean platelet volume (MPV), mean platelet distribution width (PDW), D-dimer, prothrombin time (PT), and the increase of platelet count (PLT) were of statistical significance (P<0.05). According to the results of the LASSO and multivariate logistic regression analyses, a model including preoperative portal vein diameter, preoperative portal blood flow velocity, postoperative D-dimer, and the increase of PLT was established to predict the risk of PVST after splenectomy. The model showed good accuracy with a C-index of 0.838 (95% CI: 0.750-0.926) and had a well-fitted calibration curve. Furthermore, internal validation showed it achieved a moderate C-index of 0.805. The DCA curve indicated that the model has clinical applicability when patients are treated at thresholds of 2-100%.

CONCLUSIONS: Establishing a predictive model for the risk of PVST in patients with WD and hypersplenism after splenectomy can help clinicians identify patients at high risk of PVST who require intervention measures.

PMID:36571168 | DOI:10.21037/apm-22-826

Drug Chem Toxicol. 2022 Dec 26:1-11. doi: 10.1080/01480545.2022.2160456. Online ahead of print.

ABSTRACT

This study aimed to estimate and compare dietary exposure to bisphenol A (BPA) in exclusively breastfed (EBF) and breastfed plus formula-fed (BF + FF) infants. A total of 70 mothers and their 0-6 month-old infants (40 in the EBF group and 30 in BF + FF group) were included in the study. After the questionnaire form was applied to the mothers, maternal breast milk, infant formula, and infant urine were collected from mother-infant dyads. Total BPA levels in breast milk, infant formula, and infant urine samples were analyzed by the high-pressure liquid chromatography (HPLC). While BPA was detected in 92.5% of the breast milk samples in the EBF group (mean ± SD = 0.59 ± 0.29 ng/mL), BPA was detected in all of the breast milk samples in the BF + FF group (mean ± SD= 0.72 ± 0.37 ng/mL) (p < 0.05). Similarly, 100% of the infant formula samples in the BF + FF group had detectable levels of BPA (mean ± SD = 7.54 ± 1.77 ng/g formula). The mean urinary BPA levels in the EBF infants (4.33 ± 1.89 µg/g creatinine) were not statistically different from the BF + FF infants (5.81 ± 0.11 µg/g creatinine) (p > 0.05). The average daily BPA intake in EBF infants (0.18 ± 0.13 µg/kg body weight (bw)/day) was found to be significantly higher than in BF + FF infants (0.12 ± 0.09 µg/kg bw/day) (p < 0.05). The estimated dietary intakes of BPA for infants in both groups were below the temporary tolerable daily intake (t-TDI) (4 µg/kg bw/day). Consequently, BPA intake of EBF and BF + FF infants were within safe daily limits during the first six months of life.

PMID:36571147 | DOI:10.1080/01480545.2022.2160456

Philos Trans R Soc Lond B Biol Sci. 2023 Feb 13;378(1870):20210358. doi: 10.1098/rstb.2021.0358. Epub 2022 Dec 26.

ABSTRACT

Actions in the world elicit data for learning and do so in a stream of interconnected events. Here, we provide evidence on how toddlers with their parent sample information by acting on toys during exploratory play. We observed 10 min of free-flowing and unconstrained object exploration of by toddlers (mean age 21 months) and parents in a room with many available objects (n = 32). Borrowing concepts and measures from the study of narratives, we found that the toy selections are not a string of unrelated events but exhibit a suite of what we call coherence statistics: Zipfian distributions, burstiness and a network structure. We discuss the transient memory processes that underlie the moment-to-moment toy selections that create this coherence and the role of these statistics in the development of abstract and generalizable systems of knowledge. This article is part of the theme issue ‘Concepts in interaction: social engagement and inner experiences’.

PMID:36571129 | DOI:10.1098/rstb.2021.0358