Tag: statistics

Int J Implant Dent. 2022 Apr 15;8(1):19. doi: 10.1186/s40729-022-00415-5.

ABSTRACT

PURPOSE: Tooth extraction and the projection of the tooth roots into the maxillary sinus are reported to greatly reduce the bone height from the alveolar ridge to the maxillary sinus floor, while missing teeth are reported to lead to the expansion of the maxillary sinus, all of which are important considerations during dental implant treatment for the maxillary molar region. Therefore, assessing the anatomical characteristics of the maxillary sinus acting as complicating factors is crucial before sinus augmentation. We conducted a three-dimensional examination of the effects of missing teeth and nasal septal deviation (NSD) on maxillary sinus volume (MSV).

METHODS: We selected participants with two or more missing teeth from patients who underwent maxillary sinus augmentation for a unilateral free-end saddle between April 2019 and December 2020. We calculated the MSV and NSD using cone-beam computed tomography (CBCT). We compared the relationships of the presence/absence of teeth and NSD with MSV bilaterally in each patient using the Wilcoxon t-test. p-values < 0.05 denoted statistical significance.

RESULTS: This study included 30 patients (30 sinuses; 12 men, 18 women). The average patient age was 58.2 ± 10.2 years (men, 60.4 ± 3.7 years; women, 59.2 ± 4.5 years; range, 40-77 years). The mean number of missing teeth was 2.98 ± 1.01: 13 patients had two missing teeth and 17 had three or more missing teeth. Nine patients (30%) had NSD. The mean MSV on the ipsilateral and contralateral sides of the NSD was 21.50 ± 3.84 cm³ and 22.10 ± 3.56 cm³, respectively; thus, NSD did not affect MSV (p = 0.150). The mean MSV on the edentulous and non-edentulous sides was 21.58 ± 3.89 cm³ and 21.77 ± 4.30 cm³, respectively; thus, the MSV was significantly smaller on the edentulous side (p = 0.00036).

CONCLUSION: Although this study was a limited preoperative study, three-dimensional measurement of the maxillary sinus with CBCT in partially edentulous patients revealed that missing teeth lead to substantial reductions in MSV, while NSD was not associated with MSV.

PMID:35428947 | DOI:10.1186/s40729-022-00415-5

World J Urol. 2022 Apr 15. doi: 10.1007/s00345-022-03996-3. Online ahead of print.

ABSTRACT

BACKGROUND: Extracorporeal shock wave lithotripsy (ESWL) is considered one of the best choices for the treatment of various kinds of urinary tract calculi, although it might cause acute kidney injury.

OBJECTIVE: To measure the urinary long non-coding RNA-messenger RNA (LncRNA-mRNA) panel before and after ESWL to evaluate post-ESWL renal injury in a reliable and non-invasive method.

PATIENTS AND METHODS: The study included 60 patients with renal stones treated with ESWL and 30 healthy volunteers. Voided urine samples were obtained before, 2 h, and 1 day after ESWL. We measured the urinary level of LncRNA (SBF2-AS1, FENDRR-19) and mRNA (GBP1, NLRP3) by real-time qPCR and compared the results with serum creatinine and eGFR.

RESULTS: LncRNA (SBF2-AS1, FENDRR-19) and mRNA (GBP1, NLRP3) levels were higher in patients with renal stones when compared with healthy volunteers. They showed a statistically significant increase in the level of LncRNA-mRNA panel in baseline and after ESWL treatment.

CONCLUSION: LncRNA (SBF2-AS1, FENDRR-19) and mRNA (GBP1, NLRP3) levels were significantly elevated following ESWL treatment, highlighting the usefulness of urinary biomarkers in identifying patients at higher risk of developing renal injury after ESWL treatment.

PMID:35428927 | DOI:10.1007/s00345-022-03996-3

Cardiovasc Intervent Radiol. 2022 Apr 15. doi: 10.1007/s00270-022-03136-9. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze trends and differences of endovascular, surgical and hybrid revascularization approaches and the impact of comorbidity on characteristics, costs, and outcome of in-patients with peripheral artery disease (PAD) of the lower extremity.

METHODS: Analyzing data provided by the Research Data Center of the German Federal Statistical Office, we included all hospitalizations due to PAD Fontaine IIb (Rutherford 2-3) or higher in Germany between 2009-2011 and 2016-2018. According to the individually performed procedures encoded by the Operation and Procedure Classification System, we divided hospitalizations by revascularization procedures into sole endovascular, sole surgical, hybrid, two-step and no revascularization. Patient’s comorbidity was assessed using the linear van Walraven comorbidity score (vWs).

RESULTS: 1,067,671 hospitalizations (mean age 71.3 ± 11.1 years; 60.1% male) were analyzed. Between 2009-2011 and 2016-2018, reimbursement costs rose by 28.0% from €2.72 billion (€5,350/case) to €3.49 billion (€6,238/case). The share of hospitalizations with any revascularization increased by 8.9% (67.7-73.7%) driven by an increase in two-step (+ 63.3%), hybrid (+ 58.2%) and sole endovascular revascularizations (+ 32.6%), while sole surgical approaches declined (- 18.2%). Hospitalizations of more comorbid patients (vWs ≥ 20) rose by 46.8% (21,444-31,478 cases), showed an overproportionate increase in costs of 124.6% (+ €1,750/case) and were associated with more individual procedures (+ 90.6%).

CONCLUSIONS: In-patient treatment of PAD patients shows increasing numbers of hybrid and sole endovascular revascularizations and more patients with higher comorbidity, while sole surgical interventions and in-hospital mortality decrease. Consequently, associated costs are surging especially in more comorbid patients due to an increasing number of performed procedures and escalation of therapy.

PMID:35428938 | DOI:10.1007/s00270-022-03136-9

Eur Spine J. 2022 Apr 15. doi: 10.1007/s00586-022-07200-3. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to determine the discriminatory ability of age-adjusted alignment offset and the global alignment and proportion (GAP) score parameters to predict postoperative mechanical complications.

METHODS: Surgical patients from the Adult Symptomatic Lumbar Scoliosis cohort were reviewed at 2 year follow up. Age-adjusted alignment offsets and GAP parameters were calculated for each patient. A series of nonlinear logistic regression models were fit, and the odds of mechanical complications were calculated. The discriminatory ability of the GAP score, GAP score parameters, and age-adjusted alignment offsets were determined plotting receiver operative characteristic (ROC) with the C statistic (AUC).

RESULTS: A total of 165 patients were included. A total of 49 mechanical complications occurred in 41 patients (21 proximal junctional kyphosis and 28 pseudoarthrosis). The GAP score had no discriminatory ability in this cohort. Relative lumbar lordosis 15 degrees greater than ideal lumbar lordosis was associated with greater mechanical complications. A lumbar distribution index of 90% was associated with fewer mechanical complications compared to a lumbar distribution index of 65%. Age-adjusted offset alignment targets had no discriminatory ability to predict mechanical complications.

CONCLUSION: Radiographic alignment targets using either age-adjusted alignment target offset or GAP score parameters had minimal ability to predict mechanical complications in isolation. Mechanical complications following adult spinal deformity surgery are complex, and patient factors play a critical role. Clinical trial registeration This study was registered at ClinicalTrials.gov (number NCT00854828) in March 2009.

PMID:35428916 | DOI:10.1007/s00586-022-07200-3

J Clin Endocrinol Metab. 2022 Apr 16:dgac232. doi: 10.1210/clinem/dgac232. Online ahead of print.

ABSTRACT

CONTEXT: Premenopausal women with idiopathic osteoporosis (PreMenIOP) have marked deficits in bone density, microstructure and strength.

OBJECTIVE: To define effects of treatment with teriparatide followed by denosumab on Lumbar Spine (LS) volumetric BMD (vBMD) and stiffness by finite element analysis assessed on central QCT (cQCT) scans.

DESIGN, SETTINGS AND PARTICIPANTS: Ancillary analysis of baseline, post-teriparatide and post-denosumab cQCT scans from a randomized trial of 41 women allocated to teriparatide (20 mcg daily; N=28) or placebo (N=11). After 6 months (M), those on teriparatide continued for 18M and those on placebo switched to teriparatide for 24M. After completing teriparatide, 33 enrolled in a phase 2B extension with denosumab (60mg q6M) for 12M.

MAIN OUTCOME MEASURES: Primary outcomes were percent change from baseline in LS trabecular vBMD and stiffness after teriparatide, and between end of teriparatide and completing denosumab. Percent change from baseline in LS trabecular vBMD and stiffness after sequential teriparatide and denosumab were secondary outcomes.

FINDINGS: There were large increases (all p<0.001) in trabecular vBMD (25%), other vBMD parameters, and stiffness (21%) after teriparatide. Statistically significant increases in trabecular vBMD (10%; p<0.001) and other vBMD parameters (p=0.03-0.001) were seen after denosumab, while stiffness increased by 7% (p=0.068). Sequential teriparatide and denosumab led to highly significant (all p<0.001) increases LS trabecular vBMD (43%), other vBMD parameters (15-31%) and stiffness (21%).

CONCLUSIONS: The large and statistically significant increases in volumetric density and stiffness after sequential treatment with teriparatide followed by denosumab are encouraging and support use of this regimen in PreMenIOP.

PMID:35428889 | DOI:10.1210/clinem/dgac232

J Clin Endocrinol Metab. 2022 Apr 16:dgac231. doi: 10.1210/clinem/dgac231. Online ahead of print.

ABSTRACT

CONTEXT: It is still debated whether prolonged use of proton pump inhibitors (PPIs) might affect metabolic health.

OBJECTIVE: To investigate the relationship between prolonged use of PPIs and the risk of developing diabetes.

METHODS: We performed a case-control study nested into a cohort of 777,420 patients newly treated with PPIs between 2010 and 2015 in Lombardy, Italy. A total of 50,535 cases diagnosed with diabetes until 2020 were matched with an equal number of controls that were randomly selected from the cohort members according to age, sex, and clinical status. Exposure to treatment with PPIs was assessed in case-control pairs based on time of therapy. A conditional logistic regression model was fitted to estimate the odds ratios (OR) and 95% confidence intervals (CI) for the exposure-outcome association, after adjusting for several covariates. Sensitivity analyses were performed to evaluate the robustness of our findings.

RESULTS: Compared to patients who used PPIs for <8 weeks, higher odds of diabetes of 19% (95% CI, 15-24%), 43% (38-49%), and 56% (49-64%) were observed among those who used PPIs for between 8 weeks and 6 months, 6 months and 2 years, and >2 years, respectively. The results were consistent when analyses were stratified according to age, sex and clinical profile, with higher ORs being found in younger patients and those with worse clinical complexity. Sensitivity analyses revealed that the association was consistent and robust.

CONCLUSIONS: Regular and prolonged use of PPIs is associated with a higher risk of diabetes. Physicians should therefore avoid unnecessary prescription of this class of drugs, particularly for long-term use.

PMID:35428888 | DOI:10.1210/clinem/dgac231

Sci Rep. 2022 Apr 15;12(1):6334. doi: 10.1038/s41598-022-10140-z.

ABSTRACT

In recent years, deep learning techniques have shown impressive performance in the field of identification of diseases of crops using digital images. In this work, a deep learning approach for identification of in-field diseased images of maize crop has been proposed. The images were captured from experimental fields of ICAR-IIMR, Ludhiana, India, targeted to three important diseases viz. Maydis Leaf Blight, Turcicum Leaf Blight and Banded Leaf and Sheath Blight in a non-destructive manner with varied backgrounds using digital cameras and smartphones. In order to solve the problem of class imbalance, artificial images were generated by rotation enhancement and brightness enhancement methods. In this study, three different architectures based on the framework of ‘Inception-v3’ network were trained with the collected diseased images of maize using baseline training approach. The best-performed model achieved an overall classification accuracy of 95.99% with average recall of 95.96% on the separate test dataset. Furthermore, we compared the performance of the best-performing model with some pre-trained state-of-the-art models and presented the comparative results in this manuscript. The results reported that best-performing model performed quite better than the pre-trained models. This demonstrates the applicability of baseline training approach of the proposed model for better feature extraction and learning. Overall performance analysis suggested that the best-performed model is efficient in recognizing diseases of maize from in-field images even with varied backgrounds.

PMID:35428845 | DOI:10.1038/s41598-022-10140-z

Sci Rep. 2022 Apr 15;12(1):6347. doi: 10.1038/s41598-022-09801-w.

ABSTRACT

This study presents findings in the terahertz (THz) frequency spectrum for non-contact cardiac sensing applications. Cardiac pulse information is simultaneously extracted using THz waves based on the established principles in electronics and optics. The first fundamental principle is micro-Doppler motion effect. This motion based method, primarily using coherent phase information from the radar receiver, has been widely exploited in microwave frequency bands and has recently found popularity in millimeter waves (mmWave) for breathe rate and heart rate detection. The second fundamental principle is reflectance based optical measurement using infrared or visible light. The variation in the light reflection is proportional to the volumetric change of the heart, often referred as photoplethysmography (PPG). Herein, we introduce the concept of terahertz-wave-plethysmography (TPG), which detects blood volume changes in the upper dermis tissue layer by measuring the reflectance of THz waves, similar to the existing remote PPG (rPPG) principle. The TPG principle is justified by scientific deduction, electromagnetic wave simulations and carefully designed experimental demonstrations. Additionally, pulse measurements from various peripheral body parts of interest (BOI), palm, inner elbow, temple, fingertip and forehead, are demonstrated using a wideband THz sensing system developed by the Terahertz Electronics Lab at Arizona State University, Tempe. Among the BOIs under test, it is found that the measurements from forehead BOI gives the best accuracy with mean heart rate (HR) estimation error 1.51 beats per minute (BPM) and standard deviation 1.08 BPM. The results validate the feasibility of TPG for direct pulse monitoring. A comparative study on pulse sensitivity is conducted between TPG and rPPG. The results indicate that the TPG contains more pulsatile information from the forehead BOI than that in the rPPG signals in regular office lighting condition and thus generate better heart rate estimation statistic in the form of empirical cumulative distribution function of HR estimation error. Last but not least, TPG penetrability test for covered skin is demonstrated using two types of garment materials commonly used in daily life.

PMID:35428772 | DOI:10.1038/s41598-022-09801-w

Sci Rep. 2022 Apr 15;12(1):6352. doi: 10.1038/s41598-022-09949-5.

ABSTRACT

Disease-free survival (DFS) comprises both breast cancer and non-breast cancer events. DFS has not been validated as a surrogate endpoint for overall survival (OS) in most breast cancer subtypes. We assessed changes to the type of events contributing to DFS over time. We identified adjuvant studies in breast cancer (BC) from 2000 to 2020 where the endpoint was DFS. We examined change in distant DFS events and the BC-related DFS using univariable and multivariable linear regression. Data were reported quantitatively using the Burnand criteria irrespective of statistical significance. We included 84 studies (88 cohorts), comprising 212,191 participants, 41,604 DFS events and 23,205 distant DFS events. The DFS event rate/100 participants/year has declined modestly over time (ß – 0.34, p = 0.001). Start year was negatively associated with distant DFS events (ß – 0.58, p < 0.0001); however, the effect was lost after adjusting for follow-up time (ß – 0.18, p = 0.096). The average number of BC-related events/100 participants/year also declined over time (ß – 0.28, p = 0.009). In multivariable analysis, start year and ER expression were quantitatively associated with distant DFS events and BC-related DFS events. DFS events have declined over time driven by a reduction in BC related events. As DFS events are increasingly defined by non-BC events, there will be limited surrogacy between DFS and OS.

PMID:35428842 | DOI:10.1038/s41598-022-09949-5

Sci Rep. 2022 Apr 15;12(1):6262. doi: 10.1038/s41598-022-10346-1.

ABSTRACT

An accurate prediction of major adverse events after percutaneous coronary intervention (PCI) improves clinical decisions and specific interventions. To determine whether machine learning (ML) techniques predict peri-PCI adverse events [acute kidney injury (AKI), bleeding, and in-hospital mortality] with better discrimination or calibration than the National Cardiovascular Data Registry (NCDR-CathPCI) risk scores, we developed logistic regression and gradient descent boosting (XGBoost) models for each outcome using data from a prospective, all-comer, multicenter registry that enrolled consecutive coronary artery disease patients undergoing PCI in Japan between 2008 and 2020. The NCDR-CathPCI risk scores demonstrated good discrimination for each outcome (C-statistics of 0.82, 0.76, and 0.95 for AKI, bleeding, and in-hospital mortality) with considerable calibration. Compared with the NCDR-CathPCI risk scores, the XGBoost models modestly improved discrimination for AKI and bleeding (C-statistics of 0.84 in AKI, and 0.79 in bleeding) but not for in-hospital mortality (C-statistics of 0.96). The calibration plot demonstrated that the XGBoost model overestimated the risk for in-hospital mortality in low-risk patients. All of the original NCDR-CathPCI risk scores for adverse periprocedural events showed adequate discrimination and calibration within our cohort. When using the ML-based technique, however, the improvement in the overall risk prediction was minimal.

PMID:35428765 | DOI:10.1038/s41598-022-10346-1