Tag: statistics

Hosp Pediatr. 2022 Oct 20:e2021006450. doi: 10.1542/hpeds.2021-006450. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Molecular diagnostics provide a rapid and sensitive diagnosis of gastroenteritis compared with a stool culture. In this study, we seek to describe the changes in medical management and outcomes of children with Salmonella gastroenteritis as our hospital system adopted molecular diagnostics.

METHODS: This study is a retrospective chart review of children <18 years of age diagnosed with nontyphoidal Salmonella gastroenteritis between 2008 and 2018 at a large pediatric health care system in the southeastern United States. Those with immunocompromising conditions and hemoglobinopathies were excluded. Patients diagnosed via molecular testing were compared with those diagnosed solely by stool culture for aspects of management including admission rates, blood culture obtainment, and antibiotic administration.

RESULTS: Of 965 eligible patients with Salmonella gastroenteritis, 264 (27%) had a stool molecular test and 701 (73%) only had a stool culture performed. Groups were similar in age and presentation. Those diagnosed by molecular methods had higher hospitalization rates (69% vs 50%, P <.001), more blood cultures obtained (54% vs 44%, P <.01), and received more antibiotics (49% vs 34%, P <.001) despite statistically similar rates of bacteremia (11% vs 19%, P = .05).

CONCLUSIONS: The rapid diagnosis of Salmonella gastroenteritis by molecular methods was associated with increased hospital admission rates, blood culture obtainment, and antibiotic use. This suggests possible overmedicalization of uncomplicated Salmonella gastroenteritis, and clinicians should remain cognizant of the possibility of providing low-value care for uncomplicated disease.

PMID:36263712 | DOI:10.1542/hpeds.2021-006450

Food Funct. 2022 Oct 20. doi: 10.1039/d2fo01280d. Online ahead of print.

ABSTRACT

This study assessed the effects of propolis supplementation on glucose homeostasis, lipid profile, liver function, anthropometric indices and meta-inflammation in patients with non-alcoholic fatty liver disease (NAFLD). In this double-blind placebo-controlled randomized clinical trial, 44 patients with NAFLD confirmed by ultrasonography findings were randomly allocated into either the “propolis” (n = 23) or “placebo” (n = 21) group along with a calorie-restricted diet (-500 kcal d^-1) for 8 weeks. Fasting serum levels of metabolic factors, liver enzymes, and inflammatory factors, as well as anthropometric indices, dietary intake and appetite status were assessed pre-and post-intervention. The liver fibrosis score, homeostasis model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) were also calculated. The weight, body mass index (BMI), waist and hip circumferences, and waist to height ratio significantly decreased in both groups (p < 0.001), while the waist to hip ratio (p = 0.006) and serum level of total cholesterol (p = 0.038) decreased only in the propolis arm. However, no significant changes in anthropometric measurements and lipid profile were found between the groups at the end of the intervention. Fasting blood sugar (p = 0.037), the serum insulin level (p = 0.040), HOMA-IR (p = 007), desire to eat sweet foods (p = 0.005) and the NAFLD fibrosis score (p = 0.013) decreased significantly in the propolis group compared to the placebo group, post-intervention after adjusting for baseline values and potential confounders. However, QUICKI showed a significant increase (p = 0.015) in the propolis arm compared to the placebo at the study endpoint. Although there were significant reductions in the serum levels of inflammatory factors including tumor necrosis factor-α (TNF-α), toll-like receptor-4 (TLR-4) and monocyte chemoattractant protein-1 (MCP-1), as well as liver enzymes and severity of fatty liver, between-group differences were not statistically significant after adjusting for the potential confounding factors. The estimated number needed to treat (NNT) due to 8-week propolis supplementation (510 mg per day) for at least 1-point improvement in NAFLD severity was found to be approximately 3. In conclusion, propolis supplementation along with a calorie-restricted diet for 8 weeks could significantly improve the glucose homeostasis, hepatic fibrosis score and liver function in patients with NAFLD. Further clinical trials are encouraged to study the effects of propolis supplementation in patients with long-term NAFLD.

PMID:36263703 | DOI:10.1039/d2fo01280d

J Clin Endocrinol Metab. 2022 Oct 20:dgac614. doi: 10.1210/clinem/dgac614. Online ahead of print.

ABSTRACT

INTRODUCTION: Systemic lupus erythematosus (SLE) and hypothyroidism often coexist in observational studies; however, the causal relationship between them remains controversial.

METHODS: Complementary genetic approaches, including genetic correlation, Mendelian randomization (MR) and colocalization analysis, were conducted to assess the potential causal association between SLE and primary hypothyroidism using summary statistics from large-scale genome-wide association studies (GWASs). The association between SLE and thyroid-stimulating hormone (TSH) was further analyzed to help interpret the findings. In addition, findings were verified using a validation dataset, as well as through different MR methods with different model assumptions.

RESULTS: The linkage disequilibrium score regression revealed a shared genetic structure between SLE and primary hypothyroidism, with the significant genetic correlation estimated to be 0.2488 (p = 6.00 × 10-4). MR analysis with the inverse variance weighted (IVW) method demonstrated a bidirectional causal relationship between SLE and primary hypothyroidism. The odds ratio (OR) of SLE on primary hypothyroidism was 1.037 (95% CI, 1.013-1.061; p = 2.00 × 10-3) and that of primary hypothyroidism on SLE was 1.359 (95% CI, 1.217-1.520; p < 0.001). The OR of SLE on TSH was 1.007 (95% CI, 1.001-1.013; p = 0.032) .However, TSH was not causally associated with SLE (p = 0.152). Similar results were found using different MR methods. In addition, colocalization analysis suggested that shared causal variants existed between SLE and primary hypothyroidism. The results of the validation analysis indicated a bidirectional causal relationship between SLE and primary hypothyroidism, as well as shared loci.

CONCLUSION: In summary, a bidirectional causal relationship between SLE and primary hypothyroidism was observed with complementary genetic approaches.

PMID:36263677 | DOI:10.1210/clinem/dgac614

Biomed Phys Eng Express. 2022 Oct 19. doi: 10.1088/2057-1976/ac9b5c. Online ahead of print.

ABSTRACT

OBJECTIVE: Radiodynamic therapy (RDT) uses high-energy photon beams instead of visible/near-infrared light to treat deep-seated tumors that photodynamic therapy cannot achieve due to the low penetration depth of laser beams. The purpose of this study is to investigate the therapeutic effect of RDT with 15MV photon beams combined with 5-aminolevulinic acid (5-ALA) using a mouse model.

APPROACH: A subcutaneous C57BL/6 mouse model of KP1 small-cell lung cancer cell line was used. The tumors (N=120) were randomized into four groups to observe individual and synergistic effects of 5-ALA and radiation treatment: control (untreated, N=42), radiation treatment (RT) only (N=20), 5-ALA only (N=20), and RDT (N=38). For the RT only and RDT groups, 4Gy in a single fraction was delivered to the tumors using 15MV photons. For the 5-ALA only and RDT groups, 5-ALA was injected at a dose of 100mg/kg by tail-vein 4 hours prior to RT. The tumor response was assessed by monitoring tumor growth using 1.5T MR, maximum standardized uptake value (SUV_max) and total lesion glycolysis (TLG) using [¹⁸F]FDG PET/CT, and animal survival.

MAIN RESULTS: RDT achieved a statistically significant delay in tumor growth by 52.1%, 48.1%, and 57.9% 7 days post-treatment compared to 5-ALA only, RT only, and control group (P<0.001), respectively. There were no significant differences in tumor growth between 5-ALA only and RT only groups. An additional 38.5-40.9% decrease in tumor growth was observed, showing a synergistic effect with RDT. Furthermore, RDT significantly decreased [¹⁸F]FDG uptakes in SUV_maxand TLG 7 days post-treatment by 47.4% and 66.5% (P<0.001), respectively. RDT mice survived the longest of all treatment groups.

SIGNIFICANCE: RDT with 15MV photons and 5-ALA resulted in greater tumor control compared to the control and other treatment groups. A significant synergistic effect was also observed with RDT. These preliminary results demonstrate an effective cancer treatment modality.

PMID:36263662 | DOI:10.1088/2057-1976/ac9b5c

Clin Psychopharmacol Neurosci. 2022 Nov 30;20(4):737-746. doi: 10.9758/cpn.2022.20.4.737.

ABSTRACT

OBJECTIVE: Heart rate variability (HRV) reflects the regulation of the autonomic nervous system. Panic disorder is highly associated with autonomic dysfunction, and is often accompanied by depression. The aim of this study is to determine the association between depression and HRV indices in patients with panic disorder.

METHODS: A total of 110 outpatients diagnosed with panic disorder participated in this study. The medical records of patients with panic disorder who visited the outpatient clinic of Konkuk University Hospital between December 2018 and March 2020 were retrospectively reviewed. Measurements used in this study include the Panic Disorder Severity Scale-Self Report, Beck Depression Inventory (BDI-II), Insomnia Severity Index, and HRV. Patients were divided into depressive and non-depressive groups based on their BDI-II scores. The association between HRV indices and depressive symptoms was statistically analyzed.

RESULTS: The low frequency/high frequency (LF/HF) ratio was reduced in patients with depression (mean = -0.095, p = 0.004 in the above moderate depressive group, mean = -0.120, p = 0.020 in the severe depressive group). Significant correlations were found between depressive symptoms and standard deviation of NN interval (SDNN) (ms) (-0.19, p = 0.044), very low frequency (VLF) (ms²/Hz) (-0.22, p = 0.021), LF (-0.25, p = 0.008), HF (-0.19, p = 0.043), and LF/HF (-0.25, p = 0.009). Multiple linear regression analysis showed that BDI predicted SDNN (ms), VLF (ms²/Hz), LF, HF, and LF/HF.

CONCLUSION: We confirmed that the LF/HF ratio decreases when depression is accompanied by panic disorder. HRV indices may be useful markers for detecting depressive symptoms in patients with panic disorder.

PMID:36263648 | DOI:10.9758/cpn.2022.20.4.737

Eur J Neurol. 2022 Oct 20. doi: 10.1111/ene.15607. Online ahead of print.

ABSTRACT

BACKGROUND: Changes in gut microbiota composition, enteric inflammation, impairments of the intestinal epithelial barrier (IEB) and enteric neuro-immune system have been reported in Parkinson’s disease (PD) patients and could contribute to the onset of both neurological and gastrointestinal symptoms. However, their mutual interplay has rarely been investigated. This study evaluated, in an integrated manner, changes in faecal microbiota composition, morpho-functional alterations of the colonic mucosal barrier and changes of inflammatory markers in blood and stools of PD patients.

METHODS: 19 PD patients and 19 asymptomatic subjects were enrolled. Blood lipopolysaccharide binding protein (LBP, marker of altered intestinal permeability) and Interleukin-1β (IL-1β), as well as stool IL-1β and tumour necrosis factor (TNF) levels, were evaluated. Gut microbiota analysis was performed. Epithelial mucins, collagen fibres, Claudin-1 and S-100 positive glial cells as markers of an impairment of the intestinal barrier and mucosal remodelling were evaluated on colonic mucosal specimens collected during colonoscopy.

RESULTS: Faecal microbiota analysis revealed a significant difference in the α-diversity in PD patients compared to controls, while no differences were found in the beta diversity. Compared to controls, PD patients showed a significant increase in plasma LBP, as well as faecal TNF and IL-1β levels. The histological analysis showed a decrease in epithelial neutral mucins and claudin-1 expression, and an increased expression of acidic mucins, collagen fibres and S-100 positive glial cells.

CONCLUSIONS: PD patients are characterized by intestinal inflammation and increased IEB permeability, as well as colonic mucosal barrier remodeling, associated with changes in gut microbiota composition.

PMID:36263629 | DOI:10.1111/ene.15607

Clin Psychopharmacol Neurosci. 2022 Nov 30;20(4):635-648. doi: 10.9758/cpn.2022.20.4.635.

ABSTRACT

OBJECTIVE: This study aimed to investigate the levels of serum brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), glial cell-derived neurotrophic factor (GDNF) and galanin in children with attention deficit hyperactivity disorder (ADHD).

METHODS: The study included 58 cases with ADHD and 60 healthy controls. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) together with Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) criteria were used for diagnostic evaluation. Sociodemographic data form and Conners’ Parent/Teacher Rating Scale-Revised:Long Form were applied to all cases. The serum levels of BDNF, NGF, GDNF, and galanin were evaluated in all subjects. Afterwards, methylphenidate was started in the ADHD group. ADHD cases were reevaluated in terms of the serum levels of BDNF, NGF, GDNF, galanin at the 10th week of treatment.

RESULTS: Before the treatment, the levels of BDNF, NGF, GDNF, galanin were significantly higher in the ADHD group compared to the control group. The levels of BDNF, NGF, GDNF, galanin were found to be significantly lower after treatment in ADHD group compared to pre-treatment. No correlation was between scale scores and the serum levels of BDNF, NGF, GDNF, galanin.

CONCLUSION: The levels of neurotrophic factors and galanin were thought to be parameters worth evaluating in ADHD. Further studies on the subject with longer-term treatments and larger sample groups are required.

PMID:36263639 | DOI:10.9758/cpn.2022.20.4.635

Epidemiol Infect. 2022 Sep 27;150:e171. doi: 10.1017/S0950268822001467.

ABSTRACT

Coronavirus disease 2019 (COVID-19) asymptomatic cases are hard to identify, impeding transmissibility estimation. The value of COVID-19 transmissibility is worth further elucidation for key assumptions in further modelling studies. Through a population-based surveillance network, we collected data on 1342 confirmed cases with a 90-days follow-up for all asymptomatic cases. An age-stratified compartmental model containing contact information was built to estimate the transmissibility of symptomatic and asymptomatic COVID-19 cases. The difference in transmissibility of a symptomatic and asymptomatic case depended on age and was most distinct for the middle-age groups. The asymptomatic cases had a 66.7% lower transmissibility rate than symptomatic cases, and 74.1% (95% CI 65.9-80.7) of all asymptomatic cases were missed in detection. The average proportion of asymptomatic cases was 28.2% (95% CI 23.0-34.6). Simulation demonstrated that the burden of asymptomatic transmission increased as the epidemic continued and could potentially dominate total transmission. The transmissibility of asymptomatic COVID-19 cases is high and asymptomatic COVID-19 cases play a significant role in outbreaks.

PMID:36263615 | DOI:10.1017/S0950268822001467

Mol Med Rep. 2022 Dec;26(6):356. doi: 10.3892/mmr.2022.12872. Epub 2022 Oct 20.

ABSTRACT

Fetal growth restriction (FGR) occurs when the fetus does not reach its genetically programmed intrauterine potential for growth and affects ~5‑10% of pregnancies. This condition is one of the leading causes of perinatal mortality and morbidity associated with obstetric and neonatal complications. Placental dysfunction in FGR causes an impairment in the transfer of nutrients and oxygen from the mother to the developing fetus. Maternal adaptations to placental insufficiency may also play a role in the pathophysiology of FGR. The present study aimed to compare the proteome of the placentas of 18 women with the physiological course of pregnancy and eutrophic fetus [estimated fetal weight (EFW) >10th percentile; control group] and 18 women with late FGR (EFW <10th percentile) diagnosed after 32 weeks of pregnancy, according to the Delphi consensus (study group). The U. Mann‑Whitney test was used to compare two independent groups. The R. Spearman correlation coefficient significance test was used to assess the existence of a relationship between the analyzed measurable parameters. P<0.05 was considered to indicate a statistically significant difference. The tests showed the presence of 356 different proteins which were responsible for the regulation of gene transcription control, inhibiting the activity of proteolytic enzymes, regulation of trophoblast proliferation and angiogenesis and inflammatory response. In the FGR placental proteome, other detected proteins were mostly involved in response to oxidative stress, cellular oxidation and detoxication, apoptosis, hemostatic and catabolic processes, energy transduction protein interactions, cell proliferation, differentiation and intracellular signaling. The present study used chromatographic mass‑spectrometry to compare the placental proteome profiles in pregnancies complicated by late‑onset FGR and normal pregnancy. Comparative analysis of proteomes from normal and FGR placentas showed significant differences. Further research is needed to clarify maternal and fetal adaptations to FGR.

PMID:36263610 | DOI:10.3892/mmr.2022.12872

Clin Endocrinol (Oxf). 2022 Oct 20. doi: 10.1111/cen.14834. Online ahead of print.

ABSTRACT

BACKGROUND: Papillary thyroid microcarcinoma (PTMC) comprises more than 50% of all newly detected cases of papillary thyroid carcinoma (PTC). High volume lymph node metastasis (involving >5 lymph nodes) (hv-LNM) is associated with PTMC recurrence. In half of the clinically node-negative (cN0) PTMC patients, central lymph node metastasis (CLNM) is pathologically present. However, clinical risk factors for high volume CLNM (hv-CLNM) in cN0 PTMC have not been defined well. Therefore, we aimed to obtain evidence for hv-CLNM risk factors in cN0 PTMC.

METHODS: Data on patients who visited our hospital between January 2020 and December 2021 were collected; preoperative diagnosis of cN0 and a postoperative pathological confirmation of PTMC were obtained. After filtering by inclusion versus exclusion criteria, the obtained data (N=2268) were included in the meta-analysis. Relevant studies published as of April 10, 2022 were identified from Web of Science, PubMed, WANFANG, and CNKI databases. These eligible studies were included in the meta-analysis and the association between clinicopathological factors and hv-CLNM in cN0 PTMC was assessed. SPSS and MetaXL were used for statistical analyses.

RESULTS: The meta-analysis included 10 previous studies (11734 patients) and 2268 patients enrolled in our hospital for a total of 14002 subjects. The results of which suggested that younger age (<40, OR = 3.28, 95% CI = 2.75-3.92, p<0. 001 or <45 OR = 2.93, 95%CI = 2.31-3.72, p<0. 001), male sex (OR = 2.81, 95% CI = 2.25-3.52, p<0.001), tumor size>5mm (OR = 1.85, 95%CI = 1.39-2.47, p<0.001), multifocality (OR = 1.88, 95%CI = 1.56-2.26, p<0.001), extrathyroidal extension (OR = 2.58, 95%CI = 2.02-3.30, p<0. 001), capsule invasion (OR = 2.02, 95%CI = 1.46-2.78, p<0.001), microcalcification (OR = 3.25, 95%CI = 2.42-4.36, p<0.001), and rich blood flow (OR = 1.65, 95%CI = 1.21-2.25, p = 0.002) were the significant factors related to an elevated hv-CLNM risk in cN0 PTMC patients. Hashimoto thyroiditis (OR = 0.76, 95%CI = 0.55-1.07, p = 0.114), irregular margin (VS regular margin, OR = 0.96, 95%CI = 0.68-1.33, p = 0.787), and hypoechoic (VS Non-hypoechoic, OR = 1.27, 95%CI = 0.84-1.92, p = 0.261) showed no significant association with hv-CLNM.

CONCLUSION: Younger age, tumor size>5mm, males, extrathyroidal extension, multifocality, microcalcification, capsular invasion, and rich blood flow were the significant clinicopathological risk factors for hv-CLNM risk in cN0 PTMC patients. These predictors may compensate for the sensitivity of imaging diagnosis in the preoperative period, thus helping in the effective identification of PTMCs with an invasive phenotype. This article is protected by copyright. All rights reserved.

PMID:36263602 | DOI:10.1111/cen.14834