Tag: statistics

Alzheimers Dement. 2021 Sep 27. doi: 10.1002/alz.12469. Online ahead of print.

ABSTRACT

INTRODUCTION: The determinants of the secular decline in the incidence of dementia are not clear. The aim of this study was to investigate the influences of four factors-education, wealth, cerebrovascular health, and general health-on the secular decline.

METHODS: A cohort study was conducted of all individuals aged ≥65 years in Denmark from 2005 through 2018 (N = 1,757,168). Annual incidence rates of dementia and population attributable risks of the four factors were calculated and birth cohort trends were examined.

RESULTS: The incidence of dementia declined by 22.5% in men and 34.2% in women from 2005 through 2018. Population attributable risks of lower education, lower wealth, and stroke likewise declined. Independent of these improvements, the incidence of dementia fell across successive birth cohorts.

DISCUSSION: Most of the observed plasticity in late-onset dementia is associated with a risk decline across successive birth cohorts that is independent of improvements in traditional risk factors.

PMID:34569688 | DOI:10.1002/alz.12469

Int J Geriatr Psychiatry. 2021 Sep 27. doi: 10.1002/gps.5624. Online ahead of print.

ABSTRACT

OBJECTIVES: Cognitive training exercises (CTE) are promising and effective interventions to enhance cognitive reserve and slowdown cognitive deterioration in people with subjective memory impairment (SCI) and mild cognitive impairment (MCI). In this pilot study, we aimed to assess the feasibility of CTE among Egyptian adults.

METHODS: Eighteen participants above forty years-old were recruited. They underwent baseline neuropsychological assessment and functional assessment. However, after receiving a 6 weeks’ cognitive training, eight participants (seven with MCI and one was cognitively intact) dropped out from the study. Finally, ten participants (eight participants with MCI, one with SCI and one was cognitively intact) completed twelve weeks of CTE and undergone the post assessment afterwards. CTE included visual, verbal, memory, executive function, visuospatial, attention and psychokinetic exercises through onsite and home-based sessions RESULTS: For the ten participants who completed twelve weeks of CTE, the Wilcoxon signed-rank test showed a statistically significant change in the scores of MMSE (Z= -2.546, p=.011), semantic fluency test (Z= -2.913, p=.004), SMCQ (Z= -2.913, p=.004), CERAD Word List (1st trial: Z = -2.641, p=.008;Word list recall: Z= -2.825, p=.005), construction abilities (immediate: Z= -2.121, p=.034; delayed recall: Z= -2.414, p=.016), and Digit span test (forward: Z= -2.724, p=.006; backward: Z= -2.724, p=.006).

CONCLUSIONS: The results of this study suggested that CTE are feasible among Egyptian adults, especially those with MCI, and potentially effective in enhancing global cognition and after twelve weeks of training. Future research should shed light on the efficacy of longitudinal CTE implementation in Arab adults’ populations. This article is protected by copyright. All rights reserved.

PMID:34569644 | DOI:10.1002/gps.5624

J Clin Lab Anal. 2021 Sep 27:e24025. doi: 10.1002/jcla.24025. Online ahead of print.

ABSTRACT

OBJECTIVES: To identify the SPINK1 or SPINK1-based model as a more reliable biomarker for the diagnosis of hepatocellular carcinoma (HCC).

METHODS: Serum samples and related laboratory parameters were collected from 540 subjects (119 healthy donors, 113 patients with chronic hepatitis B, 122 patients with liver cirrhosis, and 186 patients with HCC). SPINK1 was determined by ELISA assay. Differences in each variable were compared by one-way ANOVA or Kruskal-Wallis test. ROC (receiver operating characteristic) curve analysis was conducted to compare the diagnostic efficiency of alpha-fetoprotein (AFP), SPINK1, and a SPINK1-based combine model constructed by binary Logistic regression.

RESULTS: In detecting HCC using the other three groups as control, ROC curve analysis revealed that SPINK1 alone reached AUC of 0.899 (0.866-0.933), with the sensitivity of 0.812 of and specificity of 0.953. The combined model increased the AUC to 0.945 (0.926-0.964) with the sensitivity and specificity of 0.860 and 0.910, respectively. For AFP, significantly lower AUC (p < 0.0001) was shown, which was 0.695 (0.645-0.745) with the sensitivity and specificity of 0.634 and 0.718, respectively. In discriminating HCC from liver disease control, AUC of SPINK1 was 0.863(0.826-0.894), the sensitivity and specificity were 0.823 and 0.906, respectively. For combined model, the AUC, sensitivity, and specificity were 0.915 (0.884-0.940), 0.863, and 0.916, respectively. For detecting early-stage HCC, SPINK1 and combined model achieved the sensitivity of 0.788 and 0.818, respectively, much higher than AFP of 0.485 (p < 0.05); however, the difference between SPINK1 and combined model was not statistically significant (p = 1).

CONCLUSION: We provided solid evidence for SPINK1 as a robust serological tool for HCC diagnosis.

PMID:34569662 | DOI:10.1002/jcla.24025

Phys Chem Chem Phys. 2021 Sep 27. doi: 10.1039/d1cp03116c. Online ahead of print.

ABSTRACT

The energy dependence of the rates of the reactions between He⁺ and ammonia (NY₃, Y = {H,D}), forming NY₂⁺, Y and He as well as NY⁺, Y₂ and He, and the corresponding product branching ratios have been measured at low collision energies E_coll between 0 and k_B·40 K using a recently developed merged-beam technique [Allmendinger et al., ChemPhysChem, 2016, 17, 3596]. To avoid heating of the ions by stray electric fields, the reactions are observed within the large orbit of a highly excited Rydberg electron. A beam of He Rydberg atoms was merged with a supersonic beam of ammonia using a curved surface-electrode Rydberg-Stark deflector, which is also used for adjusting the final velocity of the He Rydberg atoms, and thus the collision energy. A collision-energy resolution of about 200 mK was reached at the lowest E_coll values. The reaction rate coefficients exhibit a sharp increase at collision energies below ∼k_B·5 K and pronounced deviations from Langevin-capture behaviour. The experimental results are interpreted in terms of an adiabatic capture model describing the rotational-state-dependent orientation of the ammonia molecules by the electric field of the He⁺ atom. The model faithfully describes the experimental observations and enables the identification of three classes of |JKMp〉 rotational states of the ammonia molecules showing different low-energy capture behaviour: (A) high-field-seeking states with |KM| ≥ 1 correlating to the lower component of the umbrella-motion tunnelling doublet at low fields. These states undergo a negative linear Stark shift, which leads to strongly enhanced rate coefficients; (B) high-field-seeking states subject to a quadratic Stark shift at low fields and which exhibit only weak rate enhancements; and (C) low-field-seeking states with |KM| ≥ 1. These states exhibit a positive Stark shift at low fields, which completely suppresses the reactions at low collision energies. Marked differences in the low-energy reactivity of NH₃ and ND₃-the rate enhancements in ND₃ are more pronounced than in NH₃-are quantitatively explained by the model. They result from the reduced magnitudes of the tunnelling splitting and rotational intervals in ND₃ and the different occupations of the rotational levels in the supersonic beam caused by the different nuclear-spin statistical weights. Thermal capture rate constants are derived from the model for the temperature range between 0 and 10 K relevant for astrochemistry. Comparison of the calculated thermal capture rate coefficients with the absolute reaction rates measured above 27 K by Marquette et al. (Chem. Phys. Lett., 1985, 122, 431) suggests that only 40% of the close collisions are reactive.

PMID:34569565 | DOI:10.1039/d1cp03116c

Phys Chem Chem Phys. 2021 Sep 27. doi: 10.1039/d1cp00783a. Online ahead of print.

ABSTRACT

This paper offers an expedient, efficient, and unique treatment of multimode quantum subsystems (polyatomic molecules) interacting with a classical environment in which the time evolution of the coupling term is governed by the algebraic rules of statistical mechanics in mixed quantum-classical systems developed by Kapral and Nielsen [S. Nielsen, R. Kapral, and G. Ciccotti, J. Chem. Phys., 2001, 115, 5805]. This unique time evolution of the coupling term is neither quantal nor classical but rather something different that relies heavily on Wigner transform, thereby leading to non-Newtonian mechanics. As such, an argument is presented that the approach provided herein for treating polyatomic molecular systems in a mixed quantum-classical environment is new and different as opposed to the many other schemes of semiclassical dynamics that are normally employed to study such systems. The merits of expediency and efficiency of the herein mixed quantum-classical dynamics calculations emanate from avoiding using integrals for time evolutions, and, instead, employing matrix mechanics whereby LU decomposition and singular value decomposition (SVD) numerical techniques are utilized for diagonalization. An electronic 2-level subsystem interacting with a classical bath through the spin-boson model to render accurate pure electronic dephasing in multimode molecular systems by eliminating the unphysical asymmetry in the line shape of the zero-phonon line (ZPL) exhibited by other models is exploited. This work has a superior advantage over the single-mode spin-boson model, published previously, whereby a multitude of types of vibrational modes (slow, fast, or both) of the quantum subsystem may readily be handled using different spectral densities. The spin-boson model used here is a composite system made up of a quantum subsystem, i.e., a subsystem bilinearly coupled to a multidimensional harmonic oscillator (representing the intermediate quantum vibrational modes between the electronic subsystem and the bath), interacting with a classical bath, where the coupling term is governed by the mixed quantum-classical Liouville equation. A multidimensional coherent-state approach is employed to deal with the time evolution of the quantum subsystem. A closed-form expression of linear and nonlinear optical electronic transition dipole moment time correlation functions in mixed quantum-classical dissipative media is derived. Pure electronic dephasing is probed using the aforementioned approach. Linear absorption spectra and 4-wave mixing signals (e.g., photon echo and pump-probe) are calculated showing a reasonable thermal broadening, temporal decay, and accurate pure dephasing.

PMID:34569571 | DOI:10.1039/d1cp00783a

Gerontology. 2021 Sep 21:1-15. doi: 10.1159/000518822. Online ahead of print.

ABSTRACT

OBJECTIVE: Age-related macular degeneration(AMD) has become a major cause of visual impairment worldwide, especially in the elderly. Estimates of incidence, progression rates, and risk factors of AMD vary among studies, complicating the understanding of its epidemiology.

METHODS: For this systematic review and meta-analysis, literature published up to March 1, 2021, was searched in both English and Chinese databases. Hierarchical Bayesian approaches were used to estimate pooled incidence, progression, and 95% credible intervals (CrIs).

RESULTS: Thirty studies were included. The pooled annual early and late AMD incidence rates were 1.59 (95% CrI: 1.18-2.11) and 0.23 (95% CrI: 0.14-0.34) per 100 person-years, respectively. The annual progression rate of AMD was 5.5 (95% CrI: 2.3-8.8) per 100 person-years. Smoking was an independent risk factor for both early and late AMD, whereas age, high-density lipoprotein cholesterol, and alcohol consumption were risk factors for early AMD incidence only. The projected number of new cases of early and late AMD in 2050 would be 39.05 million (95% CrI: 23.12-63.57) and 6.41 million (95% CrI: 3.37-13.22), respectively.

CONCLUSION: The prediction the number of new cases of AMD is not equal across the globe. Our findings indicate the need for more rigorous control and prevention measures in AMD focus on its risk factors for early intervention. The epidemiological estimates reported in this study could inform to identify effective strategies for preventing AMD worldwide.

PMID:34569526 | DOI:10.1159/000518822

Neonatology. 2021 Sep 17:1-7. doi: 10.1159/000518986. Online ahead of print.

ABSTRACT

BACKGROUND: In late preterm infants born in nontertiary hospitals, the occurrence of respiratory distress syndrome requires postnatal transport. This study aimed to investigate the impact of the timing of surfactant administration in late preterm infants needing postnatal transport.

METHODS: This is a retrospective study evaluating surfactant administration in late preterm infants during emergency transports by the Eastern Veneto Neonatal Emergency Transport Service between January 2005 and December 2019. The outcome measures included short-term clinical complications, stabilization time, oxygen concentration, duration of mechanical ventilation and noninvasive respiratory support, length of hospital stay, bronchopulmonary dysplasia, intraventricular hemorrhage, and sepsis.

RESULTS: Surfactant was administered to 155/303 neonates (51.1%) at 3 different time points: at a referring hospital (50 neonates), when the transport team arrived (25 neonates), or at a referral hospital (80 neonates). Stabilization time was longer in neonates receiving surfactant by the transport team (adjusted mean difference 17 min, 95% confidence interval, 4-29 min; p = 0.01). Decrease in oxygen concentrations during the transport was larger in neonates receiving surfactant at a referring hospital (adjusted mean difference -11%, 95% confidence interval, -15 to -3%; p = 0.01). The other outcome measures were not statistically different according to the timing of surfactant administration.

CONCLUSIONS: In late preterm infants with respiratory distress needing postnatal transfer, stabilization time was longer when the first surfactant was administered by the transport team, but such delay did not affect safety and clinical outcomes.

PMID:34569541 | DOI:10.1159/000518986

Eur Surg Res. 2021 Sep 16:1-9. doi: 10.1159/000518403. Online ahead of print.

ABSTRACT

OBJECTIVES: The present study aimed to identify significant causes of readmission within 30 days following coronary artery bypass graft (CABG) surgery and compare readmission incidence related to surgical site infections (SSIs) before and after implementing international recommendations for antibiotic prophylaxis.

METHODS: We analyzed 2,225 CABG patients who received either guideline-directed antibiotic prophylaxis (GDAP = 568) or institutional antibiotic prophylaxis (non-GDAP = 1,657) between January 2017 and December 2019. The primary outcome was a composite of sternal wound infection (SWI) or harvest SWI. Secondary outcomes consisted of the individual components of composite end point, the incidence of in-hospital SSIs, and prolonged postoperative length of hospital stay (LOS) (>7 days). Propensity matching was used to select pairs for final comparison.

RESULTS: Before implementing GDAP, the most frequent reason for readmission were SSIs, causing 58.2% of all readmissions within 30 days. Of 429 matched pairs, 48 patients in the GDAP group and 67 patients in the non-GDAP group were readmitted to a hospital within 30 days for any cause (11.2 vs. 15.6%, p = 0.048). We found a decreased readmission incidence for reasons related to SSIs, although these differences did not reach statistical significance (7.4 vs. 10.0%, p = 0.069). Adherence to GDAP was associated with reduced in-hospital risks of SSIs and prolonged postoperative LOS (19.6 vs. 26.6%, p = 0.015).

CONCLUSIONS: In this contemporary clinical practice study, the adherence to GDAP was an insufficient measure to decrease rehospitalization due to SSIs. The present findings warrant further investigation on factors that may contribute to SSIs development after hospital discharge.

PMID:34569485 | DOI:10.1159/000518403

Dement Geriatr Cogn Disord. 2021 Sep 16:1-7. doi: 10.1159/000519054. Online ahead of print.

ABSTRACT

BACKGROUND: Frailty syndrome is characterized by a decline in physiological and psychological reserve and may be associated with poor health outcomes.

OBJECTIVES: The current study explored frailty and its correlates among cognitively intact community-dwelling older adults.

METHODS: A secondary analysis of data collected from 109 community-dwelling older adults who are cognitively intact was conducted for the purpose of this study. The Arabic versions of the culturally adapted Tilburg Frailty Indicator, the Montreal Cognitive Assessment, the Geriatric Depression Scale, and the Short Form-36 Quality of Life (QOL) survey. Multiple linear regression was used to examine the relationships between frailty and depression.

RESULTS: The results indicated a high prevalence of frailty (78%) and depression (38%) among cognitively intact community-dwelling older adults. Frailty was found to be associated with increased age, being single or illiterate, living alone, having a high number of comorbid conditions, having high rate of depression, and having poor QOL.

CONCLUSION: High prevalence of frailty is associated with high depression scores, a high number of comorbid conditions, and poor QOL among cognitively intact community-dwelling older adults.

PMID:34569493 | DOI:10.1159/000519054

Ann Ital Chir. 2021 Sep 14;10:S0003469X21036289. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Laparoscopic surgery is a widely used surgical technique, whose benefits either for patients or for surgeons are well-recognized. Despite the rise in the use of this technique, the ergonomics of the operating room is still very low. The consequence is that injuries and illness related to laparoscopic surgery are present. The aims of this study are to investigate how an increase in the surgeon’ perception of the fatigue during the execution of the intervention influences the surgeon’ health, and to evaluate if there is a correlation between the increase in fatigue and the operating field dimension.

MATERIALS AND METHODS: The observation was conducted on a single laparoscopist working at our Institution and the Borg CR 0-10 scale was used to perform this study. Two groups of 20 surgical procedures each were analysed. Group A included laparoscopic procedures whose operating field comprehended only one abdominal quadrant. Group B included laparoscopic procedures where at least two abdominal quadrants were involved in the operative field.

RESULTS: The results from both groups were statistically compared. There was a significant correlation between the increase in perception of the exertion and duration of the intervention in both groups and a significant difference in term of Borg scale value, which was higher in group B where the laparoscopic surgery was performed on more than one quadrant of the abdomen.

CONCLUSION: We suggest an important improvement in the ergonomic aspects, especially in more complex laparoscopic procedures that require longer operating time and include more than one abdominal quadrant.

KEY WORDS: Ergonomics, Laparoscopic surgery, Operating theatre.

PMID:34569477