Tag: statistics

Zhonghua Yu Fang Yi Xue Za Zhi. 2022 Sep 6;56(9):1327-1332. doi: 10.3760/cma.j.cn112150-20220117-00061.

ABSTRACT

To analyze the clinical and endoscopic characteristics of colorectal polyps in children, and to explore the detection rate, age and gender distribution characteristics, endoscopic treatment effect and follow-up monitoring of colorectal polyps in children, so as to provide reference for disease management of colorectal polyps in children. The clinical and endoscopic characteristics of children with colorectal polyps in Xi ‘an Children’s Hospital from January 2019 to December 2019 were retrospectively analyzed. The patients were divided into 5 groups according to age (y): 0<y<1 years, 1≤ y<4 years, 4≤ y<7 years, 7≤ y<12 years, and 12≤ y ≤18 years. Independent sample t test, Pearson Chi-square test (χ²) were used to compare groups’ differences. The results showed that a total of 724 colonoscopies were completed in 2019, and 160 colorectal polyps were diagnosed, with a detection rate of 22.10%. Among the children with colorectal polyps, 105 were males, accounting for 65.62%, and 55 were females, accounting for 34.38%. The detection rate of male colorectal polyps was 22.68%, and the detection rate of female colorectal polyps was 21.08%. There was no significant difference in the detection rate of colorectal polyps between males and females (χ² = 0.25, P =0.617). Children with colorectal polyps were most common in the age group of 1≤ y<4 years, 72 cases, accounting for 41.14%(72/175). The detection rate of colorectal polyps in different age groups was statistically significant (χ²=73.929, P<0.05). The main symptom of children with colorectal polyps was hematochezia, accounting for 87.5% (140/160). Colorectal polyps were mainly single polyps in 140 patients, accounting for 87.50%, 15 patients had 2-4 polyps, accounting for 9.38%, and 5 patients had 5 or more polyps, accounting for 3.12%. A total of 210 polyps were removed, and the most common site of polyps was rectum, 123 polyps, accounting for 58.57% (123/210). 111 (52.86%, 111/210) of them were 1 cm to 2 cm in diameter. The Yamada classification was mainly type Ⅲ, 114 pieces, accounting for 54.29% (114/210). Among the 210 polyps with diameter ≥0.5 cm, 165 were removed by endoscopic mucosal resection, accounting for 78.57% (165/210). There were 23 patients with postoperative complications, including hematochezia, abdominal pain, fever, vomiting, diarrhea, dizziness, and no gastrointestinal perforation. Juvenile polyps were the main pathological type, accounting for 88.13% (141/160). The children with juvenile polyps were followed up for 3-30 months, and recurrence was considered in 2 of them. In conclusion, the detection rate of colorectal polyps in children aged 1≤ y<4 years is high, and hematochezia is the main clinical manifestation. Standardized endoscopic treatment and follow-up monitoring are very important for children with colorectal polyps.

PMID:36207899 | DOI:10.3760/cma.j.cn112150-20220117-00061

Global Spine J. 2022 Oct 7:21925682221133748. doi: 10.1177/21925682221133748. Online ahead of print.

ABSTRACT

STUDY DESIGN: Data collection of radiological parameters in non-pathological adult spines.

OBJECTIVES: Establishing a baseline database for measurements of the spinal lordosis ratio between upper and lower arcs of the lumbar spine unique to each type of spine described by Roussouly’s classification. Illustrating the importance of correct rationing of the upper and lower arcs.

METHODS: Standardised standing true lateral plain radiographs of the spine (including base of skull and proximal femurs) from 373 adult volunteers were obtained. Exclusion criteria : any history of disease involving the spine, pelvis, hips or lower limbs. Incidental detection of any spinal deformity on radiography also excluded further participation in this study. Sacro-pelvic parameters data collected : Pelvic Incidence (PI), Pelvic Tilt (PT), Sacral Slope (SS), location of Inflection Point, number of vertebras in the spinal lordosis and type of Roussouly’s spine. Values of upper arc, lower arc and spinal lordosis ratio (SLR) was determined.

RESULTS: Bivariate analysis revealed statistically significant (P < .0001) correlation between the types of sagittal spinal alignments based on Roussouly’s classification and the SLR. Type 1: SLR .76 ± .17, Type 2: SLR .60 ± .18, Type 3 with anteverted pelvis: SLR .53 ± .11, Type 3: SLR .49 ± .12, Type4: SLR .41 ± .11.

CONCLUSION: With this data we are able to quantify the ratio of lumbar lordosis unique to each type of Roussouly’s spine. It functions as a guide when planning lumbar spine surgeries in order to restore the SLR correctly and thus prevent post-op complications such as proximal junction kyphosis.

PMID:36207768 | DOI:10.1177/21925682221133748

Biol Direct. 2022 Oct 7;17(1):27. doi: 10.1186/s13062-022-00339-5.

ABSTRACT

RNA-protein interactions are crucial for diverse biological processes. In prokaryotes, RNA-protein interactions enable adaptive immunity through CRISPR-Cas systems. These defence systems utilize CRISPR RNA (crRNA) templates acquired from past infections to destroy foreign genetic elements through crRNA-mediated nuclease activities of Cas proteins. Thanks to the programmability and specificity of CRISPR-Cas systems, CRISPR-based antimicrobials have the potential to be repurposed as new types of antibiotics. Unlike traditional antibiotics, these CRISPR-based antimicrobials can be designed to target specific bacteria and minimize detrimental effects on the human microbiome during antibacterial therapy. In this study, we explore the potential of CRISPR-based antimicrobials by optimizing the RNA-protein interactions of crRNAs and Cas13 proteins. CRISPR-Cas13 systems are unique as they degrade specific foreign RNAs using the crRNA template, which leads to non-specific RNase activities and cell cycle arrest. We show that a high proportion of the Cas13 systems have no colocalized CRISPR arrays, and the lack of direct association between crRNAs and Cas proteins may result in suboptimal RNA-protein interactions in the current tools. Here, we investigate the RNA-protein interactions of the Cas13-based systems by curating the validation dataset of Cas13 protein and CRISPR repeat pairs that are experimentally validated to interact, and the candidate dataset of CRISPR repeats that reside on the same genome as the currently known Cas13 proteins. To find optimal CRISPR-Cas13 interactions, we first validate the 3-D structure prediction of crRNAs based on their experimental structures. Next, we test a number of RNA-protein interaction programs to optimize the in silico docking of crRNAs with the Cas13 proteins. From this optimized pipeline, we find a number of candidate crRNAs that have comparable or better in silico docking with the Cas13 proteins of the current tools. This study fully automatizes the in silico optimization of RNA-protein interactions as an efficient preliminary step for designing effective CRISPR-Cas13-based antimicrobials.

PMID:36207756 | DOI:10.1186/s13062-022-00339-5

J Orthop Surg Res. 2022 Oct 7;17(1):443. doi: 10.1186/s13018-022-03332-w.

ABSTRACT

BACKGROUND: Medical devices are used in almost all orthopedic surgical subspecialties, and the frequency of adverse events is increasing, which should not be ignored. To provide suggestions on how to avoid implant recalls from the perspective of manufacturers, medical institutions and supervisions, as well as how to respond promptly to adverse events.

METHODS: The research extracted recalls of osteosynthesis implants and joint replacement implants from January 1, 2011, to June 30, 2021, in the CNMPA, FDA, HC and ATGA websites and collected the information on device name, recall time, recall class, recall manufacturer, device classification and affected areas. Moreover, the McKinsey 7S model and fishbone diagram were used to analyze recall reasons.

RESULTS: A total of 315 cases of osteosynthesis implants and 286 cases of joint replacement implants were reported in China, the USA, Canada and Australia. The recalls number from 2016 to 2021 was more than that from 2011 to 2015 for osteosynthesis implant (p = 0.012) and joint replacement implant (p = 0.002), and both mainly focused on class II (76.19% and 78.32%). There were statistical differences in the four countries for both implants (p = 0.000), especially osteosynthesis implant between China and the USA (p = 0.000), China and Canada (p = 0.001), the USA and Australia (p = 0.002), and joint replacement implant between China and Australia (p = 0.000).

CONCLUSIONS: To avoid the recalls of such implants, manufacturers should strictly select implant materials and components, develop detailed labels and instructions, severely control the packaging process and establish the integrity of medical device data. Medical institutions should standardize procurement procedures, use qualified equipment and train medical workers. It also requires supervisions to conduct premarket safety assessments. In addition, regulators should strengthen supervision and establish reporting systems to deal with the occurrence of adverse events promptly.

PMID:36207755 | DOI:10.1186/s13018-022-03332-w

Popul Health Metr. 2022 Oct 7;20(1):19. doi: 10.1186/s12963-022-00296-1.

ABSTRACT

BACKGROUND: Most cancer disability-adjusted life year (DALY) studies worldwide have used broad, generic disability weights (DWs); however, differences exist among populations and types of cancers. Using breast cancer as example, this study aimed to estimate the population-level DALYs in females in China and the impact of screening as well as applying local DWs.

METHODS: Using multisource data, a prevalence-based model was constructed. (1) Overall years lived with disability (YLDs) were estimated by using numbers of prevalence cases, stage-specific proportions, and local DWs for breast cancer. Numbers of females and new breast cancer cases as well as local survival rates were used to calculate the number of prevalence cases. (2) Years of life lost (YLLs) were estimated using breast cancer mortality rates, female numbers and standard life expectancies. (3) The prevalence of and mortality due to breast cancer and associated DALYs from 2020 to 2030 were predicted using Joinpoint regression. (4) Assumptions considered for screening predictions included expanding coverage, reducing mortality due to breast cancer and improving early-stage proportion for breast cancer.

RESULTS: In Chinese females, the estimated number of breast cancer DALYs was 2251.5 thousand (of 17.3% were YLDs) in 2015, which is predicted to increase by 26.7% (60.3% among those aged ≥ 65 years) in 2030 (2852.8 thousand) if the screening coverage (25.7%) stays unchanged. However, if the coverage can be achieved to 40.7% in 2030 (deduced from the “Healthy China Initiative”), DALYs would decrease by 1.5% among the screened age groups. Sensitivity analyses found that using local DWs would change the base-case values by ~ 10%.

CONCLUSION: Estimates of DALYs due to breast cancer in China were lower (with a higher proportion of YLDs) than Global Burden of Disease Study numbers (2527.0 thousand, 8.2% were YLDs), suggesting the importance of the application of population-specific DWs. If the screening coverage remains unchanged, breast cancer-caused DALYs would continue to increase, especially among elderly individuals.

PMID:36207752 | DOI:10.1186/s12963-022-00296-1

Malar J. 2022 Oct 7;21(1):286. doi: 10.1186/s12936-022-04304-5.

ABSTRACT

BACKGROUND: Plasmodium falciparum resistance to series of anti-malarial drugs is a major challenge in efforts to control and/or eliminate malaria globally. In 1998, following the widespread of chloroquine (CQ) resistant P. falciparum, Ethiopia switched from CQ to sulfadoxine-pyrimethamine (SP) and subsequently in 2004 from SP to artemether-lumefantrine (AL) for the treatment of uncomplicated falciparum malaria. Data on the prevalence of CQ resistance markers after more than two decades of its removal is important to map the selection pressure behind the targets codons of interest. The present study was conducted to determine the prevalence of mutations in Pfcrt K76T and Pfmdr1 N86Y codons among malaria-infected patients from Adama, Olenchiti and Metehara sites of East Shewa zone, Oromia Regional State, Ethiopia.

METHODS: Finger-prick whole blood samples were collected on 3MM Whatman ® filter papers from a total of 121 microscopically confirmed P. falciparum infected patients. Extraction of parasite DNA was done by Chelex-100 method from dried blood spot (DBS). Genomic DNA template was used to amplify Pfcrt K76T and Pfmdr1 N86Y codons by nested PCR. Nested PCR products were subjected to Artherobacter protophormiae-I (APoI) restriction enzyme digestion to determine mutations at codons 76 and 86 of Pfcrt and Pfmdr1 genes, respectively.

RESULTS: Of 83 P. falciparum isolates successfully genotyped for Pfcrt K76T, 91.6% carried the mutant genotypes (76T). The prevalence of Pfcrt 76T was 95.7%, 92.5% and 84.5% in Adama, Metehara and Olenchiti, respectively. The prevalence of Pfcrt 76T mutations in three of the study sites showed no statistical significance difference (χ² = 1.895; P = 0.388). On the other hand, of the 80 P. falciparum samples successfully amplified for Pfmdr1, all carried the wild-type genotypes (Pfmdr1 N86).

CONCLUSION: Although CQ officially has been ceased for the treatment of falciparum malaria for more than two decades in Ethiopia, greater proportions of P. falciparum clinical isolates circulating in the study areas carry the mutant 76T genotypes indicating the presence of indirect CQ pressure in the country. However, the return of Pfmdr1 N86 wild-type allele may be favoured by the use of AL for the treatment of uncomplicated falciparum malaria.

PMID:36207750 | DOI:10.1186/s12936-022-04304-5

BMC Public Health. 2022 Oct 7;22(1):1872. doi: 10.1186/s12889-022-14273-8.

ABSTRACT

BACKGROUND: Women with disabilities in developing countries experience significant marginalization, which negatively affects their reproductive health. This study examined the association between disability status and sexual intimate partner violence; the determinants of sexual intimate partner violence by disability status; and the variations in the determinants by disability status.

METHODS: The study, which was based on a merged dataset of 2006, 2011 and 2016 Uganda Demographic Surveys, used a weighted sample of 9689 cases of married women selected for the domestic violence modules. Data were analyzed using frequency distributions and chi-squared tests and multivariable logistic regressions. Other key explanatory variables included partner’s alcohol consumption and witnessing parental violence. A model with disability status as an interaction term helped to establish variations in the determinants of sexual intimate partner violence by disability status.

RESULTS: Sexual IPV was higher among women with disabilities (25% compared to 18%). Disability status predicted sexual intimate partner violence with higher odds among women with disabilities (aOR = 1.51; 95% CI 1.10-2.07). The determinants of sexual intimate partner violence for women with disabilities were: partner’s frequency of getting drunk, having witnessed parental violence, occupation, and wealth index. The odds of sexual intimate partner violence were higher among women whose partners often or sometimes got drunk, that had witnessed parental violence, were involved in agriculture and manual work; and those that belonged to the poorer and middle wealth quintiles. Results for these variables revealed similar patterns irrespective of disability status. However, women with disabilities in the agriculture and manual occupations and in the poorer and rich wealth quintiles had increased odds of sexual intimate partner violence compared to nondisabled women in the same categories.

CONCLUSION: Determinants of sexual intimate partner violence mainly relate to partners’ behaviors and the socialization process. Addressing sexual intimate partner violence requires prioritizing partners’ behaviors, and gender norms and proper childhood modelling, targeting men, women, families and communities. Interventions targeting women with disabilities should prioritize women in agriculture and manual occupations, and those above the poverty line.

PMID:36207741 | DOI:10.1186/s12889-022-14273-8

J Cardiothorac Surg. 2022 Oct 7;17(1):260. doi: 10.1186/s13019-022-02016-0.

ABSTRACT

OBJECTIVE: Cardiothoracic surgery is a large field in Australia, and evidence suggests post-cardiopulmonary bypass (CPB) hyperlactataemia is associated with higher morbidity and mortality. Low thiamine levels are a potentially common yet treatable cause of hyperlactataemia and may occur in the setting of exposure to CPB non-biological material. We hypothesized that cardiopulmonary bypass would result in decreased whole-blood thiamine levels, which may therefore result in increased whole-blood lactate levels in the post-operative period.

METHODS: Adult patients undergoing non-emergent CPB were recruited in a single centre, prospective, analytic observational study at Townsville University Hospital, Australia. The primary outcome was a comparison of pre- and post-CPB thiamine diphosphate level, secondarily aiming to assess any relationship between lactate and thiamine levels. Prospective pre- and post-CPB blood samples were taken and analysed at a central reference laboratory.

RESULTS: Data was available for analysis on 78 patients. There was a statistically significant increase in thiamine diphosphate level from pre-CPB: 1.36 nmol/g Hb, standard deviation (SD) 0.31, 95% confidence intervals (CI) 1.29-1.43, to post-CPB: 1.77 nmol/g Hb, SD 0.53, 95% CI 1.43-1.88, p value < 0.001. There was a non-statistically significant (p > 0.05) trend in rising whole-blood lactate levels with increasing time. Analysis of lactate levels at varying time periods found a significant difference between baseline measurements and increased levels at 13-16 h (p < 0.05). There was no significant relationship observed between whole-blood thiamine levels and post-operative lactate levels.

CONCLUSION: Whole-blood thiamine levels were found to increase immediately post-CPB in those undergoing elective cardiac surgery. There was no correlation between whole-blood thiamine levels and post-operative arterial lactate levels.

PMID:36207738 | DOI:10.1186/s13019-022-02016-0

BMC Med Inform Decis Mak. 2022 Oct 7;22(1):261. doi: 10.1186/s12911-022-02006-1.

ABSTRACT

OBJECTIVES: The Charlson comorbidity index (CCI), the most ubiquitous comorbid risk score, predicts one-year mortality among hospitalized patients and provides a single aggregate measure of patient comorbidity. The Quan adaptation of the CCI revised the CCI coding algorithm for applications to administrative claims data using the International Classification of Diseases (ICD). The purpose of the current study is to adapt and validate a coding algorithm for the CCI using the SNOMED CT standardized vocabulary, one of the most commonly used vocabularies for data collection in healthcare databases in the U.S.

METHODS: The SNOMED CT coding algorithm for the CCI was adapted through the direct translation of the Quan coding algorithms followed by manual curation by clinical experts. The performance of the SNOMED CT and Quan coding algorithms were compared in the context of a retrospective cohort study of inpatient visits occurring during the calendar years of 2013 and 2018 contained in two U.S. administrative claims databases. Differences in the CCI or frequency of individual comorbid conditions were assessed using standardized mean differences (SMD). Performance in predicting one-year mortality among hospitalized patients was measured based on the c-statistic of logistic regression models.

RESULTS: For each database and calendar year combination, no significant differences in the CCI or frequency of individual comorbid conditions were observed between vocabularies (SMD ≤ 0.10). Specifically, the difference in CCI measured using the SNOMED CT vs. Quan coding algorithms was highest in MDCD in 2013 (3.75 vs. 3.6; SMD = 0.03) and lowest in DOD in 2018 (3.93 vs. 3.86; SMD = 0.02). Similarly, as indicated by the c-statistic, there was no evidence of a difference in the performance between coding algorithms in predicting one-year mortality (SNOMED CT vs. Quan coding algorithms, range: 0.725-0.789 vs. 0.723-0.787, respectively). A total of 700 of 5,348 (13.1%) ICD code mappings were inconsistent between coding algorithms. The most common cause of discrepant codes was multiple ICD codes mapping to a SNOMED CT code (n = 560) of which 213 were deemed clinically relevant thereby leading to information gain.

CONCLUSION: The current study repurposed an important tool for conducting observational research to use the SNOMED CT standardized vocabulary.

PMID:36207711 | DOI:10.1186/s12911-022-02006-1

BMC Public Health. 2022 Oct 7;22(1):1873. doi: 10.1186/s12889-022-14249-8.

ABSTRACT

BACKGROUND: SARS-CoV-2 (Covid-19 virus) infection exposed the unpreparedness of African countries to health-related issues, South Africa included. Africa recorded more than 211 853 deaths as a consequence of Covid-19. When rare and deadly diseases require urgent hospitalisation strikes, governments and healthcare providers are usually caught unprepared, resulting in huge loss of lives. Usually, at the beginning of such pandemics, there is no rich data for health practitioners and academics to be able to forecast the number of patients or deaths related to the pandemic. This study aims to predict the number of deaths associated with Covid-19 infection. With the availability of the number of deaths on a daily basis, the results stemming from this study are important to inform and plan health policy.

METHODS: This study uses the daily number of deaths due to Covid-19 infection. Exploratory data analysis reveals that the data exhibits non-normality, three structural breaks and volatility clustering characteristics. The Markov switching (MS)-generalized autoregressive conditional heteroscedasticity (GARCH)-type model combined with heavy-tailed distributions is fitted to the returns of the data. Using available daily reported Covid-19-related deaths up until 26 August 2021, we report 10-day ahead forecasts of deaths. All forecasts are compared to the actual observed values in the forecasting period.

RESULTS: The Anderson-Darling Goodness of fit test confirms that the fitted models are adequate for the data. The Kupiec likelihood ratio test and the root mean square error (RMSE) were used to select the robust model at different risk levels. At 95% the MS(3)-GARCH(1,1) combined with Pearson’s type IV distribution (PIVD) is the best model. This indicates that the proposed best-fitting model is reasonable and can be used for predicting the daily number of deaths due to Covid-19.

CONCLUSION: The MS(3)-GARCH(1,1)-PIVD model provides a reliable and accurate method for predicting the minimum number of death due to Covid-19. The accuracy of the proposed model will assist policymakers, academics and health practitioners in forecasting the volatility of future health-related deaths in which the predictability of volatility plays an integral role in health risk management.

PMID:36207700 | DOI:10.1186/s12889-022-14249-8