Tag: statistics

Dent Mater J. 2022 Aug 5. doi: 10.4012/dmj.2022-044. Online ahead of print.

ABSTRACT

This study aimed to comprehensively evaluate the effect of dual-cured resin luting agents with different initiator systems on the color stability of glass ceramic restorations by simulating various clinical glass ceramic restorations. Three commonly used shades from each of the two dual-cured resin luting agents with an amine-initiation system or without it were studied. The individual specimens had different translucency and thickness and were artificially aged using a xenon light aging machine. The color was measured before and after aging using a digital spectrophotometer with the difference calculated and analyzed statistically. As results, the amine-free dual-cured resin luting agents were more color stable than those using amine-initiation systems for both uncovered and bonding groups. The translucency and thickness of the ceramic, and shade and type of the resin luting agent significantly affected the color stability of glass ceramic restorations.

PMID:35934801 | DOI:10.4012/dmj.2022-044

J Atheroscler Thromb. 2022 Aug 5. doi: 10.5551/jat.63535. Online ahead of print.

ABSTRACT

AIM: Apolipoprotein E (ApoE) strongly affects arteriosclerosis but has atheroprotective effects in combination with high-density lipoprotein cholesterol (HDL-C). The impact of the quantitative relationship between serum ApoE and HDL-C levels in patients with coronary artery disease (CAD) remains unclear.

METHODS: A total of 3632 consecutive patients who underwent their first intervention between 2000 and 2016 were included. They were categorized into normal and abnormal HDL-C groups based on the normal HDL-C value, and each group was subdivided into high and low ApoE subgroups based on the group-specific median ApoE value. We evaluated the incidence of major adverse cardiac and cerebrovascular events (MACCE), including cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and all-cause death Results: During a 6.4-year follow-up, 419 patients developed MACCE and 570 patients died. The interaction term between ApoE levels and HDL-C status in MACCE and all-cause death proved to be statistically significant. Kaplan-Meier analysis revealed that the cumulative incidence of MACCE was significantly higher for elevated pre-procedural ApoE levels than for reduced preprocedural ApoE levels in the normal HDL-C group. Conversely, the cumulative incidence of MACCE was significantly higher for reduced pre-procedural ApoE levels than for elevated pre-procedural ApoE levels in the abnormal HDL-C group. After adjustment for important covariates, multivariable Cox hazard analysis revealed that the serum ApoE level was a strongly independent predictor of MACCE; this was inversely related in both groups.

CONCLUSIONS: Serum ApoE levels may have a paradoxical impact on the future cardiovascular risk depending on the HDL-C status in patients with CAD.

PMID:35934781 | DOI:10.5551/jat.63535

Appl Health Econ Health Policy. 2022 Aug 8. doi: 10.1007/s40258-022-00750-z. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to estimate the population’s willingness to pay (WTP) for an additional quality-adjusted life-year (QALY) in China.

METHODS: The WTP for an additional QALY (WTP/Q) was estimated using a contingent valuation survey with quota sampling and snowball sampling, using a pre-designed questionnaire with 18 hypothetical scenarios. The change in health state was depicted by the EQ-5D-5L. The questionnaires were completed by telephone and face-to-face interviews. Two-part regression models were used to test validity and how different factors affect WTP/Q.

RESULTS: A total of 2008 people participated in this survey and provided 3265 WTP responses for further analysis. The average WTP/Q for the entire sample is 113,120 Renminbi (RMB) (USD 16,884), which is 1.75 times the gross domestic product (GDP) per capita. For the quality-of-life improvement scenarios, the mean WTP/Q is RMB 78,907 (USD 11,777, 1.22 times GDP per capita), which is significantly lower than the life extension scenarios (RMB 177,761, USD 26,531, 2.76 times GDP per capita). Age was found to be negatively related to positive WTP. Educational level was positively related to the probability of reporting positive WTP and the level of WTP/Q. Although the EQ-5D-5L utility scores of respondents did not prove to be statistically significant determinants of WTP/Q, the two dimensions of EQ-5D-5L, pain/discomfort and anxiety/depression, had an impact on WTP/Q. In addition, WTP/Q was higher when the health outcome had a 50% probability of occurring than when the health outcome was 100% certain. WTP/Q was higher when a lower health gain was presented to the respondent.

CONCLUSION: This study provides empirical evidence of the monetary value of an additional QALY from a sample of the Chinese population. In addition, a higher threshold for end-of-life therapies should be considered.

PMID:35934772 | DOI:10.1007/s40258-022-00750-z

J Obstet Gynaecol Res. 2022 Aug 7. doi: 10.1111/jog.15371. Online ahead of print.

ABSTRACT

AIM: To evaluate the impact on urodynamic results between the laparoscopic nerve-sparing radical hysterectomy (LRH) following a step-by-step procedure and abdominal nerve-sparing radical hysterectomy (ARH) for patients with uterine cervical cancer.

METHODS: This retrospective study enrolled 76 patients with cervical cancer: 35 in the LRH group and 41 in the ARH group. We analyzed their postoperative bladder function in a urodynamics study and examined the volume of resected pelvic nerves contained in parametrial sections using S-100 antibody staining.

RESULTS: Estimated blood loss and hospital stay after operation for the LRH group were significantly better than those in the ARH group (p < 0.0001). As well, the number of harvested lymph nodes was significantly higher in the LRH group (p = 0.044). There was no difference in perioperative complications between the two groups in this study. The 5-year disease-free survival rates and overall survival rates were 91.2% and 94.0% in the LRH group and 87.8% and 95.1% in the ARH group, both respectively. Although the median residual urine volume were no statistical differences between the LRH group and the ARH group, the recovery of postoperative bladder function (uroflowmetry) in the LRH group rapidly reached presurgery levels at 1 month, and the LRH group had a smaller number of s-100 antibody stained nerves contained the parametrial sections.

CONCLUSION: We demonstrated that LRH following a step-by-step procedure could achieve a higher level of prevention of damage to the bladder branch of the pelvic splanchnic nerve plexus and thus restore bladder function more rapidly.

PMID:35934761 | DOI:10.1111/jog.15371

Acta Neurol Belg. 2022 Aug 7. doi: 10.1007/s13760-022-02040-w. Online ahead of print.

ABSTRACT

OBJECTIVES: Redundant Nerve Root (RNR) is a tortuous and elongated radiological appearance of cauda equina on Magnetic Resonance Imaging (MRI) in Lumbar Spinal Canal Stenosis (LSCS) patients. This study evaluated preoperative spinal morphometry associated with the development of RNR.

METHODS: The retrospective cohort was conducted at The Aga Khan University Hospital, and included patients undergoing decompressive spinal surgery secondary to degenerative LSCS in 2015. The patients were divided into two groups with respect to the presence of preoperative RNR. Spinal morphometry was defined by several radiological parameters, including areas of dural sac (DSA), spinal canal, spinal foramen, facets, and spinal joints, and bilateral angles based on vertebral anatomy.

RESULTS: A total of 55 patients were enrolled with a mean age of 57.1 years, in which 22 (40%) expressed RNR in their MRI. The RNR group had significantly lower mean DSA (59.64 vs 84.01 mm²; p = 0.028), bilateral posterior facet angle (Right: 33.84 vs 46.21, p = 0.004; Left: 36.43 vs 43.80, p = 0.039) and higher bilateral anterior facet angles (Right: 54.85 vs 44.57, p = 0.026; Left: 55.27 vs 46.36, p = 0.050) compared to the non-RNR group. The other bidimensional and angular parameters did not observe any statistical difference between the two groups.

CONCLUSION: RNR was associated with a higher degree of stenosis in patients with LSCS. Bilateral anterior and posterior facets angles contribute to its development, indicating particular spinal morphology to be vulnerable to the stenotic disease.

PMID:35934759 | DOI:10.1007/s13760-022-02040-w

Curr Microbiol. 2022 Aug 8;79(9):283. doi: 10.1007/s00284-022-02974-7.

ABSTRACT

Corynebacterium pseudotuberculosis is a bacillus that causes caseous lymphadenitis in small ruminants, leading to great losses to rural producers; thus, an efficient diagnosis is necessary for using disease control measures. This study aimed to evaluate the antigenic potential of four C. pseudotuberculosis recombinant proteins (rSodC, rPknG, rNanH, and rSpaC) against sera of goat and sheep experimentally infected with one of three different C. pseudotuberculosis strains. Goats were infected with CAP76 or CAP21 strain (n = 10), sheep with VD57 strain (n = 6), and a group of not-infected animals (goats and sheep) were kept as a healthy control (healthy n = 12). Sera were collected at 0, 14, 60, 90, 180, or 190 days after inoculation for antigenicity testing using Western blotting and enzyme-linked immunosorbent assay (ELISA) techniques. Cross-reactivity tests with recombinant proteins were performed in goat serum experimentally vaccinated with Nocardia sp. or Rhodococcus equi bacterin. The rSodC protein showed discriminatory antigenic reactivity with a statistically significant difference against three different C. pseudotuberculosis strains evaluated in goats and sheep samples, while rPknG showed statistical significance only against two C. pseudotuberculosis strains evaluated in goats. rSodC was proved to be a strong candidate as a tool for diagnosis of C. pseudotuberculosis infection, once it was able to recognize antibodies against all strains evaluated in goats and sheep.

PMID:35934734 | DOI:10.1007/s00284-022-02974-7

3D Print Med. 2022 Aug 8;8(1):25. doi: 10.1186/s41205-022-00151-x.

ABSTRACT

BACKGROUND: Facial deformities often demand reconstructive surgery and the placement of three-dimensional (3D) printed craniomaxillofacial prostheses. Prostheses manufacturing requires patients’ computed tomography (CT) images. Poor quality images result in incorrectly sized prostheses, necessitating repeat imaging and refitting. The Centre for Rapid Prototyping and Manufacturing (CRPM) produces most facial prostheses in South Africa but does not have a prescribed optimised CT protocol. Therefore, this study was undertaken.

METHODS: A collection of CRPM STLs used in the design and manufacturing of craniomaxillofacial prostheses is available. The image quality of stereolithography (STL) files of CRPM CT scans was evaluated to determine what constitutes good image quality. This collection was scrutinised for inclusion in the image quality evaluation. After scrutiny, 35 STLs of individuals ≥15 years of age were selected and included metadata attached to the DICOM file. Furthermore, only STLs created without manipulation by the same designer were included in the collection. Before the qualitative evaluation of the STLs, eight different critical anatomical reference points (CARPs) were identified with the assistance of an expert team. A visual acuity rating scale of three categories was devised for each CARP, where 1 was allocated to poor visual acuity, 2 to partial, and 3 to good visual acuity. Similarly, rating scales were devised for the presence of concentric rings and the overall impression score awarded by the two designers involved in the design and manufacturing of the prostheses. This stereolithography measurement rubric (SMR) was then applied to the 35 STLs by a team of three experts, including the two designers, during a structured evaluation session. The scores were used to calculate summary and inferential statistics.

RESULTS: Scores grouped around the central rating of partial visual acuity. The three evaluators’ mean total CARP scores ranged from 13.1 to 14.4 (maximum possible score 24), while the mean total CARP + ring scores ranged from 15.8 to 17.1 (maximum possible score 27). No significant differences were detected between the evaluators’ scores.

CONCLUSION: This SMR appears to be the first of its kind. This image quality assessment of STLs provides the groundwork for finer CT image quality evaluation to formulate a CT imaging protocol for the CRPM to design and manufacture accurate internal cranial prostheses.

PMID:35934728 | DOI:10.1186/s41205-022-00151-x

BMC Bioinformatics. 2022 Aug 7;23(1):325. doi: 10.1186/s12859-022-04870-0.

ABSTRACT

BACKGROUND: The malaria risk prediction is currently limited to using advanced statistical methods, such as time series and cluster analysis on epidemiological data. Nevertheless, machine learning models have been explored to study the complexity of malaria through blood smear images and environmental data. However, to the best of our knowledge, no study analyses the contribution of Single Nucleotide Polymorphisms (SNPs) to malaria using a machine learning model. More specifically, this study aims to quantify an individual’s susceptibility to the development of malaria by using risk scores obtained from the cumulative effects of SNPs, known as weighted genetic risk scores (wGRS).

RESULTS: We proposed an SNP-based feature extraction algorithm that incorporates the susceptibility information of an individual to malaria to generate the feature set. However, it can become computationally expensive for a machine learning model to learn from many SNPs. Therefore, we reduced the feature set by employing the Logistic Regression and Recursive Feature Elimination (LR-RFE) method to select SNPs that improve the efficacy of our model. Next, we calculated the wGRS of the selected feature set, which is used as the model’s target variables. Moreover, to compare the performance of the wGRS-only model, we calculated and evaluated the combination of wGRS with genotype frequency (wGRS + GF). Finally, Light Gradient Boosting Machine (LightGBM), eXtreme Gradient Boosting (XGBoost), and Ridge regression algorithms are utilized to establish the machine learning models for malaria risk prediction.

CONCLUSIONS: Our proposed approach identified SNP rs334 as the most contributing feature with an importance score of 6.224 compared to the baseline, with an importance score of 1.1314. This is an important result as prior studies have proven that rs334 is a major genetic risk factor for malaria. The analysis and comparison of the three machine learning models demonstrated that LightGBM achieves the highest model performance with a Mean Absolute Error (MAE) score of 0.0373. Furthermore, based on wGRS + GF, all models performed significantly better than wGRS alone, in which LightGBM obtained the best performance (0.0033 MAE score).

PMID:35934714 | DOI:10.1186/s12859-022-04870-0

J Plast Reconstr Aesthet Surg. 2022 Feb 27:S1748-6815(22)00120-6. doi: 10.1016/j.bjps.2022.02.041. Online ahead of print.

ABSTRACT

BACKGROUND: Neither anatomic nor functional descriptions exist of trunk/breast lymphedema following breast cancer treatment. Indocyanine green (ICG)-lymphangiography has been shown to characterize lymph channel dysfunction seen in lymphedema. We propose using ICG-lymphangiography to evaluate trunk and breast lymphedema following breast cancer surgery to characterize the regions affected via a novel, validated staging system.

METHODS: Patients undergoing revisional breast surgery with suspicion of upper extremity lymphedema between December 2014 and March 2020 were offered lymphangiography. The breast and lateral/anterior trunks were visualized and blindly evaluated using Koshima’s patterns of dermal backflow. Patients were then staged. A linear-weighted Cohen’s kappa statistic was calculated comparing each rated area and stage assignment.

RESULTS: Fifty-two sides (29 patients) were included. Eight sides underwent no treatment and were considered controls. No lymphedema was identified within this cohort. One patient (two sides) had no transit of ICG. Seventy-six percent of the non-controls had dermal backflow. This was seen in 67% of anterior trunks, 50% of lateral trunks, 50% of inframammary folds (IMFs), 43% of inferior breasts, and 5% of superior breasts. Cohen’s kappa for area agreement was 0.4117 ± 0.0535. Stage 0 was seen in 31 (±7)% of sides; stage 1: 21 (±1)%; stage 2: 22 (±5)%; stage 3: 18 (±4)%; stage 4: 5 (±1)%; and stage 5: 4 (±0). Cohen’s kappa for staging was 0.8109 ± 0.0868.

CONCLUSION: Following breast cancer surgery, lymphedema occurs throughout the trunk and breast. Severe dysfunction appears to be located around the inferior-lateral aspect of the breast and chest wall. Furthermore, the Pittsburgh Trunk Lymphedema Staging System is a validated measure of trunk and breast lymphedema.

PMID:35934664 | DOI:10.1016/j.bjps.2022.02.041

BMC Cardiovasc Disord. 2022 Aug 7;22(1):361. doi: 10.1186/s12872-022-02803-6.

ABSTRACT

BACKGROUND: Management of life-threatening arrhythmia can be incredibly challenging in advanced health systems. In sub-Saharan Africa (SSA), this is likely more challenging because of weak pre-hospital and in-hospital critical care systems. Little is known about life-threatening arrhythmia and their outcomes in SSA. The aim of this study was to examine the types and outcomes of arrhythmias among haemodynamically unstable patients presenting at a tertiary hospital in Accra-Ghana.

METHOD: This was a retrospective case series study conducted at the Korle-Bu Teaching Hospital (KBTH), Accra-Ghana. Medical records of patients who presented with or developed haemodynamically unstable arrhythmias within 24h of admission from January 2018 to December 2020 were reviewed. The demographic characteristics and clinical data including outcomes of patients were collected. Descriptive statistics were used and results presented in frequency tables.

RESULTS: A total of 42 patients with life-threatening arrhythmias were included. Haemodynamically unstable tachyarrhythmias were the most common arrhythmias found among the patients (66.7%). Approximately 52% of patients had structural heart diseases whereas 26.2% had no apparent underlying cause or predisposing factor. Cardioversion (52.4%), commonly electrical (63.6%), and transvenous pacemaker implantation (23.8%) were the common initial interventions. The majority of the patients (88.1%) survived and were discharged home.

CONCLUSION: Tachyarrhythmias are the most common haemodynamically unstable arrhythmias seen among patients presenting emergently in a leading tertiary hospital in Ghana. A high survival rate was observed and cannot be extrapolated to other healthcare settings in sub-Saharan Africa with limited resources to manage these clinical entities.

PMID:35934708 | DOI:10.1186/s12872-022-02803-6