Tag: statistics

Surg Technol Int. 2022 Feb 2;40:sti40/1547. Online ahead of print.

ABSTRACT

INTRODUCTION: Opioid use disorder (OUD) patients have an increased risk of venous thromboembolism (VTE), readmissions, and higher costs following primary elective primary total joint arthroplasty, but these risks have not yet been clarified for other arthroplasty surgeries. Thus, the purpose of this study was to investigate whether OUD patients undergoing revision total knee arthroplasty (RTKA) have higher rates of: VTEs, readmissions, and costs of care.

MATERIALS AND METHODS: Patients who had a 90-day history of OUD prior to undergoing RTKA were identified and randomly matched to a comparison cohort in a 1:4 ratio by age, sex, Elixhauser-Comorbidity Index (ECI), diabetes mellitus, hyperlipidemia, hypertension, obesity, and tobacco use with a total of 16,851 patients collectively in both groups. The 90-day frequency and odds (OR) of developing VTE, deep vein thrombosis (DVTs), and PEs along with 90-day readmission rates and 90-day costs of care were analyzed. A p-value less than 0.01 was considered statistically significant.

RESULTS: OUD patients undergoing RTKA were found to have a higher incidence and odds of VTE (2.91 vs. 1.88; OR: 1.58, p<0.0001) 90 days following RTKA. Compared to the matched cohort, patients who have OUD had a higher incidence and increased risk of lower extremity DVT (2.61 vs. 1.73; OR: 1.52, p=0.0008) and PE (0.97 vs. 55%; OR: 1.74, p=0.007). Furthermore, the likelihood (25.7 vs. 21.4%; OR: 1.26, p<0.0001) of being readmitted within 90 days was higher in OUD patients. Additionally, OUD was associated with significantly higher total global 90-day episode-of-care costs ($19,289.31 ± $17,378.71 vs. $17,292.87 vs. $11,690.61; p<0.0001).

CONCLUSION: Patients who have OUD undergoing RTKA have higher rates of thromboembolic complications, readmission rates, and total global 90-day episode-of-care costs. Orthopaedic surgeons should educate OUD patients about these risks and titrate patient opioid consumption through multi-specialty interventions prior to surgery to improve outcomes and reduce costs.

PMID:35104910

Nucleic Acids Res. 2022 Feb 1:gkac029. doi: 10.1093/nar/gkac029. Online ahead of print.

ABSTRACT

Proteins isolated from natural sources can be composed of a mixture of isoforms with similar physicochemical properties that coexist in the final steps of purification. Yet, even where unverified, the assumed sequence is enforced throughout the structural studies. Herein, we propose a novel perspective to address the usually neglected sequence heterogeneity of natural products by integrating biophysical, genetic and structural data in our program SEQUENCE SLIDER. The aim is to assess the evidence supporting chemical composition in structure determination. Locally, we interrogate the experimental map to establish which side chains are supported by the structural data, and the genetic information relating sequence conservation is integrated into this statistic. Hence, we build a constrained peptide database, containing most probable sequences to interpret mass spectrometry data (MS). In parallel, we perform MS de novo sequencing with genomic-based algorithms to detect point mutations. We calibrated SLIDER with Gallus gallus lysozyme, whose sequence is unequivocally established and numerous natural isoforms are reported. We used SLIDER to characterize a metalloproteinase and a phospholipase A2-like protein from the venom of Bothrops moojeni and a crotoxin from Crotalus durissus collilineatus. This integrated approach offers a more realistic structural descriptor to characterize macromolecules isolated from natural sources.

PMID:35104880 | DOI:10.1093/nar/gkac029

Nature. 2022 Feb 1. doi: 10.1038/s41586-022-04462-1. Online ahead of print.

ABSTRACT

The emergence of a new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant, Omicron, is an urgent global health concern (ref.¹). Our statistical modelling suggests that Omicron has spread more rapidly than the Delta variant in several countries including South Africa. Cell culture experiments show that Omicron is less fusogenic than Delta and an ancestral SARS-CoV-2 strain. Although the spike (S) protein of Delta is efficiently cleaved into two subunits, which facilitates cell-cell fusion^2,3, Omicron S is less efficiently cleaved compared to Delta S and ancestral SARS-CoV-2 S. Furthermore, in a hamster model, Omicron shows decreased lung infectivity and is less pathogenic compared to Delta and ancestral SARS-CoV-2.

PMID:35104835 | DOI:10.1038/s41586-022-04462-1

J Infect Dis. 2022 Feb 1:jiac032. doi: 10.1093/infdis/jiac032. Online ahead of print.

ABSTRACT

BACKGROUND: Analytical treatment interruptions (ATI) are pauses of antiretroviral therapy (ART) in the context of HIV cure trials. They are the gold standard in determining if interventions being tested can achieve sustained virological control in the absence ART. However, withholding ART comes with risks and discomforts to the trial participant. We used mathematical models to explore how ATI study design can be improved to maximise statistical power, while minimising risks to participants.

METHODS: Using previously observed dynamics of time to viral rebound (TVR) post ATI, we modelled estimates for optimal sample size, frequency and ATI duration required to detect a significant difference in the TVR between control and intervention groups. Groups were compared using a log-rank test, and analytical and stochastic techniques.

RESULTS: In placebo controlled TVR studies, 120 participants are required in each arm to detect 30% difference in the frequency of viral reactivation at 80% power. There was little statistical advantage to measuring viral load more frequently than weekly, or interrupting ART beyond 5 weeks in a TVR study.

CONCLUSIONS: Current TVR HIV cure studies are underpowered to detect statistically significant changes in frequency of viral reactivation. Alternate study designs can improve the statistical power of ATI trials.

PMID:35104873 | DOI:10.1093/infdis/jiac032

Urol Int. 2022 Feb 1:1-6. doi: 10.1159/000521660. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of this study was to evaluate toxicity, oncological and functional outcome, and quality of life after salvage radiotherapy for recurrent prostate cancer after high-intensity focused ultrasound (HIFU) therapy.

METHODS: A total of 13 patients undergoing salvage radiotherapy for biopsy-proven prostate cancer recurrence after HIFU therapy were included and followed up every 3 months. Oncological outcome (by PSA measurements), toxicity (according to CTCAE criteria), and functional outcome were evaluated. Quality of life was assessed by standardized questionnaires (QLQ-C30 and QLQ-PR25) at baseline, 3 months, and 12 months after salvage treatment.

RESULTS: Median age of patients was 80 years (interquartile range [IQR] 75-82). Patients underwent normofractionated salvage radiotherapy with median 73.6 Gy. PSA nadir was reached at 6 months and was 0.2 ng/mL. Median follow-up was 76 months (IQR 55-96). Biochemical recurrence occurred in 3 patients (23.1%) at a median of 36.4 months. No gastrointestinal (GI) or genitourinary (GU) toxicity ≥ grade 3 was noted during follow-up. Early and late grade II GI toxicity occurred in 1 patient (7.7%), respectively. GU toxicity grade II was noted in up to 53.8% at 3 months and 61.5% at 12 months. In terms of health-related quality of life, there was no statistically significant difference at 3 and 12 months compared to the baseline. Only differences were seen in sexual functioning (3 and 12 months) and in diarrhea (3 months), affecting patients’ wellbeing.

DISCUSSION/CONCLUSION: Salvage radiotherapy after HIFU treatment can be performed safely, thereby providing acceptable recurrence-free survival without severe impact on post-interventional quality of life.

PMID:35104820 | DOI:10.1159/000521660

Cancer Epidemiol. 2022 Jan 6;77:102098. doi: 10.1016/j.canep.2022.102098. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has greatly altered the behavior of adolescents and young adults (AYAs) with cancer. No data exists on how gender influences the adherence of individuals with cancer to COVID-19 related public health guidelines and their preferred methods of receiving COVID-19 related information.

METHODS: We conducted a cross-sectional survey of adolescents and young adults with cancer. Data were summarized using descriptive statistics. Multiple logistic regression was used to assess differences in adherence to COVID-19 preventative behaviors, and differences in preferred information sources of COVID-19 related information between men and women.

RESULTS: Among 633 participants, adherence to key COVID-19 preventative measures was 44.9-58.8% for males and 53.4-68.1% for females. After adjusting for key confounding variables in multivariable analysis, males were less likely to adhere to frequent hand washing (AOR [adjusted odds ratio] 1.45, 95% CI [confidence interval] 1.03-2.03), not touching face (AOR 1.82, 95% CI 1.29-2.56) and social distancing (AOR 1.93, 95% CI 1.37-2.71) than females. Both genders preferred to receive information from their cancer institutes and social media.

DISCUSSION: Gender-specific interventions are needed to improve the adherence of males to COVID-19 precautionary measures. Information should be disseminated via cancer institutes and social media as these are the preferred sources of COVID-19 related information among AYAs with cancer.

PMID:35104772 | DOI:10.1016/j.canep.2022.102098

Ecotoxicol Environ Saf. 2022 Jan 28;232:113254. doi: 10.1016/j.ecoenv.2022.113254. Online ahead of print.

ABSTRACT

China is the largest producer and consumer of plastics worldwide. Microplastic (MP) pollution has been a recent research hotspot in environmental science and ecology. This study collects and analyzes the statistical data for microplastics (MPs) 86 lakes in entire China’s lake ecosystems in past five years (2016-2020), their range in area is 0.056-4543.000 km² (average: 566.045 km²), and the water storage varies from 0.162 × 10⁸ to 1050.000 × 10⁸ m³ (average: 77.884 ×10⁸ m³). The results showed (1) The MP abundance in lake surface water is significantly correlated with lake area (ρ = -0.562, p ＜0.01), provincial GDP (Gross Domestic Product, GDP) (ρ = 0.377, p = 0.002), GDP per capita (ρ = 0.346, p = 0.006), urban waste water discharge and ratio of agricultural land area (ρ = 0.369, p = 0.003). (2) The MP abundance in lake sediment is significantly correlated with per capita domestic volume of garbage disposal (ρ = -0.536, p ＜0.001), per capita urban waste water discharge (ρ = -0.544, p ＜0.001) and ratio of agricultural land area (ρ = 0.635, p ＜0.001). (3) Irrespective of whether the samples were from surface water or sediment, MPs were primarily transparent, and the dominant types were fragments, films, and fibers. In addition, the size of MPs samples was mostly less than 2 mm, and the major polymers were polyethylene (PE), polypropylene (PP), and polystyrene (PS). (4) The degree of MP pollution in organisms was related to the degree of environmental pollution. These findings could provide a theoretical basis for the control and management of MP pollution in China’s lake ecosystems.

PMID:35104781 | DOI:10.1016/j.ecoenv.2022.113254

J Stroke Cerebrovasc Dis. 2022 Jan 29;31(4):106308. doi: 10.1016/j.jstrokecerebrovasdis.2022.106308. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Rigorous and regular evaluation of defined quality indicators is crucial for further improvement of both technical and clinical results after mechanical thrombectomy (MT) for acute ischemic stroke (AIS). Following the recent international multi-society consensus quality indicators, we aimed to assess trend in these indicators on national level.

MATERIAL AND METHODS: The prospective multicenter study (METRICS) was conducted in Czech Republic (CR) in year 2019. All participating centers collected technical and clinical data including defined quality indicators and results were subsequently compared with those from year 2016.

RESULTS: In the 2019, 1375 MT were performed in the CR and 1178 (86%) patients (50.3% males, mean age 70.5 ± 13.0 years) were analyzed. Recanalization (TICI 2b-3) was achieved in 83.7% of patients and 46.2% of patients had good 3-month clinical outcome. Following time intervals were shortened in comparison to 2016: “hospital arrival – GP” (77 vs. 53 min; p<0.0001), “hospital arrival – maximal achieved recanalization” (122 vs. 93 min; p<0.0001), and “stroke onset – maximal achieved recanalization” (240 vs. 229 min; p p<0.0001). More patients with tandem occlusion were treated in 2019 (7.8 vs. 16.5%; p<0.0001) and more secondary transports were in 2019 (31.3 vs. 37.8%; p=0.002). No difference was found in 3-month clinical outcome and in the rate of periprocedural complications. Results of the METRICS study met all criteria of multi-society consensus quality indicators.

CONCLUSION: Nationwide comparison between 2016 and 2019 showed improvement in the key time intervals, but without better overall clinical outcomes after MT.

PMID:35104746 | DOI:10.1016/j.jstrokecerebrovasdis.2022.106308

Diabetes Metab Syndr. 2022 Jan 24;16(2):102415. doi: 10.1016/j.dsx.2022.102415. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Wearing an accelerometer during night-time could conflate sedentary behavior time and sleep hours. It is important to assess the impact of including night-time data on sedentary and upright behavior in a sedentary population. Therefore, we investigated differences in sitting and upright time and associated energy expenditure (EE), recorded by a Fibion accelerometer, with and without night-time data in Emirati women working in desk-based jobs.

METHODS: Thirty-one healthy Emirati women working in the government offices used the Fibion accelerometer for a week. Fibion data were included if the participants wore the device for ≥600 min per day for a minimum of three weekdays and one weekend day. Sedentary (sitting) and upright time and associated energy expenditure (EE) were recorded using the Fibion. Variables were compared with and without night-time data using the paired t tests or Wilcoxon signed-rank tests. Effect sizes were determined using Cohen’s d.

RESULTS: Statistically significant differences for 15 out of 18 variables were observed when the night-time data were included. Except for cycling time, cycling EE, and vigorous activity time, nearly all other outcome measures showed a significant increase (moderate to large effect sizes) with night-time data compared to those without night-time data.

CONCLUSIONS: Cycling time/EE and vigorous activity time did not change with standard night-time data. Therefore, studies examining only cycling and/or vigorous activity time with the Fibion accelerometer do not require night-time data removal. An analysis of other variables relating to sedentary and upright time will require night-time data exclusion.

PMID:35104752 | DOI:10.1016/j.dsx.2022.102415

Epilepsy Behav. 2022 Jan 29;128:108506. doi: 10.1016/j.yebeh.2021.108506. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Seizure severity has been increasingly gaining attention as a complementary assessment to seizure frequency for the measurement of treatment responses. This study aimed to assess the reliability and external validity and of the Persian version of the Seizure Severity Questionnaire (SSQ).

METHODS: The study sample was recruited from 126 patients with epilepsy who attended the neurology outpatient clinic at Imam Khomeini and Roozbeh hospitals, Tehran, Iran. The Forward-Backward technique was applied to translate the questionnaire. The reliability of SSQ was assessed by Cronbach’s alpha coefficient. The external validity of SSQ was assessed by correlating SSQ scores with Quality of Life in Epilepsy Inventory-31 (QOLIE-31) subscales.

RESULTS: The sample comprised 63 women (50%) and 63 men (50%) aged 13-76 years. The mean scores of SSQ items ranged from 3.46 to 5.48. Distribution was skewed for all component scores, with a tendency for the item scores to concentrate toward the highest scores. Reliability for almost all domains were moderate to good, with Cronbach’s alpha ranging from 0.615 to 0.770. Component B to D and total score of SSQ had weak-to-moderate inverse correlation with QOLIE-31 subscale scores. However, the result showed no significant correlation with age, sex, or education.

CONCLUSION: With some limitations, the Persian version of the SSQ shows relatively good reliability and content validity, supporting its use as a specific measure of seizure severity in epilepsy in Iran.

PMID:35104735 | DOI:10.1016/j.yebeh.2021.108506