Tag: statistics

Nutrition. 2021 Jun 24;91-92:111397. doi: 10.1016/j.nut.2021.111397. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to examine the association between sarcopenia and recovery of independence in urination and defecation in patients undergoing convalescent rehabilitation.

METHODS: This single-center, retrospective cohort study included post-acute rehabilitation patients. Sarcopenia was diagnosed using the muscle mass index and handgrip strength according to the updated criteria of the Asian Working Group for Sarcopenia 2019. Study outcomes and the recovery of independence in urination and defecation were evaluated using the sphincter control items of the Functional Independence Measure (FIM) at discharge: urination (FIM-Bladder) and defecation (FIM-Bowel), respectively. Multivariate regression analyses were used to determine whether sarcopenia at baseline was associated with the study outcomes. Statistical significance was set at P < 0.05.

RESULTS: After enrollment, 917 patients (mean age 74.7 ± 13.5 y; 58% women) were included in the final analyses. Sarcopenia was present in 451 patients (49.2%). The median FIM-Bladder and FIM-Bowel scores at admission were 5 [2-7] and 5 [3-7], respectively. Multivariate analyses showed that the presence of sarcopenia at admission was independently and negatively associated with FIM-Bladder and FIM-Bowel at discharge (all P < 0.001), respectively, after adjusting for potential confounders including baseline outcome variables, FIM, and disease.

CONCLUSIONS: Sarcopenia was negatively associated with the recovery of independence in urination and defecation in a post-acute rehabilitation setting. This relationship was independent of physical and cognitive level and disease. Early detection of sarcopenia and treatment by rehabilitation nutrition should be implemented to predict and maximize improvement in toileting independence in this population.

PMID:34364264 | DOI:10.1016/j.nut.2021.111397

Diabetes Metab Syndr. 2021 Jul 30;15(5):102238. doi: 10.1016/j.dsx.2021.102238. Online ahead of print.

ABSTRACT

AIMS: To evaluate the dose-effect association between COVID-19 vaccination and probability of turning RT-PCR positive and to assess the correlation between disease severity and vaccination status.

METHODS: A single centre cross-sectional study was conducted amongst 583 individuals presenting to COVID-19 testing clinic and 55 hospitalized COVID-19 patients. Vaccination status was assessed by the number of doses and duration since the last dose. Disease severity was evaluated by the requirement of hospitalisation and ICU admission/death. The association between the vaccination status and development of disease and its severity were statistically analyzed.

RESULTS: The mean age of the population was 36.6 years and 82.6% had no comorbidities. The odds of turning RT-PCR positive was 0.17(95% CI: 0.11-0.27) among the clinical suspects who had taken both doses of the vaccine at least 14 days before (fully vaccinated). The odds of hospitalisation was 0.12(95% CI: 0.03-0.45) and ICU admission/death was 0.07(95% CI: 0.01-0.36) among fully vaccinated individuals. The protective role of vaccination was observed to start 14 days after receiving the first dose.

CONCLUSIONS: COVID-19 vaccination provides dose-dependent protection against the development of the disease. It also lowers the risk of hospitalisation and ICU admission/death in RT-PCR positive patients in a dose-dependent manner.

PMID:34364299 | DOI:10.1016/j.dsx.2021.102238

Comput Biol Med. 2021 Aug 2;136:104720. doi: 10.1016/j.compbiomed.2021.104720. Online ahead of print.

ABSTRACT

Cell death is critical to human health and is associated with a variety of medical conditions. Therefore, new controllers of cell death are needed for the treatment of diverse diseases. In particular, nanoparticles (NP) are now regularly used in various applications, including a variety of products and medicines. Gold nanoparticles (GNPs) are widely used in the medical field against A549 lung carcinoma cells. The present study is devoted to developing computational models of the cellular uptake potentials by A549 cells of gold nanoparticles (GNPs) under various conditions. Simplified molecular input-line entry system (SMILES) is an efficient tool to represent the molecular structure by a sequence of symbols. Quasi-SMILES represents an extended version of SMILES where symbols to denote physicochemical and/or biochemical conditions are added. In other words, the quasi-SMILES represents a biochemical (medical) phenomenon related to the whole matter (not only molecular structure). We developed models for the cellular utpake potential of gold nanoparticles (GNPs) in A549 [10-11 g Au/Cell] under various conditions based on quasi-SMILES using the Monte Carlo method. The statistical quality of these models is quite good.

PMID:34364261 | DOI:10.1016/j.compbiomed.2021.104720

Phys Med. 2021 Aug 4;89:114-128. doi: 10.1016/j.ejmp.2021.07.014. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: The development, control and optimisation of new x-ray breast imaging modalities could benefit from a quantitative assessment of the resulting image textures. The aim of this work was to develop a software tool for routine radiomics applications in breast imaging, which will also be available upon request.

METHODS: The tool (developed in MATLAB) allows image reading, selection of Regions of Interest (ROI), analysis and comparison. Requirements towards the tool also included convenient handling of common medical and simulated images, building and providing a library of commonly applied algorithms and a friendly graphical user interface. Initial set of features and analyses have been selected after a literature search. Being open, the tool can be extended, if necessary.

RESULTS: The tool allows semi-automatic extracting of ROIs, calculating and processing a total of 23 different metrics or features in 2D images and/or in 3D image volumes. Computations of the features were verified against computations with other software packages performed with test images. Two case studies illustrate the applicability of the tool – (i) features on a series of 2D ‘left’ and ‘right’ CC mammograms acquired on a Siemens Inspiration system were computed and compared, and (ii) evaluation of the suitability of newly proposed and developed breast phantoms for x-ray-based imaging based on reference values from clinical mammography images. Obtained results could steer the further development of the physical breast phantoms.

CONCLUSIONS: A new image analysis toolbox was realized and can now be used in a multitude of radiomics applications, on both clinical and test images.

PMID:34364255 | DOI:10.1016/j.ejmp.2021.07.014

Int J Drug Policy. 2021 Aug 4;95:103402. doi: 10.1016/j.drugpo.2021.103402. Online ahead of print.

ABSTRACT

BACKGROUND: Opioid-use disorders have led to a nationwide epidemic of accidental overdoses in the United States. In recent years this opioid epidemic has worsened due to the increased availability of fentanyl in the illicit drug market. The increase in fentanyl-related deaths is well known on the U.S. East Coast, however, limited comprehensive information of mortality data exists from major West Coast cities.

METHODS: Following comprehensive medico-legal death and toxicological investigations, a retrospective cohort study was performed on all accidental opioid overdose deaths (AOOD) from 2009 – 2019 in San Francisco. The sex, age and race of decedents, location, and date and time of death were described and statistically compared by the type of opioid(s) causing death.

RESULTS: Since 2016, fentanyl deaths started to replace heroin deaths leading to a sharp increase in fatal overdoses involving fentanyl, surpassing heroin and/or medicinal opioids by 2018. Fentanyl contributed to between 3% and 12% of deaths per year from 2009 to 2015, and between 20% and 73% per year from 2016 to 2019. White and Black males represented 91.5% of all AOOD. Age groups younger than 45 died using fentanyl and heroin significantly more often than older populations (60.7% of ≤45 vs. 40.7% of >45 year-olds, χ²p<0.001).

CONCLUSIONS: This study shows an upward trend in fentanyl fatal accidental overdoses in recent years in a major West Coast U.S. city. These patterns appear to follow patterns seen in eastern states, albeit with an approximate 3-year delay, and may be indicative of other western populations. The described observations provide detailed demographic, chronological and toxicological information to public health and policy-making agencies for drug harm reduction measures.

PMID:34364179 | DOI:10.1016/j.drugpo.2021.103402

Cancer Epidemiol. 2021 Aug 4;74:102000. doi: 10.1016/j.canep.2021.102000. Online ahead of print.

ABSTRACT

BACKGROUND: Cancers of unknown primary (CUPs) are tumors found after metastasizing from unidentified primary sites; these tumors generally have unknown treatment strategies, expected treatment results, and prognosis. We assessed the epidemiological characteristics of CUPs in Korea.

METHODS: We extracted records for 1999 through 2017 from the Korea Central Cancer Registry using the International Statistical Classification of Diseases and Related Health Problems (10th revision) codes for CUP as defined by the International Agency for Research on Cancer. Age-standardized rates and relative survival rates were calculated.

RESULTS: The CUPs constituted 2.1 % of the total number of cancer registrations in 1999, declining to 0.7 % in 2017. The incidence rate decreased for both sexes (5.35 to 2.20 for men, 3.15 to 1.77 for women). Patients aged 80 years and older had the highest incidence rate at 40.2, and 86.3 % of CUPs occurred in those 50 years of age or older. The cases of retroperitoneum and peritoneum sites increased over time. Cases diagnosed by microscopic methods and death certification only were 62.3 % and 7.9 %, respectively. The malignant neoplasm of the retroperitoneum and peritoneum and unknown primary site had the highest and lowest survival rates, respectively. The 5-year relative survival rate increased over time from 14.2 % (1999-2002) to 27.3 % (2013-2017).

CONCLUSIONS: Our analysis of data from the Korea Central Cancer Registry found decreasing rates of CUP, although with consistent disparities by patient age and sex. Advancements in diagnostic technology may be decreasing the number of CUP diagnoses. Expanding the amount of information recorded in the registry may further improve diagnostic accuracy.

PMID:34364188 | DOI:10.1016/j.canep.2021.102000

Clin Nutr. 2021 Jun 19;40(8):4988-4999. doi: 10.1016/j.clnu.2021.06.006. Online ahead of print.

ABSTRACT

BACKGROUND: Plasma odd-chain saturated fatty acids (OCFA) are inversely associated with type 2 diabetes (T2D) risk and may serve as biomarkers for dairy fat intake. Their distribution across different lipid classes and consequences for diabetes risk remain unknown.

AIM: To investigate the prospective associations of OCFA-containing lipid species with T2D risk and their dietary determinants.

METHODS: Within the European Prospective Investigation into Cancer and Nutrition-Potsdam study (n = 27,548), we applied a nested case-cohort design (subcohort: n = 1,248; T2D cases: n = 820; median follow-up 6.5 years). OCFA-containing lipids included triacylglycerols, free fatty acids (FFA), cholesteryl esters (CE), phosphatidylcholines, phosphatidylethanolamines, lysophosphatidylcholines, lysophosphatidylethanolamines, monoacylglycerols, and diacylglycerols. We estimated lipid class-specific associations between OCFA-containing lipids and T2D in sex-stratified Cox proportional-hazards models. We investigated correlations between lipids and dietary intakes derived from food-frequency questionnaires.

RESULTS: We observed heterogeneous integration of OCFA in different lipid classes: triacylglycerols, FFA, CE, and phosphatidylcholines contributed most to the total OCFA-plasma abundance. The relative concentration of OCFA was particularly high in monoacylglycerols, and the contribution of C15:0 versus C17:0 to the total OCFA-abundance differed across lipid classes. In women, several OCFA-containing phospholipids were inversely associated with T2D risk [phosphatidylcholine(C15:0), HR Q5 vs Q1: 0.56, 95% CI 0.32-0.97; phosphatidylcholine(C17:0), HR per SD: 0.59, 95% CI 0.48-0.71; lysophosphatidylcholine(C17:0), HR Q5 vs Q1: 0.42, 95% CI 0.23-0.76]. In men, we did not detect statistically significant inverse associations in phospholipids, and lysophosphatidylcholine(C15:0) was associated with higher T2D risk (HR Q5 vs. Q1: 1.96, 95% CI 1.06-3.63). Besides, CE(C17:0), monoacylglycerols(C15:0), and diacylglycerols(C15:0) were inversely associated with T2D risk; FFA(C17:0) was positively associated with T2D risk in women. Consumption of fat-rich dairy and fiber-rich foods were positively and red meat inversely correlated to OCFA-containing lipid plasma levels.

CONCLUSIONS: OCFA-containing lipids are linked to T2D risk in a lipid class and sex-specific manner, and they are correlated with several foods.

PMID:34364238 | DOI:10.1016/j.clnu.2021.06.006

Mar Pollut Bull. 2021 Aug 4;171:112720. doi: 10.1016/j.marpolbul.2021.112720. Online ahead of print.

ABSTRACT

Several studies have estimated global inputs of plastic into the environment, relying on national statistics and modeling approaches. However, these estimates exhibit uncertainty driven by limited primary municipal solid waste management data. We compare mismanaged plastic estimates from three global studies (Jambeck et al. (2015), Lebreton and Andrady (2019), and Borrelle et al. (2020)), finding significant differences. Specifically, 58 countries show at least a 25 percentage point difference in estimated mismanagement rates, 27 countries show at least a 50 percentage point difference, and 9 countries show at least a 75 percentage point difference. Further, several top plastic generators exhibit large discrepancies in mismanagement estimates, including China, Russia, and Indonesia. The limitations of global plastic pollution estimates are well-known in the scientific community, and some variation is expected. However, these discrepancies limit policy design and mitigation. Thus, municipal, national, and international monitoring of plastic management and pollution must be improved.

PMID:34364136 | DOI:10.1016/j.marpolbul.2021.112720

Arch Oral Biol. 2021 Jul 30;130:105218. doi: 10.1016/j.archoralbio.2021.105218. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate angiogenesis in central giant cell lesions (CGCL) and its association with biological behavior. In addition, investigation of the histone H3.3 mutation was performed.

DESIGN: Thirty-eight cases of CGCL were classified as aggressive (n = 9) or nonaggressive (n = 29). Cases were submitted to immunohistochemistry to compare angiogenesis using Wilms’ tumor protein 1 (WT1), platelet endothelial cell adhesion molecule (CD31) and endoglin (CD105) between groups. To verify the presence of genic mutation, histone H3.3 was investigated.

RESULTS: WT1 was expressed in mononuclear and giant cells of all cases. CD31 and CD105 were expressed in CGCL microvessels, with a higher CD105 microvascular density than CD31. No statistically significant difference was observed between groups. None of the cases studied showed the histone mutation.

CONCLUSIONS: There was no difference between aggressive and nonaggressive lesions regarding the angiogenic markers. The expression of WT1 and CD105 suggests that CGCL presents a tumoral vascular pattern with high neoangiogenic activity. The absence of histone mutation may indicate that CGCL is not a true giant cell tumor.

PMID:34364170 | DOI:10.1016/j.archoralbio.2021.105218

Am J Emerg Med. 2021 Jul 21;50:132-135. doi: 10.1016/j.ajem.2021.07.032. Online ahead of print.

ABSTRACT

BACKGROUND: Hyperkalemia is an electrolyte disorder commonly encountered in the emergency department that can result in significant morbidity and mortality. While sodium bicarbonate is often used for acute lowering of serum potassium, its efficacy is not well established. The purpose of this study was to evaluate and quantify the amount of potassium reduction in emergency department patients who received intravenous sodium bicarbonate as part of treatment for hyperkalemia compared with those who did not.

METHODS: A retrospective electronic chart review was conducted on adult patients who presented to the emergency department with initial potassium concentration greater than or equal to 5.4 mMol/L and received intravenous insulin as part of hyperkalemia treatment. Patients who received intravenous sodium bicarbonate in addition to intravenous insulin were included in the sodium bicarbonate group. The control group included patients who did not receive intravenous sodium bicarbonate. The primary objective of this study was to compare the absolute reduction in serum potassium between initial and second concentrations in patients from the sodium bicarbonate group and those in the control group.

RESULTS: A total of 106 patients were included in this study with 38 patients in the sodium bicarbonate group and 68 patients in the control group. Median initial potassium concentration was 6.6 mMol/L in the sodium bicarbonate group and 6.1 mMol/L in the control group (P = 0.009). Absolute reduction of potassium at first repeat was 1 and 0.9 mMol/L in sodium bicarbonate group and control group respectively (P = 0.976).

CONCLUSIONS: The addition of sodium bicarbonate therapy to intravenous insulin in the treatment of hyperkalemia did not offer statistically significant added efficacy in potassium lowering. Larger studies are needed to further validate the result findings.

PMID:34364111 | DOI:10.1016/j.ajem.2021.07.032