Tag: statistics

PLoS One. 2021 Jun 24;16(6):e0250768. doi: 10.1371/journal.pone.0250768. eCollection 2021.

ABSTRACT

BACKGROUND: Plantar fasciitis is the most common cause of pain in the plantar region of the heel, and extracorporeal shockwave therapy (ESWT) is an option used in cases where conservative treatment fails. Hyaluronic acid (HA), initially used for osteoarthrosis, is a treatment option because it has been applied to extra-articular regions, such as tendons, ligaments, and fascia. The aim of the present study will be to evaluate the outcomes of pain, function, and personal satisfaction after a single injection of HA and to compare the results with those of ESWT in patients with chronic plantar fasciitis.

METHODS: The study will include 80 patients who will be randomized to receive three sessions of ESWT (n = 40) or a single ultrasound-guided HA injection in the plantar fascia (n = 40). The outcomes will include the visual analog pain scale score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and Foot and Ankle Outcome Score (FAOS). All of the assessments will be performed at baseline and 3, 6, and 12 months after treatment. Statistical analysis will be performed using the repeated measures ANOVA (analysis of variance test) for primary and secondary outcomes and also Fisher’s Least Significant Difference, a Post-Hoc test. We will use R software for statistical analysis, randomization, and sample size calculation.

RESULTS: Recruitment and data collection will begin in November 2020, with completion scheduled for November 2022 and final publication available in March 2023.

CONCLUSION: This trial will evaluate the effects of a single ultrasound-guided HA injection for the treatment of chronic plantar fasciitis.

TRIAL REGISTRATION: Brazilian Clinical Trials Registry (Register Number: RBR-97vkx4) http://www.ensaiosclinicos.gov.br/rg/RBR-97vkx4/.

PMID:34166373 | DOI:10.1371/journal.pone.0250768

PLoS One. 2021 Jun 24;16(6):e0247908. doi: 10.1371/journal.pone.0247908. eCollection 2021.

ABSTRACT

To investigate the influence of bedding structure and different loading rates on the dynamic fracture characteristics and energy dissipation of Datong coal, a split Hopkinson bar was used to obtain the fracture characteristics of coal samples with different bedding angles. The process of crack initiation and propagation in Datong coal was recorded by the high-speed camera. The formula for the model I fracture toughness of the transversely isotropic material is obtained on the basis of the finite element method (FEM) together with the J-integral. By comparing the incident energy, absorbed energy, fracture energy and residual kinetic energy of Datong coal samples under various impact speeds, the energy dissipation characteristics during the dynamic fracture process of coal considering the bedding structure is acquired. The experimental results indicate that the fracture pattern of notched semi-circular bending (NSCB) Datong coal is tensile failure. After splitting into two parts, the coal sample rotates approximately uniformly around the contact point between the sample and the incident rod. The dynamic fracture toughness is 3.52~8.64 times of the quasi-static fracture toughness for Datong coal. Dynamic fracture toughness increases with increasing impact velocity, and the effect of bedding angle on fracture toughness then decreases. In addition, the residual kinetic energy of coal samples with the same bedding angle increases with the increase of impact speed. The energy utilization rate decreases continuously, and the overall dispersion of statistical data decreases gradually. In rock fragmentation engineering, the optimum loading condition is low-speed loading regardless of energy utilization efficiency or fracture toughness. These conclusions may have significant implications for the optimization of hydraulic fracturing process in coal mass and the further understanding of crack propagation mechanisms in coalbed methane extraction (CME). The anisotropic effect of coal should be fully considered in both these cases.

PMID:34166380 | DOI:10.1371/journal.pone.0247908

Angiol Sosud Khir. 2021;27(2):121-126. doi: 10.33529/ANGIO2021218.

ABSTRACT

AIM: This study was undertaken to investigate the preoperative incidence and severity of intimal hypertrophy, as well as the level of blood supply of arterial and venous conduits for coronary artery bypass grafting.

MATERIAL AND METHODS: Segments of the internal thoracic artery and great saphenous vein (n=13) were harvested pairwise during coronary artery bypass grafting and were then visualized by scanning electron microscopy in back-scattered electrons. The analysis of the incidence and thickness of intimal hypertrophy, as well as the calculation of the number and the area of the vasa vasorum were performed using the programme ImageJ.

RESULTS: Intimal hypertrophy was more characteristic for the great saphenous vein as compared with the internal thoracic artery (9/13 (69.2%) and 7/13 (55.8%), respectively), although this difference did not reach statistical significance. The maximal-to-minimal neointimal thickness ratio correlated with the percentage of stenosis (r=0.875, p<0.0001), the area (r=0.45, p=0.023) and the number (r=0.47, p=0.015) of the vasa vasorum in the conduits, thus confirming the hypothesis on possible participation of these vessels in the development of intimal hypertrophy, with the area of the vasa vasorum being greater in the vessels with >10% stenosis (p=0.051). The number of the vasa vasorum in the great saphenous vein exceeded that in the internal thoracic artery (p=0.0005), with this difference remaining significant after adjustment for the area of the adventitia (p=0.027). The number of the vasa vasorum per the percentage of stenosis in the great saphenous vein also exceeded that in the internal thoracic artery (p=0.039) and more strongly correlated with intimal hypertrophy in the great saphenous vein as compared with that in the internal thoracic artery (r=0.53 and r=0.27, respectively).

CONCLUSION: Intimal hypertrophy correlates with the area and number of the vasa vasorum in conduits. The great saphenous vein is characterised by a larger number and higher density of the vasa vasorum as compared with the internal thoracic artery. The number of the vasa vasorum is correlated with stenosis of the great saphenous vein more closely than with stenosis of the internal thoracic artery. This may be suggestive of significant predisposition of the great saphenous vein to the onset of adventitial inflammation followed by the development of intimal hypertrophy.

PMID:34166352 | DOI:10.33529/ANGIO2021218

Angiol Sosud Khir. 2021;27(2):114-120. doi: 10.33529/ANGIO2021214.

ABSTRACT

Annually, up to 850 000 coronary aortic bypass graft operations are performed worldwide. Despite modern technical equipment ensuring a high level of safety of the procedure, currently important remains a problem related to intraoperative myocardial damage in using artificial circulation. Early detection and clinical assessment of myocardial ischaemia often present a difficult task. This article deals with clinical, instrumental and laboratory methods of diagnosis, aimed at verification of an intraoperative cardiac lesion associated with graft dysfunction in coronary artery bypass grafting. Isolated electrocardiographic and echocardiographic signs of myocardial ischaemia between the comparison groups did not differ significantly. Analysing the markers of myocardial lesions, statistically significant differences were obtained only after 48 hours which, from the point of view of saving viable myocardium, is an utterly long-term interval. Studying the findings of intraoperative flowmetry showed statistically significant dependence between velocity characteristics, pulse index of shunts and their patency on angiographic examination. Thus, only combination of diagnostic parameters makes it possible to detect myocardial damage related to shunt dysfunction. This enables early determination of indications for performing bypass angiography and selection of the required therapeutic policy. Timely coronary artery angiography makes it possible to reveal defects of shunts and to timely perform surgical correction, preventing myocardial infarction.

PMID:34166351 | DOI:10.33529/ANGIO2021214

United European Gastroenterol J. 2021 Jun 24. doi: 10.1002/ueg2.12112. Online ahead of print.

ABSTRACT

BACKGROUND: No prognostic score is currently available for long-term survival in autoimmune hepatitis (AIH) patients.

OBJECTIVE: The aim of this study was to develop and validate such a prognostic score for AIH patients at diagnosis.

METHODS: The prognostic score was developed using uni- & multivariate Cox regression in a 4-center Dutch cohort and validated in an independent 6-center Belgian cohort.

RESULTS: In the derivation cohort of 396 patients 19 liver transplantations (LTs) and 51 deaths occurred (median follow-up 118 months; interquartile range 60-202 months). In multivariate analysis age (hazard ratio [HR] 1.045; p < 0.001), non-caucasian ethnicity (HR 1.897; p = 0.045), cirrhosis (HR 3.266; p < 0.001) and alanine aminotransferase level (HR 0.725; p = 0.003) were significant independent predictors for mortality or LT (C-statistic 0.827; 95% CI 0.790-0.864). In the validation cohort of 408 patients death or LT occurred in 78 patients during a median follow-up of 74 months (interquartile range: 25-142 months). Predicted 5-year event rate did not differ from observed event rate (high risk group 21.5% vs. 15.7% (95% CI: 6.3%-24.2%); moderate risk group 5.8% versus 4.3% (95% CI: 0.0%-9.1%); low risk group 1.9% versus 5.4% (95% CI: 0.0%-11.4%); C-statistic 0.744 [95% CI 0.644-0.844]).

CONCLUSIONS: A Dutch-Belgian prognostic score for long-term transplant-free survival in AIH patients at diagnosis was developed and validated.

PMID:34165262 | DOI:10.1002/ueg2.12112

Cancer Rep (Hoboken). 2021 Jun 24:e1411. doi: 10.1002/cnr2.1411. Online ahead of print.

ABSTRACT

BACKGROUND: Desmoid fibromatosis (DF) is a rare and locally infiltrative monoclonal fibroblastic proliferation arising from connective tissues, with lack of metastatic potential. About 10% of all DF cases are intra-abdominally sited. Complications in this site, due to the locally infiltrative nature of the disease, may be severe and potentially life threatening. However, data on incidence, management, and outcome of these complications are limited.

AIM: Data of patients with sporadic or FAP-related intra-abdominal DF treated at Istituto Nazionale dei Tumori (INT) in Milano from 2005 to 2020 who developed a serious complication during the course of their disease were retrospectively collected and analyzed with a descriptive statistics.

METHODS AND RESULTS: Out of 72 intra-abdominal DF, 8 cases were identified (M/F: 5/3, median age: 35 years, FAP-related/sporadic: 2/6): 3 with bowel obstruction, 5 with bowel perforation. In 4 cases the serious complication was the first evidence of disease; in the other 4 cases it occurred at a time interval from diagnosis in the range of 4-44 months (during an active surveillance program in one case and during chemotherapy in the other 3 cases). A surgical treatment was feasible and successful in 5 cases. In 3 surgically unmanageable patients, all progressing and experiencing acute complications while on chemotherapy, a non-surgical approach with intensive supportive treatment and with a prompt change of chemotherapy regimen was implemented, being successful in two, the other patient dying due to a concomitant progressive lymphoma thereafter.

CONCLUSION: In this series of intra-abdominal DF, the incidence of serious complications was 11%. Most patients were successfully treated with surgery. When surgery was deemed to be unfeasible, a conservative management with intensive supportive care and a careful choice of chemotherapy was adopted, ensuring a favorable outcome in most.

PMID:34165246 | DOI:10.1002/cnr2.1411

J Cell Mol Med. 2021 Jun 24. doi: 10.1111/jcmm.16736. Online ahead of print.

ABSTRACT

Irritable bowel syndrome (IBS) is a gut-brain disorder in which symptoms are shaped by serotonin acting centrally and peripherally. The serotonin transporter gene SLC6A4 has been implicated in IBS pathophysiology, but the underlying genetic mechanisms remain unclear. We sequenced the alternative P2 promoter driving intestinal SLC6A4 expression and identified single nucleotide polymorphisms (SNPs) that were associated with IBS in a discovery sample. Identified SNPs built different haplotypes, and the tagging SNP rs2020938 seems to associate with constipation-predominant IBS (IBS-C) in females. rs2020938 validation was performed in 1978 additional IBS patients and 6,038 controls from eight countries. Meta-analysis on data from 2,175 IBS patients and 6,128 controls confirmed the association with female IBS-C. Expression analyses revealed that the P2 promoter drives SLC6A4 expression primarily in the small intestine. Gene reporter assays showed a functional impact of SNPs in the P2 region. In silico analysis of the polymorphic promoter indicated differential expression regulation. Further follow-up revealed that the major allele of the tagging SNP rs2020938 correlates with differential SLC6A4 expression in the jejunum and with stool consistency, indicating functional relevance. Our data consolidate rs2020938 as a functional SNP associated with IBS-C risk in females, underlining the relevance of SLC6A4 in IBS pathogenesis.

PMID:34165249 | DOI:10.1111/jcmm.16736

Pediatr Allergy Immunol. 2021 Jun 23. doi: 10.1111/pai.13582. Online ahead of print.

ABSTRACT

BACKGROUND: Maternal vitamin D status during pregnancy has been linked with the risk of atopic dermatitis (AD) in children, while the results were inconsistent. The objective of this study was to assess the potential association.

METHODS: Serum 25-hydroxyvitamin D (25(OH)D) levels were measured in pregnant women from the birth cohort MKFOAD. Infant AD was diagnosed according to Williams’ criteria. Multivariate logistic regression model was used to examine the association of maternal serum 25(OH)D levels in the first, second and third trimester of gestation with the risk of infant AD at first year of age.

RESULTS: In total, 121 (26.5%) of 456 infants developed AD prior to 1 year of age. In general, higher maternal serum 25(OH)D levels throughout pregnancy were associated with increased risks of AD in infants prior to 1 year of age in multivariate logistic regression models, with borderline statistical significance in the first (per ln unit increase: adjusted OR = 1.93, 95% CI: 0.96, 3.88) and second (per ln unit increase: adjusted OR = 1.72, 95% CI: 0.93, 3.19) trimester. Multivariate logistic regression models using categorical variables of maternal 25(OH)D levels by tertiles showed similar results: infants born to mothers with serum 25(OH)D levels in the highest tertile had higher risk of AD than those with 25(OH)D in the lowest tertile.

CONCLUSIONS: The present study found some evidence supporting that higher maternal 25(OH)D levels during pregnancy increased the risk of infant AD. However, the clinical implication of the findings should be limited for those with blood levels over the recommendations.

PMID:34165218 | DOI:10.1111/pai.13582

Nephrology (Carlton). 2021 Jun 24. doi: 10.1111/nep.13915. Online ahead of print.

ABSTRACT

BACKGROUND: As renin angiotensin system inhibitors (RASi) are widely used in the clinic, early worsening of kidney function (EWKF) after RASi therapy deserves attention, as its clinical significance is unknown. The aim was to evaluate the relationship between EWKF and long-term outcomes including all-cause mortality, kidney and cardiovascular events, in all the patients treated with RASi.

METHODS: We searched PubMed, Embase and the Cochrane databases for controlled trials that compared the outcomes of patients with and without EWKF after RASi treatment. Our primary outcome was all-cause mortality, and secondary outcomes were kidney and cardiovascular events. We pooled data using a random effects model.

RESULTS: A total of 10 studies were enrolled, of which 8 were randomized trials (including 33 454 patients) and 2 were observational studies (including 148 144 patients). Of the 8 randomized trials, 4996 patients with type 2 diabetes, 19 118 with HF, and 9340 with atherosclerotic vascular disease and diabetes with end-organ damage. Both observational studies investigated all kinds of patients with initially RASi treatment. In patients with RASi, the EWKF group had a higher risk of all-cause mortality than the no-EWKF group in the randomized studies (n = 12 254; RR, 1.22; 95%CI, 1.04-1.42; P = 0.02) and in observational studies (n = 148 144; OR, 1.70; 95%CI, 1.43-2.01; P < 0.00001). In patients who experienced EWKF (n = 2246), no statistically significant difference was found between the efficacy of RASi and placebo in all-cause mortality (n = 1762; RR, 0.85; 95%CI, 0.68-1.06; P = 0.14).

CONCLUSION: RASi treatment led to an increased incidence of EWKF which was associated with poorer long-term outcomes. As the benefit of RAS blockade to patients with EWKF was limited, we suggest clinicians use RASi with caution when EWKF occurs.

PMID:34165226 | DOI:10.1111/nep.13915

Kathmandu Univ Med J (KUMJ). 2020 Oct.-Dec.;18(72):407-413.

ABSTRACT

Background Nutrition is believed to be very essential for socio economic development of the country and is an essential component of sustainable development goals. Malnutrition is a major public health problem in Nepal and is more common among under-five year children. Malnutrition among children is complex problem globally, affecting the physical, mental and social development. Objective To estimate the prevalence and explore the associated factors of malnutrition in study population. Method It was a community based cross-sectional study conducted among rural population of Nepal. Wards were selected by simple random sampling technique and household in each ward were selected by systemic random sampling. The mothers of 302 participants aged 12 to 59 months were interviewed for requisite information using pretested questionnaire and anthropometric measurements were taken using standard technique for each participant. Statistical Package for Social Sciences (SPSS) version 16.0 was used for data analysis. Result The prevalence of underweight, stunting and wasting was 36.8%, 37.5%, and 14.6% respectively. We found statistical significant association between underweight and children in lower age group, larger family size, lower level of mother’s education and illness in past one month. Factors that are significantly associated with stunting are children in lower age group, lower level of mother’s education and illness in past one month and wasting is significantly associated with children in lower age group. Conclusion This study showed the prevalence of malnutrition is high in study population. Factors associated with malnutrition were child’s age, family size, mother’s education and illness in past one month.

PMID:34165101