Tag: statistics

Psychooncology. 2022 Feb 22. doi: 10.1002/pon.5909. Online ahead of print.

ABSTRACT

OBJECTIVE: The diagnosis of cancer in a child is a profoundly stressful experience. The impact on parents’ somatic health, including lifestyle-related diseases, however, is unresolved.

METHODS: We conducted a nationwide population- and register-based study with parents of all children under age 20 diagnosed with cancer in Denmark between 1998 – 2013 and parents of cancer-free children, matched (1:10) on child’s age and family type. We estimated hazard ratios (HR) with 95% confidence intervals (CI) in Cox proportional hazard models for thirteen major International Classification of Diseases-10 disease-groups, selected stress- and lifestyle-related disease-groups and investigated moderation by time since diagnosis, parental sex, and cancer type.

RESULTS: Among n=7797 parents of children with cancer compared with n=74,388 parents of cancer-free children (51% mothers, mean age 42), we found no overall pattern of increased risk for 13 broad disease-groups. We found increases in digestive system diseases (HR1.06, 95% CI1.01-1.12), genitourinary system diseases (HR 1.08, 95% CI 1.02-1.14), and neoplasms (HR 1.20, 95% CI 1.13-1.27), the latter attributable mostly to increased rates of tobacco-related cancers and mothers’ diet-related cancers.

CONCLUSIONS: This is the first attempt to document the impact of childhood cancer on parents’ somatic health. With the exception of increased risk for neoplasms, likely due to shared genetic or lifestyle factors, our findings offer the reassuring message, that the burden of caring for a child with cancer does not in general increase parents’ risk for somatic diseases. This article is protected by copyright. All rights reserved.

PMID:35194898 | DOI:10.1002/pon.5909

Eur J Neurol. 2022 Feb 23. doi: 10.1111/ene.15293. Online ahead of print.

ABSTRACT

BACKGROUND: Despite the increasing number of reports on the spectrum of neurological manifestations of COVID-19 (neuro-COVID), few studies have assessed short and long-term outcome of the disease.

METHODS: This is a cohort study enrolling adult patients with neuro-COVID seen in neurological consultation. Data were collected prospectively or retrospectively in the EAN NEuro-covid ReGistrY. The outcome at discharge was measured using the modified Rankin Scale (mRS) and defined as: “stable/improved” if mRS score was equal or lower than pre-morbid score; “worse” if the score was higher than pre-morbid score. Status at 6 months was also recorded. Demographic and clinical variables were assessed as predictors of outcome at discharge and 6 months.

RESULTS: From July 2020 to March 2021, 971 patients from 19 countries were included. 810 (83.4%) were hospitalized. 432 (53.3%) were discharged with worse functional status. Older age, stupor/coma, stroke and ICU admission were predictors of worse outcome at discharge. 132 (16.3%) died in hospital. Older age, cancer, cardiovascular complications, refractory shock, stupor/coma and ICU admission were associated with death. 262 were followed for 6 months. Acute stroke or ataxia, ICU admission and degree of functional impairment at discharge were predictors of worse outcome. 65/221 hospitalized patients (29.4%) and 10/32 non-hospitalized patients (24.4%) experienced persisting neurological symptoms/signs. 10/262 patients (3.8%) developed new neurological complaints during the 6 months of follow-up.

CONCLUSIONS: Neuro-COVID is a severe disease associated with worse functional status at discharge, particularly in older subjects and those with comorbidities and acute complications of infection.

PMID:35194889 | DOI:10.1111/ene.15293

Phytochem Anal. 2022 Feb 22. doi: 10.1002/pca.3104. Online ahead of print.

ABSTRACT

INTRODUCTION: Forsythia suspensa (Thunb.) Vahl (FS), the fruit of Oleaceae plants, as a large part of traditional Chinese medicine, is classified as “Qingqiao (Q)” and “Laoqiao (L)” based on the harvest time. Because the maturation of FS is a gradual process, its accurate identification based on different maturity levels is an important issue.

OBJECTIVES: We suggest colorimetric, electronic tongue, and high-performance liquid chromatography (HPLC) characteristic fingerprints to discriminate FS in different harvest periods.

MATERIAL AND METHODS: First, FS fruits from different harvest times were collected, and then, their colour parameters, E-tongue sensory properties, HPLC characteristic fingerprints, and contents of nominal ingredients were determined. Finally, multivariate statistical analyses, including three-dimensional scatter plots, hierarchical cluster, principal component, linear discriminant, similarity, and partial least squares discriminant analyses were performed.

RESULTS: The results demonstrated that the three experimental techniques could effectively discriminate FS based on different harvest times with 100% accuracy. Under the qualitative conditions, nine common peaks were identified in the HPLC fingerprints of 60 samples, among which, six peaks [variable importance in projection (VIP) > 1] could be used as index peaks for qualitative identification. In fact, the contents of quality marker components, including forsythin, phillygenin, rutin and forsythoside A, were significant different (P < 0.001) at different harvest times. Interestingly, the quality markers not only accurately reflected the maturity of FS but also showed close correlations with the colour parameters and sensory E-tongue responses.

CONCLUSION: In our present investigation, bionic technologies, including a colorimeter, E-tongue analysis, and HPLC characteristic fingerprints, combined with chemometrics, were employed to develop a novel and accurate method for discriminating FS based on different harvest times.

PMID:35194875 | DOI:10.1002/pca.3104

Psychooncology. 2022 Feb 22. doi: 10.1002/pon.5908. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine whether the existing MICRA scale, which assesses impact of receiving genetic test results on individuals being assessed for cancer risk, can be successfully adapted to cancer patients experiencing prolonged waiting for results of germline genome sequencing (GS).

METHODS: Patients previously diagnosed with likely hereditary cancer (n=250) who were waiting for germline GS results completed questionnaires 3 months after baseline. We adapted the MICRA to measure anxiety associated with waiting for results, and assessed factor structure, internal consistency, test-retest reliability and construct validation.

RESULTS: Factor analysis revealed 4 factors: distress, positive experience, family support and uncertainty. Internal consistency for each sub-scale was high with the values of Cronbach’s alpha for the distress, positive experiences, family support, and uncertainty sub-scales 0.92, 0.88, 0.92, and 0.87, respectively. Test-retest reliability was poor, with intra-class correlations of 0.53, 0.13, 0.33 and .52 for the four factors, respectively. Construct validation showed large correlations between the MICRA distress and uncertainty sub-scale scores and the IES intrusion (0.42 and 0.62, respectively) and IES avoidant thinking sub-scales (0.40 and 0.58, respectively) but not the HADS sub-scales.

CONCLUSIONS: The adapted MICRA identified test-related anxiety and uncertainty in a population of cancer patients waiting for germline GS results. Results suggest that the distress and uncertainty sub-scales of the adapted measure are most useful in this context. This article is protected by copyright. All rights reserved.

PMID:35194887 | DOI:10.1002/pon.5908

NMR Biomed. 2022 Feb 22:e4717. doi: 10.1002/nbm.4717. Online ahead of print.

ABSTRACT

OBJECTIVE: To optimize the post-processing pipeline of 7 T chemical exchange saturation transfer imaging for reproducibility. To prove this optimization for the detection of age differences and differences between Parkinson patients versus normal subjects.

METHODS: The following 7 T CEST MRI experiments were analyzed: Repeated measurements of a healthy subject, subjects of two age cohorts (14 older, 7 younger subjects), and measurements of 12 Parkinson patients. A slab-selective, $B_1^{+}$ -homogeneous parallel transmit protocol was used. The post-processing consisting of motion correction, smoothing, $B_0$ -correction, normalization, denoising, $B_1^{+}$ -correction and Lorentzian fitting was optimized regarding the intra- and inter-subject coefficient of variation (CoV) of the amplitudes of the amide pool and the aliphatic rNOE pool within the brain.

RESULTS: Seven ‘tricks’ for post-processing accomplished an improvement of the mean voxel CoV of the amide pool and the aliphatic rNOE pool amplitudes below 5 % and 3 %, respectively. These post-processing steps are, image-based: 1)motion correction with interpolation of the motion of low-signal-offsets, 2)using the amide pool frequency offset image as reference; Z-spectrum-based, 3)normalization of the Z-spectrum using the outermost saturated measurements, 4) $B_0$ correction of the Z-spectrum with moderate spline smoothing, 5)denoising using principal component analysis preserving the 11 highest intensity-components, 6) $B_1^{+}$ correction using a linear fit, and 7)Lorentzian fitting using the 5-pool fit model. It turns out that that with the optimized post-processing pipeline, a significant age effect in the amide pool can be detected. Additionally, for the first time, an aliphatic rNOE contrast between subjects suffering from Parkinson’s disease and age-matched healthy controls in the substantia nigra is detected. Interpretation We propose an optimized post-processing pipeline for CEST multi-pool evaluation. It is shown that by the use of these seven ‘tricks’, the reproducibility and, thus, the statistical power of a CEST measurement can be greatly improved and subtle changes can be detected.

PMID:35194865 | DOI:10.1002/nbm.4717

Clin Oral Implants Res. 2022 Feb 23. doi: 10.1111/clr.13908. Online ahead of print.

ABSTRACT

AIM: To assess the frequency and quantity of interproximal contact loss (ICL) between implant restorations and adjacent teeth after at least 10 years of follow-up (FU).

METHODS: Thirty-nine patients (median age 57.3 years) with 80 implants were re-examined at least 10 years after insertion of final restorations (single-crowns or fixed dental prostheses (FDPs)). Baseline (insertion of the restorations) and FU examinations encompassed: stone casts were scanned and superimposed for metric assessment of tooth movements, radiographs and clinical measurements. Outcome measures at implant sites were: the extent of tooth movement and the frequency of interproximal contact loss [ICL], peri-implant marginal bone levels [MBLs], and clinical measurements (plaque control record [PCR], bleeding on probing [BOP] and probing depth [PD]). Data were analyzed statistically with generalized regression modelling with robust standard errors to account for within-patient clustering at 5%.

RESULTS: ICL for at least one contact point after 10 years was observed in 50% of all implants (with open interproximal spaces up to 1.64 mm). Mesial contact points were significantly more prone to ICL than distal ones (relative risk [RR]=1.79; 95% confidence interval [CI]=1.07-2.99; p=0.03). The type of restoration had a significant effect on ICL, with FDPs of 2 implants being significantly more prone to mesial ICL than single crowns (RR=1.52; 95% CI=1.02-2.25; p=0.04). ICL was also associated with a significant increase in PD (+0.46 mm (95% CI=0.04-0.88 mm; P=0.03)) compared to implant sites without ICL. BOP, MBLs and PCR were not significantly influenced by ICL.

CONCLUSION: ICL was a common finding in 50% of the implant sites and was significantly associated with an increase in PD.

PMID:35194854 | DOI:10.1111/clr.13908

Clin Oral Implants Res. 2022 Feb 23. doi: 10.1111/clr.13909. Online ahead of print.

ABSTRACT

OBJECTIVES: Buccal bone augmentation in the esthetic zone is routinely used to achieve optimal clinical outcomes. Nonetheless, long-term data are sparse, and it is unknown how baseline buccal bone volume affects the retention of the augmented volume over time.

MATERIAL AND METHODS: This is a long-term follow-up retrospective case series. After a preoperative computed tomography scan, implants were placed in the anterior maxilla following guided bone regeneration, autogenous block grafting, or both. At the follow-up, patients received a computed tomography scan and a clinical examination. Buccal bone volume was the primary outcome. Buccal bone thickness, peri-implant, and esthetic parameters were secondary outcomes.

RESULTS: After a median follow-up of 6.7 years (interquartile range: 4.9-9.4), 28 implants in 19 patients (median age at augmentation: 43.3 years, interquartile range: 34.4-56.7, 53% female) were followed up. Preoperative buccal bone volume at baseline (V₀ ) showed a moderate correlation to final buccal bone volume (V_t , r_s = 0.43) but a strong correlation to the absolute volumetric change (ΔV = V_t – V₀ , r_s = -0.80). A linear mixed model for V_t had a large intercept of 91.39 (p < 0.001) and a rather small slope of 0.11 for V₀ (p = 0.11). Observed differences between treatments were not statistically significant in the mixed model. V₀ above 105 mm³ predicted a negative volume change (ΔV < 0) with a specificity of 100% and a sensitivity of 96%.

CONCLUSIONS: The results suggest higher gains in sites with lower V₀ and point to a cutoff V₀ above which the augmented volume is not retained long-term.

PMID:35194845 | DOI:10.1111/clr.13909

Pediatr Dermatol. 2022 Feb 22. doi: 10.1111/pde.14935. Online ahead of print.

ABSTRACT

BACKGROUND/OBJECTIVES: The diagnostic distinction between atypical Spitz tumor (AST) and malignant melanoma (MM) in pediatric tumors is challenging. Molecular tests are increasingly used to characterize these neoplasms; however, limited studies are available in pediatric patients. This study aimed to provide a genomic comparison of pediatric MM and AST in the context of comprehensive clinical annotation.

METHODS: Pediatric patients diagnosed with MM (n=11) and AST (n=12) were compared to a cohort of 693 adult melanoma patients. DNA next-generation sequencing assessed kinase gene fusions, tumor mutational burden, sequence variants, copy number alterations, structural variants, microsatellite instability, and mutational signatures.

RESULTS: Seven AST cases and eight MM cases were successfully sequenced. Kinase gene fusions were identified in both the MM and AST cohorts (NTRK1, ROS1, and MET). MM cases had TERT, BRAF, and CDKN2A alterations, which were not identified in the AST cohort. Tumor mutational burden (TMB) analysis showed pediatric ASTs had an average of 2.82 mutations/Mb, pediatric MM had an average of 5.7 mutations/Mb, and adult MM cases averaged 18.8 mut/Mb. One pediatric MM case had an elevated TMB of 15 mutations/Mb and a UV mutational signature.

CONCLUSIONS: These data expand our understanding of pediatric malignant melanoma. The differences between the molecular signatures for AST and MM are not statistically significant, and histopathology remains the gold standard for the diagnosis of pediatric AST and MM at this time. With more data, molecular studies may provide additional support for diagnosis and targeted therapeutics.

PMID:35194848 | DOI:10.1111/pde.14935

Behav Sci Law. 2022 Feb 22. doi: 10.1002/bsl.2566. Online ahead of print.

ABSTRACT

Victims of abuse might deny their traumatic experiences. We studied mnemonic effects of simulating false denial of a child sexual abuse narrative. Participants (N = 127) read and empathized with the main character of this narrative. Next, half were instructed to falsely deny abuse-related information while others responded honestly in an interview. One week later, participants received misinformation for the narrative and interview. In a final source memory task, participants’ memory for the narrative and interview was tested. Participants who falsely denied abuse-related information endorsed more abuse-unrelated misinformation about the event than honest participants. Abuse-related false memory rates did not statistically differ between the groups, and false denials were not related to omission errors about (1) the interview and (2) narrative. Hence, victim’s memory for abuse-related information related to their experience might not be affected by a false denial, and inconsistencies surrounding the abuse-unrelated information are more likely to take place.

PMID:35194828 | DOI:10.1002/bsl.2566

Behav Sci Law. 2022 Feb 22. doi: 10.1002/bsl.2565. Online ahead of print.

ABSTRACT

Law enforcers are stressed, but they may be reluctant to seek psychological support due to the stigmatization of mental illness in the law enforcement culture. Given the relatively stigma-free lifestyle medicine intervention, a two-arm pilot randomized controlled trial was conducted in the Hong Kong police force to examine the efficacy of integrated lifestyle medicine practices in enhancing the mental health of law enforcers. A total of 18 participants were randomly assigned to the intervention and waitlist control groups. The intervention group attended a 6-week lifestyle medicine program consisting of five lifestyle factors. On analyzing the results of the Patient Health Questionnaire using a paired sample t-test, a statistically significant intervention effect was found. This implies that participants had significantly better general psychological well-being after the intervention in this pilot study. In conclusion, the present findings provide preliminary support to promote the relatively stigma-free lifestyle medicine interventions in law enforcement. Nevertheless, further research effort with a larger sample size is warranted to provide empirical support for the efficacy of integrated lifestyle medicine programme.

PMID:35194818 | DOI:10.1002/bsl.2565