Tag: statistics

Yonsei Med J. 2022 Feb;63(2):187-194. doi: 10.3349/ymj.2022.63.2.187.

ABSTRACT

PURPOSE: A pilot project using epinephrine at the scene under medical control is currently underway in Korea. This study aimed to determine whether prehospital epinephrine administration is associated with improved survival and neurological outcomes in out-of-hospital cardiac arrest (OHCA) patients who received epinephrine during cardiopulmonary resuscitation (CPR) in the emergency department.

MATERIALS AND METHODS: This retrospective observational study used a nationwide multicenter OHCA registry. Patients were classified into two groups according to whether they received epinephrine at the scene or not. The associations between prehospital epinephrine use and outcomes were assessed using propensity score (PS)-matched analysis. Multivariable logistic regression analysis was performed using PS matching. The same analysis was repeated for the subgroup of patients with non-shockable rhythm.

RESULTS: PS matching was performed for 1084 patients in each group. Survival to discharge was significantly decreased in the patients who received prehospital epinephrine [odds ratio (OR) 0.415, 95% confidence interval (CI) 0.250-0.670, p<0.001]. However, no statistical significance was observed for good neurological outcome (OR 0.548, 95% CI 0.258-1.123, p=0.105). For the patient subgroup with non-shockable rhythm, prehospital epinephrine was also associated with lower survival to discharge (OR 0.514, 95% CI 0.306-0.844, p=0.010), but not with neurological outcome (OR 0.709, 95% CI 0.323-1.529, p=0.382).

CONCLUSION: Prehospital epinephrine administration was associated with decreased survival rates in OHCA patients but not statistically associated with neurological outcome in this PS-matched analysis. Further research is required to investigate the reason for the detrimental effect of epinephrine administered at the scene.

PMID:35083905 | DOI:10.3349/ymj.2022.63.2.187

Dent Traumatol. 2022 Jan 26. doi: 10.1111/edt.12732. Online ahead of print.

ABSTRACT

BACKGROUND/AIM: Mouthguard thickness influences the protection ability from orofacial trauma. The aim of this study was to propose a new design for mouthguards and to evaluate the effect of the lamination order on the thicknesses of mouthguards.

MATERIALS AND METHODS: Mouthguard sheets of 2.0-mm and 4.0-mm ethylene vinyl acetate were used. The sheets were pressure formed using a pressure former. Two lamination conditions were examined: The condition 24P used the 2.0-mm sheet as the first layer and 4.0-mm sheet as the second layer. The condition 42P used the 4.0-mm sheet as the first layer and 2.0-mm sheet as the second layer. The first layer was trimmed to cover only the anterior region, and then the second layer was formed over the first layer. Mouthguard thickness was measured using a measuring device at the labial surface of the central incisor, plus the buccal and occlusal surfaces of the first molar. Differences in thickness by measurement region of mouthguards formed under different lamination conditions were analyzed by two-way analysis of variance.

RESULTS: Mouthguard thickness differed among the regions at the central incisors and the first molars (p < .01). The thickness at the labial surface of the central incisor became statistically significantly larger with the 42P condition (3.38 mm) than with the 24P condition (3.30 mm) (p < .05). The thickness at the buccal and occlusal surfaces of the first molar became statistically significantly larger with the 24P condition (2.25 mm and 2.72 mm, respectively) than with the 42P condition (1.23 mm and 1.44 mm, respectively) (p < .01).

CONCLUSIONS: The results suggest that the combination of the 2.0-mm and 4.0-mm sheets could obtain the necessary thickness for the prevention at the labial surface of the central incisor and buccal surface of the first molar.

PMID:35083841 | DOI:10.1111/edt.12732

J Esthet Restor Dent. 2022 Jan 27. doi: 10.1111/jerd.12877. Online ahead of print.

ABSTRACT

OBJECTIVE: Bi-layer zirconia-based posterior fixed dental prostheses (FDPs) have reportedly a high incidence of veneering ceramic fractures. The CADon technique employs zirconia frameworks veneered with milled lithium disilicate glass-ceramic to overcome these shortcomings but long-term clinical studies are missing. This study evaluated the clinical efficacy of posterior 3-unit CADOn FDPs over a 5-year period.

MATERIALS AND METHODS: A total of 25 patients, 16 male and 9 female with a mean age of 55.6 years, received a total of 25 posterior three-unit CADOn FDPs. Patients were recalled for baseline and for follow-up visits at 6, 12, 24, and 60 months. Parameters evaluated were fracture, marginal adaptation, marginal discoloration, wear, polish, color match, surface staining, and retention of these restorations as well as secondary caries of the abutment teeth.

RESULTS: A total of 21 FDPs evaluated at 60-months revealed a 100% survival rate. All evaluated clinical parameters were satisfactory (alpha or bravo) and there was no statistically significant difference at different time points, except for surface staining, which was also worse at 60 months compared to baseline (p $\le$ 0.001).

CONCLUSIONS: CADOn three-unit posterior FDPs demonstrate excellent fracture resistance after 5 years of clinical function. All evaluated clinical parameters were satisfactory, except for surface stain, which also increased over time.

CLINICAL SIGNIFICANCE: Conventionally veneered bi-layer zirconia-based posterior FDPs have limited clinical success. Based on this study, alternative methods such as zirconia frameworks veneered with milled lithium disilicate glass-ceramic provide a viable alternative with excellent long-term clinical outcomes.

PMID:35083844 | DOI:10.1111/jerd.12877

Psychooncology. 2022 Jan 26. doi: 10.1002/pon.5889. Online ahead of print.

ABSTRACT

BACKGROUND: Screening glioma patients regularly for possible mood disorders may facilitate early identification and referral of patients at risk. This study evaluated if the EORTC QLQ-C30 Emotional Functioning (EF) scale could be used as an initial screening measure to identify patients possibly having a mood disorder.

METHODS: EORTC QLQ-C30 EF and Hospital Anxiety and Depression Scale (HADS) scores were collected as part of a study assessing the impact of timing of patient-reported outcome assessments on actual health-related quality of life outcomes (N=99). Spearman correlations and Mann-Whitney U tests were used to determine the association between the EF and HADS (sub)scales. Receiver Operating Characteristic analyses were performed to determine optimal cut-off EF scores to identify patients possibly having a mood disorder (i.e. HADS subscale score ≥8 points).

RESULTS: EF and HADS (sub)scales correlated moderately (HADS-A: r=-0.65; HADS-D: r=-0.52). Significant EF score differences were found between patients with HADS ≥8 vs. <8 points (HADS-A: mean difference (MD)=32 and HADS-D: MD=23). The EF scale had excellent (HADS-A; AUC=0.88) and borderline excellent (HADS-D; AUC=0.78) distinguishing capabilities. A statistically optimal (EF score<80) and a most inclusive (sensitivity of 100%, corresponding to an EF score<97) EF cut-off score correctly identified 88.0% and 96.0% of patients with a possible mood disorder, respectively.

CONCLUSION: EORTC QLQ-C30 EF scale seems to be an appropriate screening measure to identify glioma patients possibly having a mood disorder in need of further assessment. This article is protected by copyright. All rights reserved.

PMID:35083812 | DOI:10.1002/pon.5889

Pediatr Transplant. 2022 Jan 26:e14229. doi: 10.1111/petr.14229. Online ahead of print.

ABSTRACT

BACKGROUND: Medulloblastoma outcomes have improved with craniospinal irradiation and chemotherapy, but such therapy has resulted in poor neurocognitive outcomes for young patients. Chemotherapy-only regimens with autologous transplant have been implemented with the intention of avoiding radiation. It is not yet known whether single or tandem transplantation is superior with respect to efficacy and/or safety.

METHODS: We performed a retrospective review of children with medulloblastoma treated at Dana-Farber Cancer Institute from 1996 to 2016 who received either single or tandem autologous transplantation after completion of induction chemotherapy. We compared safety and outcome data between the two groups.

RESULTS: Among 23 patients, 12 received tandem transplants. Median follow-up was 6.4 years (IQR = 0.8-10.5). There was no statistically significant difference in 5-year EFS or OS between the single (70.7 ± 14%, 80.2 ± 13%) and tandem transplant groups (57.1 ± 15%, 79.6 ± 13%). Seven tandem transplant patients received subsequent radiation while only four required radiation in the single transplant group (p = .41). In the single transplant regimen, patients experienced longer antibiotic duration (p = .03) and LOS (p = .01) and a trend toward increased number of transfusions (p = .06). Four cases of veno-occlusive disease were reported in the single transplant group (p = .04).

CONCLUSIONS: Outcomes were similar between regimens, but the single transplant regimen had more hepatic complications. These data suggest that tandem transplant regimens may have reduced toxicity compared to the single transplant regimen with similar outcome measures.

PMID:35083822 | DOI:10.1111/petr.14229

Eur J Neurosci. 2022 Jan 26. doi: 10.1111/ejn.15612. Online ahead of print.

ABSTRACT

Resting-state functional magnetic resonance imaging (fMRI) has provided solid evidence that the default-mode network (DMN) is implicated in self-referential processing. The functional connectivity of the DMN has also been observed in tasks where self-referential processing leads to self-prioritization (SPE) in perception and decision-making. However, we are less certain about whether (i) SPE solely depends on the interplay within parts of the DMN or is driven by multiple brain networks; and (ii) whether SPE is associated with a unique component of interconnected networks or can be explained by related effects such as emotion prioritization. We addressed these questions by identifying and comparing topological clusters of networks involved in self-and emotion prioritization effects generated in an associative-matching task. Using network-based statistics, we found that SPE controlled by emotion is supported by a unique component of interacting networks, including the medial prefrontal part of the DMN (MPFC), Frontoparietal network (FPN) and insular Salience network (SN). This component emerged as a result of a focal effect confined to few connections, indicating that interaction between DMN, FPC and SN is critical to cognitive operations for the SPE. This result was validated on a separate data set. In contrast, prioritization of happy emotion was associated with a component formed by interactions between the rostral prefrontal part of SN, posterior parietal part of FPN and the MPFC, while sad emotion reveals a cluster of the DMN, Dorsal Attention Network (DAN) and Visual Medial Network (VMN). We discussed theoretical and methodological aspects of these findings within the more general domain of social cognition.

PMID:35083806 | DOI:10.1111/ejn.15612

Int J Health Plann Manage. 2022 Jan 26. doi: 10.1002/hpm.3423. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the level of neighbourhood inequalities in infant mortality (IM) rates in the urban core of four world cities and to examine the association between neighbourhood-level income and IM. We compare our findings with those published in 2004 to better understand how these city health systems have evolved.

METHODS: We compare IM rates among and within the four cities using data from four periods: 1988-1992; 1993-1997; 2003-2008 and 2012-2016. Using a maximum-likelihood negative binomial regression model that controls for births, we predict the relationship between neighbourhood-level income and IM.

RESULTS: IM rates have declined in all four cities. Neighbourhood-level income is statistically significant for New York and, for the two most recent periods, in Paris. In contrast, there is no significant relationship between neighbourhood income and IM in London or Tokyo.

CONCLUSIONS: Despite programmes to reduce IM inequalities at national and local levels, these persist in New York. Until the early part of this century, none of the other cities experienced a relationship between neighbourhood income and IM, but growing income inequalities within Paris have changed this situation and it now has geographic inequalities that are comparable to Manhattan.

POLICY IMPLICATIONS: Policy-makers in these cities should focus on better understanding the social and economic factors associated with neighbourhood inequalities in IM.

PMID:35083793 | DOI:10.1002/hpm.3423

J Clin Lab Anal. 2022 Jan 26:e24251. doi: 10.1002/jcla.24251. Online ahead of print.

ABSTRACT

OBJECTIVES: To explore the immune-related genetic susceptibility of human leukocyte antigen (HLA) alleles and their correlation with panel reactive antibody (PRA) generation during end-stage renal disease (ESRD) progression.

MATERIALS AND METHODS: Data of the expression patterns of HLA-A, -B, and -DR alleles and PRAs of 347 ESRD patients awaiting renal transplantation in Hunan Province from 2015 to 2019 were retrospectively studied. The polymerase chain reaction with sequence-specific primers was used for HLA genotyping and the enzyme-linked immunosorbent assay for PRA detection. SPSS 21.0 software was used for all allele frequency and statistical analyses.

RESULTS: Thirteen HLA-A, 25 HLA-B, and 13 HLA-DR alleles were expressed. The allele frequencies of HLA-A2, -B48, -B52, and -B55 were significantly higher in the case group than in the control group (p < 0.05), whereas that of HLA-B60 was significantly higher in the control group (p < 0.05). The frequency of HLA alleles in the PRA-positive group was significantly higher in females than in males (p < 0.05). The allele frequencies of HLA-A2, -B38, and -B46 were significantly higher in the PRA-positive group than in the PRA-negative one (p < 0.05), whereas that of HLA-60 was significantly higher in the PRA-negative group (p < 0.05).

CONCLUSION: HLA-A2, -B48, -B52, and -B55 may be the ESRD susceptibility alleles in Han Chinese patients in Hunan Province, whereas HLA-B60 may be the protective allele. Patients carrying HLA-A2, -B38, and -B46 are more likely to develop PRA positivity, whereas the opposite is true for those with HLA-B60.

PMID:35083784 | DOI:10.1002/jcla.24251

Biomed Chromatogr. 2022 Jan 26. doi: 10.1002/bmc.5348. Online ahead of print.

ABSTRACT

Chinese hamster ovary (CHO) cells have been widely used in the biopharmaceutical industry for production of therapeutic proteins. CHO cells in fed-batch cultures produce various amino acid-derived intermediate metabolites. These small molecule metabolic byproducts have proven to be critical to cell growth, culture performance, and more interestingly antibody drug productivity. Herein, we developed a liquid chromatography – high resolution mass spectrometry (LC-HRMS) based targeted metabolomics approach for comprehensive quantification of total 21 growth inhibition related metabolites generated from 14 different amino acids in CHO cell fed-batch cultures. High throughput derivatization procedures, matrix-matched calibration curves, stable isotope-labeled internal standards, and accurate mass Full MS scan were utilized in order to achieve our goal for wide scope of metabolite screening as well as validity and reliability of metabolite quantification. We further present a novel analytical strategy for extending the assay’s dynamic range by utilizing naturally occurring isotope M+1 ion as a quantification analogue in the circumstances where the principal M ion is beyond its calibration range. The integrated method was qualified for selectivity, sensitivity, linearity, accuracy, precision, isotope analysis and other analytical aspects to demonstrate assay robustness. We then applied this metabolomics approach to characterize metabolites of interest in a CHO cell based monoclonal antibody (mAb) production process with fed-batch bioreactor culture mode. Absolute quantification combined with multivariate statistical analysis illustrated that our target analytes derived from amino acids, especially from branched-chain amino acids, closely correlated with cell viability and significantly differentiated cellular stages in production process.

PMID:35083760 | DOI:10.1002/bmc.5348

Stat Med. 2022 Jan 26. doi: 10.1002/sim.9305. Online ahead of print.

ABSTRACT

While the serotypes of Streptococcus pneumoniae are known to compete during colonization in human hosts, our knowledge of how competition occurs is still incomplete. New insights of pneumococcal between-type competition could be generated from carriage data obtained by molecular-based detection methods, which record more complete sets of serotypes involved in co-carriage than when detection is done by culture. Here, we develop a Bayesian estimation method for inferring between-type interactions from longitudinal data recording the presence/absence of the types at discrete observation times. It allows inference from data containing co-carriage of two or more serotypes, which is often the case when pneumococcal presence is determined by molecular-based methods. The computational burden posed by the increased number of types detected in co-carriage is addressed by approximating the likelihood under a multi-state model with the likelihood of only those trajectories with minimum number of acquisition and clearance events between observation times. The proposed method’s performance was validated on simulated data. The estimates of the interaction parameters of acquisition and clearance were unbiased in settings with short sampling intervals between observation times. With less frequent sampling, the estimates of the interaction parameters became more biased, but their ratio, which summarizes the total interaction, remained unbiased. Confounding due to unobserved heterogeneity in exposure could be corrected by including individual-level random effects. In an application to empirical data about pneumococcal carriage in infants, we found new evidence for between-serotype competition in clearance, although the effect size was small.

PMID:35083763 | DOI:10.1002/sim.9305