Tag: statistics

Int Urol Nephrol. 2021 Mar 6. doi: 10.1007/s11255-021-02805-x. Online ahead of print.

ABSTRACT

PURPOSE: Intradialytic hypotension (IDH) is a serious complication in dialysis patients. Diuretics might reduce the incidence of IDH by decreasing ultrafiltration. However, the effect of diuretics on IDH in maintenance dialysis patients is still unclear.

METHODS: We searched Medline, Embase, the Cochrane Library, China National Knowledge Infrastructure and clinical trials registries from 1945 to May 2019. Randomized controlled trials (RCTs) or observational studies about IDH in maintenance dialysis with diuretics were included.

RESULTS: Seven studies including 28,226 patients were included, of which 4 were RCTs involving mineralocorticoid receptor antagonists (MRAs) and 3 were observational studies involving loop diuretics. There was a trend that a lower incidence rate of IDH in maintenance dialysis patients who used loop diuretics than control, although the result was not statistically significant (OR 0.65, 95% CI 0.34-1.22, P = 0.18). Similarly, lower incidence rate of all-cause mortality (OR 0.92, 95% CI 0.87-0.99; P = 0.02) and cardiovascular (CV) mortality (OR 0.86, 95% CI 0.75-0.99, P = 0.03) in dialysis patients who used loop diuretics than control. On the contrary, there were no significant difference in the incidence of IDH (OR 1.35, 95% CI 0.78-2.34, P = 0.29) and all-cause mortality (OR 0.73, 95% CI 0.26-2.01; P = 0.54) and CV mortality (OR 0.57, 95% CI 0.14-2.25; P = 0.42) in maintenance dialysis patients who used MRAs compared with control.

CONCLUSION: Loop diuretics, but not MRAs, might have a potential benefit to reduce the incidence rate of IDH, all-cause mortality and CV mortality. More high-quality studies are needed to strengthen the arguments.

PMID:33675484 | DOI:10.1007/s11255-021-02805-x

J Med Syst. 2021 Mar 6;45(4):50. doi: 10.1007/s10916-021-01726-7.

ABSTRACT

The COVID-19 pandemic changed expectations for information dissemination and use around the globe, challenging accepted models of communications, leadership, and social systems. We explore how social media discourse about COVID-19 in Italy was affected by the rapid spread of the virus, and how themes in postings changed with the adoption of social distancing measures and non-pharmaceutical interventions (NPI). We used topic modeling and social network analysis to highlight critical dimensions of conversations around COVID-19: 1) topics in social media postings about the Coronavirus; 2) the scope and reach of social networks; and 3) changes in social media content as the nation moved from partial to full social distancing. Twitter messages sent in Italy between February 11th and March 10th, 2020. 74,306 Tweets sent by institutions, news sources, elected officials, scientists and social media influencers. Messages were retweeted more than 1.2 million times globally. Non-parametric chi-square statistic with residual analysis to identify categories, chi-square test for linear trend, and Social Network Graphing. The first phase of the pandemic was dominated by social media influencers, followed by a focus on the economic consequences of the virus and placing blame on immigrants. As the crisis deepened, science-based themes began to predominate, with a focus on reducing the spread of the virus through physical distancing and business closures Our findings highlight the importance of messaging in social media in gaining the public’s trust and engagement during a pandemic. This requires credible scientific voices to garner public support for effective mitigation. Fighting the spread of an infectious disease goes hand in hand with stemming the dissemination of lies, bad science, and misdirection.

PMID:33675427 | DOI:10.1007/s10916-021-01726-7

Insights Imaging. 2021 Mar 6;12(1):31. doi: 10.1186/s13244-021-00977-9.

ABSTRACT

With the development of machine learning (ML) algorithms, a growing number of predictive models have been established for predicting the therapeutic outcome of patients with hepatocellular carcinoma (HCC) after various treatment modalities. By using the different combinations of clinical and radiological variables, ML algorithms can simulate human learning to detect hidden patterns within the data and play a critical role in artificial intelligence techniques. Compared to traditional statistical methods, ML methods have greater predictive effects. ML algorithms are widely applied in nearly all steps of model establishment, such as imaging feature extraction, predictive factor classification, and model development. Therefore, this review presents the literature pertaining to ML algorithms and aims to summarize the strengths and limitations of ML, as well as its potential value in prognostic prediction, after various treatment modalities for HCC.

PMID:33675433 | DOI:10.1186/s13244-021-00977-9

Eur J Epidemiol. 2021 Mar 6. doi: 10.1007/s10654-021-00730-y. Online ahead of print.

ABSTRACT

To investigate whether physical and cognitive fitness measured in late adolescence was associated with future risk of Parkinson’s disease (PD). The cohort included 1,259,485 Swedish men with physical fitness, body mass index (BMI), resting heart rate (RHR), blood pressure, intelligence quotient (IQ), and stress resilience measured at the age of 17-20 in relation to conscription. Incident cases of PD were ascertained from the Swedish Patient Register. Hazard ratios were estimated from Cox models, after controlling for multiple confounders. We further performed Mendelian randomization (MR) analyses to assess the causality of the associations, using GWAS summary statistics with > 800,000 individuals. During follow-up, we identified 1,034 cases of PD (mean age at diagnosis = 53). Men with an RHR > 100 beats per minute had a higher risk of PD compared to men with an RHR of 60-100 beats per minute (HR = 1.47; 95% CI = 1.08-1.99). Men with IQ above the highest tertile had a higher risk of PD compared to men with an IQ below the lowest tertile (HR = 1.46; 95% CI = 1.19-1.79). We found no association for physical fitness, BMI, blood pressure, or stress resilience. A causal relationship was suggested by the MR analysis between IQ and PD, but not between RHR and PD. RHR and IQ in late adolescence were associated with a higher risk of PD diagnosed at relatively young age. The association of IQ with PD is likely causal, whereas the association of RHR with PD suggests that altered cardiac autonomic function might start before 20 years of age in PD.

PMID:33675447 | DOI:10.1007/s10654-021-00730-y

Curr Microbiol. 2021 Mar 6. doi: 10.1007/s00284-021-02376-1. Online ahead of print.

ABSTRACT

By increasing the environmental pollution, crop losses, and side effects of chemically synthesized vitamins; new vitamin sources should be included. Through this study, we introduce novel riboflavin bacterial producer Novosphingobium panipatense-SR3 (MT002778) and tested various nutritional factors with interactions effects on the production abilities. Yeast extract, maltose, and glycine were the best nitrogen, carbon, and amino acid sources for enhancing the production, respectively. The interaction between the previous factors with three concentrations of each (+, 0, -) studied statistically using Box-Behnken statistical quadric design 13- run. The perfect interaction increases the production to 497.12 mg/l (predicted 489.45 mg/l) using 30 g/l maltose, 10 g/l yeast extract, and 1 g/l glycine. The F and P- values of the tested model of riboflavin and OD600 indicating significant results with probability ≤ 0.05. Also, the evaluating statistical parameter coefficient (R²) was 0.994 of riboflavin and 0.992 of OD600 with adjusted R² value 0.976, and 0.967, respectively, which indicated that the whole variations were explained highly by the statistical model. The novel producer proved its high riboflavin production ability especially under the optimized conditions comparing with previous producers and represents a new high-speed riboflavin producer that could utilize in the industrial process.

PMID:33675404 | DOI:10.1007/s00284-021-02376-1

Rheumatol Int. 2021 Mar 6. doi: 10.1007/s00296-021-04807-5. Online ahead of print.

ABSTRACT

In this double-blind, controlled, cross-sectional study, we compared structural changes in the cervical vertebrae of patients with nonradiographic axial spondyloarthropathy (nr-axSpA), patients with ankylosing spondylitis (AS), and a control group. We used the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) to determine whether the involvement of the cervical spine occurs earlier and is more severe than that of the lumbar spine in axial spondyloarthropathy (axSpA). A statistically significant difference was found in the total mSASSS between the AS and nr-axSpA groups (p = 0.038), but not in the cervical and lumbar mSASSS. Although the duration of the symptoms was shorter in the nr-axSpA group than in the AS group, no statistically significant difference was found in the cervical mSASSS between the AS and nr-axSpA groups. In both the AS and nr-axSpA groups, the cervical mSASSS values were found to be higher than the lumbar mSASSS values for the majority of the patients (82.8 and 89.5%, respectively). This may indicate that structural changes in the cervical spine occur during an early period of axSpA.

PMID:33675418 | DOI:10.1007/s00296-021-04807-5

J Neurol. 2021 Mar 6. doi: 10.1007/s00415-021-10494-w. Online ahead of print.

ABSTRACT

BACKGROUND: For most viral encephalitides, therapy is merely supportive. Intravenous immunoglobulins (IVIG) have been used as a prophylactic and therapeutic approach. We conduct a systematic review on the safety and efficacy of IVIG in viral encephalitis.

METHODS: We conducted a systematic review assessing PubMed, Cochrane Database, Biosis Previews and the ClinicalTrials.gov website to identify all reports on patients with viral encephalitis treated with IVIG as of May 31, 2019. The main outcomes assessed were therapeutic efficacy and safety. For an increased homogeneity of the population, atypical viral infections were excluded, as were reports on prophylactic IVIG use, intrathecal application of immunoglobulins, or use of antibody-enriched IVIG-preparations. Data were extracted from published studies. Descriptive statistics were used.

RESULTS: We included a total of 44 studies (39 case reports). The case reports cover a total of 53 patients. Our search retrieved two prospective and three retrospective studies. These show heterogeneous results as to the efficacy of IVIG therapy. Only one study reports a significant association between IVIG-use and death (odds ratio 0.032; 95% confidence interval 0.0033-0.3024; p = 0.0027). None of the studies report significant differences in the number of serious adverse events.

CONCLUSION: Data on the efficacy of IVIG-therapy is heterogeneous. While it seems generally safe, evident superiority compared to supportive treatment has not been demonstrated so far. Future trials should also investigate the optimal dosing and timing of IVIG and their benefit in the immunosuppressed.

PMID:33675421 | DOI:10.1007/s00415-021-10494-w

Theor Appl Genet. 2021 Mar 6. doi: 10.1007/s00122-021-03778-2. Online ahead of print.

ABSTRACT

Adaptation to abiotic stresses such as high-temperature conditions should be considered as its independent components of total performance and responsiveness. Understanding and identifying improved adaptation to abiotic stresses such as heat stress has been the focus of a number of studies in recent decades. However, confusing and potentially misleading terminology has made progress difficult and hard to apply within breeding programs selecting for improved adaption to heat stress conditions. This study proposes that adaption to heat stress (and other abiotic stresses) be considered as the combination of total performance and responsiveness to heat stress. In this study, 1413 doubled haploid lines from seven populations were screened through a controlled environment assay, subjecting plants to three consecutive eight hour days of an air temperature of 36 °C and a wind speed of 40 km h^-1, 10 days after the end of anthesis. QTL mapping identified a total of 96 QTL for grain yield determining traits and anthesis date with nine correlating to responsiveness, 72 for total performance and 15 for anthesis date. Responsiveness QTL were found both collocated with other performance QTL as well as independently. A sound understanding of genomic regions associated with total performance and responsiveness will be important for breeders. Genomic regions of total performance, those that show higher performance that is stable under both stressed and non-stressed conditions, potentially offer significant opportunities to breeders. We propose this as a definition and selection target that has not previously been defined for heat stress adaptation.

PMID:33675373 | DOI:10.1007/s00122-021-03778-2

Pediatr Radiol. 2021 Mar 6. doi: 10.1007/s00247-021-05019-6. Online ahead of print.

ABSTRACT

BACKGROUND: Ultrasound (US)-guided tunneled femoral peripherally inserted central catheters (PICCs) are a safe central venous access option in infants and neonates. Studies have shown, however, that femoral central venous access has the potential for high central line-associated bloodstream infection (CLABSI) rates with a significant increase in risk around line day 30, though no studies have evaluated these risks exclusively for tunneled femoral PICCs.

OBJECTIVE: The primary purpose of this study was to evaluate the relationship between line duration and the risk of CLABSI in tunneled femoral PICCs in children.

MATERIALS AND METHODS: Four hundred forty-five patients (196 females, 249 males; median age: 49.4 days; median weight: 3.7 kg) who underwent 573 tunneled femoral PICC placements or exchanges from Jan. 1, 2017, to Jan. 31, 2020, were included in the study. All tunneled femoral PICCs were placed using US technique and catheter specifications, including catheter size (French) and length (cm), were retrieved from the electronic medical record. The location of the PICC placement, the number of lumens, the laterality of placement, and the patient’s age and weight were also recorded. Only non-mucosal barrier injury CLABSIs, according to the Centers for Disease Control and Prevention (CDC) definitions, were counted as CLABSI for this study. The number of central line days until a CLABSI event was analyzed with an accelerated failure time model using the exponential, Weibull, and log-normal distributions to determine the probability of a CLABSI over time, taking into consideration the recorded covariates.

RESULTS: Tunneled femoral PICC placements accounted for 14,855 line days, during which 20 non-mucosal barrier injury CLABSIs (CLABSI rate of 1.35 per 1,000 line days) occurred during the study period. The highest CLABSI rate occurred in PICCs placed in the neonatal intensive care unit (NICU) at 2.01 per 1,000 line days and the lowest occurred in PICCs placed in interventional radiology at 0.26 per 1,000 line days. Overall, PICCs placed outside of interventional radiology had a CLABSI rate of 1.72 per 1,000 line days. The CLABSI rate during the first 30 days a line was in situ was lower than the rate after 30 days (0.51 per 1,000 line days vs. 3.06 per 1,000 line days, respectively). Statistical modeling and hazard estimation using the Akaike information criterion corrected for small sample size (AICc)-average of log-normal, Weibull and exponential distributions demonstrate the daily risk of CLABSI rapidly increases from day 1 to day 30, with the risk remaining high for the duration of line days.

CONCLUSION: While tunneled femoral PICCs are a relatively safe and effective central venous access alternative, the rate of CLABSI appears to rapidly increase with increasing line days until around day 30 and then remains high thereafter.

PMID:33675377 | DOI:10.1007/s00247-021-05019-6

J Cancer Res Clin Oncol. 2021 Mar 6. doi: 10.1007/s00432-021-03573-y. Online ahead of print.

ABSTRACT

OBJECTIVE: During the COVID-19 pandemic, tumor patients not only perceived fears and worries but were experiencing also positive changes as the perception of nature and silence, moments of wondering awe, and more intense relationships. We intended to analyze whether these perceptions may differ between patients from waves 1 and 2 of the pandemic.

METHODS: Cross-sectional study at two time periods (May to June, sample 1) and September to November 2020 (sample 2) with standardized questionnaires (i.e. WHO-5, MLQ, PCQ-12).

RESULTS: Patients from sample 1 (n = 292) and sample 2 (n = 221) did not differ with respect to gender, age, partner or tumor status. Most are still “irritated by statements about danger and course of the infection” (58%) and are “worrying to be infected and to have complicated course of disease” (55%). Neither their well-being nor meaning in life nor fears and worries were significantly different. In sample 2 patients, Worrying reflections and loneliness scored significantly lower, while their Perception of nature and silence was lower in trend only; more intense relationships are still relevant. Moments of wondering awe and religious trust were perceived less often during wave 2. Particularly religious patients scored stronger for Perception of nature and silence and Worrying reflections and loneliness.

CONCLUSION: Oncologists/psychologist have to know that patients’ situation has not changed within the time of pandemic and that they still require information, close support and encouragement to rely on their resources to cope. Perceived changes are reflecting coping strategies that could be trained to increase patients’ resilience during further pandemic waves.

PMID:33675401 | DOI:10.1007/s00432-021-03573-y