Tag: statistics

Asian J Psychiatr. 2021 Sep 20;65:102866. doi: 10.1016/j.ajp.2021.102866. Online ahead of print.

ABSTRACT

Agomelatine is a novel antidepressant that was developed to counter the adverse effects associated with the standard SSRIs and SNRIs that limited their usage. Publication bias was identified in antidepressant trials which can potentially overestimate the treatment efficacy. This meta-analysis was designed to assess the overall antidepressant effect of Agomelatine by pooling all the published and unpublished studies available till date. Studies conducted on adult patients who met with the criteria for MDD that evaluated efficacy of Agomelatine at acute phase (6-12weeks) and at long term phase (24weeks) were included. The primary efficacy measured with SMD of final mean scores of HAM-D and MADRS. Secondary efficacy measures of Response, remission and safety parameters were evaluated with relative risks. RevMan version 5.4 was used for analysis of both continuous (Standardized mean difference) and dichotomous outcomes (response, remission and all cause of discontinuation). Efficacy parameters were presented with 99% confidence intervals while safety parameters were presented with 95% CI. A total of 9233 patients were included from 27 studies. In acute phase placebo controlled studies, Agomelatine had a statistically significant SMD of – 0.24 (-0.39 to -0.09) and response rate of (1.25, 1.07-1.47). In comparison (RR 0.99, 0.92-1.07) Agomelatine is an effective antidepressant having similar efficacy with the currently used antidepressants.

PMID:34592623 | DOI:10.1016/j.ajp.2021.102866

Cancer Genet. 2021 Sep 23;258-259:80-84. doi: 10.1016/j.cancergen.2021.09.003. Online ahead of print.

ABSTRACT

Escape from nonsense mediated mRNA decay (NMD-) can produce activated or inactivated gene products, and bias in rates of escape can identify functionally important genes in germline disease. We hypothesized that the same would be true of cancer genes, and tested for NMD- bias within The Cancer Genome Atlas pan-cancer somatic mutation dataset. We identify 29 genes that show significantly elevated or suppressed rates of NMD-. This novel approach to cancer gene discovery reveals genes not previously cataloged as potentially tumorigenic, and identifies many potential driver mutations in known cancer genes for functional characterization.

PMID:34592632 | DOI:10.1016/j.cancergen.2021.09.003

Respir Med. 2021 Sep 21;188:106610. doi: 10.1016/j.rmed.2021.106610. Online ahead of print.

ABSTRACT

This study identifies participants ineligible for lung cancer screening with the greatest likelihood of future eligibility. Lung cancer risk in participants enrolled in longitudinal lung screening was assessed using the Prostate, Lung, Colorectal and Ovarian lung cancer risk calculator (PLCO_m2012) at two timepoints: baseline (T₁) and follow-up (T₂). Separate analyses were performed on four PLCO_m2012 eligibility thresholds (3.25%, 2.00%, 1.50%, and 1.00%); only participants with a T₁ risk less than the threshold were included in that analysis. Cox-models identified T₁ risk factors associated with screen-eligibility at T₂. Three models, applying differing assumptions of participant behavior, predicted future eligibility and were benchmarked against the observed cohort. Nine hundred and fifty-six participants had a T₁ risk <3.25%; at 2.00% n= 755; at 1.50% n= 652; at 1.00% n= 484. Lung cancer risk increased over time in most screen-ineligible participants. However, risk increased much faster in participants who became screen-eligible at T₂ compared to those who remained screen-ineligible (median per-year increase of 0.35% versus 0.02%, when using a 3.25% threshold). Participants smoking for >30 years, current smokers, less educated participants, and those with chronic obstructive pulmonary disease (COPD) at T₁ were significantly more likely to become screen-eligible. New diagnoses of COPD and/or non-lung cancers between T₁ and T₂ precipitated eligibility in a subset of participants. The prediction model that assumed health behaviors observed at T₁ continued to T₂ reasonably predicted changes in lung cancer risk. This prediction model and the identified baseline risk factors can identify screen-ineligible participants who should be closely followed for future eligibility.

PMID:34592536 | DOI:10.1016/j.rmed.2021.106610

Respir Med. 2021 Sep 24;188:106625. doi: 10.1016/j.rmed.2021.106625. Online ahead of print.

ABSTRACT

OBJECTIVES: We aimed to identify the inspiratory muscle strength thresholds below which exercise capacity is compromised in men with chronic obstructive pulmonary disease (COPD).

METHODS: We measured the maximum static inspiratory mouth pressure (PImax) and the percentage of predicted values (%PImax) in 113 patients with COPD. Six-minute walk distance (6-MWD) was measured as an indicator of functional exercise capacity, and a 6-MWD of <350 m was defined as functional exercise intolerance. Thresholds were determined as values with high specificity (>0.90) and maximal sensitivity. Statistical significance was set at P < 0.01.

RESULTS: The data of 96 patients (74 ± 6 years old; forced expiratory volume in 1-s [FEV₁], 56.5 ± 26.2% predicted) were analyzed; three women and 14 participants with missing data were excluded. Multivariate logistic regression models identified significant associations of PImax (odds ratio at 99% confidence interval [CI]: 0.95 [0.92-0.98]) and %PImax (odds ratio at 99% CI: 0.97 [0.95-0.99]) with 6-MWD, after adjustments for height and FEV₁. C-statistics showed that the area under the curves (99% CI) of PImax and %PImax were comparable (0.87 [0.77-0.96] and 0.83 [0.72-0.94]). The thresholds of PImax and %PImax were 45.1 cmH₂O and 66%; PImax and %PImax also had moderate positive likelihood ratios of 4.44 and 5.00.

CONCLUSIONS: Thresholds of inspiratory muscle strength in men with COPD could help clinicians evaluate whether their patient’s inspiratory muscle strength is inadequate to achieve a 6-MWD of ≥350 m, and identify patients who should be targeted for inspiratory muscle training.

PMID:34592537 | DOI:10.1016/j.rmed.2021.106625

J Environ Radioact. 2021 Sep 27;240:106740. doi: 10.1016/j.jenvrad.2021.106740. Online ahead of print.

ABSTRACT

The results of the first detailed study, involving a large number of samples, on water equivalent factor (WEQ_p), non-exchangeable organically bound tritium (NE-OBT) and tissue free water tritium (TFWT) activity concentrations in predominant plant species of the tropical monsoonal climatic region, are presented. A total of 369 samples from the vicinity of the PHWR nuclear power plant (NPP) at Kaiga, West Coast of India, and 47 samples of the control region (region not affected by local anthropogenic sources) were analysed. The WEQ_p varied in the range of 0.347-0.666 L kg^-1 with an overall mean value of 0.540 ± 0.045 L kg^-1. The NE-OBT activity concentration varied in the range of <9.8-60.9 Bq L^-1 of combustion water (mean = 24.6 ± 11.5 Bq L^-1) and that of TFWT in the range of 9.2-60.5 Bq L^-1 (mean = 30.7 ± 10.9 Bq L^-1) in the vicinity of the NPP. Rigorous statistical analysis of the data confirmed that (i) the activity concentrations of both forms of tritium decreased with the increase in the distance between the sampling location and NPP, and beyond 10 km, it was similar to that of the control region, (ii) the incorporation of tritium released from the NPP into wild plant leaves is not species-dependent, (iii) the NE-OBT activity concentration in the 5-10 km zone exhibited a dependence on the prevailing wind regime with respect to the NPP, but not in the 2.3-5 km zone which suggests that the transport of tritium, released into the atmosphere as the gaseous effluent, through diffusion is a dominating factor governing its activity concentration in the 2.3-5 km zone. The NE-OBT to TFWT specific activity concentration ratio (R-value) had a mean value of 0.82 ± 0.27 (range: 0.38-1.64) for samples collected from the vicinity of the NPP and 1.93 ± 0.50 (range: 1.35-3.19) for the control region. Recording higher NE-OBT activity concentration and R-value at the control region highlights the necessity of detailed studies to understand the mechanism of NE-OBT partitioning in the terrestrial environment.

PMID:34592534 | DOI:10.1016/j.jenvrad.2021.106740

Ecotoxicol Environ Saf. 2021 Sep 27;226:112829. doi: 10.1016/j.ecoenv.2021.112829. Online ahead of print.

ABSTRACT

BACKGROUND: Previous studies have found associations between single toxic metals, such as arsenic and cadmium, and kidney function in adults with diabetes. However, studies with regards to other metals and metal mixtures are still limited.

OBJECTIVE: Our study aimed to investigate the associations between urinary concentrations of 5 selected metals and metal mixtures and kidney function using a sample of older adults with diabetes mellitus in Chinese communities.

METHODS: In a sample of older adults (n = 5186), 592 eligible subjects were included in this study. Urinary concentrations of 5 metals, i.e., arsenic (As), cadmium (Cd), vanadium (V), cobalt (Co), and thallium (Tl), were measured by inductively coupled plasma mass spectrometer (ICP-MS). Estimated glomerular filtration rate (eGFR) was calculated and dichotomized into indicator of chronic kidney disease (CKD). Logistic analysis and Bayesian kernel machine regression (BKMR) were used to explore the associations between single metals and metal mixtures and CKD, respectively.

RESULTS: Urinary levels of As and V were positively correlated with CKD (OR=2.37, 95% CI: 1.31-4.30 for As; OR=2.24, 95% CI: 1.25-4.03 for V), when compared the 4th quartile with the 1st quartile. After adjustment for potential confounders, the significant association between As and CKD still existed (OR=2.73, 95% CI: 1.23-6.07). BKMR analyses showed strong linear positive associations between As and V and CKD. Higher urinary levels of the mixture were significantly associated with higher odds of CKD in a dose-response pattern. As and V showed the highest posterior inclusion probabilities.

CONCLUSION: Urine As and V were positively associated with CKD in older adults with diabetes mellitus, separately and in a mixture. The metals mixture showed a linear dose-response association with the odds of CKD. The analyses of mixtures, rather than of single metals, may provide a real-world perspective on the relationship between metals and kidney function.

PMID:34592520 | DOI:10.1016/j.ecoenv.2021.112829

Int J Nurs Stud. 2021 Aug 21;124:104069. doi: 10.1016/j.ijnurstu.2021.104069. Online ahead of print.

ABSTRACT

BACKGROUND: Responding to legal medically assisted dying requests may become the most frequent form of nurses’ participation in that service. Recent research has explored nurses’ discrete responses to requests about or for assisted dying; however, nurses likely hold intentions for multiple responses to these requests. These intentions form patterns shaped by individual factors such as attitude and beliefs. No research has investigated patterns of multiple responses to requests for assisted dying, how these patterns form profiles of nurses and factors that might explain these response profiles.

OBJECTIVES: Identify patterns of multiple responses that nurses intend for requests for assisted dying. Explore how these patterns form profiles of nurses’ who share similar patterns of intended responses. Finally, investigate how attitude, norms and beliefs distinguish response profiles.

DESIGN: Cross-sectional survey SETTINGS: Online survey of Australian nurses PARTICIPANTS: 365 experienced registered nurses (years in nursing mean = 23, SD = 14.21) working primarily with adults across various practice settings.

METHODS: Principal components analysis identified five types of intended responses. K-means cluster analysis was then used to develop profiles of nurses’ intended responses across these five responses. Multinomial logit regression was utilised to examine psychosocial variables that distinguished different profiles RESULTS: Cluster analysis resulted in five profiles that reflect different patterns of intended responses by nurses – Facilitator, Complier, Expediter, Objector, and Detached. Logit regressions of explanatory variables indicated that nurses’ attitude toward assisted dying, ethical beliefs, and social norms predicted nurses’ membership in intended response profiles. The overall model was statistically significant, χ²(20) = 106.527, p < .001, and the predictors accounted for 25.3% of the variance in the profiles (Cox and Snell test: Pseudo R² = 0.253).

CONCLUSION: Nurses intended responses have been usefully constructed as five patterns or profiles of multiple responses. These profiles represent different types and levels of engagement with requests. Further, attitude and social expectations distinguish profiles with stronger intentions to engage positively. Using a cluster analysis methodology provides a more holistic understanding of nurses’ intended responses to assisted dying requests by focusing on various responses and demonstrating that nurses have distinctive patterns of responses.

PMID:34592533 | DOI:10.1016/j.ijnurstu.2021.104069

Ecotoxicol Environ Saf. 2021 Sep 27;226:112794. doi: 10.1016/j.ecoenv.2021.112794. Online ahead of print.

ABSTRACT

BACKGROUND: Scientific studies have identified various adverse effects of particulate matter (PM) on respiratory disease (RD) and type 2 diabetes (T2D). However, whether short-term exposure to PM triggers the onset of RD with T2D, compared with RD without T2D, has not been elucidated.

METHODS: A two-stage time-series study was conducted to evaluate the acute adverse effects of PM on admission for RD and for RD with and without T2D in Beijing, China, from 2014 to 2020. District-specific effects of PM_2.5 and PM₁₀ were estimated using the over-dispersed Poisson generalized addictive model after adjusting for weather conditions, day of the week, and long-term and seasonal trends. Meta-analyses were applied to pool the overall effects on overall and cause-specific RD, while the exposure-response (E-R) curves were evaluated using a cubic regression spline.

RESULTS: A total of 1550,154 admission records for RD were retrieved during the study period. Meta-analysis suggested that per interquartile range upticks in the concentration of PM_2.5 corresponded to 1.91% (95% CI: 1.33-2.49%), 2.16% (95% CI: 1.08-3.25%), and 1.92% (95% CI: 1.46-2.39%) increments in admission for RD, RD with T2D, and RD without T2D, respectively, at lag 0-8 days, lag 8 days, and lag 8 days. The effect size of PM_2.5 was statistically significantly higher in the T2D group than in the group without T2D (z = 3.98, P < 0.01). The effect sizes of PM₁₀ were 3.86% (95% CI: 2.48-5.27%), 3.73% (95% CI: 1.72-5.79%), and 3.92% (95% CI: 2.65-5.21%), respectively, at lag 0-13 days, lag 13 days, and lag 13 days, respectively, and no statistically significant difference was observed between T2D groups (z = 0.24, P = 0.81). Significant difference was not observed between T2D groups for the associations of PM and different RD and could be found between three groups for effects of PM₁₀ on RD without T2D. The E-R curves varied by sex, age and T2D condition subgroups for the associations between PM and daily RD admissions.

CONCLUSIONS: Short-term PM exposure was associated with increased RD admission with and without T2D, and the effect size of PM_2.5 was higher in patients with T2D than those without T2D.

PMID:34592518 | DOI:10.1016/j.ecoenv.2021.112794

J Basic Clin Physiol Pharmacol. 2020 Nov 19;32(5):899-910. doi: 10.1515/jbcpp-2020-0107.

ABSTRACT

OBJECTIVES: The objective of this study is to explore the efficacy and safety of N-acetyl-cysteine (NAC) as adjuvant therapy in female infertility.

CONTENT: We performed a systematic literature search of PubMed, Cochrane Library, Embase, and Ovid databases through April 2019 for Randomized Controlled Trials (RCTs) evaluating the effectiveness and safety of NAC as adjuvant therapy in female infertility. The outcomes assessed were rates of ovulation, pregnancy, miscarriage and multiple pregnancy, presented as pooled odds ratio with 95% confidence interval (CI) using the random-effects model. Heterogeneity and inconsistency of the measurements were identified through Cochrane’s Q statistic and I2 statistic. We also performed a sensitivity analysis, publication bias (using funnel plot and Begg’s test), and subgroup analysis.

SUMMARY: Fifteen RCTs recruiting 2330 female receiving NAC were included. The pooled estimate showed the statistically insignificant improvement in outcomes; clinical pregnancy rate 1.55 (95% CI 0.98-2.47; I2=68%; p<0.01), ovulation rate 1.77 (95% CI 0.76-4.14; I2=90%; p<0.01), multiple pregnancy rate 0.83 (95% CI 0.34-1.99; I2=10%; p=0.31) and miscarriage rate 0.76 (95% CI= 0.37, 1.53; I2=0%; p=0.69) . NAC was found less efficacious and safe than metformin in all outcomes. Overall, NAC showed statistically insignificant (OR=0.98-2.47).

OUTLOOK: NAC can be an effective adjuvant in PCOS related and unexplained female infertility. The effect could be more profound in women with high BMI, insulin resistance, and oxidative stress. However, the findings need further confirmation in well-designed randomized controlled trials to examine clinical outcomes such as live birth rate in more extended follow-up periods.

PMID:34592079 | DOI:10.1515/jbcpp-2020-0107

Orthod Craniofac Res. 2021 Sep 30. doi: 10.1111/ocr.12539. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the level of agreement between the conventional method and a machine learning approach to facial midline determination and asymmetry assessment.

SETTINGS AND SAMPLE POPULATION: The study included a total of 90 samples (53 female; 37 male) with different levels of mandibular asymmetry.

MATERIALS AND METHODS: Two researchers placed predefined soft tissue landmarks individually on selected facial frontal photographs and created 10 reference lines. The midsagittal line was determined as perpendicular to the midpoint of the bipupillary line, and the same two reference lines and facial landmarks were automatically determined by the software using machine learning algorithms, and researchers created the other 8 reference lines using the facial landmarks that were determined automatically by the software. In the following stage, 2 linear and 10 angular measurements were made by a single researcher on 270 photographs, and the consistency and differences between the measurements were evaluated with a one sample t-test, an intraclass correlation coefficient (ICC) and Bland-Altman Plots.

RESULTS: The level of agreement of measurements between the researchers and the software was low for eight parameters (ICC˂0.70). The one-sample t-test revealed that differences between the software and researcher measurements of lip canting and pronasale deviation were not statistically significantly different (P>0.05). Aside from the body inclination difference in Group 3 (samples with a mandibular body inclination difference >6°), there was no clinically significant difference (˂3°) between the measurements of the two methods.

CONCLUSIONS: Machine learning algorithms have the potential for clinical use in asymmetry assessment and midline determination, and can help clinicians in a manual approaches.

PMID:34592067 | DOI:10.1111/ocr.12539