Tag: statistics

Vopr Kurortol Fizioter Lech Fiz Kult. 2021;98(3):18-28. doi: 10.17116/kurort20219803118.

ABSTRACT

There are convincing data on the association of psycho-emotional disorders with the degree of bone mineral density (BMD) loss and the risk of fractures on the basis of osteoporosis (OP) but the nature of the causal relationship has not yet been clearly established. The study of this issue is important to substantiate the need and nature of psychological correction within the framework of comprehensive rehabilitation programs in patients with osteoporotic fractures.

OBJECTIVE: Study of the severity of symptoms of depression and anxiety in patients who have suffered compression fractures of the vertebrae (VF) of osteoporotic genesis who entered the II stage of medical rehabilitation, as well as the contribution to the development of psycho-emotional age disorders, the severity of OP, pain syndrome and the use of orthotics.

MATERIAL AND METHODS: The study sample consisted of 120 women 50 to 80 years old with an established diagnosis of OP based on the results of bone densitometry. The main group included 60 patients with OP complicated by at least one VF. The control group included 60 patients with OP without a history of osteoporotic fractures comparable in age, body mass index and BMD in the spine with the main group. The complex of examination included the collection of complaints, anamnesis of OP, previous fractures, assessment of pain syndrome according to VAS, BMD study and verification of VF by X-ray methods. To assess the level of depression (DL) we used the Tsung depression scale modified by T.I. Balashova, situational (SA) and personal anxiety (PA) – Spielberger-Khanin questionnaire.

RESULTS: In the main group in comparison with the control group the proportion of patients without symptoms of depression was lower (66.7 and 88.3%, respectively; p=0.042), as well as the frequency of detection of high degree of SA was higher (85.0 and 73.4%, respectively; p=0.039). In patients with VF it was higher than in the control, DL – 46.0 [42.0; 54.5] (27-70) and 43.0 [38.0; 47.5] (25-65) points, respectively (p=0.0009), as well as the SA degree – 61.5 [54.0; 71.0] (20-75) and 52.5 [43.5; 64.0] (20-68) points, respectively (p=0.0006). Statistically significant direct correlation dependences of DL on age (r=0.317; p=0.00042), the duration of the postmenopausal period (r=0.325; p=0.0003), the number of VFs (g= -0.245; p=0.00013) were established. Moreover, the intensity of pain syndrome (g= -0.234; p=0.00034), as well as feedbacks of this indicator with BMD in the spine (r= -0.342; p=0.00017) and the duration of the use of thoracolumbar orthoses (r = -0.504; p = 0.00016). There were direct dependence of the SA degree on age (r=0.281; p=0.0019) and the intensity of pain syndrome (g=0.258; p=0.0044). Negative correlation of SA with body weight (r= -0.183; p=0.045), BMD in the spine (r= -0.207; p=0.026), duration of orthosis application (r= -0.327; p=0.0095) and the amount of VF in the lumbar spine (g= -0.214; p=0.044) were detected. There was a significant correlation between the degree of PA and BMD in the lumbar vertebrae (r= -0.18; p=0.046) and the intensity of pain syndrome (g=0.137; p=0.039).

CONCLUSION: The results obtained indicate the need for psychological correction in the framework of the complex rehabilitation of women who underwent VF based on OP due to increased DL and SA especially in older age groups.

PMID:34223751 | DOI:10.17116/kurort20219803118

Arch Razi Inst. 2021 Jul;76(2):223-229. doi: 10.22092/ari.2020.128417.1413. Epub 2021 Jul 1.

ABSTRACT

Fascioliasis is an emerging and important food and water-borne disease in human communities which has become one of the most important health challenges in countries, like Iran. It causes weight loss, a decrease in feed conversion ratio as well as milk and meat production, and also reduces fertility in animals the prevalence of fasciolosis is increasing in some regions of the world due to various factors. Different methods have been used for the detection of Fasciola hepatica in animals. This study is the first to detect F. hepatica in Lori sheep using polymerase chain reaction (PCR) and conventional diagnostic methods in Western Iran. During three months, 195 fecal samples were collected from sheep in Lorestan province, Iran, using the stratified random sampling method. The conventional diagnostic methods, including wet mount microscopic examination and concentration assays, as well as the PCR technique targeting the intergenic spacer gene of F. hepatica, were used for the detection of the parasite in sheep. In total, 4 (2.1%) out of 195 examined stool samples were positive for F. hepatica based on the conventional assays. The PCR test was positive for F. hepatica in7 (3.6%) samples of 195 studied specimens. Statistical analyses of the data revealed that there is a significant difference between the results of diagnostic methods for F. hepatica detection (P=0.0421). Finally, the results showed that PCR has more diagnostic sensitivity, compared to conventional diagnostic methods, including the concentration techniques and microscopic examination. Hence, it can be advised to use PCR for the detection of F. hepatica in sheep.

PMID:34223721 | DOI:10.22092/ari.2020.128417.1413

Arch Razi Inst. 2021 Jul;76(2):253-259. doi: 10.22092/ari.2019.126417.1343. Epub 2021 Jul 1.

ABSTRACT

The keratinolytic activities of dermatophyte species are accompanied by the secretion of enzymes, such as serine proteases, which are coded by the Subtilisin (SUB) genes. This study aimed to determine the presence of the SUB genes in the clinical and nonclinical samples of Trichophyton verrucosum and Microsporum gypseum. Isolation was carried out by direct and laboratory examination. Following that, for the determination of the presence of the SUB gene, polymerase chain reaction with specific primers was conducted. The frequencies of the SUB gene were observed in almost 66% of the isolates. Statistical analysis showed a significant relationship between the presence of the SUB gene and the samples collected from human, animals, and soil (p ˂0.005). The current investigation has been the first study of the presence/absence of the SUB gene in the clinical and nonclinical isolates of T. verrucosum and M. gypseum in Iran which may be a new step to perform further studies.

PMID:34223724 | DOI:10.22092/ari.2019.126417.1343

J Cardiovasc Electrophysiol. 2021 Jul 5. doi: 10.1111/jce.15135. Online ahead of print.

ABSTRACT

BACKGROUND: Local impedance (LI) drop measured with micro-fidelity electrodes embedded in the tip of an ablation catheter accurately reflects tissue heating during radiofrequency (RF) ablation. Previous studies found 15-30Ω LI drops created successful lesions, while >40Ω drops were associated with steam pops. The objective of this study was to evaluate the safety and efficacy of LI-guided ablation using standard (30W) and high-power (50W) in a pre-clinical model.

METHODS: RF lesions were created in explanted swine hearts (n=6) to assess the feasibility of LI-guided ablation by targeting 10, 20, or 30Ω (n=20/group) drops. Subsequently LI-guided ablation was evaluated in a chronic animal model (n=8 Canines, 25-29kg, 30/50W). During the index procedure point-by-point intercaval line ablation and left inferior pulmonary vein (PV) isolation were performed. RF duration was at the operators’ discretion, but discontinued early if a 15-30Ω drop was achieved. Operators attempted to avoid LI drops >40Ω⊡ At 1-month, durable conduction block was evaluated with electroanatomic mapping followed by necropsy and histopathology.

RESULTS: In explanted tissue, terminating ablation at 10, 20, or 30Ω LI drops created statistically larger lesions (p<0.05; 1.8 [1.6-2.4]mm, 3.3 [3.0-3.7]mm; 4.9 [4.3-5.5]mm). LI-guided high-power ablation in vivo significantly reduced RF duration per application compared to standard-power (p<0.05; Intercaval: 8.9±5.2 versus 18.1±11.0sec, PV: 9.6±5.4 versus 23.2±10.3sec). LI drops of 15-40Ω were more readily achievable for high-power (90.1%, 318/353) than standard-power (71.7%, 243/339). All intercaval lines and PV isolations were durable (16/16) at 1-month. Necropsy revealed no major collateral injury to the pericardium, phrenic nerve, esophagus, or lungs. There was no pericardial effusion, stroke, tamponade, or PV stenosis. Vagal nerve injury was found in two 30W animals after using 19.7±13.9 and 19.5±11.8 sec RF applications.

CONCLUSION: LI-guided ablation was found to be safe and efficacious in a chronic animal model. High-power ablation more readily achieved >15Ω drops, reduced RF duration compared to standard-power, and had no major RF collateral injury.

CONDENSED ABSTRACT: This study evaluated the safety and efficacy of Local Impedance (LI)-guided High-power ablation in a pre-clinical model. Radiofrequency(RF) lesions were created in explanted swine hearts (n=6) to assess the feasibility of LI-guided ablation. Subsequently LI-guided lesions were created at the pulmonary veins and intercaval line in a chronic animal model. The durability of conduction block was evaluated after 1-month. We found that terminating ablation at 10, 20, or 30Ω LI drops created statistically larger lesions (p<0.05) and was safe. LI-guided high-power ablation in vivo significantly reduced RF duration (p<0.05), also all lesions were durable at 1-month. This article is protected by copyright. All rights reserved.

PMID:34223691 | DOI:10.1111/jce.15135

Birth Defects Res. 2021 Jul 5. doi: 10.1002/bdr2.1939. Online ahead of print.

ABSTRACT

BACKGROUND: Bortezomib, a selective inhibitor of 26S proteasome, is commonly used as a chemotherapeutic agent against different types of human cancer cells. While cancer during pregnancy is a rare condition, the trends in becoming pregnant at an advanced age increase the risk of cancer associated with pregnancy. Cancers need to be treated carefully without harming the fetus during pregnancy for the patients who desire to continue their pregnancy. The aim of this study is to demonstrate the potential side effects of bortezomib as this drug has so far not been investigated during preimplantation embryo development.

MATERIALS AND METHODS: Two cell stage embryos were flushed from mated female CD1 mice and were cultured. Two-cell, eight-cell, and morula stage embryos were exposed to different concentrations of bortezomib in vitro. Morphologic alterations of the embryos were evaluated and the data were statistically analyzed.

RESULTS: Our study showed that bortezomib exposure caused a statistically significant decrease in embryo survival and developmental competence and potential rate. We detected those early stages of embryos are more susceptible to bortezomib exposure than later stages.

CONCLUSION: We indicated that bortezomib adversely affects preimplantation embryo development in a dose, time, and developmental stage dependent manner. Moreover, bortezomib treatment inhibits preimplantation embryo development and induces cytoplasmic fragmentation and cell-cycle arrest on embryos.

PMID:34223698 | DOI:10.1002/bdr2.1939

Eur J Prosthodont Restor Dent. 2021 Jun 17. doi: 10.1922/EJPRD_2285Muehlemann11. Online ahead of print.

ABSTRACT

This study analyzed the fit accuracy of the removable partial denture (RPD) metal frameworks produced using digital and conventional manufacturing technologies. Mandibular RPD metal frameworks (N=15, n=3 per group) were fabricated on a representative clinical case. RPDs were fabricated using one of the following manufacturing procedures: a) conventional lost-wax casting technique (C-LW), b) conventional casting of milled sacrificial patterns (C-M), c) conventional casting of printed sacrificial patterns (C-P), d) selective laser melting (SLM), e) direct metal laser sintering (DMLS) technologies. The fit accuracy of RPD frameworks was analyzed by fabricating replicas with silicone registration material and measuring with a digital microscope. A total of 11 sites and 29 areas in the RPD metal frameworks were considered for the accuracy measurements (μm). Data were statistically analyzed using Wilcoxon signed rank and Friedman test (α=0.05). Before finishing and polishing, C-M method presented overall significantly better (P⟨.001) fit accuracy (118 μm) than those of other methods (195-265 μm). After finishing and polishing, C-M method showed overall significantly better (P⟨.033) fit accuracy (205.7 μm) than C-LW and SLM methods (285.7 μm; 249 μm) and comparable fit accuracy to that of C-P and DMLS methods. Accuracy at the minor and major connector areas of RPDs were affected from the manufacturing technologies. Clinical Implications: When accuracy of RPDs are considered, digital technologies tested presented similar results to those of conventional manufacturing method except for minor and major connector areas which necessitates further improvement.

PMID:34223713 | DOI:10.1922/EJPRD_2285Muehlemann11

J Paediatr Child Health. 2021 Jul 5. doi: 10.1111/jpc.15639. Online ahead of print.

ABSTRACT

AIMS: To assess the outcomes of an early oxygen saturation screening programme in apparently healthy newborns for the detection of cardiac and non-cardiac disease. To describe the aetiology and incidence of infants with oxygen saturations <95% in the first 6 h of life and describe the management to discharge. In addition, we sought to identify any risk factors for failed early saturations.

METHODS: This is a retrospective hospital cohort assessing outcomes of an early saturation screening programme performed in apparently healthy newborns. Infants with oxygen saturations less than 95% were identified and their clinical notes were hand-searched. Descriptive statistics were used to present demographics, proportion of infants who passed or failed screening, subsequent diagnoses and short-term outcome. Multivariate logistic regression was used to identify independent associations of clinical factors (birthweight, gestation, elective caesarean section and gender) with failed screening.

RESULTS: Between 2014 and 2019, 14 956 healthy newborns were assessed within the first 6 h, 94 (0.63%) failed the early saturation screen. The most common causes for saturation <95% were respiratory disease or delayed transition. There were 31 (33%) infants admitted to the NICU with an additional baby requiring emergency transfer to a cardiac centre. Infants were 28 times more likely to have saturations <95% if born by elective caesarean section (odds ratio 28, conflict of interest (18.54-42.82)).

CONCLUSION: In apparently healthy newborns, early assessment of oxygen saturation, combined with clinical assessment and subsequent intervention can identify important conditions and should be considered as standard care.

PMID:34223680 | DOI:10.1111/jpc.15639

J Magn Reson Imaging. 2021 Jul 5. doi: 10.1002/jmri.27803. Online ahead of print.

ABSTRACT

BACKGROUND: Diffusion weighted imaging (DWI) is fundamental for prostate cancer (PCa) detection with MRI; however, limited by susceptibility artifact from hip prosthesis.

PURPOSE: To evaluate image quality and ability to detect PCa with quantitative T2-mapping and DWI in men with hip prosthesis undergoing prostate MRI.

STUDY TYPE: Prospective, cross-sectional study.

POPULATION: Thirty consecutive men with hip replacement (18 unilateral, 12 bilateral) undergoing prostate MRI from 2019 to 2021.

FIELD STRENGTH/SEQUENCE: 3-T; multiparametric MRI (T2W, DCE-MRI, echo-planar [EPI]-DWI), T2-mapping (Carr-Purcell-Meiboom-Gill), FOCUS-EPI-DWI, PROPELLER-DWI.

ASSESSMENT: Five blinded radiologists independently evaluated MRI image quality using a 5-point Likert scale. PI-RADS v2.1 scores were applied in four interpretation strategies: 1) T2W-FSE+DCE-MRI+EPI-DWI, 2) T2W-FSE+DCE-MRI+EPI-DWI+FOCUS-EPI-DWI, 3) T2W-FSE+DCE-MRI+EPI-DWI+PROPELLER-DWI, 4) T2W-FSE+DCE-MRI+EPI-DWI+T2-maps. Five-point confidence scores were recorded.

STATISTICAL ANALYSIS: ANOVA, Kruskal-Wallis with pair-wise comparisons by Wilcoxon sign-rank, and paired t-tests, P < 0.05 was considered significant. Cohen’s Kappa (k) for PI-RADSv2.1 scoring and proportion of correctly classified lesions tabulated for pathology-confirmed cases with 95% confidence intervals (CIs).

RESULTS: For all radiologists, T2-map image quality was significantly higher than EPI-DWI, FOCUS-EPI-DWI, and PROPELLER-DWI and similar (P = 0.146-0.706) or significantly better (for two readers) than T2W-FSE and DCE-MRI. PI-RADS v2.1 agreement improved comparing strategy A (k = 0.46) to strategy B (k = 0.58) to strategy C (k = 0.58) and was highest with strategy D which included T2-maps (k = 1.00). Radiologists’ confidence was significantly highest with strategy D. Strategies B and C had similar confidence (P = 0.051-0.063) both significantly outperforming strategy A. Twelve men with 17 lesions had pathology confirmed diagnoses (13 PCa, 4 benign). Strategy D had the highest proportion of correctly classified lesions (76.5-82.4%) with overlapping 95% confidence intervals.

DATA CONCLUSION: T2-mapping may be a valuable adjunct to prostate MRI in men with hip replacement resulting in improved image quality, higher reader confidence, interobserver agreement, and accuracy in PI-RADS scoring.

LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY STAGE: 2.

PMID:34223675 | DOI:10.1002/jmri.27803

J Genet Couns. 2021 Jul 5. doi: 10.1002/jgc4.1457. Online ahead of print.

ABSTRACT

The objective of this study was to assess the level of interest in preconception carrier screening among reproductive-aged persons presenting for gynecologic care and to identify demographic factors predictive of pursuing screening. Patients aged 18-40 who were presenting for gynecologic care at a single U.S. academic medical center were provided with information about current options for preconception carrier screening and were offered genetic counseling referral with the possibility to undergo screening. Outcomes of interest were desire for genetic counseling referral and attendance at genetic counseling visit. Statistical analyses were performed as appropriate using R version 3.6.1 with variables significant at 0.1 included in a multivariable logistic regression. Of 193 participants, 79 (41%) desired genetic counseling referral. Participants aged 25-34 (OR 3.39, 95% CI 1.47-8.10) and nulliparas (OR 2.69, 95% CI 1.23-6.03) were more likely to desire referral. Thirty-five participants (44.3% of those who desired referral) attended a visit with genetic counseling. Having an advanced degree (OR 3.27, 95% CI 1.06-10.4) was associated with visit attendance. Thirteen participants underwent screening, and five were found to be a carrier of at least one X-linked or autosomal recessive condition. Surprisingly, presenting for a gynecologic visit directly related to planning a pregnancy was not associated with increased interest in preconception carrier screening. Nulliparas and those aged 25-34 likely expressed greater interest in referral due to high potential for future childbearing in these groups. The increased level of visit attendance in participants with advanced degrees is likely confounded by the high level of health literacy and financial resources in this group.

PMID:34223670 | DOI:10.1002/jgc4.1457

J Clin Nurs. 2021 Jul 5. doi: 10.1111/jocn.15854. Online ahead of print.

ABSTRACT

AIMS AND OBJECTIVES: This study aimed to measure the frequency of spiritual needs, identify the factors associated with these needs among Korean and American persons living with an advance chronic illness and compare them from a cross-cultural perspective.

BACKGROUND: Persons with serious or life-limiting illnesses often have spiritual needs. Unmet spiritual needs are associated with poor well-being and threaten psychological health. Little is known about how specific spiritual needs vary across cultures.

DESIGN: A quantitative, cross-sectional, observational cross-cultural comparison was undertaken.

METHODS: The study has been prepared in accordance with the STROBE guidelines. Convenience sampling was used to recruit participants from outpatient clinics in South Korea and Southern California (N = 202). Spiritual needs were measured using the Spiritual Interests Related to Illness Tool (SpIRIT); demographic and illness-related variables were also assessed using paper-and-pencil questionnaires. Data were analysed using various parametric statistical tests, including multiple regression analysis.

RESULTS: The findings quantify the intensity and types of spiritual needs that persons living with an advanced chronic illness experience. Furthermore, they show how the spiritual needs of religiously diverse samples of South Koreans and Americans differ. The findings also indicate that self-reported spirituality and religiosity independently explain a substantial amount of the variance in spiritual needs.

CONCLUSIONS: In both the samples, spiritual needs were reported and associated with spirituality and religiosity. Although all the eight domains of spiritual needs assessed by the SpIRIT were pertinent to the Korean and American samples, they were prioritised differently.

RELEVANCE TO CLINICAL PRACTICE: Screening patients to ascertain how important spirituality or religiosity is to them may help clinicians focus their in-depth assessments on those who report high levels of spirituality or religiosity because these patients may experience the strongest spiritual needs. The SpIRIT shows promise as a measure of diverse spiritual needs.

PMID:34223672 | DOI:10.1111/jocn.15854