Greater Level Of Significance Research Articles

Chaotic Global Metric Analysis of Heart Rate Variability Following Six Power Spectral Manipulations in Malnourished Children

Background and Aim: The study objective was to assess chaotic global metrics in malnourished children following power spectral manipulations. Methods: We evaluated the complexity of heart rate (HR) variability (HRV) in malnourished subjects via six power spectra (Welch, multi-taper method (MTM), Burg, covariance, Yule-Walker, and periodogram) and then, when adjusted by the MTM parameters, for further refinement. Seventy children were split equally (controls & malnourished) and the HR was monitored for 20 min; 1000 RR-intervals were attained for HRV analysis. Results: The results stipulate that CFP1 (chaotic forward parameter) and CFP3 are the best metrics to distinguish the two groups. The most appropriate power spectra were Welch, MTM, and Yule-Walker. Results indicate that CFP3 calculated using MTM power spectra is the best combination to discriminate between the two groups. Yet, if the RR intervals are set to 400, discrete prolate spheroidal sequences (DPSS) to 3, and Thomson’s nonlinear combination to ‘adaptive’, a greater level of significance can be achieved (Cohen’s ds = -1.57). This significantly outperforms that under default conditions (Glass’s ∆ Delta = -1.06, and Cohen’s ds = -0.95). Conclusion: Malnourished children have a lower response to chaotic global metrics than the control group. CFP3 with the aforementioned settings is the best combination to discriminate between these groups on the basis of RR intervals. It has the greatest significance by Cohen’s ds. Our data suggest impaired autonomic function in malnourished children, which may have consequences for cardiovascular risks.

Analysis of the relationship of the vertical extension of mouth opening with muscle rigidity and sociodemographic factors in Parkinson's disease

Abstract Introduction Changes caused by the rigidity of Parkinson’s Disease (PD) can affect the mandibular musculature. However, few studies have been published about its impact on the oral opening. Objective To analyze the relationship of the vertical extension of the oral opening with muscular rigidity and sociodemographic factors of the elderly with PD. Material and method This is a cross-sectional, quantitative study that collected data from a primary study conducted at the Hospital das Clínicas of the Federal University of Pernambuco in 2018. Data were collected from medical records and from the questionnaire, Research Diagnostic Criterion for Temporomandibular Disorders (RDC/TMD). The sample was composed of 81 parkinsonians and characterized using: sociodemographic variables and the presence or absence of muscular rigidity. The measures of vertical extension of the oral opening evaluated were: mouth opening without assistance and without pain (ABASD), and maximum mouth opening without assistance (AMBSA). The Pearson’s linear correlation and Spearman’s correlation tests were applied to investigate the relationship among the continuous variables. Analyses of association were conducted using simple logistic regression. The level of significance was set at p<0.05. Result Limitation of the oral opening was not related to age or sex. The greatest level of significance was between mouth opening without assistance and without pain and muscular rigidity (p=0.012), and years of schooling (p=0.038). Conclusion The limitation of mouth opening in people with PD was shown to be related to muscular rigidity and fewer years of schooling.

The Relationship between Sound and Amenities of Transit-Oriented Developments.

Experts in diverse fields have investigated sound in cities throughout the United States. This research aims to examine sound levels and determine its contributors at the transit-oriented development (TOD) station and neighborhood levels by studying selected Dallas Area Rapid Transit (DART) light rail stations. A multilevel analysis was performed to model the likelihood of TOD stations and neighborhoods affecting sound levels, controlling for station amenities, socio-demographics and built environment characteristics. Sound measurements were sampled in three time intervals with 15 min sampling over weekdays and weekends at TOD and non-TOD stations by a type II SPL meter that was mounted on a small camera tripod at a height of 1.5 m, at a distance of 1.5 m from rails and curbs. The research team found that amenities, built environmental characteristics, and neighborhood features have significant implications on sound levels at both the TOD station and the neighborhood level, which affects quality of life (QoL). TOD stations that include more amenities have a greater level of significance on sound levels. Additionally, neighborhoods with a pervasive street grid configuration, public facilities, and built environment densities are significantly associated with a likelihood of high sound levels. Conversely, higher population densities and intersection densities decrease the likelihood of a high sound level environment. These patterns provide an arena for transportation, urban, and environmental planning and policymaking to generate transformative solutions and policies.

Proper bile duct flow, rather than radical excision, is the most critical factor determining treatment outcomes of bile duct cysts

BackgroundThe purpose of this study was to compare the impact of the extent of excision and the patent bile duct flow on treatment outcomes of bile duct cysts (BDCs).MethodsWe retrospectively analyzed the records of 382 patients who received surgery for BDCs from January 2005 to December 2014.ResultsFor Type Ia cysts, proper bile flow was associated with good long-term treatment outcomes with a greater level of significance (p < 0.001) than complete excision (p = 0.012). For Type IVa cysts, proper bile flow, but not complete excision, was associated with good long-term outcomes (p < 0.00001). In addition, 96.3% (104/108) of Type IVa patients with proper bile flow had no late complications and good biliary function, while no patient without patent bile flow had a good clinical outcome. For Type Ic cysts, 92 patients who received partial excisions had good outcomes when proper bile flow was restored. Regression analysis revealed that the absence of proper bile flow, in comparison to incomplete excision, is a greater risk factor for poor long-term treatment effects for Type Ia and Type IVa cysts.ConclusionsCompared to complete excision, the establishment of proper bile flow exerted a greater impact on improving long-term clinical outcomes after BDC surgery.

Micronuclei and sialic acid as markers of genotoxic damage in tobacco-related oral lesions

Background: Carcinogens and co-carcinogens act in an additive, synergistic and antagonistic manner. Tobacco is the most common carcinogen related to oral cancer. The aim of this study was to assess the effect of tobacco on the oral epithelium by evaluating genotoxic damage to cells as quantitated by micronuclei and also the alterations to the cell membrane were correlated by the measurement of free sialic acid and protein-bound sialic acid in saliva and in serum. Materials and Methods: Blood samples collected from 15 untreated oral squamous cell carcinoma patients, 15 patients with oral precancerous conditions, 15 tobacco chewers without clinically evident lesion and 15 non-tobacco chewers. Serum and salivary sialic acid levels both in free and bound form were measured spectrophotometrically. Smear was taken from the same patient from the suspicious site and assessment of micronuclei was done by acridine orange method. Results: Serum free sialic acid and micronuclei assessment showed greater level of signifi cance (P=?0.05) between all other groups. This implies it’s potential use as an indicator of oral cancer. Predictability of occurrence of oral Cancer = 0.561+ 0.005× serum protein-bound sialic acid+ 0.244 serum free sialic acid + 0.71 M, where M=mean of micronuclei in 500 exfoliated oral cells. Predictability of occurrence of oral Premalignancy = 0.13+ 0.909× serum free sialic acid+ 0.045 M, where M=mean of micronuclei in 500 exfoliated oral cells. Conclusion: Micronuclei, serum and salivary sialic acid levels may be a good marker for prediction of premalignancy and oral squamous cell carcinoma transformation. Journal of Pathology of Nepal (2013) Vol. 3, No.1, Issue 5, 379-385 DOI: http://dx.doi.org/10.3126/jpn.v3i5.7862

Predictive physiological anticipation preceding seemingly unpredictable stimuli: a meta-analysis.

This meta-analysis of 26 reports published between 1978 and 2010 tests an unusual hypothesis: for stimuli of two or more types that are presented in an order designed to be unpredictable and that produce different post-stimulus physiological activity, the direction of pre-stimulus physiological activity reflects the direction of post-stimulus physiological activity, resulting in an unexplained anticipatory effect. The reports we examined used one of two paradigms: (1) randomly ordered presentations of arousing vs. neutral stimuli, or (2) guessing tasks with feedback (correct vs. incorrect). Dependent variables included: electrodermal activity, heart rate, blood volume, pupil dilation, electroencephalographic activity, and blood oxygenation level dependent (BOLD) activity. To avoid including data hand-picked from multiple different analyses, no post hoc experiments were considered. The results reveal a significant overall effect with a small effect size [fixed effect: overall ES = 0.21, 95% CI = 0.15–0.27, z = 6.9, p < 2.7 × 10−12; random effects: overall (weighted) ES = 0.21, 95% CI = 0.13–0.29, z = 5.3, p < 5.7 × 10−8]. Higher quality experiments produced a quantitatively larger effect size and a greater level of significance than lower quality studies. The number of contrary unpublished reports that would be necessary to reduce the level of significance to chance (p > 0.05) was conservatively calculated to be 87 reports. We explore alternative explanations and examine the potential linkage between this unexplained anticipatory activity and other results demonstrating meaningful pre-stimulus activity preceding behaviorally relevant events. We conclude that to further examine this currently unexplained anticipatory activity, multiple replications arising from different laboratories using the same methods are necessary. The cause of this anticipatory activity, which undoubtedly lies within the realm of natural physical processes (as opposed to supernatural or paranormal ones), remains to be determined.

Health-related quality of life (HRQoL) in newly diagnosed patients (pts) with chronic phase chronic myelogenous leukemia (CP CML) treated with bosutinib (BOS) or imatinib (IM).

6612 Background: BOS, a dual Src/Abl kinase inhibitor, demonstrated significantly higher response rates versus IM in evaluable pts with CP CML in a phase 3, open-label study. Given the length of time a pt may receive 1st-line treatment for CP CML (>8 yrs), understanding the impact on HRQoL is important, as pts may not present with significant symptom burden. The effect of BOS and IM on HRQoL was an exploratory endpoint. Methods: Pts with newly diagnosed CP CML were randomized 1:1 to BOS or IM. HRQoL was measured using the 44-item Functional Assessment of Cancer Therapy–Leukemia (FACT-Leu). The FACT-Leu is rated on a scale of 0-4 and consists of the Physical Well-being (PWB), Social/Family Well-being (SFWB), Emotional Well-being (EWB), Functional Well-being (FWB), Leukemia Subscale (LeuS), Treatment Outcome Index (TOI), FACT-G Total, and FACT-Leu Total scores; higher scores reflect better HRQoL. Minimal important differences (MID) on the scales range from 2-12 points. The FACT-Leu was completed at baseline (BL), every 3 mo on study, and at treatment completion. Paired t-tests and repeated measures mixed-effects models were used to assess within and between-group differences. Results: Of 250 and 252 pts randomized to BOS and IM, respectively, BL HRQoL data was available for 233 and 235 pts; median follow-up times were 16.0 and 16.5 mo; 71% and 80% of pts remain on treatment. No differences between groups were observed at BL or over the first 12 mo of therapy; however, the study was not powered to detect between-group differences. At 3 mo, significant improvements from BL for BOS and IM pts were observed in EWB (P <0.05 and P <0.001, respectively) and LeuS (P <0.01 and P <0.001); IM pts also reported significant improvements on the FACT-G Total (P <0.05), TOI (P <0.001), and FACT-Leu (P <0.001). At 12 mo, trends noted at 3 mo were evident at the same or greater level of significance, except EWB for BOS pts. None of the changes exceeded the MID. Conclusions: These early HRQoL data suggest both BOS and IM increase several aspects of HRQoL in newly diagnosed CP CML pts. This finding is important given the reported efficacy and manageable, but distinct, safety profiles of BOS and IM.

Evaluating the glucose tolerance test in mice

The objective of this study was to determine the optimal conditions under which to assess glucose tolerance in chow- and high-fat-fed C57BL/6J mice. Mice were fed either chow or high-fat diet for 8 wk. Variables tested were fasting duration (0-, 3-, 6-, and 24-h and overnight fasting), route of administration (intraperitoneal vs. oral) load of glucose given (2, 1, or 0.5 g/kg and fixed 50-mg dose), and state of consciousness. Basal glucose concentrations were increased in high-fat- compared with chow-fed mice following 6 h of fasting (9.1 +/- 0.3 vs. 7.9 +/- 0.4 mmol/l P = 0.01). Glucose tolerance was most different and therefore significant (P = 0.001) in high-fat-fed mice after 6 h of fasting (1,973 +/- 96 vs. 1,248 +/- 83 mmol.l(-1).120 min(-1)). The difference in glucose tolerance was greater following an OGTT (142%), in contrast to an IPGTT, with a 127% difference between high fat and chow. We also found that administering 2 g/kg of glucose resulted in a greater level of significance (P = 0.0008) in glucose intolerance in high-fat- compared with chow-fed mice. A fixed dose of 50 mg glucose regardless of body weight was enough to show glucose intolerance in high-fat- vs. chow-fed mice. Finally, high-fat-fed mice showed glucose intolerance compared with their chow-fed counterparts whether they were tested under conscious or anesthetized conditions. We conclude that 2 g/kg glucose administered orally following 6 h of fasting is best to assess glucose tolerance in mice under these conditions.

Aortic Wall Mechanics in the Marfan Syndrome Assessed by Transesophageal Tissue Doppler Echocardiography

The aim of this study was to investigate the value of tissue Doppler imaging (TDI) using transesophageal echocardiography (TEE) in assessing the elastic properties of the thoracic aorta in patients with Marfan's syndrome. Aortic distensibility, stiffness index, and pulse-wave velocity were calculated using M-mode data in a TEE short-axis view in 31 patients with Marfan's syndrome and 22 normal controls. Acceleration time, maximum wall expansion velocity (Vmax), and wall strain were determined from TDI tracings. Indexes derived from TDI differed at a greater level of significance than M-mode-derived indexes in patients with dilated and normal aortas. Significant predictors of aortic dilation were systolic blood pressure, aortic stiffness index, Vmax, and strain. Decreased aortic strain and Vmax and increased stiffness index were predictive of aortic dissection (odds ratios 4.5, 3.3, and 2.2). In conclusion, the TDI assessment of aortic wall mechanics is complementary to standard M-mode measurements in discriminating normal subjects from patients with Marfan's syndrome and is accurate in predicting aortic dilation and dissection.

Association of mu-opioid receptor subunit gene and idiopathic generalized epilepsy.

To replicate and extend the previously reported association between the opioid receptor mu subunit gene (OPRM1) and idiopathic absence epilepsy (IAE), using a sample of 230 probands with idiopathic generalized epilepsy (IGE). In humans and in animal models, several lines of evidence implicate opioid receptors with seizures. The G118 allele of OPRM1 was associated with IAE (p = 0.019). Three single nucleotide polymorphisms (SNP) of OPRM1 were investigated by association studies with IGE using a case/control design, one of which also used a within-family design. Association was found for G118 with IGE (p = 0.00027, odds ratio [OR] = 1.86), replicating the previous association. Within-family tests of linkage and association (haplotype-based haplotype relative risk and transmission disequilibrium test) confirmed this result. Further evidence for involvement of OPRM1 in IGE was provided by an association with G-172T, located in the 5' untranslated region (p = 0.0015, OR = 2.36). Haplotypes of the two SNPs were associated with IGE with a greater level of significance (p = 0.000087) suggesting that both SNPs might be in linkage disequilibrium with a single functional variant. Analysis of the results by subgroups of IGE showed association with all subgroups tested. These results confirm the previous association and support the hypothesis of a role for OPRM1 in IGE, including absence syndromes. However, the authors found no evidence for a specific association between OPRM1 and idiopathic absence epilepsy. The data suggest that the functional variant predisposing to IGE is located within 60kb of exon 1.

Partial peripheral nerve injury leads to activation of astroglia and microglia which parallels the development of allodynic behavior

Three different cell markers were studied in rats to note changes in the immunoreactivity (IR) in the lumbar spinal cord 1 to 84 days following partial sciatic nerve ligation (PSNL). Alteration in average IR were studied for complement receptor C3bi (OX42; microglia), major histocompatibility complex II (OX6; microglia), and glia fibrillary acidic protein (GFAP; astroglia). Thirty-four female rats underwent ligation of approximately 1/2 of the sciatic nerve (PSNL). This injury resulted in the development of mechanical allodynia, which was quantitated by the measurement of foot withdrawal threshold to the application of Von Frey filaments. Ipsilateral increase in IR of OX42 and GFAP was observed to occur within 2 days, maximized by day 14, and did not return to contralateral spinal gray matter IR levels by day 84 (time period of study). Increases in OX42 IR and GFAP IR were observed within the spinal segments innervated by the sciatic nerve. GFAP IR was not expressed in all lumbar segments. OX42 staining with the upper portion of the dorsal horn was found to localize within the areas of deafferentation demonstrated by loss of thiamine monophosphatase activity within the substantia gelatinosa. OX6 IR was only seen in a few cells within the ipsilateral gray matter, indicating that microglia did not become phagocytic. Both GFAP IR and OX42 IR were found to linearly correlate with allodynic behavior with OX42 IR being more statistically significant. Correlation of OX42 IR in only the upper portion of the dorsal horn (not including the neck) resulted in an even a greater level of significance. These findings demonstrate that microglia and astroglia are activated following PSNL and that their increase in IR correlates with the development of allodynic behavior.

Partial peripheral nerve injury leads to activation of astroglia and microglia which parallels the development of allodynic behavior

Three different cell markers were studied in rats to note changes in the immunoreactivity (IR) in the lumbar spinal cord 1 to 84 days following partial sciatic nerve ligation (PSNL). Alteration in average IR were studied for complement receptor C3bi (OX42; microglia), major histocompatibility complex II (OX6; microglia), and glia fibrillary acidic protein (GFAP; astroglia). Thirty-four female rats underwent ligation of approximately ½ of the sciatic nerve (PSNL). This injury resulted in the development of mechanical allodynia, which was quantitated by the measurement of foot withdrawal threshold to the application of Von Frey filaments. Ipsilateral increase in IR of OX42 and GFAP was observed to occur within 2 days, maximized by day 14, and did not return to contralateral spinal gray matter IR levels by day 84 (time period of study). Increases in OX42 IR and GFAP IR were observed within the spinal segments innervated by the sciatic nerve. GFAP IR was not expressed in all lumbar segments. OX42 staining with the upper portion of the dorsal horn was found to localize within the areas of deafferentation demonstrated by loss of thiamine monophosphatase activity within the substantia gelatinosa. OX6 IR was only seen in a few cells within the ipsilateral gray matter, indicating that microglia did not become phagocytic. Both GFAP IR and OX42 IR were found to linearly correlate with allodynic behavior with OX42 IR being more statistically significant. Correlation of OX42 IR in only the upper portion of the dorsal horn (not including the neck) resulted in an even a greater level of significance. These findings demonstrate that microglia and astroglia are activated following PSNL and that their increase in IR correlates with the development of allodynic behavior. GLIA 23:75–83, 1998. © 1998 Wiley-Liss, Inc.