Mann-Whitney U-Wilcoxon Rank Sum Research Articles

Variation in Neurophysiological Function and Evidence of Quantitative Electroencephalogram Discordance: Predicting Cocaine-Dependent Treatment Attrition

Variation in Neurophysiological Function and Evidence of Quantitative Electroencephalogram Discordance: Predicting Cocaine-Dependent Treatment Attrition

Association between level of education and oral health status in 35-, 50-, 65- and 75-year-olds.

The aim of the present study was to evaluate the association between educational level and dental disease, treatment needs and oral hygiene habits. Randomized samples of 35-, 50-, 65- and 75-year-olds, classified according to the educational level: [low (LE): elementary school or higher (HE)], were identified. In 1091 subjects, a number of characteristics such as (i) number of teeth, (ii) periodontal attachment levels (PAL), (iii) caries and (iv) occlusal function were recorded. Educational level, oral hygiene and dietary habits were self-reported. Non-parametric variables were analyzed by chi2, Mann-Whitney U-Wilcoxon's rank sum tests, and parametric variables by Student's t-test (level of significance 95%). A two-way anova was performed on decayed, missing and filled surfaces to investigate the interaction between age and educational level. All statistical procedures were performed in the SPSS statistical package. The number of remaining teeth was similar for LE and HE in the 35-year olds (25.8 versus 26.6), but in the older age groups LE had significantly a larger number of missing teeth. The LE groups (except in 65-year olds) exhibited significantly more PAL loss. LE had significantly fewer healthy gingival units in all but the 75-year age group. In all age groups, LE had fewer intact tooth surfaces and a significantly poorer occlusal function. The frequency of tooth cleaning measures and dietary habits did not differ between LE and HE. Educational level was shown to influence the oral conditions and should be considered in assessing risk, and in planning appropriate preventive measures.

C-REACTIVE PROTEIN AND INTERLEUKIN 6 RECEPTOR IN POST-TRAUMATIC STRESS DISORDER: A PILOT STUDY

Background: it has been reported that psychological stress in humans is associated with a derangement of biological homeostasis. This pilot study aimed to examine the inflammatory response to post-traumatic stress disorder (PTSD) through measurements of the serum levels of the receptor to interleukin6 (sIL-6r) and C-reactive protein (CRP), in relation to measures of psychological disturbance.Methods: 15 patients with established PTSD and eight control patients with musculoskeletal injuries were studied at least three months after their index trauma. All completed revised impact of events scale (RIES), Davidson's trauma scale (DTS) and the general health questionnaire (GHQ), and gave blood samples that were assayed for CRP and sIL-6r. Statistical analysis was by the Mann–Whitney U-Wilcoxon rank sum tests.Results: positive relationships were found between sIL-6r and the RIES intrusion score (P=0.026), and between CRP and DTS intrusion scores (P=0.016), GHQ depression (P=0.028), and RIES intrusion (P=0.044) in the case group.Discussion: we have demonstrated a relationship between post-traumatic psychological and biological disturbance, which provides the basis for further research on the effects of psychological disturbance on physical recovery after injury.

Assessment of optic nerve compression in graves' ophthalmopathy: The usefulness of a quick T1-weighted sequence

Diagnosis of optic nerve compression can be difficult in patients with equivocal clinical signs. We examined the usefulness of a quick coronal MR sequence performed at a predetermined plane as a screening tool for selecting patients at high risk of optic nerve compression. Direct coronal images of the orbit were obtained in 37 patients with Graves' disease in a predetermined plane. The muscular indices (MI) of each orbit were calculated. Mann-Whitney U-Wilcoxon rank sum test was used to assess if there was any statistically significant difference between patients with and without signs of optic nerve compression. The ROC curve was used to identify a value useful for discriminating patients with a higher risk of developing optic nerve compression. There was a statistically significant difference (p<0.05) in the MI between patients with and without optic nerve compression. An MI of -0.48 had 100% sensitivity, 89% specificity and 91% accuracy in identifying patients with optic nerve compression. CONCLUSION. A quick coronal MR image obtained at the mid-orbital plane is useful in screening patients with Graves' disease for optic nerve compression.

Saliva biomonitoring of atrazine exposure among herbicide applicators.

A field study was conducted in which saliva samples were collected from a cohort of herbicide applicators during the pre-emergent spray season in Ohio in 1996. Atrazine concentrations were detected in human saliva samples using an enzyme-linked immunosorbent assay (ELISA) method. Trend due to atrazine exposure and subsequent elimination in the body were evidenced by the temporal pattern of decreasing atrazine concentrations in saliva over time. Median salivary concentrations of atrazine on non-spray days were significantly lower than on spray days for each sampling time (Mann-Whitney U-Wilcoxon rank sum test, P < 0.01). Within spray days, median salivary atrazine concentrations were significantly higher on days atrazine was sprayed than on days herbicides other than atrazine were sprayed for each sampling time (Mann-Whitney U-Wilcoxon rank sum test, P = 0.02 for 4 6 p.m. samples, P = 0.04 for bedtime samples, P = 0.03 for next-morning samples). Median salivary atrazine concentrations on days atrazine was sprayed were higher than the median concentration for the corresponding sampling time on non-spray days and on days when other herbicides were sprayed. Salivary concentration of atrazine is a plausible indicator of those days in which atrazine spraying was likely to have occurred. Salivary concentrations of atrazine not only reflect exposures resulting from spraying atrazine, but also exposures from other field activities where applicators may come in contact with atrazine. The results of this study confirmed data from animal experiments that atrazine is able to cross the cell membranes of salivary glands, and can be measured in human saliva with high sensitivity. The sampling method itself is convenient and easy to use in the field, with a high compliance rate, and analytical procedures are rapid and inexpensive. It is, therefore, concluded that saliva sampling of atrazine exposure among herbicide applicators is a feasible biomonitoring method.

A randomised controlled trial of the costs of hospital as compared with hospital in the home for acute medical patients

To test the cost effectiveness of Hospital in the Home compared to hospital admission for acute medical conditions. Randomised controlled trial at the Prince of Wales Hospital, Sydney, from October 1995 to February, 1997; 100 patients with acute medical conditions admitted through the Emergency Department. The Hospital in the Home (HITH) group costs per separation ($1,764, CI 95% $1,416-$2,111, n = 50) were significantly lower (p < 0.0001, Mann-Whitney U-Wilcoxon Rank Sum) than the control group hospital separation ($3,614, CI 95% $2,881.37-$4,347.27, n = 47) with no significant difference in clinical outcomes, and comparable or better user satisfaction. Given the favourable clinical outcomes the HITH model produces at a lower cost, the cost-effectiveness of the care mode is high, and the allocative efficiency favourable. As a care model and critical pathway, HITH offers hospitals real bed day savings that can either be used to rationalise resource usage for a given level of activity, or increase throughput.

Optical Coherence Tomography for Retinal Thickness Measurement in Diabetic Patients Without Clinically Significant Macular Edema

To evaluate the potential of optical coherence tomography (OCT) as a screening method for retinal thickness measurements in diabetic patients. We used a previously described pattern of six 5 mm OCT scans through the center of fixation in 45 diabetic patients without clinically significant macular edema: 22 patients (group 1) had no diabetic retinopathy (ETDRS classification); 18 (group 2) had nonproliferative retinopathy; 5 patients with peripheral neovascularization did not enter statistical analysis; 25 normal healthy subjects were used as a control group. Retinal thickness was measured at five locations in each scan: in the fovea, at the foveal rim, and outside the macula. Measurements were identified in nonaligned images and taken from raw data A-scans. Locations were grouped into hemispheres, quadrants and rings, and mean values tested for statistically significant differences using Mann-Whitney U-Wilcoxon rank sum W test. Differences in retinal thickness were found to be significant in the macula (controls vs group 2 P = 0.0266), at the foveal rim (controls vs group 1 and 2: P = 0.0386 and P = 0.0193), in the nasal and superior hemisphere (controls vs group 2: P = 0.0251 and P = 0.0187), and in the superior nasal quadrant (controls vs group 1 and group 1 vs group 2: P = 0.0022 and P = 0.0462). Significant differences of retinal thickness between patients with diabetic retinopathy and normals can be detected by OCT even in the absence of clinically significant macular edema. Significant differences between diabetic patients with and without retinopathy are most likely to be found in the superior nasal quadrant.

4652 The effectiveness of preoperative drainage for malignant biliary obstruction.

Background :Malignant biliary obstruction carries a very poor prognosis. Preoperative biliary drainage provides a better surgical condition, but some reports show various adverse effects of this procedure.We evaluated the effectiveness of preoperative drainage with the assessment of several factors which might influence clinical outcome. Methods :Forty-four patients with malignant biliary obstruction who underwent Whipple's operation from January, 1996 to March, 1999 were analyzed. The patients were divided into 3 groups: no drainage, PTBD and ENBD groups.We analyzed patient chracteristics, laboratory findings, operating factors, hospital courses and complications. Statistical evaluation was performed using Kruskal-Wallis one-way ANOVA test and Mann-Whitney U-Wilcoxon Rank Sum W test by SPSS programe. Results :There were no differences of basic characteristics, initial or preoperative laboratory data, tumor size and invasiveness. Significant difference couldn't be found between complications, operating factors and hospital courses, however, the duration of jaundice in PTBD group were longer than in ENBD group. The drain itself was well functioning because there was no difference of preoperative bilirubin. To divide the patients according to initial bilirubin >or ≤9.0 mg/dl, there was also no difference of hospital courses and operating factors except day of jaundice, initial bilirubin and alkaine phosphatase expressed a biliary obstructive data. Conclusion :The preoperative biliary drainage in malignant biliary obstruction did not affect postoperative complications, operative difficulty and hospital courses. Careful patient selection could be recommended.

A biomechanical investigation of the effect of additional transpedicular fixation of the corpectomied vertebrae on stability: a calf spine model

Objectives: To investigate whether an additional transpedicular screw fixation of the injured vertebra would increase the stability of posterior fixation. Methods: Ten fresh calf spine segments, each containing three motion segments, were obtained and anterior corpectomy was performed at the middle vertebra of each specimen. Posterior spinal instrumentation was performed in all specimens. In one group (n=5), screws were placed into the pedicle one level above and below the corpectomy level. In another group (n=5), additional transpedicular fixations were made at the corpectomy level. Stability of both groups was tested using compressive loads. The results were statistically evaluated using Mann-Whitney U-Wilcoxon rank sum W test. Results: The model showed not only that additional screw placement at the injury level did not contribute to the stability of the posterior stabilization of the vertebrae but also that screws applied to the corpectomied vertebra gave rise to additional injury to the pedicles. Conclusion: Due to small sample size and since only compressive forces were studied, further studies are required on flexion, extension, lateral bending, and torsional forces and the results should be supported by clinical studies.

PSYCHOPHYSIOLOGICAL EFFICACY OF A 2% AMINOPHYLLINE-BASED THIGH REDUCING CREAM.

1019 Aminophylline-based creams are marketed as fat reducing agents for the thighs. The purposes of this study were to determine if: 1) a thigh reducing cream would influence body image, 2) product price would influence perception of effectiveness and, 3) the product would decrease thigh size. Serving as their own control, 11 women with thigh cellulite were randomly assigned to a double-blinded, counterbalanced cream treatment with 2% aminophylline (A) on one leg and a placebo (P) on the other (age: 26±7 yrs.; BMI: 23±2 kg/m2; Body Fat (BF): 24±4%; VO2: 39±4 ml/kg/min). They were also randomly assigned into a fictitious expensive (E) or inexpensive (I) cream treatment group. In the lab, subjects massaged 4.5 g of either A or P cream for 1 min into each thigh 5 d/wk for 6 wks. Pre/post testing was done 1 wk prior and immediately after the 6 wk intervention. Dependent measures included thigh girth and skinfolds (distal, mid, proximal to patella) and psychological indices (mood, body image, rating of effectiveness). Results: No significant differences (NSD) were found at baseline between the E vs. I groups for VO2, %BF, or BMI (Independent T's, p>.20). NSD were found for the right vs. left thigh measures at baseline, nor for pre-post measures of VO2, %BF, or BMI (Paired T's, p>.22). NSD were found for skinfold and girth measures between A vs. P-treated thighs (Paired T's, p>.10). Subjects in both the E and I groups reported improved thigh image (Friedman 2-way ANOVA, p=.046), but neither the E nor I group were influenced by product cost (Mann-Whitney U-Wilcoxon Rank Sum Test, p>.17). Conclusions: The 2% A cream was not effective in reducing thigh size, however, the subjects felt more positive about their thighs and overall body build. (Partially supported by FAU Foundation)

Quantitative analysis on the localization of chondroitin sulfate proteoglycan in renal tissues of patients with calcium nephrolithiasis.

Previous studies have shown a significant decrease of heparin sulfate proteoglycan (HSPG) in the basement membrane of the glomerulus and the mucosa of the ureter/renal pelvis in patients with calcium nephrolithiasis. In this study, we looked at the localization of another influential proteoglycan, chondroitin sulfate (CSPG), using similar study groups by indirect immunofluorescence staining. Microscopic images were digitized and image analysis was used to quantitate the staining intensity of CSPG present in the basement membrane of the nephron. Our data showed significant loss of CSPG in the Bowman's capsule and the basement membrane of the mucosa of the ureter/renal pelvis using Mann-Whitney U-Wilcoxon Rank Sum W test with P-values of 0.0043 and 0.0041, respectively. However, absence of staining was noted in the basement membrane of the glomerulus and no significant change in the basement membrane of the tubular epithelium was observed. In conclusion, our results showed changes in the localization of CSPG in the basement membrane of the nephron, accompanied with HSPG, which may contribute to the pathological condition of calcium nephrolithiasis.

Student and preceptor perceptions of factors in a successful learning partnership.

Thirty-two registered nurse preceptors and 42 senior undergraduate nursing students completed a survey ranking factors related to both participants in the clinical learning partnership. Mann-Whitney U-Wilcoxon Rank Sum W tests showed statistically significant differences in the ranking of four factors (the ability to give and receive criticism, knowledge of the preceptoring process, clinical competence, and compatibility) that contribute to successful learning partnerships. Nurse educators and professional nurses should acknowledge these perceptual differences and include these in student and preceptor orientation programs to promote a positive teaching and learning partnership.

The Role of Nutrition Support Dietitians as Viewed by Chief Clinical and Nutrition Support Dietitians: Implications for Training

Objectives To determine current and ideal frequencies with which nutrition support dietitians perform each item on a list of 15 tasks and evaluate dietitian preparation for the practice of nutrition support. Design Data were collected using two questionnaires, one completed by the chief clinical dietitian and the other completed by the nutrition support dietitian at each hospital surveyed. Both versions of the questionnaires contained a list of 15 tasks that had been validated as being related to advanced nutrition support by a panel of 20 nutrition support experts using a modified Delphi method. Follow-up telephone calls were made to increase the number of responses. Sample Questionnaires were mailed to the chief clinical dietitian at 300 randomly selected, general medical/surgical hospitals with 300 or more beds in the United States and Puerto Rico. A total of 134 chief clinical dietitians (45%) and 129 nutrition support dietitians (43%) responded to the surveys; 124 (41%) and 120 (40%) questionnaires, respectively, were usable for statistical analyses. Statistical analyses The Wilcoxon matched-pairs signed-ranks test was used to determine differences between nutrition support dietitian actual and ideal frequencies and between chief clinical dietitian actual and ideal frequencies for each of the 15 tasks. The Mann-Whitney U-Wilcoxon rank sum W test was used to determine differences between nutrition support dietitian and chief clinical dietitian actual frequencies and between nutrition support dietitian and chief clinical dietitian ideal frequencies for each of the 15 tasks. Descriptive statistics were used to analyze the questions regarding educational preparation for nutrition support practice and demographic data. Results The ideal frequency for each of the 15 tasks was significantly greater ( P<.0001) than the actual frequency reported by nutrition support dietitians and chief clinical dietitians. Whereas chief clinical dietitians and nutrition support dietitians agreed on the ideal frequency for most tasks, the nutrition support dietitian ideal frequency indicated for the tasks “determines macronutrient composition of parenteral nutrition” and “performs physical examinations related to nutritional status, fluid status, and gastrointestinal function” was significantly greater ( P<.001, P<.05), respectively) than the ideal frequency indicated by chief clinical dietitians. Of the nutrition support dietitians, 79% agreed and 16% somewhat agreed that experiences beyond those required for becoming a registered dietitian are needed to provide nutrition support dietitians with specialized clinical skills. Applications/conclusions Nutrition support dietitians desire increased responsibility for delivering nutrition support to their patients and this desire is largely supported by chief clinical dietitians. Nutrition support dietitians appear to have a strong interest in postregistration qualifying experiences that would provide a foundation for expanding their roles. According to the results of this study, programs designed to provide practical, clinical experience in nutrition support are needed. J Am Diet Assoc. 1997;97:1255-1260,1263.

Circulating interleukin-1 receptor antagonist levels in neonates.

Circulating interleukin-1 receptor antagonist (IL-1 Ra) levels have been shown to reflect disease activity in certain conditions in adults. We determined circulating IL-1Ra references values for healthy neonates (healthy preterms and term infants with mild disease only) on days 2 (n = 17) and 4 of life (n = 23). Mean gestational age was 35 +/- 2.6 weeks. On the 2nd day of life IL1-Ra levels were 0.78 ng/ml (0.49/2.65), on day 4 0.38 ng/ml (0.20/0.48) (median, 25th/75th percentile, P = 0.01). The values were not influenced by gender. In neonates with severe illness (septicaemia, asphyxia, neonatal respiratory distress syndrome), who received invasive intensive care, circulating IL-1Ra levels were significantly higher than in the reference group of healthy newborns. On the 2nd day of life (14.72 ng/ml (4.38/18.67) versus 0.78 ng/ml (0.49/2.65), P < 0.0001; on day 4 of life, 3.38 ng/ml (0.80/11.99) versus 0.38 ng/ml (0.20/0.48), P < 0.005 (values are median; 25th/75th percentile, Mann-Whitney U-Wilcoxon Rank Sum W Test, two-tailed P). Compared to healthy individuals beyond the neonatal period, Il-1Ra concentrations are physiologically elevated within the first days of life and decline to low levels within days. In contrast, IL-1Ra levels are strikingly elevated in sick neonates.

Characterization of sugar receptor expression by neoglycoproteins in oral and oropharyngeal squamous cell carcinomas.

Recognition of the carbohydrate part of cellular glycoconjugates by sugar receptors like lectins may contribute to biosignaling and interactions between normal and transformed cells. Such recognitions may be essential for establishing phenotypic characteristics in neoplastic cells, including metastasis-associated properties. To evaluate various glycoconjugates in tumor diagnosis and clinical therapy, a panel of 18 biotinylated neoglycoproteins was prepared. This included conjugates of a histochemically inert carrier protein and crucial sugar moieties such as D-glucuronic acid, alpha- and beta-N-acetyl-galactosamine, beta-N-acetyl-glucosamine, melibiose, lactose, maltose, cellobiose, mannose, mannose-6-phosphate, fucose, rhamnose, and xylose. In so doing the diazo derivative of the respective p-aminophenyl glycosides was coupled with galactose, beta-N-acetyl-galactosamine or beta-N-acetyl-glucosamine via an epoxy group-containing aliphatic spacer. Other glycoconjugates used were the proteoglycan heparin and the sulfated fucan fucoidan. Labeling was effected with cyanogen bromide activation and aminoalkylation for specific detection of endogeneous sugar receptors, especially lectins. Tissues studied were paraformaldehyde-fixed, paraffin-embedded surgical biopsies from patients with different stages of squamous cell carcinomas (SCCs) of the oral cavity (n = 16) and oropharynx (n = 17), including three lymph node metastases from oropharyngeal primary tumors. Semiquantitative binding differences of probes to tumor stages were evaluated statistically by the Mann-Whitney U-Wilcoxon rank sum W test. Specific binding of a probe to cytoplasmic and nuclear structures was detected with apparent quantitative differences. Overall, the cytoplasmic compartment revealed a higher intensity of histochemical reaction than did nuclear structures, indicating a comparatively higher density of specific carbohydrate receptors.(ABSTRACT TRUNCATED AT 250 WORDS)