Statistical P-value Research Articles

Risk of contralateral breast and other cancers in patients with invasive lobular breast cancer.

555 Background: Women with early-stage breast cancer (BCa) are living longer, and survivorship issues including second primary cancers (SPCs) are therefore increasingly important. This study seeks to determine the risk of SPCs, including contralateral breast cancer (CBCa), in women with early-stage invasive lobular carcinoma (ILC). Methods: The study population consisted of women with BCa diagnosis between 2000-2018 within the NCI Surveillance, Epidemiology, and End Results (SEER v 3.2.9) registry and between 2000-2021 in the Mayo Clinic Cancer Registry. In the SEER registry, the standardized incidence ratios (SIR) for SPCs were estimated for adult women with histologically confirmed early stage (I-III) ILC compared to the development of any primary cancer in the general population. For reference, SIRs for SPCs for a similar patient population with invasive ductal carcinoma (IDC) of the breast were also estimated. For comparison of CBCa between ILC and IDC, follow up records from the Mayo Clinic Cancer Registry were evaluated among adult women who underwent lumpectomy or unilateral mastectomy for early stage ILC or IDC. A multivariable Cox proportional hazards regression was performed to compare the risk of CBCa between ILC and IDC while adjusting for the age at diagnosis, race/ethnicity and estrogen receptor status of the primary tumor. Results: An increased incidence (p<0.05) of any SPCs and second BCa was noted for both ILC and IDC compared to the expected rate of primary cancer in the general population (Table). Interestingly, women with ILC were observed to have a significantly increased incidence of subsequent gastric cancer which was not seen for women with IDC. An SIR >1.5 was noted for subsequent risk of sarcoma, myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) for both ILC and IDC (Table). In the Mayo Clinic Cancer Registry of 2,218 women with ILC and 14,629 women with IDC meeting the inclusion criteria, the 5-year risk of CBCa was 2.6% and 1.5% (log rank statistic p-value =0.001) for ILC and IDC respectively. A significantly increased risk of CBCa was noted in women with ILC (Hazard Ratio 1.82, 95% CI 1.34-2.47, p<0.001) compared to women with IDC in the multivariable analysis. Conclusions: Women with ILC may have an increased risk of SPC and second BCa compared to the risk of any primary cancer in the general population. The increased incidence of gastric cancer and the higher risk of CBCa in ILC survivors compared to women with IDC is intriguing and needs to be investigated further including evaluation of the role of germline genetic factors. [Table: see text]

Treatment-Related Coronary Disorders of Fluoropyrimidine Administration: A Systematic Review and Meta-Analysis.

Background: Coronary disorders are recognized as the most common manifestation of fluoropyrimidine-related cardiotoxicity in clinical practice. However, there are limited and conflicting data on the incidence and profiles of fluoropyrimidine-related coronary disorders. In this meta-analysis, we aimed to systematically assess the incidence of all-grade and grade 3 or higher fluoropyrimidine-related coronary disorders, and further explore the factors that influence its occurrence. Methods: Studies reporting the fluoropyrimidine-related coronary disorders were retrieved from a systematic search of English literature in the PubMed, Web of Science, Medline, and Cochrane database from 1 Jan 2001, to 1 Jan 2022. The NIH assessment tool was used to evaluate the quality of each study. The data of basic study characteristics, treatment details, and results of coronary toxicities were extracted. According to the results of the heterogeneity test (I2 and p-value statistic), a random-effect model or fixed-effect model was selected for the pooled analysis of the incidence of adverse coronary events. Subgroup analysis was conducted to further explore the risks influencing the occurrence of fluoropyrimidine-related coronary disorders. The stability and publication bias of our results were evaluated by sensitivity analysis and Egger test, respectively. Results: A total of 63 studies were finally included in our pooled analysis, involving 25,577 patients. The pooled cumulative incidence of all-grade and grade 3 or higher coronary disorders was 2.75% (95% CI 1.89%–3.76%) and 1.00% (95% CI 0.62%–1.47%), respectively. The coronary disorders were most reported as myocardial ischemia (1.28%, 95% CI 0.42%–2.49%) and angina/chest pain (1.1%, 95% CI 0.54%–1.81%). Subgroup analysis revealed that studies in the female-only population seemed to have a lower incidence of fluoropyrimidine-related coronary disorders. The occurrence of adverse coronary events varied among different tumor types. Patients with esophageal cancer have the highest coronary toxicity (6.32%), while those with breast cancer have a relatively lower incidence (0.5%). Coronary disorders induced by 5-FU monotherapy are more frequent than that induced by capecitabine (3.31% vs. 1.21%, p < 0.01). Fluoropyrimidine combination therapy, whether combined with other chemotherapy drugs, targeted therapy drugs, or radiotherapy, significantly increased the incidence of coronary complications (p < 0.01). Conclusion: This meta-analysis has defined the incidence of fluoropyrimidine-related coronary disorders and depicted its epidemiological profiles for the first time, which may provide a reference for clinical practice in cancer management.

GGAA-Microsatellites of NR0B1 Promoter Region in Ewing’s Sarcoma Patients and Healthy Individuals of a Southern Brazilian Population

Introduction: The very aggressive soft tissue and bone pediatric tumor Ewing’s sarcoma (ES) is caused in most cases by the chromosomal translocation t(11;22)(q24;q12), which encodes an aberrant chimeric transcription factor (EWS-FLI1) that regulates target genes, including the critical oncogene NR0B1 (Xp21.2), via GGAA microsatellites. Objective: Our objective was to analyze the GGAA microsatellites of NR0B1 promoter region of ES patients and healthy subjects in our population. Methodology: Ten male ES patients and 71 adult healthy males from Rio Grande do Sul state, Brazil, were included in this study. Leukocyte DNA was extracted, amplified by PCR, sequenced by the Sanger method and analyzed by capillary electrophoresis. Total number of GGAA motifs, length of microsatellite in base pairs, number of segments separated by "A" insertions and greatest number of consecutive GGAA motifs were analyzed. Statistical analyses were performed in the SPSS® statistical software and p-value &lt;0,05 was considered significant. Results: A total of 21 different alleles was identified in the 81 subjects, with 24.2 allele [(GGAA)7A(GGAA)7A(GGAA)10 sequence] being the most frequent, but when comparing the data between the two groups, no significant difference was found. Conclusion: We concluded that the studied sample was highly variable in terms microsatellite structure, including the presence of rare alleles, giving us the opportunity to describe our population which is a fundamental step on identifying genetic implications in ES tumorigenesis.

Home care for patients with COVID-19 by family caregivers during covid-19 pandemic

Background: Covid-19 transmission is very easy, and simultaneously, resulting in a higher incidence of morbidity and mortality. The special incidence rate in Ende Tengah District, Onekore Health Center area, in February 2021 there were 11 close contacts, 42 people were the highest SWAB-PCR positive in Ende Regency, 2 people were isolated at the Ende Regional General Hospital, while 40 people were self-isolating. at home, 2 people died. Special attention from families is needed by treating patients in self-isolation according to health protocols, to prevent transmission of COVID-19. Purpose: To determine Covid-19 transmission to family caregivers during home care of members with COVID-19.Method: The design uses a mixed-method with a cross-sectional approach. The sample size is 40 self-isolated patients using total sampling. Data were collected using Chi-Square Bivariate Analysis and Multivariate Logistic Regression Test.Results: There is no effect of work on the prevention of Covid-19 transmission with the results of the bivariate statistical test p-value 0.232. There is an effect of self-isolation patient care at home in the variable not leaving the room, bivariate statistical test p-value = 0.001 ( p&gt; 0.05). The results of the logistic regression statistical test p-value (2.211 - 47.842). However, there was no influence from the four variables, namely recognizing the signs and symptoms of severe Covid-19 ( p-value = 0.894), using the correct health protocol (p-value = 0.163), giving good nutrition (p-value = 0.087) and the needs of patients are served by healthy people (p-value = 0.308). The results of the logistic regression statistical test on the effect of recognizing severe symptoms of Covid-19, the p-value (0.198-6.385). The effect of using health protocols p-value (0.573-20.103) The effect of providing good nutrition p-value 1.476 ( 2.862). The effect of serving the needs of patients by healthy people is the p-value (0.407 – 15.751).Conclusion: The main treatment for self-isolated patients is that patients are not allowed to leave the room to prevent the transmission of Covid-19, by including counseling of family members by nurses at the community health center.

Evaluating the Effect of Routine Hoof Trimming on Fore and Hind Hooves Impact Phase Kinetics

Imbalances and altered kinetics of the hoof result in lameness in horses. Previously, studies have focused on the midstance phase of a gait, hence, available information on the impact phase is scarce. This study aimed to investigate the effect of hoof trimming on the fore and hindhooves at the impact phase of the walk. Our objective was to compare the kinetic variables of force (N), contact area (cm2), contact pressure (kPa), and peak contact pressure (kPa) before and after hoof trimming. Nine Arabian horses were walked straight over a pressure plate to collect the above kinetic variables for both left and right fore and hindhooves. The impact phase was defined as the first contact of each hoof with the pressure plate, which was collected as the first frame of data. The signed rank test was used to determine the difference of each kinetic variable between pre and post trimming for each hoof. A statistical P-value <.05 was considered significant. Routine hoof trimming of the forehooves did not significantly change the hoof kinetic variables, except for an increase of 56% (P = .0391) for contact area (CA) after trimming of the right forehooves. For the left hindhooves, force increased by 35% (P = .019) and CA increased by 18% (P = .039) after trimming. The data revealed how hoof trimming may affect hoof kinetics at the impact phase of the walk for this group of horses and demonstrates the need for further research in other breeds and disciplines.

Relevance of Preoperative Pain Education To The Cardiac Patients on Their Response To Postoperative Pain Therapy

To observe the effects of preoperative pain education on Coronary artery bypass graft surgery (CABG) patients on postoperative pain management. Methods: A randomized control trial was performed from April-December 2019, after seeking ethical approval. Patients of Punjab institute of cardiology, Lahore, scheduled for CABG were selected after informed consent. Those with psychiatric illness, chronic pain/opioid addiction, or allergic to opioids, were excluded. The population was divided into control (received routine preoperative care) and interventional (received additional preoperative education via pain management booklet) groups, data was collected postoperatively via questionnaire and analyzed on SPSS. Chi-square was used as a statistical test and p-value &lt;0.05 was significant. Results: Eighty patients with 47 males and 33 females aged 50-80 years (mean=61.05±8.32) were recruited. The interventional group agreed to the significance of instant in-hospital notifying/managing pain and 38(95%) controls agreed to it, 39(98%) interventional patients were willing for a stronger pain-relief medicine if not cured by the initial dose, while 12(30%) controls were willing for it. 38(95%) interventional patients denied the fear of addiction to painkillers, contrarily 5(12.5%) controls negated this fear. All interventional patients rejected the concern of incurable nausea with pain-relief medicine, while 37(92.5%) controls were threatened with this concern. Constipation associated with pain-relief medicine was refused by all interventional patients, 25(62.5%) controls accepted it. All the differences between both groups were significant (p&lt;0.001). Conclusion: A significantly improved postoperative patient compliance/outcome (pain-related) was observed in the interventional group who preoperative received pain education compared to the control.

Efektifitas Penambahan Source to Image Distance (SID) terhadap Penurunan Dosis Radiasi pada Pemeriksaan Radiografi Cranium

Background: Cranial radiographs are routinely made in 2 projections, namely Antero Posterior (AP) and Lateral with a minimum distance of 100 cm from the radiation source to the image receptor. In addition, it has been shown that increasing the SID from 40 to 48 inches reduces the skin dose even when the requirement for an increase in mAs is considered. A 44-inch or 48-inch SID is recommended where departmental equipment and protocols allow. This study aims to determine the effectiveness of the addition of SID to decrease the radiation dose on cranium radiographs.Methods: This type of research is a pre-experimental quantitative. The study was conducted at the radiology laboratory of Diploma Three Program of Radiology Purwokerto, Semarang Health Politechnic of Ministry of Health. The research subject is a Radiographic Xray Cranial Phantom. At the time of exposure, the radiation dose was measured and the resulting image was measured CNR value.Results: The results of radiation dose measurements at each SID setting for AP cranium radiographs are shown in the table above. setting SID 100 cm produces a radiation dose of 5.58 mSv, SID 110 cm produces a radiation dose of 5.16 mSv, SID 120 cm produces a radiation dose of 5.02 mSv, SID 130 cm produces a radiation dose of 4.84 mSv, SID 140 cm produces a radiation dose of 4.64 mSv and SID 150 cm produces a radiation dose of 4.36 mSv. There are differences in radiation dose values between SID settings of 100 cm, 110 cm, 120 cm, 130 cm, 140 cm and 150 cm with a statistical test p-value 0.001. The results of statistical tests on the Contrast to Noise Ratio value on changes in the SID value of the AP cranium radiography examination showed no significant difference. The p-value of the statistical test is 0.274 which means there is no difference in the CNR value between the SID settings of 100 cm, 110 cm, 120 cm, 130 cm, 140 cm and 150 cm.Conclusions: An increase in SID causes a decrease in radiation dose. The increase in SID did not cause a significant difference to the quality of the Contrast to Noise Ratio on the AP cranium radiograph image.

Induction of Labour at Term: Comparison of Prostaglandin E2 with Foley Catheter

ABSTRACT Background: Induction of labour (IOL) or cervical ripening of an unfavourable cervix can be achieved by both pharmacological and surgical methods. When the cervix is unripe, Foley catheters and prostaglandins method of IOL is used. In this study, we aimed to compare the success rate and cost-effectiveness of vaginal prostaglandin E2 pessary with Foley catheter. Methods: This quasi-experimental study was conducted at the Gynaecological department of Ziauddin hospital from June-December 2019. A total of n=256 women at term were selected according to inclusion criteria. Group 1 was induced with Foley catheter and group 2 with Prostaglandins E2 vaginal pessary. The success rate to achieve delivery, the time interval between induction, delivery and the cost were recorded and compared between the two methods. Student’s t-test (continuous variables) and Chi-square (categories) were used for statistical analysis and p-value &lt; 0.05 was considered statistically significant. Results: The mean age of the females was 27.15 ± 5.5 years. The mean induction to the delivery time interval for PGE2 (group 2) was 15.77 ± 7.37 hours and Foley catheter (group 1) 17.31 ± 7.19 hours (p=0.02). The study did not find any statistically significant difference between the two methods of labour induction(p&gt;0.05). It was found that overall, 198 (77.3%) women delivered by spontaneous vaginal deliveries and 58 (22.7%) by lower Caesarean section (p=0.02, 0.04). However, the total cost of prostaglandins (Rs.1500/-) was higher than the cost of Foley catheter (Rs. 256/-) (p=0.00). Conclusion: Foley catheter to induce labour in an unfavourable cervix is an effective, safe, and inexpensive method of labour induction. Keywords: Foley Catheter; Prostaglandin E2; Induction of Labour; Cost.

Rate and predictors of 30-day readmission for clostridiodes difficile: a United States analysis

Background Clostridiodes difficile is a leading cause of healthcare-associated diarrhea. In this study, we aimed to identify the rates and predictors for 30-day readmissions of Clostridiodes difficile Enterocolitis (CDE) in the United States. Methods We conducted a retrospective study of the Nationwide Readmissions Database to identify adult hospitalizations with a principal diagnosis of CDE for 2018. Individuals <18 years old and elective hospitalizations were excluded. Primary outcomes included readmission rate and the top ten principal diagnosis on readmission, while the secondary outcomes were inpatient mortality, hospital costs and independent predictors of 30-day all-cause readmissions. Furthermore, we devised a scoring system to estimate the risk of CDE readmissions. Stata® Version 16 was used for statistical analysis and p-values ≤0.05 were statistically significant. Results We identified 94,668 index hospitalizations and 18,296 readmissions at 30-days for CDE in 2018. The 30-day all-cause readmission rate was 25.7%. On readmission, CDE was the most common principal diagnosis (25.7%), followed by unspecified sepsis, and acute renal failure. A female predominance was also noted for index and 30-day readmissions of CDE. Compared to index admissions, we noted higher odds of inpatient mortality [4.4 vs 1.4%, Odds Ratio (OR):3.32, 95% Confidence Interval (CI):2.87–3.84, p < 0.001], longer mean length of stay (LOS) [6.4 vs 5.6 days, Mean Difference (MD):0.9, 95% CI:0.7–1.0, p < 0.001), and higher mean total hospital charge (THC) [$56,015 vs $40,871, MD:15,144, 95% CI:13,260–17,027, p < 0.001] for 30-day readmissions of CDE. Independent predictors for 30-day all-cause readmissions of CDE included discharged against medical advice (AMA) [Adjusd Hazard Ratio (aHR):2.01, 95% CI:1.73–2.53, p < 0.001], diabetes mellitus (DM) [aHR:1.22, 95% CI:1.16–1.29, p < 0.001], and chronic kidney disease (CKD) [aHR:1.29, 95% CI:1.21–1.37, p < 0.001]. Conclusion The all-cause 30-day readmission rate and inpatient mortality for CDE was 25.7% and 4.4%, respectively. Discharge AMA, DM and CKD were independent predictors for 30-day all-cause readmissions of CDE. KEY MESSAGE The 30-day all-cause readmission rate for Clostridiodes difficile Enterocolitis was noted to be 21.4% in 2018. Independent predictors of 30-day all-cause readmissions for Clostridiodes difficile Enterocolitis include diabetes mellitus, discharged against medical advice and chronic kidney disease. Readmissions of Clostridiodes difficile Enterocolitis had higher mortality rates, healthcare cost and length of hospital stay compared to index admissions.

Celiac disease hospitalizations: an emerging challenge in the United States.

BackgroundThis study aimed to assess the trends and characteristics of celiac disease (CeD) hospitalizations in the United States (US).MethodsThe National Inpatient Sample was analyzed from 2007-2017 to identify all adult hospitalizations with a primary discharge diagnosis of CeD. Demographic trends, associations, and other aspects of CeD hospitalizations were analyzed. SAS 9.4 was used for statistical analysis and P-values ≤0.05 were considered statistically significant.ResultsFrom 2007-2017, we noted an increasing trend of CeD hospitalizations from 19,385 in 2007 to 38,395 in 2017 (P-trend <0.001). The mean age was 57.85 years, with a declining trend. Females and patients with a Charlson Comorbidity Index score ≥3 had a rising trend of CeD hospitalizations from 70.68% in 2007 to 73% in 2017 (P-trend <0.001) and from 16.96% in 2007 to 26.59% in 2017 (P-trend <0.001), respectively. Additionally, a White predominance was seen in the study cohort. Furthermore, for CeD hospitalizations, all-cause inpatient mortality increased from 1.30% in 2007 to 1.58% in 2017 (P-trend <0.001) and the mean total hospital charge increased from $26,299 in 2007 to $49,282 in 2017 (P-trend <0.001). However, we noted a decline in the mean length of stay (LOS) from 4.88 days in 2007 to 4.59 days in 2017 (P-trend=0.0015) and rates of esophagogastroduodenoscopy performed from 2.09% in 2007 to 1.89% in 2017 (P-trend <0.001).ConclusionWe noted a rising trend in hospitalizations, inpatient mortality, and hospital costs for CeD hospitalizations in the US; however, inpatient EGDs performed and mean LOS showed a decline.

Status of Mast Cells in Autopsy Specimens of Prostate: A Cross-sectional Study

Introduction: Mast cells are found in areas rich in connective tissues and beneath epithelial surfaces. Mast cells have been extensively studied for their orchestration of allergic reactions and autoimmunity. Mast cells infiltrate various prostatic lesions in varying concentrations. Autopsy specimens had not been investigated extensively in the previous literature. Aim: To find out a quantitative estimation of mast cells and the association of the number of mast cells in various prostatic lesions that included both inflammatory and neoplastic lesions in autopsy cases. Materials and Methods: A cross-sectional, analytical study was carried out in the Department of Pathology, R.G. Kar Medical College and Hospital, Kolkata, India from April 2017 to March 2018. Sixty autopsy specimens of the prostate were dissected from the deceased males above 30 years of age. Four to six paraffin embedded sections from different lobes and peri-urethral areas were taken. Haematoxylin and Eosin (H&amp;E) stained sections for histopathological diagnosis and toluidine-blue stain after water mounting to demonstrate mast cells by its metachromasia were performed. Mast cell densities were estimated by a light microscope under high power magnification (400X) on an average of 100 fields. Gross and microscopic findings were recorded. Data analysis correlation was done using Statistical Package for the Social Sciences (SPSS) software version 18.0. Mean and standard deviations were determined for different prostatic lesions. Group means were compared using the student’s t-test. For statistical significance p-value of less than 0.05 was considered. Results: A total of 60 autopsy specimens of the prostate were studied comprising 8 (13.5%) specimens of normal prostate, which acted as a control, 6 (10%) specimens of prostatitis, 27 (45%) specimens of Benign Hypertrophy of Prostate (BHP), 12 (20%) specimens of BHP with Prostatic Intraepithelial Neoplasia (PIN), 3 (5%) specimens of prostatitis with focal PIN and 4 (6.5%) specimens of prostatic adenocarcinoma. Mast Cell Density (MCD) was higher in prostatitis {6-8 per High Power Fields (HPF)}, compared to normal (1-3/HPF) and BHP (3-5/ HPF), lowest in adenocarcinoma (1-2/HPF) and intermediate in PIN (2-4/HPF). Conclusion: Mast cell density was the lowest in prostatic adenocarcinoma and significantly higher in prostatitis, probably due to a lack of antitumour immunity in higher grades, whereas it was significantly higher in chronic non specific prostatitis possibly because of inflammatory response.

Assessment of Normal Intracranial Parameters of the Sellar Region in Healthy Subjects of South Indian Population: A Retrospective Study

Introduction: There is a significant degree of anatomical variation at the level of the sphenoid sinus and sella turcica and a wide range of these values have been reported in literature and ethnic variation has also been found to contribute to this. Thus preoperative imaging of the central skull base with a knowledge of the normal anatomy and measurements in a specific population is imperative to identify these variations and prevent avoidable intraoperative complications. Aim: To assess the normal intracranial measurements of the intercarotid distance, pituitary fossa width, optic chiasm height, optic chiasm width and the pituitary to optic chiasm distance in healthy subjects of the South Indian population aged between 10 to 80 years and establish normal reference ranges across the various age groups. Materials and Methods: This retrospective study was conducted in the Radiology Department at SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India, from July 2021 to December 2021. The study included normal Magnetic Resonance Imaging (MRI) brains of 700 healthy subjects (378 males and 322 females) in the age range of 10 to 80 years. Subjects were divided into seven groups of 100 subjects for each decade. The variables that were measured included the intercarotid distance, pituitary fossa width, optic chiasm height, optic chiasm width and the pituitary to optic chiasm distance. RStudio version 1.2.1093 was used for statistical analysis and p-value &lt;0.05 was considered statistically significant. Association between age and outcome variables was assessed by Pearson’s correlation coefficient and its 95% confidence interval. Results: The overall mean age was 45.4 years. The overall mean intercarotid distance was 16.2±3.7 mm, optic chiasm width was 13.1±1.6 mm, optic chiasm height was 2.18±2.7 mm, pituitary width was 12.1±2.3 mm, pituitary to optic chiasm distance was 5.7±1.84 mm. The overall pituitary fossa width and pituitary to optic chiasm distance was found to be higher in males (p-value &lt;0.001; p-value=0.03 respectively) than females while there was no significant difference between genders in the rest of the parameters. A low and positive correlation was found between age and the pituitary width, age (r-value=0.175, p-value &lt;0.001) and the pituitary to optic chiasm distance (r-value=0.342, p-value &lt;0.001) and pituitary width and optic chiasm width (r-value=0.236, p-value &lt;0.001). A strong and positive correlation was found between the pituitary width and the intercarotid distance (r-value=0.736, p-value &lt;0.001). Conclusion: Establishment of normal reference values across various age groups of the South Indian population may prove useful for future reference and improving diagnostic accuracy.

Correlation of Serum Biochemical Parameters and Oxidative Stress in Malnourished Children: A Case-control Study

Introduction: There are evidence regarding enhanced oxidative stress in the form of serum Malondialdehyde (MDA) and depleted activities of serum zinc and iron in malnourished children. The deficiency of trace elements predisposes the susceptibility to various infections. Changes in oxidant and antioxidant levels may be responsible for grading in Protein Energy Malnutrition (PEM). Aim: To correlate the levels of serum biochemical parameters such as proteins, zinc, iron with oxidative stress in the form of Malondialdehyde (MDA), in malnourished children of 1-5 years of age and also to compare the findings with age and gender matched well-nourished children. Materials and Methods: This case-control study was conducted in the Biochemistry Department at Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India, from January to December 2014. A total of 202 children (aged 1-5 years) were included in the study. Out of these, 103 children were undernourished and 99 children were healthy control. Out of 103 undernourished children 46 were severe malnourished and 57 were moderate malnourished. Blood samples were analysed for the estimation of serum zinc, iron, MDA, albumin and total protein. T-test, one-way Analysis of Variance (ANOVA) and Pearson correlation were used for statistical analysis and p-value &lt;0.001 was considered significant. Results: Mean weight of moderate malnourished (10.44±2 kg) and severe malnourished children (9.36±1.54 kg) were significantly low (p-value &lt;0.001) when compared with control group (12.73±2.36 Kg). Compared to controls (0.71±0.18 nmol/mL) the serum MDA level were significantly high (p-value &lt;0.001) in both moderate (1.84±0.38 nmol/mL) and severe (3.44±0.59 nmol/mL) malnourished children. Serum zinc and serum iron levels, serum total protein and albumin of malnourished cases were significantly low (p-value &lt;0.001) as compared to the control subjects. Conclusion: Compared to control, the malnourished children had significant high level of serum MDA while low levels of serum zinc, iron, albumin, globulin and total proteins. Early replacement of antioxidants, nutrients, proteins, zinc and iron supplement could be useful in the therapy of this disease.

A Glymphatic System and New Etiopathogenic Hypothesis on Glaucoma Patients Who Underwent Osteopathic Manipulative Treatment: A Pilot Study

Purpose Malfunction of the lymphatic or glymphatic system recently shown in the brain, seems to play an important role in central neurodegenerative pathologies through a build-up of neurotoxins. Recent studies have shown functional links between aqueous humour and cerebrospinal fluid via the glymphatic system, offering new perspectives and unifying theories on the vascular, biomechanical and biochemical causes of chronic and openangle glaucoma (POAG). The aim of this randomized pilot study is to compare the variations in intraocular pressure between 20 cases of compensated POAG under pharmacological therapy and 20 glaucoma patients undergoing osteopathic treatment, hypothesizing that this manipulation can influence intraocular pressure. Materials and Methods The 40 patients under study, all covered by the Helsinki convention, were randomly divided into 2 groups (treated group or TG and control group or CG). The 40 patients were chosen from compensated glaucoma sufferers, who required neither changes in therapy nor operations which would affect their eye pressure which was measured both before and after manipulative osteopathic treatment scheduled into 4 sessions at intervals of 7.3 and 150 days, then compared with the control group (20 patients) who were undergoing pharmacological treatment only. Results The average IOP in the TG was compared with the CG throughout the entire treatment cycle showing a statistically inconclusive reduction in the right eye RE P-value (0.0561), while for the left eye a significant effect was shown LE (0.0073). The difference between the reduction in IOP between TG and CG was observable 10 months after the first session or rather 5 months after the last, and demonstrable during a check-up 13 months after the beginning of the study, or rather 8 months in absence of treatment with a highly significant statistical p-value (0.000434). Conclusions This study has shown that manipulative osteopathic treatment can affect intraocular pressure after each session and that the pressure is significantly lower even months after the last treatment session.

The Glymphatic System and New Etiopathogenic Hypotheses Concerning Glaucoma Based on Pilot Study on Glaucoma Patients Who Underwent Osteopathic Manipulative Treatment (OMT)

Purpose Malfunction of the lymphatic or glymphatic system recently shown in the brain, seems to play an important role in central neurodegenerative pathologies through a build-up of neurotoxins. Recent studies have shown functional links between aqueous humour and cerebrospinal fluid via the glymphatic system, offering new perspectives and unifying theories on the vascular, biomechanical and biochemical causes of chronic and open angle glaucoma (POAG). The aim of this randomized pilot study is to compare the variations in intraocular pressure between 20 cases of compensated POAG under pharmacological therapy and 20 glaucoma patients undergoing osteopathic treatment, hypothesizing that this manipulation can influence intraocular pressure. Materials and Methods The 40 patients under study, all covered by the Helsinki convention, were randomly divided into 2 groups (treated group or TG and control group or CG). The 40 patients were chosen from compensated glaucoma sufferers, who required neither changes in therapy nor operations which would affect their eye pressure which was measured both before and after manipulative osteopathic treatment scheduled into 4 sessions at intervals of 7.3 and 150 days, then compared with the control group (20 patients) who were undergoing pharmacological treatment only. Results The average IOP in the TG was compared with the CG throughout the entire treatment cycle showing a statistically inconclusive reduction in the right eye RE P-value (0.0561), while for the left eye a significant effect was shown LE (0.0073). The difference between the reduction in IOP between TG and CG was observable 10 months after the first session or rather 5 months after the last, and demonstrable during a check-up 13 months after the beginning of the study, or rather 8 months in absence of treatment with a highly significant statistical p-value (0.000434). Conclusions This study has shown that manipulative osteopathic treatment can affect intraocular pressure after each session and that the pressure is significantly lower even months after the last treatment session.

CT evaluated sarcopenia signals: Shorter survival for small cell lung cancer patients.

Sarcopenia is an independent risk factor for morbidity and mortality in patients suffering from small cell lung cancer (SCLC), however, a universal indicator of sarcopenia usable in clinical practice is still missing. A novel indicator for describing the severity of cancer could be helpful in tailoring the anti-tumor therapy. The aim of this study was to evaluate the computed tomography (CT) scans of total muscle area and radiation attenuation in patients suffering from small cell lung cancer. We used staging CT scans performed at the time of diagnosis to measure total muscle area (TMA) and average psoas density (PD) at level of the 3rd lumbar vertebra. TMA and PD were statistically evaluated in association with overall survival and disease staging. We used Mann-Whitney test and Spearman´s correlation coefficient for statistical testing and p-value under 0.05 was considered statistically significant. Retrospectively we examined 47 patients suffering from SCLC (mean age 65.05+/-7.3 years, BMI 23.97+/-4.4 kg/m2, BSA 1.77+/-0.2 m2, 30-day mortality was 4.3 % with 10 months median survival). As sarcopenia was pointed TMA under 55 and 39 cm2/m2 for men and women respectively. The sarcopenic patients had significantly shorter median survival (7 vs. 11 months, p=0.05). We observed a significant relationship between survival and performance status (Spearman´s correlation, R=-0.39, p=0.05). The patients were divided into two groups according to the extensive (ED, n=34) or limited (LD, n=13) form of the disease. We observed significant difference in PD (42.49+/-6.1 vs. 47.67+/-4.5 HU, p=0.006) between ED vs. LD groups.

Using bi-dimensional representations to understand patterns in COVID-19 blood exam data

Blood tests play an essential role in everyday medicine and are used by doctors in several diagnostic procedures. Moreover, this data is multivariate – and often some diseases, such as COVID-19, could have different symptom manifestations and outcomes. This study proposes a method of extracting useful information from blood tests using UMAP technique - Uniform Manifold Approximation and Projection for Dimension Reduction combined with DBSCAN clustering and statistical approaches. The analysis performed here indicates several clusters of infection prevalence varying between 2%–37%, showing that our procedure is indeed capable of finding different patterns. A possible explanation is that COVID-19 is not just a respiratory infection but a systemic disease with critical hematological implications, primarily on white-cell fractions, as indicated by relevant statistical test p-values in the range of 0.03–0.1. The novel analysis procedure proposed could be adopted in other data-sets of different illnesses to help researchers to discover new patterns of data that could be used in various diseases and contexts.

Gene-Based Testing of Interactions Using XGBoost in Genome-Wide Association Studies.

Among the myriad of statistical methods that identify gene–gene interactions in the realm of qualitative genome-wide association studies, gene-based interactions are not only powerful statistically, but also they are interpretable biologically. However, they have limited statistical detection by making assumptions on the association between traits and single nucleotide polymorphisms. Thus, a gene-based method (GGInt-XGBoost) originated from XGBoost is proposed in this article. Assuming that log odds ratio of disease traits satisfies the additive relationship if the pair of genes had no interactions, the difference in error between the XGBoost model with and without additive constraint could indicate gene–gene interaction; we then used a permutation-based statistical test to assess this difference and to provide a statistical p-value to represent the significance of the interaction. Experimental results on both simulation and real data showed that our approach had superior performance than previous experiments to detect gene–gene interactions.

Role of IL-33 and IL-1α in Ovarian Cancer Metastasis

Aim: The current study conducted with aims to evaluate the levels of various inflammatory cytokines in women affected by ovarian cancer.&#x0D; Methods: Case-control study was conducted from 1st January 2018 to 4th March 2018 among women affected by ovarian cancer in Institute of Molecular Biology and Biotechnology, The University of Lahore, Pakistan. Ovarian cancer patients (n=50) and control individuals (n=50) were included in present study. Serum was separated from patients and control individuals from which levels of various interleukins (IL-6, IL-33, IL-8, IL-10, IL-1α) and TNF-α were measured by ELISA kit method.&#x0D; Results: The results of present study explain that increased levels of IL-10, IL-6, IL-8 and TNF-α were recorded in women affected by ovarian cancer in contrary with control individuals. Elevated trend of IL-33 and IL-1α were recorded in ovarian cancer patients (9.02±2.55 pg/ml and 8.44±2.55 pg/ml) in contrary with healthy group (3.88±1.02 pg/ml and 3.56±1.32 pg/ml) with statistical significant p-value=0.000.&#x0D; Conclusion: Study has concluded that inflammatory cytokines particularly IL-1α and IL-33 are major source of inflammatory pathway in the development of ovarian cancer invasion, proliferation and metastasis.

Testing Gene-Gene Interactions Based on a Neighborhood Perspective in Genome-wide Association Studies.

Unexplained genetic variation that causes complex diseases is often induced by gene-gene interactions (GGIs). Gene-based methods are one of the current statistical methodologies for discovering GGIs in case-control genome-wide association studies that are not only powerful statistically, but also interpretable biologically. However, most approaches include assumptions about the form of GGIs, which results in poor statistical performance. As a result, we propose gene-based testing based on the maximal neighborhood coefficient (MNC) called gene-based gene-gene interaction through a maximal neighborhood coefficient (GBMNC). MNC is a metric for capturing a wide range of relationships between two random vectors with arbitrary, but not necessarily equal, dimensions. We established a statistic that leverages the difference in MNC in case and in control samples as an indication of the existence of GGIs, based on the assumption that the joint distribution of two genes in cases and controls should not be substantially different if there is no interaction between them. We then used a permutation-based statistical test to evaluate this statistic and calculate a statistical p-value to represent the significance of the interaction. Experimental results using both simulation and real data showed that our approach outperformed earlier methods for detecting GGIs.