Statistical Evidence Of Association Research Articles

Nature, prevalence, and risk factors for self-neglect among older people: a pilot study from Vellore, South India

Changes in demography in developing countries haves led to new issues among older rural populations, such as self-neglect which is under researched.Self-neglect identified as poor self-care, unsafe living quarters, inadequate medical care and poor utilization of services increase the odds of morbidity and mortality.Methods Our study was conducted in Kaniyambadi, a rural block in Vellore district in the state of Tamil Nadu, India. Ten villages were randomly selected. The study was conducted among people older than 60 years who were selected by random sampling using a computer-generated list. The following assessments were done: (i) A 19-item questionnaire was used to assess self-neglect, (ii) Katz index of daily living to assess functional activity, (iii) Mini Mental State Examination to evaluate cognition, (iv) Geriatric Depression Scale to identify depression, (v) Duke Social Support Index to measure social supports. Clinical data and anthropometric data were also collected. Data were entered into Epidata v3.1. All analyses were performed using SPSS v23.0.Results One hundred fourteen people above 60 years of age participated. The prevalence of self-neglect was 21.1% (95% CI 14.9%—29%); about half of the elderly population (47.38%) refused to seek or follow medical advice. Lower levels of education (OR 3.678, 95% CI 1.017 – 13.301), lower social class (OR 4.455, 95% CI 1.236 – 16.050) and functional impairment (3.643, 95% CI 1.373 – 9.668) were found to be significant factors associated with self–neglect. Though prevalence of comorbidities (70%) and depression (27%) were high, there was no statistical evidence of association with self-neglect.

Female Genital Schistosomiasis and HIV-1 Incidence in Zambian Women: A Retrospective Cohort Study.

BackgroundFemale genital schistosomiasis (FGS) has been associated with prevalent HIV-1. We estimated the incidence of HIV-1 infection in Zambian women with and without FGS.MethodsWomen (aged 18–31, nonpregnant, sexually active) were invited to participate in this study in January–August 2018 at the final follow-up of the HPTN 071 (PopART) Population Cohort. HIV-1-negative participants at enrollment (n = 492) were included in this analysis, with testing to confirm incident HIV-1 performed in HPTN 071 (PopART). The association of incident HIV-1 infection with FGS (Schistosoma DNA detected by polymerase chain reaction [PCR] in any genital specimen) was assessed with exact Poisson regression.ResultsIncident HIV-1 infections were observed in 4.1% (20/492) of participants. Women with FGS were twice as likely to seroconvert as women without FGS but with no statistical evidence for a difference (adjusted rate ratio, 2.16; 95% CI, 0.21–12.30; P = .33). Exploratory analysis suggested an association with HIV-1 acquisition among women with ≥2 positive genital PCR specimens (rate ratio, 6.02; 95% CI, 0.58–34.96; P = .13).ConclusionsDespite higher HIV seroconversion rates in women with FGS, there was no statistical evidence of association, possibly due to low power. Further longitudinal studies should investigate this association in a setting with higher schistosomiasis endemicity.

Polygenic Risk Scores in Alzheimer's Disease: Current Applications and Future Directions.

Genome-wide association studies have identified nearly 40 genome-wide significant single nucleotide polymorphisms (SNPs) which are associated with Alzheimer's Disease (AD). Due to the polygenicity of AD, polygenic risk scores (PRS) have shown high potential for AD risk prediction. PRSs have been shown to successfully discriminate between AD cases and controls achieving a prediction accuracy of up to 84% based on area under the receiver operating curve. The prediction accuracy in AD is higher compared with other complex genetic disorders. PRS can be restricted to SNPs which reside in biologically relevant gene-sets; the predictive value of these gene-sets in the general population is not as high as genome-wide PRS, but they may play an important role to identify mechanisms of disease development and inform biological experiments. Multiple methods are available to derive PRSs, such as selecting SNPs based on statistical evidence of association with the disease or using prior evidence for SNP selection. All methods have advantages, but PRS produced using different methodologies are often not comparable, and results should be interpreted with care. Similarly, this is true when PRS is based on different background populations. With the exponential growth in development of digital electronic devices it is easy to calculate an individual's disease risk using public databases. A major limitation for the utility of PRSs is that the risk score is sample and method dependent. Therefore, replicability and interpretability of PRS is an important issue. PRS can be used to determine the probability of developing disease which incorporates information about disease risk in the general population or in a specific AD risk group. It is essential to consult with genetic counselors to ensure genetic risk is communicated appropriately.

Relationship between inflammation and metabolic regulation of energy expenditure by GLP-1 in critically ill children.

Critical illness is associated with derangement in the metabolic and inflammatory response. Previous investigators have highlighted the cross-link between feeding, inflammation and gut homeostasis. Glucagon like peptide-1 (GLP-1) is a gut derived hormone that plays an important role in the modulation of energy metabolism through appetite regulation and promotion of gastric motility. Growing evidence suggests that GLP-1 might influence energy expenditure. The aim of this study was to assess the relationship between inflammatory activation and metabolic regulation of energy expenditure by assessing cytokine release, levels of GLP-1 and energy expenditure in a cohort of critically ill children. This is a prospective study conducted in critically ill children. A blood sample was collected from each child during the first few days of critical illness, for the analysis of serum inflammatory cytokines (TNF-α, IL-10, IL-6 and IL-1β) and GLP-1 in 42 children. Indirect calorimetry (IC) measurements were performed concurrently in a subset of 21 children. The metabolic index was determined using the ratio of Measured Resting Energy Expenditure (MREE)/Predicted Resting Energy Expenditure (PREE) based on the Schofield equation. Correlation analysis was performed, followed by a stepwise linear regression analysis to assess factors affecting GLP-1 and the metabolic index. A total of 42 children (0-14 years) were included in this study. The regression analysis indicated that CRP, TNF-α, IL-6 and IL-1β statistically influenced GLP-1 concentrations (p<0.01). Where IC measurements were performed (N=21), GLP-1 showed a statistically significant association with the metabolic index (p<0.01). No evidence of statistical association was recorded between the inflammatory mediators and the metabolic index. Overall the results showed that circulating GLP-1 was increased in response to inflammatory stimuli in critically ill children. GLP-1 contributed to the changes observed in MREE induced by critical illness in our cohort. Energy expenditure is extremely variable in critically ill children, our study suggests that changes in GLP-1 might contribute to a significant amount of this variation. If confirmed in larger studies, GLP-1 could be used as a correction factor for REE predictive equations in critically ill children.

Armed conflict as a determinant of children malnourishment: a cross-sectional study in The Sudan

BackgroundChildren’s nutritional status influences their physical, socioemotional and cognitive development throughout the life course. We aimed to determine the role of armed conflict on the prevalence of childhood malnourishment in The Sudan, and understand the underlying mechanisms using a framework based on the social determinants of health.MethodsWe analysed cross-sectional data from the 2014-Sudan Multiple Indicator Cluster Survey (n = 14,081) to compare the prevalence of malnourishment in states undergoing armed conflict and states free of conflict. Four-level multilevel multivariate modelling was conducted to identify the contribution of the social determinants of malnourishment in explaining the role of armed conflict in child health, with conflict status as the central predictor and progressive adjustments for child-, household- and cluster- and state-level predictors.ResultsArmed conflict is strongly associated with greater risk of severe and moderate underweight among children under-5. Adjusting for key social determinants of health reduced the strength of the association between armed conflict and risk of underweight, but there is statistical evidence of association between armed conflict and risk of severe underweight (OR: 1.60, 95%CI: 1.03–2.49 for the low intensity group).ConclusionConflict-exposed children are particularly vulnerable to malnourishment, and this association is mostly explained by key socio-demographic factors. With the prolonged political instability in The Sudan, sustainable nutritional interventions are necessary to ease hard conditions in conflict-exposed states, and also among disadvantaged families in conflict-free regions.

Age-, tumor-, and metastatic tissue-associated DNA hypermethylation of a T-box brain 1 locus in human kidney tissue

BackgroundWhile a considerable number of tumor-specific hypermethylated loci have been identified in renal cell cancer (RCC), DNA methylation of loci showing successive increases in normal, tumoral, and metastatic tissues could point to genes with high relevance both for the process of tumor development and progression. Here, we report that DNA methylation of a locus in a genomic region corresponding to the 3′UTR of the transcription factor T-box brain 1 (TBR1) mRNA accumulates in normal renal tissues with age and possibly increased body mass index. Moreover, a further tissue-specific increase of methylation was observed for tumor and metastatic tissue samples.ResultsBiometric analyses of the TCGA KIRC methylation data revealed candidate loci for age-dependent and tumor-specific DNA methylation within the last exon and in a genomic region corresponding to the 3′UTR TBR1 mRNA. To evaluate whether methylation of TBR1 shows association with RCC carcinogenesis, we measured 15 tumor cell lines and 907 renal tissue samples including 355 normal tissues, 175 tissue pairs of normal tumor adjacent and corresponding tumor tissue as well 202 metastatic tissues samples of lung, bone, and brain metastases by the use of pyrosequencing. Statistical evaluation demonstrated age-dependent methylation in normal tissue (R = 0.72, p < 2 × 10−16), association with adiposity (P = 0.019) and tumor-specific hypermethylation (P = 6.1 × 10−19) for RCC tissues. Comparison of tumor and metastatic tissues revealed higher methylation in renal cancer metastases (P = 2.65 × 10−6).ConclusionsOur analyses provide statistical evidence of association between methylation of TBR1 and RCC development and disease progression.

Do magnetic resonance imaging abnormalities of the non-dominant wrist correlate with ulnar-sided wrist pain in elite tennis players?

Ulnar-sided injuries of the non-dominant wrist are common in elite tennis players that use the double-handed backhand technique. This study aimed to define the relationship between ulnar-sided wrist pain in symptomatic and asymptomatic elite tennis players, and the presence of abnormalities on magnetic resonance imaging (MRI). Fourteen symptomatic tennis players, 14 asymptomatic tennis players, and 12 healthy controls who did not play tennis, were analyzed prospectively, after undergoing MRI of their non-dominant wrist. Five anatomical regions were analyzed, thought to relate to ulnar-sided wrist pain. These consisted of the triangular fibrocartilage complex (TFCC), ulnar collateral ligament (UCL), extensor carpi ulnaris tendon (ECU), osseous-articular structures, and ganglia. Images were independently reviewed by two blinded musculoskeletal radiologists. Non-dominant, ulnar-sided, wrist pain in elite tennis players was not statistically significantly associated with an increased number of MRI abnormalities when compared with asymptomatic tennis players (p > 0.05). However, some evidence of statistical association was seen with an increased prevalence of ECU tendon abnormalities (OR = 8.0, 95% CI = (0.74, 20.00), p = 0.07). A statistically significant increase in MRI abnormalities of osseous structures (OR = 15.1, 95% CI = (1.56, 656.05), p = 0.02) and the dorsal radioulnar ligament (DRUL) (OR = 12.5, 95% CI = (2.15, 111.11), p = 0.03), was observed in symptomatic players compared with controls. Non-dominant, ulnar-sided, wrist pain in a subgroup of elite tennis players using a double-handed backhand technique is not associated with a statistically significant increased prevalence of MRI abnormalities when compared with asymptomatic tennis players, other than some evidence of statistical association with ECU tendon abnormalities. Therefore, significance of MRI abnormalities should be interpreted in the context of clinical findings.

Prevalence of Metabolic Syndrome and Its Components in Workers of a High-Level Educational Institution, Cartagena-Colombia

To determine the prevalence of metabolic syndrome, components and their relationship in workers of a higher education institution of Cartagena-Colombia. An analytical cross-sectional study was carried out, with a probabilistic sample of 162 workers in a higher education institution. Sociodemographic data were recorded, physical examination including abdominal circumference, blood pressure, height, weight, as well as clinical tests of lipid laboratory (total cholesterol, HDL cholesterol and triglycerides) and fasting glycemia determined by colorimetric and enzymatic methods. The parameters established by the American Heart Association-AHA were used to identify metabolic syndrome. A prevalence of metabolic syndrome of 11.1% was estimated. The most frequent components among individuals with metabolic syndrome were: increase in abdominal circumference (83.3%), hypertriglyceridemia (66.7%) and low levels of HDL-c (50.0%). The elevation of the abdominal perimeter was the most frequent component. No statistical evidence of association between any of the components of the syndrome was found. These evidences suggest to improve the life habits of the workers evaluated, in terms of their nutrition and physical activity.

The Schumpeter creative destruction hypothesis: a spatial assessment on Portuguese regions

Shumpeter characterised the innovative role of the entrepreneur on economic growth (Schumpeter, 1942). By inventing new products, new processes or techniques, the entrepreneur searches for monopoly rents and forces the social and economic structure to evolve. The routines, characterised by accommodative behaviour, which may endure for long periods are suddenly broken, in a sequence of stagnation and evolutionary periods (Schumpeter, 1947). Therefore, according to the Schumpeter theory, innovation is at the core of economic growth, and goes further as it causes social and economic structural changes. The present article leads on with an empirical assessment about the Schumpeter creative destruction hypothesis at the Portuguese Regional level, using a spatial econometric framework, based on Elhorst (2003) and Bhattacharjee et al. (2012). We estimate a model with spatial fixed effect, exploring the relation between R&D intensity at the firm level, productivity and firm demography dynamics, using a panel data for the 28 Portuguese continental NUTsIII regions between 2006 and 2009. The results obtained confirm the association between productivity and firm demographic dynamics – i.e., regions with higher level of productivity present also higher rates of birth and mortality among firms. We have not found, as it would be predictable according to the Schumpeter hypothesis, statistical evidence of association between productivity and R&D intensity at the firm level. This result indicates that Portuguese firms behaviour is more of imitation rather than innovation.

NADPH oxidase p22phox C242T polymorphism is associated with macroalbuminuria in diabetic patients: A meta-analysis

AimsPrevious studies suggested an association between C242T polymorphism in NADPH Oxidase p22phox and diabetic nephropathy (DN) risk, but the results were inconsistent. To obtain a more precise estimation, we carried out a meta-analysis to analyze the effect of C242T polymorphism in NADPH Oxidase p22phox on DN risk. MethodsWe searched PubMed, ISI Web of Science, and China National Knowledge Infrastructure for all eligible case–control studies through May 2016. The odds ratios (ORs), together with the 95% confidence intervals (CIs), were calculated to evaluate the strength of association between C242T SNP in NADPH Oxidase p22phox on DN risk. ResultsOverall, ten eligible studies involving a total of 1894 cases and 1746 controls were included in our meta-analysis. The results showed that there was no statistical evidence of association between NADPH oxidase p22phox C242T polymorphism and DN in all genetic models (T vs. C: OR 1.16, 95% CI 0.85–1.59, p=0.34; TT vs. CC: OR 1.49, 95% CI 0.80–2.76, p=0.21; TT/CT vs. CC: OR 1.18, 95% CI 0.81–1.72, p=0.40; TT vs. CT/CC: OR 1.31, 95% CI 0.82–2.11, p=0.26). However, significant association was found in diabetic patients with macroalbuminuria. ConclusionThis meta-analysis indicates that NADPH oxidase p22phox C242T polymorphism is associated with macroalbuminuria in diabetic patients. However, this conclusion should be interpreted with caution due to the small sample size. Larger sample-size studies with homogeneous patients and well-matched controls are required.

A percepção de apoio social e a sintomatologia depressiva em mulheres jovens atendidas em uma Unidade de Saúde da Família

Objetivo: O estudo buscou identificar a percepção de apoio social em 55 mulheres de 20 a 39 anos, cadastradas em uma Unidade de Saúde da Família de uma cidade de médio porte localizada no interior do Estado de São Paulo, verificando possível associação com sintomas depressivos e características sociodemográficas, clínicas e de configuração familiar. Métodos: Estudo observacional de corte transversal realizado com auxílio de um Roteiro de Entrevista Estruturado, Inventário de Depressão de Beck e Escala de Apoio Social da Medical Outcomes Study. Os dados foram analisados por meio de estatística descritiva e submetidos a testes não paramétricos. Resultados: Os resultados indicaram sintomas sugestivos de depressão em 25,5% da amostra; correlação negativa entre as dimensões de apoio social e depressão, bem como evidências de associação da percepção de apoio social em relação às características sociodemográficas (renda) e de configuração familiar (estado civil e número de filhos). Não foram encontradas evidências estatísticas na associação com as características clínicas. Conclusão: Estes resultados corroboram os achados da literatura nacional e internacional, indicando a necessidade do cuidado com mulheres jovens independentemente da vulnerabilidade específica.

Fatores Contribuintes da Vulnerabilidade Individual dos Jovens ao HIV

Introduction: In the decision-making process, the development of effective strategies to minimize vulnerability of young people to the human immunodeficiency virus (HIV), and the understanding of background determinants in which they interact, are important auxiliary tools for HIV prevention. Objective: To outline the contributing factors for individual vulnerability of young people to HIV infection. Material and Methods: This was a population-based survey with 417 individuals from elementary schools in the city of Joao Pessoa, PB, Brazil. A questionnaire was used to collect the data, which were analyzed through statistical inference using the Chi-square (χ2) test. Results: The results demonstrated statistical evidence of association of the sociodemographic variables (p-value<0.0001), initiation of sexual life, and vulnerable behavior due to multiple partners, as determinants of individual vulnerability of young people to HIV. Study participants declared themselves Latin-Americans (54.9 %); not performing any labor activity by then (82.7 %); with family income up to two minimum wages (62.1%); and with no affective/sexual relationship (46.3%). The majority of respondents (88.2%) reported not having had sexual intercourses with multiple partners over the past six months. Conclusion: The vulnerability trends point to feminization and pauperization of HIV infection. Thus, to a greater or lesser extent all social actors of the health-illness process may be vulnerable to HIV. DESCRIPTORS HIV. Adolescent Health. Health Vulnerability.

Analgesic Use and Pain in Robust, Pre-Frail and Frail Older Outpatients with Cancer.

BackgroundPain management can be challenging in frail older people with cancer due to drug–drug interactions and heightened susceptibility to adverse drug events.ObjectiveTo investigate the relationship between analgesic use and pain by frailty status in older outpatients with cancer.MethodsA total of 385 consecutive patients aged 70 years and over who presented to an outpatient oncology clinic between January 2009 and July 2010 completed structured assessments of analgesic use (opioids, paracetamol or non-steroidal anti-inflammatory drugs), pain (10-point visual analogue scale) and clinical factors. Frailty was derived using modified Fried’s frailty phenotype. Logistic regression was used to compute adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) for the relationship between analgesic use and pain for each frailty group (robust, pre-frail or frail).ResultsFor robust outpatients (n = 101), there was weak evidence for a 30 % relative increase in the adjusted odds of analgesic use between outpatients who differed by one unit of pain score (95 % CI 0.995−1.71, p = 0.0532). For pre-frail outpatients (n = 190), there was evidence for a negative quadratic relationship (adjusted OR for the quadratic coefficient: 0.952, 95 % CI 0.910−0.993, p = 0.0244). For frail outpatients (n = 94), there was an 8 % relative increase in the adjusted odds of analgesic use between outpatients who differed by one unit of pain score, but no statistical evidence for association (95 % CI 0.934−1.26; p = 0.298).ConclusionsThese findings can be considered for the ongoing development of safe, effective strategies for analgesic use in older outpatients with cancer.

Targeting Patient at High Risk of Thrombocytopenia and Neutropenia with Cybord, Vel-Dex and VMP: Time to Decrease the Number of Blood Tests ?

Introduction Subcutaneous (SC) injection of bortezomib is more convenient for patients and staff. In September 2012, we standardised all bortezomib containing-protocols at our centre and changed the route of administration form intravenous to SC. Hematologic toxicity is commonly reported with these protocols. Currently, in our protocols, a complete blood count (CBC) is needed before every injection.Objectives This retrospective study aimed to analyse the rate of neutropenia and thrombocytopenia with Vel-Dex, VMP and CyBorD based on a threshold at day 1 to see if a CBC is needed before every injection in all patients. Blood pressure (BP) was measured before and after each SC injection to evaluate the risk of hypotension.Methods This retrospective study included all patients who received SC bortezomib in Vel-Dex, VMP and CyBorD protocols for multiple myeloma or amyloidosis at the Centre hospitalier de l’Université de Montréal (CHUM) between June 1, 2012 and May 31, 2013. Data was collected through medical and pharmaceutical patient records. Our local ethics board approved this study. Our main outcome is defined as the presence of neutropenia and thrombocytopenia for CyBorD (days 1, 8, 15 and 22 q 28 days), Vel-Dex (days 1, 4, 8 and 11 q 21 days) and VMP (days 1, 8, 22 and 29 q 42 days or days 1, 8, 15, 22 q 35 days) dichotomized at a threshold of ≥ 1.5 x 109 and ≥ 75 x 109respectively. A McNemar Test was used to estimate the association between the neutropenia and thrombocytopenia based on the dichotomized value on day 1.Results A total of 69 patients received bortezomib for MM (65 patients) or amyloidosis (4 patients). Median age was 67 years (SD ± 9.1) and 58 % of patients were male. Patients received Vel-Dex (23.2%), VMP (36.2%) and CyBorD (40.6%) protocols in 1st line eligible to stems cells transplant (26.2%), 1st line non-eligible (40.0%) or ≥ 2nd line (33.8%) for a total of 349 cycles. The median starting dose of bortezomib was 1.3 mg/m2 (SD ± 0.14). As shown in tables I and II, there is a statistical evidence of association when neutrophils ≥ 1.5 x 109 and platelets ≥ 75 x 109 at day 1 with the minimum of neutrophils and platelets on the CBC for the rest of the cycle of CyBorD and VMP. For Vel-Dex no significant association was seen because the incidence of neutropenia and thrombocytopenia is very low and doesn’t depend on a threshold at day 1. A patient, who has values above this threshold at day 1, could receive the rest of the cycle (Vel-Dex, CyBorD or VMP) without additional CBCs. When patients had blood counts below this threshold, chemotherapy was delayed 18 times (generally at day 1) or cancelled 39 times (other days). Patient previously exposed to many lines of therapy tend to have lower neutrophils or platelets counts. Also, a total of 1224 BP values before after SC bortezomib were analysed. No significant difference was detected between the average systolic (122 vs 122; p=0.43) and diastolic BP (70 vs 71; p=0.33) before and after treatment. Hypotension, defined as a drop of 20 mmHg of systolic BP, occurred 37 times (3.0%) but systolic BP was never below 90 mmHg and treatment was not necessary. A small increase of heart rate (82 vs 84; p<0.001) was seen although it was not clinically significant.Table I:Rate of neutropenia during the cycle according to day-1 neutrophil countsProtocolsCyBorDVMPVel-DexNeutrophils at day 1 of each cyclen ≥ 1.5n < 1.5p valuen ≥ 1.5n < 1.5p valuen ≥ 1.5n < 1.5p valueNeutrophils ≥ 1.5 for the rest of the cycle81.8 %20 %p<0.00177.8 %0 %p<0.00195.5 %100 %NSNeutrophils < 1.5 for the rest of the cycle18.1 %80 %22.2 %100 %4.5 %0 %TOTAL of cycle12125- - -1177- - -672- - -Table II:Rate of thrombocytopenia during the cycle according to day-1 platelet countsProtocolsCyBorDVMPVel-DexPlatelets at day 1 of each cyclePlt ≥ 75Plt < 75p valuePlt ≥ 75Plt < 75p valuePlt ≥ 75Plt < 75p valuePlatelets ≥ 75 for the rest of the cycle97.7 %15.4 %p<0.00183 %33.3 %p<0.00198.5 %0 %NSPlatelets < 75 for the rest of the cycle2.3 %84.6 %17 %66.7 %1.5 %100 %TOTAL of cycle13313- - -1413- - -681- - -Conclusion Our results demonstrate that the rate of thrombocytopenia and neutropenia was very low in patients who have neutrophils and platelets ≥ 1.5 x 109 and ≥ 75 x 109 at day 1 of each cycle of Vel-Dex, VMP and CyBorD. In these patients, no CBC seems necessary for the rest of cycle. Decreasing the number of CBC will use less resources, decrease costs and most importantly, improve the patient’s care by minimising interventions without increasing risk of adverse events. DisclosuresAdam:Janssen: Honoraria. Lemieux-Blanchard:Celgene: Honoraria. Lemieux:Janssen: Honoraria.

Effects of Pro12Ala polymorphism in peroxisome proliferator-activated receptor-γ2 gene on metabolic syndrome risk: A meta-analysis

BackgroundAssociations between peroxisome proliferator-activated receptor γ2 (PPARγ2) gene polymorphism and metabolic syndrome risk remained controversial and ambiguous. Thus, we performed a meta-analysis to assess the association between Pro12Ala polymorphism in PPARγ2 gene and metabolic syndrome susceptibility. MethodsAn electronic literature search was conducted on Medline, OVID, Cochrane Library database, and the China National Knowledge Internet up to March 2013. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to calculate the strength of association in the fixed or random effects model. ResultsTen studies involving a total of 4456 cases and 10343 controls were included in this meta-analysis. No statistical evidence of association was found between Pro12Ala polymorphism and metabolic syndrome risk in all genetic models (homozygote model: OR=0.83, 95% CI=0.62–1.12; heterozygote model: OR=1.04, 95% CI=0.94–1.14; dominant model: OR=1.02, 95% CI=0.93–1.12; recessive model: OR=0.83, 95% CI=0.62–1.11). No statistical evidence of significant association was observed when stratified by ethnicity, definition of metabolic syndrome, source of control groups and quality score of the selected articles. All in all, the results did not support a major role of the Pro12Ala variant of the PPARγ2 gene in metabolic syndrome risk. ConclusionsThis meta-analysis suggested that the effect of Pro12Ala polymorphism in PPARγ2 gene may not be related to metabolic syndrome as an entity. However, Pro12Ala may affect the single component of metabolic syndrome. A large, well designed study is required to more adequately assess the role for Pro12Ala polymorphism on metabolic syndrome.

Lack of an Association between CYP11B2 C-344T Gene Polymorphism and Ischemic Stroke: A Meta-Analysis of 7,710 Subjects

BackgroundThe association between aldosterone synthase (CYP11B2) C-344T gene polymorphism and ischemic stroke remains controversial and ambiguous. To better explain the association between CYP11B2 polymorphism and ischemic stroke risk, a meta-analysis was performed.MethodsBased on comprehensive searches of Medline, Embase, Web of Science, CNKI and CBM databases, we identified and abstracted outcome data from all articles to evaluate the association between CYP11B2 polymorphism and ischemic stroke. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were performed in all genetic models. Fixed or random effects model was separately used depending on the heterogeneity between studies. Publication bias was tested by Begg's funnel plot and Egger's regression test.ResultsA total of 12 studies including 3,620 ischemic stroke cases and 4,090 controls were identified. There was no statistical evidence of association between CYP11B2 C-344T polymorphism and ischemic stroke in all genetic models (allelic model: OR = 1.19, 95% CI = 0.95–1.49; additive model: OR = 1.43, 95% CI = 0.91–2.27; dominant model: OR = 1.30, 95% CI = 0.89–1.89; and recessive model: OR = 1.24, 95% CI = 0.96–1.60). On subgroup analysis by ethnicity, similarly results were found in both Asians and non-Asians. For Asians, the combined ORs and 95% CIs were (allelic model: OR = 1.07, 95% CI = 0.87–1.32; additive model: OR = 1.15, 95% CI = 0.77–1.71; dominant model: OR = 1.13, 95% CI = 0.92–1.38; and recessive model: OR = 1.09, 95% CI = 0.84–1.40). For none-Asians, the combined ORs and 95% CIs were (allelic model: OR = 1.58, 95% CI = 0.90–2.76; additive model: OR = 2.37, 95% CI = 0.79–7.05; dominant model: OR = 1.79, 95% CI = 0.77–4.19; and recessive model: OR = 1.80, 95% CI = 0.96–3.36).ConclusionThe present meta-analysis suggested that CYP11B2 C-344T polymorphism was unlikely contribute to ischemic stroke susceptibility.

Effect of surgical exposure technique, age, and grade of impaction on ankylosis of an impacted canine, and the effect of rapid palatal expansion on eruption: A prospective clinical study

This study had 2 aims: (1) to assess whether the surgical exposure technique, the patient's age, and the grade of impaction are associated with ankylosis of the impacted canine; and (2) to investigate the effect of rapid palatal expansion on an impacted canine's automatic eruption. The sample for this prospective longitudinal study consisted of 118 orthodontic patients (72 female, 46 male) who were treated surgically and orthodontically by the first author (S.I.K.) over 18 years. The patients' ages at the beginning of therapy ranged from 11.2 to 46.1 years. They had 157 impacted canines (150 maxillary, 7 mandibular), grouped in 7 categories (grades I-VII) according to their radiographic position in the orthopantomogram at the onset of treatment. Univariate and multivariate generalized estimating equation logistic regression analyses were used to assess the effect of the predictors of interest on ankylosis. (In this research, a broad definition of "ankylosis" was used, to include impacted canines immobilized a priori or during traction, due to all the possible causes that could contribute to immobilization, such as all types of external tooth resorption and other known or unknown factors.) Thirty-eight canines erupted spontaneously after space gaining, and the other 119 were treated surgically with an open (57 cases) or a closed (62 cases) exposure technique. Eleven canines of the 119 that were treated surgically had ankylosis, either a priori or during orthodontic traction. The percentages of ankylosis were 3.5% in the open technique and 14.5% in the closed technique. Evidence of statistical association was found between age and ankylosis, grade of impaction and ankylosis, and rapid palatal expansion and automatic eruption of the impacted canine. Evidence of an association between exposure technique and ankylosis was found. Additionally, there was evidence that the grade of impaction and the patient's age are significant predictors of ankylosis, as is the use of rapid palatal expansion a predictor of automatic eruption.

Mobile Phone Use for Contacting Emergency Services in Life-threatening Circumstances

BackgroundThe potential health benefits of mobile phone use have not been widely studied, except for telemedicine-type applications. Study ObjectivesThis study seeks to determine whether initial contact with emergency services via a mobile phone in life-threatening situations is associated with potential health benefits when compared to contact via a landline. MethodsA record-linkage study was carried out in which data from all emergency dispatches for immediately life-threatening events from a United Kingdom county ambulance service were linked to the Patient Admission System at two major local hospitals. Mortality (at the scene, at the emergency department [ED], and during hospitalization); transfer to the ED; admission (inpatient care, and intensive care unit); and length of stay were analyzed for calls classified as Code Red (immediately life-threatening) by initial exposure (mobile phone vs. landline), while controlling for potential confounding variables. ResultsOf 354,199 ambulances dispatched to attend emergency incidents, 66% transported patients to the hospital while 2% stood down due to death at the scene. Mobile phone compared to landline reporting of emergencies resulted in significant reductions in the risk of death at the scene (odds ratio [OR] 0.77), but not for death in the ED or during inpatient admission. The risk of being transferred to the ED and subsequent inpatient admission were significantly lower with reporting from mobile phones compared to landline (OR 0.93 and OR 0.82, respectively). ConclusionsIn this study, evidence of statistical association was demonstrated between the use of mobile phones to alert ambulance services in life-threatening situations and improved outcomes for patients.

An Examination of Candidate Gene SNPs for Dyslexia in an Indian Sample

Developmental dyslexia (DD) is a complex neuro-genetic disorder associated with difficulty in learning to read despite adequate intelligence and educational opportunities. Studies in different populations have established associations between DD and single nucleotide polymorphisms (SNPs) in a number of candidate genes, including DYX1C1, KIAA0319 and DCDC2. In an ongoing DD study in India, we screened twenty SNPs located within the coding region of these three candidate genes by mass-ARRAY technique. At this point, there is no statistical evidence of association between the allelic variation in the three candidate genes and DD in our sample, although there might be some promising leads for future research that should involve a large and a better characterized sample.

Association of Skin Barrier Genes within the PSORS4 Locus Is Enriched in Singaporean Chinese with Early-Onset Psoriasis

Psoriasis (OMIM#177900) is a common polygenic skin disorder affecting approximately 2% of the northern European population and 0.1% of the Han Chinese. Psoriasis patients suffer from chronic skin inflammation, manifested by erythematous scaly lesions. PSORS1-PSORS9 have been confirmed as psoriasis susceptibility loci in independent genetic studies on predominantly Caucasian populations, with psoriasis susceptibility loci (PSORS1, PSORS9) and additional loci at 9q33-34 and 2p22.3-11.2 reported in Han Chinese patients. In this study, we show the association of PSORS4 with psoriasis in Singaporean Chinese. Dense genotyping of single-nucleotide polymorphism-tagging candidate genes within the epidermal differentiation complex revealed significant association in the proximity of the involucrin gene (IVL); the strongest association was seen in early-onset psoriasis patients (P=0.0014). A follow-up genome-wide association screen localized the psoriasis susceptibility region to approximately 360 kb along chromosome 1 in the vicinity of IVL, small proline-rich region (SPRR) and proline-rich region 9 (PRR9) genes. The study of interactions between the causative variant(s) in this locus will provide insights into a possible role for epidermal barrier formation in the pathogenesis of psoriasis.