Evaluation of the ability of the trypsin-like peptidase activity assay to detect severe periodontitis

Objectives N-benzoyl-DL-arginine peptidase (trypsin-like peptidase) is specifically produced by certain strains of periodontitis-associated bacteria. We aimed to examine the effectiveness of an objectively quantified trypsin-like peptidase activity assay (TLP-AA) for detecting severe periodontitis. Methods The study population included 347 adults (108 men and 239 women; average age, 43.3 years) who underwent a full-mouth periodontal examination. Specimens for the TLP-AA were obtained using tongue swabs. Using a color reader, the TLP-AA results were obtained as a* values, with higher positive a* values indicating an increased intense enzymatic activity. The predictive validity of the TLP-AA results for severe periodontitis was assessed using receiver operating characteristic curve analysis and the periodontitis case definition provided by the Centers for Disease Control and Prevention/American Academy of Periodontology as the gold standard. Furthermore, multivariable logistic regression analyses were performed to predict severe periodontitis using the TLP-AA results and health characteristics, as the exposure variables. Results Severe periodontitis was observed in 5.2% of the participants. TLP-AA had high diagnostic accuracy for severe periodontitis, with an area under the curve of 0.83 (95% confidence interval [CI]: 0.75–0.92). The cut-off score for the a* value that best differentiated individuals with severe periodontitis was 0.09, with a sensitivity of 83% and specificity of 77%. Multivariable logistic regression analyses revealed that the TLP-AA results were significantly associated with severe periodontitis after adjusting for health characteristics (adjusted odds ratios: 1.90 [95% CI: 1.37–2.62] for the a* value). Conclusions Objectively quantified TLP-AA results are potentially useful for detecting severe periodontitis in epidemiological surveillance.

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A Preliminary Study on the Ability of the Trypsin-Like Peptidase Activity Assay Kit to Detect Periodontitis

Dentistry Journal ◽

10.3390/dj8030098 ◽

2020 ◽

Vol 8 (3) ◽

pp. 98

Author(s):

Masanori Iwasaki ◽

Michihiko Usui ◽

Wataru Ariyoshi ◽

Keisuke Nakashima ◽

Yoshie Nagai-Yoshioka ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Operating Characteristic ◽

Area Under The Curve ◽

Population Based ◽

Case Definition ◽

Peptidase Activity ◽

Activity Assay ◽

Severe Periodontitis ◽

Study Population ◽

Preliminary Study

This study aimed to explore whether the Trypsin-Like Peptidase Activity Assay Kit (TLP-AA-Kit), which measures the activity of N-benzoyl-dl-arginine peptidase (trypsin-like peptidase), can be used as a reliable tool for periodontitis detection in population-based surveillance. In total, 105 individuals underwent a full-mouth periodontal examination and provided tongue swabs as specimens for further analyses. The results of the TLP-AA-Kit were scored between 1 and 5; higher scores indicated higher trypsin concentrations. Receiver operating characteristic analyses were used to evaluate the predictive validity of the TLP-AA-Kit, where the periodontitis case definition provided by the Centers for Disease Control/American Academy of Periodontology served as the reference. Severe and moderate periodontitis were identified in 4.8% and 16.2% of the study population, respectively. The TLP-AA-Kit showed high diagnostic accuracy for severe periodontitis, with an area under the curve of 0.93 (95% confidence interval = 0.88–0.99). However, the diagnostic accuracy of the TLP-AA-Kit for moderate/severe periodontitis was not reliable. While further studies are necessary to validate our results, the results provided herein highlight the potential of the TLP-AA-Kit as a useful tool for the detection of periodontitis, particularly in severe cases, for population-based surveillance.

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Development of a new sternal dehiscence prediction scale for decision making in sternal closure techniques after cardiac surgery

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01555-2 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Ehab Nooh ◽

Colin Griesbach ◽

Johannes Rösch ◽

Michael Weyand ◽

Frank Harig

Keyword(s):

Logistic Regression ◽

Risk Score ◽

Characteristic Curve ◽

Multivariable Analysis ◽

Individual Risk ◽

Dependent Diabetes Mellitus ◽

Analysis Model ◽

Multivariable Logistic Regression Model ◽

Sternal Dehiscence ◽

Multivariable Logistic Regression

Abstract Background After sternotomy, the spectrum for sternal osteosynthesis comprises standard wiring and more complex techniques, like titanium plating. The aim of this study is to develop a predictive risk score that evaluates the risk of sternum instability individually. The surgeon may then choose an appropriate sternal osteosynthesis technique that is risk- adjusted as well as cost-effective. Methods Data from 7.173 patients operated via sternotomy for all cardiovascular indications from 2008 until 2017 were retrospectively analyzed. Sternal dehiscence occurred in 2.5% of patients (n = 176). A multivariable analysis model examined pre- and intraoperative factors. A multivariable logistic regression model and a backward elimination based on the Akaike Information Criterion (AIC) a logistic model were selected. Results The model showed good sensitivity and specificity (area under the receiver-operating characteristic curve, AUC: 0.76) and several predictors of sternal instability could be evaluated. Multivariable logistic regression showed the highest Odds Ratios (OR) for reexploration (OR 6.6, confidence interval, CI [4.5–9.5], p < 0.001), obesity (body mass index, BMI > 35 kg/m2) (OR 4.23, [CI 2.4–7.3], p < 0.001), insulin-dependent diabetes mellitus (IDDM) (OR 2.2, CI [1.5–3.2], p = 0.01), smoking (OR 2.03, [CI 1.3–3.08], p = 0.001). After weighting the probability of sternum dehiscence with each factor, a risk score model was proposed scaling from − 1 to 5 points. This resulted in a risk score ranging up to 18 points, with an estimated risk for sternum complication up to 74%. Conclusions A weighted scoring system based on individual risk factors was specifically created to predict sternal dehiscence. High-scoring patients should receive additive closure techniques.

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Predictors of thermal increase in magnetic resonance–guided focused ultrasound treatment for essential tremor: histogram analysis of skull density ratio values for 1024 elements

Journal of Neurosurgery ◽

10.3171/2021.5.jns21669 ◽

2021 ◽

pp. 1-6

Author(s):

Ken Iijima ◽

Hajime Yokota ◽

Toshio Yamaguchi ◽

Masayuki Nakano ◽

Takahiro Ouchi ◽

...

Keyword(s):

Logistic Regression ◽

Operating Characteristic ◽

Focused Ultrasound ◽

Characteristic Curve ◽

Density Ratio ◽

Predictive Ability ◽

Curve Analysis ◽

Regression Analyses ◽

Multivariate Logistic Regression ◽

Operating Characteristic Curve

OBJECTIVE Sufficient thermal increase capable of generating thermocoagulation is indispensable for an effective clinical outcome in patients undergoing magnetic resonance–guided focused ultrasound (MRgFUS). The skull density ratio (SDR) is one of the most dominant predictors of thermal increase prior to treatment. However, users currently rely only on the average SDR value (SDRmean) as a screening criterion, although some patients with low SDRmean values can achieve sufficient thermal increase. The present study aimed to examine the numerical distribution of SDR values across 1024 elements to identify more precise predictors of thermal increase during MRgFUS. METHODS The authors retrospectively analyzed the correlations between the skull parameters and the maximum temperature achieved during unilateral ventral intermediate nucleus thalamotomy with MRgFUS in a cohort of 55 patients. In addition, the numerical distribution of SDR values was quantified across 1024 elements by using the skewness, kurtosis, entropy, and uniformity of the SDR histogram. Next, the authors evaluated the correlation between the aforementioned indices and a peak temperature > 55°C by using univariate and multivariate logistic regression analyses. Receiver operating characteristic curve analysis was performed to compare the predictive ability of the indices. The diagnostic performance of significant factors was also assessed. RESULTS The SDR skewness (SDRskewness) was identified as a significant predictor of thermal increase in the univariate and multivariate logistic regression analyses (p < 0.001, p = 0.013). Moreover, the receiver operating characteristic curve analysis indicated that the SDRskewness exhibited a better predictive ability than the SDRmean, with area under the curve values of 0.847 and 0.784, respectively. CONCLUSIONS The SDRskewness is a more accurate predictor of thermal increase than the conventional SDRmean. The authors suggest setting the SDRskewness cutoff value to 0.68. SDRskewness may allow for the inclusion of treatable patients with essential tremor who would have been screened out based on the SDRmean exclusion criterion.

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Risk factors for symptomatic Avascular Necrosis (AVN) in a multi-ethnic Systemic Lupus Erythematosus (SLE) cohort

PLoS ONE ◽

10.1371/journal.pone.0248845 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0248845

Author(s):

Syahrul Sazliyana Shaharir ◽

Siew Huoy Chua ◽

Rozita Mohd ◽

Ruslinda Mustafar ◽

Malehah Mohd Noh ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Avascular Necrosis ◽

Lupus Erythematosus ◽

Osteoporotic Fractures ◽

Protective Effects ◽

Regression Analyses ◽

Mobility Limitations ◽

Factors Associated ◽

Multivariable Logistic Regression

Avascular necrosis of bone (AVN) is increasingly being recognized as a complication of SLE and causes significant disability due to pain and mobility limitations. We studied the prevalence and factors associated with avascular necrosis (AVN) in a multiethnic SLE cohort. SLE patients who visited the outpatient clinic from October 2017 to April 2019 were considered eligible. Their medical records were reviewed to identify patients who developed symptomatic AVN, as confirmed by either magnetic resonance imaging or plain radiography. Subsequently, their SLE disease characteristics and treatment were compared with the characteristics of patients who did not have AVN. Multivariable logistic regression analyses were performed to determine the independent factors associated with AVN among the multiethnic SLE cohort. A total of 390 patients were recruited, and the majority of them were females (92.6%); the patients were predominantly of Malay ethnicity (59.5%), followed by Chinese (35.9%) and Indian (4.6%). The prevalence of symptomatic AVN was 14.1%, and the mean age of AVN diagnosis was 37.6 ± 14.4 years. Both univariate and multivariable logistic regression analyses revealed that a longer disease duration, high LDL-C (low density lipoprotein cholesterol), positive anti-cardiolipin (aCL) IgG and anti-dsDNA results, a history of an oral prednisolone dose of more than 30 mg daily for at least 4 weeks and osteoporotic fractures were significantly associated with AVN. On the other hand, hydroxychloroquin (HCQ), mycophenolate mofetil (MMF) and bisphosphonate use were associated with a lower risk of AVN. No associations with ethnicity were found. In conclusion, several modifiable risk factors were found to be associated with AVN, and these factors may be used to identify patients who are at high risk of developing such complications. The potential protective effects of HCQ, MMF and bisphosphonates warrant additional studies.

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Beliefs about the Harmfulness of Heated Tobacco Products Compared with Combustible Cigarettes and Their Effectiveness for Smoking Cessation among Korean Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17155591 ◽

2020 ◽

Vol 17 (15) ◽

pp. 5591

Author(s):

Seung Hee Kim ◽

Seo Young Kang ◽

Hong-Jun Cho

Keyword(s):

Higher Education ◽

Smoking Cessation ◽

Logistic Regression ◽

Online Survey ◽

Electronic Cigarettes ◽

Regression Analyses ◽

Tobacco Products ◽

Korean Adults ◽

Multivariable Logistic Regression ◽

Negative Perceptions

Heated tobacco products (HTPs) have been widely used in Korea since their introduction in 2017. In this study, we investigated the perceptions of their relative harmfulness and smoking cessation effects. We performed an online survey in 7000 Koreans in 2018 (2300 males and 4700 females aged 20–69 years) by matching their age, sex, and provincial distribution. To investigate the factors causing HTPs to be perceived as less harmful than combustible cigarettes (CCs) and helpful for smoking cessation, we used multivariable logistic regression analyses. HTPs were less harmful than CCs in 16.8% of participants, particularly among HTP-only users and dual and triple users of HTPs, electronic cigarettes (ECs), or CCs than among CC-only users, those who were aged ≤ 34 years, males, and those with higher incomes. HTPs were reportedly helpful for smoking cessation in 11.2% of participants. Similar perceptions were more likely among HTP-only users, as well as dual and triple users than among CC-only users and adults with higher education/incomes. Although Korean adults generally had negative perceptions of the harmfulness and smoking cessation effects of HTPs compared with CCs, dual and triple users were more likely to have positive perceptions. Monitoring the use of multiple tobacco products and HTPs is a new challenge for Korean policymakers.

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The relationship between ratio of serum triglyceride to high-density lipoprotein cholesterol and frequency of sarcopenia in Chinese community adults

10.21203/rs.3.rs-36062/v3 ◽

2020 ◽

Author(s):

Na Wang ◽

Mengjun Chen ◽

Danhong Fang

Keyword(s):

Logistic Regression ◽

High Density Lipoprotein ◽

High Density Lipoprotein Cholesterol ◽

Density Lipoprotein ◽

Serum Triglyceride ◽

High Density ◽

Lipoprotein Cholesterol ◽

Regression Analyses ◽

Chinese Community ◽

Multivariable Logistic Regression

Abstract Background In a previous study, the high ratio of serum triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) was relevant to a high risk of sarcopenia in Korean old males. In this study, the purpose was to discover the association in Chinese community adults.MethodsChinese adults who had physical examinations from May 2016 to August 2017 at the First Affiliated Hospital of Wenzhou Medical University were involved in this study. The univariable and multivariable logistic regression analyses were applied to evaluate possible effect.ResultsIn total, 2613 adults were involved in the study, with 13.85% presenting sarcopenia. Individuals with TG/HDL-C ratios <2.78 or ≥2.78 were categorized as TG/HDL-Clow or TG/HDL-Chigh, respectively. 1266 individuals were in high group and the remaining were in the low group. By univariate and multivariable logistic regression analyses, the ratio of TG/HDL-C remained independent association with sarcopenia status(OR: 0.63; 95%CI: 0.49-0.81). ConclusionsThe negative association between sarcopenia and TG/HDL-C ratio was discovered in Chinese community population.

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Ten-year inhospital mortality trends for patients with trauma in Japan: a multicentre observational study

BMJ Open ◽

10.1136/bmjopen-2017-018635 ◽

2018 ◽

Vol 8 (2) ◽

pp. e018635 ◽

Cited By ~ 10

Author(s):

Isao Nagata ◽

Toshikazu Abe ◽

Masatoshi Uchida ◽

Daizoh Saitoh ◽

Nanako Tamiya

Keyword(s):

Logistic Regression ◽

Observational Study ◽

Injury Severity Score ◽

Severity Score ◽

Injury Severity ◽

Whole Body ◽

Inhospital Mortality ◽

Regression Analyses ◽

Mortality Trends ◽

Multivariable Logistic Regression

ObjectivesTrauma is one of the main causes of death in Japan, and treatments and prognoses of these injuries are constantly changing. We therefore aimed to investigate a 10-year trend (2004–2013) in inhospital mortality among patients with trauma in Japan.DesignMulticentre observational study.SettingJapanese nationwide trauma registry (the Japan Trauma Data Bank) data.ParticipantsAll patients with trauma whose Injury Severity Score (ISS) were 3 and above, who were aged 15 years or older, and whose mechanisms of injury (MOI) were blunt and penetrating between 2004 and 2013 (n=90 833).Outcome measuresA 10-year trend in inhospital mortality.ResultsInhospital mortality for all patients with trauma significantly decreased over the study decade in our Cochran-Armitage test (P<0.001). Similarly, inhospital mortality for patients with ISS 16 or more and patients who scored 50% or better on the Trauma and Injury Severity Score (TRISS) probability of survival scale significantly decreased (P<0.001). In addition, the OR for inhospital mortality of these three patient groups decreased yearly after adjusting for age, gender, MOI, ISS, Glasgow Coma Scale, systolic blood pressure and respiratory rate on hospital arrival in multivariable logistic regression analyses. Furthermore, inhospital mortality for patient with blunt trauma significantly decreased in injury mechanism-stratified Mantel-extension testing (P<0.001). Finally, multivariable logistic regression analyses showed that the OR for inhospital mortality of patients with ISS 16 and over decreased each year after adding and adjusting for means of transportation and usage of whole-body CT.ConclusionInhospitalmortality for patients with trauma in Japan significantly decreased during the study decade after adjusting for patient characteristics, injury severity and the response environment after injury.

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Stone Localization Is Pivotal for the Success of Percutaneous Nephrolithotomy

Urologia Internationalis ◽

10.1159/000513188 ◽

2021 ◽

pp. 1-7

Author(s):

Tammo Lesch ◽

Jens Uphoff ◽

Wolfgang Mayer ◽

Alexander Winter ◽

Friedhelm Wawroschek ◽

...

Keyword(s):

Logistic Regression ◽

Percutaneous Nephrolithotomy ◽

Treatment Success ◽

Regression Analyses ◽

Multivariable Logistic Regression ◽

Controlled Treatment ◽

Minimally Invasive Percutaneous Nephrolithotomy ◽

Impact On Treatment ◽

Free Status ◽

Residual Stones

Objective: The objective of this study was to predict computed tomography (CT)-controlled treatment success after minimally invasive percutaneous nephrolithotomy (Mini-PCNL). Patients and Methods: We relied on retrospective single institutional data from 92 kidney stone patients treated with Mini-PCNL. Residual stones after treatment were evaluated by post-Mini-PCNL CT scans. Stone-free status was defined as clinically insignificant residual stones ≤3 mm after surgery. Multivariable logistic regression analyses predicted stone-free status after Mini-PCNL. Results: Overall, 53 (57.6%) patients achieved stone-free status after Mini-PCNL treatment. In multivariable logistic regression analyses, stone localization was the strongest predictor for stone-free status after Mini-PCNL. Specifically, patients with exclusively pelvic stones were 7.1-fold more likely to achieve stone-free status than those patients with stones at multiple localizations (OR: 7.1; p = 0.005). Additionally, stone size represented a barrier for stone-free status (OR: 0.9; p = 0.03). Conclusions: Stone localization revealed the highest impact on treatment success after Mini-PCNL. Especially, those patients with exclusively pelvic stones were most likely to achieve stone-free status. Conversely, patients with multiple stone localizations were less likely to achieve stone-free status and need to be informed about higher risk of additional interventions after initial Mini-PCNL.

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Development of a New Sternal Dehiscence Prediction Scale for Decision Making in Sternal Closure Techniques After Cardiac Surgery

10.21203/rs.3.rs-114648/v1 ◽

2020 ◽

Author(s):

Frank Harig ◽

Ehab Nooh ◽

Colin Griesbach ◽

Michael Weyand ◽

Johannes Rösch

Keyword(s):

Logistic Regression ◽

Risk Score ◽

Characteristic Curve ◽

Multivariable Analysis ◽

Individual Risk ◽

Dependent Diabetes Mellitus ◽

Analysis Model ◽

Multivariable Logistic Regression Model ◽

Sternal Dehiscence ◽

Multivariable Logistic Regression

Abstract BackgroundAfter sternotomy, the spectrum for sternal osteosynthesis comprises standard wiring and more complex techniques, like titanium plating. The aim of this study is to develop a predictive risk score that evaluates the risk of sternum instability individually. The surgeon may then choose an appropriate sternal osteosynthesis technique that is risk- adjusted as well as cost-effective.MethodsData from 7.173 patients operated via sternotomy for all cardiovascular indications from 2008 until 2017 were retrospectively analyzed. Sternal dehiscence occurred in 2.5% of patients (n=176). A multivariable analysis model examined pre- and intraoperative factors. A multivariable logistic regression model and a backward elimination based on the Akaike Information Criterion (AIC) a logistic model were selected.ResultsThe model showed good sensitivity and specificity (area under the receiver-operating characteristic curve, AUC: 0.76) and several predictors of sternal instability could be evaluated. Multivariable logistic regression showed the highest Odds Ratios (OR) for reexploration (OR 6.6, confidence interval, CI [4.5-9.5], p <0.001), obesity (body mass index, BMI >35kg/m²) (OR 4.23, [CI 2.4-7.3], p<0.001), insulin-dependent diabetes mellitus (IDDM) (OR 2.2, CI [1.5-3.2], p=0.01), smoking (OR 2.03, [CI 1.3-3.08], p=0.001). After weighting the probability of sternum dehiscence with each factor, a risk score model was proposed scaling from -1 to 5 points. This resulted in a risk score ranging up to 18 points, with an estimated risk for sternum complication up to 74%.ConclusionsA weighted scoring system based on individual risk factors was specifically created to predict sternal dehiscence. High-scoring patients should receive additive closure techniques.

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The Influence of COVID-19 Information Sources on the Attitudes and Practices Toward COVID-19 Among the General Public of Saudi Arabia: Cross-sectional Online Survey Study (Preprint)

10.2196/preprints.28888 ◽

2021 ◽

Author(s):

Noor Alshareef ◽

Ismaeel Yunusa ◽

Mohammed Khaled Al-Hanawi

Keyword(s):

Social Media ◽

Logistic Regression ◽

Saudi Arabia ◽

General Public ◽

Preventive Measures ◽

Regression Analyses ◽

Sources Of Information ◽

Cross Sectional ◽

Attitudes And Practices ◽

Multivariable Logistic Regression

BACKGROUND The COVID-19 pandemic has resulted in panic among the general public, leading many people to seek out information related to COVID-19 through various sources, including social media and traditional media. Identifying public preferences for obtaining such information may help health authorities to effectively plan successful health preventive and educational intervention strategies. OBJECTIVE The aim of this study was to examine the impact of the types of sources used for obtaining COVID-19 information on the attitudes and practices of the general public in Saudi Arabia during the pandemic, and to identify the socioeconomic and demographic factors associated with the use of different sources of information. METHODS This study used data from a cross-sectional online survey conducted on residents of Saudi Arabia from March 20 to 24, 2020. Data were analyzed using descriptive, bivariate, and multivariable logistic regression analyses. Bivariate analysis of categorical variables was performed to determine the associations between information sources and socioeconomic and demographic factors. Multivariable logistic regression analyses were employed to examine whether socioeconomic and demographic variables were associated with the source of information used to obtain information about COVID-19. Moreover, univariable and multivariable logistic regression analyses were conducted to examine how sources of information influence attitudes and practices of adhering to preventive measures. RESULTS In this analysis of cross-sectional survey data, 3358 participants were included. Most participants reported using social media, followed by the Ministry of Health (MOH) of the Kingdom of Saudi Arabia, as their primary source of information. Seeking information via social media was significantly associated with lower odds of having an optimistic attitude (adjusted odds ratio [aOR] 0.845, 95% CI 0.733-0.974; P=.02) and adhering to preventive measures (aOR 0.725, 95% CI 0.630-0.835; P<.001) compared to other sources of information. Participants who obtained their COVID-19 information via the MOH had greater odds of having an optimistic attitude (aOR 1.437, 95% CI 1.234-1.673; P<.001) and adhering to preventive measures (aOR 1.393, 95% CI 1.201-1.615; P<.001) than those who obtained information via other sources. CONCLUSIONS This study provides evidence that different sources of information influence attitudes and preventive actions differently within a pandemic crisis context. Health authorities in Saudi Arabia should pay attention to the use of appropriate social media channels and sources to allow for more effective dissemination of critical information to the public.

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