scholarly journals Peritumoral Brain Edema in Metastases May Be Related to Glymphatic Dysfunction

2021 ◽  
Vol 11 ◽  
Author(s):  
Cheng Hong Toh ◽  
Tiing Yee Siow ◽  
Mauricio Castillo
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Brain Metastases ◽  
Brain Edema ◽  
Tumor Volume ◽  
Linear Regression Analysis ◽  
Cerebral Metastasis ◽  
Dynamic Susceptibility ◽  
Factors Associated ◽  
Peritumoral Brain Edema

ObjectivesThe proliferation of microvessels with increased permeability is thought to be the cause of peritumoral brain edema (PTBE) in metastases. The contribution of the glymphatic system to the formation of PTBE in brain metastases remains unexplored. We aimed to investigate if the PTBE volume of brain metastases is related to glymphatic dysfunction.Materials and MethodsA total of 56 patients with brain metastases who had preoperative dynamic susceptibility contrast-enhanced perfusion-weighted imaging for calculation of tumor cerebral blood volume (CBV) and diffusion tensor imaging for calculations of tumor apparent diffusion coefficient (ADC), tumor fractional anisotropy (FA), and analysis along perivascular space (ALPS) index were analyzed. The volumes of PTBE, whole tumor, enhancing tumor, and necrotic and hemorrhagic portions were manually measured. Additional information collected for each patient included age, sex, primary cancer, metastasis location and number, and the presence of concurrent infratentorial tumors. Linear regression analyses were performed to identify factors associated with PTBE volume.ResultsAmong 56 patients, 45 had solitary metastasis, 24 had right cerebral metastasis, 21 had left cerebral metastasis, 11 had bilateral cerebral metastases, and 11 had concurrent infratentorial metastases. On univariable linear regression analysis, PTBE volume correlated with whole tumor volume (β = -0.348, P = 0.009), hemorrhagic portion volume (β = -0.327, P = 0.014), tumor ADC (β = 0.530, P <.001), and ALPS index (β = -0.750, P <.001). The associations of PTBE volume with age, sex, tumor location, number of tumors, concurrent infratentorial tumor, enhancing tumor volume, necrotic portion volume, tumor FA, and tumor CBV were not significant. On multivariable linear regression analysis, tumor ADC (β = 0.303; P = 0.004) and ALPS index (β = -0.624; P < 0.001) were the two independent factors associated with PTBE volume.ConclusionMetastases with higher tumor ADC and lower ALPS index were associated with larger peritumoral brain edema volumes. The higher tumor ADC may be related to increased periarterial water influx into the tumor interstitium, while the lower ALPS index may indicate insufficient fluid clearance. The changes in both tumor ADC and ALPS index may imply glymphatic dysfunction, which is, at least, partially responsible for peritumoral brain edema formation.

scholarly journals Hospitalization costs among immobile patients with hemorrhagic or ischemic stroke in China: a multicenter cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hongpeng Liu ◽  
Chen Zhu ◽  
Jing Cao ◽  
Jing Jiao ◽  
Baoyun Song ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Ischemic Stroke ◽  
Linear Regression ◽  
Average Length ◽  
Linear Regression Analysis ◽  
Hospital Charges ◽  
Hospital Level ◽  
Cross Sectional ◽  
Factors Associated ◽  
Hospitalization Costs

Abstract Background In this study, we aimed to analyze the hospitalization costs for immobile patients with hemorrhagic stroke (IHS) or ischemic stroke (IIS) in China and to determine the factors associated with hospitalization costs. Methods We evaluated patients with IHS and IIS hospitalized between November 2015 and July 2016 in six provinces or municipality cities of China. Linear regression analysis was used to examine the association with hospitalization costs and predictors. Results In total, 1573 patients with IHS and 3143 with IIS were enrolled and analyzed. For IHS and IIS, the average length of stay (LoS) was 17.40 ± 12.3 and 14.47 ± 11.55 days. The duration of immobility was 12.11 ± 9.98 and 7.36 ± 9.77 days, respectively. Median hospitalization costs were RMB 47000.68 (interquartile range 19,827.37, 91,877.09) for IHS and RMB 16578.44 (IQR 7020.13, 36,357.65) for IIS. In both IHS and IIS groups, medicine fees accounted for more than one-third of hospitalization costs. Materials fees and medical service fees accounted for the second and third largest proportions of hospital charges in both groups. Linear regression analysis showed that LoS, hospital level, and previous surgery were key determinants of hospitalization costs in all immobile patients with stroke. Subgroup analysis indicated that hospital level was highly correlated with hospitalization costs for IHS whereas pneumonia and deep vein thrombosis were key factors associated with hospitalization costs for IIS. Conclusions We found that hospitalization costs were notably higher in IHS than IIS, and medicine fees accounted for the largest proportion of hospitalization costs in both patient groups, perhaps because most patients ended up with complications such as pneumonia thereby requiring more medications. LoS and hospital level may greatly affect hospitalization costs. Increasing the reimbursement ratio of medical insurance for patients with IHS is recommended. Decreasing medicine fees and LoS, preventing complications, and improving treatment capability may help to reduce the economic burden of stroke in China.

Cervix cancer regression measured using weekly MR imaging during fractionated radiotherapy: Radiobiologic modeling and correlation with tumor hypoxia

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5547-5547
Author(s):  
K. S. Lim ◽  
P. Chan ◽  
R. Dinniwell ◽  
A. Fyles ◽  
M. Haider ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Regression Analysis ◽  
Linear Regression ◽  
Mr Imaging ◽  
Tumor Volume ◽  
Tumor Regression ◽  
Linear Regression Analysis ◽  
Tumor Hypoxia ◽  
Cervix Cancer ◽  
Pre Treatment

5547 Background: To utilize cervix cancer volumetry, as measured with MR imaging during definitive chemoirradiation (RT-CT), to derive radiobiological parameters using a mathematical model of tumor regression, and compare them to pre-treatment measurements of tumor hypoxia. Methods: Twenty-eight patients receiving RT-CT for cervix cancer underwent weekly magnetic resonance imaging (MRI) scans. Tumor volume was assessed on each of these scans and the rate of regression plotted. A mathematical model of tumor regression was formulated to simulate the relationship between three independent radiobiological parameters, 1) surviving fraction of cells after 2 Gy, SF2, 2) the cell clearance constant Tc, and 3) the cellular proliferation constant Tp. Non-linear regression analysis was applied to fit the MR-derived tumor volumes to the mathematical model and to derive SF2 and Tc values for each patient. These were compared to pre-treatment hypoxia measurements. Results: Initial tumor volume ranged between 8 and 209 cm3. Relative reduction in volume during treatment was 0.02 to 0.79. Simulations using representative values of the independent biologic variables derived from the literature showed SF2 and Tc to strongly influence the shape of the volume response curves. Non-linear regression analysis yielded a median SF2 of 0.71 and median Tc of 10 days. Radioresistant tumors (SF2 >0.71) were significantly more hypoxic at diagnosis (p=0.02). Conclusion: Based on serial MR imaging during treatment, a marked variation in cervix tumor regression is seen from patient to patient. Through our radiobiological model, tumors can be classified as radioresistant or radiosensitive, which correlates with hypoxia [Table: see text] No significant financial relationships to disclose.

scholarly journals Change of Retinal Vessel Density After Lowering Intraocular Pressure in Ocular Hypertension

2021 ◽  
Vol 8 ◽  
Author(s):  
Xuhao Chen ◽  
Ying Hong ◽  
Haohao Di ◽  
Qianru Wu ◽  
Di Zhang ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Intraocular Pressure ◽  
Linear Regression ◽  
Ocular Hypertension ◽  
Linear Regression Analysis ◽  
Vessel Density ◽  
Factors Associated ◽  
Rnfl Thickness ◽  
Deep Layers ◽  
The Mean

Purpose: To investigate the relationship between retinal microvasculature changes and intraocular pressure (IOP) for ocular hypertension (OHT) patients and further assess the factors associated with retinal microcirculation changes.Methods: This was a single-center prospective study designed for OHT patients, which consisted of two visits. After collecting baseline data of those who met the eligibility criteria, these patients were treated with latanoprost 0.005% ophthalmic solution for 4 weeks. Peripapillary vessel density (VD) of radial peripapillary capillaries (RPC) layer, macular VD in both superficial and deep layers, and foveal avascular zone (FAZ) area were measured by optical coherence tomography angiography (OCTA) before and after the treatment. We compared the changes in IOP and VD among the two visits by paired-sample t-test. Bonferroni correction was applied. Factors associated with VD changes were analyzed by linear regression analysis.Results: Thirty-four eyes of thirty-four patients were included. The mean IOP decreased by 6.5 ± 2.2 mmHg (p < 0.001). The peripapillary RPC VD increased significantly from 51.8 ± 2.5 to 53.0 ± 3.1% (Adjusted-p = 0.012). We found no significant difference in detailed sectors of the peripapillary region after correction. In the macular area, both the superficial and deep layers in foveal (superficial: 0.2 ± 1.9%, p = 0.523; deep: 0.0 ± 2.3%, p = 0.969) and parafoveal (superficial: 0.3 ± 3.0%, p = 0.565; deep: 0.5 ± 3.1%, p = 0.423) VD remained unchanged. The decrease of the mean FAZ area was insignificant (p = 0.295). The percentage of IOP reduction (β = 0.330, p = 0.031) and the baseline RNFL thickness (β = 0.450, p = 0.004) significantly correlated with the percentage of peripapillary RPC VD improvement in the multivariate linear regression analysis.Conclusion: The peripapillary VD in OHT patients increased after the reduction of IOP. The mild change of IOP did not alter the microcirculation in the macula. In addition, the percentage of IOP change and the baseline RNFL thickness were independent factors for the peripapillary RPC VD improvement.

scholarly journals Current status and influencing factors of self-management in patients with non-valvular atrial fibrillation under different anticoagulant therapy in Jiangsu province, China: A multi-center across‑sectional study

2020 ◽  
Author(s):  
ting Liu ◽  
mengxiao Ren ◽  
lingling Cui ◽  
bingqing Lu ◽  
jie Hui ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Regression Analysis ◽  
Linear Regression ◽  
Linear Regression Analysis ◽  
Jiangsu Province ◽  
Self Management ◽  
Current Status ◽  
Sectional Study ◽  
Factors Associated ◽  
Warfarin Group

Abstract Background: There is little research focusing on the current status and influencing factors of self-management in patients with non-valvular atrial fibrillation (NVAF) under different anticoagulant therapy. This study aims to explore the current status of self-management of NVAF who took Warfarin, New Oral Anticoagulant (NOAC), Aspirin and No medication, and analyze the factors associated with their self-management ability in Jiangsu province, China. Methods: This was a multi-center, cross-sectional study that was conducted in six hospitals from December 2017 to October 2018. The general information and self-management of patients were collected by questionnaires and from the medical records. Multivariate linear regression analysis was used to identify factors associated with self-management.Results: A total of 555 participant completed the survey. The status of self-management was unsatisfactory in patients with NVAF, there were significant differences (P＜0.01) of self-management among patients in different anticoagulant groups and Warfarin group was relatively better (71.21±12.33). Multiple linear regression analysis demonstrated that the determinants of poor self-management in Warfarin group was the lower educational status (P＜0.01); in Aspirin group, comorbidities (P=0.015) and age＜65 years (P＜0.01) were the determinants of self-poor management; while in No medication group, age＜65 years (P=0.047), single (P＜0.01), poor sleep quality (P＜0.01) and permanent AF (P＜0.01) were the determinants of poor self-management. Conclusion: The current status of self-management among Chinese patientswith NVAF in Jiangsu province does not appear optimistic. Therefore, further studies should focus on how to improve the self-management among NVAF patients. In addition, policy makers should pay attention to identify patients at risk of poor self-management and take measures to improve their self-management.

scholarly journals Effect of the dose regimen on the serum amisulpride concentration and simulation of concentration reference ranges based on population pharmacokinetics

2021 ◽  
Author(s):  
Lu Li ◽  
Lin Li ◽  
Shan-Qin Huang ◽  
Hao-Yang Lu ◽  
Tao Xiao ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Multiple Linear Regression ◽  
Population Pharmacokinetics ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Population Pharmacokinetic ◽  
Serum Drug Concentration ◽  
Reference Ranges ◽  
Factors Associated

Abstract Aims This study aims to determine the factors associated the large variability and provided the concentrations reference ranges for different dose ranges. Methods A retrospective study was conducted in a psychiatric hospital. The factors associated with the serum amisulpride concentration were examined using multiple linear regression analysis. A comparison of serum amisulpride concentrations among different dose regimens was conducted via analysis of covariance. The amisulpride concentration range for different dosing regimens was simulated using the population pharmacokinetics of Chinese patients with schizophrenia using the Monte Carlo method. Results In total, 472 samples from 291 patients were examined to determine the factors associated with amisulpride concentrations. Multiple linear regression analysis indicated that age and the daily dose were positively correlated with the serum drug concentration, whereas male gender and sampling time before the last administration were negative correlated with its concentration. The serum amisulpride concentration significantly differed among the dose regimens. Using an established amisulpride population pharmacokinetic model, the simulated trough concentrations exceeded 320 ng/mL for most regimens with daily doses greater than 600 mg/day. Conclusion Differences in dose regimens and daily doses contributed to the large variation of the serum amisulpride concentration. The currently recommended reference does not ensure the attainment of appropriate therapeutic concentrations.

scholarly journals Factors associated with prolonged duration of viral clearance in non-severe SARS-CoV-2 patients in Osaka, Japan

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Emma Nakagawa Hoffman ◽  
Haruna Kawachi ◽  
Atsushi Hirayama ◽  
Jingwen Zhang ◽  
Ayumi Murayama ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Linear Regression ◽  
Observational Study ◽  
Symptom Onset ◽  
Linear Regression Analysis ◽  
Viral Clearance ◽  
Factors Associated ◽  
Longitudinal Observational Study ◽  
Prolonged Duration

Abstract Background We investigated factors associated with prolonged viral clearance of SARS-CoV-2 among non-severe adult patients in Osaka, Japan. A total of 706 laboratory-confirmed COVID-19 patients were enrolled in this longitudinal observational study between 29 January 2020 and 31 May 2020, across 62 hospitals and three non-hospital recuperation facilities. Methods Logistic regression analysis was performed to investigate the factors associated with prolonged (29 days: upper 25% in duration) viral clearance of SARS-CoV-2. Linear regression analysis was conducted to assess these factors 14 days after symptom onset. Results The median duration of viral clearance was 22 days from symptom onset. After adjustment for sex, age, symptoms, comorbidity, and location of recuperation, comorbidities were associated with prolonged duration: (OR, 1.77 [95% CI, 1.11–2.82]) for one, (OR, 2.47 [95% CI, 1.32–4.61]) for two or more comorbidities. Viral clearance 14 days after symptom onset was 3 days longer for one comorbidity and 4 days longer for two or more comorbidities compared to clearance when there was no comorbidity. Conclusion The presence of comorbidity was a robust factor associated with a longer duration of viral clearance, extending by 3 to 4 days compared to patients with no comorbidity.

Correlations Between Lung, Cardiac Functions and Hematologic Parameters in SCA-Chidren

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1067-1067
Author(s):  
Clément Tassel ◽  
Cécile Arnaud ◽  
Annie Kamdem ◽  
Nadia Médejel ◽  
Elodie Fauveau ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Linear Regression ◽  
Multiple Linear Regression ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Systolic Pulmonary Artery Pressure ◽  
Biological Parameters ◽  
Alveolar Volume ◽  
Factors Associated

Abstract Abstract 1067 Background: Elevation of tricuspid regurgitant jet velocity (TRJV) predicts high systolic pulmonary artery pressure and early mortality in adults with sickle cell anemia (SCA). To date, few studies have reported the concomitant analysis of lung alterations and high TRJV in SCA-children. Objective: To evaluate the relationship between lung function, TRJV and hematologic parameters in SCA-children. Patients and Methods: SCA-children of the Creteil-CHIC cohort were assessed at steady state on the same day by cardiac echocardiography, pulmonary function tests (PFT), clinical and biological parameters. All data were recorded in the CHIC database. Forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), total lung capacity (TLC) and diffusing capacity for carbon monoxide (DLCO) were measured with the single-breath technique. DLCO was adjusted to hemoglobin and to the alveolar volume (KCOc). Univariate and multivariate linear regression analyses were performed to evaluate factors correlating with TRJV and KCOc and logistic regression was applied to evaluate the risk factors associated with elevated TRJV (≥ 2.5 m/s). Results: A total of 228 check-ups with cardiac and lung assessment, performed in 163 SCA-patients (160 SS, 3 SB0) was analyzed. Check-ups were performed at the median age of 13.2 years (range: 5.7–19.9). Among the 228 check-ups, 151 were performed after intensification (59 on hydroxyurea, 57 on transfusion program and 38 after hematopoietic stem cell transplantation (HSCT). TRJV (median value: 2.2 m/s, range 1.4–3.1) was significantly positively correlated with age (r=0.164, p=0.013), was not correlated with TLC but was significantly and negatively correlated with FVC before b2 (r=−0.145, p=0.03) and after b2 (r=−0.184, p=0.008), FEV1 before b2 (r=−0.213, p=0.001) and after b2 (r=−0.178, p=0.012), FEV1/FVC before b2 (r=23?0.165, p=0.013) and positively correlated with KCOc (r=0.379, p<0.001). Multiple linear regression analysis including age and all significant PFT data retained only KCOc as a significantly correlated factor (standardized beta: 0.390, p<0.001). Among biological parameters, TRJV was not correlated to HbF %, platelets, LDH and proBNP but significantly correlated to hemoglobin, hematocrite, reticulocytes, WBC, neutrophils, HbS %, ASAT and bilirubin. Multiple linear regression including all these biological significant biological parameters retained only reticulocytes as significantly associated with TRJV (standardized beta: 0.361, p=0.008). The addition of KCOc to the model retained reticulocytes (standardized beta: 0.198, p=0.010) and KCOc (standardized beta: 0.327, p<0.001) as significantly correlated. Among the biological parameters significantly correlated with KCOc (hemoglobin, reticulocytes, LDH, WBC, platelets, HbS%, ASAT, bilirubin), multiple linear regression analysis retained HbS% (standardized beta: 0.190, p=0.027) and reticulocytes (standardized beta: 0.212, p=0.014) as significantly and positively independent correlated factors. Elevated TRJV (≥ 2.5 m/s) was observed in 39 patients. Reticulocytes per 1×109/L increase (OR: 1.005; 95% CI:1.001–1.009; p=0.007) and KCOc per 1% increase (OR: 1.022; 95% CI:1.007–1.037; p=0.004) were retained as independent and significant factors associated to the risk of TRJV ≥ 2.5 m/s by multivariate logistic regression. When comparing the check-ups in patients without intensification, only those performed after HSCT showed significantly lower KCOc (p<0.001), reticulocytes (p<0.001) and TRJV (p=0.035) Conclusion: In this study, we confirm that SCA-children have an elevated gas transfer per unit lung volume (KCOc) correlated to hemolysis and HbS%. We show for the first time that an increase in KCOc significantly raises the risk for TRJV ≥ 2.5 m/s, even after adjustment for reticulocytes. Only HSCT, which resulted in significantly lower reticulocytes and KCOc, is significantly associated with lower TRJV. These data are encouraging and suggest that HSCT could be recommended to patients with elevated TRJV Disclosures: No relevant conflicts of interest to declare.

ANALISIS PENGARUH INFLASI, KURS DAN IHSG TERHADAP RETURN REKSA DANA SAHAM PT NIKKO SECURITIES INDONESIA PERIODE 2014-2017

2019 ◽  
Vol 2 (2) ◽  
pp. 103
Author(s):  
Muhammad Rois Rois ◽  
Manarotul Fatati Fatati ◽  
Winda Ihda Magfiroh
Keyword(s):  
Regression Analysis ◽  
Exchange Rate ◽  
Linear Regression ◽  
Multiple Linear Regression ◽  
Stock Price ◽  
Price Index ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Equity Fund ◽  
Stock Price Index

This study aims to determine the effect of Inflation, Exchange Rate and Composite Stock Price Index (IHSG) to Return of PT Nikko Securities Indonesia Stock Fund period 2014-2017. The study used secondary data obtained through documentation in the form of PT Nikko Securities Indonesia Monthly Net Asset (NAB) report. Data analysis is used with quantitative analysis, multiple linear regression analysis using eviews 9. Population and sample in this research are PT Nikko Securities Indonesia. The result of multiple linear regression analysis was the coefficient of determination (R2) showed the result of 0.123819 or 12%. This means that the Inflation, Exchange Rate and Composite Stock Price Index (IHSG) variables can influence the return of PT Nikko Securities Indonesia's equity fund of 12% and 88% is influenced by other variables. Based on the result of the research, the variables of inflation and exchange rate have a negative and significant effect toward the return of PT Nikko Securities Indonesia's equity fund. While the variable of Composite Stock Price Index (IHSG) has a negative but not significant effect toward Return of Equity Fund of PT Nikko Securities Indonesia

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