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Phylogeny-independent detection of functional residues.

MOTIVATION: Current projects for the massive characterization of proteomes are generating protein sequences and structures with unknown function. The difficulty of experimentally determining functionally important sites calls for the development of computational methods. The first techniques, based on the search for fully conserved positions in multiple sequence alignments (MSAs), were followed by methods for locating family-dependent conserved positions. These rely on the functional classification implicit in the alignment for locating these positions related with functional specificity. The next obvious step, still scarcely explored, is to detect these positions using a functional classification different from the one implicit in the sequence relationships between the proteins. Here, we present two new methods for locating functional positions which can incorporate an arbitrary external functional classification which may or may not coincide with the one implicit in the MSA. The Xdet method is able to use a functional classification with an associated hierarchy or similarity between functions to locate positions related to that classification. The MCdet method uses multivariate statistical analysis to locate positions responsible for each one of the functions within a multifunctional family. RESULTS: We applied the methods to different cases, illustrating scenarios where there is a disagreement between the functional and the phylogenetic relationships, and demonstrated their usefulness for the phylogeny-independent prediction of functional positions.

Amino Acid Sequence↗

Multiple imputation procedures allow the rescue of missing data: an application to determine serum tumor necrosis factor (TNF) concentration values during the treatment of rheumatoid arthritis patients with anti-TNF therapy.

Longitudinal studies aimed at evaluating patients clinical response to specific therapeutic treatments are frequently summarized in incomplete datasets due to missing data. Multivariate statistical procedures use only complete cases, deleting any case with missing data. MI and MIANALYZE procedures of the SAS software perform multiple imputations based on the Markov Chain Monte Carlo method to replace each missing value with a plausible value and to evaluate the efficiency of such missing data treatment. The objective of this work was to compare the evaluation of differences in the increase of serum TNF concentrations depending on the -308 TNF promoter genotype of rheumatoid arthritis (RA) patients receiving anti-TNF therapy with and without multiple imputations of missing data based on mixed models for repeated measures. Our results indicate that the relative efficiency of our multiple imputation model is greater than 98% and that the related inference was significant (p-value < 0.001). We established that under both approaches serum TNF levels in RA patients bearing the G/A -308 TNF promoter genotype displayed a significantly (p-value < 0.0001) increased ability to produce TNF over time than the G/G patient group, as they received successively doses of anti-TNF therapy.

Antibodies, Monoclonal↗

Prognostic factors in restoration of pulmonary flow after submassive pulmonary embolism: a multiple regression analysis.

Defects as evaluated by lung perfusion scans may persist even 6 months after pulmonary embolism (PE), when treatment is withdrawn. The aim of this study was to evaluate the effect of several potential factors on the resolution of lung perfusion defects, both during the first days and at 6 months, when patients were discharged. In a retrospective follow-up cohort study we included 102 patients with PE, diagnosed lung from a ventilation/perfusion (V'/Q') scan, following Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) criteria, together with a phlebographic study of lower extremities or angiography. Lung perfusion scan was performed at diagnosis, and in two follow-up evaluations, at 7-10 days and at 6 months. Potential factors studied were: age; sex; presence of underlying cardiac or pulmonary disease; venous insufficiency; alveolar-arterial pressure difference for oxygen; delay in diagnosis; abnormalities in electrocardiogram or chest radiograph; and the size of defects as shown in lung perfusion scans. All factors were studied with regards to the size of the defects at the two follow-up evaluations, through a univariate statistical analysis and two multiple stepwise regression analysis. Multivariate statistical analysis selected four factors: size of defects at diagnosis; prior cardiopulmonary disease; delay in diagnosis; and sex, as synergistic variables to predict defect size at 7-10 days. On the other hand, the defect size at 7-10 days was the only variable selected as a predictor of the size of defects at 6 months. Resolution of pulmonary defects during the first days after diagnosis of pulmonary embolism is influenced by the initial defect size, prior cardiopulmonary diseases and sex. The size of residual defects at 6 months depends mainly on the size of defects at 7-10 days.

Cohort Studies↗

Statistical analysis: the need, the concept, and the usage.

In general, better understanding of the need and usage of statistics would benefit the medical community in India. This paper explains why statistical analysis is needed, and what is the conceptual basis for it. Ophthalmic data are used as examples. The concept of sampling variation is explained to further corroborate the need for statistical analysis in medical research. Statistical estimation and testing of hypothesis which form the major components of statistical inference are construed. Commonly reported univariate and multivariate statistical tests are explained in order to equip the ophthalmologist with basic knowledge of statistics for better understanding of research data. It is felt that this understanding would facilitate well designed investigations ultimately leading to higher quality practice of ophthalmology in our country.

Data Interpretation, Statistical↗

[On statistical evaluation of efficacy for dichotomous test result].

Today in our country multivariate statistical analysis in health science are not very widespread, they are used only in few selected health center. So I will try to elucidate some multidimensional procedure to evaluate dichotomous results in diagnostic test. Anyway, someone can take a further advantage to apply these techniques to complex therapeutic treatments. New technologies make possible everyone to process data by means of the multivariate methodology, so I propose tested techniques like logistic regression combined with area under the ROC (Receiver Operating Characteristic) curve.

Diagnostic Techniques and Procedures↗

Volumetric assessment of pulmonary nodules with ECG-gated MDCT.

OBJECTIVE: The objective of our study was to assess physiologic lung deformation and compression originating from cardiovascular motion and their subsequent impact on determining the volume of small pulmonary nodules throughout the cardiac cycle on ECG-gated MDCT. SUBJECTS AND METHODS: Seventy-three small noncalcified pulmonary nodules were identified in 30 patients who underwent ECG-gated MDCT. The volume of each nodule was assessed throughout the cardiac cycle using computer-aided automatic segmentation algorithms, and the assessment was repeated three times. To ensure the validity of the subtle changes in volume that were detected, we determined the volume and signal attenuation in phantom data sets and patient nodules without temporal or spatial differentiation. Subsequently, nodules were assigned to pulmonary segments, and volume changes were correlated to cardiac phases, nodular location, and mean nodular size. Statistical multivariate tests were performed to evaluate significant patterns. RESULTS: The validity of significant measurements was proven in evaluated phantom data sets with a general tendency toward overestimating nodular volume (p = 0.492). Statistical evaluation of nodular signal attenuation confirmed true deformation and compression of nodules rather than partial volume effects as the reason for volume variations (p = 0.874). Differentiating pulmonary nodules in cardiac phases, pulmonary locations, and mean nodular volumes, we found that one single effect did not determine the amount of cardiovascular motion conveyed to pulmonary parenchyma and subsequently led to nodule deformation. Multivariate testing revealed statistically significant measures identifying patterns correlating variation in nodular volume with cardiac phase (p < 0.001), nodular location (p = 0.007), and mean nodular size (p < 0.001). CONCLUSION: Cardiovascular motion was disproportionately conveyed to various pulmonary segments and led to changes in the volume of pulmonary nodules, especially in small pulmonary nodules. A precise volumetric assessment was therefore possible only by identifying the underlying cardiac phase.

Adult↗

Relation between body fat-corrected ECG voltage and ambulatory blood pressure in patients with essential hypertension.

Because adipose tissue has high electric resistance, the amount of body fat influences ECG voltage. In this study, body fat weight of patients with essential hypertension was measured by means of the impedance method and was used to correct mean ECG voltage. Then the relation between body fat-corrected mean ECG voltage (Vfm) and ambulatory blood pressure (BP) was investigated. The subjects were 172 patients with essential hypertension (88 men, 84 women, none receiving medication) between the ages of 30 and 75 years. Ambulatory BP was measured by a multi-biomedical recorder. Minimum sleep-time BP (base BP) was calculated to correspond with minimum sleep-time heart rate. The tetrapolar bioelectric impedance method was used to measure body fat (kg). Left ventricular mass (LVM) was obtained by echocardiography. Then comparisons were made with standard 12-lead ECG, and the statistical mean ECG voltage (Vm) and Vfm were derived by multivariate statistical analysis. The following formula was devised to obtain Vfm resulting from the multivariate analysis that demonstrated a high correlation with LVM (r=0.85): Vfm=0.175(Body Fat)1/3xVm+0.5 (mV). The coefficient of correlation (r) between Vfm and ambulatory BP was not smaller than that between LVM and ambulatory BP. Base systolic BP demonstrated a significantly higher r value (r=0.83) with Vfm/BSA1/2 (where BSA is body surface area) than mean daytime SBP (r=0.65). In many subjects with white-coat hypertension, Vfm/BSA1/2 was <1.33 mV/m (34 of 38 cases; sensitivity, 89%; specificity, 89%). These results indicate that Vfm is a better indicator of hypertensive left ventricular hypertrophy and that it may be useful in estimating minimum sleep-time systolic BP and in diagnosing white-coat hypertension in the outpatient clinic.

Adipose Tissue↗

Statistical assessment of population variability: a methodological approach.

We have implemented a multivariate statistical methodology to assess the degree and pattern of cranial variability in skeletal samples. Specifically, the method is designed to test whether variability in a skeletal sample exceeds "normal within-group variability" defined in the present instance as variability present among crania from a cemetery associated with a village. It involves comparing a covariance matrix derived from a sample of unknown composition to one representing "normal within-group variability." The method has been applied to two Plains Indian craniometric samples. The Leavenworth site (39CO9) represents the remnants of previously autonomous Arikara Indian villages devastated by epidemic diseases in the late 1700s. The Bad River 2 Phase is an archaeological designation grouping together closely related sites in the Bad-Cheyenne region of South Dakota dating from 1740-1795 AD. We were able to show substantial heterogeneity among crania from Leavenworth. District burial areas at Leavenworth account for some of the heterogeneity, supporting the notion that they represent an attempt to maintain former social distinctions. We were unable to differentiate among sites within the Bad River 2 Phase, suggesting that it is a valid biological unit.

Analysis of Variance↗

Divergence in distribution and prognostic significance of major basement components in laryngeal carcinomas.

In previous studies, we demonstrated a loss of major basement membrane (BM) components in laryngeal squamous cell carcinomas and provided initial evidence that this was of potential prognostic significance. In our current study, we extended the panel of BM antibodies and enlarged our study group in order to perform a multivariate statistical analysis. We analyzed 26 laryngeal squamous cell carcinomas immunohistochemically for the distribution of the BM-components collagen IV, collagen VII, laminin-1, laminin-5, perlecan and fibronectin. The resulting data were correlated with clinical prognostic factors and statistical correlation coefficients were determined for independent uni- and multivariate analysis. All carcinomas analyzed revealed defects of the peritumoral BM with more extensive loss of collagen VII than collagen IV, laminin-1, perlecan and fibronectin. Laminin-5 in contrast was present even in poorly differentiated tumors showing an enhanced intracytoplasmatic staining in the tumor cells. Furthermore, our statistical analysis did not show independent prognostic significance of any of the BM-components. Our observations indicate a divergence between the loss of several major BM-components (collagens IV, VII, laminin-1, perlecan) and an enhanced deposition of laminin-5. This suggests a severely altered cell-matrix interaction, since laminin-5 links the collagen VII-containing anchoring fibrils to cell receptors of the integrin type.

Adult↗

Lesions of bulbo-spinal serotonergic or noradrenergic pathways reduce nociception as measured by the formalin test.

Intrathecal administration of the neurotoxins 5,6-dihydroxytryptamine (5,6-DHT) and 6-hydroxydopamine (6-OHDA) in rats selectively lesioned the descending spinal serotonergic and noradrenergic pathways, respectively. Four days after neurotoxin administration the behaviour was evaluated in the formalin test. Several behavioural variables were recorded. The statistical analysis of the results was supplemented using a multivariate statistical method (partial least squares projection to latent variables, PLS) in addition to traditional analysis of variance. The described methods for recording and statistical analysis of behaviour appear to be useful in describing drug-induced differences in behavioural patterns in the formalin test. Both types of lesion reduced the pain-related behaviour in the formalin test (protection of the paw, biting and licking). The results indicate that the descending monoaminergic pathways are parts of a network which maintains adequate nociceptive responses to a chemical stimulus, or to stimuli lasting several minutes, as in the formalin test.

Animals↗

Artificial neural networks for assessing the risk of urinary calcium stone among men.

The pathophysiology of idiopathic calcium oxalate nephrolithiasis involves metabolic abnormalities. Previous studies gave conflicting results about the metabolic factors in stone formers. Artificial neural networks (ANN) are new methods based on computer programming that have outperformed conventional methods in prediction of outcomes in different medical applications. The aim of our study was to compare with ANN the clinical and biochemical parameters implicated in urinary calcium stone between stone formers (SF) and controls (C). We compared 11 clinical and biochemical variables among 119 male idiopathic calcium oxalate SF and 96 C by univariate and multivariate statistical analyses. Univariate analyses included discriminant analysis, logistic regression analysis, and ANN. For multivariate analyses, stepwise discriminant analysis and ANN were performed. Variables included age, body mass index (BMI), family history of nephrolithiasis, supersaturation with respect to calcium oxalate, calcemia, and 24-h urinary calcium, oxalate, uric acid, urea, sodium, and citrate. With univariate and multivariate analyses, ANN were as efficient as classical statistical analyses in discriminating the different parameters. The sensitivity, the specificity, and the percentage of correctly classified patients were similar in all analyses. With ANN, supersaturation (receiver operating characteristic, ROC curves index 0.73) and urea (ROC 0.72) were the most discriminant followed by family history and urinary calcium (ROC 0.67). ROC index was 0.63 for citrate, 0.61 for oxalate and urate, 0.60 for sodium and calcemia, 0.58 for age, and 0.56 for BMI, but these parameters were not statistically different between SF and C. ANN gave additional information since they made it possible to determine the cut-off values of the parameters and their predictive power. Cut-off values for being a stone former were 8.9 for supersaturation and 363 mmol/day for urinary urea with a predictive power of 0.69 and 0.70, respectively. Univariate and multivariate analysis evidenced supersaturation and 24-h urinary urea excretion as the most discriminant parameters between the two populations. In addition to high supersaturation, the negative impact of protein intake was confirmed.

Adolescent↗

Probing latent biomarker signatures and in vivo pathway activity in experimental disease states via statistical total correlation spectroscopy (STOCSY) of biofluids: application to HgCl2 toxicity.

A new multivariate statistical approach, based on the novel combination of projection on latent structure analysis with an inbuilt orthogonal filter (OPLS-DA) coupled with a spectroscopic correlation method statistical total correlation spectroscopy (STOCSY), was used to characterize the in vivo metabolic pathway perturbations of a model renal cortical toxin HgCl2, in the rat, using urine as an indicator of metabolic homeostasis disruption. This method provided an unbiased, sensitive approach to biomarker extraction and identification, and showed potential for generating potential novel pathway connectivities.

Acute Kidney Injury↗

Papillary thyroid microcarcinoma (PTMC): prognostic factors, management and outcome in 403 patients.

AIM: To investigate an "optimal" therapeutic management of patients with papillary thyroid microcarcinoma (PTMC). METHODS: We evaluated a group of 403 consecutive patients affected by PTMC operated on by the same surgeon. Prognostic factors were evaluated by uni- and multivariate statistical analysis. RESULTS: After a mean follow-up of 8.5 years, 372 patients were living without disease (undetectable serum thyroglobulin levels), 24 patients were living with disease (increased serum thyroglobulin levels), 6 patients were deceased due to causes different from thyroid cancer, and 1 patient was deceased due to metastatic thyroid cancer. No statistically significant prognostic factor was found at uni- and multivariate analysis. However, it is worth noting that in patients with a larger primary tumour (size> or =5mm) and treated by partial thyroidectomy alone, the prevalence of recurrent disease was higher than in patients treated by total thyroidectomy and (131)I administration. CONCLUSION: It appears reasonable to perform total thyroidectomy (possibly associated with central compartment node dissection), (131)I whole body scan (followed by (131)I therapy when necessary) and TSH-suppressive hormonal therapy in patients with PTMC.

Carcinoma, Papillary↗

Obesity and low back pain.

Obesity and low back pain (LBP) are common health problems among patients attending Primary Health Care (PHC) in general practice at the United Arab Emirates (UAE). The objective of this study was to determine whether obesity is associated with low back pain. A cross-sectional face-to-face interview questionnaire survey was conducted. The questionnaire was a modified version of the Roland-Morris Scale for evaluating back disability. The interviews were conducted in Arabic by qualified nurses. A multi-stage stratified sample 1,103 UAE national aged 25-65 years, who attended PHC clinics for any reason, were invited to participate but only 802 subjects were eligible to be included for the statistical analysis. The data were analyzed using univariate and multivariate statistical methods. Of the 802 subjects, 428 (53.4%) were males and 374 (46.6%) were females. The mean age of the males was 40.5 +/- 11.5 years and females was 38.2 +/- 10.5 years (p = 0.004). The mean BMI of the males was 26.4 +/- 7.4 and females was 27.8 +/- 5.6 (p = 0.002). The overall prevalence of LBP in the present study was 64.9% (95% confidence interval, 61.0-68.8) and respectively, 56.1% in males and 73.8% in females. The results revealed that there was association between BMI and some socio-demographic variables with the respect of with low back pain. Back pain had more influence on the life style habits on females than in males. Stepwise multiple regression analysis showed that only age (p < 0.0001), educational level (p = 0.001), gender (p = 0.002), place of living (p = 0.019), BMI (p < 0.0001), and housing condition (p = 0.02) had significant effect on the presence of LBP in patients. The present study showed that obesity is moderately associated with low back pain.

Adult↗

Quantitative nuclear morphometry, Markovian texture descriptors, and DNA content captured on a CAS-200 Image analysis system, combined with PCNA and HER-2/neu immunohistochemistry for prediction of prostate cancer progression.

One hundred and twenty-four localized prostate cancer patients operated on at Johns Hopkins Hospital (JHH) since 1975 were identified. The sample was optimized for evaluation of prostate cancer progression. Based upon accurate clinical histories, these radical prostatectomy patients included 50 progressors and 74 non-progressors using appearance of serum PSA as an indication of recurrence (mean follow-up = 8.6 +/- 1.8 years, range 7-15 years). All patients included in the study had no involvement of their seminal vesicles or lymph nodes at the time of prostatectomy. Average time to progression was 3.6 +/- 2 years, range of 1-8 years. Using paraffin-embedded specimens, several five micron sections were cut and placed on Probe-On slides; one slide was H&E-stained and the other was Feulgen-stained. The H&E and Feulgen-stained slides were screened and "dotted" by pathologists at JHH and CytoDynostics, Inc. A CAS-200 Image analysis system (Cell Image Systems, Elmhurst, IL) equipped with a Cell Measurement Program version 1.2 beta, was used to capture the Feulgen-stained images and to perform the calculations. From the "dotted" areas, 150 cancer cells were selected for measurement of DNA content and 27 nuclear morphometric shape and size factors, including 21 Markovian chromatin texture variables. Additional sections were used for immunochemistry staining with an alkaline phosphatase streptavidin-biotin complex stain to detect and quantitate cancer cells binding monoclonal antibodies directed against proliferating cell nuclear antigen (PCNA) and HER-2/neu antigen. All data were entered into a statistical program (STATA) for further analysis and univariate and multivariate statistical analysis was performed using logistic regression and its stepwise variant. The biomarkers of greatest utility to detect progressors when analyzed univariately included post-operative Gleason score (p = < 0.0001), HER-2/neu antigenicity (p = 0.0147), CAS-200 DNA ploidy (p = 0.008), and twelve Markovian nuclear texture and shape features (p = < 0.0001), whereas PCNA (p = 0.160) failed. The optimal set of nuclear morphometry progression tumor features were selected using backward stepwise logistic regression estimate analysis which drops variables due to collinearity. Although post-operative Gleason score is a strong univariate predictor of progression, DNA ploidy and HER-2/neu contributed significantly to further stratification of higher risk groups within the low Gleason score subpopulation. The best Markovian features combined with post-operative Gleason score generated sensitivity = 90%, specificity = 96%, positive predictive value = 94%, negative predictive value = 93% and the area under the receiver operator curve was 0.975.

Biomarkers, Tumor↗

Evaluation of eye irritation potential: statistical analysis and tier testing strategies.

Eye irritation testing, specifically the Draize test, has been the centre of controversy for many reasons. Several alternatives, based on the principles of reduction, refinement and replacement, have been proposed and are being used by the industry and government authorities. However, no universally applicable, validated non-animal alternative(s) is currently available. This report presents a statistical analysis and two testing approaches: the partial least squares multivariate statistical analysis of de Silva and colleagues from France, the tier-testing approach for regulatory purposes described by Gerner and colleagues from Germany, and the three-step tier-testing approach of the US Interagency Regulatory Alternatives Group described by Gupta and Hill. These approaches were presented as three separate papers at the November 1993 Interagency Regulatory Alternatives Group (IRAG) Workshop on Eye Irritation Testing; they have been summarized and combined into the following three-part report. The first part (de Silva et al.) presents statistical techniques for establishing test batteries of in vitro alternatives to the eye irritation test. The second (Gerner et al.) and third (Gupta and Hill) parts are similar in that they stage assessment of information by using a combination of screening information and animal testing to effect reductions in animal use and distress.

Animal Testing Alternatives↗

Risk factors for third molar extraction difficulty.

PURPOSE: The purpose of this study was to measure the difficulty of third molar (M3) extractions and to identify demographic, anatomic, and operative variables associated with extraction difficulty. MATERIALS AND METHODS: To address the research purpose, we implemented a prospective cohort study and enrolled a sample composed of patients presenting for M3 removal. Predictor variables were categorized as demographic, anatomic, and operative. The primary outcome variable was difficulty of extraction, measured as extraction time per tooth. The secondary outcome variable was the surgeons postoperative estimate of M3 extraction difficulty, measured on a 100-mm visual analog scale (VAS). Appropriate univariate, bivariate, and multivariate statistics were computed. RESULTS: The sample was composed of 82 subjects, having 250 M3s (53.2% mandibular) extracted, with a mean age of 26.2 +/- 10.7 years; 57.3% were female, 72.0% were white. The mean operating time per M3 extraction was 6.9 +/- 7.6 minutes. The mean estimate of difficulty was 39.6 +/- 24.7 mm and was significantly correlated (r = 0.68) with extraction time (P < .01). Surgical experience, M3 location (maxillary versus mandibular), procedure type, tooth position, number of teeth extracted, and tooth morphology were statistically associated (P < or = .05) with extraction time in a multivariate model. CONCLUSION: Our model indicates that the difficulty of M3 extractions is governed primarily by anatomic and operative factors with minimal influence from demographic factors.

Adolescent↗

Risk based characterisation of contaminated industrial site using multivariate and geostatistical tools.

Human and ecological risk assessment requires the sources, distribution, mobility and environmental behaviour of contaminants to be investigated on a site-specific basis. It often deals with data sets which are relatively small and affected by sampling gaps. In the case of a polycyclic aromatic hydrocarbon (PAH) contaminated industrial site, Kriging interpolation of spatial data and principal component analysis (PCA) proved useful for extracting additional value from the data set. Kriging was adopted for assessing the horizontal and vertical distribution and transport of PAHs in soil. PCA was applied to PAH concentration and relative abundance in soil samples and interpreted on the basis of the PAH physico-chemical and bio-degradation properties. It revealed correlation with the products of a neighbouring factory and the weathering of the lighter PAHs. The geo- and multivariate statistical results were coupled with the previous hydrogeological characterisation of the site to develop a site-conceptual model for use in the exposure scenario modelling for risk assessment.

Factor Analysis, Statistical↗