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Concept: Exact test


Inactivated poliovirus vaccine (IPV) is efficacious against paralytic disease, but its effect on mucosal immunity is debated. We assessed the efficacy of IPV in boosting mucosal immunity. Participants received IPV, bivalent 1 and 3 oral poliovirus vaccine (bOPV), or no vaccine. A bOPV challenge was administered 4 weeks later, and excretion was assessed 3, 7, and 14 days later. Nine hundred and fifty-four participants completed the study. Any fecal shedding of poliovirus type 1 was 8.8, 9.1, and 13.5% in the IPV group and 14.4, 24.1, and 52.4% in the control group by 6- to 11-month, 5-year, and 10-year groups, respectively (IPV versus control: Fisher’s exact test P < 0.001). IPV reduced excretion for poliovirus types 1 and 3 between 38.9 and 74.2% and 52.8 and 75.7%, respectively. Thus, IPV in OPV-vaccinated individuals boosts intestinal mucosal immunity.

Concepts: Vaccine, Poliomyelitis, Polio vaccine, Effectiveness, Fisher's exact test, Exact test, Poliomyelitis eradication, Poliovirus


Cancer results from the acquisition of somatic driver mutations. Several computational tools can predict driver genes from population-scale genomic data, but tools for analyzing personal cancer genomes are underdeveloped. Here we developed iCAGES, a novel statistical framework that infers driver variants by integrating contributions from coding, non-coding, and structural variants, identifies driver genes by combining genomic information and prior biological knowledge, then generates prioritized drug treatment. Analysis on The Cancer Genome Atlas (TCGA) data showed that iCAGES predicts whether patients respond to drug treatment (P = 0.006 by Fisher’s exact test) and long-term survival (P = 0.003 from Cox regression). iCAGES is available at .

Concepts: DNA, Gene, Genetics, Organism, Genome, Genomics, Fisher's exact test, Exact test


International Journal of Paediatric Dentistry 2013; 23: 145-152 Background.  Alternatives to vital pulpotomy treatment in primary teeth are being sought because of the high formaldehyde content of traditional formocresol (FC) pulpotomy medicaments. Aim.  The aim was to compare the clinical and radiographic success of vital pulpotomy treatment in primary molars using 3% sodium hypochlorite (NaOCl) versus a 1 : 5 dilution of Buckley’s FC. Design.  Pulpotomies were performed in primary molars of healthy children between 3 and 10 years old. Sixty-five primary teeth were randomized into two groups that were evaluated for treatment outcomes. Following treatment, the pulp chamber was filled with zinc oxide eugenol (ZnOE) and restored with a stainless steel crown cemented with glass ionomer cement. Clinical and radiographic outcomes were recorded at 6 and 12 months. Results.  The control (FC) and experimental (NaOCl) groups demonstrated 100% clinical success at 6 and 12 months. The NaOCl group had 86% (19/22) radiographic success at 6 months and 80% (12/15) at 12 months. The FC group had 84% (21/25) radiographic success at 6 months and 90% (9/10) at 12 months. No significant differences were found in the radiographic outcomes between the two groups at 6 and 12 months (Fisher’s exact test; P = 0.574 and P = 0.468, respectively). Conclusion.  NaOCl demonstrated clinical and radiographic success comparable to FC.

Concepts: Horse, Chlorine, Teeth, Molar, Fisher's exact test, Exact test, Canine tooth, Zinc oxide eugenol


Abstract Background: Recurrent herniation is a well-known complication following the initial repair of congenital diaphragmatic hernias (CDHs). The role of minimally invasive surgical techniques in recurrent CDH remains undefined. The purpose of this study was to evaluate our early experience with thoracoscopic repair compared with traditional open repair in children with recurrent CDH. Subjects and Methods: We retrospectively reviewed all recurrent Bochdalek CDH cases (n=24) managed at a single tertiary-care referral center between January 1990 and March 2011. Children who underwent thoracoscopic repair for recurrent CDH were identified, and their data were compared by the unpaired t test and the two-sided Fisher’s exact test, as appropriate, with those of children who underwent open repair. Significance was defined as P<.05. Results: Thoracoscopic repair was attempted in 6 (25%) children with recurrent CDH. Four (67%) repairs were successfully completed without conversion to an open procedure. The mean age at thoracoscopic repair was 11.5 months (range, 8.1-16.1 months). The mean operative time was 191 minutes (range, 94-296 minutes), and all children were extubated within 24 hours. The mean hospital length of stay was 3.75 days (range, 1-6 days). There were no deaths or subsequent recurrences after a mean follow-up of 26.5 months (range, 14.3-41.3 months). There were no statistical differences in any of the measured outcome variables when compared with the open repair group. Conclusions: Our initial experience suggests that thoracoscopic repair is a feasible alternative to open repair in selected children with recurrent Bochdalek diaphragmatic hernias.

Concepts: Statistical tests, Statistics, Surgery, Statistical significance, Ronald Fisher, Fisher's exact test, Exact test, Congenital diaphragmatic hernia


Abstract A microanastomosis might tolerate a torsion up to 360°, but the effects of arterial microanastomosis torsion on the survival of the flap it supplies are unclear. The aim of this study was to investigate the consequences of microarterial anastomosis torsion on the groin flap in rats. Forty Sprague-Dawley rats were divided into five groups. An oblique groin flap was harvested as an island flap and a patch-to-side arterial anastomosis was performed with torsion angles of 0°, 90°, 180°, 270°, and 360°. Six of eight flaps in Group I (0° torsion), six of eight flaps in Group II (90°), three of eight flaps in Group III (180°), and none of the flaps in Groups IV and V (270° and 360°) were found to be viable after 1 week. The patency and flap survival rates observed in Groups II, III, IV, and V were compared with those in Group I using Fisher’s exact test. The patency rates and flap survival rates in Groups IV and V were significantly lower compared with those in Group I. Our data show that skin flaps can survive even if their arterial pedicle is anastomosed with a torsion of up to 180°.

Concepts: Statistical tests, Group, Ronald Fisher, Anastomosis, Fisher's exact test, Exact test


Abstract Release of nucleated red blood cells (nRBCs) into the peripheral blood occurs in stillbirths/neonates with a probable hypoxic mode of death and antenatal stress. We correlate the number of nRBCs in the placenta with the occurrence of intradural (IDH) and subdural hemorrhage (SDH) and its potential link with fetal hypoxia. Two groups of 22 cases each of non- macerated term or near term ({greater than or equal to} 36 weeks of gestational age) stillborn or newborns dying in the 1st day of life were studied. One group had IDH (with or without SDH) and the other did not have IDH or SDH. In each case the number of nRBCs was determined in 10 consecutive placental fields at 40x. Data was analyzed with Fisher’s exact test, ROC Curve analysis and logistic regression. There was a significant association between the diffuse IDH and increased number of nRBCs (Fisher’s Exact Test p = 0.0165) . A ROC Curve Analyses showed that the cut-off number of nRBCs with the highest accuracy was 2.15 nRBCs/HPF, with 79% sensitivity and 67% specificity. The presence of diffuse IDH was associated with SDH (Fisher exact test, p-value = 0.002).. The absence of hypoxic brain change was associated with absence of diffuse IDH (OR 0.308 (p=0.039). We established a significant correlation between nRBCs in the placenta and the occurrence of diffuse IDH, and between this latter and the occurrence of SDH.

Concepts: Pregnancy, Blood, Embryo, Fetus, Red blood cell, Gestational age, Fisher's exact test, Exact test


Background and Study Aims/Object Oral nimodipine is recommended to reduce poor outcome related to aneurysmal subarachnoid hemorrhage (SAH). In addition, animal experiments and clinical trails revealed a beneficial effect of enteral and parenteral nimodipine for the regeneration of cranial nerves following skull base, laryngeal, and maxillofacial surgery. Despite these findings there is a lack of pharmacokinetic data in the literature, especially concerning its distribution in nerve tissue.Patients/Material and Methods Samples were taken from a consecutive series of 57 patients suffering from skull base lesions and treated with nimodipine prophylaxis from the day before surgery until the seventh postoperative day. Both groups received standard dosages for enteral (n = 25) and parenteral (n = 32) nimodipine . Nimodipine levels were measured in serum, cerebrospinal fluid (CSF), and tissue samples, including vestibular nerves.Results Nimodipine levels were significantly higher following parenteral as compared with enteral administration for intraoperative serum (p < 0.001), intraoperative CSF (p < 0.001), tumor tissues (p = 0.01), and postoperative serum (p < 0.001). In addition, nimodipine was significantly more frequently detected in nerve tissue following parenteral administration (Fisher's exact test, p = 0.015).Conclusions From a pharmacokinetic point of view, parenteral nimodipine medication leads to higher levels in serum and CSF. Furthermore, traces are more frequently found in nerve tissue following parenteral as compared with enteral nimodipine administration, at least in the early course.

Concepts: Cranial nerves, Subarachnoid hemorrhage, Cerebrospinal fluid, Route of administration, Nerve, Fisher's exact test, Exact test, Routes of administration


BACKGROUND & AIMS: Celiac disease is an increasingly recognized disorder in Caucasian populations of European origin. Little is known about its prevalence in non-Caucasians. Although it is thought to be a cause of iron deficiency anemia, little is known about the extent to which celiac disease contributes to iron deficiency in Caucasians, and especially non-Caucasians. We analyzed samples collected from participants in the Hemochromatosis and Iron Overload Screening (HEIRS) study to identify individuals with iron deficiency and assess the frequency of celiac disease. METHODS: We analyzed serum samples from white men (25 y old or older) and women (50 y old or older) who participated the HEIRS study; cases were defined as individuals with iron deficiency (serum level of ferritin ≤12 mg/L) and controls were those without (serum level of ferritin >100 mg/L in men and >50 mg/L in women). All samples were also analyzed for human recombinant tissue transglutaminase immunoglobulin A; positive results were confirmed by an assay for endomysial antibodies. Patients with positive results from both celiac disease tests were presumed to have untreated celiac disease, and those with a positive result from only 1 test were excluded from analysis. We analyzed HLA genotypes and frequencies of celiac disease between Caucasians and non-Caucasians with iron deficiency. RESULTS: Celiac disease occurred in 14 of 567 of cases (2.5%) and in only 1 of 1136 controls (0.1%; Fisher’s exact test, P=1.92 10(-6)). Celiac disease was more common in Caucasian cases (14/363, 4%) than non-Caucasian cases (0/204; P=.003). Only 1 Caucasian control and no non-Caucasian controls had celiac disease. The odds of celiac disease in individuals with iron deficiency was 28-fold (95% confidence interval, 3.7-212.8) that of controls; 13/14 cases with celiac disease carried the DQ2.5 variant of the HLA genotype. CONCLUSIONS: Celiac disease is associated with iron deficiency of Caucasians. Celiac disease is rare among non-Caucasians-even among individuals with features of celiac disease, such as iron deficiency. Celiac disease is also rare among individuals without iron deficiency. Men and post-menopausal women with iron deficiency should be tested for celiac disease.

Concepts: Hemoglobin, Iron, Iron deficiency anemia, Coeliac disease, Transferrin, Human iron metabolism, Fisher's exact test, Exact test


Aseptic techniques are required to manipulate central venous lines and prepare intravenous doses. This study aimed to examine whether different aseptic techniques affect the contamination rates of intravenous doses prepared on hospital wards. Syringes of tryptic soy broth test media prepared by one pharmacy operator and five nurses were assessed for contamination. The pharmacy operator achieved lower contamination than the nurses (0.0% vs 6.9%; Fisher’s exact test, P < 0.001). Contamination differed significantly between nurses (∼2-17% of syringes; binary logistic regression, P = 0.018). In conclusion, appropriate training and experience in aseptic techniques should be embedded into routine clinical practice to reduce contamination rates.

Concepts: Regression analysis, Logistic regression, Statistical tests, Ronald Fisher, Fisher's exact test, Exact test, Categorical data, Aseptic technique


The primary objective of this study was to investigate if differences in dog bite characteristics exist amongst legislated and non-legislated dog breeds listed under breed-specific legislation in Ireland (age when bitten, anatomical bite locations, triggers for biting, victim’s relationship with the dog, geographical location and owner presence, history of aggression, reporting bite incident to authorities, medical treatment required following the bite, and type of bite inflicted). A second objective of the current study was to investigate dog control officer’s enforcement and perceptions of current legislation. Data for statistical analyses were collated through a nationally advertised survey, with Pearson Chi-square and Fisher’s Exact Test statistical methods employed for analyses. A total of 140 incident surveys were assessed comprising of non-legislated (n = 100) and legislated (n = 40) dog bite incidents.

Concepts: Statistical tests, Statistics, Injuries, Ronald Fisher, Fisher's exact test, Exact test, Chi-square test, Bite