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Nevin Manimala Statistics

Causal effects of inflammatory bowel disease on risk of type 2 diabetes: a two-sample multivariable Mendelian randomization study

Acta Diabetol. 2024 Mar 1. doi: 10.1007/s00592-024-02254-9. Online ahead of print.

ABSTRACT

AIM: This study aimed to explore the causal association between inflammatory bowel disease (IBD) and the risk of type 2 diabetes (T2D) based on a two-sample Mendelian randomization (MR) study.

METHODS: Summary single nucleotide polymorphism (SNP)-phenotype association data were obtained from published two genome-wide association studies (GWAS) including SNPs related to IBD, UC, or CD in European participants (n = 71,997) and East Asian participants (n = 16,805). Two GWAS including SNPs associated with T2D included 655,666 Europeans and 433,540 East Asians. A series of screening processes were performed to select qualified instrumental SNPs strongly related to exposure. We applied the inverse variance weighted (IVW), the MR-Egger regression, and the weighted median to estimate the causal effects of IBD, ulcerative colitis (UC) or Crohn’ disease (CD) on T2D. Cochran’s Q test was conducted to evaluate the statistical heterogeneity between SNPs in the IVW method. The leave-one-out analysis was employed to assess whether the results were caused by any single SNP associated with IBD, UC, or CD. Odds ratio (OR) and 95% confidence interval (CI) were calculated.

RESULTS: The IVW results demonstrated that IBD could increase the risk of T2D in the European population (OR = 1.0230, 95%CI: 1.0073-1.0390). UC was positively associated with the risk of T2D according to the weighted median (OR = 1.0274, 95%CI: 1.0009-1.0546) and IVW (OR = 1.0244, 95%CI: 1.0071-1.0421) results in the European population. The IVW results indicated that the CD was positively associated with the risk of T2D in the European population (OR = 1.0187, 95%CI: 1.0045-1.0330). In the East Asian population, there are no associations between the IBD, UC, or CD and the risk of T2D (all P > 0.05). MVMR results revealed that the causal effect UC on T2D was still statistically significant after including body mass index (BMI) or low-density lipoprotein (LDL).

CONCLUSION: IBD, UC, or CD had causal effects on the risk of T2D in the European population, which might provide evidence for the prevention of T2D in patients with IBD, UC, or CD.

PMID:38427067 | DOI:10.1007/s00592-024-02254-9

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History of pain around the lumbopelvic region during perinatal period: a prospective cohort study

Eur Spine J. 2024 Mar 1. doi: 10.1007/s00586-024-08193-x. Online ahead of print.

ABSTRACT

PURPOSE: Many women experience pain around the low back and pelvic girdle during/after pregnancy. These pains have different risk factors and require independent management strategies. Therefore, an epidemiological database is required to understand when each type of pain occurs, and how serious it could be. Thus, the history of pain in the lumbopelvic region throughout the perinatal period was investigated.

METHODS: The information of 170 women recruited at the obstetrics and gynecology clinics in Japan was collected at 12, 24, 30, and 36 weeks of pregnancy, in the early days after childbirth, and one month after childbirth. The presence and severity of sacroiliac joint pain, pubic pain, groin pain, and low back pain were assessed using a numerical rating scale. Descriptive statistics were used to determine changes in the prevalence of pain. In addition, the change in the severity of each type of pain was observed through descriptive statistics, by including only those who had pain.

RESULTS: The sacroiliac joint pain showed a twofold increase from 12 to 24 weeks, while the pubic pain suddenly increased after 24 weeks. The severity of pubic and groin pain increased sharply during pregnancy. Regarding low back pain, the change in the severity was lesser than the other pains. The sacroiliac joint pain was the highest among the four pains during pregnancy.

CONCLUSION: Each type of pain had a different incidence rate and a different time of onset and aggravation. These results help women and health professionals to manage, and prevent these harmful symptoms.

PMID:38427055 | DOI:10.1007/s00586-024-08193-x

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Metatarsal lengthening by distraction osteogenesis for brachymetatarsia in paediatric patients: is it safe and effective?

Eur J Orthop Surg Traumatol. 2024 Mar 1. doi: 10.1007/s00590-024-03860-7. Online ahead of print.

ABSTRACT

PURPOSE: The primary aim is to assess the efficacy of the surgical callus distraction technique of the metatarsus in paediatric patients. Secondary objectives are to assess complications and treatment duration. We have also described the details of our surgical technique.

MATERIALS AND METHODS: A case series review of paediatric patients who had metatarsal lengthening at our unit between 2014 and 2022. Patient demographics, duration of time in frame, complications and metatarsal length achieved were recorded. The AOFAS Midfoot and the MOXFQ were taken pre-operatively and at final follow-up.

RESULTS: Sixteen metatarsals in 8 patients (14 feet) underwent lengthening between 2014 and 2022 using the MiniRail OrthoFix 100 (Orthofix Medical Inc, Lewisville, TX, USA). The mean age was 13.3 (12-17) years. The average duration between surgery and implant removal was 5.2 months. According to Paley’s classification, there was one obstacle encountered in a patient who required a revision of their osteotomy and one problem in another patient who had an infected metatarsophalangeal joint stabilising k-wire treated with oral antibiotics. The Mean AOFAS Midfoot score improved from 53.10 to 86.40 (p < 0.0001) and the Mean MOXFQ improved from 32.5000 to 12.1250 (p < 0.05); these were statistically significant.

CONCLUSION: Gradual metatarsal lengthening using the MiniRail external fixator is a safe and effective method to treat brachymetatarsia in paediatric patients. This preliminary report describes and supports metatarsal lengthening in appropriate patients. Holistic care in terms of a pre-operative assessment, psychological support and preparation for the extended rehabilitation period are vital.

PMID:38427053 | DOI:10.1007/s00590-024-03860-7

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Predictive factors for infection after osteosynthesis of tibial plateau fractures: a retrospective study of 314 patients

Eur J Orthop Surg Traumatol. 2024 Mar 1. doi: 10.1007/s00590-024-03856-3. Online ahead of print.

ABSTRACT

INTRODUCTION: The reported incidence of infection related with tibial plateau fractures (IRTPF) ranges from 2 to 23%. This complication can result in catastrophic consequences such as deformity, post-traumatic osteoarthritis, chronic pain, loss of function, and substantial economic burdens on healthcare systems due to extended hospital stays and the resources required for treatment. Consequently, it is imperative to emphasize the identification of infection risk factors.

METHODS: A retrospective case-control study was designed, encompassing patients who underwent surgery for tibial plateau fractures between 2015 and 2020. Frequencies and measures of central tendency were compared between infected patients (cases) and non-infected patients (controls) using rank-based statistical tests. Subsequently, two logistic regression models were employed to control for potential confounding variables.

RESULTS: A total of 314 patients were included, predominantly male (71.15%). Average age of 44.41 years. IRTPF were observed in 7.64% of the patients. In the univariate inferential statistical analysis, high-energy fractures (OR 6.35, p < 0.001), fractures with compartment syndrome (OR 7.10, p < 0.001), two-stage management with temporary external fixation (OR 8.18, p < 0.001), the use of 2 or more approaches in definitive surgery (OR 2.93, p = 0.011), and the use of two or more plates (OR 9.17, p < 0.001) were identified as risk factors for infection. On average, the duration of surgery in infected patients was 201.2 min, compared to 148.4 min in non-infected patients (p < 0.001). When performing two logistic regression models, the following independent risk factors were identified: high-energy fractures (OR 5.04, p = 0.012), the presence of compartment syndrome (OR 4.53, p = 0.007), and the use of two or more plates in definitive surgery (OR 5.04, p = 0.023).

CONCLUSIONS: High-energy tibial plateau fractures (Schatzker IV, V, and VI), the presence of concomitant compartment syndrome, and the use of 2 or more plates in definitive surgery are associated with a higher risk of infection related to fracture following open reduction and osteosynthesis treatment.

LEVEL OF EVIDENCE: Case-Control Study.

PMID:38427052 | DOI:10.1007/s00590-024-03856-3

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Value of the surgical pancreatic duct anatomy and associated outcomes in pancreatic cancer

ANZ J Surg. 2024 Mar 1. doi: 10.1111/ans.18903. Online ahead of print.

ABSTRACT

INTRODUCTION: Pancreatic cancer recurrence following surgery is a significant challenge, and personalized surgical care is crucial. Topographical variations in pancreatic duct anatomy are frequent but often underestimated. This study aimed to investigate the potential importance of these variations in outcomes and patient survival after Whipple’s procedures.

METHODS: Data were collected from 105 patients with confirmed pancreatic head neoplasms who underwent surgery between 2008 and 2020. Radiological measurements of pancreatic duct location were performed, and statistical analysis was carried out using IBM SPSS.

RESULTS: Inferior pancreatic duct topography was associated with an increased rate of metastatic spread and tumour recurrence. Additionally, inferior duct topography was associated with reduced overall and recurrence-free survival. Posterior pancreatic duct topography was associated with decreased incidence of perineural sheet infiltration and improved overall survival.

DISCUSSION: These findings suggest that topographical diversity of pancreatic duct location can impact outcomes in Whipple’s procedures. Intraoperative review of pancreatic duct location could help surgeons define areas of risk or safety and deliver a personalized surgical approach for patients with beneficial or deleterious anatomical profiles. This study provides valuable information to improve surgical management by identifying high-risk patients and delivering a personalized surgical approach with prognosis stratification.

PMID:38426386 | DOI:10.1111/ans.18903

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Characterization of BCL-XL, MCL-1, and BAX Protein Expression in Response to Neoadjuvant Chemotherapy in Breast Cancer

Appl Immunohistochem Mol Morphol. 2024 Mar 1. doi: 10.1097/PAI.0000000000001189. Online ahead of print.

ABSTRACT

The use of chemotherapy has improved the overall treatment of breast cancer, which is frequently administered in the form of neoadjuvant chemotherapy (NAC). Apoptosis is an established cell stress response to NAC in preclinical models; however, there is limited understanding of its role in clinical cancer, specifically, its contribution to favorable pathologic responses in breast cancer therapy. Here, we aimed to characterize the change in protein expression of 3 apoptosis-associated biomarkers, namely, BCL-XL, MCL-1, and BAX in breast cancer in response to NAC. For this, we utilized a set of 68 matched invasive breast cancer FFPE samples that were collected before (pre) and after (post) the exposure to NAC therapy that were characterized by incomplete pathologic response. Immunohistochemistry (IHC) analysis suggested that most of the samples show a decrease in the protein expression of all 3 markers following exposure to NAC as 90%, 69%, and 76% of the matched samples exhibited a decrease in expression for BCL-XL, MCL-1, and BAX, respectively. The median H-score of BCL-XL post-NAC was 150/300 compared with 225/300 pre-NAC (P value <0.0001). The median H-score of MCL-1 declined from 200 pre-NAC to 160 post-NAC (P value <0.0001). The median H-score of BAX protein expression decreased from 260 pre-NAC to 190 post-NAC (P value <0.0001). There was no statistically significant association between the expression of these markers and stage, grade, and hormone receptor profiling (luminal status). Collectively, our data indicate that the expression of apoptosis regulatory proteins changes following exposure to NAC in breast cancer tissue, developing a partial pathologic response.

PMID:38426376 | DOI:10.1097/PAI.0000000000001189

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Treatment of erythematous acne scars using 595-nm pulsed dye laser combined with 1565-nm ResurFX nonablative fractional laser

J Cosmet Dermatol. 2024 Mar 1. doi: 10.1111/jocd.16235. Online ahead of print.

ABSTRACT

BACKGROUND: Acne vulgaris is a common inflammatory disease associated with various sequelae after skin lesion remission. Acne erythema has been considered simple erythema or a vascular lesion; however, because the understanding of this disease has improved, acne erythema is currently considered an early scar with erythematous components.

AIMS: This study evaluated the efficacy of using both a 595-nm pulsed dye laser (PDL) and 1565-nm nonablative fractional laser (NAFL) for the treatment of erythematous scars caused by acne.

METHODS: Ninety patients with acne scars were equally randomized to two groups. Group A (n = 45) received treatment with the NAFL. Group B (n = 45) received treatment with the PDL and NAFL. Each patient underwent one treatment session and 4 weeks of follow-up.

RESULTS: Qualitative (χ2 = 12.415; p < 0.05) and quantitative (t = 2.675; p < 0.05) scores of Groups A and B were determined using a global scarring grading system and exhibited statistically significant differences. The quantitative score of Group A was higher than that of Group B (6.67 ± 3.46 vs. 4.98 ± 2.44). The erythema areas of the groups differed significantly after treatment, with Group B exhibiting more notable score improvements (5.00 [3.10, 7.10] vs. 2.80 [1.65, 4.60]; Z = 3.072; p < 0.05). The erythema regression rate of Group B (88.9%) was significantly higher than that of Group A (66.7%) (χ2 = 20.295; p < 0.001). Adverse events, including redness and swelling (86.6%), scabbing (78.8%), and purpura (36.6%), occurred within 7 days for 86.6% of patients.

CONCLUSIONS: The combined use of the PDL and NAFL is safe and effective for erythematous acne scars.

PMID:38426374 | DOI:10.1111/jocd.16235

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MetaCerberus: distributed highly parallelized HMM-based processing for robust functional annotation across the tree of life

Bioinformatics. 2024 Feb 29:btae119. doi: 10.1093/bioinformatics/btae119. Online ahead of print.

ABSTRACT

MOTIVATION: MetaCerberus is a massively parallel, fast, low memory, scalable annotation tool for inference gene function across genomes to metacommunities. MetaCerberus provides an elusive HMM/HMMER-based tool at a rapid scale with low memory. It offers scalable gene elucidation to major public databases, including KEGG (KO), COGs, CAZy, FOAM, and specific databases for viruses, including VOGs and PHROGs, from single genomes to metacommunities.

RESULTS: MetaCerberus is 1.3x as fast on a single node than eggNOG-mapper v2 on 5x less memory using an exclusively HMM/HMMER mode. In a direct comparison, MetaCerberus provides better annotation of viruses, phages, and archaeal viruses than DRAM, Prokka, or InterProScan. MetaCerberus annotates more KOs across domains when compared to DRAM, with a 186x smaller database, and with 63x less memory. MetaCerberus is fully integrated for automatic analysis of statistics and pathways using differential statistic tools (i.e., DESeq2 and edgeR), pathway enrichment (GAGE R), and pathview R. MetaCerberus provides a novel tool for unlocking the biosphere across the tree of life at scale.

AVAILABILITY: MetaCerberus is written in Python and distributed under a BSD-3 license. The source code of MetaCerberus is freely available at https://github.com/raw-lab/metacerberus compatible with Python 3 and works on both Mac OS X and Linux. MetaCerberus can also be easily installed using bioconda: mamba create -n metacerberus -c bioconda -c conda-forge metacerberus.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:38426351 | DOI:10.1093/bioinformatics/btae119

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Assessing racial/ethnic and nativity disparities in US cancer mortality using a new integrated platform

J Natl Cancer Inst. 2024 Feb 29:djae052. doi: 10.1093/jnci/djae052. Online ahead of print.

ABSTRACT

BACKGROUND: Foreign-born (FB) populations in the US have significantly increased, yet cancer trends remain unexplored. Survey-based Population-Adjusted Rate Calculator (SPARC) is a new tool for evaluating nativity differences in cancer mortality.

METHODS: Using SPARC, we calculated 3-year (2016-2018) age-adjusted mortality rates (AAMRs) and rate ratios (RRs) for common cancers by sex, age group, race/ethnicity, and nativity. Trends by nativity were examined for the first time for 2006-2018. Traditional cancer statistics draw populations from decennial censuses. However, nativity-stratified populations are from the American Community Surveys, thus involve sampling errors. To rectify this, SPARC employed bias-corrected estimators. Death counts came from the National Vital Statistics System.

RESULTS: AAMRs were higher among US-born (UB) populations across nearly all cancer types, with the largest UB- FB difference observed in lung cancer among Black females (RR = 3.67, 95%CI = 3.37-4.00). The well-documented White-Black differences in breast cancer mortality existed mainly among UB women. For all cancers combined, descending trends were more accelerated for the UB compared to the FB in all race/ethnicity groups with changes ranging from -2.6% per year in UB Black males to stable (non-significant) among FB Black females. Pancreas and liver cancers were exceptions with increasing, stable, or decreasing trends depending on nativity and race/ethnicity. Notably, FB Black males and FB Hispanic males did not show a favorable decline in colorectal cancer mortality.

CONCLUSIONS: While all groups show beneficial cancer mortality trends, those with higher rates in 2006 have experienced sharper declines. Persistent disparities between the UB and the FB, especially among Black people, necessitate further investigation.

PMID:38426333 | DOI:10.1093/jnci/djae052

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Temperament and sex as moderating factors of the effects of exposure to maternal depression on telomere length in early childhood

Dev Psychopathol. 2024 Mar 1:1-14. doi: 10.1017/S0954579424000518. Online ahead of print.

ABSTRACT

Individual differences in sensitivity to context are posited to emerge early in development and to influence the effects of environmental exposures on a range of developmental outcomes. The goal of the current study was to examine the hypothesis that temperament characteristics and biological sex confer differential vulnerability to the effects of exposure to maternal depression on telomere length in early childhood. Telomere length has emerged as a potentially important biomarker of current and future health, with possible mechanistic involvement in the onset of various disease states. Participants comprised a community sample of children followed from infancy to age 3 years. Relative telomere length was assessed from DNA in saliva samples collected at infancy, 2 years, and 3 years. Maternal depressive symptoms and the child temperament traits of negative affectivity, surgency/extraversion, and regulation/effortful control were assessed via maternal report at each timepoint. Analyses revealed a 3-way interaction among surgency/extraversion, sex, and maternal depressive symptoms, such that higher surgency/extraversion was associated with shorter telomere length specifically among males exposed to elevated maternal depressive symptoms. These findings suggest that temperament and sex influence children’s susceptibility to the effects of maternal depression on telomere dynamics in early life.

PMID:38426330 | DOI:10.1017/S0954579424000518