Category: Statistics

Hepatol Res. 2023 Nov 29. doi: 10.1111/hepr.13995. Online ahead of print.

ABSTRACT

AIM: We evaluated the safety and efficacy of vascular endothelial growth factor receptor (VEGFR) -targeted peptide vaccines for the immunization of patients with unresectable hepatocellular carcinoma who had responded to transarterial chemoembolization.

METHODS: Twenty-two patients were randomized 1:1 to receive VEGFR-targeted peptides or placebo. The primary endpoint was the safety assessment of the immunization. The secondary endpoints were evaluation of immunological responses and clinical outcomes.

RESULTS: The study agents induced no severe adverse event. Among the 12 patients in the vaccine group, a VEGFR1 specific cytotoxic T lymphocyte (CTL) response was induced in eight (66.7%) patients and a VEGFR2 specific CTL response was induced in ten (83.3%). The median progression free survival (PFS) and overall survival (OS) rates were 4.8 months and 52.0 months in the vaccine group, and 2.7 months and 21.8 months in the placebo group. No statistically significant differences were found between the two groups (PFS P=0.925, OS P=0.190). When divided into two groups according to immunoreactivity, the median PFS of patients with and without a strong immune response to VEGFR1 were 7.4 months and 2.7 months, and that to VEGFR2 were 10.6 months and 2.7 months, respectively; there were significant differences according to the immune response.

CONCLUSIONS: Immunotherapy with peptides vaccines targeting VEGFR1 and VEGFR2 was well tolerated with no serious adverse events. It also effectively induced peptide-specific CTLs in patients with unresectable hepatocellular carcinoma. This article is protected by copyright. All rights reserved.

PMID:38018304 | DOI:10.1111/hepr.13995

J Cachexia Sarcopenia Muscle. 2023 Nov 28. doi: 10.1002/jcsm.13384. Online ahead of print.

ABSTRACT

BACKGROUND: Cancer cachexia is a severe complication of advanced malignancy, with few therapeutic options. To promote interprofessional care for cancer cachexia, healthcare providers’ needs should be addressed in detail. This pre-planned subgroup analysis of the Global Educational Needs Evaluation: a systemic interprofessional study in cancer cachexia (GENESIS-CC) survey aimed to identify barriers to interprofessional care of cancer cachexia in Japan.

METHODS: A nationwide survey was electronically conducted for healthcare providers in oncological or general healthcare facilities from January to March 2021 in Japan. The Japanese Regional Advisory Board developed a barrier scoring system with 33 from the 58 original survey items to quantify six domains of barriers: (1) lack of confidence, (2) lack of knowledge, (3) barriers in personal practice, (4) barriers in perception, (5) barriers in team practice and (6) barriers in education. The largest possible barrier score was set at 100 points. We compared the scores by profession.

RESULTS: A total of 1227 valid responses were obtained from 302 (24.6%) physicians, 252 (20.5%) pharmacists, 236 (19.2%) nurses, 218 (17.8%) dietitians, 193 (15.7%) rehabilitation therapists and 26 (2.0%) other professionals. Overall, 460 (37.5%) were not very or at all confident about cancer cachexia care, 791 (84.1%) agreed or strongly agreed that care was influenced by reimbursement availability and 774 (81.9%) did not have cancer cachexia as a mandatory curriculum. The largest mean barrier score (± standard deviation) was 63.7 ± 31.3 for education, followed by 55.6 ± 21.8 for team practice, 43.7 ± 32.5 for knowledge, 42.8 ± 17.7 for perception and 36.5 ± 16.7 for personal practice. There were statistically significant interprofessional differences in all domains (P < 0.05), especially for pharmacists and nurses with the highest or second highest scores in most domains.

CONCLUSIONS: There is a need to improve the educational system and team practices of cancer cachexia for most Japanese healthcare providers, especially pharmacists and nurses. Our study suggests the need to reform the mandatory educational curriculum and reimbursement system on cancer cachexia to promote interprofessional care for cancer cachexia in Japan.

PMID:38018293 | DOI:10.1002/jcsm.13384

Vox Sang. 2023 Nov 28. doi: 10.1111/vox.13564. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Although the genetic determinants of haemoglobin and ferritin have been widely studied, those of the clinically and globally relevant iron deficiency anaemia (IDA) and deferral due to hypohaemoglobinemia (Hb-deferral) are unclear. In this investigation, we aimed to quantify the value of genetic information in predicting IDA and Hb-deferral.

MATERIALS AND METHODS: We analysed genetic data from up to 665,460 participants of the FinnGen, Blood Service Biobank and UK Biobank, and used INTERVAL (N = 39,979) for validation. We performed genome-wide association studies (GWASs) of IDA and Hb-deferral and utilized publicly available genetic associations to compute polygenic scores for IDA, ferritin and Hb. We fitted models to estimate the effect sizes of these polygenic risk scores (PRSs) on IDA and Hb-deferral risk while accounting for the individual’s age, sex, weight, height, smoking status and blood donation history.

RESULTS: Significant variants in GWASs of IDA and Hb-deferral appear to be a small subset of variants associated with ferritin and Hb. Effect sizes of genetic predictors of IDA and Hb-deferral are similar to those of age and weight which are typically used in blood donor management. A total genetic score for Hb-deferral was estimated for each individual. The odds ratio estimate between first decile against that at ninth decile of total genetic score distribution ranged from 1.4 to 2.2.

CONCLUSION: The value of genetic data in predicting IDA or suitability to donate blood appears to be on a practically useful level.

PMID:38018286 | DOI:10.1111/vox.13564

Int J Dermatol. 2023 Nov 28. doi: 10.1111/ijd.16924. Online ahead of print.

ABSTRACT

BACKGROUND: Isotretinoin has been used in the treatment of acne for decades through the reduction of sebaceous secretion. There are reports in the literature that isotretinoin may be associated with decreased skin thickness, especially in patients with thick nasal skin for whom rhinoplasty can be more challenging. The objective of this study was to quantify, through ultrasonography, the effect of the use of oral isotretinoin in patients undergoing rhinoplasty, pre- and postoperatively.

METHODS: Twenty-four patients participated in this randomized, single-blind controlled pilot clinical trial. The intervention group used oral isotretinoin (20 mg/day) for 2 months before rhinoplasty and for 4 months after. Both groups underwent rhinoplasty in the same plastic surgery department and were submitted to high-frequency (22 MHz) ultrasound evaluation of the epidermis and dermis on the nasal dorsum, nasal tip, and left nose wing at the beginning of the study and 6 months after rhinoplasty, with the aim of assessing changes in skin thickness.

RESULTS: Six months after rhinoplasty, a statistically significant reduction was observed in the thickness of the epidermis and dermis of the nasal dorsum and left nose wing, as well as of the epidermis of the nasal tip, but only in the intervention group. The results of the satisfaction questionnaire were better after rhinoplasty in both groups, with no statistical difference between them regarding the specific questions; however, the intervention group had significantly higher satisfaction scores than the control group.

CONCLUSIONS: Isotretinoin was effective in reducing the thickness of the skin covering the nose of the evaluated sites.

PMID:38018283 | DOI:10.1111/ijd.16924

Curr Cardiol Rev. 2023 Nov 23. doi: 10.2174/011573403X256576231017110252. Online ahead of print.

ABSTRACT

BACKGROUND: Congestive Heart Failure with reduced Ejection Fraction (CHFrEF) guidelines adherence is not accessible everywhere, especially in countries with a high prevalence of low socioeconomic status, which resembles many of the middle eastern countries. However, adherence to the guidelines is correlated with lower mortality and morbidity rates.

OBJECTIVE: We are going to investigate the degree of treatment guideline adherence in CHFrEF in a patient population in the Middle East and correlate the compliance level with morbidity and mortality. Methods and Statistics: A retrospective study conducted on patients with CHFrEF in the Middle East region, maintained on Sacubitril/Valsartan for up to 4 years (190 patients), including a follow-up for morbidity and mortality rates, in addition to their correlations to the level of guidelines adherence.

RESULTS: Statistical analysis was done through IBM SPSS® 27th version. NYHA (pretreatment and post-treatment) was statistically significant in the partial adherence group as well as in full adherence. Moreover, Ejection fraction (pretreatment and post-treatment) was statistically significant in the partial adherence group as well as in full adherence, hence regardless of the level of adherence to the use of Sacubitril/Valsartan in CHFrEF, there was an improvement in the morbidity and mortality rates over up to four years of follow up.

CONCLUSION: Despite of our full support to full CHFrEF guideline adherence, we recognize how hard this task to be achieved, nevertheless this study supports the theme that any guideline adherence is correlated with better morbidity and mortality rates over a long term follow up.

PMID:38018202 | DOI:10.2174/011573403X256576231017110252

Curr Pharm Des. 2023 Nov 23. doi: 10.2174/0113816128265009231102063840. Online ahead of print.

ABSTRACT

BACKGROUND: The outbreak of Corona Virus Disease 2019 (COVID-19) has resulted in millions of infections and raised global attention. Bitter almonds and licorice are both Traditional Chinese Medicines (TCM), often used in combination to treat lung diseases. Several prescriptions in the guidelines for the diagnosis and treatment of coronavirus disease 2019 (trial version ninth) contained bitter almond-licorice, which was effective in the treatment of COVID-19. However, the active ingredients, drug targets and therapeutic mechanisms of bitter almonds-licorice for the treatment of COVID-19 remain to be elucidated.

METHODS: The active ingredients and targets were derived from the Traditional Chinese Medicine Systems Pharmacology (TCMSP). Meanwhile, targets associated with COVID-19 were obtained from the GeneCards database, PharmGkb database and DrugBank database. Then, the potential targets of bitter almond-licorice against COVID-19 were screened out. Protein-protein interaction (PPI) networks and core targets were analyzed through the String database and Cytoscape software. In addition, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed based on potential targets using R statistical software. Finally, molecular docking was used to validate the binding of the active ingredients to the core targets.

RESULTS: The results of the TCMSP database showed that the bitter almond-licorice had 89 active components against COVID-19, involving 102 targets. PPI network and core target analysis indicated that IL-6, TNF, MAPK1, and IL1B were the key targets against COVID-19. In addition, GO and KEGG enrichment analysis showed that the bitter almond-licorice were involved in various biological processes through inflammation-related pathways such as TNF signaling pathway and IL-17 signaling pathway. Finally, molecular docking approaches confirmed the affinity between the active components of the bitter almond-licorice and the therapeutic targets.

CONCLUSION: The bitter almond-licorice could be used to treat COVID-19 by inhibiting inflammatory responses and regulating cellular stress. This work is based on data mining and molecular docking, and the findings need to be interpreted with caution.</P>.

PMID:38018195 | DOI:10.2174/0113816128265009231102063840

J Biosoc Sci. 2023 Nov 29:1-13. doi: 10.1017/S0021932023000275. Online ahead of print.

ABSTRACT

This study focuses on analysing the heights of 10,953 Korean men aged 20 to 40 years who were measured during the Joseon dynasty, the Japanese colonialisation period, and the contemporary period, the latter including both North and South Korea. This study thus provides rare long-term statistical evidence on how biological living standards have developed over several centuries, encompassing Confucianism, colonialism, capitalism, and communism. Using error bar analysis of heights for each historical sample period, this study confirms that heights rose as economic performance improved. For instance, economically poorer North Koreans were expectedly shorter, by about 6 cm, than their peers living in the developed South. Similarly, premodern inhabitants of present-day South Korea, who produced a gross domestic product (GDP) per capita below the world average, were about 4 cm shorter than contemporary South Koreans, who have a mean income above the world average. Along similar lines, North Koreans, who have a GDP per capita akin to that of the premodern Joseon dynasty, have not improved much in height. On the contrary, mean heights of North Koreans were even slightly below (by about 2.4 cm) heights of Joseon dynasty Koreans. All in all, the heights follow a U-shaped pattern across time, wherein heights were lowest during the colonial era. Heights bounced back to Joseon dynasty levels during the interwar period, a time period where South Korea benefitted from international aid, only to rise again and surpass even premodern levels under South Korea’s flourishing market economy.

PMID:38018165 | DOI:10.1017/S0021932023000275

J Exp Orthop. 2023 Nov 29;10(1):124. doi: 10.1186/s40634-023-00709-6.

ABSTRACT

PURPOSE: According to the homeostasis model, patellofemoral pain (PFP) results from disturbed homeostasis due to vascular insufficiency in the anterior knee. Near-Infrared Spectroscopy (NIRS) measures relative changes in concentrations (in µmol/cm²) of (de-)oxygenated hemoglobine (HHb and O₂Hb). The aims were to: 1) investigate the characteristics of the NIRS signal derived from the patella during experiments affecting hemodynamics in healthy controls, and 2) determine the test-retest reliability of NIRS in positions clinically relevant for PFP patients.

METHODS: Two experiments were conducted on 10 healthy controls and analysed using Student’s t-test. Reliability (ICC_2,1) was evaluated for two activities (‘Prolonged Sitting’ and ‘Stair Descent’) in five PFP patients and 15 healthy controls, performed twice within five days.

RESULTS: The NIRS signal (HHb and O₂Hb) showed a statistically significant increase (p < .001 – .002) on all optodes (30, 35, 40 mm) during ‘Venous Occlusion’ (M = 1.0 – 2.0), while it showed no statistically significant change (p = .075 – .61) during ‘Skin Compression’ (M = -0.9 – 0.9) on the 30 and 35 mm optode. Reliability of NIRS (HHb and O₂Hb) ranged from moderate to almost perfect (ICC_2,1 = .47 – .95) on the 30 mm optode for ‘Prolonged Sitting’, and from moderate to substantial (ICC_2,1 = .50 – .68) on the 35 mm optode for ‘Stair Descent’.

CONCLUSIONS: Patella NIRS measurements are affected by venous occlusion, but not by skin compression, and are sufficiently reliable as research application to compare real-time patellar bone hemodynamics. These insights may assist to improve effectiveness of evidence-based treatment strategies for PFP.

TRIAL REGISTRATION: ISRCTN Trial Registration under number: 90377123.

PMID:38017345 | DOI:10.1186/s40634-023-00709-6

Jpn J Ophthalmol. 2023 Nov 29. doi: 10.1007/s10384-023-01033-3. Online ahead of print.

ABSTRACT

PURPOSE: To explore the clinical features of COVID-19-associated conjunctivitis with the objective of preventing the spread of infection.

STUDY DESIGN: Retrospective cohort study.

METHODS: From March 2020 to March 2021, we retrospectively reviewed 26 (9.8%) consecutive COVID-19 patients with conjunctivitis among 282 COVID-19 cases admitted to our hospital. Clinical symptoms, onset date of conjunctivitis, time to patient recovery, and eye drop intervention were investigated. In addition, risk factors for developing conjunctivitis were statistically examined among 206 inpatients available for within 5 days of the onset. A multivariate analysis of conjunctivitis risk factors was performed.

RESULTS: Among the 282 COVID-19 patients, 4 (1.4%) had conjunctival hyperemia as the primary symptom. The median time of onset was 4 days after the COVID-19 onset. Hyperemia was observed in all cases, but other ocular symptoms were rare. The median duration of hyperemia was 3 days. A multiple logistic regression analysis revealed that a young age (p=0.005) and current smoking habit (p=0.027) were independent risk factors for conjunctivitis after COVID-19.

CONCLUSIONS: COVID-19-associated conjunctivitis is rare in the elderly and strongly associated with a history of smoking. It often occurs in the early stages of infection, and while hyperemia is recognized as a clinical symptom, other ocular symptoms are rare or non-existent. Many cases recover within a short time.

PMID:38017339 | DOI:10.1007/s10384-023-01033-3

J Cancer Surviv. 2023 Nov 29. doi: 10.1007/s11764-023-01494-y. Online ahead of print.

ABSTRACT

PURPOSE: This study investigates the association between socioeconomic position (SEP) and health-related quality of life (HRQoL) in a cross-sectional cohort among cancer survivors and compares with cancer-free people.

METHODS: Survivors of colorectal, hematological, gynecological, prostate, thyroid cancer, and melanoma diagnosed 2000-2014 were identified in the PROFILES registry, and an age- and sex-matched cancer-free population were identified in the CentER panel. HRQoL, education, and comorbidity were self-reported. Street-level income and clinical factors were obtained from Statistics Netherlands and the Netherlands Cancer Registry. Multivariable logistic regression was used to examine associations of SEP (measured by education and income) and impaired HRQoL among cancer survivors and the cancer-free population, adjusting for age, sex, and time since diagnosis.

RESULTS: We included 6693 cancer survivors and 565 cancer-free people. Cancer survivors with low versus medium SEP more frequently reported impaired HRQoL (odds ratio (OR) range for all HRQoL outcomes, 1.06-1.78 for short education and 0.94-1.56 for low income). Survivors with high compared to medium SEP reported impaired HRQoL less frequently (OR range for all HRQoL outcomes, 0.46-0.81 for short education and 0.60-0.84 for low income). The association between SEP and HRQoL was similar in the matched cancer-free population.

CONCLUSION: Low SEP was associated with impaired HRQoL in both cancer survivors and cancer-free people.

IMPLICATIONS FOR CANCER SURVIVORS: Targeted care is warranted for cancer survivors with impaired HRQoL, especially among those with low SEP.

PMID:38017320 | DOI:10.1007/s11764-023-01494-y