Category: Statistics

Int J Infect Dis. 2023 Jul 29:S1201-9712(23)00681-1. doi: 10.1016/j.ijid.2023.07.031. Online ahead of print.

ABSTRACT

BACKGROUND: A previous review demonstrated that the majority of NTM infections in the Northern Territory (NT) are pulmonary in nature,[1] however skin and soft tissue (SST) are likely the next most common sites of disease. The current epidemiology of NTM SST infections across the NT is not known. We aimed to establish the current and historical incidence rates, and the organisms involved.

METHODS: All NTM cases reported to the Centre for Disease Control in Darwin from 1989-2021 were retrospectively reviewed.

RESULTS: 226 NTM notifications were reviewed. 73 (32%) cases were SST infections. The incidence of SST cases increased over the study period. Female cases were more common (p=0·002). Disease occurred across a wide age range (1-85 years). Only 16% of cases occurred in Aboriginal individuals. Many cases had no clear provocation, but localised trauma was the most common risk factor. The most common organism identified was M. fortuitum (41%). Diagnosis was often delayed, with a median time to diagnosis of 69 days (IQR=31-149). Most cases (60%) underwent surgical intervention with adjunctive anti-mycobacterial medical therapy.

CONCLUSION: NTM SST incidence rates increased over the study period. NTM SST infections are a rare but important differential diagnosis for non-healing cutaneous wounds.

PMID:37524256 | DOI:10.1016/j.ijid.2023.07.031

J Foot Ankle Surg. 2023 Jul 29:S1067-2516(23)00174-6. doi: 10.1053/j.jfas.2023.07.007. Online ahead of print.

ABSTRACT

Charcot neuroarthropathy (CNA) is a progressive disease that affects the bones and joints of the foot. To prevent collapse and loss of stability within the pedal architecture, CNA should be diagnosed and managed early. The objective of this retrospective study was to review patients who underwent midfoot CNA reconstructive surgery and evaluate subsequent rates of minor and major amputations. Secondary objectives include identifying patients that underwent midfoot CAN with and without a subtalar joint arthrodesis. Out of the 72 patients, 4 (5.6%) underwent minor (digital, ray) amputation, 2 (2.8%) underwent proximal amputations (either below or above the knee), and none underwent midfoot amputation (transmetatarsal, Lisfranc, Chopart). A Fisher’s exact test was employed to compare the outcomes of minor and major amputation rates in our CNA cohort with those who underwent midfoot CNA reconstruction with STJ arthrodesis and found no statistical significance (P = 0.15). Overall, a total progression to amputation was 8.4 % following midfoot CNA reconstruction, with 2.8 % of patients undergoing major amputation (below knee or above knee). Despite no statistical significance, we recommend surgeons to consider including an STJ arthrodesis in addition to midfoot CNA reconstruction to establish a stable and plantigrade foot. LEVEL OF CLINICAL EVIDENCE: 3.

PMID:37524241 | DOI:10.1053/j.jfas.2023.07.007

Mol Phylogenet Evol. 2023 Jul 29:107892. doi: 10.1016/j.ympev.2023.107892. Online ahead of print.

ABSTRACT

As genomic data proliferates, the prevalence of post-speciation gene flow is making species boundaries and relationships increasingly ambiguous. Although current approaches inferring fully bifurcating phylogenies based on concatenated datasets provide simple and robust answers to many species relationships, they may be inaccurate because the models ignore inter-specific gene flow and incomplete lineage sorting. To examine the potential error resulting from ignoring gene flow, we generated both a RAD-seq and a 500 protein-coding loci highly multiplexed amplicon (HiMAP) dataset for a monophyletic group of 12 species defined as the Bactrocera dorsalis sensu lato clade. With some of the world’s worst agricultural pests, the taxonomy of the B. dorsalis s.l. clade is important for trade and quarantines. However, taxonomic confusion confounds resolution due to intra- and interspecific phenotypic variation and convergence, mitochondrial introgression across half of the species, and viable hybrids. We compared the topological convergence of our datasets using concatenated phylogenetic and various multispecies coalescent approaches, some of which account for gene flow. All analyses agreed on species delimitation, but there was incongruence between species relationships. Under concatenation, both datasets suggest identical species relationships with mostly high statistical support. However, multispecies coalescent and multispecies network approaches suggest markedly different hypotheses and detected significant gene flow. We suggest that the network approaches are likely more accurate because gene flow violates the assumptions of the concatenated phylogenetic analyses, but the data-reductive requirements of network approaches resulted in reduced statistical support and could not unambiguously resolve gene flow directions. Our study highlights the importance of testing for gene flow, particularly with phylogenomic datasets, even when concatenated approaches receive high statistical support.

PMID:37524217 | DOI:10.1016/j.ympev.2023.107892

Rev Esp Med Nucl Imagen Mol (Engl Ed). 2023 Jul 29:S2253-8089(23)00069-1. doi: 10.1016/j.remnie.2023.07.006. Online ahead of print.

ABSTRACT

INTRODUCTION AND OBJECTIVES: 18F-FDG PET with the Deauville score (DS) is a unique semiquantitative method for lymphoma. However, type of standard uptake values (max, mean, and peak) reconstruction algorithms could affect DS. We compared the Bayesian Penalized Likelihood reconstruction algorithm (BPL) with Ordered Subsets Expectation Maximization (OSEM) on quantitative parameters and DS in lymphoma. We investigated the effect of the size of the lymph node on quantitative variation.

PATIENTS AND METHODS: Raw PET data of 255 lymphoma patients were reconstructed separately with Q.Clear (GE Healthcare), a BPL, and SharpIR (GE Healthcare), an OSEM algorithm. In both images, each patient’s liver, mediastinal blood pool, and SUVs (SUVmax, SUVmean, and SUVpeak) of a total of 487 lesions selected from the patients were performed. DSmax, DSmean, and DSpeak were compared.

RESULTS: In our study, DS increased significantly with BPL (p < 0.001), and the DS increased to 4-5 in thirty patients evaluated as 1-2-3 with OSEM. It was found that the quantitative values of the lymph nodes increased statistically with BPL (p < 0.001), and the liver from the reference regions were significantly decreased (p < 0.001). In addition, difference in lymph node was independently associated with size of lesion and was significantly more pronounced in small lesions (p < 0.001). The effects of BPL algorithm were more pronounced in SUVmax than in SUVmean and SUVpeak. DS-mean and DS-peak scores were less changed by BPL than DS-max.

CONCLUSION: Different reconstruction algorithms in FDG PET/CT affect the quantitative evaluation. That variation may affect the change in DS in lymphoma patients, thus affecting patient management.

PMID:37524200 | DOI:10.1016/j.remnie.2023.07.006

J Dent. 2023 Jul 29:104643. doi: 10.1016/j.jdent.2023.104643. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the influence of two glutaraldehyde-based desensitizers (L: GLUMA Desensitizer, Heraeus Kulzer and G: GLUMA Desensitizer PowerGel) prior to the adhesive procedures on microtensile bond strength (µTBS) to dentin and endogenous enzymatic activity.

METHODS: Noncarious human third molars (N=48) were cut to expose middle coronal dentin. Six experimental groups were formed according to the dentin pre-treatment (L or G) and the universal adhesives (IBU – iBond universal, Kulzer or AU – Adhese Universal, Ivoclar Vivadent) used in the self-etch mode (n=8): 1) L/IBU; 2) G/IBU; 3) IBU; 4) L/AU; 5) G/AU; 6) AU. Specimens were cut into sticks and stressed until failure after 24h (T₀) or 1yr of aging (T₁₂). Additional 4 teeth were used for in situ zymography evaluation and data were statistically analyzed (α = 0.05).

RESULTS: Dentin pre-treatment, adhesive and ageing statistically influenced bond strength and enzymatic activity (P<0.001). AU demonstrated higher bond strength values than IBU (P<0.001). The L resulted in higher bond strength compared to the G and control groups (P<0.001). Ageing statistically influenced bonding performance, especially when no dentin pre-treatment was performed (P<0.001). In situ zymography revealed that at baseline the control groups exhibited lower interfacial fluorescence compared to the experimental groups, irrespective of the adhesive used (P<0,001). However, after 1 yr of artificial storage, no differences were found among the groups (P>0.05).

CONCLUSIONS: Glutharldeadeyde-based products increased bond strength and determined a stabilization of the adhesive interface over time apparently not related to the MMPs inhibition.

CLINICAL SIGNIFICANCE: The results of this in vitro study suggest that the application of glutaraldehyde-based desensitizers prior to the adhesive procedures when associated with universal adhesives could result in increased bond strength and stabilization of the adhesive interface over time.

PMID:37524197 | DOI:10.1016/j.jdent.2023.104643

Gait Posture. 2023 Jul 27;105:104-109. doi: 10.1016/j.gaitpost.2023.07.285. Online ahead of print.

ABSTRACT

BACKGROUND: Toe-walking is one of the most common gait deviations (due to soleus and/or gastrocnemius muscle contractures), compromising the first (heel rocker) and second (ankle rocker) of the foot during walking. The aim of this study is to evaluate the effect of emulated artificially gastrocnemius and soleus contractures on the first and second rocker during walking.

METHOD: An exoskeleton was built to emulate contractures of the bilateral gastrocnemius and soleus muscles. Ten healthy participants were recruited to walk under the following conditions: without emulated contractures or with bilateral emulated contractures at 0°,10°, 20° and 30° of plantarflexion of the soleus or gastrocnemius in order to create an artificial restriction of dorsiflexion ankle movement. A linear regression from the ankle plantar-dorsiflexion angle pattern was performed on 0-5 % of the gait cycle (first rocker) and on 12-31 % of the gait cycle (second rocker) to compute the slope of the curve. The proportion of participants with the presence of the first and second rocker was then computed. A Statistical Parametric Mapping (SPM) analysis assessed the kinematic variations among different degrees of emulated contractures.

FINDINGS: The first and second rockers are completely absent from 10° of plantarflexion emulated contracture. The data indicate there was a non-linear shift of the gait pattern of the ankle kinematics and an important shift toward plantarflexion values with the loss of the rockers.

INTERPRETATION: This study suggests that toe-walking in the experimental simulation situation is not necessarily due to a high emulated contracture level and can occur with a small emulated contracture by an adaptation choice. This study may improve interpretation of clinical gait analysis and shows that the link between the level of gastrocnemius/soleus emulated contracture and progression of toe-walking (increased plantarflexion during gait) is not linear.

PMID:37523808 | DOI:10.1016/j.gaitpost.2023.07.285

Pathol Res Pract. 2023 Jul 27;248:154716. doi: 10.1016/j.prp.2023.154716. Online ahead of print.

ABSTRACT

BACKGROUND: Colorectal cancer (CRC), the fourth of the world’s major common malignancy, poses a serious threat to the physical and mental health of the population. Nevertheless, the prognosis of CRC patients remains unsatisfactory. Consequently, it is still imperative to continuously discover the CRC mechanisms.

METHODS: The expression profiles of mRNAs were recognized by whole transcriptome sequencing to identity differentially expressed mRNA (DE-mRNA). TCGA COAD cohort, PPOGgene and Kaplan-Meier Plotter databases were utilized to validate RNF114 relevance to CRC prognosis. The effect of RNF114 on the malignant biological behavior of CRC was explored in CRC cells and subcutaneous tumor models and lung metastasis model after exogenous regulation of RNF114.

RESULTS: A total of 1358 DE-mRNAs were identified, including 617 up-regulated and 741 down-regulated DE-mRNAs, and they were mainly involved in the term of receptor ligand activity, Wnt signaling pathway and pathway in cancer. Notably, RNF114 was hyper-expressed in tissues and cell of CRC, and significantly correlated with tumor invasion depth and TNM stage of CRC patients. RNF114 expression were significantly associated with overall survival, and had superior diagnostic value in CRC. In vitro, knockdown of RNF114 statistically diminished the proliferation, stemness, invasion and wound healing of CRC cells and facilitated their apoptosis, and the opposite result was observed for overexpression of RNF114. In vivo, knockdown of RNF114 effectively diminished the mass and volume of tumors, and lung metastasis in animal model.

CONCLUSIONS: In summary, we identified DE-mRNAs in CRC, and elucidated that RNF114 facilitates CRC process. The discovery will contribute to theoretical foundation for RNF114 as a potential therapeutic target and biomarker, and offer new perspectives for CRC research.

PMID:37523804 | DOI:10.1016/j.prp.2023.154716

Cytokine. 2023 Jul 29;169:156310. doi: 10.1016/j.cyto.2023.156310. Online ahead of print.

ABSTRACT

OBJECTIVE: We compare cytokine profiles at the time of initial CSF shunt placement between children who required no subsequent shunt revision surgeries and children requiring repeated CSF shunt revision surgeries for CSF shunt failure. We also describe the cytokine profiles across surgical episodes for children who undergo multiple subsequent revision surgeries.

METHODS: This pilot study was nested within an ongoing prospective multicenter study collecting CSF samples and clinical data at the time of CSF shunt surgeries since August 2014. We selected cases where CSF was available for children who underwent an initial CSF shunt placement and had no subsequent shunt revision surgeries during >=24 months of follow-up (n = 7); as well as children who underwent an initial CSF shunt placement and then required repeated CSF shunt revision surgeries (n = 3). Levels of 92 human cytokines were measured using the Olink immunoassay and 41 human cytokines were measured using Luminex based bead array on CSF obtained at the time of each child’s initial CSF shunt placement and were displayed in heat maps.

RESULTS: Qualitatively similar profiles for the majority of cytokines were observed among the patients in each group in both Olink and Luminex assays. Lower levels of MCP-3, CASP-8, CD5, CXCL9, CXCL11, eotaxin, IFN-γ, IL-13, IP-10, and OSM at the time of initial surgery were noted in the children who went on to require multiple surgeries. Pro- and anti-inflammatory cytokines were selected a priori and shown across subsequent revision surgeries for the 3 patients. Cytokine patterns differed between patients, but within a given patient pro-inflammatory and anti-inflammatory cytokines acted in a parallel fashion, with the exception of IL-4.

CONCLUSIONS: Heat maps of cytokine levels at the time of initial CSF shunt placement for each child undergoing only a single initial CSF shunt placement and for each child undergoing repeat CSF shunt revision surgeries demonstrated qualitatively similar profiles for the majority of cytokines. Lower levels of MCP-3, CASP-8, CD5, CXCL9, CXCL11, eotaxin, IFN-γ, IL-13, IP-10, and OSM at the time of initial surgery were noted in the children who went on to require multiple surgeries. Better stratification by patient age, etiology, and mechanism of failure is needed to develop a deeper understanding of the mechanism of inflammation in the development of hydrocephalus and response to shunting in children.

PMID:37523803 | DOI:10.1016/j.cyto.2023.156310

Epilepsy Behav. 2023 Jul 28;146:109367. doi: 10.1016/j.yebeh.2023.109367. Online ahead of print.

ABSTRACT

BACKGROUND: A high prevalence of epilepsy has been observed in the onchocerciasis-endemic focus of Mahenge, Tanzania. This study sought to assess the degree of disability experienced by persons with epilepsy (PWE) in Mahenge and identify associations with sociodemographic and clinical features.

METHOD: This cross-sectional study was conducted in Mahenge, Tanzania, between February and July 2020. PWE were recruited from the Mahenge epilepsy clinic and four neighbouring rural villages (Mdindo, Mzogezi, Mzelezi and Sali). Data were collected using the 36-item version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) questionnaire for adults. For children aged 5-17 years, we used the Module on Child Functioning developed by UNICEF and the Washington Group. Questionnaires were administered by trained research assistants. Descriptive statistics were performed, and multivariable analyses (gamma and logistic regressions) were conducted.

RESULTS: A total of 321 adults (45.5% males) and 48 children (55.3% males) with epilepsy participated. The overall median WHODAS 2.0 score was 4.8% (IQR: 0.9-18.9). The most affected disability domain was ‘participating in the society’ (median score: 12.5%, IQR: 0-29.2). Fifteen (31.3%) of the children with epilepsy had a disability in at least one domain of the child functioning module, with the ‘accepting change’ domain harbouring the highest proportion of disabled children (12.5%). Higher seizure frequency and longer epilepsy duration were associated with more disability.

CONCLUSION: PWE in Mahenge experience variable degrees of disability. The affected domains indicate the need for societal rehabilitation of PWE in various community and/or social activities. Peer-support groups were instituted at the study sites to address these needs.

PMID:37523798 | DOI:10.1016/j.yebeh.2023.109367

Aesthet Surg J. 2023 Jul 31:sjad243. doi: 10.1093/asj/sjad243. Online ahead of print.

ABSTRACT

BACKGROUND: The results of preoperative and 1-year postoperative measurements in aesthetic breast surgery were outlined in chart form in the Aesthetic Surgery Journal in 2020. Measurements were performed preoperatively and postoperatively, but the authors concentrated on 1-year follow-up because it is generally accepted as the minimum time to define a stable surgical result. Extensive statistical analysis was outlined in the previous paper.

OBJECTIVES: This paper translates those results into a visual form so that the surgeon can see the changes which occur in breast reduction, breast augmentation, mastopexy, mastopexy-augmentation and implant removal with mastopexy.

METHODS: There were 548 patients in the breast augmentation group, 388 patients in the breast reduction group, 244 patients for mastopexy-augmentation and 90 patients for mastopexy. Only primary surgeries were reviewed that had a full year follow-up comparing preoperative and postoperative measurements. Measurements were performed by the senior author preoperatively and at each postoperative visit. The measurements that were included in this study were clavicle to upper breast border, upper breast border to nipple, suprasternal notch to nipple, suprasternal notch to inframammary fold, and midline to nipple.

RESULTS: The preoperative and postoperative measurement changes in aesthetic breast surgery are consistent, with minimal variation for each of the aesthetic breast surgery procedures.

CONCLUSIONS: The visual interpretation of these results allows the surgeon to accurately plan preoperatively in order to achieve good, predictable results.

PMID:37523745 | DOI:10.1093/asj/sjad243