Category: Statistics

Health Promot Int. 2023 Aug 1;38(4):daad077. doi: 10.1093/heapro/daad077.

ABSTRACT

There is a need for both feasible and enjoyable physical activity programmes for people on a cancer journey. Emerging evidence suggests that dance can have a positive effect on health and well-being in this cohort. We aimed to synthesize the quantitative and qualitative literature exploring the effectiveness and impact of community dance interventions in people with all types and stages of cancer. A systematic search was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in Pubmed, EMBASE, Medline Ovid, CINAHL and PEDro databases. Quantitative and qualitative data were extracted and synthesized using a convergent segregated approach. The numeric data were analysed using descriptive statistics, narrative synthesis and meta-analysis where possible. The qualitative data were analysed using thematic analysis. The Downs and Black critical appraisal tool and the Critical Appraisal Skills Programme were used to assess the quality of the quantitative and qualitative literature, respectively. Eighteen studies were included in this mixed-methods review with seven trials included in the meta-analysis. Statistically significant improvements were found in favour of community dance for functional capacity, fatigue, quality-of-life and depression in comparison to no intervention. Evidence suggests dance is a safe and feasible form of physical activity both during and after cancer treatment. Participants reported good social support, education regarding physical activity and local access as key facilitators to participation. We concluded that dance is a feasible and enjoyable intervention for many people with various forms of cancer. Community dance programmes can improve both physical and psychological outcomes in people on a cancer journey.

PMID:37536669 | DOI:10.1093/heapro/daad077

Am J Trop Med Hyg. 2023 Aug 2;109(2):436-442. doi: 10.4269/ajtmh.22-0584. Print 2023 Aug 2.

ABSTRACT

Early-life experiences of enteric infections and diarrheal illness are common in low-resource settings and are hypothesized to affect child development. However, longer-term associations of enteric infections with school-age cognitive outcomes are difficult to estimate due to lack of long-term studies. The objective of this study was to examine the relationship between enteropathogen exposure in the first 2 years of life with school-age cognitive skills in a cohort of children followed from birth until 6 to 8 years in low-resource settings in Brazil, Tanzania, and South Africa. The study included participants from three sites from the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health Study who were enrolled just after birth and followed for enteric infections, diarrheal illness, and cognitive development until 2 years of age. When the children were school-age, further data were collected on reasoning skills and semantic/phonemic fluency. We estimated associations between the burden of specific enteric pathogens and etiology-specific diarrhea from 0 to 2 years with cognitive test scores at 6 to 8 years using linear regression and adjusting for confounding variables. In this study, children who carried more enteric pathogens in the first 2 years of life showed overall decreases in school-age cognitive abilities, particularly children who carried protozoa, although this was not statistically significant in this sample. Socioeconomic factors such as maternal education and income were more closely associated with school-age cognitive abilities. Early-life enteric pathogens may have a small, lasting influence on school-age cognitive outcomes, although other socioeconomic factors likely contribute more significantly.

PMID:37536666 | DOI:10.4269/ajtmh.22-0584

Life Sci. 2023 Aug 1:121996. doi: 10.1016/j.lfs.2023.121996. Online ahead of print.

ABSTRACT

AIM: Sepsis is a common cause of acute kidney injury (AKI). Lipopolysaccharides (LPS) are the main gram-negative bacterial cell wall component with a well-documented inflammatory impact. Diclofenac (DIC) is a non-steroidal anti-inflammatory drug with a potential nephrotoxic effect. Curcumin (CUR) and silymarin (SY) are natural products with a wide range of pharmacological activities, including antioxidant and anti-inflammatory ones. The objective of this study was to examine the protective impact of CUR and SY against kidney damage induced by LPS/DIC co-exposure.

MATERIALS AND METHODS: Four groups of rats were used; control; LPS/DIC, LPS/DIC + CUR, and LPS/DIC + SY group. LPS/DIC combination induced renal injury at an LPS dose much lower than a nephrotoxic one.

KEY FINDING: Nephrotoxicity was confirmed by histopathological examination and significant elevation of renal function markers. LPS/DIC induced oxidative stress in renal tissues, evidenced by decreasing reduced glutathione and superoxide dismutase, and increasing lipid peroxidation. Inflammatory response of LPS/DIC was associated with a significant increase of renal IL-1β and TNF-α. Treatment with either CUR or SY shifted measured parameters to the opposite side. Moreover, LPS/DIC exposure was associated with upregulation of mTOR and endoplasmic reticulum stress protein (CHOP) and downregulation of podocin These effects were accompanied by reduced gene expression of cystatin C and KIM-1. CUR and SY ameliorated LPS/DIC effect on the aforementioned genes and protein significantly.

SIGNIFICANCE: This study confirms the potential nephrotoxicity; mechanisms include upregulation of mTOR, CHOP, cystatin C, and KIM-1 and downregulation of podocin. Moreover, both CUR and SY are promising nephroprotective products against LPS/DIC co-exposure.

PMID:37536613 | DOI:10.1016/j.lfs.2023.121996

J Vasc Surg Venous Lymphat Disord. 2023 Aug 1:S2213-333X(23)00307-4. doi: 10.1016/j.jvsv.2023.07.009. Online ahead of print.

ABSTRACT

OBJECTIVES: After foam sclerotherapy in the truncal saphenous vein, the clinical impact of additional eccentric compression has not been explored.

METHODS: Between April 2020 and February 2021, we enrolled 42 patients (84 limbs) who underwent bilateral endovenous combined therapy for great saphenous vein (GSV) reflux. Each patient received the same type of endovenous ablation in both above-the-knee GSVs (Laser, Radiofrequency, Cyanoacrylate glue) and combined foam sclerotherapy was performed on both below-knee GSVs. Subsequently, we conducted a prospective randomized, single-blind, within-person study in which each subject’s bilateral truncal saphenous vein of the calves underwent two different compression therapy: regular class II compression stocking on one side (RC group) and additional eccentric compression on the other side (AC group). The primary endpoint was the occlusion range (0-10) of the BK truncal GSV after foam sclerotherapy. The secondary outcomes were the pain score (visual analog scale, VAS, 0-10) of the paired limb, the required numbers of additional foam sclerotherapy, compliance to compression therapy, and procedure-related complications.

RESULTS: For the above-the-knee GSV, endovenous laser treatment (n=44), endovenous radiofrequency ablation (n=14), and endovenous cyanoacrylate procedure (n=26) were performed. The mean sub-compression pressure of the medial calf in the supine and standing position were 16.7± 2.34 and 24.5±6.6 mmHg in the RC group and 38.5±5.5 and 45.3±8.2 mmHg in the AC group, respectively (p=0.000). Secondary outcomes of pain score, numbers of additional UGFS, and pigmentation were not statistically different between the two groups. Patient-reported satisfaction scores on compression (0-10) at postoperative 24 hours were 8.03±1.9 in the AC group and 7.98±1.9 in the RC group (p=0.317, Wilcoxon Signed Ranks Test). In both groups, the closure rate of AK GSV at the post-operative one month was 100%. Regarding procedure-related complications within one month, DVT, numbness, or skin necrosis requiring additional medical attention was not identified.

CONCLUSION: The 24 hours of additional eccentric compression on truncal GSV, compared to the conventional knee-level stocking only, did not yield any clinical advantages in terms of occlusion range, postoperative pain, the need for additional sclerotherapy, and skin pigmentation after foam sclerotherapy. The decision on whether types of compression therapy to perform after foam sclerotherapy in the truncal vein should be comprehensively determined. (https://cris.nih.go.kr/, Clinical Trial Number: KCT 0005605).

PMID:37536560 | DOI:10.1016/j.jvsv.2023.07.009

Neuroimage. 2023 Aug 1:120303. doi: 10.1016/j.neuroimage.2023.120303. Online ahead of print.

ABSTRACT

Convolutional neural networks (CNN) have demonstrated good accuracy and speed in spatially registering high signal-to-noise ratio (SNR) structural magnetic resonance imaging (sMRI) images. However, some functional magnetic resonance imaging (fMRI) images, e.g., those acquired from arterial spin labeling (ASL) perfusion fMRI, are of intrinsically low SNR and therefore the quality of registering ASL images using CNN is not clear. In this work, we aimed to explore the feasibility of a CNN-based affine registration network (ARN) for registration of low-SNR three-dimensional ASL perfusion image time series and compare its performance with that from the state-of-the-art statistical parametric mapping (SPM) algorithm. The six affine parameters were learned from the ARN using both simulated motion and real acquisitions from ASL perfusion fMRI data and the registered images were generated by applying the transformation derived from the affine parameters. The speed and registration accuracy were compared between ARN and SPM. Several independent datasets, including meditation study (10 subjects × 2), bipolar disorder study (26 controls, 19 bipolar disorder subjects), and aging study (27 young subjects, 33 older subjects), were used to validate the generality of the trained ARN model. The ARN method achieves superior image affine registration accuracy (total translation/total rotation errors of ARN vs. SPM: 1.17mm/1.23° vs. 6.09mm/12.90° for simulated images and reduced MSE/L1/DSSIM/Total errors of 18.07% / 19.02% / 0.04% / 29.59% for real ASL test images) and 4.4 times (ARN vs. SPM: 0.50s vs. 2.21s) faster speed compared to SPM. The trained ARN can be generalized to align ASL perfusion image time series acquired with different scanners, and from different image resolutions, and from healthy or diseased populations. The results demonstrated that our ARN markedly outperforms the iteration-based SPM both for simulated motion and real acquisitions in terms of registration accuracy, speed, and generalization.

PMID:37536525 | DOI:10.1016/j.neuroimage.2023.120303

J Proteomics. 2023 Aug 1:104983. doi: 10.1016/j.jprot.2023.104983. Online ahead of print.

ABSTRACT

BRCA2 and RAD51 are two proteins that play a central role in homologous recombination (HR) and DNA double strand break (DSB) repair. BRCA2 assists RAD51 fibrillation and defibrillation through binding with its eight BRC repeats, with BRC4 being one of the most efficient and best characterized. RAD51 inactivation by small molecules has been proposed as a strategy to impair BRCA2/RAD51 binding and, ultimately, the HR pathway, with the aim of making cancer cells more sensitive to PARP inhibitors (PARPi). This strategy, which mimics a synthetic lethality (SL) approach, has been successfully performed in vitro by using the myristoylated derivative of BRC4 (myr-BRC4), designed for a more efficient cell entry. The present study applies a method to obtain a proteomic fingerprint after cellular treatment with the myr-BRC4 peptide using a mass spectroscopy (MS) proteomic approach. (Data are available via ProteomeXchange with identifier PXD042696.) We performed a comparative proteomic profiling of the myr-BRC4 treated vs. untreated BxPC-3 pancreatic cancer cells and evaluated the differential expression of proteins. Among the identified proteins, we focused our attention on proteins shared by both the RAD51 and the BRCA2 interactomes, and on those whose reduction showed high statistical significance. Three downregulated proteins were identified (FANCI, FANCD2, and RPA3), and protein downregulation was confirmed through immunoblotting analysis, validating the MS approach. Our results suggest that, being a direct consequence of myr-BRC4 treatment, the detection of FANCD2, FANCI, and RPA3 downregulation could be used as an indicator for monitoring HR impairment. SIGNIFICANCE: RAD51’s inhibition has gained increasing attention because of its possible implications in personalized medicine through the SL approach. Chemical disruption of protein-protein interactions (PPIs) between RAD51 and BRCA2, or some of its partner proteins, could potentiate PARPi DNA damage-induced cell death. This could have application for difficult to treat cancers, such as BRCA-competent and olaparib (PARPi) resistant pancreatic adenocarcinoma. Despite RAD51 being a widely studied target, researchers still lack detailed mechanistic information. This has stifled progress in the field with only a few RAD51 inhibitors having been identified, none of which have gained regulatory approval. Nevertheless, the peptide BRC4 is one of the most specific and best characterized RAD51 binder and inhibitor reported to date. Our study is the first to report the proteomic fingerprint consequent to cellular treatment of myr-BRC4, to offer a reference for the discovery of specific protein/pathway alterations within DNA damage repair. Our results suggest that, being a direct consequence of myr-BRC4 treatment, and ultimately ofBRCA2/RAD51 disruption, the detection of FANCD2, FANCI, and RPA3 downregulation could be used as an indicator for monitoring DNA damage repair impairment and therefore be used to potentiate the development of new effective therapeutic strategies.

PMID:37536521 | DOI:10.1016/j.jprot.2023.104983

Eur J Vasc Endovasc Surg. 2023 Aug 1:S1078-5884(23)00614-7. doi: 10.1016/j.ejvs.2023.07.048. Online ahead of print.

ABSTRACT

OBJECTIVE: Fenestrated and branched thoracic endovascular aortic repair (f/b-TEVAR) of the aortic arch is a viable approach in patients unsuitable for open repair. The aim is to summarise the published results of manufactured f/b-TEVAR devices for partial and total repair of the aortic arch, and to compare fenestrated vs. branched configurations.

DATA SOURCES: PubMed, Scopus and The Cochrane Library were searched for articles (2018 – 2021) about patients with elective/urgent/emergent aortic requiring a proximal landing zone in the aortic arch (zone 0 – 1 – 2) and treated by f/b-TEVAR.

REVIEW METHODS: Systematic review and meta-analysis were performed according to the PRISMA guidelines. Open repair, supra-aortic trunk (SAT) debranching + standard TEVAR, and in situ/physician modified/parallel grafts were excluded. Primary outcomes were technical success and 30 day mortality. Secondary outcomes were 30 day major adverse events, and overall survival and procedure related endpoints during follow up.

RESULTS: Out of 458 articles screened, 18 articles involving 571 patients were selected. Indications for intervention were chronic dissections (50.1%), degenerative aneurysms (39.6%), penetrating aortic ulcers (7.4%), and pseudoaneurysms (2%). f-TEVAR, b-TEVAR, and f + b-TEVAR were used in 38.4%, 54.1%, and 7.5% of patients, respectively. Overall, technical success was 95.9% (95% confidence interval [CI] 0.93 – 0.97; I² = 0%; p for heterogeneity (Het) = .77) and 30 day mortality was 6.7% (95% CI 0.05 – 0.09; I² = 0%; p Het = .66). No statistical differences were found comparing fenestrated vs. branched endografts, except for a higher rate of type I – III endoleaks in f-TEVAR (9.8% vs 2.6%; p = .034). Overall survival rate and freedom from aortic related death at the one year follow up ranged between 82 – 96.4% and 94 – 94.7%, respectively. Thirteen and five studies were considered at moderate and high risk of bias, respectively.

CONCLUSION: f/b-TEVAR for the treatment of the aortic arch, nowadays show, according to experience in dedicated centres, a satisfactory level of technical success together with progressive lowered load in terms of early mortality. There are of several limitations, and further studies are needed to reach clearer conclusions.

PMID:37536517 | DOI:10.1016/j.ejvs.2023.07.048

Drug Alcohol Depend. 2023 Jul 28;250:110910. doi: 10.1016/j.drugalcdep.2023.110910. Online ahead of print.

ABSTRACT

BACKGROUND: Although homelessness is a well-documented risk factor for drug overdose at the individual level, less is known about state-level homelessness and overdose mortality in the United States (US).

METHODS: This study used 2007-2020 panel data for all US states and the District of Columbia, from the following sources: US Department of Housing and Urban Development (homelessness data); Centers for Disease Control and Prevention (drug overdose death counts, population estimates, and opioid prescribing rates); Bureau of Labor Statistics (unemployment rates); and the National Forensic Laboratory Information System (drug seizure data). Two-way (state and year) fixed effects models regressed log-transformed drug overdose mortality rates on homelessness prevalence, in nested models adding demographic composition and unemployment measures, as well as drug supply measures. Models were weighted by state population size, and standard errors (SEs) were clustered at the state level.

RESULTS: Homelessness prevalence was significantly and positively associated with rates of drug overdose mortality after adjusting for nationwide trends, time-invariant differences between states, demographic composition, and unemployment rates (b[SE]=0.98[0.36], p=0.009). The positive association between homelessness prevalence and overdose mortality was attenuated at higher levels of fentanyl availability (fentanyl involvement in drug seizures; interaction term b[SE]=-0.02[0.01], p=0.001).

CONCLUSION: The positive association between state-level homelessness and drug overdose mortality suggests that policies and programs to prevent and reduce homelessness represent fundamental elements of a comprehensive response to the US overdose crisis.

PMID:37535991 | DOI:10.1016/j.drugalcdep.2023.110910

Rev Med Inst Mex Seguro Soc. 2023 Jul 31;61(4):420-426. doi: 10.5281/zenodo.8200105.

ABSTRACT

BACKGROUND: Currently, epithelial ovarian cancer is diagnosed in advanced stages (EC IIIC) in 75-80% of cases worldwide. In this group of patients treatment with neoadjuvant chemotherapy is started, followed by interval cytoreduction of residual disease and even require peritonectomy with application of hyperthermic intraperitoneal chemotherapy (HIPEC).

OBJECTIVE: To identify the overall survival and progression-free survival associated with peritonectomy, in patients with peritoneal carcinomatosis secondary to ovarian cancer treated in the oncology gynecology service from January 2009 to January 2019 at the UMAE Hospital de Oncología Centro Médico Nacional Siglo XXI.

MATERIAL AND METHODS: Observational, descriptive, cross-sectional, retrospective study, information was obtained from the clinical file of patients treated with peritonectomy with the use of hyperthermic intraperitoneal chemotherapy in the gynecological oncology service from January 2009 to January 2019 at the UMAE Hospital de Oncología Centro Médico Nacional Siglo XXI.

RESULTS: Information was obtained from a total of 36 patients (n=100%), 36.1% received intraperitoneal chemotherapy and 63.8% underwent cytoreduction without the application of intraoperative chemotherapy. The most frequently used drug was cisplatin followed by mitomycin. There was no statistical significance when comparing both groups, however there was a trend in favor of the use of intraoperative chemotherapy by obtaining a greater number of months in terms of overall survival.

CONCLUSION: Peritonectomy with hyperthermic intraperitoneal chemotherapy is an option in selected patients with advanced stage ovarian cancer in primary and recurrent surgery, as well as in patients with platinum-resistant ovarian cancer.

PMID:37535978 | DOI:10.5281/zenodo.8200105

Med Phys. 2023 Aug 3. doi: 10.1002/mp.16645. Online ahead of print.

ABSTRACT

PURPOSE: The recently proposed sparsifying transform (ST) models incur low computational cost and have been applied to medical imaging. Meanwhile, deep models with nested network structure reveal great potential for learning features in different layers. In this study, we propose a network-structured ST learning approach for X-ray computed tomography (CT), which we refer to as multi-layer clustering-based residual sparsifying transform (MCST) learning. The proposed MCST scheme learns multiple different unitary transforms in each layer by dividing each layer’s input into several classes. We apply the MCST model to low-dose CT (LDCT) reconstruction by deploying the learned MCST model into the regularizer in penalized weighted least squares (PWLS) reconstruction.

METHODS: The proposed MCST model combines a multi-layer sparse representation structure with multiple clusters for the features in each layer that are modeled by a rich collection of transforms. We train the MCST model in an unsupervised manner via a block coordinate descent (BCD) algorithm. Since our method is patch-based, the training can be performed with a limited set of images. For CT image reconstruction, we devise a novel algorithm called PWLS-MCST by integrating the pre-learned MCST signal model with PWLS optimization.

RESULTS: We conducted LDCT reconstruction experiments on XCAT phantom data, Numerical Mayo Clinical CT dataset and “LDCT image and projection dataset” (Clinical LDCT dataset). We trained the MCST model with two (or three) layers and with five clusters in each layer. The learned transforms in the same layer showed rich features while additional information is extracted from representation residuals. Our simulation results and clinical results demonstrate that PWLS-MCST achieves better image reconstruction quality than the conventional filtered back-projection (FBP) method and PWLS with edge-preserving (EP) regularizer. It also outperformed recent advanced methods like PWLS with a learned multi-layer residual sparsifying transform (MARS) prior and PWLS with a union of learned transforms (ULTRA), especially for displaying clear edges and preserving subtle details.

CONCLUSIONS: In this work, a multi-layer sparse signal model with a nested network structure is proposed. We refer this novel model as the MCST model that exploits multi-layer residual maps to sparsify the underlying image and clusters the inputs in each layer for accurate sparsification. We presented a new PWLS framework with a learned MCST regularizer for LDCT reconstruction. Experimental results show that the proposed PWLS-MCST provides clearer reconstructions than several baseline methods. The code for PWLS-MCST is released at https://github.com/Xikai97/PWLS-MCST.

PMID:37535932 | DOI:10.1002/mp.16645