Category: Statistics

Arch Dermatol Res. 2022 Dec 26. doi: 10.1007/s00403-022-02521-1. Online ahead of print.

ABSTRACT

Mycosis Fungoides (MF) makes up the most of the cutaneous lymphomas. As a malignant disease, the greatest diagnostical challenge is to timely differentiate MF from inflammatory diseases. Contemporary computational methods successfully identify cell nuclei in histological specimens. Deep learning methods are especially favored for such tasks. A deep learning model was used to detect nuclei Hematoxylin-Eosin(H-E) stained micrographs. Nuclear properties are extracted after detection. A multi-layer perceptron classifier is used to detect lymphocytes specifically among the detected nuclei. The comparisons for each property between MF and non-MF were carried out using statistical tests the results are compared with the findings in the literature to provide a descriptive analysis as well. Random forest classifier method is used to build a model to classify MF and non-MF lymphocytes. 10 nuclear properties were statistically significantly different between MF and non-MF specimens. MF nuclei were smaller, darker and more heterogenous. Lymphocyte detection algorithm had an average 90.5% prediction power and MF detection algorithm had an average 94.2% prediction power. This project aims to fill the gap between computational advancement and medical practice. The models could make MF diagnoses easier, more accurate and earlier. The results also challenge the manually examined and defined nuclear properties of MF with the help of data abundance and computer objectivity.

PMID:36571610 | DOI:10.1007/s00403-022-02521-1

Abdom Radiol (NY). 2022 Dec 26. doi: 10.1007/s00261-022-03774-0. Online ahead of print.

ABSTRACT

PURPOSE: To explore the clinical value of contrast-enhanced computed tomography (CECT) radiomics in predicting primary site response to neoadjuvant chemotherapy in high-risk neuroblastoma.

MATERIALS AND METHODS: Seventy patients were retrospectively included and separated into very good partial response (VGPR) group and non-VGPR group according to the changes in primary tumor volume. The clinical features with statistical difference between the two groups were used to construct the clinical models using a logistic regression (LR) algorithm. The radiomics models based on different radiomics features selected by Kruskal-Wallis (KW) test and recursive feature elimination (RFE) were established using support vector machine (SVM) and LR algorithms. The radiomics score (Radscore) and clinical features were integrated into the combined models. Leave-one-out cross-validation (LOOCV) was used to validate the predictive performance of models in the entire dataset.

RESULTS: The optimal clinical model achieved an area under the curve (AUC) of 0.767 [95% confidence interval (CI): 0.638, 0.896] and an accuracy of 0.771 after LOOCV. The AUCs of the best KW + SVM, KW + LR, RFE + SVM, and RFE + LR radiomics models were 0.816, 0.826, 0.853, and 0.850, respectively, and the corresponding AUCs after LOOCV were 0.780, 0.785, 0.755, and 0.772, respectively. The AUC and accuracy after LOOCV of the optimal combined model was 0.804 (95% CI: 0.694, 0.915) and 0.814, respectively. The Delong test showed a statistical difference in predictive performance between the optimal clinical and combined models after LOOCV (Z = 2.003, P = 0.045). The decision curve analysis showed that the combined model performs better than the clinical model.

CONCLUSION: The CECT radiomics models have a favorable predictive performance in predicting VGPR of high-risk neuroblastoma to neoadjuvant chemotherapy. When integrating radiomics features and clinical features, the predictive performance of the combined models can be further improved.

PMID:36571609 | DOI:10.1007/s00261-022-03774-0

Eur Radiol. 2022 Dec 26. doi: 10.1007/s00330-022-09370-6. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to investigate the association between the perivascular fat attenuation index (FAI) and the success of the antegrade percutaneous coronary intervention (PCI) for chronic total occlusion (CTO).

METHODS: This study evaluated patients with only one CTO lesion observed on conventional coronary angiography (CAG) who underwent coronary computed tomography angiography (CCTA) < 1 month before CAG, from 2018 to 2019. The clinical data, CCTA-based CTO lesion morphologic characteristics, and perivascular FAI of CTO lesions were recorded and analysed.

RESULTS: In total, 156 patients with CTOs were enrolled in this study. Successful antegrade PCI (A-PCI) was achieved in 105 CTO lesions (67.3%). The perivascular FAI of the failed A-PCI group was significantly lower than the successful A-PCI group (-84.76 ± 10.44 Hounsfield unit (HU) vs. -67.54 ± 9.94 HU; p < 0.001), and the cut-off value determined by the receiver operating characteristic (ROC) curve was -77.50 HU. Multivariable analysis revealed no statistical significance in the clinical data, FAI ≤ -77.50 HU (odds ratio (OR): 33.96), negative remodeling (OR: 4.36), severe calcification degree (OR: 4.43) and occlusion length ≥ 20.25 mm (OR: 3.89) were independent predictors of A-PCI failure. The prediction performance of combining the three morphologic characteristics (severe calcification, occlusion length ≥ 20.25 mm, and negative remodeling) with FAI ≤ -77.50 HU was better than that of the three morphologic characteristics alone (0.93 versus 0.77, p < 0.001).

CONCLUSIONS: As a non-invasive index for detecting coronary inflammation, FAI complements indicators based on coronary CTA well and may be helpful for choosing appropriate interventional strategies.

KEY POINTS: • Perivascular FAI of CTO was significantly higher in the failed A-PCI group. • The combination of FAI with other morphological predictors showed higher predictive performance of failed A-PCI for CTOs. • FAI is a good complement to indicators based on coronary CTA.

PMID:36571603 | DOI:10.1007/s00330-022-09370-6

Clin Oral Investig. 2022 Dec 26. doi: 10.1007/s00784-022-04823-0. Online ahead of print.

ABSTRACT

OBJECTIVE: The study aims to compare differences among iliac bone flaps with different iliac crest orientations for the repair of mandibular defects with an aim to analyze their advantages, disadvantages, and effects.

MATERIAL AND METHODS: Clinical data and computed tomography scans of all patients who underwent iliac bone flap repair of the mandible in Peking University School and Hospital of Stomatology from January 2016 to April 2021 were collected. Patients were divided into the iliac crest towards alveolar process (Group A) and the iliac crest towards mandibular inferior margin (Group B). Software was used to measure corresponding indicators. The results obtained for the groups were statistically analyzed.

RESULTS: The study included 78 patients (25 and 53 in groups A and B, respectively). The symmetry of the LC-type defect was better in group A (p < 0.05). The all-bone width of the alveolar process side in group A was greater than 6 mm; in 15 cases of group B, the width was less than 6 mm (p < 0.05). The intermaxillary distance of two sites were higher in group B (p < 0.05). The bone cortical thickness was significantly thicker in group A (p < 0.05).

CONCLUSION: One year after the mandibular body defect was reconstructed with a vascularized iliac bone flap, the iliac crest towards alveolar process group showed better bone symmetry, width, intermaxillary distance, and cortical thickness to meet the planting requirements.

CLINICAL RELEVANCE: The use of an iliac crest towards alveolar process may be a better approach for mandible reconstruction.

PMID:36571588 | DOI:10.1007/s00784-022-04823-0

Ann Neurol. 2022 Dec 26. doi: 10.1002/ana.26588. Online ahead of print.

ABSTRACT

OBJECTIVE: Polygenic variation accounts for a substantial portion of the risk of Alzheimer’s disease, but its effect on the rate of fibrillar-tau accumulation as a key driver of dementia symptoms is unclear.

METHODS: We combined the to-date largest number of genetic risk variants of AD (n = 85 lead SNPs) from recent GWAS to generate a PGS. We assessed longitudinal tau-PET, amyloid-PET, and cognition in 231 participants from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Using the PGS, together with global amyloid-PET, we predicted the rate of tau-PET increases in Braak-stage regions-of-interest and cognitive decline. We also assessed PGS-risk enrichment effects on the required sample size in clinical trials targeting tau pathology.

RESULTS: We found that a higher PGS was associated with higher rates of tau-PET accumulation, in particular at elevated amyloid-PET levels. Tau-PET increases mediated the association between PGS and faster cognitive decline. Risk enrichment through high PGS afforded sample size savings by 34%.

INTERPRETATION: Our results demonstrate that the PGS predicts faster tau progression and thus cognitive decline, showing utility to enhance statistical power in clinical trials. This article is protected by copyright. All rights reserved.

PMID:36571564 | DOI:10.1002/ana.26588

Cancer. 2022 Dec 26. doi: 10.1002/cncr.34626. Online ahead of print.

ABSTRACT

BACKGROUND: This study was aimed at developing and validating a decision-making tool predictive of overall survival (OS) for patients receiving stereotactic body radiation therapy (SBRT) for spinal metastases.

METHODS: Three hundred sixty-one patients at one institution were used for the training set, and 182 at a second institution were used for external validation. Treatments most commonly involved one or three fractions of spine SBRT. Exclusion criteria included proton therapy and benign histologies.

RESULTS: The final model consisted of the following variables and scores: Spinal Instability Neoplastic Score (SINS) ≥ 6 (1), time from primary diagnosis < 21 months (1), Eastern Cooperative Oncology Group (ECOG) performance status = 1 (1) or ECOG performance status > 1 (2), and >1 organ system involved (1). Each variable was an independent predictor of OS (p < .001), and each 1-point increase in the score was associated with a hazard ratio of 2.01 (95% confidence interval [CI], 1.79-2.25; p < .0001). The concordance value was 0.75 (95% CI, 0.71-0.78). The scores were discretized into three groups-favorable (score = 0-1), intermediate (score = 2), and poor survival (score = 3-5)-with 2-year OS rates of 84% (95% CI, 79%-90%), 46% (95% CI, 36%-59%), and 21% (95% CI, 14%-32%), respectively (p < .0001 for each). In the external validation set (182 patients), the score was also predictive of OS (p < .0001). Increasing SINS<zaq;6> was predictive of decreased OS as a continuous variable (p < .0001).

CONCLUSIONS: This novel score is proposed as a decision-making tool to help to optimize patient selection for spine SBRT. SINS may be an independent predictor of OS.

PMID:36571507 | DOI:10.1002/cncr.34626

Eur J Cardiothorac Surg. 2022 Dec 26:ezac576. doi: 10.1093/ejcts/ezac576. Online ahead of print.

ABSTRACT

OBJECTIVES: This retrospective observational study aimed to assess the geometrical features, including diameters, length and angulation, of the ascending aorta with bicuspid and tricuspid aortic valve and to identify imaging markers potentially predicting whether aortopathy is likely to evolve chronically or to complicate with acute type A dissection.

METHODS: Angio-computed-tomography scans of 354 patients (from 3 Centers) with non-dilated (n = 97), aneurysmal (n = 100) or dissected aorta (n = 157) were reviewed. Diameters were measured at root, sinotubular junction, ascending, brachio-cephalic trunk origin; centerline lengths of the root and tubular tract, and ascending-arch angle (between the ascending tubular tract axis and the proximal arch axis) were also measured. For 12 dissection patients, pre-dissection scans were available to investigate predisposing aortic geometry. Statistical analysis included: tricuspid versus bicuspid comparisons in each subgroup; univariate and multivariate analysis of the predictors of ascending-arch angle narrowing; estimation of diagnostic accuracy of the angle parameter.

RESULTS: Diameters and lengths were similar between aneurysms and dissections, whereas dissections showed a significant ascending-arch angle narrowing (117°±13 in tricuspid, 115°±14 in bicuspid) compared to non-dilated and aneurysmal aortas (all p < 0.001). The best angle cut-off to discriminate dissection patients was 131° (96% sensitivity). In patients with a pre-dissection scan, Asc-Arch narrowing was already present before dissection. In non-dissected aortas over-angulation was predicted by root phenotype dilatation both in bicuspid and tricuspid patients. Bicuspid patients with non-dilated aorta showed elongated root (p = 0.027), a feature significantly correlated with Asc-Arch angle narrowing (p = 0.008).

CONCLUSIONS: The ascending-arch angle is promising as a risk marker for dissection to be used along with diameter. Its narrowing seems to be associated with elongation of the root, a feature that bicuspid patients can show even without significant dilatation. Root-phenotype aortopathy may be at higher risk also with tricuspid aortic valve.

PMID:36571506 | DOI:10.1093/ejcts/ezac576

Aust Endod J. 2022 Dec 26. doi: 10.1111/aej.12734. Online ahead of print.

ABSTRACT

This study aimed to evaluate the amount of apically extruded debris caused by different NiTi files. One hundred mandibular premolars were included in this study. The specimens were divided into five groups (n = 20): (i) TruNatomy, (ii) WaveOne Gold, (iii) 2Shape, (iv) ProTaper Next and (v) Reciproc Blue. The extruded debris was collected into preweighed Eppendorf tubes. These tubes were weighed again, and the net weight of debris was calculated. Data were statistically analysed, and the significance level was set at 5%. The least amount of extruded debris was observed in the TruNatomy group (p < 0.05). Statistically significant differences were not found among (iii), (iv) and (v) groups (p > 0.05). However, these groups resulted in significantly higher amounts of debris when compared to (i) and (ii) groups (p < 0.05). The results lead us to conclude that all instrumentation systems caused apical extrusion of debris at varying weights.

PMID:36571483 | DOI:10.1111/aej.12734

Zhen Ci Yan Jiu. 2022 Dec 25;47(12):1041-7. doi: 10.13702/j.1000-0607.20220586.

ABSTRACT

OBJECTIVE: To observe the effect of electroacupuncture (EA) of “Xiusanzhen” ［bilateral “Yingxiang”(LI20)+”Yintang”(GV24⁺)］ on synaptophysin (SYN), postsynaptic density protein-95 (PSD-95), Iba-1⁺ CD68⁺ microglia and complement C related protein expression of hippocampus in Parkinson’s disease dementia (PDD) mice, so as to explore its mechanism in improving memory impairment of PDD.

METHODS: Male C57BL/6 mice were randomly divided into control, sham operation, model and EA groups, with 10 mice in each group. The PDD model was established by injecting 6-OHDA into the medial forebrain tract. EA (2 Hz, 1 mA) was applied to unilateral LI20 and GV29 for 20 min once daily for consecutive 14 days. Morris water maze and new object recognition test were used to evaluate the learning and memory ability. Western blot was used to detect the expression of SYN and PSD-95 proteins in hippocampus. Immunofluorescence was used to label Iba-1⁺ CD68⁺ microglia and C1q positive cells in hippocampal CA1 region. The content of C3 protein in hippocampus was detected by ELISA.

RESULTS: Compared with the control group, there was no statistical significance in all the observed indexes in the sham operation group. Compared with the sham operation group, the average escape latency (AEL) prolonged significantly (P<0.01), the target platform crossing times (TPCT) and new object recognition index (NORI) decreased remarkably (P<0.01); the expressions of SYN and PSD-95 proteins in hippocampal CA1 region were significantly decreased (P<0.01); the rate of Iba-1+CD68+ microglia, the rate of C1q positive cells and the content of C3 protein were significantly increased (P<0.01) in the model group. In comparison with the model group, the AEL was shortened (P<0.01), the TPCT and NORI were increased (P<0.05) remarkably; the expressions of SYN and PSD-95 proteins in hippocampal CA1 region were increased (P<0.01, P<0.05); the rate of Iba-1⁺ CD68⁺ microglia, the rate of C1q positive cells and the content of C3 protein were significantly decreased (P<0.01) in the EA group.

CONCLUSION: “Xiusanzhen” can alleviate the learning and memory impairment of PDD model mice, and improve the synaptic plasticity of hippocampal CA1 area. The mechanism may be related to the reduction of C1q and C3 deposition in hippocampal CA1 region and the reduction of microglia phagocytosis.

PMID:36571217 | DOI:10.13702/j.1000-0607.20220586

Free Radic Res. 2022 Dec 26:1-12. doi: 10.1080/10715762.2022.2162392. Online ahead of print.

ABSTRACT

BACKGROUND: Vitamin B₁₂ is involved in biochemical metabolic pathways. B₁₂ deficiency is common in childhood when the need for the vitamin increases and growth and development occur. Various hematological, neurological, psychiatric, and gastrointestinal disorders are observed in its deficiency. In addition, B₁₂ deficiency is associated with oxidative stress and DNA damage.

AIM: Therefore, the aim of our study is to evaluate oxidative stress, thiol/disulfide homeostasis, and DNA damage pre and post-treatment in children diagnosed with B₁₂ deficiency.

METHODS: A total of 40 children with B₁₂ deficiency were included in the study after the consent form was approved. Blood was drawn from children pre and post-treatment. Hemoglobin (HGB), hematocrit (HCT), and red blood cells (RBC) were measured by autoanalyzer; total antioxidant status (TAS), total oxidant status (TOS), total thiol (TT), and native thiol (NT) were measured by the photometric method, and DNA damage was analyzed by the comet assay method. Oxidative stress index (OSI) and disulfide (DIS) values were calculated.

RESULTS: As a result of the experiments, HGB, HCT, and RBC increased with treatment. While TAS, TT, and NT as antioxidant parameters increased; TOS, OSI, and DIS decreased with treatment compared to pretreatment. DNA damage was also found to decrease with treatment. Additionally, these data were statistically significant (p < 0.001).

CONCLUSIONS: It was found that oxidative stress and DNA damage decreased with oral B₁₂ treatment in children with B₁₂ deficiency, and clinical parameters were also improved.

PMID:36571212 | DOI:10.1080/10715762.2022.2162392