Category: Statistics

Pediatrics. 2022 Jul 25:e2022057206. doi: 10.1542/peds.2022-057206. Online ahead of print.

NO ABSTRACT

PMID:35871698 | DOI:10.1542/peds.2022-057206

J Egypt Natl Canc Inst. 2022 Jul 25;34(1):31. doi: 10.1186/s43046-022-00132-5.

ABSTRACT

BACKGROUND: Metastatic breast cancer (MBC) is a major health problem worldwide. Some patients improve on tamoxifen and others do not respond to treatment. Therefore, the aim of the current study is to assess genetic aberrations in the Her2/EGFR-PDGFR pathway associated with tamoxifen response in MBC patients.

METHODS: This is a retrospective cohort study, including 157 hormone receptors positive, locally recurrent inoperable and/or MBC patients on tamoxifen treatment. Patients were categorized into 78 (49.7%) tamoxifen responders and 79 (50.3%) tamoxifen non-responder patients. Genetic aberrations of 84 genes involved in the Her2/EGFR-PDGFR pathway were assessed in the tumor tissue samples obtained from the patients using SA-Bioscience assay. The identified panel was correlated to patients’ response to treatment, to detect the differentially expressed genes in tamoxifen responders and non-responders.

RESULTS: One hundred twenty-three (78.3%) patients were estrogen receptor (ER) and progesterone receptor (PR) positive, 108 (68.8%) were ER only positive, and 78 (49.7%) were PR only positive. There were 56 genes overexpressed in the refractory group compared to responders. However, only five out of these 56 genes, Janus kinase 1 (JAK1), collagen type I alpha 1 (COL1A1), GRB2-associated binding protein 1 (GAB1), fibronectin-1 (FN1), and MAP kinase-interacting serine/threonine-protein kinase (MKNK1), showed statistical significance between the two groups. Patients with bone metastasis showed a better response to treatment compared to those with metastatic deposits in other sites such as visceral metastasis (P < 0.005).

CONCLUSIONS: Genetic profiling using simple quantitative real-time polymerase chain reaction (qRT-PCR) protocols could be used to assess response to tamoxifen treatment in MBC patients. According to our data, a five-gene panel in the EGFR pathway (JAK1, COL1A1, GAB1, FN1 and MKNK1) could be used to categorize MBC patients into groups according to treatment response.

PMID:35871690 | DOI:10.1186/s43046-022-00132-5

BMC Sports Sci Med Rehabil. 2022 Jul 24;14(1):143. doi: 10.1186/s13102-022-00536-9.

ABSTRACT

BACKGROUND: Both able-bodied and Class 7 para-table tennis players compete while standing, but do they use the same techniques to hit the ball? This case study examined the shoulder joint kinematics of a highly skilled para-table tennis player with severe leg impairment.

METHODS: One international level Class 7 male para-table tennis player was compared with a control group of 9 male, competitive university team players. Participants performed 15 trials of forehand and 15 trials of backhand topspin drives. Shoulder abduction/adduction angles and joint range of motion (ROM) were measured using an inertial measurement system.

RESULTS: The joint ROM of the para-player was comparable to the control group in the forehand [para-player 38°, controls 32 (15)°] and slightly larger in backhand [para-player 35°, controls 24 (16)°]. Waveform analysis revealed significant differences in the entire forehand drives (p < .001) and the preparation (p < .001) and follow-through phases (p = .014) of the backhand drives.

CONCLUSIONS: Coaches should not simply instruct para-table tennis players to replicate the characteristics of able-bodied players. Depending on the nature of the physical impairment, para-players should optimise their movement strategies for successful performance.

PMID:35871683 | DOI:10.1186/s13102-022-00536-9

BMC Surg. 2022 Jul 24;22(1):284. doi: 10.1186/s12893-022-01733-6.

ABSTRACT

BACKGROUND: The superiorities in proximal facet joint protection of robot-assisted (RA) pedicle screw placement and screw implantation via the cortical bone trajectory (CBT) have rarely been compared. Moreover, findings on the screw accuracy of both techniques are inconsistent. Therefore, we analyzed the screw accuracy and incidence of facet joint violation (FJV) of RA and CBT screw insertion in the same study and compared them with those of conventional pedicle screw (PS) insertion. The possible factors affecting screw accuracy and FJV were also analyzed.

METHODS: A total of 166 patients with lumbar degenerative diseases requiring posterior L4-5 fusion were retrospectively included and divided into the RA, PS, and CBT groups from March 2019 to December 2021. The grades of intrapedicular accuracy and superior FJV were evaluated according to the Gertzbin-Robbins scale and the Babu scale based on postoperative CT. Univariable and multivariable analyses were conducted to assess the possible risk factors associated with intrapedicular accuracy and superior FJV.

RESULTS: The rates of optimal screw insertion in the RA, PS, and CBT groups were 87.3%, 81.3%, and 76.5%, respectively. The difference between the RA and CBT groups was statistically significant (P = 0.004). Superior FJVs occurred in 28.2% of screws in RA, 45.0% in PS, and 21.6% in CBT. The RA and CBT groups had fewer superior FJVs than the PS group (P = 0.008 and P < 0.001, respectively), and no significant difference was observed between the RA and CBT groups (P = 0.267). Multivariable analysis revealed that the CBT technique was an independent risk factor for intrapedicular accuracy. Furthermore, older age, the conventional PS technique and a smaller facet angle were independently associated with the incidence of superior FJVs.

CONCLUSIONS: The RA and CBT techniques were associated with fewer proximal FJVs than the PS technique. The RA technique showed a higher rate of intrapedicular accuracy than the CBT technique. The CBT technique was independently associated with screw inaccuracy. Older age, conventional PS technique and coronal orientation of the facet join were independent risk factors for superior FJV.

PMID:35871659 | DOI:10.1186/s12893-022-01733-6

World J Surg. 2022 Jul 24. doi: 10.1007/s00268-022-06663-1. Online ahead of print.

ABSTRACT

BACKGROUND: This study’s objective was to conduct a multinational registry of patients with carotid body tumors (CBTs) and to analyze patients’ clinical characteristics, treatments, and outcomes.

METHODS: Retrospective study from the Carotid Paraganglioma Cooperative International Registry involving eleven medical centers in Bolivia, Ecuador, Mexico, and Spain, of all patients with a CBT who underwent resection between 2009 and 2019.

RESULTS: A total of 1432 patients with a CBT surgically treated were included. Median patient age was 54 years (range: 45-63 years), and 82.9% (1184) of the study cohort were female. While at low altitude, the proportion of female-to-male cases was 2:1, at high altitude, this proportion increased to 8:1, with statistically significant differences (p = .022). Median operative time was 139 min (range: 110-180 min), while median operative blood loss was 250 ml (range: 100-500 ml), with statistically significant difference in increased blood loss (p = .001) and operative time (p = .001) with a higher Shamblin classification. Eight (0.6%) patients suffered stroke. Univariate analysis analyzing for possible factors associated with increased odds of stroke revealed intraoperative vascular lesion to present an OR of 2.37 [CI 95%; 1.19-4.75] (p = 0.001). In 245 (17.1%), a cranial nerve injury was reported. Seven (0.5%) deaths were recorded.

CONCLUSION: The most common CBT type on this cohort was hyperplasic, which might be partially explained by the high altitudes where these patients lived. Increased blood loss and operative time were associated with a higher Shamblin classification, and the risk of stroke was associated with patients presenting transoperative vascular lesions.

PMID:35871656 | DOI:10.1007/s00268-022-06663-1

J Clin Periodontol. 2022 Jul 24. doi: 10.1111/jcpe.13706. Online ahead of print.

ABSTRACT

AIM: To evaluate the efficacy of recombinant human platelet-derived growth factor-BB (rhPDGF) combined with a cross-linked collagen matrix (CCM) for the treatment of multiple adjacent gingival recession type 1 defects (MAGRs) in combination with the coronally advanced flap (CAF).

MATERIALS AND METHODS: Thirty patients were enrolled in this triple-blind, randomized, placebo-controlled, trial and treated with either CAF + CCM + rhPDGF, or CAF + CCM + saline. The primary outcomes was mean root coverage (mRC) at 6 months. Complete root coverage (CRC), gain in gingival thickness (GT), keratinized tissue width (KTW), volumetric and ultrasonographic changes and patient-reported outcome measures (PROMs) were also assessed. Mixed-modeling regression analyses were used for statistical comparisons.

RESULTS: At 6 months, the mRC of the CCM + rhPDGF and CCM alone groups were 88.25%, and 77.72% respectively (p=0.02). A significant gain in GT was consistently observed for both treatment arms, and more so for the patients receiving the matrix containing rhPDGF through time (0.51 mm vs 0.80 mm, on average, p=0.01). The rhPDGF + CCM treated patients presented greater volume gain, higher soft tissue thickness, and a superior esthetic score.

CONCLUSION: rhPDGF enhances the clinical, volumetric, and esthetic outcomes of MAGRs above the results achieved with CAF + CCM alone. (ClinicalTrials.gov NCT04462237).

PMID:35871600 | DOI:10.1111/jcpe.13706

Adv Sci (Weinh). 2022 Jul 24:e2202756. doi: 10.1002/advs.202202756. Online ahead of print.

ABSTRACT

The local structure of a transition metal (TM) ion is a function of cation elements and valence states. More than that, in this work, by employing a trove of first-principles data of TM oxides, the local structures of TM cations are statistically analyzed to extract detailed information about cation site preference, bond length, site structural distortion, and cation magnetization. It is found that cation radius alone poorly describes the local structure of a transition metal oxide, while the statistics of coordination number as well as the TMO bond length distribution, especially that of the 3d TMs, can provide comprehensive knowledge for understanding the behavior of TM elements. Based on these statistics, the interplay of site distortion due to the Jahn-Teller effect, cation site similarity, and a new set of ionic radii are all obtained to chart the “persona” of transition metal ions in solids.

PMID:35871555 | DOI:10.1002/advs.202202756

Gerontology. 2022 Jul 22:1-12. doi: 10.1159/000525581. Online ahead of print.

ABSTRACT

INTRODUCTION: Data on frailty frequency are heterogeneous and mostly based on cross-sectional studies. Little is known about frailty development and progression over time. Our aim was to conduct a systematic analysis of frailty prevalence and incidence in a large cohort of older adults and to evaluate the association with incident disability, in order to tackle the current paucity and fragmentation of longitudinal data on frailty.

METHODS: As secondary analysis of the Italian Longitudinal Study on Aging (ILSA) population-based cohort (n = 5,632, 65-84), frailty status was operationalized according to Fried criteria (n = 2,457). Weighted prevalence and incidence rates were calculated at each ILSA wave (T0 1992-1993, T1 1995-1996, T2 2000-2001). The association with incident disability in Activities of Daily Living (ADL) or Instrumental Activities of Daily Living (IADL) was investigated through Cox proportional hazard models, controlling for possible confounders.

RESULTS: Prevalence of frailty and pre-frailty at baseline (mean age 71.6 years; women 58.9%) were 4.0% (95% confidence interval [CI]: 3.4-4.6) and 44.6% (95% CI: 43.1-46.1), respectively. Incidence rates per 1,000 person-years for the T0-T1 interval were 7.3 (95% CI: 5.2-9.3) for frailty and 83.7 (95% CI: 73.6-93.8) for pre-frailty. Prevalence and incidence of frailty, and to a lesser degree of pre-frailty, were overall higher for women and increased with age, yet no increasing trend with advancing age was detected for pre-frailty incidence. Frailty incidence rates were significantly higher among pre-frail than non-frail individuals at follow-up entry. After full adjustment, being frail markedly increased the risk of incident disability in ADL (hazard ratio [HR] 3.58, 95% CI: 1.97-6.52) and IADL (HR 2.56, 95% CI: 1.58-4.16) over a 4-year period.

DISCUSSION/CONCLUSION: According to our findings, frailty is common among older people and is a strong and independent predictor of disability. Further research on factors and characteristics related to frailty progression, and especially remission, over time is crucial to calibrate effective public health preventive measures.

PMID:35871516 | DOI:10.1159/000525581

Clin Transl Sci. 2022 Jul 24. doi: 10.1111/cts.13378. Online ahead of print.

ABSTRACT

It is unclear whether activated partial thromboplastin time (APTT) is predictive of survival in acute pancreatitis(AP) patients. Our study aimed to investigate the relationship between APTT and short-term prognosis in AP. From the Medical Information Mart for Intensive Care (MIMIC)-IV database, a total of 844 patients with AP were randomly divided into the training cohort (n=591) and the validation cohort (n=253) at a ratio of 7:3. Based on their APTT values, the patients were divided into the normal and high groups. The primary outcome of this study was 30- and 60-day survival. Kaplan-Meier survival analysis and Cox regression models were used to analyze associations between groups and outcomes. The training and validation cohort matched well on all parameters(P > 0.05). In terms of 30- and 60-day survival, Kaplan-Meier survival curves from both training and validation cohorts demonstrated a lower survival probability for patients in the high APTT group than the normal group(Log-rank P <0.05). In the training cohort, patients in the high APTT group had a statistically significantly higher risk of death than those in the normal group after controlling for possible confounders in Cox regression(P < 0.05). For the high APTT group, the hazard ratios (95% CI) were 1.63(1.10, 2.61) (P=0.035) and 1.49(1.01, 2.38) (P=0.041), respectively. APTT performed as well as BISAP, Ranson, APACHE II models in predicting 30- and 60-day survival in patients with AP. The results above have been verified in the validation cohort. Prolonged APTT in patients with AP may increase the risk of short-term death.

PMID:35871496 | DOI:10.1111/cts.13378

Dermatol Ther. 2022 Jul 24:e15730. doi: 10.1111/dth.15730. Online ahead of print.

ABSTRACT

Bleomycin is a known chemotherapeutic agent which its beneficial effects have been recently shown in the treatment of keloids and hypertrophic scars, however, it is unclear how effective it is in comparison with corticosteroids. To compare the safety and efficacy of intralesional bleomycin vs. intralesional triamcinolone in the treatment of hypertrophic scars and keloids. 60 patients were divided into two groups and treated by intralesional injection of triamcinolone (20 mg/mL) or bleomycin (1.5 IU/mL). The treatments were repeated every 3 weeks until the lesions flattened or for a maximum of 6 sessions. The clinical improvement was evaluated using the Japan Scar Workshop scar scale (JSS) and the physician global assessment of flattening of the lesions. Side effects were also noted and recorded 55 patients completed the study, 4 patients from the bleomycin group and 1 patient from the triamcinolone group dropped out of the study. In both groups, the total JSS scores decreased significantly after treatment compared to baseline (P < 0.001); however, the difference between groups was not statistically significant after treatment (P = 0.052). Moreover, the degree of flattening of the lesions was comparable between groups (p = 0.933). Side effects in the triamcinolone group were Hypopigmentation(55.2%), atrophy(51.7%), and telangiectasia(41.4%) and in bleomycin group included persistent pain after injection (61.5%) ulceration (69.2%), hyperpigmentation(76.9%), and secondary infection (34.6%). Intralesional bleomycin (1.5 IU/mL) is effective as triamcinolone(20 mg/mL) in the treatment of keloids and hypertrophic scars, however, bleomycin should be used carefully, due to adverse events such as pain, ulceration, and hyperpigmentation. This article is protected by copyright. All rights reserved.

PMID:35871490 | DOI:10.1111/dth.15730