Category: Statistics

Int J Retina Vitreous. 2022 Jun 7;8(1):35. doi: 10.1186/s40942-022-00388-y.

ABSTRACT

BACKGROUND: To evaluate the efficacy of retinal photography obtained by undergraduate students using a smartphone-based device in screening and early diagnosing diabetic retinopathy (DR).

METHODS: We carried out an open prospective study with ninety-nine diabetic patients (194 eyes), who were submitted to an ophthalmological examination in which undergraduate students registered images of the fundus using a smartphone-based device. At the same occasion, an experienced nurse captured fundus photographs from the same patients using a gold standard tabletop camera system (Canon CR-2 Digital Non-Mydriatic Retinal Camera), with a 45º field of view. Two distinct masked specialists evaluated both forms of imaging according to the presence or absence of sings of DR and its markers of severity. We later compared those reports to assess agreement between the two technologies.

RESULTS: Concerning the presence or absence of DR, we found an agreement rate of 84.07% between reports obtained from images of the smartphone-based device and from the regular (tabletop) fundus camera; Kappa: 0.67; Sensitivity: 71.0% (Confidence Interval [CI]: 65.05-78.16%); Specificity: 94.06% (CI: 90.63-97.49%); Accuracy: 84.07%; Positive Predictive Value (PPV): 90.62%; Negative Predictive Value (NPV): 80.51%. As for the classification between proliferative diabetic retinopathy and non-proliferative diabetic retinopathy, we found an agreement of 90.00% between the reports; Kappa: 0.78; Sensitivity: 86.96%; (CI: 79.07-94.85%); Specificity: 91.49% (CI: 84.95-98.03%); Accuracy: 90.00%; PPV: 83.33%; NPV: 93.48%. Regarding the degree of classification of DR, we found an agreement rate of 69.23% between the reports; Kappa: 0.52. As relating to the presence or absence of hard macular exudates, we found an agreement of 84.07% between the reports; Kappa: 0.67; Sensitivity: 71.60% (CI: 65.05-78.16%); Specificity: 94.06% (CI: 90.63-97.49%); Accuracy: 84.07%; PPV: 90.62%; NPV: 80.51%.

CONCLUSION: The smartphone-based device showed promising accuracy in the detection of DR (84.07%), making it a potential tool in the screening and early diagnosis of DR.

PMID:35672839 | DOI:10.1186/s40942-022-00388-y

Stem Cell Res Ther. 2022 Jun 7;13(1):241. doi: 10.1186/s13287-022-02911-2.

ABSTRACT

BACKGROUND: Repairing radiation-induced bone injuries remains a significant challenge in the clinic, and few effective medicines are currently available. Psoralen is a principal bioactive component of Cullen corylifolium (L.) Medik and has been reported to have antitumor, anti-inflammatory, and pro-osteogenesis activities. However, less information is available regarding the role of psoralen in the treatment of radiation-induced bone injury. In this study, we explored the modulatory effects of psoralen on skeletal stem cells and their protective effects on radiation-induced bone injuries.

METHODS: The protective effects of psoralen on radiation-induced osteoporosis and irradiated bone defects were evaluated by microCT and pathological analysis. In addition, the cell proliferation, osteogenesis, and self-renewal of SSCs were explored. Further, the underlying mechanisms of the protective of psoralen were investigated by using RNA sequencing and functional gain and loss experiments in vitro and in vivo. Statistical significance was analyzed using Student’s t test. The one-way ANOVA was used in multiple group data analysis.

RESULTS: Here, we demonstrated that psoralen, a natural herbal extract, mitigated radiation-induced bone injury (irradiation-induced osteoporosis and irradiated bone defects) in mice partially by rescuing the stemness of irradiated skeletal stem cells. Mechanistically, psoralen restored the stemness of skeletal stem cells by alleviating the radiation-induced suppression of AKT/GSK-3β and elevating NRF2 expression in skeletal stem cells. Furthermore, the expression of KEAP1 in skeletal stem cells did not significantly change in the presence of psoralen. Moreover, blockade of NRF2 in vivo partially abolished the promising effects of psoralen in a murine model of irradiation-induced osteoporosis and irradiated bone regeneration.

CONCLUSIONS: In summary, our findings identified psoralen as a potential medicine to mitigate bone radiation injury. In addition, skeletal stem cells and AKT-GSK-3β and NRF2 may thus represent therapeutic targets for treating radiation-induced bone injury.

PMID:35672836 | DOI:10.1186/s13287-022-02911-2

BMC Complement Med Ther. 2022 Jun 7;22(1):151. doi: 10.1186/s12906-022-03637-7.

ABSTRACT

BACKGROUNDS: Asthma and idiopathic pulmonary fibrosis (IPF) are common chronic diseases of the respiratory system in clinical practice. However, the relationship and molecular links remain unclear, and the current treatment’s efficacy is disappointing. Bu-Shen-Yi-Qi (BSYQ) decoction has proven effective in treating various chronic airway inflammatory diseases, including asthma and IPF. But the underlying pharmacological mechanisms are still to be elucidated.

METHODS: This study searched the proteins related to asthma and IPF via TTD, CTD, and DisGeNET databases and then submitted to the STRING to establish the protein-protein interaction (PPI) network. The co-bioinformatics analysis was conducted by Metascape. The active ingredients of BSYQ decoction were screened from TCMSP, ETCM, BATMAN-TCM databases, and HPLC/MS experiment. The corresponding targets were predicted based on TCMSP, ETCM, and BATMAN-TCM databases. The shared targets for asthma and IPF treatment were recognized, and further GO and KEGG analyses were conducted with the DAVID platform. Finally, molecule docking via Autodock Vina was employed to predict the potential binding mode between core potential compounds and targets.

RESULTS: Finally, 1333 asthma-related targets and 404 IPF-related proteins were retrieved, 120 were overlapped between them, and many of the asthma-related proteins fall into the same statistically significant GO terms with IPF. Moreover, 116 active ingredients of BSYQ decoction were acquired, and 1535 corresponding targets were retrieved. Eighty-three potential compounds and 56 potential targets were recognized for both asthma and IPF treatment. GO and KEGG analysis indicated that the inflammation response, cytokine production, leukocyte differentiation, oxygen level response, etc., were the common pathological processes in asthma and IPF, which were regulated by BSYQ decoction. Molecule docking further predicted the potential binding modes between the core potential compounds and targets.

CONCLUSION: The current study successfully clarified the complex molecule links between asthma and IPF and found the potential common targets. Then we demonstrated the efficacy of BSYQ decoction for asthma and IPF treatment from the angle of network pharmacology, which may provide valuable references for further studies and clinical use.

PMID:35672815 | DOI:10.1186/s12906-022-03637-7

BMC Oral Health. 2022 Jun 7;22(1):224. doi: 10.1186/s12903-022-02254-7.

ABSTRACT

BACKGROUND: This study aimed to investigate the effect of enamel-surface modifications on the shear bond strength between ceramic brackets bonded using different adhesive materials and the enamel surface and to identify the most suitable clinical adhesive and bonding method. Whether the non-acid-etching treatment met the clinical bond strength was also determined.

METHODS: A total of 108 extracted premolars were divided into nine groups (n = 12) based on the different enamel-surface modification techniques (acid etching, deproteinization, and wetting). Group 1 was bonded with Transbond™ XT adhesive, whereas groups 2-9 were bonded with resin-modified glass ionomer cement (RMGIC). The treatment methods for each group were as follows: groups 1 and 2, acid etching; group 3, acid etching and wetting; group 4, acid etching and deproteinization; group 5, acid etching, deproteinization, and wetting; group 6, deproteinization; group 7, deproteinization and wetting; group 8, without treatment; and group 9, wetting. The samples’ shear bond strength was measured using an universal testing machine. Adhesive remnant index (ARI) was examined using a stereomicroscope. The enamel-surface morphology was observed with a scanning electron microscope. One-way ANOVA with Tukey’s post-hoc test and chi-square test were used for statistical analysis, and p < 0.05 and α = 0.05 were considered statistically significant.

RESULTS: The ARIs of groups 1-5 and 6-9 were statistically significant (p = 0.000). The enamel surface of groups 1-5 was demineralized, and only a tiny amount of protein remained in groups 7 and 8, whereas a thick layer of protein remained in groups 8 and 9.

CONCLUSIONS: RMGIC adhesive did not damage the enamel surface and achieved the required clinical bond strength. The enamel surface was better treated with 5.25% sodium hypochlorite preferably under non-acid-etching conditions.

PMID:35672818 | DOI:10.1186/s12903-022-02254-7

Adv Rheumatol. 2022 Jun 7;62(1):19. doi: 10.1186/s42358-022-00250-7.

ABSTRACT

BACKGROUND: Primary Sjögren syndrome (pSS) is a chronic autoimmune disease with its main target being exocrine glands, and is the connective tissue disease more frequently associated with other autoimmune diseases. The aim of this study was to assess the frequency of another autoimmune rheumatic disease (ARD) developed in primary Sjögren syndrome (pSS) patients and to describe it’s clinical, serological and histologic characteristics.

MATERIALS AND METHODS: This is a retrospective cohort study. Data of patients with pSS diagnosis (American-European criteria 2002), included in the GESSAR database (Grupo de Estudio Síndrome de Sjögren, Sociedad Argentina de Reumatología) were analyzed. The development of a second ARD was registered during the follow up.

RESULTS: 681 patients were included, 94.8% female. The mean age was 54 (SD 14) years and mean age at diagnosis of 50 (SD 13) years. The mean follow-up was 4.7 (SD 4.9) years; 30 patients (4.41%, CI 95%: 3.1-5.7) developed a second ARD during the follow up, incidence rate was 9.1/1000 patients-year (IR 95%: 5.8-12.4/1000 patients-year), the most frequent being rheumatoid arthritis (RA). 96% out of these 30 patients had xerophthalmia, 86.2% xerostomia, 92% positive Schirmer test, 88.24% positive Rosa Bengala test, lisamine green or Ocular Staining Score, 81.2% positive unstimulated salivary flow, 82.1% Ro(+) and 33.33% La(+). Minor salivary gland biopsy had been performed in 14 of the 30 patients, 12 with positive results. There were no statistically significant differences respect baseline characteristics when comparing the patients who developed another ARD to the ones that did not.

CONCLUSIONS: Of all the patients analyzed, 4.4% presented another ARD during their follow-up. It is important to be aware of this, to make an early and proper diagnosis and treatment of our patients.

PMID:35672809 | DOI:10.1186/s42358-022-00250-7

Stem Cell Res Ther. 2022 Jun 7;13(1):237. doi: 10.1186/s13287-022-02931-y.

ABSTRACT

BACKGROUND: Stem cell transplantation may improve visual acuity in patients with dry age-related macular degeneration. Herein, we aimed to summarise the evidence on the risks and benefits of stem cell transplantation for improving visual acuity, including the risk of adverse events.

METHODS: Data were obtained from the PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials databases, and each database was interrogated from the date of inception until 19 March 2022. The rates of visual acuity outcomes and adverse events associated with stem cell transplantation were examined. All statistical analyses were conducted using Review Manager 5.4. The study was registered with PROSPERO (CRD 42022322902).

RESULTS: The analysis examined 10 studies (102 patients), including one and three, randomised and non-randomised clinical trials, and one and five, multicentre prospective and prospective clinical trials, respectively. Meta-analysis showed changes in best-corrected visual acuity in the study eyes after stem cell transplantation (6 months: risk ratio [RR] = 17.00, 95% confidence interval [CI] 6.08-47.56, P < 0.00001; 12 months: RR = 11.00, 95% CI 2.36-51.36, P = 0.002). Subgroup analysis showed that different stem cell types achieved better best-corrected visual acuity at post-operative 6 months, compared to that observed at baseline. Four cases of related ocular adverse events and no related systemic adverse events were reported.

CONCLUSION: This meta-analysis suggests that stem cell transplantation may improve best-corrected visual acuity in dry age-related macular degeneration, based on small sample sizes and fewer randomised controlled trials.

PMID:35672801 | DOI:10.1186/s13287-022-02931-y

BMC Psychol. 2022 Jun 7;10(1):144. doi: 10.1186/s40359-022-00858-w.

ABSTRACT

BACKGROUND: Disclosing traumatic events experienced by parents to their children is a central issue in the intergenerational trauma transmission. However, little is known about this question among migrant population. The main objective of this study was to examine the choice to disclose the traumatic experiences of migrant women in France to their children.

METHODS: This pilot study examined fourteen mother-child dyads in which migrant mothers (M = 30 years; range = 19-42 years) were exposed to traumatic events. A sequential mixed method design was used. In addition to the completion of the Impact Event Scale-Revised, qualitative data were collected through semi-structured interviews. These data were analyzed using thematic and cross-cultural methods. The survey took place from May 2019 to July 2020.

RESULTS: Our study revealed three profiles of mothers with regard to the choice to disclose the traumatic story to the child: one group of mothers opted for silence (n = 4), the other for disclosure (n = 7) and the last group who were hesitant (n = 3). The modalities of choice were statistically associated with the severity of the post-traumatic stress symptoms, F (2, 11) = 4,62, p < .05. Specifically, women who made the choice of silence (M = 72.75, SD = 4.99) and those hesitated on the choice to disclosure (M = 71.33, SD = 7.51) reported higher scores on IES-R than those who made the choice to disclosure (M = 59.86, SD = 12.44). Six main themes emerged from the thematic and cross-cultural analysis of participants’ narratives: (1) the personalization of the traumatic experience, (2) the child seen as a weapon against collapse, (3) the fear of the child’s personal reactions, (4) the possible partial disclosure, (5) the trauma narrative according to the child’s age, and (6) the trap of the in-between two cultures.

CONCLUSION: Our results suggest that the recovery of these mothers from their trauma, through culturally appropriate therapeutic care, can effectively contribute to the choice to disclose their traumatic experiences to their children. This treatment can support them in developing open and healthy communication strategies to prevent the transmission of traumatic effects to their children.

PMID:35672800 | DOI:10.1186/s40359-022-00858-w

Genome Biol. 2022 Jun 7;23(1):127. doi: 10.1186/s13059-022-02694-y.

ABSTRACT

BACKGROUND: Multiple sclerosis (MS) is an autoimmune condition of the central nervous system with a well-characterized genetic background. Prior analyses of MS genetics have identified broad enrichments across peripheral immune cells, yet the driver immune subsets are unclear.

RESULTS: We utilize chromatin accessibility data across hematopoietic cells to identify cell type-specific enrichments of MS genetic signals. We find that CD4 T and B cells are independently enriched for MS genetics and further refine the driver subsets to T_h17 and memory B cells, respectively. We replicate our findings in data from untreated and treated MS patients and find that immunomodulatory treatments suppress chromatin accessibility at driver cell types. Integration of statistical fine-mapping and chromatin interactions nominate numerous putative causal genes, illustrating complex interplay between shared and cell-specific genes.

CONCLUSIONS: Overall, our study finds that open chromatin regions in CD4 T cells and B cells independently drive MS genetic signals. Our study highlights how careful integration of genetics and epigenetics can provide fine-scale insights into causal cell types and nominate new genes and pathways for disease.

PMID:35672799 | DOI:10.1186/s13059-022-02694-y

J Transl Med. 2022 Jun 7;20(1):261. doi: 10.1186/s12967-022-03458-9.

ABSTRACT

BACKGROUND: High immune infiltration is associated with favourable prognosis in patients with non-small-cell lung cancer (NSCLC), but an automated workflow for characterizing immune infiltration, with high validity and reliability, remains to be developed.

METHODS: We performed a multicentre retrospective study of patients with completely resected NSCLC. We developed an image analysis workflow for automatically evaluating the density of CD3⁺ and CD8⁺ T-cells in the tumour regions on immunohistochemistry (IHC)-stained whole-slide images (WSIs), and proposed an immune scoring system “I-score” based on the automated assessed cell density.

RESULTS: A discovery cohort (n = 145) and a validation cohort (n = 180) were used to assess the prognostic value of the I-score for disease-free survival (DFS). The I-score (two-category) was an independent prognostic factor after adjusting for other clinicopathologic factors. Compared with a low I-score (two-category), a high I-score was associated with significantly superior DFS in the discovery cohort (adjusted hazard ratio [HR], 0.54; 95% confidence interval [CI] 0.33-0.86; P = 0.010) and validation cohort (adjusted HR, 0.57; 95% CI 0.36-0.92; P = 0.022). The I-score improved the prognostic stratification when integrating it into the Cox proportional hazard regression models with other risk factors (discovery cohort, C-index 0.742 vs. 0.728; validation cohort, C-index 0.695 vs. 0.685).

CONCLUSION: This automated workflow and immune scoring system would advance the clinical application of immune microenvironment evaluation and support the clinical decision making for patients with resected NSCLC.

PMID:35672787 | DOI:10.1186/s12967-022-03458-9

Res Integr Peer Rev. 2022 Jun 7;7(1):3. doi: 10.1186/s41073-022-00122-0.

ABSTRACT

BACKGROUND: Structured, systematic methods to formulate consensus recommendations, such as the Delphi process or nominal group technique, among others, provide the opportunity to harness the knowledge of experts to support clinical decision making in areas of uncertainty. They are widely used in biomedical research, in particular where disease characteristics or resource limitations mean that high-quality evidence generation is difficult. However, poor reporting of methods used to reach a consensus – for example, not clearly explaining the definition of consensus, or not stating how consensus group panellists were selected – can potentially undermine confidence in this type of research and hinder reproducibility. Our objective is therefore to systematically develop a reporting guideline to help the biomedical research and clinical practice community describe the methods or techniques used to reach consensus in a complete, transparent, and consistent manner.

METHODS: The ACCORD (ACcurate COnsensus Reporting Document) project will take place in five stages and follow the EQUATOR Network guidance for the development of reporting guidelines. In Stage 1, a multidisciplinary Steering Committee has been established to lead and coordinate the guideline development process. In Stage 2, a systematic literature review will identify evidence on the quality of the reporting of consensus methodology, to obtain potential items for a reporting checklist. In Stage 3, Delphi methodology will be used to reach consensus regarding the checklist items, first among the Steering Committee, and then among a broader Delphi panel comprising participants with a range of expertise, including patient representatives. In Stage 4, the reporting guideline will be finalised in a consensus meeting, along with the production of an Explanation and Elaboration (E&E) document. In Stage 5, we plan to publish the reporting guideline and E&E document in open-access journals, supported by presentations at appropriate events. Dissemination of the reporting guideline, including a website linked to social media channels, is crucial for the document to be implemented in practice.

DISCUSSION: The ACCORD reporting guideline will provide a set of minimum items that should be reported about methods used to achieve consensus, including approaches ranging from simple unstructured opinion gatherings to highly structured processes.

PMID:35672782 | DOI:10.1186/s41073-022-00122-0