Category: Statistics

Wound Manag Prev. 2021 Nov;67(11):12-25.

ABSTRACT

BACKGROUND: Turning nursing home residents every 2 hours has been a long-held standard for pressure injury (PrI) prevention in individuals with mobility impairments although evidence to substantiate this practice is limited. New guidelines recommend personalizing turning schedules to support person-centered care but lack specific recommendations about which turning frequencies are appropriate for various risk levels.

PURPOSE: This quality improvement program aimed to determine the feasibility and outcomes of using individualized turn schedules for newly admitted nursing home residents.

METHODS: An expert panel of wound clinicians developed, tested, and implemented a turn frequency tool that allowed staff in 2 nursing homes to select a turning schedule of 1, 2, 3, or 4 hours based on resident risk factors. Turning schedules were operationalized using a wearable sensor-based visual cueing technology that alerted staff to resident repositioning needs. Nonparticipating resident data were collected for comparison of PrI incidence. Descriptive statistics were calculated for all covariates. Significance of differences tests were performed as appropriate.

RESULTS: Over 7 months, 154 residents had their turn period individualized, with 56% qualifying for 3-hour (Q3H) or 4-hour (Q4H) schedules. Facility-acquired PrI incidence was 94% lower in participants than in nonparticipants (P < .0001). Use of 3-hour and 4-hour intervals saved roughly 21 and 35 minutes of staff time, respectively, per resident per shift.

CONCLUSION: Individualizing turning schedules is feasible. Residents with longer turning intervals did not develop PrIs, supporting previous studies about safely extending turning periods for most residents.

PMID:35030094

J Med Life. 2021 Sep-Oct;14(5):710-715. doi: 10.25122/jml-2021-0304.

ABSTRACT

Cancer testis antigens have been discovered in various cancers, and several studies have suggested that since they exhibit such distinct patterns of expression, these antigens might be attractive targets for cancer detection and immunotherapy. Our work attempted to clarify the function played by cancer-testis antigens in ovarian cancers, notably in the XAGE1 gene. The investigation was conducted on 74 tissue samples from newly diagnosed patients with ovarian cancer. The control group included twenty-eight benign ovarian tumors. The expression of XAGE1 mRNA was assessed using RT-PCR. Compared to benign tumors, cancer samples exhibited higher levels of XAGE1 gene expression, which was statistically significant (P0.01). There were no statistically significant differences between menopausal status and family history. Gene expression was substantially connected with age groups as the higher level of gene expression in patients 50-74 years of age (P 0.01) was seen. Mucinous tumors exhibited significant correlations (P0.01) across histopathological tumor types. In correlation with tumor stages, stage III was substantially linked compared to stage I (P0.01). In conclusion, we referred to the potential to use XAGE1 to discriminate malignant ovarian tumors as a diagnostic biomarker. The connection of high XAGE 1 level with advanced ovarian cancer stages has also been established, supporting XAGE 1’s proposed role in poor prognosis. Finally, finding the specific involvement of this gene in ovarian cancer and other kinds of malignancies may require further investigations.

PMID:35027975 | PMC:PMC8742904 | DOI:10.25122/jml-2021-0304

J Med Life. 2021 Sep-Oct;14(5):695-699. doi: 10.25122/jml-2021-0052.

ABSTRACT

Over the last ten years, the incidence of the pathology of the bronchus-pulmonary system in children has increased 3.6 times, mainly due to acute and recurrent inflammatory diseases of the upper and lower respiratory tract. Thus, the problem of identifying children with recurrent episodes of acute obstructive bronchitis and an increased risk of developing asthma is relevant and promising. The goal of this study was to find molecular genetic markers associated with increased susceptibility of children to repeated episodes of acute obstructive bronchitis. The molecular genetic testing of the IL4 gene of a single nucleotide polymorphism C-33T was performed in 35 children with recurrent episodes of acute obstructive bronchitis and 35 children with acute bronchitis. The results were statistically processed on a personal computer with the calculation of values the arithmetic mean (M), of the errors arithmetic mean (m), Student criterion (t), the degree of probability (p), Pearson criterion (χ²), and the odds ratio (OR). Statistically significant differences were figured at p<0.01 and p<0.05. It has been proved that the presence of a child’s genotype 33CT IL4 increases the risk of recurrent acute obstructive bronchitis four times.

PMID:35027973 | PMC:PMC8742891 | DOI:10.25122/jml-2021-0052

J Med Life. 2021 Sep-Oct;14(5):700-709. doi: 10.25122/jml-2021-0362.

ABSTRACT

The main aim of this study is to systematically record Cerebrolysin treatment modalities and concomitant medication, according to local standards, in patients with moderate to severe neurological deficits after acute ischemic stroke and to assess the impact of these parameters on therapy outcome during early rehabilitation (day 21) and on day 90. An open observational treatment design based on the principles of high-quality comparative effectiveness research (HQCER) has been chosen to capture the therapies as applied in real-world clinical practice. HQCER opens a new horizon for strengthening the validity of the results from observational trials, thereby enhancing the associated level of evidence. Rigorous pre-specification of analytical procedures and tight risk-based centralized monitoring were additional measures to improve the impact of the observational approach. The value for real-world studies has become obvious, and such studies based on comparative effectiveness designs supplement the classical study designs by enabling the inclusion of larger proband numbers and more statistical reliability for practical use.

PMID:35027974 | PMC:PMC8742899 | DOI:10.25122/jml-2021-0362

J Med Life. 2021 Sep-Oct;14(5):667-675. doi: 10.25122/jml-2021-0115.

ABSTRACT

This study aimed to investigate the expression level of miR-126 in children with psoriasis in the epidermis affected by psoriasis and intact buccal epithelium, establish the impact on the characteristics of the course of psoriasis and the results of therapy in children with psoriasis of initial expression levels of miR-126. miR-126 expression levels in psoriatic keratinocytes and buccal epithelium were determined in 54 children with psoriasis on the severity of psoriasis, treatment efficacy. miR-126 levels in the buccal epithelium in children with psoriasis were reduced compared to healthy children (AUC=0.776±0.048, p<0.001). There were no discrepancies between miR-126 expression levels in psoriatic keratinocytes and buccal epithelium (p=0.097). There are statistically significant discrepancies between miR-126 expression levels in the psoriatic epidermis depending on the clinical form of psoriasis (AUC=0.637±0.056; p=0.014) and severity according to BSA (AUC=0.634±0.063; p=0.034). Depending on the miR-126 level in the buccal epithelium, the response to treatment (PASI<75) in children with high miR-126 is worse than in children with expected miR-126 levels (OR 2.79; 95%; CI: 1.19 – 6.51). Treatment failures were observed in children with high levels of miR-126 in the buccal epithelium compared to miR-126 in the psoriatic epidermis: children aged 12/13 to 17 years (OR 2.44; 95% CI: 1.02 – 5.85), children with PGA=4 (OR 3.16; 95% CI: 1.34 – 7.43). The location and level of miR-126 expression affects the course of psoriasis and the outcome of treatment. High levels of miR-126 in psoriatic keratinocytes lead to manifestations of plaque psoriasis with a course of moderate to severe forms. Initial miR-126 levels in the buccal epithelium in children with psoriasis are a prognostic criterion for response to therapy and can be used as a marker for prescribing systemic treatment.

PMID:35027969 | PMC:PMC8742889 | DOI:10.25122/jml-2021-0115

Comput Math Methods Med. 2022 Jan 4;2022:5784283. doi: 10.1155/2022/5784283. eCollection 2022.

ABSTRACT

PURPOSE: This research was designed to investigate the protective effect of rifampicin (RIF) loaded by N-(2-hydroxypropyl) methylacrylamide- (HPMA-) polylactic acid (PLA) nanopolymer on macrophages infected with Mycobacterium tuberculosis (MTB).

METHODS: We first induced H37Rv to infect macrophages to build a cell model. Then, the HPMA-PLA nanopolymer loaded with RIF was prepared to treat MTB-infected macrophages. The macrophage activity was tested by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, the nitric oxide (NO) in cells was measured through Griess reagent, and the bacterial activity of MTB was observed via the colony-forming unit (CFU) assay. The inflammation-related factors in cells were detected via the enzyme-linked immunosorbent assay (ELISA), the apoptosis of macrophages was examined via flow cytometry, and the expression of apoptosis-related proteins was determined by western blot (WB).

RESULTS: HPMA-PLA had no obvious toxicity to macrophages. The expression of NO and inflammatory factors in macrophages infected with MTB increased significantly, but the apoptosis rate was not significantly different from that of uninfected cells. However, after treatment with HPMA-PLA-RIF or free RIF, the inflammatory reaction of infected cells was inhibited, the expression of NO was decreased, the apoptosis rate was increased, and the bacterial activity in cells was decreased, with statistically significant differences; moreover, HPMA-PLA-RIF was more effective than free RIF.

CONCLUSIONS: HPMA-PLA-RIF has a high protective effect on macrophages infected with MTB, with high safety. Its protective mechanism is at least partly through inhibiting the production of NO and inflammatory response, which can inhibit bacterial activity and induce cell apoptosis.

PMID:35027942 | PMC:PMC8752210 | DOI:10.1155/2022/5784283

J Renin Angiotensin Aldosterone Syst. 2021 Dec 28;2021:1829873. doi: 10.1155/2021/1829873. eCollection 2021.

ABSTRACT

BACKGROUND: The efficacy of sacubitril/valsartan, a newly introduced combination drug for heart failure with reduced ejection fraction (HFrEF), was demonstrated in the PARADIGM-HF trial conducted in Western countries. However, these findings need to be verified in the Middle Eastern context, where patients may exhibit a different response due to different environmental and racial factors.

OBJECTIVES: The goal of this study was to evaluate the efficacy of submaximal sacubitril/valsartan doses in terms of improving the disease symptoms, as measured by the New York Heart Association (NYHA) classification and left ventricular ejection fraction (LVEF) percentage, as well as establish long-term morbidity and mortality associated with HFrEF among Palestinian patients administered target doses of an angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARBs). Material and Methods. This study involved a retrospective review of charts related to patients with HFrEF maintained on sacubitril/valsartan and was conducted in a referral cardiology clinic in Palestine. The inclusion criteria were age 18+, HFrEF diagnosis, sacubitril/valsartan usage for at least six months during the period between January 1, 2016, and June 30, 2019, and LVEF < 40%. The exclusion criteria included LVEF ≥ 40% and drug administration duration < 6 months. The collected data included NYHA class, as well as LVEF, serum sodium (Na), potassium (K), serum creatinine (Cr), and blood urea nitrogen (BUN) levels and the mortality rate before and after the minimum treatment duration. IBM SPSS STATISTICS for Windows, version 20.0, Armonk, NY: IBM Corp. IBM Corp., released 2012, was used for data analysis, whereby T score was calculated for comparisons between numerical groups, and p < 0.05 was considered statistically significant.

RESULTS: The initial study sample comprised of 205 consecutive patients with HFrEF maintained on sacubitril/valsartan for at least six months from January 1, 2016, to June 30, 2019. Three patients were excluded due to attrition, along with further 12 patients with LVEF ≥ 40% (based on the PARADIGM-HF trial criteria). Throughout the treatment period, most patients showed escalating improvement in terms of the LVEF and NYHA classification, as LVEF = 29.8% and NYHA = 3 were obtained on average before initiating sacubitril/valsartan, compared to 41% and 1.7, respectively, after 6-month treatment (p = 0.0003 and 0.046, respectively). These improvements in LVEF and NYHA class were noted across all sacubitril/valsartan doses (50-400 mg). However, 23 patients (12%) died while undergoing sacubitril/valsartan treatment.

CONCLUSION: A significant long-term reduction in the mortality and morbidity rates was observed in Palestinian patients with HFrEF maintained on submaximal doses of sacubitril/valsartan.

PMID:35027945 | PMC:PMC8727118 | DOI:10.1155/2021/1829873

J Oncol. 2022 Jan 4;2022:4984866. doi: 10.1155/2022/4984866. eCollection 2022.

ABSTRACT

BACKGROUND: Studies have found that the abnormality of the Hedgehog signaling pathway is related to the occurrence and development of a variety of tumors, but the effect of this signaling pathway on melanoma cells is still unclear.

METHODS: This study aimed to discuss the effect of Hedgehog signaling pathway on the proliferation and apoptosis of human malignant melanoma A375 cells and explore its possible mechanism in the proliferation and apoptosis of melanoma cells. Different concentrations of Hedgehog signaling pathway inhibitor cyclopamine (5, 10, 20 and 40 μM) were used to treat human melanoma A375 cells for 24, 48, and 72 h, and set a blank control group (0 μM). Trypan blue cell counting method was used to detect cell viability. MTT method was used to detect the inhibition rate of cell proliferation. Transwell was used to detect cell invasion, and flow cytometry was used to detect cell apoptosis.

RESULTS: Through the trypan blue cell counting method and MTT experiment, it was found that the Hedgehog signaling pathway inhibitor cyclopamine has an inhibitory effect on the proliferation and viability of melanoma A375 cells (P < 0.05), and the proliferation inhibitory effect is enhanced with prolonged action time in a dose- and time-dependent manner. Transwell experiment showed that compared with the blank control group, the invasion and migration ability of the treated melanoma A375 cells are significantly reduced, and the difference is statistically significant (P < 0.05). Cell apoptosis experiment showed that compared with the blank control group, the apoptosis rate of A375 cells is significantly higher after treated by 40 μM cyclopamine for 24 h, and the difference is statistically significant (P < 0.05). Gli1 and Bcl-2 protein are highly expressed in melanoma A375 cells, and their expressions show a downward trend (P < 0.05) after being treated by cyclopamine.

CONCLUSION: Cyclopamine inhibits cell proliferation and induces cell apoptosis by downregulating Gli1. Hedgehog signaling pathway can be used as a new target for the treatment of malignant melanoma, and multiple measures can be used to inhibit the signaling pathway to achieve a therapeutic effect.

PMID:35027924 | PMC:PMC8752239 | DOI:10.1155/2022/4984866

Int J Dent. 2022 Jan 3;2022:7239339. doi: 10.1155/2022/7239339. eCollection 2022.

ABSTRACT

Mandibular third molar surgical extraction, either partially erupted or fully impacted, is the most common surgical procedure in oral and maxillofacial surgery (OMFS). However, this procedure can be associated with many postoperative complications including persistent pain, swelling, trismus, and paresthesia due to nerve injury. This study aimed to identify the correlation of postoperative complications with patient’s age, sex, and surgical difficulty level. This study was a cross-sectional retrospective and single-center research conducted on patients with a history of mandibular third molar surgical extraction in the period between 2017 and 2019 at Dental and Oral Hospital Universitas Airlangga, Surabaya, Indonesia. The researchers assessed the factors of age, sex, and surgical difficulty level regarding postoperative complications on the first day of the surgery and after one week on the 7th day of it. Among 916 respondents, the majority of the sample was females (59%) and the dominant age group (60.9%) was the age group of 21-30 years while the dominant surgical difficulty level was shown by the advanced cases group (77%). The statistical analysis showed that there was a significant correlation between surgical difficulty level and postoperative complications including pain, trismus, and paresthesia on the first-day assessment. On the other hand, age was significantly related to complications like pain, swelling, and trismus on the first-week assessment. Age and surgical difficulty level were the most common risk factors of the mandibular third molar extraction postoperative complications. Dentists should take into consideration that older patients (≥51 years) and patients with complex surgical level are more vulnerable to severe postoperative complications.

PMID:35027927 | PMC:PMC8749374 | DOI:10.1155/2022/7239339

Front Endocrinol (Lausanne). 2021 Dec 28;12:725202. doi: 10.3389/fendo.2021.725202. eCollection 2021.

ABSTRACT

OBJECTIVE: To investigate the effect of two treatments on the outcome of freeze-thaw embryo transfer for pregnancy assistance in thin endometrium.

METHODS: A retrospective study was conducted on 66 patients who failed in the first cycle treated in the reproductive medicine center of the Second Hospital of Hebei Medical University from January 2018 to December 2019. Granulocyte colony stimulating factor (G-CSF) was used through cavity infusion in one group (n=25, and growth hormone (GH) was subcutaneously injected in the group (n=41). The clinical data of the two groups were compared, including morphology and thickness of the endometrium, biochemical pregnancy rate, clinical pregnancy rate, implantation rate, miscarriage rate, and live birth rate in each period of the hormone replacement cycle.

RESULTS: There was no significant difference in age, BMI, AMH, FSH, LH, E₂, infertility years, number of transferred embryos, basal endometrium, and thickness of endometrium on the day of P administration before and after treatment (P> 0.05). After treatment, compared to the GH group, the G-CSF group presented higher biochemical pregnancy rate (56% versus 48.8%; P=0.569), clinical pregnancy rate (52% versus 46.3%; P=0.655), implantation rate (34.8% versus 27.5%; P=0.391), and live birth rate (40% versus 31.7%; P=0.493), but the differences were not statistically significant (P > 0.05). On the 5th day of treatment, the endometrial thickness in the G-CSF group was thinner than that in the GH group (4.83 ± 0.85 versus 5.75 ± 1.27; P< 0.05), but it had no correlation with pregnancy outcome (P > 0.05). There was no significant difference in endometrial thickness between the two groups on the 7th, 9th day of treatment and the day of P administration (P > 0.05). On the 5th day of treatment, the proportion of endometrial type A morphology in the GH group was significantly higher than that in the G-CSF group (P < 0.05), while the type B morphology in the G-CSF group was significantly higher than that in the GH group (P< 0.05).

CONCLUSION: Although G-CSF and GH may not have a role in increasing endometrium, both of them can improve the pregnancy outcomes of patients with thin endometrium in the FET cycle. And the effects of the two treatments were similar.

PMID:35027908 | PMC:PMC8750567 | DOI:10.3389/fendo.2021.725202