Category: Statistics

J Cosmet Dermatol. 2022 Apr 7. doi: 10.1111/jocd.14973. Online ahead of print.

ABSTRACT

BACKGROUND: Acne tarda (AT) is typically known as adult acne and most preferably affected 25-45 age groups. Used isotretinoid mono-therapy is not effective and also produces side effects from long treatment.

AIM: The present study assesses the effectiveness of combined treatment of oral isotretinoid with topical chemical peeling (20% salicylic and 10% mandelic acid known as SM peeling) by a comparative double-blind randomized single-center interventional open-label study.

MATERIALS AND METHODS: A total fifty-eight participants AT outpatients (25-45 age-groups) attending for diagnosis in two groups and effectiveness of proposed combined treatments were determined at baseline and follow-up within 4weeks interval. Briefly group A (n=28) received 0.5 mg/kg of oral isotretinoin once daily for sixteen weeks and group B (n=30) received the same oral dose, addition with SM peeling every four weeks interval for sixteen weeks. After four weeks, treatment efficacy was assessed based on Michelson’s acne severity index (MASI) and visual analog scale (VAS), further validated using statistical tools.

RESULTS: Based on MASI and VAS scores, combined treatment was significantly effective than the monotherapy. The pre- and post-treatment analyses of response to scarring, inflammatory components at baseline and at the end of treatment were also statistically significant with p>0.008.

CONCLUSION: The above investigation revealed that the combination of oral isotretinoin with SM peeling was highly effective and could be used as newer therapy against AT without any serious side effects.

PMID:35388606 | DOI:10.1111/jocd.14973

Oral Dis. 2022 Apr 7. doi: 10.1111/odi.14203. Online ahead of print.

ABSTRACT

OBJECTIVE: Tumor-stroma Ratio(TSR) is a promising parameter representing the abundance of the stroma which has been validated in many solid tumors. However, it is still not clear which part of stroma mainly contribute to the prognostic value of TSR. The aim of this study is to confirm the prognostic value of TSR in a large cohort of oral squamous cell carcinoma (OSCC) and further demonstrated that cancer associated fibroblasts (CAFs)-stroma ratio (CSR) contributed to the prognostic value of TSR.

MATERIALS AND METHODS: TSR was evaluated on hematoxylin and eosin-stained tissue samples from 581 patients with OSCC, which divides patients into high (>50%) and low (<50%) stroma. Then, CSR was estimated on immunohistochemical staining slides of 100 patients selected from 581patients.

RESULTS: In multivariate analysis, TSR was identified as an independent prognostic factor for disease-free survival (DFS) (P < 0.001) and oral cancer-specific survival (OCSS) (P < 0.001). The interaction term reached statistical significance for histological grade for DFS and OCSS separately. Furthermore, the high-stroma group had a higher CSR than the low-stroma group.

CONCLUSION: The prognostic value of TSR is validated in OSCC particularly in moderate and high differentiation. And CSR palys its part in the prognosis of TSR.

PMID:35388593 | DOI:10.1111/odi.14203

Orthop Surg. 2022 Apr 7. doi: 10.1111/os.13231. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the learning curve of total hip arthroplasty in direct anterior approach (DA-THA) without requiring corrective osteotomy for patients with unilateral developmental dysplasia of the hip (DDH) through the evaluation of clinical and radiographic results.

METHOD: From December 2015 to January 2021, we retrospectively evaluated a surgeon’s first 100 patients with unilateral hip dysplasia (Crowe I-III) who underwent DA-THA. All procedures were performed by a fellowship-trained joint surgeon. Cementless hemispheric porous-coated acetabular cups and tapered cementless stems were used in all hips. The radiographic data, including leg length, the height of the center of rotation, femoral head offset, the cup anteversion and inclination angle, were measured. The cumulative sum analysis (CUSUM) and risk-adjusted cumulative sum analysis (RA-CUSUM) were used to determine the learning curve of DA-THA for each patient’s operation time. By analyzing the operation time, complication rate, postoperative length of hospitalization and creatine kinase (before surgery and the third day after surgery), estimated blood loss, Harris score, radiographic data were compared between the different stages of the learning curve.

RESULTS: The mean follow-up time was 35.45 ± 16.82 months. The CUSUM method obtained the maximum turning point of the curve at 43 cases, which divided the learning curve into Learning Period and Mastery Period. The CUSUM learning curve was best modeled as a cubic curve with the equation: CUSUM (min) = 0.001x³ – 0.495x² + 33.60x – 10.00, which had a higher R² value of 0.967. The pre-operative data, creatine kinase, estimated blood loss and postoperative Harris scores of the two stages were not statistically significant (P > 0.05). The mean operation time was 118 min in the Learning Period and 87 min in the Mastery Period. Statistically significant differences were detected in the operation time (P < 0.001), postoperative length of hospitalization(P = 0.024), and postoperative leg length discrepancy (P = 0.012) between the two stages. The overall complication rates were 27.9% in the Learning Period and 12.3% in the Mastery Period (p = 0.049). The overall outliers of radiographic data were 34 cases in the Learning Period and 31 cases in the Mastery Period (79.07% vs 54.39%, P = 0.010).

CONCLUSIONS: The DA-THA is a valuable alternative to achieve satisfactory clinical results for mild-to-moderate DDH patients. Furthermore, accurate analysis of the learning curve of DA-THA for hip dysplasia by the CUSUM method showed that the surgeons need to finish about 43 cases to master the technique.

PMID:35388599 | DOI:10.1111/os.13231

Hemodial Int. 2022 Apr 6. doi: 10.1111/hdi.13012. Online ahead of print.

ABSTRACT

INTRODUCTION: Post-dialysis recovery time (DRT) has an important relationship to quality of life and survival, as identified in studies of ESRD patients on conventional dialysis. ESRD patients are often discharged from hospitals to skilled nursing facilities (SNFs) where on-site treatment using home hemodialysis technology is increasingly offered, but nothing is known about DRT in this patient population.

METHODS: From November 4, 2019 to June 11, 2021, within a dialysis organization providing service across 12 states and 154 SNFs, patients receiving in-SNF, more frequent dialysis (MFD) (modeled to deliver 14 treatment hours minimum per week and stdKt/V ≥2.0) were asked to describe their post-dialysis recovery time following their previous treatment, within predefined categoric choices: 0-½, ½-1, 1-2, 2-4, 4-8, 8-12 h, by next morning, or not even by next morning. Patients reporting DRT following at least one full-week treatment opportunity were included in a mixed model logistic regression of rapid recovery (DRT ≤2 h).

FINDINGS: Two thousand three hundred and nine patients met the statistical modeling inclusion criteria, providing DRT on 108,876 dialysis sessions, while receiving mean (SD) 4.3 (0.96) weekly dialysis treatments. 2118 (92%) reported DRT ≤2 h. Results appeared biologically plausible, as lower odds of rapid DRT were observed for patients who were older, missed their previous treatment, or experienced intradialytic hypotension. Greater odds of rapid DRT were observed in patients receiving five dialyses in the previous week or having 160-179 mmHg pre-hemodialysis systolic blood pressure. Rapid recovery was associated with reduced mortality or hospitalization.

DISCUSSION: SNF dialysis patients receiving 5x per week MFD report rapid recovery time ≤2 h in 92% of dialyses despite advanced age, frailty, and comorbidities. Future studies will assess the practical ramifications of rapid DRT perception/experience on nursing home rehabilitation programs, which could impact patient health beyond the nursing home stay.

PMID:35388580 | DOI:10.1111/hdi.13012

J Obstet Gynaecol Res. 2022 Apr 6. doi: 10.1111/jog.15257. Online ahead of print.

ABSTRACT

OBJECTIVE: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a bleeding disease that can cause fetal hydrops, a rare but life-threatening condition in which abnormal amounts of fluid accumulate in one or two areas of the fetus’s body. A case of FNAIT with fetal hydrops caused by anti-HPA-15b antibodies was involved in this study, as we investigated whether or not anti-HPA-15b antibodies can induce endothelial angiogenesis and apoptosis.

METHODS: The monoclonal antibody immobilization of platelet antigens assay (MAIPA) was used to identify anti-HPA-15b antibodies. The three groups in Tube formation and apoptosis assays were the PBS group, the AB serum IgG group, and the anti-HPA-15b serum IgG group, all reacted with HPA-15bb HUVEC.

RESULTS: The presence of anti-HPA-15b antibodies was found in this case by MAIPA assay. The OD values are 0.33 and 0.21, reacted with HPA-15bb and HPA-15ab platelets, respectively (cutoff OD value = 0.2). Quantitative analysis revealed that the length of capillary-like tube induced by anti-HPA-15b antibodies was significantly decreased over that of AB serum IgG (*p = 0.0005), but weaker than when incubated with thrombin (**p = 0.0009). The apoptosis results show a significantly increased number of apoptotic endothelial cells in the anti-HPA-15b antibody IgG group when compared with the PBS and AB serum IgG groups (*p < 0.0001, **p < 0.0001). In addition, there is no statistical difference between the PBS and AB serum groups.

CONCLUSION: Anti-HPA-15b antibodies can inhibit angiogenesis and induce apoptosis. This may associate with hydrops fetalis (HF), or fetal hydrops of FNAIT.

PMID:35388576 | DOI:10.1111/jog.15257

NMR Biomed. 2022 Apr 6. doi: 10.1002/nbm.4738. Online ahead of print.

ABSTRACT

PURPOSE: Diffusion-weighted imaging (DWI)-based thermometry offers potential as a non-invasive method for measuring temperatures deep inside the human brain. However, DWI might be influenced by the pulsatile flow of cerebrospinal fluid (CSF). This study aimed to investigate the influence of such pulsations on DWI thermometry in healthy individuals.

MATERIALS AND METHODS: A total of 104 participants (50 men, 54 women; mean (± standard deviation) age, 44.2 ± 14.3 years; range 21-69 years) were investigated. DWI-based brain temperature (T_DWI ) was acquired at three speeds (maximum and minimum speeds of ascending flow and random timing at the cerebral aqueduct) of CSF pulsation using a 3.0-T magnetic resonance imaging scanner. Magnetic resonance spectroscopy (MRS)-based temperature (T_MRS ) at the thalamus was also obtained as a reference standard for brain temperature. The three different CSF pulsatile flows were monitored by heart rate during the scan. The difference between reference temperature and brain temperature (ΔT = T_DWI – T_MRS ) along with the three CSF speeds were statistically compared using Student’s matched pair t-test.

RESULTS: No significant difference in ΔT was evident among CSF speeds (P > 0.05). No significant linear correlation between ΔT and CSF flow speed at the cerebral aqueduct was observed.

CONCLUSION: Using DWI thermometry with clinical acquisition settings, which utilizes mean values within thresholds, no effect of CSF pulsation speed was observed in the estimation of ΔT.

PMID:35388508 | DOI:10.1002/nbm.4738

Am J Hum Biol. 2022 Apr 6:eajhb. doi: 10.1002/ajhb.23750. Online ahead of print.

ABSTRACT

OBJECTIVES: The secondary sex ratio (SSR, i.e., the number of male births per 100 female births) has long been proposed as a sentinel health indicator. Studies have suggested that exogenous environmental stressors reduce SSR after 3 to 6 months (via disproportionate male fetus deaths) and after 9 months (via reduced male conception). We aimed to examine whether SSR declined after the coronavirus disease 2019 (COVID-19) pandemic in Japan.

METHODS: We used monthly vital statistics records collected between January 2013 and April 2021 (the -number of male and female live births, in particular). Using information reported before the pandemic struck Japan (i.e., January 2013 to January 2020), we predicted SSRs for the months after the pandemic (i.e., February 2020 to April 2021) and compared reported and predicted SSRs. We also stratified the analysis by including two groups of prefectures with different degrees of possible influence from the pandemic.

RESULTS: We observed a significant reduction in SSR during December 2020 of 102.81 (i.e., 9-10 months after the pandemic affected the country), which was below the lower bound of the 95% prediction intervals (103.12-106.33). This was the lowest SSR observed during the 100-month study period. In addition, the reduction in SSR during December 2020 was more pronounced in the more seriously affected prefectures.

CONCLUSION: In Japan, we found a significant reduction in SSR (i.e., fewer male live births) 9-10 months after COVID-19 was declared a pandemic. This suggests the onset of the COVID-19 pandemic was a significant population-level stressor.

PMID:35388546 | DOI:10.1002/ajhb.23750

Perspect Psychiatr Care. 2022 Apr 6. doi: 10.1111/ppc.13075. Online ahead of print.

ABSTRACT

PURPOSE: This study was conducted using a descriptive design to examine the correlation between spousal support and postpartum depression (PPD) in fathers.

DESIGN AND METHODS: The participants of the study were the fathers of infants born in the obstetrics and gynecology clinic of a state hospital affiliated with the Ministry of Health in a province in Turkey.

FINDINGS: It was determined that while the possibility of paternal PPD was lower in the early postpartum period (p < 0.001), it increased in the late postpartum period (p < 0.001). A negative statistically significant correlation was identified between the Edinburgh Postnatal Depression Scale (EPDS) scores and the Spouse Support Scale (SSS) scores of the participants in the early postpartum period (p = 0.031). There was a highly negative significant correlation between late postpartum EPDS scores and the early (p < 0.001) and late period (p < 0.001) SSS scores. A highly negative significant correlation was observed between the mean score of the early spousal support period and the mean score of the late spousal support period (p < 0.001). In this study, spousal support decreased PPD in fathers.

PRACTICE IMPLICATIONS: This study indicated the necessity of routinely screening men for PPD symptoms. Early diagnosis and spousal support would contribute to reducing early and late paternal PPD, thus protecting the family’s integrity.

PMID:35388478 | DOI:10.1111/ppc.13075

J Neurol Surg A Cent Eur Neurosurg. 2022 Apr 6. doi: 10.1055/s-0042-1743515. Online ahead of print.

ABSTRACT

BACKGROUND: We evaluate the feasibility of a single-stage posterior corpectomy and circumferential arthrodesis with the aid of spinal navigation for the treatment of traumatic thoracolumbar burst fractures.

METHODS: This was a single-center, retrospective study. Demographics, clinical, and radiologic data of 19 patients who underwent surgery at our institution for thoracolumbar burst fractures between 2016 and 2019 were collected. All patients enrolled in the present study underwent surgery by means of posterior fixation and transpedicular corpectomy with the aid of an intraoperative image-guided neuronavigation system.

RESULTS: Postoperative correction of the vertebral height ratio was achieved in all cases, with an average increase of 23.6% (p = 0.0005). No statistical differences (p = 0.9) were found comparing 1- and 3-month postoperative CT scans, in relation to vertebral height ratio. A statistically significant difference was found between the pre- and postoperative kyphotic angles for the thoracolumbar and lumbar segments (p = 0.0018 and 0.005, respectively), but no difference was found between kyphotic angles at the 3-month follow-up. A unilateral approach was performed on 15 patients (79%), while 4 cases (21%) required a bilateral laminectomy. We did not observe any significant intraoperative complication.

CONCLUSION: Single-stage posterior corpectomy and fixation is a safe and effective approach for thoracic and lumbar burst fractures. It provides excellent 360-degree reconstruction in a single surgical stage with satisfactory results in terms of kyphosis reduction, biomechanical stability, and reduced invasiveness. Spinal navigation represents a fundamental tool to overcome some anatomical limits of the presented technique.

PMID:35388449 | DOI:10.1055/s-0042-1743515

J Anim Ecol. 2022 Apr 7. doi: 10.1111/1365-2656.13698. Online ahead of print.

ABSTRACT

1. Individual decisions regarding how, why, and when organisms interact with one another and with their environment scale up to shape patterns and processes in communities. Recent evidence has firmly established the prevalence of intraspecific variation in nature and its relevance in community ecology, yet challenges associated with collecting data on large numbers of individual conspecifics and heterospecifics has hampered integration of individual variation into community ecology. 2. Nevertheless, recent technological and statistical advances in GPS-tracking, remote sensing, and behavioral ecology offer a toolbox for integrating intraspecific variation into community processes. More than simply describing where organisms go, movement data provide unique information about interactions and environmental associations from which a true individual-to-community framework can be built. 3. By linking the movement paths of both conspecifics and heterospecifics with environmental data, ecologists can now simultaneously quantify intra- and interspecific variation regarding the Eltonian (biotic interactions) and Grinnellian (environmental conditions) factors underpinning community assemblage and dynamics, yet substantial logistical and analytical challenges must be addressed for these approaches to realize their full potential. 4. Across communities, empirical integration of Eltonian and Grinnellian factors can support conservation applications and reveal metacommunity dynamics via tracking-based dispersal data. As the logistical and analytical challenges associated with multi-species tracking are surmounted, we envision a future where individual movements and their ecological and environmental signatures will bring resolution to many enduring issues in community ecology.

PMID:35388473 | DOI:10.1111/1365-2656.13698