Tag: pubmed

Acta Oncol. 2024 Aug 8;63:642-648. doi: 10.2340/1651-226X.2024.40199.

ABSTRACT

PURPOSE AND OBJECTIVE: Squamous cell carcinoma of the anal margin (SCCAM) is an uncommon lesion that comprises one-third to a quarter of all anal squamous cell carcinoma. Treatment involves surgery or exclusive radiotherapy for small tumours, whereas the preferred treatment for larger tumours is chemoradiotherapy. In our department, selected patients with SCCAM are treated with electron beam radiotherapy using one perineal field. The present study evaluates this strategy.

MATERIAL AND METHODS: All consecutive patients with SCCAM and treated with electron beam radiotherapy from 2012 to 2022 were included. Data were retrospectively extracted from the medical records and analysed descriptively. Local control (LC) and overall survival (OS) were analysed using Kaplan-Meier statistics.

RESULTS: Forty patients were evaluated. Primary radiotherapy was delivered in 35 (87.5%) patients. Five (12.5%) patients had postoperative radiotherapy. Median prescription dose was 60.0 (range 45.0-60.2) Gy in 28 (range 10-30) fractions delivered with 8 (range 4-18) MeV using a standard circular aperture and bolus. At a median follow-up of 73 (range 9-135) months, 7 (17.5%) patients were diagnosed with local recurrences. The 5-year LC rate was 84.3% (95% CI: 71.4%-97.2%). Analysis of LC according to T-stage revealed a 5-year LC of 100% (95% CI: 100%-100%) in T1 tumours compared to 57.0% (95% CI: 27.4%-86.6%) in T2 tumours (p < 0.001). 5-year OS was 91.6% (95% CI: 83.0%-100%). Late grade 3 toxicity included ulceration in the skin and subcutis in 2 (5.0%) patients.

INTEPRETATION: Electron beam radiotherapy enables the delivery of ‘eye-guided’ radiotherapy directly to the tumour. LC is good in patients with T1 tumours. Patients with T2 tumours have less satisfactory LC and should be treated with chemoradiotherapy. Electron beam radiotherapy enables the delivery of “eye-guided” RT directly to the tumour. LC is excellent in patients with T1 tumours. Patients with T2 tumours have less satisfactory LC and should be treated with chemoradiotherapy.

PMID:39114949 | DOI:10.2340/1651-226X.2024.40199

JMIR Public Health Surveill. 2024 Aug 2;10:e53879. doi: 10.2196/53879.

ABSTRACT

BACKGROUND: Prior research has linked exposure to particulate matter with an aerodynamic diameter of ≤2.5 μm (PM2.5) with preterm birth (PTB). However, the modulating effect of preconception thyroid stimulating hormone (TSH) levels on the relationship between PM2.5 exposure and PTB has not been investigated.

OBJECTIVE: This study aimed to assess whether preconception TSH levels modulate the impact of PM2.5 exposure on PTB.

METHODS: This cohort study was conducted in Guangdong, China, as a part of the National Free Pre-Pregnancy Checkups Project. PM2.5 exposure was estimated by using the inverse distance weighting method. To investigate the moderating effects of TSH levels on trimester-specific PM2.5 exposure and PTB, we used the Cox proportional hazards model. Additionally, to identify the susceptible exposure windows for weekly specific PM2.5 exposure and PTB, we built distributed lag models incorporating Cox proportional hazards models.

RESULTS: A total of 633,516 women who delivered between January 1, 2014, to December 31, 2019, were included. In total, 34,081 (5.4%) of them had abnormal preconception TSH levels. During the entire pregnancy, each 10-μg/m3 increase in PM2.5 was linked to elevated risks of PTB (hazard ratio [HR] 1.559, 95% CI 1.390-1.748), early PTB (HR 1.559, 95% CI 1.227-1.980), and late PTB (HR 1.571, 95% CI 1.379-1.791) among women with abnormal TSH levels. For women with normal preconception TSH levels, PM2.5 exposure during the entire pregnancy was positively associated with the risk of PTB (HR 1.345, 95% CI 1.307-1.385), early PTB (HR 1.203, 95% CI 1.126-1.285), and late PTB (HR 1.386, 95% CI 1.342-1432). The critical susceptible exposure windows were the 3rd-13th and 28th-35th gestational weeks for women with abnormal preconception TSH levels, compared to the 1st-13th and 21st-35th gestational weeks for those with normal preconception TSH levels.

CONCLUSIONS: PM2.5 exposure was linked with a higher PTB risk, particularly in women with abnormal preconception TSH levels. PM2.5 exposure appears to have a greater effect on pregnant women who are in the early or late stages of pregnancy.

PMID:39114947 | DOI:10.2196/53879

Muscle Nerve. 2024 Aug 8. doi: 10.1002/mus.28209. Online ahead of print.

ABSTRACT

INTRODUCTION/AIMS: The single simple question (SSQ), “What percentage of normal (0%-100%) do you feel regarding your disease?” has proven feasible and valid in assessing myasthenia gravis and a heterogeneous spectrum of neuropathies. This study explores the utility of the SSQ in axonal polyneuropathies (PNPs), encompassing diabetic neuropathy, and evaluates its responsiveness to scale changes.

METHODS: A retrospective chart review of 150 patients with axonal PNP responding to the SSQ was performed. Patients underwent clinical and electrophysiological evaluations, and were evaluated by clinical and disability scales, including the Medical Research Council sum score, modified Toronto Clinical Neuropathy score (mTCNS), Overall Neuropathy Limitation Scale, and Rasch-built Overall Disability Scale (RODS).

RESULTS: The SSQ total scores correlated moderately with both the RODS score (r = .59, p < .001) and the mTCNS symptom score (r = -.43, p < .001), maintaining significance after adjustment for multiple comparisons. Longitudinally, after adjusting for multiple comparisons, the change in mTCNS symptom score retained statistical significance (adjusted p = .048). The SSQ did not show any association with electrophysiological parameters or sensory symptoms, other than a lower score in those with pain (100% with SSQ <40%, 85% with SSQ 40%-70%, and 34% with SSQ >70%).

DISCUSSION: The SSQ is a feasible, valid scale that may be utilized to assess and follow patients with length-dependent axonal PNPs. Given that the SSQ is not strongly associated with clinical and disability scales or electrophysiological findings, additional investigations are required for a comprehensive assessment of PNP.

PMID:39114923 | DOI:10.1002/mus.28209

Biol Rev Camb Philos Soc. 2024 Aug 8. doi: 10.1111/brv.13127. Online ahead of print.

ABSTRACT

Big biodiversity data sets have great potential for monitoring and research because of their large taxonomic, geographic and temporal scope. Such data sets have become especially important for assessing temporal changes in species’ populations and distributions. Gaps in the available data, especially spatial and temporal gaps, often mean that the data are not representative of the target population. This hinders drawing large-scale inferences, such as about species’ trends, and may lead to misplaced conservation action. Here, we conceptualise gaps in biodiversity monitoring data as a missing data problem, which provides a unifying framework for the challenges and potential solutions across different types of biodiversity data sets. We characterise the typical types of data gaps as different classes of missing data and then use missing data theory to explore the implications for questions about species’ trends and factors affecting occurrences/abundances. By using this framework, we show that bias due to data gaps can arise when the factors affecting sampling and/or data availability overlap with those affecting species. But a data set per se is not biased. The outcome depends on the ecological question and statistical approach, which determine choices around which sources of variation are taken into account. We argue that typical approaches to long-term species trend modelling using monitoring data are especially susceptible to data gaps since such models do not tend to account for the factors driving missingness. To identify general solutions to this problem, we review empirical studies and use simulation studies to compare some of the most frequently employed approaches to deal with data gaps, including subsampling, weighting and imputation. All these methods have the potential to reduce bias but may come at the cost of increased uncertainty of parameter estimates. Weighting techniques are arguably the least used so far in ecology and have the potential to reduce both the bias and variance of parameter estimates. Regardless of the method, the ability to reduce bias critically depends on knowledge of, and the availability of data on, the factors creating data gaps. We use this review to outline the necessary considerations when dealing with data gaps at different stages of the data collection and analysis workflow.

PMID:39114921 | DOI:10.1111/brv.13127

Turk J Gastroenterol. 2024 Mar 12;35(6):488-496. doi: 10.5152/tjg.2024.23508.

ABSTRACT

Quality indicators during the insertion phase of colonoscopy require exploration. Unsatisfactory insertion experiences cause endoscopist psychophysiological fatigue and affect the quality of their inspection. This comparative study used propensity score matching (PSM) to determine whether endoscopist satisfaction during scope insertion was related to polyp detection rate (PDR). Patients who underwent colonoscopy screening between April 2019 and December 2022 were enrolled in this study. The endoscopist satisfaction score (high and low) during the insertion phase in each examination was recorded based on the level of fatigue and presence of paradoxical scope movement. All examinations were classified into 2 groups: a high and a low satisfaction score group. After PSM with potential confounding factors related to polyp detection (endoscopist, insertion and withdrawal time, and sedative agent use), the PDR and adenoma detection rate (ADR) were compared. Overall, 4142 patients (average age, 54.1 years old; 54.4% male) underwent colonoscopies performed by twelve experienced endoscopists. Analysis using a logistic regression model revealed that a high satisfaction score during the insertion phase was an independent predictor of polyp detection (P < .001, odds ratio 1.79, 95% CI 1.41-2.33), whereas insertion time was not. After PSM, 513 patients from both groups were eligible for comparison. Polyp detection rate and ADR were significantly higher in the high-satisfaction group than in the low-satisfaction group (49.5% vs. 36.6%, P < .001; 35.1% vs. 27.1%, P = .007). The endoscopists’ level of satisfaction with the insertion phase was shown to be a potential predictor of PDR in screening colonoscopy.

PMID:39114910 | DOI:10.5152/tjg.2024.23508

J Periodontal Res. 2024 Aug 8. doi: 10.1111/jre.13331. Online ahead of print.

ABSTRACT

AIM: The aim of this study was to evaluate the clinical and radiographic effects of hyaluronic acid (HA) gel application as an adjunct to minimally invasive nonsurgical treatment (MINST) in intrabony defects ≥3 mm.

METHODS: A total of 36 patients were included and randomly assigned to two groups: (a) MINST + HA (test; n = 17) and (b) MINST (control, n = 19). Subgingival 0.8% HA gel was applied in intrabony defects of test group and repeated 4 weeks following MINST protocol. Clinical measurements including probing depth (PD), clinical attachment level (CAL), and gingival recession (GR) were recorded at baseline and repeated at 3 and 6 months. Radiographic evaluation was performed at baseline and 6 months.

RESULTS: Test group showed significantly greater reduction in PD and gain in CAL at 3 months compared to baseline than that of controls (p < .05), but the changes (Δ) at 6 months compared to baseline did not differ between the groups (p > .05). Although, both groups showed statistically significant GR in all evaluated time periods (p < .05), control group showed higher ΔGR than that of test group (p < .05). There was no significant difference between the groups in terms of radiographic defect fill/bone gain (p > .05).

CONCLUSIONS: The additional use of 0.8% HA gel in the treatment of periodontal intrabony defects did not provide additional benefits in clinical and radiographic parameters. On the other hand, GR measurements showed favorable results in the test group.

PMID:39114889 | DOI:10.1111/jre.13331

Anal Chem. 2024 Aug 8. doi: 10.1021/acs.analchem.4c03092. Online ahead of print.

ABSTRACT

A one-step, enzyme-free, and highly sensitive digital microRNA (miRNA) assay is rationally devised based on flow cytometric counting of target miRNA-clicked nanobead dimers via a facile mix-and-read manner. In this strategy, highly efficient miRNA-sandwiched click chemical ligation of two DNA probes may remarkably stabilize and boost the dimer formation between two kinds of fluorescence-coded nanobeads, and the number of as-produced bead dimers will be target dose-responsive, particularly when the trace number of miRNA is much less than that of employed nanobeads. Finally, each fluorescence-coded bead dimer can be easily identified and digitally counted by a powerful flow cytometer (FCM) and accordingly, the amount of target miRNA can be accurately quantified in a digital way. This new digital miRNA assay can be accomplished with a facile mix-and-read operation just by simply mixing the target miRNA with two kinds of preprepared DNA probe-functionalized nanobeads, which do not require any nucleic acid amplification, purification, and complex operation procedures. In spite of the extremely simple one-step operation, benefiting from the low-background but high target-mediated click ligation efficiency, and the powerfully digital statistical capability of FCM, this strategy achieves high sensitivity with a quite low detection limit of 5.2 fM target miRNA as well as high specificity and good generality for miRNA analysis, pioneering a new direction for fabricating digital bioassays.

PMID:39114879 | DOI:10.1021/acs.analchem.4c03092

Plast Reconstr Surg Glob Open. 2024 Aug 6;12(8):e6024. doi: 10.1097/GOX.0000000000006024. eCollection 2024 Aug.

ABSTRACT

BACKGROUND: Driven by demand for nonexcisional alternatives to address lax skin following liposuction, various energy-based technologies have become available. Helium plasma radiofrequency (RF) and bipolar RF have gained prominence. These technologies have distinctly different methods of action and indications, potentially influencing procedural safety and duration.

METHODS: Conducted to collect and evaluate real-world procedure and safety data, this retrospective, single-center, contiguous series study included patients who underwent either helium plasma RF or bipolar RF following a liposuction or body contouring procedure.

RESULTS: The helium plasma RF group (N = 229) averaged 4.9 concurrent procedures, whereas the bipolar RF group (N = 236) averaged 4.4 concurrent procedures. The total treatment time, including concurrent procedures, was 182 minutes for the helium plasma RF group and 196 minutes for the bipolar RF group. The findings from the subanalysis group (n = 9) indicated that the treatment time for the helium plasma RF side of the body was 50% shorter than the bipolar RF side. A statistically significant difference in adverse events by group was observed. There were 45 events in 34 patients for helium plasma RF and 93 events in 62 patients for bipolar RF. Notably, fewer occurrences of burns, hematoma, hypertrophic scar, and seroma were reported for helium plasma RF compared with bipolar RF.

CONCLUSIONS: The analysis reveals a notable difference in the occurrence of adverse events, with statistically significantly fewer incidents observed for helium plasma RF compared with bipolar RF. Data suggests that helium plasma RF exhibits shorter durations in the operating room compared with bipolar RF, suggesting increased procedural efficiency.

PMID:39114803 | PMC:PMC11302937 | DOI:10.1097/GOX.0000000000006024

Plast Reconstr Surg Glob Open. 2024 Aug 7;12(8):e6034. doi: 10.1097/GOX.0000000000006034. eCollection 2024 Aug.

ABSTRACT

BACKGROUND: Craniosynostosis, a common congenital anomaly, results from premature fusion of the cranial sutures. One of the forms of craniosynostosis is premature fusion of the metopic suture, referred to as trigonocephaly, but the diagnosis of metopic suture synostosis remains controversial. The purpose of this study was to clarify, using geometric morphometric analysis, if a metopic ridge alone observed in cases of mild trigonocephaly represents a pathological phenomenon.

METHODS: Three different cranial morphologies were compared among patients up to 2 years old who were categorized into the true group, the mild group, and the normal group, based on the presence or absence of specific symptoms, history of cranioplasty for trigonocephaly, or lack of any abnormality on computed tomography. Using the obtained computed tomography images, 235 anatomical landmarks and semi-landmarks were plotted on the entire cranial surface for analysis of neurocranial morphology, and the cranial shapes represented by landmarks were analyzed using geometric morphometrics. Principal components of shape variations among specimens were then computed, based on the variance-covariance matrix of the Procrustes residuals of all specimens, and statistically analyzed.

RESULTS: The principal component analyses of the variations in endocranial shape, frontal bone shape, and occipital bone shape did not show any significant differences in cranial morphology between mild trigonocephaly and normal skulls; however, true trigonocephaly was found to differ significantly from mild trigonocephaly and normal skulls.

CONCLUSIONS: These findings suggest that in assessments of cranial morphology, the presence of a ridge alone cannot be diagnosed as fundamentally pathological, and may represent normal morphology.

PMID:39114798 | PMC:PMC11305778 | DOI:10.1097/GOX.0000000000006034

Plast Reconstr Surg Glob Open. 2024 Aug 7;12(8):e6040. doi: 10.1097/GOX.0000000000006040. eCollection 2024 Aug.

ABSTRACT

BACKGROUND: As HIV-positive individuals utilizing highly active antiretroviral therapy live longer, the burden of breast cancer increases in the population. Breast reconstruction is an integral aspect of surgical treatment for many patients after a breast cancer diagnosis, prompting this examination of the characteristics and outcomes of breast reconstruction in this growing patient population.

METHODS: Using Merative MarketScan Research Databases, a large multipayer database, HIV-positive adult patients who underwent autologous or implant-based breast reconstruction between 2007 and 2021 were identified using International Classification of Disease codes and Common Procedural Terminology codes. In both HIV-positive and -negative cohorts, patient demographics, procedure-related complications, and postoperative revisions were recorded. Shapiro-Wilk, chi-square, Wilcoxon-Mann-Whitney, and multivariable logistic regression tests were used for statistical analysis.

RESULTS: Of 173,421 patients who underwent breast reconstruction, 1816 had an HIV diagnosis. HIV-positive patients were younger (P < 0.001), underwent surgery more recently (P < 0.001), more often underwent immediate breast reconstruction (P < 0.001), and had higher comorbidity levels (P < 0.001). There was a regional variation in which the patient cohorts underwent breast reconstruction. There was no significant difference in overall complication rates between patient groups, but HIV-negative patients more often underwent revision procedures (P = 0.009).

CONCLUSIONS: When compared to their HIV-negative counterparts, breast reconstruction can be considered safe and efficacious in patients living with HIV. HIV-positive patients are a growing demographic who seek breast reconstruction, and surgeons must continue to further understand the unique implications of breast reconstruction in this population.

PMID:39114797 | PMC:PMC11305706 | DOI:10.1097/GOX.0000000000006040