Tag: pubmed

J Robot Surg. 2024 Dec 19;19(1):30. doi: 10.1007/s11701-024-02193-1.

ABSTRACT

Robotic distal gastrectomy (RDG) has been increasingly used for the treatment of gastric cancer, however, its comparative safety and efficacy against the laparoscopic approach (LDG), remains unclear, especially when accounting the reconstruction method as a confounder. This systematic review and meta-analysis aims to evaluate the short-term outcomes of RDG vs LDG In patIents with gastric cancer, undergoing Billroth I and II reconstruction. A systematic review was conducted in accordance with PRISMA guidelines. We searched Pubmed, Scopus and the Cochrane Library, up to October 22nd, 2024. The primary outcomes analyzed were the blood loss, operative duration, and the number of harvested lymph nodes and the secondary outcomes included overall complications, time to oral intake, duration of hospitalization and time to first flatus. Random-effects models were used to calculate weighted mean differences (WMD) and Odds ratios (OR) with 95% confidence intervals (CI), and heterogeneity was assessed using the I² statistic. P values were also calculated. Sensitivity analysis was performed for outcomes with moderate to high heterogeneity. Five studies were included, involving 811 patients (RDG: n = 289, LDG: n = 522). RDG was associated with a significantly longer operative duration compared to LDG (WMD = 34.14 min, 95%CI 10.92 to 57.35, P = 0.004, I² = 91%). RDG patients initiated oral intake earlier (WMD = -0.20 days, 95%CI -0.39 to -0.01, P = 0.03, I² = 45%). RDG resulted in shorter hospital stays (WMD = -1.48 days, 95%CI -2.91 to -0.04, P = 0.04, I² = 86%). RDG patients had a faster return to bowel function (time to first flatus) (WMD = -0.33 days, 95%CI -0.50 to -0.15, P = 0.00003, I² = 57%). No statistically significant differences were observed regarding blood loss between RDG and LDG (WMD = -3.88 mL, 95%CI -21.63 to 13.87, P = 0.67, I² = 78%). There was no statistically significant difference in complication rates (OR = 0.61, 95%CI 0.36 to 1.03, P = 0.06, I² = 0%). No significant differences were observed regarding the number of lymph nodes harvested (WMD = -0.49, 95%CI -3.02 to 2.04, P = 0.70, I² = 24%). Sensitivity analysis confirmed the robustness of the findings of operative duration and time to first flatus. RDG with BI/ BII requires longer operative duration, but it associated with faster recovery compared to LDG. No differences were observed between RDG and LDG with regards to overall complications, number of harvested lymph nodes and blood loss, showing that RDG is as safe and oncological equivalent to LDG. Future studies particularly, multi-center randomized clinical trials, should have a longer follow up period and examine the type of reconstruction separately. PROSPERO registration: CRD42024605895.

PMID:39699804 | DOI:10.1007/s11701-024-02193-1

Discov Ment Health. 2024 Dec 19;4(1):67. doi: 10.1007/s44192-024-00121-1.

ABSTRACT

BACKGROUND: Adaptation to disability (AD) is linked to positive feelings (PF) and positive emotional well-being (PEWB), while emotional suppression can improve adaptation and provide temporary PEWB but will not lead to sustainable positive mental health. This study examined whether and to what extent PF might mediate the link between AD and PEWB in a sample of students with congenital physical disabilities (CPD) in Rwanda.

METHODS: A sample of 46 students with CPD (21 females, i.e., 45.65% and 25 males i.e., 54.34%; mean age: M = 20 years; SD = 2.05) were administered questionnaires to assess their AD, PF, and PEWB.

RESULTS: Results showed that PF (r = – 0.37, p < 0.05) and PEWB (r = – 0.37, p < 0.05) were significantly and negatively correlated with AD, while PF was significantly and positively correlated with PEWB (r = 0.70, p < 0.01). Results further suggested that there was a strong indirect negative relationship between AD and PEWB mediated by PF (a*b = – 0.68, Bootstrap CI95 = – 1.30 and – 0.26), with the Sobel test statistics of – 2.4131 against a significant one-tailed p-value (p < 0.01) and two-tailed p-value (p < 0.05).

CONCLUSIONS: Results emphasize that understanding AD and PF for students with CPD at risk of decreased PEWB could lead to suitable interventions. Also, results can be used by future researchers, policymakers, and other related institutions to understand the inner feelings of students with CPD for further support.

PMID:39699786 | DOI:10.1007/s44192-024-00121-1

Acta Ophthalmol. 2024 Dec 19. doi: 10.1111/aos.17432. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effects of customized corneal collagen cross-linking (CXL) on higher-order aberrations (HOAs) in keratoconus (KC): vertical coma (VC), horizontal coma (HC), spherical aberration (SA), trefoil (TF) and astigmatism, compared with the same effects in healthy eyes undergoing CXL for low-grade myopia.

METHODS: This mixed-designed study included 38 eyes of 38 patients with KC, treated and followed prospectively, who received customized epi-on CXL in high oxygen, and a retrospective control group of 23 eyes from 23 patients who underwent central 4-mm CXL treatment for low-grade myopia. VC, HC, SA, TF and keratometry values were obtained from Pentacam HR® measurements at baseline and at 1, 6, 12 and 24 months post-treatment. Statistical analyses included paired T-tests for changes over time and Pearson correlation tests to assess relationships between aberrations, best spectacle-corrected and low-contrast visual acuities (BSCVA and LCVA, respectively) and CXL parameters.

RESULTS: Reduced HOAs and improved visual acuities were observed in KC. A 20% reduction in VC was observed at 24 months (from -1.82 ± 1.15 μm to -1.46 ± 1.01 μm; 95% CI: [0.155, 0.629], p = 0.002), while a 17% reduction in HC was observed at 12 months (from -0.35 ± 0.56 μm to -0.29 ± 0.62 μm; 95% CI: [0.003, 0.096], p = 0.037). A positive correlation was found between baseline VC and the level of improvement in VC at 24 months (R² = 0.200, p = 0.015). SA increased by 126% at 24 months (from -0.21 ± 0.62 μm to 0.054 ± 0.52 μm; 95% CI: [0.143, 0.347], p ≤ 0.001). TF and astigmatism did not alter from the treatment. In myopia, the natural positive SA increased by 57% post-treatment (from 0.14 ± 0.061 μm to 0.22 ± 0.076 μm at 24 months; 95% CI: [0.067, 0.098], p ≤ 0.001), while changes in VC and HC were minor and BSCVA remained stable.

CONCLUSION: Customized CXL effectively reduces HOAs in KC. For VC the improvement is larger in cases with higher preoperative VC, indicating that the concept of customization has its intended effect. Accordingly, SA and visual acuities improve in KC whereas CXL for low-grade myopia tends to increase corneal SA unfavourably.

PMID:39698801 | DOI:10.1111/aos.17432

J Clin Psychol. 2024 Dec 19. doi: 10.1002/jclp.23759. Online ahead of print.

ABSTRACT

Exposure exercises as seen in cognitive behavioral therapy (CBT) and exposure and response prevention (ERP) are standard in the treatment of obsessive-compulsive disorder (OCD). In the last two decades, additional research has been conducted on acceptance and commitment therapy (ACT) and the ways that exposure exercises are conducted from an ACT model. Empirical support for conducting exposures from an ACT model exists. Group level statistics suggest that ACT with ACT-based exposures is as effective as traditional ERP or CBT. A key component of ACT and values-based exposures is the focus on teaching psychological flexibility to allow for engagement with values-based exposures. In this case study, we present an adult woman with OCD who completed 24 sessions of ACT+ values-based exposures. Client scores on the Y-BOCS decreased from severe levels to mild-moderate levels through treatment. Additionally, the client was more actively engaged in her life and reported greater quality of life at the conclusion of treatment. The goal of this case study is to demonstrate how values-based exposures can be used in the treatment of OCD.

PMID:39698800 | DOI:10.1002/jclp.23759

J Dent Res. 2024 Dec 19:220345241291528. doi: 10.1177/00220345241291528. Online ahead of print.

ABSTRACT

Early childhood caries (ECC) is the most common noncommunicable childhood disease-an important health problem with known environmental and social/behavioral influences lacking consensus genetic risk loci. To address this knowledge gap, we conducted a genome-wide association study of ECC in a multiancestry population of U.S. preschool-age children (N = 6,103) ages 3 to 5 y participating in a community-based epidemiologic study of early childhood oral health. Calibrated examiners used International Caries Detection and Assessment System criteria to measure ECC; the primary trait was the number of primary tooth surfaces with caries experience (i.e., dmfs index). We estimated heritability and concordance rates and conducted genome-wide association analyses to estimate overall genetic effects as well as stratified by sex, household water fluoride, and dietary sugar and leveraged combined gene/gene-environment effects using 2-degree-of-freedom joint tests. Common genetic variants explained 24% of ECC phenotypic variance among unrelated individuals, while concordance rates were 0.64 (95% confidence interval [CI] = 0.42-0.79) among monozygotic twins and 0.44 (95% CI = 0.34-0.53) among first-degree relatives. Across all analyses, we identified 21 novel nonoverlapping genome-wide significant loci (P < 5 × 10^-8) and 1 genome-wide significant gene (TAAR6) associated with ECC. The taste receptor activity gene set, with known roles in chemosensing, bacterial recognition, and innate immunity in the oral cavity, was strongly associated with ECC. While no locus remained significant after studywise multiple-testing correction, 3 loci were nominally significant (P < 0.05) and directionally consistent in external cohorts of 285,248 adults (rs1442369, DLGAP1 and rs74606067, RP11-856F16.2) and 18,994 children (rs71327750, SLC41A3). Meanwhile, the strongest marker known to be associated with adult caries (rs1122171, tagging the long noncoding RNA PITX1-AS1) was nominally significant (P = 0.01) and directionally consistent with ECC in our study. Taken together, the results of this study add to the genomics knowledge base for early childhood caries, offer several plausible candidates for future mechanistic studies, and underscore the importance of accounting for sex and pertinent environmental exposures in genetic investigations.

PMID:39698793 | DOI:10.1177/00220345241291528

Adv Clin Exp Med. 2024 Dec 19. doi: 10.17219/acem/189851. Online ahead of print.

ABSTRACT

BACKGROUND: Dysphagia, prevalent in 90% of children with neurological disorders, poses risks of medical complications and is associated with cognitive and psychosocial challenges. The absence of the sucking-swallowing reflex and variations in the gag reflex contribute to feeding difficulties.

OBJECTIVES: This study focuses on examining the impact of the gag reflex on the masticatory system structure in children with cerebral palsy, aiming to assess its significance.

MATERIAL AND METHODS: This observational study investigated the gag reflex and soft palate shape in 25 children with cerebral palsy (average age: 14 years). Inclusion criteria considered specific levels of the Eating and Drinking Ability Classification System (EDACS) and the Gross Motor Function Classification System (GMFCS). Exclusion criteria comprised hypotension, inflammation and tumors. The Castillo-Morales questionnaire assessed variables and statistical analysis (Spearman’s rank correlation and non-parametric tests) utilizing PQStat v. 1.8.6.120 software.

RESULTS: Findings did not reveal an association between the absence of the gag reflex and abnormal palate structure in children. Our results showed a correlation between higher tension of the buccinator muscles and mobility of the tongue on the structure of the palate.

CONCLUSIONS: Children with neurological disorders, such as cerebral palsy, are a diverse group requiring specialized orthodontic treatment and close interdisciplinary collaboration.

PMID:39698777 | DOI:10.17219/acem/189851

Intern Med J. 2024 Dec 19. doi: 10.1111/imj.16612. Online ahead of print.

ABSTRACT

BACKGROUND: Optimal heart failure (HF) pharmacotherapy (guideline-directed medical therapy and diuretics) in older people with frailty is uncertain due to limited evidence.

AIMS: To evaluate utilisation of HF pharmacotherapy and prevalence of polypharmacy, adverse drug events (ADEs), falls, delirium, renal impairment and duration of hospitalisation in older inpatients, according to frailty.

METHODS: A retrospective cross-sectional study of the TO HOME cohort of 2000 inpatients ≥75 years admitted for ≥48 h to rehabilitation, geriatric or general medicine from 1 July 2016 to 30 June 2017 across six hospitals in Sydney, Australia. Data were collected from electronic medical records. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification identified HF diagnosis, ADEs and frailty using hospital frailty risk score. Outcomes included utilisation of HF pharmacotherapy; polypharmacy; ADEs, falls, delirium, renal and impairment; and duration of hospitalisation.

RESULTS: Among 439 (22.0% of TO HOME cohort) patients with undifferentiated HF, 284 (69.5%) had intermediate or high risk of frailty, and 412 (94%) took ≥1 HF pharmacotherapy, with 357 (81.3%) patients on loop diuretics. Patients with high frailty risk frequently continued beta-blockers (70%) and discontinued renin-angiotensin system inhibitors (57%). Most patients experienced polypharmacy (n = 426, 97.0%). Renal impairment prevalence was 67%-76% across frailty groups. Increasing frailty risk (low, intermediate and high) was associated with increasing prevalence of ADEs (31%, 56% and 84%), falls (12%, 25% and 46%) and delirium (8%, 27% and 49%) and longer hospitalisation.

CONCLUSIONS: Frailty, HF-pharmacotherapy changes in hospital and ADEs were common among older inpatients with HF. The association of adverse outcomes according to frailty needs further investigation. Poor documentation of HF phenotype may be a barrier to medication optimisation in older inpatients.

PMID:39698760 | DOI:10.1111/imj.16612

Med Vet Entomol. 2024 Dec 19. doi: 10.1111/mve.12782. Online ahead of print.

ABSTRACT

Aedes albopictus (Diptera: Culicidae), commonly known as the Asian tiger mosquito, is an important vector transmitting dangerous arboviruses to humans. This study investigated the phenotypic and genetic variation of this species in Thailand through wing geometric morphometric (GM) and mitochondrial cytochrome c oxidase subunit I (COI) gene sequence analyses. A total of 236 Ae. albopictus specimens from 12 populations in Thailand and 89 specimens from invasive populations in Florida, Hawaii and Brazil underwent wing GM analysis. The centroid size (CS) of Ae. albopictus populations in Thailand ranged from 2.00 mm in Bangkok to 2.36 mm in Chanthaburi, while in invasive populations, CS varied from 2.25 mm in Brazil to 2.47 mm in Florida. Pairwise comparisons of wing shape revealed significant differences for most population pairs, with distances ranging from 1.63 to 10.02. The clustering tree indicated distant relationships in wing shape between native and invasive populations. Additionally, partial COI gene sequences were amplified from 108 specimens, revealing a mean haplotype diversity of 0.842 ± 0.025 and a mean nucleotide diversity of 0.002 ± 0.001. The results from neutral Tajima’s D and Fu’s Fs tests indicated negative and statistically significant values (-2.159 and -33.846, respectively), suggesting population expansion. Further examination of haplotype relationships between Thailand and other countries identified two distinct groups: a Southeast Asia group, with Thai haplotypes clustered exclusively within it, and a non-Southeast Asia group. These findings highlight the phenotypic and genetic variation of Ae. albopictus in Thailand, providing essential insights for disease control strategies and tracing the mosquito’s origins across regions.

PMID:39698758 | DOI:10.1111/mve.12782

Biom J. 2025 Feb;67(1):e70016. doi: 10.1002/bimj.70016.

ABSTRACT

Gene set analysis, a popular approach for analyzing high-throughput gene expression data, aims to identify sets of genes that show enriched expression patterns between two conditions. In addition to the multitude of methods available for this task, users are typically left with many options when creating the required input and specifying the internal parameters of the chosen method. This flexibility can lead to uncertainty about the “right” choice, further reinforced by a lack of evidence-based guidance. Especially when their statistical experience is scarce, this uncertainty might entice users to produce preferable results using a “trial-and-error” approach. While it may seem unproblematic at first glance, this practice can be viewed as a form of “cherry-picking” and cause an optimistic bias, rendering the results nonreplicable on independent data. After this problem has attracted a lot of attention in the context of classical hypothesis testing, we now aim to raise awareness of such overoptimism in the different and more complex context of gene set analyses. We mimic a hypothetical researcher who systematically selects the analysis variants yielding their preferred results, thereby considering three distinct goals they might pursue. Using a selection of popular gene set analysis methods, we tweak the results in this way for two frequently used benchmark gene expression data sets. Our study indicates that the potential for overoptimism is particularly high for a group of methods frequently used despite being commonly criticized. We conclude by providing practical recommendations to counter overoptimism in research findings in gene set analysis and beyond.

PMID:39698741 | DOI:10.1002/bimj.70016

Biom J. 2025 Feb;67(1):e70023. doi: 10.1002/bimj.70023.

ABSTRACT

In a longitudinal clinical registry, different measurement instruments might have been used for assessing individuals at different time points. To combine them, we investigate deep learning techniques for obtaining a joint latent representation, to which the items of different measurement instruments are mapped. This corresponds to domain adaptation, an established concept in computer science for image data. Using the proposed approach as an example, we evaluate the potential of domain adaptation in a longitudinal cohort setting with a rather small number of time points, motivated by an application with different motor function measurement instruments in a registry of spinal muscular atrophy (SMA) patients. There, we model trajectories in the latent representation by ordinary differential equations (ODEs), where person-specific ODE parameters are inferred from baseline characteristics. The goodness of fit and complexity of the ODE solutions then allow to judge the measurement instrument mappings. We subsequently explore how alignment can be improved by incorporating corresponding penalty terms into model fitting. To systematically investigate the effect of differences between measurement instruments, we consider several scenarios based on modified SMA data, including scenarios where a mapping should be feasible in principle and scenarios where no perfect mapping is available. While misalignment increases in more complex scenarios, some structure is still recovered, even if the availability of measurement instruments depends on patient state. A reasonable mapping is feasible also in the more complex real SMA data set. These results indicate that domain adaptation might be more generally useful in statistical modeling for longitudinal registry data.

PMID:39698740 | DOI:10.1002/bimj.70023