Tag: pubmed

J Clin Lab Anal. 2022 Jul 8:e24535. doi: 10.1002/jcla.24535. Online ahead of print.

ABSTRACT

OBJECTIVE: JKAP modifies T-cell immune response and inflammation, also involves in cardia-cerebrovascular disease etiology. This study intended to explore JKAP’s relation with T-helper 1 (Th1), T-helper 17 (Th17) cell levels, clinical properties, and recurrence-free survival (RFS) in acute ischemic stroke (AIS) patients.

METHODS: A total of 155 AIS patients were analyzed. Serum JKAP, interferon-gamma (IFN-γ), and interleukin-17A (IL-17A) were detected by ELISA; then blood Th1 and Th17 cells were quantified by flow cytometry. Besides, 30 healthy subjects were enrolled as controls to detect JKAP, Th1, and Th17 cells.

RESULTS: JKAP level was lower (p < 0.001), Th1 cells were not differed (p = 0.068), but Th17 cells were elevated in AIS patients versus controls (p < 0.001). Meanwhile, JKAP was negatively correlated with Th1 cells (p = 0.038), Th17 cells (P<0.001), IFN-γ (p = 0.002), and IL-17A (p < 0.001) in AIS patients. JKAP was negatively associated with the National Institutes of Health Stroke Scale (NIHSS) score (p < 0.001), but Th17 cells (p = 0.001), IFN-γ (p = 0.035), and IL-17A (p = 0.008) levels were positively associated with NIHSS score. Additionally, accumulating RFS was numerically longer in patients with JKAP Quantile (Q) 4 than patients with JKAP Q1-Q3 (p = 0.068), and numerically better in patients with JKAP Q3-Q4 than patients with JKAP Q1-Q2 (p = 0.069), but without statistical significance.

CONCLUSION: JKAP correlates with lower Th1 and Th17 cell percentages as well as milder disease severity.

PMID:35808912 | DOI:10.1002/jcla.24535

J Magn Reson Imaging. 2022 Jul 9. doi: 10.1002/jmri.28336. Online ahead of print.

ABSTRACT

BACKGROUND: Studies have identified imaging markers of binge drinking. Functional connectivity during both task challenges and resting state was shown to distinguish binge and nonbinge drinkers. However, no studies have compared the efficacy of task and resting data in the classification.

HYPOTHESIS: Task outperforms resting-state functional magnetic resonance imaging (fMRI) data in the differentiation of binge and nonbinge drinkers. We tested the hypothesis via multiple deep learning algorithms.

STUDY TYPE: Cross-sectional; retrospective.

POPULATION: A total of 149 binge (107 men) and 151 demographically matched, nonbinge (92 men) drinkers curated from the Human Connectome Project, with 80% randomly selected for model development and 20% for validation/test.

FIELD STRENGTH/SEQUENCE: A 3 T; fMRI with a blood oxygen level-dependent (BOLD) gradient-echo echo-planar sequence.

ASSESSMENT: FMRI data of resting state and seven behavioral tasks were acquired. Graph convolutional network (GCN), long short-term memory, convolutional, and recurrent neural network models were built to distinguish bingers and nonbingers using connectivity matrices of 8, 116, and 268 regions of interest (ROI). Nodal metrics including betweenness centrality, degree centrality, clustering coefficient, efficiency, local efficiency, and shortest path length were calculated from the GCN model.

STATISTICAL TESTS: Model performance was quantified by the area under the curve (AUC) in receiver operating characteristic analysis. A P value < 0.05 was considered statistically significant.

RESULTS: Task outperformed resting data in classification by approximately 8% by AUC in the test set. Across models and ROI sets, the gambling, motor, language and working memory tasks, each with AUC of 0.614, 0.612, 0.605, and 0.603, performed better than resting data (AUC = 0.548). Models with 116 ROIs (AUC = 0.602) consistently outperformed those with 8 ROIs (AUC = 0.569). Task data performed best with GCN (AUC = 0.619). Nodal metrics of left supplementary motor area and right cuneus showed significant group main effect across tasks.

CONCLUSION: Neural responses to cognitive challenges relative to resting state better characterize binge drinking. The performance of different network models may depend on behavioral tasks and the number of ROIs.

EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 2.

PMID:35808911 | DOI:10.1002/jmri.28336

Scand J Caring Sci. 2022 Jul 9. doi: 10.1111/scs.13096. Online ahead of print.

ABSTRACT

The aim of this study was to describe and compare family members’ experiences of approach in encounters with healthcare professionals and possible feelings of alienation in the professional care within four care contexts: the care of older people, psychiatric care, palliative care and diabetes care. The design was an explorative cross-sectional survey study. Data were collected in Sweden using the Family Involvement and Alienation Questionnaire-Revised (FIAQ-R). It measures family members’ experiences of the healthcare professionals’ approach and the family members’ feeling of alienation from the provision of professional care. A total of 1047 questionnaires were distributed to family members using convenient sampling method, of which 294 were included. Data were analysed using rank-based, non-parametric statistical methods. The results indicated that most respondents experienced a positive actual approach from the healthcare professionals. Many participants rated the importance of approach at a higher level than their actual experience. Participants in the context of diabetes care reported a more negative actual approach from the healthcare professionals than did participants in the other contexts and considered the healthcare professionals’ approach towards them as being less important. The results for the entire group indicated that the participants felt a low level of alienation from the professional care. Participants in the context of the care of older people reported significantly lower level of feeling of being alienated than did participants in the contexts of psychiatric care and diabetes care. The differences between participants in diabetes care and other care contexts can possibly be explained by a more fully implemented self-care approach among the patients in diabetes care than in the other care contexts. Even though the results are quite positive, it is still important that nurses consider a family-centred approach to better adapt to the needs of both the family members and the patients.

PMID:35808909 | DOI:10.1111/scs.13096

Dermatol Ther. 2022 Jul 9:e15704. doi: 10.1111/dth.15704. Online ahead of print.

ABSTRACT

BACKGROUND: Pemphigus poses a therapeutic challenge and Rituximab is increasingly used in its treatment. Long term data regarding efficacy and safety of Rituximab in pemphigus is limited.

METHODS: This study was a retrospective analysis of 76 pemphigus patients with primary endpoint being the percentage of patients achieving complete remission (CR) on/off therapy. Secondary endpoints were time to relapse, mean cumulative dose of prednisolone after Rituximab infusion, mean duration of follow up and adverse events to Rituximab if any.

RESULTS: A total of 62 (82.7%) attained complete remission on/off treatment, out of which 42 were off therapy. Mean interval between first dose rituximab administration and complete remission off treatment was 6.9 ± 3.7 months. Complete remission off treatment was sustained for a mean duration of 21.4 ± 17.8 months before relapse. Over a mean follow-up duration of 42.7 ± 24.9 months (median 41, maximum 83 months), 22 of 62 patients (35.5%) who had achieved complete remission after the first cycle of rituximab relapsed. A mean total cumulative dose of 8716.3 ± 10533.8 mg prednisolone was prescribed over a mean duration of 18.05 ± 15.64 months after the first cycle of rituximab. Adverse events were noted in 18 out of 76 patients (23.7%) which included infusion reactions (n=3), minor infections (n=7), transitory disease flare (n=6) and mortality (n=2). No statistically significant correlation was found between remission/relapse rates and age, gender, pemphigus subtype or disease duration.

CONCLUSION: This study substantiates the long-term efficacy and safety of single cycle of Rituximab in pemphigus.

PMID:35808907 | DOI:10.1111/dth.15704

J Clin Ultrasound. 2022 Jul 8. doi: 10.1002/jcu.23268. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the application value of combined intravenous contrast-enhanced ultrasound (IV-CEUS) with intrabiliary contrast-enhanced ultrasound (IB-CEUS) in the preoperative evaluation of hilar cholangiocarcinoma (HCCA) resectability.

METHODS: Clinical data from 82 patients with HCCA confirmed by surgery and pathology were retrospectively analyzed. Preoperative IV-CEUS + IB-CEUS and magnetic resonance cholangiopancreatography (MRCP) were performed and the results were compared with surgical and pathological findings.

RESULTS: The accuracy of the Bismuth-Corlette classification confirmed by IV-CEUS + IB-CEUS and MRCP was 95.12% (78/82) and 87.8% (72/82), respectively. The diagnostic precision of IV-CEUS + IB-CEUS was better than MRCP (p = 0.001). The sensitivity, specificity, and precision of CEUS for diagnosing lymph node metastases (72.7%, 93.3%, and 87.8%), intrahepatic metastases (78.6%, 98.5%, and 93.9%), invasion of the hepatic artery (92.9%, 98.5%, and 97.6%) and invasion of the portal vein (93.8%, 98.5%, and 97.6%) of HCCA were, respectively. The consistency between the preoperative evaluation of resectability confirmed by IV-CEUS +IB-CEUS and MRCP was 85.4% (70/82) and 78.0% (64/82), respectively. In addition, the evaluations did not have statistically significant differences (p > 0.05). There were no significant differences between the two evaluations (p = 0.266).

CONCLUSION: IV-CEUS combined with IB-CEUS has significant value in classifying HCCA and evaluating the resectability of lymph node metastases, liver metastases, and vessel invasion.

PMID:35808898 | DOI:10.1002/jcu.23268

J Hand Surg Asian Pac Vol. 2022 Jun;27(3):466-472. doi: 10.1142/S242483552250045X.

ABSTRACT

Background: Bony deformities and arthropathies have been noticed in thalassemia patients. The aim of this study is to compare the arc of motion and radiological parameters of the wrist and patient rated wrist evaluation (PRWE) between adult transfusion-dependent thalassemics and normal subjects. Methods: An observational cross-sectional study was done in the department of orthopaedics over a period of 2 years where a total of 30 skeletally mature thalassemia major patients (group A) were assessed. The data was then compared with the data of demographically matched 30 healthy adults (group B). Arc of motion of the dominant wrist that included flexion, extension, radial and ulnar deviation, pronation and supination was measured using a handheld goniometer for both groups. Radiographs of the dominant wrist were obtained in both groups and used to determine the radial height, radial articular angle and carpal slip. PRWE was used to assess the function of the wrist. A p-value of <0.05 was considered statistically significant. Results: Clinical abnormalities at the wrist joint were found in 80% of thalassaemia patients. There was a statistically significant increase in ulnar deviation, wrist extension and decrease in wrist flexion in group A compared to group B. Radiological abnormalities were found in 100% of thalassaemia patients. All the radiological parameters were significantly increased in group A compared to group B. There were no differences in PRWE scores between both groups. Conclusion: Clinical and radiological changes of wrist joint occur in skeletally mature thalassaemia major patients due to shortened ulna compared to healthy adults. This may be due to disease itself, bone marrow expansion, osteopenia, drug (chelating agent) or iron toxicity. Understanding the changes at the wrist in patients with thalassemia major is important to increasing the life expectancy of these patients. Level of Evidence: Level IV (Diagnostic).

PMID:35808882 | DOI:10.1142/S242483552250045X

J Hand Surg Asian Pac Vol. 2022 Jun;27(3):453-458. doi: 10.1142/S2424835522500473.

ABSTRACT

Background: The aims of this study were to investigate the impact of diabetes mellitus on patient-reported functional outcome measures (PROMs) and satisfaction following surgical treatment of Dupuytren contracture. Methods: Preoperative and 1-year postoperative PROMs were collected prospectively over 6 years (2013-2019). Patients completed the QuickDASH score and were asked ‘how normal is your hand?’, recording responses on a 100-point visual analogue scale. Patient satisfaction was also self-reported. Results: Paired responses were available for 520 hands (478 patients; 72% follow-up rate). There were 62 patients with diabetes (12%). Pre (12.5 vs. 9.1; p = 0.01) and postoperative (11.4 vs. 6.8; p = 0.02) QuickDASH scores were significantly, but not clinically, worse in diabetic patients. Patient satisfaction was high in both groups. A large and significant improvement in self-perceived hand normality was observed in both groups (p < 0.05). No significant differences were observed in preoperative or change in hand normality between the groups, but the postoperative normal hand score was significantly higher in non-diabetic patients (94 vs. 90; p = 0.02). Conclusion: Our study has demonstrated statistically significantly worse disability in diabetic patients with Dupuytren contracture both pre- and postoperatively, though the observed differences were far below the minimum clinically important difference for the QuickDASH. Both groups reported a large and statistically significant improvement in self-perceived hand normality following surgery. Level of Evidence: Level III (Therapeutic).

PMID:35808876 | DOI:10.1142/S2424835522500473

J Hand Surg Asian Pac Vol. 2022 Jun;27(3):421-429. doi: 10.1142/S2424835522300043.

ABSTRACT

Interpreting research is an important skill to ensure one can maintain their practise with current evidence. The technicalities of statistics can be daunting and thus, this article aims to provide a clear overview of key statistical tests that a surgeon will encounter. It highlights the various study designs, summary statistics and comparative tests that are used in clinical research. Furthermore, it provides a guide to determine which statistical method is most appropriate for various study designs. Overall, it aims to act as an introductory text to supplement further reading into the more advanced statistical methodologies. Level of Evidence: Level V.

PMID:35808879 | DOI:10.1142/S2424835522300043

Biol Rev Camb Philos Soc. 2022 Jul 8. doi: 10.1111/brv.12876. Online ahead of print.

ABSTRACT

Disturbances alter biodiversity via their specific characteristics, including severity and extent in the landscape, which act at different temporal and spatial scales. Biodiversity response to disturbance also depends on the community characteristics and habitat requirements of species. Untangling the mechanistic interplay of these factors has guided disturbance ecology for decades, generating mixed scientific evidence of biodiversity responses to disturbance. Understanding the impact of natural disturbances on biodiversity is increasingly important due to human-induced changes in natural disturbance regimes. In many areas, major natural forest disturbances, such as wildfires, windstorms, and insect outbreaks, are becoming more frequent, intense, severe, and widespread due to climate change and land-use change. Conversely, the suppression of natural disturbances threatens disturbance-dependent biota. Using a meta-analytic approach, we analysed a global data set (with most sampling concentrated in temperate and boreal secondary forests) of species assemblages of 26 taxonomic groups, including plants, animals, and fungi collected from forests affected by wildfires, windstorms, and insect outbreaks. The overall effect of natural disturbances on α-diversity did not differ significantly from zero, but some taxonomic groups responded positively to disturbance, while others tended to respond negatively. Disturbance was beneficial for taxonomic groups preferring conditions associated with open canopies (e.g. hymenopterans and hoverflies), whereas ground-dwelling groups and/or groups typically associated with shady conditions (e.g. epigeic lichens and mycorrhizal fungi) were more likely to be negatively impacted by disturbance. Across all taxonomic groups, the highest α-diversity in disturbed forest patches occurred under moderate disturbance severity, i.e. with approximately 55% of trees killed by disturbance. We further extended our meta-analysis by applying a unified diversity concept based on Hill numbers to estimate α-diversity changes in different taxonomic groups across a gradient of disturbance severity measured at the stand scale and incorporating other disturbance features. We found that disturbance severity negatively affected diversity for Hill number q = 0 but not for q = 1 and q = 2, indicating that diversity-disturbance relationships are shaped by species relative abundances. Our synthesis of α-diversity was extended by a synthesis of disturbance-induced change in species assemblages, and revealed that disturbance changes the β-diversity of multiple taxonomic groups, including some groups that were not affected at the α-diversity level (birds and woody plants). Finally, we used mixed rarefaction/extrapolation to estimate biodiversity change as a function of the proportion of forests that were disturbed, i.e. the disturbance extent measured at the landscape scale. The comparison of intact and naturally disturbed forests revealed that both types of forests provide habitat for unique species assemblages, whereas species diversity in the mixture of disturbed and undisturbed forests peaked at intermediate values of disturbance extent in the simulated landscape. Hence, the relationship between α-diversity and disturbance severity in disturbed forest stands was strikingly similar to the relationship between species richness and disturbance extent in a landscape consisting of both disturbed and undisturbed forest habitats. This result suggests that both moderate disturbance severity and moderate disturbance extent support the highest levels of biodiversity in contemporary forest landscapes.

PMID:35808863 | DOI:10.1111/brv.12876

Glob Chang Biol. 2022 Jul 8. doi: 10.1111/gcb.16336. Online ahead of print.

ABSTRACT

Extreme precipitation and drought events are predicted to become more intense and more frequent over the Amazon rainforest. Because changes in forest dynamics could prompt strong feedback loops to the global climate, it is of crucial importance to gain insight into the response of tropical forests to these recurring extreme climatic events. Here, we evaluated the Amazon forest stability (resistance and resilience) to drought in the context of past dry and wet climatic events using MODIS EVI satellite imagery and cumulative water deficit anomalies. We observed large spatial differences in the occurrence of extreme climatic events from 1980 to 2019, with an increase in drought frequency in the central and northern Amazon and drought intensity in the southern Amazon basin. An increasing trend in the occurrence of wet events was found in the western, southern, and eastern Amazon. Furthermore, we found significant legacy effects of previous climatic events on the forest drought response. An extreme drought closely preceding another drought decreased forest resilience, while the occurrence of a recent drier-than-usual event also decreased the forest resistance to later droughts. Both wetter-than-usual and extreme wet events preceding an extreme drought increased the resistance of the forest, and with similar effects sizes as dry events, indicating that wet and dry events have similarly sized legacy effects on the drought response of tropical forests. Our results indicate that the predicted increase in drought frequency and intensity can have negative consequences for the functioning of the Amazon forest. However, more frequent wet periods in combination with these droughts could counteract their negative impact. Finally, we also found that more stable forests according to the alternative stable states theory are also more resistant and resilient to individual droughts, showing a positive relationship between the equilibrium and non-equilibrium stability dynamics.

PMID:35808855 | DOI:10.1111/gcb.16336