Tag: pubmed

Med Image Anal. 2022 Mar 17;78:102418. doi: 10.1016/j.media.2022.102418. Online ahead of print.

ABSTRACT

Automatic and accurate prostate ultrasound segmentation is a long-standing and challenging problem due to the severe noise and ambiguous/missing prostate boundaries. In this work, we propose a novel polar transform network (PTN) to handle this problem from a fundamentally new perspective, where the prostate is represented and segmented in the polar coordinate space rather than the original image grid space. This new representation gives a prostate volume, especially the most challenging apex and base sub-areas, much denser samples than the background and thus facilitate the learning of discriminative features for accurate prostate segmentation. Moreover, in the polar representation, the prostate surface can be efficiently parameterized using a 2D surface radius map with respect to a centroid coordinate, which allows the proposed PTN to obtain superior accuracy compared with its counterparts using convolutional neural networks while having significantly fewer (18%∼41%) trainable parameters. We also equip our PTN with a novel strategy of centroid perturbed test-time augmentation (CPTTA), which is designed to further improve the segmentation accuracy and quantitatively assess the model uncertainty at the same time. The uncertainty estimation function provides valuable feedback to clinicians when manual modifications or approvals are required for the segmentation, substantially improving the clinical significance of our work. We conduct a three-fold cross validation on a clinical dataset consisting of 315 transrectal ultrasound (TRUS) images to comprehensively evaluate the performance of the proposed method. The experimental results show that our proposed PTN with CPTTA outperforms the state-of-the-art methods with statistical significance on most of the metrics while exhibiting a much smaller model size. Source code of the proposed PTN is released at https://github.com/DIAL-RPI/PTN.

PMID:35349838 | DOI:10.1016/j.media.2022.102418

Am J Hum Genet. 2022 Mar 22:S0002-9297(22)00101-X. doi: 10.1016/j.ajhg.2022.03.005. Online ahead of print.

ABSTRACT

Since 2005, genome-wide association (GWA) datasets have been largely biased toward sampling European ancestry individuals, and recent studies have shown that GWA results estimated from self-identified European individuals are not transferable to non-European individuals because of various confounding challenges. Here, we demonstrate that enrichment analyses that aggregate SNP-level association statistics at multiple genomic scales-from genes to genomic regions and pathways-have been underutilized in the GWA era and can generate biologically interpretable hypotheses regarding the genetic basis of complex trait architecture. We illustrate examples of the robust associations generated by enrichment analyses while studying 25 continuous traits assayed in 566,786 individuals from seven diverse self-identified human ancestries in the UK Biobank and the Biobank Japan as well as 44,348 admixed individuals from the PAGE consortium including cohorts of African American, Hispanic and Latin American, Native Hawaiian, and American Indian/Alaska Native individuals. We identify 1,000 gene-level associations that are genome-wide significant in at least two ancestry cohorts across these 25 traits as well as highly conserved pathway associations with triglyceride levels in European, East Asian, and Native Hawaiian cohorts.

PMID:35349783 | DOI:10.1016/j.ajhg.2022.03.005

Complement Ther Clin Pract. 2022 Mar 23;47:101575. doi: 10.1016/j.ctcp.2022.101575. Online ahead of print.

ABSTRACT

BACKGROUND: and purpose:Intrauterine adhesion (IUA) and re-adhesion were common problems in women of childbearing age. The aim of our research was to evaluate the efficacy of hyaluronic acid gel on preventing IUA and improving the fertility.

METHODS: A systematic search for randomized controlled trial (RCT) articles that tested the effectiveness of using hyaluronic acid gel during intrauterine surgery in prevention of IUA and improvement of fertility was performed in PubMed, Medline, Embase, the Cochrane Library and clinicaltrials.gov until December 2020. Data were extracted independently and analyzed using RevMan statistical software version 5.3.

RESULTS: Twelve articles (11 studies) were deemed eligible for inclusion. There was a significantly reduced proportion of IUA after using hyaluronic acid gel during intrauterine operation (OR 0.39, 95% CI 0.29 to 0.52). It has significantly reduced the incidence of moderate-to-severe IUA after using hyaluronic acid gel, but no effect on the mild IUA. In addition, our analysis showed that the hyaluronic acid gel group was associated with a significant increased incidence of pregnancy (OR 1.64, 95% CI 1.08 to 2.50).

CONCLUSION: Our analysis confirmed that using hyaluronic acid gel during intrauterine operation seemed to be more helpful for patients with high risk of IUA. However, larger and well-designed studies would be desired in the future to confirm its efficacy and safety in protecting fertility.

PMID:35349823 | DOI:10.1016/j.ctcp.2022.101575

Global Spine J. 2022 Mar 29:21925682221084969. doi: 10.1177/21925682221084969. Online ahead of print.

ABSTRACT

STUDY DESIGN: This is a meta-analysis and systematic review of the available literature.

OBJECTIVE: In the case of severe foraminal stenosis, conducting uncinate process resection (UPR) during ACDF could achieve complete nerve root decompression and significant relief of neurological symptoms for CR. However, there is some controversy regarding its necessity and safety. This study aims to compare the safety and efficacy of ACDF with UPR and ACDF.

METHODS: The following electronic databases were searched: Medline, PubMed, Embase, the Cochrane Central Register of Controlled Trials, Evidence Based Medicine Reviews, VIP, and CNKI. And the following data items were considered: baseline demographics, efficacy evaluation indicators, radiographic outcome, and surgical details.

RESULTS: 10 studies were finally identified, including 746 patients who underwent ACDF with UPR compared to 729 patients who underwent ACDF. The group of ACDF with UPR had statistically longer intraoperative time (95% CI: 4.83, 19.77, P = .001) and more intraoperative blood loss (95% CI: 12.23, 17.76, P < .001). ACDF with UPR obtained a significantly better improvement of Arm VAS at postoperative first follow-up (95% CI: -1.85, -.14 P = .02). There was no significant difference found in improvement of Neck VAS at postoperative latest follow-up (95% CI: -.88, .27, P = .30), improvement of Arm VAS at postoperative latest follow-up (95% CI: -.59, -.01, P = .05), improvement of NDI (95% CI: -2.34, .33, P = .14), JOA (95% CI: -.24, .43, P = .56), change of C2-C7 lordosis (95% CI: -.87, 1.33, P = .68), C2-C7 SVA (95% CI: -.73, 5.08, P = .14), T1 slope (95% CI: -2.25, 1.51, P = .70), and fusion rate (95% CI: .83, 1.90 P = .29).

CONCLUSION: ACDF with UPR is an effective and necessary surgical method for CR patients with severe foraminal stenosis.

PMID:35349779 | DOI:10.1177/21925682221084969

Brain Behav. 2022 Mar 29:e2549. doi: 10.1002/brb3.2549. Online ahead of print.

ABSTRACT

PURPOSE: There are few studies on the gender differences in mental health, happiness, and their related factors among the older population through the structural equation model (SEM) in Iran. We conducted this study to evaluate the factors affecting mental health and happiness in the elderly using an SEM by gender differences.

METHODS: A cross-sectional study was conducted on 739 elderly people in 2019 in Karaj, Iran. Sociodemographic, Symptom Checklist-90-Revised (SCL90-R), and the Oxford Happiness Inventory were applied to evaluate the relationships between happiness, mental health, and sociodemographic factors by using statistical path analysis with Lisrel 8.8 and SPSS-17.

RESULTS: Overall, 55.5% of the participants in the study were female. The SCL90 (p value = .000) and happiness (p value = .000) scores showed significant differences between men and women. Fit indices confirmed the high model fitness, desirability, and logical relationships between the variables according to the conceptual model in both men (X2 = 3.2, df = 1) and women (X2 = 5.4, df = 2) groups. According to the path analysis, among the variables that affected happiness just through the direct path, education had the most positive causal relationship in men (B = .13) and women (B = .16), but mental health problems in men (B = -.33) and women (B = -.26), as well as the distance from home to the healthcare center in men (B = -.13) and women (B = -.11), had the most negative causal relationship with happiness respectively. Age was the only variable that was negatively related to happiness through direct and indirect paths in the women (B = -.188).

CONCLUSION: We provided an empirical model that illustrates the relationships between happiness, mental health, and related factors in the older population. Gender differences in path analysis showed that age negatively affects the happiness of older women but not men.

PMID:35349774 | DOI:10.1002/brb3.2549

Hepatology. 2022 Mar 29. doi: 10.1002/hep.32494. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: The diagnostic accuracy of Liver Imaging Reporting and Data System (LI-RADS) v.2018 and European Association for the Study of the Liver (EASL) criteria for the diagnosis of hepatocellular carcinoma has been widely evaluated, but their reliability has not. We aimed to assess and compare the reliability of LI-RADS v.2018 and EASL criteria for the diagnosis of hepatocellular carcinoma using MRI with extracellular contrast agents (ECA) and gadoxetic acid (GA) and to determine the effect of ancillary features on LI-RADS reliability. Approach and Results Ten readers reviewed MRI studies of 92 focal liver lesions measuring <3 cm acquired with ECA and GA less than 1 month apart from two prospective trials, assessing EASL criteria, LI-RADS major and ancillary features, and LI-RADS categorization with and without including ancillary features. Inter-reader agreement for definite HCC diagnosis were substantial and similar for the two contrasts for both EASL and LI-RADS criteria. For ECA-MRI and GA-MRI, respectively, inter-reader agreement was k=0.72 (95%CI:0.63-0.81) and k=0.72 (95%CI:0.63-0.8) for nonrim hyperenhancement, k=0.63 (95%CI:0.54-0.72) and 0.57 (95%CI:0.48-0.66) for nonperipheral washout, and k=0.49 (95%CI:0.4-0.59) and k=0.48 (95%CI:0.37-0.58) for enhancing capsule. The inter-reader agreement for LI-RADS after applying ancillary features remained in the same range of agreement.

CONCLUSION: Agreement for definite hepatocellular carcinoma was substantial and similar for both scoring systems and the two contrast agents in small focal liver lesions. The agreement for LI-RADS categorization was lower for both contrast agents, and including LI-RADS ancillary features did not improve the agreement.

PMID:35349760 | DOI:10.1002/hep.32494

J Cosmet Dermatol. 2022 Mar 29. doi: 10.1111/jocd.14948. Online ahead of print.

ABSTRACT

This study aimed to evaluate the safety and efficacy of a novel therapeutic strategy, a microneedle fractional radiofrequency system, for hand rejuvenation. Sixteen subjects were enrolled in a self-controlled evaluator-blind prospective trial. All subjects received three microneedle fractional radiofrequency treatments at 4-week intervals. Hand volume was evaluated through subjective (Hand Volume Rating Scale) and quantitative measurements. Patients were also assessed on the Global Aesthetic Improvement Scale using digital photographs. Patients were followed up at 1, 3, and 6 months after the last radiofrequency treatment. Statistically significant improvements on the Global Aesthetic Improvement Scale and Hand Rating Volume Scale were noted (p<0.05). Compared with the control side, the treated hand showed a 44% improvement in dorsal skin surface roughness (p<0.05). Quantitative measurements of hand volume showed a trend toward increased volume for the treated hand, but the difference was not statistically significant. We conclude that microneedle fractional radiofrequency is a safe therapeutic option for hand rejuvenation.

PMID:35349759 | DOI:10.1111/jocd.14948

Immun Inflamm Dis. 2022 Apr;10(4):e597. doi: 10.1002/iid3.597.

ABSTRACT

BACKGROUND: Systemic reactivation of Epstein-Barr virus (EBV) may occur in novel coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). However, the clinical consequences of EBV reactivation remain uncertain.

METHODS: In this retrospective study, we screened 1314 patients with confirmed COVID-19 who died or were discharged between January 1, 2020 and March 12, 2020, in Wuhan Infectious Disease Hospital, Wuhan, China. Patients who had complete data for EBV serology and cytomegalovirus (CMV) serology were eligible. Serum levels of viral capsid antigen (VCA)-immunoglobulin G (IgG), Epstein-Barr nuclear antigen-IgG, VCA-IgM, early antigen (EA)-IgG, CMV-IgG, and CMV-IgM were compared between survivors and nonsurvivors. Dynamic changes of laboratory tests and outcomes were compared in patients with and without ganciclovir treatment. We used 1:1 matching based on age, gender, and illness severity to balance baseline characteristics.

RESULTS: EBV reactivation was present in 55 of 217 patients. EBV reactivation was associated with age (57.91 [13.19] vs. 50.28 [12.66] years, p < .001), female gender (31 [56%] vs. 60 [37%], p = .02). Patients with EBV reactivation have statistically nonsignificant higher mortality rate (12 [22%] vs. 18 [11%], p = .08). EA-IgG levels were significantly higher in nonsurvivors than in survivors (median difference: -0.00005, 95% confidence interval, CI [-3.10, 0.00], p = .05). As compared to patients with COVID-19 who did not receive ganciclovir therapy, ganciclovir-treated patients had improved survival rate (0.98, 95% CI [0.95, 1.00] vs. 0.88, 95% CI [0.81, 0.95], p = .01). Hemoglobin (p < .001) and prealbumin (p = .02) levels were significantly higher in ganciclovir-treated patients.

CONCLUSION: A high proportion of COVID-19 patients had EBV reactivation that may be associated with an increased risk of death. Whether treatment with ganciclovir may decrease the mortality of COVID-19 patients complicated with EBV reactivation warrants to be addressed in a placebo-controlled randomized trial in the future.

PMID:35349757 | DOI:10.1002/iid3.597

Clin Exp Dent Res. 2022 Mar 29. doi: 10.1002/cre2.555. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study was to evaluate the effect of finishing protocol and exposure to staining solutions on color stability of dental resin composites.

MATERIALS AND METHODS: A nanofill and microhybrid composite, three finishing protocols (mylar, Soflex disc, and white polishing stone) and four staining solutions (tea, red wine, khat extract-two concentrations, control-distilled water) were evaluated. A digital spectrophotometer was used for color change (ΔE) measurements employing the CIE-Lab-color system. Paired/independent-sample t test and two-way analysis of variance (ANOVA) followed by Tukey’s honestly significant difference posthoc test were used for inferential statistics at α = .05.

RESULTS: Soflex finish was associated with least staining and comparable color stability for the two materials in tea and red wine. In Khat 2, microhybrid composite had statistically significant better color stability than nanofill for Soflex finish (14 days t = 3.270, p = .011). For microhybrid composite, mylar resulted in highest mean ΔE, whereas Soflex recorded the least in all staining solutions. For nanofill composite, white stone resulted in highest mean ΔE, whereas Soflex demonstrated the least mean ΔE in all staining solutions, except red wine where mylar demonstrated the least mean ΔE. For mylar finish, nanofill demonstrated statistically significant better color stability than microhybrid in both red wine (14 days t = 4.902, p = .001) and Khat 1 (14 days t = 3.252, p = .012). For stone finish, microhybrid demonstrated statistically significant better color stability than nanofill in all staining solutions (14 days t ≥ 4.785, p ≤ .001). Two-way ANOVA showed a statistically significant difference in mean ΔE between and within specimens (F = 42.658, p < .001). All staining solutions caused clinically unacceptable discoloration for mylar and white stone finish. For Soflex finish, red wine produced clinically unacceptable color difference beyond 48 h.

CONCLUSION: There was a difference in color stability of resin composites depending on filler type, further influenced by finishing protocol. Soflex disc finish results in better color stability than mylar and white stone in both microhybrid and nanofill composites.

CLINICAL SIGNIFICANCE: Esthetic dental restorations such as resin composites are routine in contemporary restorative practice. Color stability of composites may be influenced by surface finish, dependent on the filler type, and consumption of chromogenic substances such as khat. To prolong their service, selection of suitable finishing protocols is an important consideration.

PMID:35349747 | DOI:10.1002/cre2.555

Immun Inflamm Dis. 2022 Apr;10(4):e607. doi: 10.1002/iid3.607.

ABSTRACT

BACKGROUND: Oral immunotherapy (OIT) is a promising therapeutic approach for children with persistent IgE-mediated cow’s milk allergy (CMA) but data are still limited.

OBJECTIVE: To analyze the prevalence of life-threatening anaphylaxis in children with persistent CMA undergoing OIT and to evaluate potential risk factors.

METHODS: This is a retrospective cohort study among children with persistent CMA undergoing OIT over a 20-year period, following a specific Oral Tolerance Induction protocol. Adverse reactions during the whole period and data on long-term outcome were registered. Descriptive and nondescriptive statistics were used to describe data.

RESULTS: Three hundred forty-two children were evaluated. During OIT, 12 children (3.5%) presented severe anaphylactic reactions that needed an adrenaline injection. None required intubation, intensive care unit (ICU) admission, or showed a fatal outcome. Five of them abandoned OIT, five reached unrestricted diet and the others are still undergoing OIT. As far as outcome is concerned, 51.2% reached an unrestricted diet; 13.5% are at the build-up stage; and 28.0% (97 patients) stopped the OIT. Among these 96 children, 6.3% experienced a severe reaction induced by accidental ingestion of milk with two fatal outcomes.

CONCLUSIONS: The risk of life-threatening reactions was nearly two times lower (3.5% vs. 6.3%) among patients assuming milk during OIT than in those who stopped the protocol. A trend in favor of more severe reactions, requiring ICU admission, or fatal, was shown in patients who stopped OIT.

PMID:35349753 | DOI:10.1002/iid3.607