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Nevin Manimala Statistics

47XXY and 47XXX in Scleroderma and Myositis

ACR Open Rheumatol. 2022 Mar 29. doi: 10.1002/acr2.11413. Online ahead of print.

ABSTRACT

OBJECTIVE: We undertook this study to examine the X chromosome complement in participants with systemic sclerosis (SSc) as well as idiopathic inflammatory myopathies.

METHODS: The participants met classification criteria for the diseases. All participants underwent single-nucleotide polymorphism typing. We examined X and Y single-nucleotide polymorphism heterogeneity to determine the number of X chromosomes. For statistical comparisons, we used χ2 analyses with calculation of 95% confidence intervals.

RESULTS: Three of seventy men with SSc had 47,XXY (P = 0.0001 compared with control men). Among the 435 women with SSc, none had 47,XXX. Among 709 men with polymyositis or dermatomyositis (PM/DM), seven had 47,XXY (P = 0.0016), whereas among the 1783 women with PM/DM, two had 47,XXX. Of 147 men with inclusion body myositis (IBM), six had 47,XXY, and 1 of the 114 women with IBM had 47,XXX. For each of these myositis disease groups, the excess 47,XXY and/or 47,XXX was significantly higher compared with in controls as well as the known birth rate of Klinefelter syndrome or 47,XXX.

CONCLUSION: Klinefelter syndrome (47,XXY) is associated with SSc and idiopathic inflammatory myopathies, similar to other autoimmune diseases with type 1 interferon pathogenesis, namely, systemic lupus erythematosus and Sjögren syndrome.

PMID:35352506 | DOI:10.1002/acr2.11413

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Single-cell RNA sequencing technologies and applications: A brief overview

Clin Transl Med. 2022 Mar;12(3):e694. doi: 10.1002/ctm2.694.

ABSTRACT

Single-cell RNA sequencing (scRNA-seq) technology has become the state-of-the-art approach for unravelling the heterogeneity and complexity of RNA transcripts within individual cells, as well as revealing the composition of different cell types and functions within highly organized tissues/organs/organisms. Since its first discovery in 2009, studies based on scRNA-seq provide massive information across different fields making exciting new discoveries in better understanding the composition and interaction of cells within humans, model animals and plants. In this review, we provide a concise overview about the scRNA-seq technology, experimental and computational procedures for transforming the biological and molecular processes into computational and statistical data. We also provide an explanation of the key technological steps in implementing the technology. We highlight a few examples on how scRNA-seq can provide unique information for better understanding health and diseases. One important application of the scRNA-seq technology is to build a better and high-resolution catalogue of cells in all living organism, commonly known as atlas, which is key resource to better understand and provide a solution in treating diseases. While great promises have been demonstrated with the technology in all areas, we further highlight a few remaining challenges to be overcome and its great potentials in transforming current protocols in disease diagnosis and treatment.

PMID:35352511 | DOI:10.1002/ctm2.694

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Does Gender Impact a Diagnosis of Ankylosing Spondylitis?

ACR Open Rheumatol. 2022 Mar 29. doi: 10.1002/acr2.11428. Online ahead of print.

ABSTRACT

OBJECTIVE: The study objective was to explore differences in ankylosing spondylitis (AS) diagnosis experiences between men and women by examining the coding of health events over the 2 years preceding AS diagnosis.

METHODS: Claims data (January 2006-April 2019) from the MarketScan databases were examined. Patients who had received two or more AS diagnoses at least 30 days apart and had at least 2 years of insurance enrollment before their first AS diagnosis were analyzed. Men were matched 1:1 to women by age, diagnosis date, insurance type, and enrollment duration. Health events (diagnosis and provider codes) were examined over 2 years before AS diagnosis and stratified by gender. Data were analyzed using univariate χ2 tests.

RESULTS: Among 7744 patients, 274 of 1906 AS-related codes showed statistically significant differences between men and women. Women received more diagnosis codes than men across diagnoses and providers; the largest difference in diagnosis codes among women versus men was in peripheral symptom coding (57.7% vs. 43.9%, respectively). More women than men received diagnosis codes for depression (21.2% vs. 9.8%) and other musculoskeletal symptoms (52.8% vs. 40.0%); only gout was more common in men (6.5%) than in women (2.2%). Among men, backache codes gradually increased 12 months before AS diagnosis, whereas axial and sacroiliitis coding increased sharply immediately before diagnosis. The greatest difference in physician types visited was for rheumatologists: 64.2% of women had visits compared with 45.1% of men.

CONCLUSION: Further investigation into the dissimilarities in diagnostic experiences between men and women is needed to determine whether differences are due to disease phenotype or potential cognitive bias influencing diagnostic decision-making.

PMID:35352497 | DOI:10.1002/acr2.11428

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Efficacy of topical steroids for the treatment of olfactory disorders caused by COVID-19: A systematic review and meta-analysis

Clin Otolaryngol. 2022 Mar 30. doi: 10.1111/coa.13933. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the effect of topical steroids on acute-onset olfactory dysfunction in patients infected with COVID-19.

DESIGN AND SETTING: Systematic review and meta-analysis of cohort studies.

PARTICIPANTS: Patients infected with COVID-19.

MAIN OUTCOME MEASURES: PubMed, Embase, the Web of Science, SCOPUS, Cochrane database, and Google Scholar were searched for articles up to September 2021. We analyzed studies comparing the improvement of olfactory dysfunction between topical steroid treatment and control groups (placebo or no treatment). In addition, we performed a subgroup analysis by study type.

RESULTS: The improvement of olfactory score at 2 (standardized mean difference [SMD] = 0.7272, 95% confidence interval = [0.3851, 1.0692], p < 0.0001, I2 = 62.1%) and 4 weeks posttreatment (SMD = 1.0440 [0.6777, 1.4102], p < 0.0001, I2 = 61.2%) was statistically greater in the treatment than control group. However, there was no significant difference (odds ratio [OR] = 1.4345 [0.9525, 2.1604], p = 0.0842, I2 = 45.4%) in the incidence of fully recovery from anosmia/hyposmia between the treatment and control groups. In subgroup analysis, there were no significant differences in the improvement of olfactory score at 4 weeks posttreatment (OR = 0.6177 [0.1309, 1.1045] vs. 0.1720 [0.8002, 1.5438], p = 0.0761) or the incidence of full recovery from anosmia/hyposmia (OR = 1.8478 [0.6092, 5.6053] vs. 1.3784 [0.8872, 2.1414], p = 0.8038) between randomized and non-randomized controlled trials.

CONCLUSIONS: Although this meta-analysis found that topical steroids improved the acute onset olfactory dysfunction caused by COVID-19, there was no difference in the rate of full olfactory recovery between treated and control patients.

PMID:35352483 | DOI:10.1111/coa.13933

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Prevention and management of acneiform rash associated with EGFR inhibitor therapy: A systematic review and meta-analysis

Asia Pac J Clin Oncol. 2022 Mar 29. doi: 10.1111/ajco.13740. Online ahead of print.

ABSTRACT

INTRODUCTION: Epidermal growth factor receptor (EGFR) inhibitors are established therapies for advanced lung, colorectal, and head and neck cancers. They commonly cause acneiform eruptions that affect patient quality of life and may lead to discontinuation of therapy.

METHODS: A systematic review and meta-analysis was undertaken to assess strategies for the prevention and reactive management of acneiform rash associated with EGFR inhibitor therapy for advanced lung, colorectal, and head and neck cancers. A systematic Medline, Embase, and EBM Reviews database search was conducted on the 2nd of January 2021. The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed and the studies were critically appraised. Studies were selected if they focused on preventing or treating acneiform eruptions in adults being treated for advanced lung cancer, colorectal cancer, and head and neck cancers with EGFR inhibitors.

RESULTS: Oral antibiotics had the greatest efficacy in preventing grade 2 or higher acneiform eruptions with a relative risk reduction of 40% (RR = .6, 95% CI .46-.79, p < .01). Other treatment modalities did not have statistically significant results. Topical antibiotics had a total relative risk reduction of 19% (RR = .81, 95% CI .45-1.48, p = .5). Vitamin K1 cream did not reduce the relative risk (RR = 1.08, 95% CI .45-1.48, p = .50). Sunscreen had a total relative risk reduction of 25% (RR = .75, 95% CI .49-1.14, p = .18).

CONCLUSIONS: The results of this meta-analysis reinforce the fact that oral tetracycline antibiotics are the most efficacious prophylactic option for acneiform eruptions in EGFR inhibitors. They should be offered to suitable patients commencing treatment and used with a general skin-care routine involving emollients and avoidance of irritants.

PMID:35352492 | DOI:10.1111/ajco.13740

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A ten-year follow-up of the prevalence of pressure injuries in the Czech Republic: Analysis of the National Registry

Int Wound J. 2022 Mar 29. doi: 10.1111/iwj.13793. Online ahead of print.

ABSTRACT

The study aims to follow up on the analysis of Pressure injuries (PIs) prevalence conducted between 2007 and 2014 and after the new methodological requirements for PIs surveillance establishment at the national level. A retrospective, nationwide cross-sectional analysis of data regarding the STROBE checklist was collected by the National Health Information System (NHIS). The International Classification of Diseases (ICD-10) diagnoses L89.0-L89.9 for PIs were used in the period 2010-2019. A total of 264 442 records of patients with diagnoses of L89.0-L89.9 were identified from 2010 to 2019 (26 444 patients per year on average). The numbers are increasing every year, and there is a 40% increase between 2010 and 2019. When comparing recorded PIs, the percentage of PIs occurrence in category I decreased, and the number of PIs in category IV increased in the second analysed period. Still, in absolute numbers, there is an increase across all categories. The age of patients with recorded PIs also rose slightly in the second analysed period. We have proven the PIs prevalence increase in an ageing population.

PMID:35352481 | DOI:10.1111/iwj.13793

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Modeling total predation to avoid perverse outcomes from cat control in a data-poor island ecosystem

Conserv Biol. 2022 Mar 30. doi: 10.1111/cobi.13916. Online ahead of print.

ABSTRACT

Data hungry, complex ecosystem models are often used to predict the consequences of threatened species management, including perverse outcomes. Unfortunately, this approach is impractical in many systems, which have insufficient data to parameterize ecosystem interactions or reliably calibrate or validate such models. Here we demonstrate a different approach, using a minimum realistic model to guide decisions in data- and resource-scarce systems. We illustrate our approach with a case-study in an invaded ecosystem from Christmas Island, Australia, where there are concerns that cat eradication to protect native species, including the red-tailed tropicbird, could release meso-predation by invasive rats. We use biophysical constraints (metabolic demand) and observable parameters (e.g. prey preferences) to assess the combined cat and rat abundances which would threaten the tropicbird population. We find that the population of tropicbirds cannot be sustained if predated by 1607 rats (95% credible interval (CI) [103, 5910]) in the absence of cats, or 21 cats (95% CI [2, 82]) in the absence of rats. For every cat removed from the island, the bird’s net population growth rate improves, provided that the rats do not increase by more than 77 individuals (95% CI [30, 174]). Thus, in this context, one cat is equivalent to 30-174 rats. Our methods are especially useful for on-the-ground predator control in the absence of knowledge of predator-predator interactions, to assess whether 1) the current abundance of predators threatens the prey population of interest, 2) managing one predator species alone is sufficient to protect the prey species given potential release of another predator, and 3) control of multiple predator species is needed to meet the conservation goal. Our approach demonstrates how to use limited information for maximum value in data-poor systems, by shifting the focus from predicting future trajectories, to identifying conditions which threaten the conservation goal. This article is protected by copyright. All rights reserved.

PMID:35352431 | DOI:10.1111/cobi.13916

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The relationship between occupational dust exposure and incidence of diabetes in male workers: a retrospective cohort study

Diabet Med. 2022 Mar 30:e14837. doi: 10.1111/dme.14837. Online ahead of print.

ABSTRACT

AIM: Previous studies have focused on the association between ambient particulate matter and diabetes. However, the relationship between subacute exposure to occupational dust and diabetes has not been explored. We aimed to assess this relationship.

METHODS: Men who worked in dust-related process factories between January 2013 and December 2017 were recruited from a Korea Health Worker Examination Common Data Model cohort. A history of physician-diagnosed diabetes, use of an anti-diabetic drug, or a fasting blood glucose level of ≥7 mmol/L were considered the criteria to diagnose diabetes. Multivariable time-dependent Cox analysis estimated hazard ratios (HRs) and 95% CIs for incident diabetes associated with exposure to occupational dust exposure; interactions with lifestyle factors were analysed. Sensitivity analyses used propensity score matching and landmark analysis RESULTS: Among 5,141 male participants (median follow-up duration, 3.85 years), 349 participants had diabetes. Occupational dust exposure was related to an increased risk of diabetes in the time-dependent Cox analysis (entire cohort: HR 1.66 [95% CI 1.25-2.19], matched cohort: HR 1.65 [95% CI 1.22-2.24]). The findings showed the same direction in the landmark analysis (HR 1.42 [95% CI 1.01-1.99]).

CONCLUSIONS: A significant relationship exists between occupational dust exposure and increased risk of diabetes in male workers. Further studies should be conducted to confirm that occupational dust exposure is a possible risk factor for diabetes.

PMID:35352388 | DOI:10.1111/dme.14837

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Bioimpedance Spectroscopy Reveals Important Association of Fluid Status and T1 -Mapping by Cardiovascular Magnetic Resonance

J Magn Reson Imaging. 2022 Mar 30. doi: 10.1002/jmri.28159. Online ahead of print.

ABSTRACT

BACKGROUND: Extracellular matrix expansion is a key pathophysiologic feature in heart failure and can be quantified noninvasively by cardiac magnetic resonance T1 -mapping. Free water within the interstitial space of the myocardium, however, may also alter T1 -mapping results.

PURPOSE: To investigate the association between systemic fluid status and T1 -mapping by cardiac magnetic resonance.

STUDY TYPE: Prospective, observational single-center study.

POPULATION: Two-hundred eighty-five consecutive patients (44.4% female, 70.0 ± 14.9 years old) scheduled for cardiac MR due to various cardiac diseases.

SEQUENCE AND FIELD STRENGTH: 1.5-T scanner (Avanto Fit, Siemens Healthineers, Erlangen, Germany). For T1 -mapping, electrocardiographically triggered modified-Look-Locker inversion (MOLLI) recovery sequence using a 5(3)3 prototype on a short-axis mid-cavity slice and with a four-chamber view was performed.

ASSESSMENTS: MR parameters including native myocardial T1 -times using MOLLI and extracellular volume (MR-ECV) were assessed, and additionally, we performed bioimpedance analysis (BIA). Furthermore, demographic data and comorbidities were assessed.

STATISTICS: Wilcoxon’s rank-sum test, chi-square tests, and for correlation analysis, Pearson’s correlation coefficients were used. Regression analyses were performed to investigate the association between patients’ fluid status and T1 -mapping results. A P-value <0.05 was considered statistically significant.

RESULTS: The mixed cohort presented with a mean overhydration (OH) of +0.2 ± 2.4 liters, as determined by BIA. By MR, native T1 -times were 1038 ± 51 msec and MR-ECV was 31 ± 9%. In the multivariable regression analysis, only OH was significantly associated with MR-ECV (adj. beta: 0.711; 95% CI: 0.28 to 1.14) along with male sex (adj. beta: 2.529; 95% CI: 0.51 to 4.55). In linear as well as multivariable analysis, only OH was significantly associated with native T1 times (adj. beta: 3.750; 95% CI: 1.27 to 6.23).

CONCLUSION: T1 -times and MR-ECV were significantly associated with the degree of OH on BIA measurement. These effects were independent from age, sex, body mass index, and hematocrit. Patients’ volume status may thus be an important factor when T1 -time and MR-ECV values are interpreted.

LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 3.

PMID:35352420 | DOI:10.1002/jmri.28159

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Psoriasis risk after betablocker exposure: description of a pharmacovigilance signal

Br J Clin Pharmacol. 2022 Mar 29. doi: 10.1111/bcp.15330. Online ahead of print.

ABSTRACT

AIM: We aimed to investigate French pharmacovigilance data. The objective was to characterize psoriatic conditions occurred after BB exposure and bright to light a possible pharmacovigilance signal.

METHODS: Spontaneous reports of psoriatic conditions recorded in the French national Pharmacovigilance database (FPVD) between 1985 and 2019 were extracted. We performed a retrospective, descriptive analysis of reports linked to BB exposure. Association between psoriasis risk and BB exposure was assessed using a case/non-case study.

RESULTS: Two hundred and twenty-five reports of psoriatic conditions after BB exposure were recorded in the FPVD during the study period. Both, cardioselective and non-cardioselective, topical and systemic, BBs are involved. Therapeutic indication of BB was mainly hypertension Mean time to onset was 5 months and outcome was favorable in 68% after BB discontinuation. These features were concordant with those of literature reports. The reporting odds ratio (ROR) was 8.95 (95%CI 7.75 – 10.33).

CONCLUSION: We highlighted a statistically significant disproportionality which constitutes a pharmacovigilance signal. Psoriasis risk with BBs is a class effect. Increasing surveillance during the 1st year of BB exposure is needed.

PMID:35352377 | DOI:10.1111/bcp.15330