Tag: pubmed

Arch Dermatol Res. 2022 Jun 25. doi: 10.1007/s00403-022-02366-8. Online ahead of print.

ABSTRACT

Disparities in racial diversity in the field of dermatology continue to persist given that dermatology has the second lowest percentage of underrepresented minorities (URM), only second to orthopedic surgery. This study aims to investigate any trends in racial representation of dermatology residency applicants over a 5-year period from 2016 to 2020. Dermatology residency applicant race data were extracted from the Electronic Residency Application Service (ERAS) of the Association of American Medical Colleges (AAMC) for application seasons 2016-2020 for a retrospective review study. There was an overall increase in the number of dermatology residency applicants during the 5-year study period. Prior to 2018 (midpoint of the study), 14.1% of applicants identified as URM compared to 16.2% after 2018, although this difference was not statistically significant (p = 0.25). Our findings suggest that in the study period analyzed, racial representation remained relatively similar, with a non-statistically significant increase in URM applicants. Outlining the current trends in dermatology residency applicants may be helpful in identifying factors affecting the disparity in racial representation within the field. There is hope that dermatology residency applicants are becoming more racially diverse with improved representation of URMs.

PMID:35751663 | DOI:10.1007/s00403-022-02366-8

Arch Dermatol Res. 2022 Jun 25. doi: 10.1007/s00403-022-02367-7. Online ahead of print.

ABSTRACT

Disparities in racial diversity in the field of dermatology continue to persist given that dermatology has the second lowest percentage of underrepresented minorities (URM), only second to orthopedic surgery. This study aims to investigate any trends in racial representation of Mohs Micrographic Surgery (MMS) fellowship applicants over a five-year period from 2016 to 2020. Dermatology residency applicant race data were extracted from the San Francisco Match for application seasons 2016-2020 for a retrospective review study. There was an overall increase in the number of MMS fellowship applicants during the five-year study period. Prior to 2018 (midpoint of study), 6.6% of matched applicants and 10.9% of unmatched applicants identified as URMs, compared to 8.1% of matched applicants and 10.1% of unmatched applicants after 2018, but this increase was not statistically significant (p = 0.62). There is hope that Mohs Micrographic Surgery fellowship applicants are becoming more racially diverse with improved representation of underrepresented minorities.

PMID:35751662 | DOI:10.1007/s00403-022-02367-7

Eur Heart J. 2022 Jun 25:ehac322. doi: 10.1093/eurheartj/ehac322. Online ahead of print.

ABSTRACT

AIMS: To search for sequence variants associated with ACEi discontinuation and to test their association with ACEi-associated adverse drug reactions (ADRs).

METHODS AND RESULTS: A genome-wide association study (GWAS) on ACEi discontinuation was conducted, including 33 959 ACEi-discontinuers and 44 041 controls. Cases were defined as persons who switched from an ACEi treatment to an angiotensin receptor blocker. Controls were defined as persons who continued ACEi treatment for at least 1 year. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were computed for ACEi discontinuation risk by mixed model regression analysis. Summary statistics from the individual cohorts were meta-analyzed with a fixed-effects model. To test for association with specific ACEi-associated ADRs, any genome-wide significant (P < 5 × 10-8) ACEi discontinuation variants was tested for association with ACEi-associated cough and angioedema. A polygenetic risk score (PRS) based on ACEi discontinuation GWAS data was constructed and tested for association with ACEi-associated cough and angioedema in two population-based samples. In total, seven genetic genome-wide loci were identified, of which six were previously unreported. The strongest association with ACEi discontinuation was at 20q13.3 (NTSR1; OR: 1.21; 95% CI: 1.17-1.24; P = 2.1 × 10-34). Five of seven lead variants were associated with ACEi-associated cough, whereas none were associated with ACEi-associated angioedema. The ACEi discontinuation PRS was associated with ACEi-associated cough in a dose-response manner but not with ACEi-associated angioedema. ACEi discontinuation was genetically correlated with important causes for cough, including gastro-esophageal reflux disease, allergic rhinitis, hay fever, and asthma, which indicates partly shared genetic underpinning between these traits.

CONCLUSION: This study showed the advantage of using prescription patterns to discover genetic links with ADRs. In total, seven genetic loci that associated with ACEi discontinuation were identified. There was evidence of a strong association between our ADR phenotype and ACEi-associated cough. Taken together, these findings increase insight into the pathophysiological processes that underlie ACEi-associated ADRs.

PMID:35751511 | DOI:10.1093/eurheartj/ehac322

Orthod Craniofac Res. 2022 Jun 25. doi: 10.1111/ocr.12597. Online ahead of print.

ABSTRACT

PURPOSE: To apply geometric morphometrics and multivariate statistics to evaluate changes of the face for female Chinese patients who underwent orthodontic treatment with different type of anchorage control.

METHODS: Forty-six adult female patients were enrolled including 33 four first premolars extraction cases (17 patients with mini-implants for maximum anchorage control and 16 patients without mini-implants) and 13 non-extraction cases with minimum treatment duration of 15 months. Spatially-dense correspondence were established among all the images The pre-and post-treatment average faces of the two extraction groups and the non-extraction group were generated. Partial least squares regression was used to test the statistical significance of the effects of treatment for different anchorage choice.

RESULTS: The upper and lower lips were retruded significantly after treatment in the extraction groups. In the maximum anchorage control group, the temple and cheek were depressed by approximately 1mm and the zygomatic regions were increased in the mid-face. However, these changes were not statistically significant. In comparison, no statistically significant facial changes occurred in the non-extraction group.

CONCLUSIONS: The anchorage choice and the removal of four first premolars extraction influence lip shape as well as the perioral regions. However, extraction treatment does not impact the appearance of the cheeks and temples on a statistically level, as compared to orthodontic treatment without premolar extractions. Spatially-dense geometric morphometric facilitates comprehensive treatment effects quantification and visualization on the full facial changes for improving orthodontic outcome evaluation.

PMID:35751510 | DOI:10.1111/ocr.12597

Epilepsia. 2022 Jun 25. doi: 10.1111/epi.17347. Online ahead of print.

ABSTRACT

Seizure clusters are seizures that occur in rapid succession during periods of heightened seizure risk and are associated with substantial morbidity and sudden unexpected death in epilepsy. The objective of this feasibility study is to evaluate the performance of a novel seizure cluster forecasting algorithm. Chronic ambulatory electrocorticography recorded over an average of 38 months in 10 subjects with drug-resistant epilepsies was analyzed pseudoprospectively by dividing data into training (first 85%) and validation periods. For each subject, the probability of seizure clustering, derived from the Kolmogorov-Smirnov statistic using a novel algorithm, was forecasted in the validation period using individualized autoregressive models that were optimized from training data. The primary outcome of this study was the mean absolute scaled error (MASE) of 1-day horizon forecasts. From 10 subjects, 394±142 (mean±SD) ECoG-based seizure events were extracted for analysis, representing a span of 38±27 months of recording. MASE across all subjects were 0.74±0.09, 0.78±0.09, and 0.83±0.07 at 0.5-, 1-, and 2-day horizons. The feasibility study demonstrates that seizure clusters are quasiperiodic and can be forecasted to clinically meaningful horizons. Pending validation in larger cohorts, the forecasting approach described herein may herald chronotherapy during imminent heightened seizure vulnerability.

PMID:35751497 | DOI:10.1111/epi.17347

Orthod Craniofac Res. 2022 Jun 25. doi: 10.1111/ocr.12596. Online ahead of print.

ABSTRACT

OBJECTIVE: This randomized controlled trial (RCT) aims to investigate the short-term effects of chlorhexidine mouthwash (MW) on gingival health surrounding orthodontic miniscrew implants (OMIs) and their overall survivability.

MATERIALS AND METHODS: Thirty-two participants (mean age, 22.8 years) undergoing fixed orthodontic appliance treatment after maxillary premolar extraction were randomly allocated in a parallel fashion to either receive (1) MW with an active component of chlorhexidine, or (2) a placebo. Each participant received two maxillary buccal OMIs for anchorage reinforcement purposes. Participants were assessed for their gingival oral health status around all inserted OMIs and had their OMI survivability recorded at three time points; T1=1 month, T2=3 months, and T3=6 months after OMI placement. A Kaplan Meier plot was used to estimate the survival function of OMIs.

RESULTS: All randomized participants completed the follow-up period. In terms of gingival oral health, there were no statistically significant differences at any time point between the chlorhexidine MW group and the placebo-controlled group (P > 0.05). One OMI was lost in the chlorhexidine MW group and another two OMIs in the control group. There was no significant difference between both groups in terms of survivability (P = 0.585).

CONCLUSION: The use of chlorhexidine MW does not seem to have a significant clinical impact on the gingival health around OMIs or their survivability in this pilot study.

PMID:35751508 | DOI:10.1111/ocr.12596

Mol Ecol. 2022 Jun 25. doi: 10.1111/mec.16578. Online ahead of print.

ABSTRACT

Examining natural selection in wild populations is challenging, but crucial to understanding many ecological and evolutionary processes. Additionally, in hybridizing populations, natural selection may be an important determinant of the eventual outcome of hybridization. We characterized several components of relative fitness in hybridizing populations of Yellowstone cutthroat trout and rainbow trout in an effort to better understand the prolonged persistence of both parental species despite predictions of extirpation. Thousands of genomic loci enabled precise quantification of hybrid status in adult and subsequent juvenile generations; a subset of those data also identified parent-offspring relationships. We used linear models and simulations to assess the effects of ancestry on reproductive output and mate choice decisions. We found a relatively low number of late-stage (F3+) hybrids and an excess of F2 juveniles relative to the adult generation in one location, which suggests the presence of hybrid breakdown decreasing the fitness of F2+ hybrids later in life. Assessments of reproductive output showed that Yellowstone cutthroat trout are more likely to successfully reproduce and produce slightly more offspring than their rainbow trout and hybrid counterparts. Mate choice appeared to be largely random, though we did find statistical support for slight female preference for males of similar ancestry. Together, these results show that native Yellowstone cutthroat trout are able to outperform rainbow trout in terms of reproduction and suggests that management action to exclude rainbow trout from spawning locations may bolster the now-rare Yellowstone cutthroat trout.

PMID:35751487 | DOI:10.1111/mec.16578

Head Neck. 2022 Jun 25. doi: 10.1002/hed.27123. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with oral cancer are at higher risk of developing second primary esophageal cancer (SPEC) and the consensus for screening strategies remains unclear. This study aimed to examine comparative effectiveness and the stage-shift effect of endoscopic exam among patients with oral cancer.

METHOD: A population-based longitudinal retrospective observational matched case and control cohort study with at least 5 years follow-up was conducted. We identified 45 457 newly diagnosed patients with oral cancer, 2004-2013, and the eligible patient with oral cancer was 39 401. Propensity score matching was used to match comparable groups, and the two groups (screening vs. nonscreening) was 5941, individually. The study primary endpoints were to compare detection of incident SPEC and the stage-shift effect of endoscopic screening between screened and nonscreened incident oral cancer patients. Cox proportional hazard and competing risk models were analyzed. Statistical analyses were conducted in 2020-2021.

RESULT: Detection of incident SPEC in the screened group was significantly higher than in the nonscreened group (hazard ratio: 2.92, 95% confidence interval [CI]: 2.29-3.72). The stage-shift effect from endoscopic screening was found overall in patients with oral cancer (odds ratio [OR]: 0.39, 95%CI: 0.21-0.70), in particular in advanced-stage patients (OR: 0.25, 95%CI: 0.11-0.61), but not in early-stage patients (OR: 0.60, 95%CI: 0.26-1.40).

CONCLUSION: This study confirmed that endoscopic screening achieved early detection of SPEC among patients with oral cancer. To improve the screening stage-shift effect, patients with oral cancer are encouraged to undergo routine endoscopic screening.

PMID:35751477 | DOI:10.1002/hed.27123

J Obstet Gynaecol Res. 2022 Jun 24. doi: 10.1111/jog.15343. Online ahead of print.

ABSTRACT

AIM: To evaluate the effectiveness of a preeclampsia (PE) screening program using the National Institute for Health and Care Excellence (NICE) guideline in pregnant Thai women.

METHODS: A total of 2552 pregnancies received antenatal care and were delivered at Songklanagarind Hospital between November 2016 and April 2020. PE screening with the NICE guideline was used to identify mothers at risk. In cases of positive screening results, a daily dose of 81 mg aspirin was prescribed. Pregnancy outcomes were compared with 2783 participants who had maternity care before the implementation of the screening program. The effectiveness of aspirin prophylaxis following the NICE guideline was assessed by a logistic regression model to compare the risk of PE development between before and after guidance.

RESULTS: The screening positive rate by NICE was 8.3%. Of these, 77.36% of the participants received aspirin prophylaxis according to the NICE recommendation. After the implementation of the PE screening program, the incidence of PE slightly decreased (from 4.31% to 3.72%, p = 0.274). The chance of PE in pregnancies who had high-risk factors was reduced after using low-dose aspirin prophylaxis, even though the difference was not statistically significant.

CONCLUSIONS: Screening with the NICE guidelines followed by prescription of low-dose aspirin (81 mg/day) was probably not an effective strategy for the prevention of PE in our population. Combining biophysical and biochemical markers to identify pregnant women who subsequently develop PE, concurrently with an increased dose of aspirin prophylaxis, may provide a better outcome in clinical practice.

PMID:35751401 | DOI:10.1111/jog.15343

ESC Heart Fail. 2022 Jun 24. doi: 10.1002/ehf2.14035. Online ahead of print.

ABSTRACT

AIMS: The analysis of heart rate (HR) changes, such as the HR variability or HR turbulence, has been reported as a marker of cardiovascular events during sinus rhythm; however, those relationships during atrial fibrillation (AF) remain controversial, and those parameters are not commonly used in AF patients. We sought to investigate the relationship between a simple index focused on the HR and heart failure (HF) events in patients with permanent AF.

METHODS AND RESULTS: We enrolled 198 patients with permanent AF and evaluated the HR range, defined as the maximum HR minus the minimum HR on 24-h Holter electrocardiogram recordings. The patients were divided into two groups, i.e., the larger (n = 101) and smaller (n = 97) HR range (HRR) groups, determined by the median value. The HF events were defined as hospitalizations for HF or urgent hospital visits due to exacerbations of one’s HF status. The observation period of this study was set at 5 years from registration. The median age was 73 (68-77) years, and 29% were female. The median HRR was 84 (63-118) beats per minutes (bpm). During the observational period of 1825 days (median), HF events occurred in 37 (0.047 per patient-year) patients. In a log-rank test, the larger HRR group had more frequent HF events than the smaller HRR group (P = 0.0078). In the adjusted Cox proportional hazards model using the significantly different factors from the univariate analysis (Model 1) and factors and medications associated with HF (Model 2), the larger HRR group had a higher prevalence of HF events than the smaller HRR group for both models [Model 1, adjusted hazard ratio = 3.21, 95% confidence interval (CI) 1.593-6.708, P = 0.0009; Model 2, adjusted hazard ratio = 3.12, 95% CI 1.522-6.685, P = 0.002]. When analysed using the time-dependent Cox proportional hazards model, the HRR was associated with HF with a statistically significant difference in both the univariate and multivariate analyses [hazard ratio = 1.01, 95% CI 1.006-1.020, P = 0.0002; Model 1, adjusted hazard ratio = 1.02, 95% CI 1.011-1.027, P < 0.0001; Model 2, adjusted hazard ratio = 1.01, 95% CI 1.008-1.021, P = 0.0003). There was no significant difference in the chronotropic medications between the two groups.

CONCLUSIONS: In patients with permanent AF, a larger HRR was associated with HF events.

PMID:35751389 | DOI:10.1002/ehf2.14035