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Nevin Manimala Statistics

Outcome of the frozen elephant trunk procedure as a redo operation

Interact Cardiovasc Thorac Surg. 2021 Mar 1:ivab059. doi: 10.1093/icvts/ivab059. Online ahead of print.

ABSTRACT

OBJECTIVES: The goal of this study was to determine the outcome of patients undergoing an elective frozen elephant trunk (FET) procedure as a redo operation following previous cardiac surgery.

METHODS: One hundred and eighteen consecutive patients underwent FET procedures between October 2010 and October 2019 at our centre. Patients were registered in a dedicated database and analysed retrospectively. Clinical and follow-up characteristics were compared between patients undergoing a FET operation as a primary (primary group) or a redo procedure (redo group) using logistic regression and Cox regression analysis. Emergency procedures (n = 33) were excluded from the analysis.

RESULTS: A total of 36.5% (n = 31) of the FET procedures were redo operations (redo group) and 63.5% (n = 54) of the patients underwent primary surgery (primary group). There was no significant difference in the 30-day mortality [primary group: 7.4%; redo group: 3.2%; 95% confidence interval (CI) (0.19-35.29); P = 0.63] and the 3-year mortality [primary group: 22.2%; redo group: 16.7%; 95% CI (0.23-3.23); P = 0.72] between redo and primary cases. Furthermore, the adjusted statistical analysis did not reveal significant differences between the groups in the occurrence of transient or permanent neurological deficit, paraplegia, acute renal failure and resternotomy. The redo group showed a higher rate of recurrent nerve palsy, which did not reach statistical significance [primary group: 3.7% (n = 2); redo group: 19.4% (n = 6); P = 0.091].

CONCLUSIONS: Elective FET procedures as redo operations performed by a dedicated aortic team following previous cardiac surgery demonstrate an adequate safety profile.

PMID:33667306 | DOI:10.1093/icvts/ivab059

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Nevin Manimala Statistics

Piscirickettsia salmonis shedding and tissue burden, and hematological responses during cohabitation infections in chum Oncorhynchus keta, pink O. gorbuscha and Atlantic salmon Salmo salar

PLoS One. 2021 Mar 5;16(3):e0248098. doi: 10.1371/journal.pone.0248098. eCollection 2021.

ABSTRACT

BACKGROUND: Salmonid rickettsial septicemia is an emergent and geographically widespread disease of marine-farmed salmonids caused by infection with the water-borne bacterium Piscirickettsia salmonis. Very little is known about the route, timing, or magnitude of bacterial shedding from infected fish.

METHODOLOGY/PRINCIPAL FINDINGS: A cohabitation challenge model was used to assess shedding from chum Oncorhynchus keta, pink O. gorbuscha and Atlantic salmon Salmo salar. Infections in donor fish were established by intraperitoneal injection of P. salmonis. Naïve recipients were cohabitated with donor fish after which cumulative percent morbidity and mortality (CMM) was monitored, and bacterial burdens in kidney and in tank water were measured by qPCR. All donor fish died with mean days-to-death (MDD) among species ranging from 17.5 to 23.9. Among recipients, CMM ranged from 42.7% to 77.8% and MDD ranged from 49.7 to 56.4. In each trial, two peaks of bacterial DNA concentrations in tank water closely aligned with the MDD values of donor and recipient fish. Bacterial tissue burden and shedding rate, and plasma physiological parameters were obtained from individual donors and recipients. Statistically significant positive correlations between the shedding rate and P. salmonis kidney burden were measured in donor pink and in donor and recipient chum salmon, but not in donor or recipient Atlantic salmon. In Atlantic salmon, there was a negative correlation between kidney bacterial burden and hematocrit, plasma Ca++ and Mg++ values, whereas in infected chum salmon the correlation was positive for Na+ and Cl- and negative for glucose.

CONCLUSIONS: A dependency of bacterial shedding on species-specific patterns of pathogenesis was suggested. The coincidence of bacterial shedding with mortality will inform pathogen transmission models.

PMID:33667267 | DOI:10.1371/journal.pone.0248098

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Nevin Manimala Statistics

Genetic impacts on thermostability of onco-lncRNA HOTAIR during the development and progression of endometriosis

PLoS One. 2021 Mar 5;16(3):e0248168. doi: 10.1371/journal.pone.0248168. eCollection 2021.

ABSTRACT

HOTAIR is a well-known long non-coding RNA (lncRNA) involved in various cellular signaling, whereas its functional impacts on endometriosis development are still largely unknown. To this end, six potential functional single nucleotide polymorphisms (SNPs) in HOTAIR, with minor allele frequencies more than 10% in Han population and altered net energy of RNA structures larger than 0.5 kcal/mol, were selected for genotyping study. The study included 207 endometriosis patients and 200 healthy women. Genetic substitutions at rs1838169 and rs17720428 were frequently found in endometriosis patients, and rs1838169 showed statistical significance (p = 0.0174). The G-G (rs1838169-rs17720428) haplotype showed the most significant association with endometriosis (p < 0.0001) with enhanced HOTAIR stability, and patients who harbor such haplotype tended to show higher CA125. Data mining further revealed higher mRNA HOTAIR levels in the endometria of patients with severe endometriosis which consistently showed reduced HOXD10 and HOXA5 levels. HOTAIR knockdown with specific shRNAs down-regulated cell proliferation and migration with the induction of HOXD10 and HOXA5 expression in human ovarian clear cancer cells. Our study therefore provided evidence to indicate a prominent role of HOTAIR in promoting endometriosis, which could be used as a potential target for clinical applications.

PMID:33667269 | DOI:10.1371/journal.pone.0248168

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Nevin Manimala Statistics

Impact of age on survival in radioiodine refractory differentiated thyroid cancer patients

Eur J Endocrinol. 2021 Mar 1:EJE-20-1073.R3. doi: 10.1530/EJE-20-1073. Online ahead of print.

ABSTRACT

OBJECTIVE The objectives of our study were to analyze the influence of age on the survival of patients with RAIR-DTC and to determine their prognostic factors according to age. METHODS This single centre, retrospective study enrolled 155 patients diagnosed with RAIR-DTC. The primary end point was overall survival (OS) according to different cut-off (45,55,65,75 years). Secondary endpoints were progression free survival (PFS) and prognostic factors in patients under and over 65 years. RESULTS Median OS after RAIR diagnosis was 8.2 years (95% IC: 5.3-9.6). There was no difference according to age with a 65 (p=0.47) and 55 years old cut-off (p=0.28). Median OS was significantly improved before 45 years old (p=0,0043). After 75 years old, median OS significantly decrease (p= 0,0008). Median PFS was 2.1 years (95% CI: 0.8-3) in patients < 65 years, and 1 year in patients ≥ 65 years (95% CI: 0.8-1.55) with no statistical difference (p=0.22). There was no impact of age on PFS with any cut-off. In both groups, progressive disease despite 131I treatment reduced OS. In patients < 65, an interval of less than 3 years between the initial diagnosis and the diagnosis of RAIR metastatic disease was predictive of poor survival. In patients > 65, the presence of a mediastinum metastasis was a significant factor for mortality (HR: 4.55, 95% CI: 2.27-9.09). CONCLUSION In RAIR-DTC patients, a cut-off age of 65 years old was not a significant predictive factor of survival. 45 and 75 years old cut off were predictive for OS, but not PFS.

PMID:33667193 | DOI:10.1530/EJE-20-1073

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Health-related quality of life and associated factors among people living with human immunodeficiency virus on highly active antiretroviral therapy in North East Ethiopia: Cross-sectional study

PLoS One. 2021 Mar 5;16(3):e0247777. doi: 10.1371/journal.pone.0247777. eCollection 2021.

ABSTRACT

INTRODUCTION: HIV/AIDS remains a public health concern affecting millions of people across the world. Although the health-related quality of life (HRQoL) of patients living with HIV has significantly improved after treatment, its chronicity makes the HRQoL uncertain. This study assessed factors associated with the health-related quality of life among people living with HIV/AIDS on HAART in North-East Ethiopia.

METHODS: An institutional-based cross-sectional study was conducted from March to April 2018, and systematic random sampling was used to select 235 participants who were on HAART. HRQoL was assessed using the Medical Outcomes Study HIV Health Survey. Descriptive and multiple linear regression analysis were computed using the statistical package for social sciences version 20.

RESULTS: The study revealed one-factor structure and had good overall internal consistency (78.5). Over one-third (42.6%; 95% CI; 36.2%, 48.9%) of participants had good HRQoL. The least HRQoL mean score was found for cognitive functioning 32.21(±19.78), followed by social functioning 40.58(±29.8). Factors associated with the overall HRQoL were 25-45 years of age (β = – 3.55, 95% CI;-6.54, -0.55), working in private sector (β = -5.66, 95% CI;-9.43, -1.88), government (β = -4.29, 95% CI;-7.83, -0.75) and self-employment (β = -8.86, 95% CI;-13.50, -4.21), 100-200 (β = – 4.84, 95% CI;-9.04, -0.63) and 201-350 CD4 at the time of diagnosis (β = – 7.45, 95% CI;-11.73, -3.16), 351-500 current CD4 level (β = 8.34, 95% CI;5.55, 11.41), 6-10 years of disease duration (β = -8.28, 95% CI;-12.51, -4.04), WHO stage II (β = -4.78, 95% CI;-8.52, -1.04) and III (β = 3.42, 95% CI;0.06, 6.79) during treatment initiation and not taking of Cotrimoxazole prophylaxis (β = -5.79, 95% CI;-8.34, -3.25).

CONCLUSIONS: High proportion of participants had a poor HRQoL. Routine assessment and appropriate interventions at each visit is recommended to improve HRQoL.

PMID:33667245 | DOI:10.1371/journal.pone.0247777

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Nevin Manimala Statistics

Prognostic significance of estrogen, progesterone and HER2 receptors’ status conversion following neoadjuvant chemotherapy in patients with locally advanced breast cancer: Results from a tertiary Cancer Center in Saudi Arabia

PLoS One. 2021 Mar 5;16(3):e0247802. doi: 10.1371/journal.pone.0247802. eCollection 2021.

ABSTRACT

BACKGROUND: The prognostic impact of neoadjuvant chemotherapy (NAC) on the receptor expression status in patients with locally advanced breast cancer (LABC) is still not fully understood. We aimed to evaluate the changes in hormone (estrogen and progesterone) receptor (HR) and human epidermal growth factor receptor 2 (HER2) status post-NAC and their correlation with survival.

METHODS: Patients with LABC who have received NAC between 2008 and 2015 and have been followed up till December 2019 at the Oncology Center, King Saud University, KSA were analyzed retrospectively. biomarker analysis of ER, PR & HER2 were done using immunohistochemistry (IHC) and Fluorescent in situ hybridization.

RESULTS: Ninety-one patients fulfilled the inclusion criteria. HR status changed in 21(23.1%) patients, with a significant difference between patients with stable receptors and those with any receptor conversion; p = 0.000. Five (5.5%) initially HER2 negative tumors became HER2 positive and 10 (11%) initially HER2 positive tumors became HER2 negative after NAC. The difference in HER2 expression level before and after NAC was not statistically significant (p = 0.302). Univariate analysis relating patients’ characteristics and 10-years disease-free survival (DFS) showed only significant correlations with the expressions of ER, PR, and any receptor conversion, (ER and/or PR) p< 0.001, p< 0.001, and p = 0.001; respectively. In the univariate analysis, none of the clinicopathological features showed a significant correlation with the OS except for the molecular subtypes P<0.001.

CONCLUSIONS: Patients with LABC have significant changes in the ER and PR receptor status following NAC. Post-NAC expressions change of ER and PR (ER and/or PR) are correlated to DFS. Retesting of the hormone receptors should be considered after NAC in Saudi patients with LABC.

PMID:33667252 | DOI:10.1371/journal.pone.0247802

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Nevin Manimala Statistics

Asking People to Explain Complex Policies Does Not Increase Political Moderation: Three Preregistered Failures to Closely Replicate Fernbach, Rogers, Fox, and Sloman’s (2013) Findings

Psychol Sci. 2021 Mar 5:956797620972367. doi: 10.1177/0956797620972367. Online ahead of print.

ABSTRACT

Fernbach et al. (2013) found that political extremism and partisan in-group favoritism can be reduced by asking people to provide mechanistic explanations for complex policies, thus making their lack of procedural-policy knowledge salient. Given the practical importance of these findings, we conducted two preregistered close replications of Fernbach et al.’s Experiment 2 (Replication 1a: N = 306; Replication 1b: N = 405) and preregistered close and conceptual replications of Fernbach et al.’s Experiment 3 (Replication 2: N = 343). None of the key effects were statistically significant, and only one survived a small-telescopes analysis. Although participants reported less policy understanding after providing mechanistic policy explanations, policy-position extremity and in-group favoritism were unaffected. That said, well-established findings that providing justifications for prior beliefs strengthens those beliefs, and well-established findings of in-group favoritism, were replicated. These findings suggest that providing mechanistic explanations increases people’s recognition of their ignorance but is unlikely to increase their political moderation, at least under these conditions.

PMID:33667138 | DOI:10.1177/0956797620972367

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The efficacy and safety of topical 10% potassium hydroxide for molluscum contagiosum: a systematic review and meta-analysis

J Dermatolog Treat. 2021 Mar 5:1-21. doi: 10.1080/09546634.2021.1898527. Online ahead of print.

ABSTRACT

BACKGROUND: Molluscum contagiosum (MC) is a self-limited cutaneous viral infection. Topical 10% potassium hydroxide (KOH) has been used for treating MC. However, it remains unclear whether it is beneficial or not to apply topical 10% KOH for treating MC.

METHODS: To confirm the efficacy and safety of topical 10% KOH compared with placebo as well as other treatments for MC, meta-analysis was used. Up to September 2020, we performed a comprehensive search of literature based on three databases with following keywords including “molluscum contagiosum” and “potassium hydroxide”.

RESULTS: Our meta-analyses demonstrated a significant difference between topical 10% KOH and placebo for complete clearance of MC (RR: 2.96, 95% CI: 1.69 – 5.17, p = 0.0001), while there were no statistical differences between them in the number of patients with adverse events (RR: 1.73, 95% CI: 0.67 – 4.45, p = 0.2562). Also, topical 10% KOH was as effective as mechanical treatments for MC (RR: 0.95, 95% CI: 0.84 – 1.07, p = 0.3833).

CONCLUSION: We demonstrate that application of topical 10% KOH may be one of effective and appropriate methods for the treatment of MC compared with awaiting spontaneous resolution due to its safety and effectiveness.

PMID:33667150 | DOI:10.1080/09546634.2021.1898527

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The effect of nursing interventions on immigrant women living in Northern Cyprus on their breastfeeding self-efficacy and success: a randomized controlled trial

Health Care Women Int. 2021 Mar 5:1-13. doi: 10.1080/07399332.2021.1883023. Online ahead of print.

ABSTRACT

This study was conducted as a randomized controlled study to determine the effect of nursing interventions, which were based on Dennis’s Breastfeeding Self-Efficacy Theory and Pender’s Health Promotion Model during home visits, on the breastfeeding self-efficacy and success of immigrant women living in Northern Cyprus. The sample consisted of N = 60 primipar immigrant women (experimental group n = 30, control group n = 30) who attended a primary healthcare center in Northern Cyprus between April 2019 and January 2020. The data were collected from the participants using a Socio-Demographic Questionnaire, the Breastfeeding Self-Efficacy Scale and the LATCH Breastfeeding Assessment Tool. Before the study, no statistically significant difference was found between two groups in terms of breastfeeding self-efficacy and the LATCH assessment (p > 0.05). After the intervention, the mean score for the Breastfeeding Self-Efficacy Scale increased by 9.73 in the experimental group and 3.16 in the control group compared to before the study, and the effect size was found to be 6.57. The score for the LATCH assessment increased by 3.2 in the experimental group and 1.44 in the control group, and the effect size was found to be 1.76 (p < 0.05).

PMID:33667155 | DOI:10.1080/07399332.2021.1883023

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Nevin Manimala Statistics

Multi-task deep learning for image segmentation using recursive approximation tasks

IEEE Trans Image Process. 2021 Mar 5;PP. doi: 10.1109/TIP.2021.3062726. Online ahead of print.

ABSTRACT

Fully supervised deep neural networks for segmentation usually require a massive amount of pixel-level labels which are manually expensive to create. In this work, we develop a multi-task learning method to relax this constraint. We regard the segmentation problem as a sequence of approximation subproblems that are recursively defined and in increasing levels of approximation accuracy. The subproblems are handled by a framework that consists of 1) a segmentation task that learns from pixel-level ground truth segmentation masks of a small fraction of the images, 2) a recursive approximation task that conducts partial object regions learning and data-driven mask evolution starting from partial masks of each object instance, and 3) other problem oriented auxiliary tasks that are trained with sparse annotations and promote the learning of dedicated features. Most training images are only labeled by (rough) partial masks, which do not contain exact object boundaries, rather than by their full segmentation masks. During the training phase, the approximation task learns the statistics of these partial masks, and the partial regions are recursively increased towards object boundaries aided by the learned information from the segmentation task in a fully data-driven fashion. The network is trained on an extremely small amount of precisely segmented images and a large set of coarse labels. Annotations can thus be obtained in a cheap way. We demonstrate the efficiency of our approach in three applications with microscopy images and ultrasound images.

PMID:33667164 | DOI:10.1109/TIP.2021.3062726