Tag: statistics

Chin Med. 2023 Jul 10;18(1):82. doi: 10.1186/s13020-023-00737-5.

ABSTRACT

BACKGROUND: Knee osteoarthritis (KOA) is a common degenerative joint condition that causes disability and pain in the elderly population. The prevalence of KOA among persons aged 63 or above is approximately 30%. Previous studies have reported the positive effects of Tui-na treatment and the Chinese herbal formula Du-Huo-Ji-Sheng Decoction (DHJSD) for KOA treatment. The current study aims to evaluate the add-on therapeutic effect of oral administration of DHJSD on KOA in addition to Tui-na.

METHODS: We conducted a prospective, randomized, controlled clinical trial. Seventy study subjects with KOA were randomly assigned to the treatment and control groups in a 1:1 ratio. Both two groups received eight sessions of Tui-na manipulation for 4 weeks. The DHJSD was only administered to the study subjects in the treatment group. The primary outcome measure was rated using the WOMAC at the end of treatment (4 weeks). Secondary outcomes were assessed using EQ-5D-5L, a health-related quality of life with 5-level EQ-5D version at end of treatment (week 4) and follow-up (week 8).

RESULTS: No statistically significant difference was found between two groups on WOMAC scores at the end of treatment. The mean WOMAC Pain subscale score was significantly lower in the treatment group than control group at week 8 follow up (mean difference, MD – 1.8, 95% CI – 3.5 to – 0.02, P = 0.048). The mean WOMAC Stiffness subscale score was significantly lower in the treatment group than in the control group at week 2 (MD 0.74, 95% CI 0.05 to 1.42, P = 0.035) and week 8 follow up (MD 0.95, 95% CI 0.26 to 1.65, P = 0.008). The mean EQ-5D index value was significantly improved in the treatment group than in the control group at week 2 (MD 0.17, 95% CI 0.02 to 0.31, P = 0.022). The analysis of WOMAC scores and EQ-5D-5L in both groups showed statistically significant improvement with time. No significant adverse effect was found during the trial.

CONCLUSION: DHJSD may have an add-on effect in addition to Tui-na manipulation relieving pain and improving stiffness as well as quality of life (QOL) in patients with KOA. The combined treatment was generally safe and well tolerated. Trial registration The study was registered at the ClinicalTrials.gov (website: https://clinicaltrials.gov/ct2/show/NCT04492670 , registry number: NCT04492670), registered on 30 July 2020.

PMID:37424023 | DOI:10.1186/s13020-023-00737-5

BMC Biol. 2023 Jul 10;21(1):151. doi: 10.1186/s12915-023-01641-y.

ABSTRACT

BACKGROUND: Chronic kidney disease (CKD) accelerates atherosclerosis, but the mechanisms remain unclear. Tyrosine sulfation has been recognized as a key post-translational modification (PTM) in regulation of various cellular processes, and the sulfated adhesion molecules and chemokine receptors have been shown to participate in the pathogenesis of atherosclerosis via enhancement of monocyte/macrophage function. The levels of inorganic sulfate, the essential substrate for the sulfation reaction, are dramatically increased in patients with CKD, which indicates a change of sulfation status in CKD patients. Thus, in the present study, we detected the sulfation status in CKD patients and probed into the impact of sulfation on CKD-related atherosclerosis by targeting tyrosine sulfation function.

RESULTS: PBMCs from individuals with CKD showed higher amounts of total sulfotyrosine and tyrosylprotein sulfotransferase (TPST) type 1 and 2 protein levels. The plasma level of O-sulfotyrosine, the metabolic end product of tyrosine sulfation, increased significantly in CKD patients. Statistically, O-sulfotyrosine and the coronary atherosclerosis severity SYNTAX score positively correlated. Mechanically, more sulfate-positive nucleated cells in peripheral blood and more abundant infiltration of sulfated macrophages in deteriorated vascular plaques in CKD ApoE null mice were noted. Knockout of TPST1 and TPST2 decreased atherosclerosis and peritoneal macrophage adherence and migration in CKD condition. The sulfation of the chemokine receptors, CCR2 and CCR5, was increased in PBMCs from CKD patients.

CONCLUSIONS: CKD is associated with increased sulfation status. Increased sulfation contributes to monocyte/macrophage activation and might be involved in CKD-related atherosclerosis. Inhibition of sulfation may suppress CKD-related atherosclerosis and is worthy of further study.

PMID:37424015 | DOI:10.1186/s12915-023-01641-y

Thyroid Res. 2023 Jul 10;16(1):23. doi: 10.1186/s13044-023-00165-5.

ABSTRACT

BACKGROUND: Thyroid cancer (TC) patients are understudied but appear to be at risk for poor physical and psychosocial outcomes. Knowledge of the course and determinants of these deteriorated outcomes is lacking. Furthermore, little is known about mediating biological mechanisms.

OBJECTIVES: The WaTCh-study aims to; 1. Examine the course of physical and psychosocial outcomes. 2. Examine the association of demographic, environmental, clinical, physiological, and personality characteristics to those outcomes. In other words, who is at risk? 3. Reveal the association of mediating biological mechanisms (inflammation, kynurenine pathway) with poor physical and psychological outcomes. In other words, why is a person at risk?

DESIGN AND METHODS: Newly diagnosed TC patients from 13 Dutch hospitals will be invited. Data collection will take place before treatment, and at 6, 12 and 24 months after diagnosis. Sociodemographic and clinical information is available from the Netherlands Cancer Registry. Patients fill-out validated questionnaires at each time-point to assess quality of life, TC-specific symptoms, physical activity, anxiety, depression, health care use, and employment. Patients are asked to donate blood three times to assess inflammation and kynurenine pathway. Optionally, at each occasion, patients can use a weighing scale with bioelectrical impedance analysis (BIA) system to assess body composition; can register food intake using an online food diary; and can wear an activity tracker to assess physical activity and sleep duration/quality. Representative Dutch normative data on the studied physical and psychosocial outcomes is already available.

IMPACT: WaTCh will reveal the course of physical and psychosocial outcomes among TC patients over time and answers the question who is at risk for poor outcomes, and why. This knowledge can be used to provide personalized information, to improve screening, to develop and provide tailored treatment strategies and supportive care, to optimize outcomes, and ultimately increase the number of TC survivors that live in good health.

PMID:37424010 | DOI:10.1186/s13044-023-00165-5

BMC Public Health. 2023 Jul 10;23(1):1313. doi: 10.1186/s12889-023-16243-0.

ABSTRACT

INTRODUCTION: Cardiovascular disease and obesity are both significantly influenced by physical inactivity. A rapidly expanding corpus of research contends that features of the built environment might encourage adolescents to lead active lives. There are still issues with the present evidence for determining which aspects of the built environment give adolescents the opportunity to engage in leisure-time physical activity (LTPA). This study looked at the relationship between the characteristics of the built environment and moderate-to-vigorous leisure-time physical activity (Leisure-time MVPA) of adolescents.

METHODS: 2628 adolescents between the ages of 11 and 18 were chosen as study participants from 19 Suzhou urban communities. They must have resided in the neighborhood for longer than six months and be permanent residents there. The International Physical Activities Questionnaire (n = 2628) and the Neighborhood Environment Walkability Scale for Chinese Children (NEWS-CC) were used to collect the data. LTPA are connected to different modes: Walking, leisure-time MPA, and leisure-time VPA. Univariate analysis and multinomial logistic regression were used to screen for potential associations between the built environment and the leisure-time MVPA in adolescents.

RESULTS: Univariate analysis of the general demographic and built environment showed statistically significant differences in gender, residential density, accessibility, pedestrian safety, aesthetic and security (P < 0.05). Step by walking reference category, security (P < 0.05, OR = 1.131) were associated with adolescents’ leisure-time MPA, aesthetics (P < 0.05, OR = 1.187) were associated with adolescents’ leisure-time VPA, they both have a significant positive correlation.

CONCLUSION: Security was positively associated with adolescents’ leisure-time MPA, aesthetics was positively associated with adolescents’ leisure-time VPA. This suggests that built environment may associated with leisure-time MVPA of Suzhou adolescents.

PMID:37424006 | DOI:10.1186/s12889-023-16243-0

Updates Surg. 2023 Jul 9. doi: 10.1007/s13304-023-01579-4. Online ahead of print.

ABSTRACT

International guidelines exclude from surgery patients with peritoneal carcinosis of colorectal origin and a peritoneal cancer index (PCI) ≥ 16. This study aims to analyze the outcomes of patients with colorectal peritoneal carcinosis and PCI greater or equal to 16 treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) (CRS + HIPEC). We retrospectively performed a multicenter observational study involving three Italian institutions, namely the IRCCS Policlinico San Matteo in Pavia, the M. Bufalini Hospital in Cesena, and the ASST Papa Giovanni XXIII Hospital in Bergamo. The study included all patients undergoing CRS + HIPEC for peritoneal carcinosis from colorectal origin from November 2011 to June 2022. The study included 71 patients: 56 with PCI < 16 and 15 with PCI ≥ 16. Patients with higher PCI had longer operative times and a statistically significant higher rate of not complete cytoreduction, with a Completeness of Cytoreduction score (CC) 1 (microscopical disease) of 30.8% (p = 0.004). The 2-year OS was 81% for PCI < 16 and 37% for PCI ≥ 16 (p < 0.001). The 2-years DFS was 29% for PCI < 16 and 0% for PCI ≥ 16 (p < 0.001). The 2-year peritoneal DFS for patients with PCI < 16 was 48%, and for patients with PCI ≥ 16 was 57% (p = 0.783). CRS and HIPEC provide reasonable local disease control for patients with carcinosis of colorectal origin and PCI ≥ 16. Such results form the basis for new studies to reassess the exclusion of these patients, as set out in the current guidelines, from CRS and HIPEC. This therapy, combined with new therapeutical strategies, i.e., pressurized intraperitoneal aerosol chemotherapy (PIPAC), could offer reasonable local control of the disease, preventing local complications. As a result, it increases the patient’s chances of receiving chemotherapy to improve the systemic control of the disease.

PMID:37423956 | DOI:10.1007/s13304-023-01579-4

J Math Biol. 2023 Jul 10;87(2):25. doi: 10.1007/s00285-023-01955-z.

ABSTRACT

Genome rearrangements are evolutionary events that shuffle genomic architectures. The number of genome rearrangements that happened between two genomes is often used as the evolutionary distance between these species. This number is often estimated as the minimum number of genome rearrangements required to transform one genome into another which are only reliable for closely-related genomes. These estimations often underestimate the evolutionary distance for genomes that have substantially evolved from each other, and advanced statistical methods can be used to improve accuracy. Several statistical estimators have been developed, under various evolutionary models, of which the most complete one, INFER, takes into account different degrees of genome fragility. We present TruEst-an efficient tool that estimates the evolutionary distance between the genomes under the INFER model of genome rearrangements. We apply our method to both simulated and real data. It shows high accuracy on the simulated data. On the real datasets of mammal genomes the method found several pairs of genomes for which the estimated distances are in high consistency with the previous ancestral reconstruction studies.

PMID:37423919 | DOI:10.1007/s00285-023-01955-z

Rural Remote Health. 2023 Jul;23(3):7553. doi: 10.22605/RRH7553. Epub 2023 Jul 10.

ABSTRACT

INTRODUCTION: In this study, a psychosocial support-based (PSSB) psychoeducation program was provided to pregnant adolescents for improving their mental health and providing them with knowledge and skills to make positive behavioral changes. This study aimed to determine the effect of PSSB psychoeducation on anxiety, depression and perceived social support.

METHODS: This study was conducted using a pre-test-post-test randomized controlled design. The population of the study included pregnant adolescents presenting to the obstetrics and gynecology outpatient clinic of a state hospital located in eastern Turkey. The sample size, determined using power analysis, included 105 pregnant adolescents (experimental group n=50, control group n=55). The participants in the experimental group were given PSSB psychoeducation. The control group did not receive any intervention. The data were collected using an introductory characteristics form, the Beck Anxiety Inventory, the Edinburgh Postpartum Depression Scale and the Multidimensional Scale of Perceived Social Support. SPSS v24.0 was used to analyze the data, and p-values less than 0.05 were accepted as statistically significant.

RESULTS: It was established that there was a significant decrease in the anxiety and depression levels and a significant increase in the perceived social support levels in the experimental group in comparison to the control group after the PSSB psychoeducation intervention (p<0.05). In the intragroup comparisons, the difference between the pre-test and post-test scores for anxiety, depression and perceived social support was statistically significant in the experimental group (p<0.05), whereas this difference was insignificant in the control group (p>0.05).

CONCLUSION: The PSSB psychoeducation program reduced anxiety and depression and increased perceived social support levels of the pregnant adolescents. The PSSB psychoeducation program is a useful practical intervention for the mental health of pregnant adolescents. Thus, we recommend that psychiatric nurses take an active role in planning and implementing psychosocial interventions for pregnant adolescents and develop culture-specific interventions.

PMID:37423899 | DOI:10.22605/RRH7553

Clin Genitourin Cancer. 2023 Jun 28:S1558-7673(23)00155-6. doi: 10.1016/j.clgc.2023.06.016. Online ahead of print.

ABSTRACT

BACKGROUND: The interaction between lymph node dissection (LND) during radical cystectomy (RC) and neoadjuvant chemotherapy (NAC) remains unclear. This study aimed to evaluate the role of LND in patients undergoing RC after NAC.

PATIENTS AND METHODS: We retrospectively analyzed 259 patients with muscle-invasive bladder cancer (MIBC) who underwent RC following NAC at Fujita Health University Hospital and Fujita Health University Okazaki Medical Center between 2010 and 2022. Baseline characteristics, pathological outcomes, recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) were compared between propensity score (PS)-matched cohorts.

RESULTS: PS matching analysis resulted in 94 matched pairs from the adequate (standard or extended template) and inadequate (limited template or unilateral- or no-LND) LND groups. The median number of dissected nodes was significantly higher in the adequate LND group than in the inadequate LND group (19 vs. 5, P < .001). Similarly, a higher pathological node-positive rate (ypN+) was observed in the adequate group than in the inadequate group (18.1% vs. 7.4%, P = .03). The adequate LND group identified more ypN+ with ≤ ypT1 cases than the inadequate group (4 vs. 1). There were no statistically significant differences between the adequate and inadequate groups in RFS (P = .94), CSS (P = .54), and OS (P = .65). Subgroup analysis also showed comparable survival rates, even in patients with ≥ pT3 or cN+ disease. ypN+ was an independent predictor of OS in the Cox regression analysis, while adequate LND and the number of lymph nodes removed (≥10 or ≥15) were not associated with survival.

CONCLUSIONS: Although adequate LND did not show a significant therapeutic effect in RC after NAC, adequate LND may have an important diagnostic role in detecting ypN+, which is a robust predictor, and is a useful biomarker to perform appropriate adjuvant immunotherapy especially in ≤ ypT1 cases.

PMID:37423863 | DOI:10.1016/j.clgc.2023.06.016

HPB (Oxford). 2023 Jun 14:S1365-182X(23)00558-0. doi: 10.1016/j.hpb.2023.06.006. Online ahead of print.

ABSTRACT

BACKGROUND: The 2022 incoming fellows’ expectations for their robotics training, as well as their perceptions of the utility of the surgical robot, are not well defined.

METHODS: Cross-sectional survey of 24 AHPBA fellows in 2022, analyzed with descriptive statistics and Spearman’s rho.

RESULTS: Of 33 current AHPBA fellows, 22 completed the survey (66.7%). Study participants had limited-to-moderate experience with robotics prior to fellowship (mean 2.5 ± SD 1.1; range 1-4). Most participants agreed that robotics influenced their fellowship choice (mean 4.14 ± SD 0.87; range 1-5), would make then more marketable (mean 4.77 ± SD 0.52; range 1-5) and improve job prospects (mean 4.68 ± SD 0.87; range 1-5). Of the study participants, 55% responded that robotics training is “essential” in fellowship, while 64% responded that it is “essential” for their careers. Fellows were only slightly satisfied with overall robotics training within their respective programs (mean 3.44 ± SD 1.17; range 1-5) The majority (73.7%) expect that robotics will comprise <25% of their training. Notably, the majority (75%) have no formal robotics training curriculum.

DISCUSSION: This survey identifies potential gaps where robotics training could be improved for future incoming AHPBA fellows.

PMID:37423851 | DOI:10.1016/j.hpb.2023.06.006

Chin J Traumatol. 2023 Jun 14:S1008-1275(23)00050-0. doi: 10.1016/j.cjtee.2023.06.002. Online ahead of print.

ABSTRACT

PURPOSE: The incidence of heatstroke (HS) is not particularly high; however, once it occurs, the consequences are serious. It is reported that calcitonin gene-related peptide (CGRP) is protective against brain injury in HS rats, but detailed molecular mechanisms need to be further investigated. In this study, we further explored whether CGRP inhibited neuronal apoptosis in HS rats via protein kinase A (PKA)/p-cAMP response element-binding protein (p-CREB) pathway.

METHODS: We established a HS rat model in a pre-warmed artificial climate chamber with a temperature of (35.5 ± 0.5) °C and a relative humidity of 60% ± 5%. Heatstress was stopped once core body temperature reaches above 41 °C. A total of 25 rats were randomly divided into 5 groups with 5 animals each: control group, HS group, HS+CGRP group, HS+ CGRP antagonist (CGRP8-37) group and HS+CGRP+PKA/p-CREB pathway blocker (H89) group. A bolus injection of CGRP was administered to each rat in HS+CGRP group, CGRP8-37 (antagonist of CGRP) in HS+CGRP8-37 group, and CGRP with H89 in HS+CGRP+H89 group. Electroencephalograms were recorded and the serum concentration of S100B, neuron-specific enolase (NSE), neuron apoptosis, activated caspase-3 and CGRP expression, as well as pathological morphology of brain tissue were detected at 2 h, 6 h, and 24 h after HS in vivo. The expression of PKA, p-CREB, and Bcl-2 in rat neurons were also detected at 2 h after HS in vitro. Exogenous CGRP, CGRP8-37, or H89 were used to determine whether CGRP plays a protective role in brain injury via PKA/p-CREB pathway. The unpaired t-test was used between the two samples, and the mean ± SD was used for multiple samples. Double-tailed p < 0.05 was considered statistically significant.

RESULTS: Electroencephalogram showed significant alteration of θ (54.50 ± 11.51 vs. 31.30 ± 8.71, F = 6.790, p = 0.005) and α wave (16.60 ± 3.21 vs. 35.40 ± 11.28, F = 4.549, p = 0.020) in HS group compared to the control group 2 h after HS. The results of triphosphate gap terminal labeling (TUNEL) showed that the neuronal apoptosis of HS rats was increased in the cortex (9.67 ± 3.16 vs. 1.80 ± 1.10, F = 11.002, p = 0.001) and hippocampus (15.73 ± 8.92 vs. 2.00 ± 1.00, F = 4.089, p = 0.028), the expression of activated caspase-3 was increased in the cortex (61.76 ± 25.13 vs. 19.57 ± 17.88, F = 5.695, p = 0.009) and hippocampus (58.60 ± 23.30 vs. 17.80 ± 17.62, F = 4.628, p = 0.019); meanwhile the expression of serum NSE (5.77 ± 1.78 vs. 2.35 ± 0.56, F = 5.174, p = 0.013) and S100B (2.86 ± 0.69 vs. 1.35 ± 0.34, F = 10.982, p = 0.001) were increased significantly under HS. Exogenous CGRP decreased the concentrations of NSE and S100B, and activated the expression of caspase-3 (0.41 ± 0.09 vs. 0.23 ± 0.04, F = 32.387, p < 0.001) under HS; while CGRP8-37 increased NSE (3.99 ± 0.47 vs. 2.40 ± 0.50, F = 11.991, p = 0.000) and S100B (2.19 ± 0.43 vs. 1.42 ± 0.30, F = 4.078, p = 0.025), and activated the expression caspase-3 (0.79 ± 0.10 vs. 0.23 ± 0.04, F = 32.387, p < 0.001). For the cell experiment, CGRP increased Bcl-2 (2.01 ± 0.73 vs. 2.15 ± 0.74, F = 8.993, p < 0.001), PKA (0.88 ± 0.08 vs. 0.37 ± 0.14, F = 20.370, p < 0.001), and p-CREB (0.87 ± 0.13 vs. 0.29 ± 0.10, F = 16.759, p < 0.001) levels; while H89, a blocker of the PKA/p-CREB pathway reversed the expression.

CONCLUSIONS: CGRP can protect against HS-induced neuron apoptosis via PKA/p-CREB pathway and reduce activation of caspase-3 by regulating Bcl-2. Thus CGRP may be a new target for the treatment of brain injury in HS.

PMID:37423838 | DOI:10.1016/j.cjtee.2023.06.002