Tag: statistics

Eye (Lond). 2023 Mar 18. doi: 10.1038/s41433-023-02467-2. Online ahead of print.

ABSTRACT

BACKGROUND/OBJECTIVES: Endothelial keratoplasty (EK) is a commonly performed transplant procedure used in the treatment of corneal endothelial dysfunction. The aim of this systematic review and meta-analysis is to evaluate the differences in visual acuity outcomes, endothelial cell density (ECD) and complications between two forms of EK, ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) and Descemet membrane endothelial keratoplasty (DMEK).

METHODS: A literature search of MEDLINE, Embase and Cochrane Library was conducted to identify studies reporting comparative results of UT-DSAEK versus DMEK. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used for search strategy. Of 141 titles, 7 studies met the inclusion criteria; best corrected visual acuity (BCVA) (LogMAR), ECD (cells/mm²), and complications were compared, with all statistical analysis performed using Review Manager.

RESULTS: A total of 362 eyes were included for analysis. DMEK resulted in significantly better BCVA at 3 months (0.14 vs 0.22, p = 0.003), 6 months (0.08 vs 0.18, p = 0.005) and 1 year post-op (0.07 vs 0.14, p = 0.0005). UT-DSAEK resulted in significantly lower total complications (25.2% vs 57.3%, p = 0.0001) and rates of re-bubbling (11.0% vs 33.7%, p = 0.004). No differences were found in ECD between the two procedures (1541 vs 1605, p = 0.77).

CONCLUSIONS: DMEK results in superior visual acuity rates with quicker recovery. However, UT-DSAEK has a more favourable complication profile, particularly regarding lower rates of re-bubbling. Both are valuable options in the treatment of corneal endothelial disease and choice of procedure may depend on surgical expertise.

PMID:36934158 | DOI:10.1038/s41433-023-02467-2

Bone Marrow Transplant. 2023 Mar 18. doi: 10.1038/s41409-023-01953-1. Online ahead of print.

NO ABSTRACT

PMID:36934148 | DOI:10.1038/s41409-023-01953-1

Sci Rep. 2023 Mar 18;13(1):4501. doi: 10.1038/s41598-023-31521-y.

ABSTRACT

A normalizing flow (NF) is a mapping that transforms a chosen probability distribution to a normal distribution. Such flows are a common technique used for data generation and density estimation in machine learning and data science. The density estimate obtained with a NF requires a change of variables formula that involves the computation of the Jacobian determinant of the NF transformation. In order to tractably compute this determinant, continuous normalizing flows (CNF) estimate the mapping and its Jacobian determinant using a neural ODE. Optimal transport (OT) theory has been successfully used to assist in finding CNFs by formulating them as OT problems with a soft penalty for enforcing the standard normal distribution as a target measure. A drawback of OT-based CNFs is the addition of a hyperparameter, [Formula: see text], that controls the strength of the soft penalty and requires significant tuning. We present JKO-Flow, an algorithm to solve OT-based CNF without the need of tuning [Formula: see text]. This is achieved by integrating the OT CNF framework into a Wasserstein gradient flow framework, also known as the JKO scheme. Instead of tuning [Formula: see text], we repeatedly solve the optimization problem for a fixed [Formula: see text] effectively performing a JKO update with a time-step [Formula: see text]. Hence we obtain a “divide and conquer” algorithm by repeatedly solving simpler problems instead of solving a potentially harder problem with large [Formula: see text].

PMID:36934141 | DOI:10.1038/s41598-023-31521-y

Sci Rep. 2023 Mar 18;13(1):4487. doi: 10.1038/s41598-023-30286-8.

ABSTRACT

High intensity focused ultrasound (HIFU) systems have been approved for therapeutic ultrasound delivery to cause tissue ablation or induced hyperthermia. Microbubble agents have also been used in combination with sonication exposures. These require temperature feedback and monitoring to prevent unstable cavitation and prevent excess tissue heating. Previous work has utilized lower power and pressure to oscillate microbubbles and transfer energy to endothelial cells in the absence of thermally induced damage that can radiosensitize tumors. This work investigated whether reduced acoustic power and pressure on a commercial available MR-integrated HIFU system could result in enhanced radiation-induced tumor response after exposure to ultrasound-stimulated microbubbles (USMB) therapy. A commercially available MR-integrated HIFU system was used with a hyperthermia system calibration provided by the manufacturer. The ultrasound transducer was calibrated to reach a peak negative pressure of – 750 kPa. Thirty male New Zealand white rabbits bearing human derived PC3 tumors were grouped to receive no treatment, 14 min of USMB, 8 Gy of radiation in a separate irradiation cabinet, or combined treatments. In vivo temperature changes were collected using MR thermometry at the tumor center and far-field muscle region. Tissues specimens were collected 24 h post radiation therapy. Tumor cell death was measured and compared to untreated controls through hematoxylin and eosin staining and immunohistochemical analysis. The desired peak negative pressure of – 750 kPa used for previous USMB occurred at approximately an input power of 5 W. Temperature changes were limited to under 4 °C in ten of twelve rabbits monitored. The median temperature in the far-field muscle region of the leg was 2.50 °C for groups receiving USMB alone or in combination with radiation. Finally, statistically significant tumor cell death was demonstrated using immunohistochemical analysis in the combined therapy group compared to untreated controls. A commercial MR-guided therapy HIFU system was able to effectively treat PC3 tumors in a rabbit model using USMB therapy in combination with radiation exposures. Future work could find the use of reduced power and pressure levels in a commercial MR-guided therapy system to mechanically stimulate microbubbles and damage endothelial cells without requiring high thermal doses to elicit an antitumor response.

PMID:36934140 | DOI:10.1038/s41598-023-30286-8

Sci Rep. 2023 Mar 18;13(1):4511. doi: 10.1038/s41598-023-31727-0.

ABSTRACT

In single subcortical infarction (SSI), changes in lesion size are a major determinant of early neurological deterioration. We evaluated the association between END and infarct growth velocity (IGV) in patients with SSI. We included consecutive patients with SSI who underwent MRI within 24 h of symptom onset between 2010 and 2020. END was defined as an increase of ≥ 2 in the total National Institutes of Health Stroke Scale (NIHSS) score or ≥ 1 in the motor NIHSS score. IGV was calculated using the following formula: IGV (mL/h) = diffusion-weighted imaging volume (mL)/time to MRI (h). A total of 604 patients with SSI were evaluated. Multivariable logistic regression analysis showed that IGV remained significant after adjusting for confounders (aOR = 1.34, 95% CI 1.12-1.61). In a subgroup analysis based on the type of SSI, only patients with distal SSI showed an association between IGV and END (aOR = 1.64, 95% CI 1.24-2.16). In patients with proximal SSI, IGV did not show any statistical association with END. In conclusion, IGV was positively associated with END in patients with SSI. IGV should be interpreted differently in clinical settings depending on the location of the SSI lesion.

PMID:36934120 | DOI:10.1038/s41598-023-31727-0

Sci Rep. 2023 Mar 18;13(1):4472. doi: 10.1038/s41598-023-30592-1.

ABSTRACT

Tipping points (TPs) in Earth’s climate system have been the subject of increasing interest and concern in recent years, given the risk that anthropogenic forcing could cause abrupt, potentially irreversible, climate transitions. Paleoclimate records are essential for identifying past TPs and for gaining a thorough understanding of the underlying nonlinearities and bifurcation mechanisms. However, the quality, resolution, and reliability of these records can vary, making it important to carefully select the ones that provide the most accurate representation of past climates. Moreover, as paleoclimate time series vary in their origin, time spans, and periodicities, an objective, automated methodology is crucial for identifying and comparing TPs. To address these challenges, we introduce the open-source PaleoJump database, which contains a collection of carefully selected, high-resolution records originating in ice cores, marine sediments, speleothems, terrestrial records, and lake sediments. These records describe climate variability on centennial, millennial and longer time scales and cover all the continents and ocean basins. We provide an overview of their spatial distribution and discuss the gaps in coverage. Our statistical methodology includes an augmented Kolmogorov-Smirnov test and Recurrence Quantification Analysis; it is applied here, for illustration purposes, to selected records in which abrupt transitions are automatically detected and the presence of potential tipping elements is investigated. These transitions are shown in the PaleoJump database along with other essential information about the records, including location, temporal scale and resolution, as well as temporal plots. This open-source database represents, therefore, a valuable resource for researchers investigating TPs in past climates.

PMID:36934110 | DOI:10.1038/s41598-023-30592-1

Electrophoresis. 2023 Mar 18. doi: 10.1002/elps.202200176. Online ahead of print.

ABSTRACT

DNA methylation patterns can be used to identify the type of tissue or body fluid found at a crime scene. However, tissue-related methylation levels have not been analyzed in individuals with different illnesses and medical conditions in forensic-specific studies. The primary goal of this study was to investigate if certain clinical phenotypes can alter the methylation levels of CpG sites in genes involved in tissue typing. Four studies with focus on DNA methylation analysis on individuals with different clinical conditions were selected from the Gene Expression Omnibus database. Then, a list of 137 CpG sites was compiled for further investigation. Statistical tests were performed to compare the beta-values results obtained for the control groups and the individuals affected by medical conditions. For each study, CpG sites that presented significant statistical differences between patients and control group were identified and it was possible to notice that DNA methylation levels can be affected in sites with potential forensic use. Although the observed DNA methylation variation (less than 10% difference) in this study would likely not cause any issues in body fluid identification, the results are important to show that this type of analysis should be taken into consideration when investigating and further validating body fluid markers. The CpG sites identified in this study should be further investigated by future studies on body fluids identification, and due to the significant difference in methylation levels in samples from affected individuals, caution must be taken before including these sites in tissue identification investigations. This article is protected by copyright. All rights reserved.

PMID:36934081 | DOI:10.1002/elps.202200176

Enferm Intensiva (Engl Ed). 2023 Mar 16:S2529-9840(23)00012-5. doi: 10.1016/j.enfie.2022.02.002. Online ahead of print.

ABSTRACT

AIM: To know the characteristics of the handover performed by nurses working in Critical Care Units in Spain.

METHODS: Descriptive and cross-sectional study, whose population was nurses working in Critical Care Units in Spain. An ad hoc questionnaire was used to explore the characteristics of the process, the training received, the information forgotten and the influence of this activity on patient care. The questionnaire was online and dissemination was done through social networks. The sample was selected by convenience. A descriptive analysis was performed according to the nature of the variables and comparison of groups through ANOVA with R software version 4.0.3 (R Project for Statistical Computing).

RESULTS: The sample was 420 nurses. Most of them answered that (79,5%) perform this activity in an individual way, from outgoing nurse to incoming nurse. Location varied according to the size of the unit (p<0,05). Interdisciplinary handover was rare (p<0.05). In the last month, with regard to the time of data collection, 29,5% had to contact the unit due to forgetting relevant information, using WhatsApp as the first channel to transmit this information.

CONCLUSIONS: There is a lack of standardization in the handoff between shifts, in terms of the physical space where it is done, tools to structure the information, participation of other professionals and the use of unofficial communication channels to contact for omitted information during the handover. Shift change was identified as a vital process to ensure continuity of care and patient safety, so further researchs are important for patients handoffs.

PMID:36934076 | DOI:10.1016/j.enfie.2022.02.002

An Bras Dermatol. 2023 Mar 16:S0365-0596(23)00055-7. doi: 10.1016/j.abd.2022.07.005. Online ahead of print.

ABSTRACT

BACKGROUND: Achieving adequate surgical margins and preventing recurrence are important in the treatment of basal cell carcinoma (BCC).

OBJECTIVES: The objectives of this study were to evaluate the adequacy of surgical margins and the re-excision rates in patients with primary BCC who underwent standard surgical treatment using our proposed algorithm and to define the risk factors in patients with recurrent BCC.

METHODS: The medical records of patients who were histopathologically diagnosed with BCC were reviewed. An algorithm created based on previous literature was used to determine the distribution of optimal surgical margins adequacy and re-excision rates.

RESULTS: Statistically significant differences were observed between the cases with and without recurrence in age at diagnosis (p=0.004), tumor size (p=0.023), tumor location in the H zone of the face (p=0.005), and aggressive histopathological subtype (p=0.000). When the tumors were evaluated for adequacy of deep and lateral surgical margins and re-excision rates, higher rates of adequate excision (457 cases, 68.0%) and re-excision (43 cases, 33.9%) were noted for tumors in the H or M zone.

STUDY LIMITATIONS: Inadequate follow-up of newly diagnosed patients in terms of recurrence and metastasis and the retrospective application of our proposed algorithm are the limitations of the present study.

CONCLUSIONS: Our results showed that if BCC was detected at an early age and at an early stage, recurrence was lower. The H and M zones were the regions with the highest rates of optimal surgical outcomes.

PMID:36934062 | DOI:10.1016/j.abd.2022.07.005

Am J Orthod Dentofacial Orthop. 2023 Mar 16:S0889-5406(23)00099-9. doi: 10.1016/j.ajodo.2023.02.006. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to evaluate changes in palatal shape after orthodontic treatment from a borderline sample of extraction and nonextraction patients with a Class I relationship.

METHODS: A borderline sample regarding premolar extractions was obtained through discriminant analysis and comprised 30 nonextraction and 23 extraction patients. The digital dental casts of these patients were digitized with 3 curves and 239 landmarks placed on the hard palate. Procrustes superimposition and principal component analysis were implemented to assess group shape variability patterns.

RESULTS: The success of the discriminant analysis in identifying a borderline sample regarding the extraction modality was validated using geometric morphometrics. Concerning palatal shape, no sexual dimorphism was found (P = 0.78). The first 6 principal components that were statistically significant accounted for 79.2% of the total shape variance. Palatal changes were 61% more pronounced in the extraction group, which exhibited a decrease in palatal length (P = 0.02; 10,000 permutations). In contrast, the nonextraction group showed an increase in the palatal width (P <0.001; 10,000 permutations). Intergroup comparisons indicated that the nonextraction group exhibited longer palates, whereas the extraction group exhibited higher palates (P = 0.02; 10,000 permutations).

CONCLUSIONS: Considerable changes in palatal shape were seen for the nonextraction and extraction treatment group, with the latter exhibiting more pronounced changes, mainly in terms of palatal length. Further investigations are needed to clarify the clinical significance of the palatal shape changes in borderline patients after extraction and nonextraction treatment.

PMID:36934057 | DOI:10.1016/j.ajodo.2023.02.006