Tag: statistics

Front Surg. 2023 Jan 23;9:1062451. doi: 10.3389/fsurg.2022.1062451. eCollection 2022.

ABSTRACT

OBJECTIVE: The purpose of this study was to investigate the clinical efficacy of unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) for lumbar spinal stenosis (LSS).

METHODS: Patients who underwent UBE-TLIF due to single-segment LSS between August 2019 and July 2021 were retrospectively included in the study. Clinical outcomes evaluated include operative time, estimated blood loss (including postoperative drainage), time to ambulation, postoperative hospital stay, complications, visual analog scale (VAS) scores of low back pain and leg pain, Japanese Orthopaedic Association (JOA) score, Oswestry disability index (ODI), and modified Macnab criteria. Interbody bony fusion at the index level was assessed using Bridwell grading criteria.

RESULTS: A total of 73 patients (29 males and 44 females) were enrolled in this study. All surgeries were successfully performed without intraoperative conversion to open surgery. Magnetic resonance imaging (MRI) revealed optimal direct neural decompression after UBE-TLIF. The mean operative time was 150.89 ± 15.58 min. The mean estimated blood loss was 126.03 ± 17.85 ml (postoperative drainage was 34.84 ± 8.31 ml). Time to ambulation was 2.0 ± 0.75 days after the procedure. Postoperatively, the mean hospital stay was 5.96 ± 1.38 days. VAS scores of low back pain and leg pain, JOA, and ODI were significantly improved postoperatively compared with those before the operation, and differences were statistically significant (P < 0.05). Excellent and good outcomes were reported by 87.67% of patients according to the modified Macnab criteria at the final follow-up. A total of nine perioperative complications occurred, with an incidence of 12.33%. X-ray or computerized tomography (CT) 6 months after the procedure showed that 37 cases (50.68%) presented with segmental fusion, 30 cases (41.10%) showed incomplete fusion, and 6 cases (8.22%) showed no signs of fusion. However, bony fusion was achieved in all cases at the final follow-up.

CONCLUSIONS: UBE-TLIF for LSS has the advantages of less surgical invasiveness and fast postoperative recovery.

PMID:36756660 | PMC:PMC9901529 | DOI:10.3389/fsurg.2022.1062451

Sci Rep. 2023 Feb 8;13(1):2231. doi: 10.1038/s41598-023-29444-9.

ABSTRACT

Backscattered circularly polarized light from turbid media consists of helicity-flipped and helicity-preserved photon sub-populations (i.e., photons of perpendicular and parallel circular handedness). Their intensities and spatial distributions are found to be acutely sensitive to average scatterer size and modestly sensitive to the scattering coefficient (medium turbidity) through an interplay of single and multiple scattering effects. Using a highly sensitive intensified-CCD camera, helicity-based images of backscattered light are captured, which, with the aid of corroborating Monte Carlo simulation images and statistics, enable (1) investigation of subsurface photonic pathways and (2) development of the novel ‘spatial helicity response’ metric to quantify average scatterer size and turbidity of tissue-like samples. An exciting potential application of this work is noninvasive early cancer detection since malignant tissues exhibit alterations in scatterer size (larger nuclei) and turbidity (increased cell density).

PMID:36755076 | DOI:10.1038/s41598-023-29444-9

Sci Rep. 2023 Feb 8;13(1):2274. doi: 10.1038/s41598-023-29296-3.

ABSTRACT

Age assessment is regularly used in clinical routine by pediatric endocrinologists to determine the physical development or maturity of children and adolescents. Our study investigates whether age assessment can be performed using CT scout views from thoracic and abdominal CT scans using a deep neural network. Hence, we retrospectively collected 1949 CT scout views from pediatric patients (acquired between January 2013 and December 2018) to train a deep neural network to predict the chronological age from CT scout views. The network was then evaluated on an independent test set of 502 CT scout views (acquired between January 2019 and July 2020). The trained model showed a mean absolute error of 1.18 ± 1.14 years on the test data set. A one-sided t-test to determine whether the difference between the predicted and actual chronological age was less than 2.0 years was statistically highly significant (p < 0.001). In addition, the correlation coefficient was very high (R = 0.97). In conclusion, the chronological age of pediatric patients can be assessed with high accuracy from CT scout views using a deep neural network.

PMID:36755075 | DOI:10.1038/s41598-023-29296-3

Nat Commun. 2023 Feb 8;14(1):688. doi: 10.1038/s41467-023-36122-x.

ABSTRACT

A proper understanding of disease etiology will require longitudinal systems-scale reconstruction of the multitiered architecture of eukaryotic signaling. Here we combine state-of-the-art data acquisition platforms and bioinformatics tools to devise PAMAF, a workflow that simultaneously examines twelve omics modalities, i.e., protein abundance from whole-cells, nucleus, exosomes, secretome and membrane; N-glycosylation, phosphorylation; metabolites; mRNA, miRNA; and, in parallel, single-cell transcriptomes. We apply PAMAF in an established in vitro model of TGFβ-induced epithelial to mesenchymal transition (EMT) to quantify >61,000 molecules from 12 omics and 10 timepoints over 12 days. Bioinformatics analysis of this EMT-ExMap resource allowed us to identify; -topological coupling between omics, -four distinct cell states during EMT, -omics-specific kinetic paths, -stage-specific multi-omics characteristics, -distinct regulatory classes of genes, -ligand-receptor mediated intercellular crosstalk by integrating scRNAseq and subcellular proteomics, and -combinatorial drug targets (e.g., Hedgehog signaling and CAMK-II) to inhibit EMT, which we validate using a 3D mammary duct-on-a-chip platform. Overall, this study provides a resource on TGFβ signaling and EMT.

PMID:36755019 | DOI:10.1038/s41467-023-36122-x

Transl Psychiatry. 2023 Feb 8;13(1):49. doi: 10.1038/s41398-023-02337-1.

ABSTRACT

Treatment resistance in alcohol use disorders (AUD) is a major problem for affected individuals and for society. In the search of new treatment options, few case studies using deep brain stimulation (DBS) of the nucleus accumbens have indicated positive effects in AUD. Here we report a double-blind randomized controlled trial comparing active DBS (“DBS-EARLY ON”) against sham stimulation (“DBS-LATE ON”) over 6 months in n = 12 AUD inpatients. This 6-month blind phase was followed by a 12-month unblinded period in which all patients received active DBS. Continuous abstinence (primary outcome), alcohol use, alcohol craving, depressiveness, anxiety, anhedonia and quality of life served as outcome parameters. The primary intention-to-treat analysis, comparing continuous abstinence between treatment groups, did not yield statistically significant results, most likely due to the restricted number of participants. In light of the resulting limited statistical power, there is the question of whether DBS effects on secondary outcomes can nonetheless be interpreted as indicative of an therapeutic effect. Analyses of secondary outcomes provide evidence for this, demonstrating a significantly higher proportion of abstinent days, lower alcohol craving and anhedonia in the DBS-EARLY ON group 6 months after randomization. Exploratory responder analyses indicated that patients with high baseline alcohol craving, depressiveness and anhedonia responded to DBS. The results of this first randomized controlled trial are suggestive of beneficial effects of DBS in treatment-resistant AUD and encourage a replication in larger samples.

PMID:36755017 | DOI:10.1038/s41398-023-02337-1

Health Econ. 2023 Feb 8. doi: 10.1002/hec.4657. Online ahead of print.

ABSTRACT

This article investigates the relationship between school openings and Covid-19 diffusion when school-age vaccination becomes available. The analysis relies on a unique geo-referenced high frequency database on age of vaccination, Covid-19 cases and hospitalization indicators from the Italian region of Sicily. The study focuses on the change of Covid-19 diffusion after school opening in a homogeneous geographical territory (i.e., with the same control measures and surveillance systems, centrally coordinated by the Regional Government). The identification of causal effects derives from a comparison of the change in cases before and after school opening in the school year 2020/21, when vaccination was not available, and in 2021/22, when the vaccination campaign targeted individuals of age 12-19 and above 19. Results indicate that, while school opening determined an increase in the growth rate of Covid-19 cases in 2020/2021, this effect has been substantially reduced by school-age vaccination in 2021/2022. In particular, we find that an increase of approximately 10% in the vaccination rate of school-age population reduces the growth rate of Covid-19 cases after school opening by approximately 1%.

PMID:36754980 | DOI:10.1002/hec.4657

Eur J Clin Nutr. 2023 Feb 8. doi: 10.1038/s41430-023-01271-1. Online ahead of print.

ABSTRACT

BACKGROUND: Consumption of ultra-processed foods (UPFs) has been linked to risk of chronic diseases, with scant evidence in relation to multiple sclerosis (MS).

METHODS: We tested associations between UPF consumption and likelihood of a first clinical diagnosis of central nervous system demyelination (FCD) (267 cases, 508 controls), a common precursor to MS. We used data from the 2003-2006 Ausimmune Study and logistic regression with full propensity score matching for age, sex, region of residence, education, smoking history, body mass index, physical activity, history of infectious mononucleosis, dietary misreporting, and total energy intake.

RESULTS: Higher UPF consumption was statistically significantly associated with an increased likelihood of FCD (adjusted odds ratio = 1.08; 95% confidence interval = 1.0,1.15; p = 0.039), representing an 8% increase in likelihood of FCD per one energy-adjusted serving/day of UPFs.

CONCLUSION: Higher intakes of UPF were associated with increased likelihood of FCD in this Australian cohort. Nutrition education and awareness of healthy eating patterns may benefit those at high risk of FCD.

PMID:36754977 | DOI:10.1038/s41430-023-01271-1

Sci Data. 2023 Feb 8;10(1):81. doi: 10.1038/s41597-023-01989-4.

ABSTRACT

Japan is a highly urbanized and severely aging society. In an aging society, chronic disease and disability are prevalent, and the population is sensitive to environmental issues and climate change. To identify the effects of population changes, formulate population and public health policies, and assist environmental projects, a high-resolution and accurate gridded population dataset is highly desirable. To provide basic data for research in these areas, we created an open access annual dataset from 2001 to 2020 containing the total, male, and female population counts in each grid at a resolution of 500 m. A random forest method was employed to fill the gaps in Japan’s nationwide census data collected in 2005, 2010, 2015, and 2020. The yearly population dataset was based on the 4^th-level mesh data from the Statistics Bureau of Japan to make it easy to use. The dataset is provided here along with descriptions of the data and methods used in the fitting, cross-validation, and prediction processes.

PMID:36754963 | DOI:10.1038/s41597-023-01989-4

Lifetime Data Anal. 2023 Feb 8. doi: 10.1007/s10985-022-09586-0. Online ahead of print.

ABSTRACT

Multi-state models are used to describe how individuals transition through different states over time. The distribution of the time spent in different states, referred to as ‘length of stay’, is often of interest. Methods for estimating expected length of stay in a given state are well established. The focus of this paper is on the distribution of the time spent in different states conditional on the complete pathway taken through the states, which we call ‘conditional length of stay’. This work is motivated by questions about length of stay in hospital wards and intensive care units among patients hospitalised due to Covid-19. Conditional length of stay estimates are useful as a way of summarising individuals’ transitions through the multi-state model, and also as inputs to mathematical models used in planning hospital capacity requirements. We describe non-parametric methods for estimating conditional length of stay distributions in a multi-state model in the presence of censoring, including conditional expected length of stay (CELOS). Methods are described for an illness-death model and then for the more complex motivating example. The methods are assessed using a simulation study and shown to give unbiased estimates of CELOS, whereas naive estimates of CELOS based on empirical averages are biased in the presence of censoring. The methods are applied to estimate conditional length of stay distributions for individuals hospitalised due to Covid-19 in the UK, using data on 42,980 individuals hospitalised from March to July 2020 from the COVID19 Clinical Information Network.

PMID:36754952 | DOI:10.1007/s10985-022-09586-0

Ann Surg Oncol. 2023 Feb 8. doi: 10.1245/s10434-023-13174-3. Online ahead of print.

ABSTRACT

BACKGROUND: Although colorectal hepatic metastases (HM) and peritoneal surface disease (PSD) are distinct biologic diseases, they may have similar long-term survival when optimally treated with surgery.

METHODS: This study retrospectively reviewed prospectively managed databases. Patients undergoing R0 or R1 resections were analyzed with descriptive statistics, the Kaplan-Meier method, and Cox regression. Survival was compared over time for the following periods: 1993-2006, 2007-2012, and 2013-2020.

RESULTS: The study enrolled 783 HM patients undergoing liver resection and 204 PSD patients undergoing cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC). Compared with PSD patients, HM patients more often had R0 resections (90.3% vs. 32.4%), less often had pre-procedure chemotherapy (52.4% vs. 92.1%), and less often were functionally independent (79.7% vs. 95.6%). The 5-year overall survival for HM was 40.9%, with a median survival period of 45.8 months versus 25.8% and 33.4 months, respectively, for PSD (p < 0.05). When stratified by resection status, R0 HM and R0 PSD did not differ significantly in median survival (49.0 vs. 45.4 months; p = 0.83). The median survival after R1 resection also was similar between HM and PSD (32.6 vs. 26.9 months; p = 0.59). Survival between the two groups again was similar over time when stratified by resection status. The predictors of survival for HM patients were R0 resection, number of lesions, intraoperative transfusion, age, and adjuvant chemotherapy. For the PSD patients, the predictors were peritoneal cancer index (PCI) score, estimated blood loss (EBL), and female gender.

CONCLUSION: The study showed that R0 resections are associated with improved outcomes and that median survival is similar between HM and PSD patients when it is achieved. Surveillance and treatment strategies that facilitate R0 resections are needed to improve results, particularly for PSD.

PMID:36754944 | DOI:10.1245/s10434-023-13174-3