Tag: statistics

Acta Ophthalmol. 2022 Sep 19. doi: 10.1111/aos.15260. Online ahead of print.

ABSTRACT

PURPOSE: The aim of the present study was to determine whether microperimetric parameters could predict the progression of an eye at high risk of age-related macular degeneration (AMD) at 24 months.

METHODS: We conducted a multicentric prospective non-comparative open-label study including patients with one eye in stage 4 of the Age-Related Eye Disease Study Group (AREDS) classification, and the other eye in AREDS stage 3 (study eye). A microperimetry examination (MAIA™, CenterVue, Padova, Italy) was performed at baseline and every 6 months during the 2-year follow-up. At the end of the follow-up, each study eye was classified as ‘progressive’ (i.e. AREDS stage 4) or ‘non-progressive’ (i.e. AREDS stage 3).

RESULTS: A total of 147 patients were analysed, of which 30.6% progressed from AREDS stage 3 to stage 4. The microperimetry criterion ‘mean retinal sensitivity’ was significantly different at baseline between non-progressive and progressive eyes (p = 0.022), with lower values for the latter. With a threshold for mean retinal sensitivity set at 24.7 dB, diagnostic sensitivity was 80% [95%CI (65.4-90.4)], specificity was 30.4% [95%CI (21.7-40.3)], positive predictive value was 33.6% [95%CI (24.8-43.4)], and negative predictive value was 77.5% [95%CI (61.5-89.2)]. In the multivariate analysis including microperimetric parameters and other routine ophthalmologic examinations, mean retinal sensitivity was the only predictive parameter statistically associated with progression (p = 0.0004).

CONCLUSIONS: Our findings are encouraging as regards the use of microperimetry, and mean retinal sensitivity value in particular, to predict the 2-year risk of progression to AREDS stage 4 eye.

PMID:36120870 | DOI:10.1111/aos.15260

Leuk Lymphoma. 2022 Sep 18:1-11. doi: 10.1080/10428194.2022.2123222. Online ahead of print.

ABSTRACT

We conducted a single-center retrospective study to assess cardiovascular (CV) toxicity and treatment discontinuation for CV toxicity in diffuse large B-cell lymphoma (DLBCL) or follicular lymphoma (FL) patients treated with immunochemotherapy (R-CHOP-like). Between 2006 and 2017, 433 patients were included (DLBCL: n = 345, FL: n = 88). The median age was 63 years (50-73). We defined three types of CV toxicity: early-onset cardiovascular toxicity (the event occurred within 6 months following treatment start); subacute toxicity (the event occurred between 6 months and 1 year after treatment start) and late toxicity (the event occurred 1 year or more after treatment start). Forty-eight (11.1%) patients experienced at least one anthracycline-related CV event. Seven patients experienced treatment discontinuation due to CV toxicity. Early-onset and subacute cardiac events were primarily acute heart failure (34.3%) and atrial fibrillation (28.6%). History of ischemic heart disease (p = 0.02) and valvular heart disease (p = 0.03) were associated with a higher risk of anthracycline-related CV event occurrence.

PMID:36120853 | DOI:10.1080/10428194.2022.2123222

Acta Radiol. 2022 Sep 18:2841851221124461. doi: 10.1177/02841851221124461. Online ahead of print.

ABSTRACT

BACKGROUND: Ultrasound examination of the medial side of the hip joint has been rarely used to evaluate the status of developmental dysplasia of the hip (DDH) in Pavlik harness treatment according to the literature.

PURPOSE: To analyze the effects of cartilaginous acetabulum, hip joint labrum, and acetabular tissue on the reduction of DDH.

MATERIAL AND METHODS: A total of 50 cases (100 hips) were detected by the Graf method with a high-frequency linear transducer (L 5-12), and there were 59 dislocated hips and 41 non-dislocated hips. Patients were treated with a Pavlik harness. Ultrasound examination of the medial side of the hip joint was performed for follow-up. The hip joints were divided into three groups: the non-dislocated group; the reducible group; and the non-reducible group.

RESULTS: The success rate of reduction was significantly higher when the acetabulum cartilage was located on the cephalic side (chi-square = 28.12, P < 0.001). The success rate was also significantly higher when the hip joint labrum was located on the cephalic side (chi-square = 17.21, P < 0.001). Type III and D had a higher success rate of reduction than type IV (P < 0.001). The pairwise comparison of the measurements of acetabular tissue between the non-dislocated group, the reducible group, and the non-reducible group showed statistical differences (P < 0.001).

CONCLUSION: The present study confirmed that the location of acetabulum cartilage and hip joint labrum affected the outcome of treatment. The degree of dislocation and the amount of acetabular tissue were correlated with the success rate of treatment.

PMID:36120851 | DOI:10.1177/02841851221124461

Acta Radiol. 2022 Sep 18:2841851221126596. doi: 10.1177/02841851221126596. Online ahead of print.

ABSTRACT

BACKGROUND: An abundance of CD8+ tumor infiltrating lymphocytes (TILs) in the center of solid tumors is a reliable predictive biomarker for patients eligible for immunotherapy.

PURPOSE: To develop a computed tomography (CT)-based radiomics signature for a preoperative prediction of an abundance of CD8+ TILs in non-small-cell lung cancer (NSCLC).

MATERIAL AND METHODS: In this retrospective study, 117 consecutive patients with pathologically confirmed NSCLC were included and randomly divided into training (n = 77) and test sets (n = 40). A total of 107 radiomics features were extracted from the three-dimensional volumes of interest of each patient. Least absolute shrinkage and selection operator (LASSO) regression was used to select the strongest features for abundance of CD8+ TILs in NSCLC, and the radiomics score was constructed through a linear combination of these selected features. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive performance of the radiomics score.

RESULTS: The radiomics score was associated with an abundance of CD8+ TILs in NSCLC, which achieved an area under the curve (AUC) of 0.83 (95% CI=0.73-0.92) and 0.68 (95% CI=0.54-0.87) in the training and test sets, respectively. The difference was not statistically significant (P = 0.20). The tumors with high CD8+ TILs tended to have heterogeneous dependences (high value of Dependence Non-Uniformity Normalized) and complicated texture (high value of Informational Measure of Correlation 1).

CONCLUSION: CT-based radiomics features have the ability to predict CD8+ TILs expression levels of an abundance of CD8+ TILs in NSCLC, which was shown to be a potential imaging biomarker for stratifying patients who may benefit from immunotherapy.

PMID:36120843 | DOI:10.1177/02841851221126596

J Esthet Restor Dent. 2022 Sep 19. doi: 10.1111/jerd.12961. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the clinical outcome of three esthetic implant-supported crown systems fabricated with semi-digital workflow and their influence on the clinical outcome of dental implants.

MATERIAL AND METHODS: A total of 30 participants had received dental implants restoring missing maxillary first/second premolars. After 6 weeks, customized zirconia abutments were early loaded. Two months later, the definitive crowns were fabricated using semi-digital workflow and cemented. According to the crown material, 3 groups were randomly allocated; group (Z): ultrahigh-translucent monolithic zirconia, group (C): resin-matrix ceramic and group (P): polyetherketoneketone veneered with light-cured composite resin. Clinical outcomes including the survival and success rates were evaluated at baseline, 6, 12, 18, and 24 months.

RESULTS: The survival rate for all studied groups was 100%, while their success rate was 100% for group (Z) and 90% for group (C) and group (P). Based on the functional implant prosthodontic score, a statistically significant difference was detected between group (Z) and group (P) (p < 0.001) as well as between group (C) and group (P) (p = 0.01).

CONCLUSIONS: The zirconia group had the most favorable clinical behavior, while the polyetherketoneketone had the least. All crown systems had comparable success rates with similar values of the peri-implant marginal bone loss.

CLINICAL SIGNIFICANCE: Using semi-digital workflow, ultrahigh-translucent monolithic zirconia, resin-matrix ceramic and polyetherketoneketone veneered with light-cured composite resin can be considered as favorable implant-supported crowns. The implant-supported crown system based on polyetherketoneketone veneered with light-cured composite resin is counted as a promising esthetic and restorative option.

PMID:36120840 | DOI:10.1111/jerd.12961

Aging Ment Health. 2022 Sep 19:1-8. doi: 10.1080/13607863.2022.2122932. Online ahead of print.

ABSTRACT

Objectives. This study examined the relationships between economic hardships (i.e. perceived financial hardship and job interference) and caregiver burden among Korean American family caregivers of persons with dementia and explored their lived experience caring for their loved ones.Methods. Using a mixed-methods research design, we first conducted a survey with 36 Korean American family caregivers. We also conducted semi-structured, in-depth, individual interviews (n = 33) and subsequently compared the results.Results. Cohabiting with their loved ones, the total duration of caregiving, and financial hardship were statistically significant predictors of higher levels of caregiver burden. Our thematic analysis resulted in four themes: (1) financial hardship, (2) early retirement, (3) dual responsibilities contributing to physical and emotional challenges, and (4) a lack of caregiver support.Conclusion. Our findings suggest the importance of developing culturally appropriate interventions that are affordable and accessible to Korean American family caregivers of persons with dementia.

PMID:36120839 | DOI:10.1080/13607863.2022.2122932

Cleft Palate Craniofac J. 2022 Sep 18:10556656221125392. doi: 10.1177/10556656221125392. Online ahead of print.

ABSTRACT

OBJECTIVE: The role of MMP16 in lip development is unclear. This study aimed to identify nonsyndromic cleft lip with or without palate (NSCL ± P) susceptible loci of MMP16 in western Han Chinese.

DESIGN: We performed targeted sequencing around MMP16 combined with a 2-phase association analysis on common variants. Phase 2 association analysis was performed with NSCL ± P specific subphenotypes (NSCL and NSCLP). Then we used rare variants burden analysis and genotyping, accompanied by motif analysis.

SETTING: This study was completed in a tertiary medical center.

PATIENTS, PARTICIPANTS: Phase 1 targeted sequencing included 159 patients with NSCL ± P and 542 normal controls; phase 2 included 1626 patients with NSCL ± P (1047 NSCL and 579 NSCLP) and 2255 normal controls.

INTERVENTIONS: Venous blood samples were collected from patients and used to extract DNA.

MAIN OUTCOME MEASURES: After Bonferroni correction, phase 1 significant threshold of p-value was 4.28 × 10^-5 (0.05/1167 single nucleotide polymorphisms [SNPs]), and phase 2 was .00025 (0.05/200 SNPs). Burden analysis significant threshold p-value was .05.

RESULTS: Common variants phase 1 association analysis identified 11 statistically significant SNPs (lowest p = 1.90 × 10^-9, odds ratio (OR) = 0.27, 95% CI: 0.17-0.44), phase 2 replication identified 16 SNPs in NSCL ± P (lowest p = 6.26 × 10^-6, OR = 0.77, 95% CI: 0.69-0.86) and 9 in NSCL (lowest p = 8.44 × 10^-5, OR = 0.76, 95% CI: 0.66-0.87). Rare variants burden analysis showed no significant results, genotyping results showed they were maternally inherited.

CONCLUSIONS: Our study identified MMP16 susceptible SNPs in NSCL ± P and NSCL, emphasizing its potential role in lip development. Our study also highlighted the importance to perform association analysis with subphenotypes divided.

PMID:36120833 | DOI:10.1177/10556656221125392

Orthop Surg. 2022 Sep 19. doi: 10.1111/os.13477. Online ahead of print.

ABSTRACT

OBJECTIVE: During PCL reconstruction surgery, precise and personalized positioning of the graft tunnel is very important. In order to obtain patient-specific anatomical data, we established a three-dimensional knee joint fusion model to provide a unified imaging strategy, as well as anatomical information, for individualized and accurate posterior cruciate ligament (PCL) reconstruction.

METHODS: This is an exploration study. From January 2019 to January 2020, 20 healthy adults randomly were enrolled and assessed via CT and MRI imaging. A three-dimensional fusion model of the knee joint was generated using the modified MIMIMICS and image fusion software. On the fused image, the areas of the femoral and tibial PCL footprint of both knees were measured. The anatomical center of the PCL footprint was measured at the femoral and tibial ends. The relevant bony landmarks surrounding the PCL femoral and tibial attachment were also measured. Paired t-tests were employed for all statistical analyzes, and p < 0.05 was considered as statistically significant.

RESULTS: All 20 subjects achieved successful image fusion modeling and measurement, with an average duration of 12 h. The lengths of the LF1-LF3 were 32.1 ± 1.8, 6.8 ± 2.5, and 23.3 ± 2.1 mm, respectively. The lengths of the LT1-LT3 were 37.3 ± 3.3, 45.6 ± 5.3, and 6.0 ± 1.2 mm, respectively. The distances between the tibial PCL center of the left knee to the medial groove, champagne-glass drop-off, and the apex of the medial intercondylar were 8.4 ± 2.4, 9.2 ± 1.8, and 15.3 ± 1.4 mm, respectively, and the corresponding distances from the right knee were 8.0 ± 2.0, 9.4 ± 2.2, and 16.1 ± 1.8 mm, respectively. We observed no difference between the bilateral sides, in terms of the distance from the PCL center to the PCL attachment-related landmark, under arthroscopic guidance. The area of the femoral and tibial PCL footprints on the left knee were 115.3 ± 33.5 and 146.6 ± 24.4 mm² , respectively, and the corresponding areas on the right knee were 121.8 ± 35.6 and 142.8 ± 19.5 mm² , respectively. There was no difference between the bilateral sides in terms of the PCL footprint areas.

CONCLUSION: In the fusion image, the PCL attachment center and relevant bony landmarks which can be easily identified under arthroscopy can be accurately measured. The model can also obtain personalized anatomical data of the PCL on the unaffected side of the patient, which can guide clinical PCL reconstruction.

PMID:36120826 | DOI:10.1111/os.13477

Orthop Surg. 2022 Sep 19. doi: 10.1111/os.13497. Online ahead of print.

ABSTRACT

OBJECTIVE: How to restrict sliding of cephalomedullary nail and rigid reconstruct medial support for unstable intertrochanteric fractures remains a challenge. This study aims to explore the feasibility of a novel cephalomedullary nail for restriction sliding and reconstruction of medial femoral support to prevent failure in unstable trochanteric fractures through finite element analysis.

METHODS: The DICOM files of a unilateral femur spiral computed tomography (CT) scans from a elderly female were converted into STL files, and the most common clinical trochanteric fracture model with the absence of medial support, AO/OTA 31-A2.3 was simulated by removing the posterior medial femur. The model of a novel medial sustain nail (MSN-II) and a widely used nail (proximal femoral nail anti-rotation PFNA-II) were modeled according to the manufacturer-provided engineering drawing. Different loads were applied to the femoral head to simulate the postoperative weight bearing gait. The sliding distance of helical blade in femoral neck, maximum stress of femur and nail, displacement of proximal fragment were analyzed to revealing the mechanical stability of unstable trochanteric fracture stabilized by different implant.

RESULTS: The sliding distance of helical blade in the femoral neck, the maximum stress on the femur and nail, the displacement of proximal fragment in MSN-II under 2100N axial load were 0.65 mm, 689 MPa, 1271 MPa, 16.84 mm respectively, while that were 1.43 mm, 720.8 MPa, 1444 MPa, 18.18 mm, respectively in PFNA-II. The difference between the two groups was statistically significant (P < 0.05) and the stress was mainly distributed in medial distal side of nail but helical blade and the proximal aperture for the nail in MSN-II. Compared to PFNA-II, MSN-II demonstrates biomechanical merit against femur medialization, cut-out and coax varus.

CONCLUSION: The sliding distance of helical blade in femoral neck, the maximum stress on the femur and nail, and the displacement of proximal fragment of MSN-II were less than those of PFNA-II in the treatment of unstable intertrochanteric fractures. Therefore MSN-II has better stability than PFNA-II and it may have the potential to avoid femur medialization and cut out. It might be an option in unstable trochanteric fracture because of its superiority in restricted sliding and medial support reconstruction.

PMID:36120825 | DOI:10.1111/os.13497

J Cosmet Dermatol. 2022 Sep 19. doi: 10.1111/jocd.15397. Online ahead of print.

ABSTRACT

BACKGROUND: Keloid (KD) treatment is challenging for both physicians and patients. It can be functional debilitating and psychologically distressing. Available current therapeutics modalities give inconsistently effective results.

OBJECTIVES: To evaluate the efficacy and safety of innovative cold atmospheric plasma (CAP) technology in the treatment of keloid METHODS: This prospective, randomized control trial, the assessor-blinded trial, includes 18 patients with keloids. The keloid lesion was divided into two halves. One side was randomly treated with CAP technology biweekly on the same treated side for five sessions with a follow-up 30 days after finishing the final treatment. Another half was left untreated as a control. Efficacy assessment using POSAS, VSS, Patients’ satisfaction scale, Antera 3D® skin imaging system. The safety assessment using VAS and adverse effects monitoring was completed.

RESULTS: Objective assessment using Antera 3D® skin imaging system (Miravex, Dublin, Ireland) showed statistically significant improvement (p-value <0.05) on the treated side compared to the untreated side in all parameters, color, melanin, hemoglobin, texture, except for volume. POSAS, patient and observer overall opinion score, and patient and observer total score in the summary of all rated characteristics, comparing the treated and untreated areas, showed a statistically significant reduction in all parameters after two treatments (*P-value < 0.05). VSS showed statistically significant improvement after the second treatment and continued to the last follow-up. Most patients rated satisfaction scales up to 72.2% as moderate improvement, 11.1% as great improvement, 11.1% as slight improvement, and 5.6 % as no change. The adverse effect was only a small scab in one patient.

CONCLUSION: CAP technology could be considered an alternative treatment for keloid offering mild to moderate improvement with minimal side effects.

PMID:36120805 | DOI:10.1111/jocd.15397