Tag: statistics

J Cosmet Dermatol. 2022 Sep 10. doi: 10.1111/jocd.15375. Online ahead of print.

ABSTRACT

BACKGROUND: Subcision method is one of the main techniques for treatment of acne scars or Stromal-Vascular Fraction (SVF) and combined therapy can improve treatment strategy.

OBJECTIVE: To use subcision method along with SVF for treatment of acne scar and comprised with alone subcision method.

MATERIALS AND METHODS: In this double-blind clinical trial study, ten patients with acne scars were entered into the study. Subcision technique was randomly performed on one side of the face and subcision technique plus SVF on opposite side of the face. All patients were examined before treatment and after three months by Visioface for volume, area, and depth of scars, as well as thickness and density of the epidermis and dermis of the scars in question. In addition, doctor’s and patients’ satisfaction, tolerability, and safety were determined after three months of treatment. Finally, statistical analysis was done by SPPS, version 25.

RESULTS: In terms of volume and area of scars, the mean percent change were 46.55± 13.92 and 44.60± 5.76, for the case group, and 13.31± 9.27 and 11.28± 9.64 for the control group, respectively. So combined therapy led to significant recovery compared with alone subcision method (p value<0.001). In both interventions, increase of density and thickness was proven after treatment, alsoa significant difference in complete, epidermal, and dermal thickness and epidermal density variables was observed between combined therapy and alone subcision (p value< 0.05). Mean score of doctor’s and patients’ satisfaction in combined therapy (7.10± 0.74 and 7.10± 0.99, respectively) was also significantly higher than subcision alone (5.50± 0.53 and 5.30± 1.25, respectively). Finally, No complications were observed in the patients.

CONCLUSION: According to acquired results, combined therapy can be considered as effective and safe treatment for acne scars with significant higher efficacy compared with subcision alone.

PMID:36086927 | DOI:10.1111/jocd.15375

Eur J Neurol. 2022 Sep 10. doi: 10.1111/ene.15549. Online ahead of print.

ABSTRACT

BACKGROUND: Circulating metabolites have been implicated in stroke pathogenesis, but their genetic determinants is understudied. Using Mendelian randomization approach, we aim to provide evidence for the relationship of circulating metabolites on risk of stroke and its subtypes.

METHODS: Genetic instruments of 102 circulating metabolites were obtained from a genome-wide association study (GWAS), including 24,925 European individuals. Stroke were extracted from MEGASTROKE dataset (67,162 cases; 454,450 controls) and lacunar stroke dataset (7338 cases; 254,798 controls). The magnetic resonance imaging (MRI) markers of cerebral small vessel diseases (CSVD) and microstructural injury were evaluated by GWAS of white matter hyperintensities (N=18,381), fractional anisotropy (N=17,663), mean diffusivity (N=17,467) and brain microbleeds (N=25,862). The inverse-variance weighted method Mendelian randomization was used as primary analytical method, and directional pleiotropy and heterogeneity were examined in sensitivity analyses.

RESULTS: Genetic predisposition to higher level of cholesterol in small and low-density lipoprotein (LDL) were associated with risk of stroke (OR[95%CI]=1.14[1.08-1.21], p=5.98*10^-7 ), especially for large-artery atherosclerotic stroke (OR[95%CI]=1.34[1.19-1.52], p=1.90*10^-6 ). Total lipids in LDL particles were also associated with risk of stroke. Genetically determined higher cholesterol level in high-density lipoprotein (HDL-C) was associated with risk of intracerebral hemorrhage (OR[95%CI]=1.74[1.23-2.45], p=1.66*10^-3 ). No statistically significant association was found between genetic predisposition to circulating metabolites and MRI markers of CSVD and microstructural injury.

CONCLUSIONS: Genetically determined levels of lipids in small LDL were associated with the risk of stroke, suggesting a therapeutic strategy targeting small LDL levels may be crucial for stroke prevention. HDL-C was positively associated with the risk of intracerebral hemorrhage.

PMID:36086915 | DOI:10.1111/ene.15549

Photochem Photobiol. 2022 Sep 10. doi: 10.1111/php.13711. Online ahead of print.

ABSTRACT

Gingival fibroblasts have critical roles in oral wound healing. Photobiomodulation (PBM) has been shown to promote mucosal healing and is now recommended for managing oncotherapy-associated oral mucositis. This study examined the effects of the emission mode of a 940 nm diode laser on the viability and migration of human gingival fibroblasts. Cells were cultured in a routine growth media and treated with PBM (average power 0.1 W/cm² , average fluence 3 J/cm² , every 12h for 6 sessions) in one continuous wave (CW) and two pulsing settings with 20 % and 50 % duty cycles. Cell viability was assessed using MTT, and digital imaging quantified cell migration. After 48 and 72 hours, all treatment groups had significantly higher viability (n = 6, p < 0.05) compared to the control. The highest viability was seen in the pulsed (20% duty cycle) group at the 72-hour time point. PBM improved fibroblast migration in all PBM-treated groups, but differences were not statistically significant (n = 2, p > 0.05). PBM treatments can promote cell viability in both continuous and pulsed modes. Further studies are needed to elucidate the optimal setting for PBM-evoked responses for its rationalized use in promoting specific phases of oral wound healing.

PMID:36086909 | DOI:10.1111/php.13711

J Physiol. 2022 Sep 10. doi: 10.1113/JP282758. Online ahead of print.

ABSTRACT

Naturally log-scaled quantities abound in the nervous system. Distributions of these quantities have nonintuitive properties, which have implications for data analysis and understanding of neural circuits. Here we review the log-scaled statistics of neuronal spiking and the relevant analytical probability distributions. Recent work using log-scaling revealed that inter-spike intervals of forebrain neurons segregate into discrete modes that reflect spiking at different timescales and are each well-approximated by a gamma distribution. Each neuron spends most of the time in an irregular spiking ‘ground state’ with the longest intervals, which determines the mean firing rate of the neuron. Across the entire neuronal population, firing rates are log-scaled and well approximated by the gamma distribution, with a small number of highly active neurons and an overabundance of low rate neurons (the ‘dark matter’). These results are intricately linked to a heterogeneous balanced operating regime, which confers upon neuronal circuits multiple computational advantages and has evolutionarily ancient origins. This article is protected by copyright. All rights reserved.

PMID:36086892 | DOI:10.1113/JP282758

Cell Transplant. 2022 Jan-Dec;31:9636897221120434. doi: 10.1177/09636897221120434.

ABSTRACT

Congenital heart diseases, including single ventricle circulations, are clinically challenging due to chronic pressure overload and the inability of the myocardium to compensate for lifelong physiological demands. To determine the clinical relevance of autologous umbilical cord blood-derived mononuclear cells (UCB-MNCs) as a therapy to augment cardiac adaptation following surgical management of congenital heart disease, a validated model system of right ventricular pressure overload due to pulmonary artery banding (PAB) in juvenile pigs has been employed. PAB in a juvenile porcine model and intramyocardial delivery of UCB-MNCs was evaluated in three distinct 12-week studies utilizing serial cardiac imaging and end-of-study pathology evaluations. PAB reproducibly induced pressure overload leading to chronic right ventricular remodeling including significant myocardial fibrosis and elevation of heart failure biomarkers. High-dose UCB-MNCs (3 million/kg) delivered into the right ventricular myocardium did not cause any detectable safety issues in the context of arrhythmias or abnormal cardiac physiology. In addition, this high-dose treatment compared with placebo controls demonstrated that UCB-MNCs promoted a significant increase in Ki-67-positive cardiomyocytes coupled with an increase in the number of CD31+ endothelium. Furthermore, the incorporation of BrdU-labeled cells within the myocardium confirmed the biological potency of the high-dose UCB-MNC treatment. Finally, the cell-based treatment augmented the physiological adaptation compared with controls with a trend toward increased right ventricular mass within the 12 weeks of the follow-up period. Despite these adaptations, functional changes as measured by echocardiography and magnetic resonance imaging did not demonstrate differences between cohorts in this surgical model system. Therefore, this randomized, double-blinded, placebo-controlled pre-clinical trial establishes the safety of UCB-MNCs delivered via intramyocardial injections in a dysfunctional right ventricle and validates the induction of cardiac proliferation and angiogenesis as transient paracrine mechanisms that may be important to optimize long-term outcomes for surgically repaired congenital heart diseases.

PMID:36086821 | DOI:10.1177/09636897221120434

Acta Psychiatr Scand. 2022 Sep 9. doi: 10.1111/acps.13499. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to estimate the association between urbanicity and the onset of posttraumatic stress disorder (PTSD) and to investigate heterogeneity therein according to age and socioeconomic position (SEP).

METHODS: We analysed administrative data from the Korean National Health Insurance Database for patients with PTSD from 2004-2018 (N=109,230) and for a 1:4 sample of age-, sex-, and enrollment year-matched controls. Information on eligibility, SEP (proxied by insurance premium), place of residence, diagnosis, and medical claims was obtained. Urbanicity of administrative districts was assessed using data from the Korean Statistical Information Service, 2005-2018. We estimated hazard ratios (HRs) from baseline and time-dependent models. Subgroup analyses and polynomial splines were used to investigate heterogeneity by age and SEP.

RESULTS: Urbanicity was associated with an increased risk of PTSD (per 10%p increase, HR = 1.056, 95% CI 1.050 – 1.061). A positive association was estimated among patients aged 0-29 years (HR = 1.115, CI 1.106 – 1.124), while negative associations were estimated among patients aged 30-64 years (HR=0.990, CI 0.987 – 0.994) and 65 years or older (HR = 0.992, CI 0.979 – 1.014). The estimated associations with urbanicity were more prominent at the extremes of SEP, but only among younger participants.

CONCLUSION: Urban residence was associated with an increased risk of PTSD diagnosis. The estimated association was larger among younger individuals (but not among middle-aged and older individuals). Among younger individuals, the estimated association was larger at both extremes of SEP.

PMID:36086797 | DOI:10.1111/acps.13499

Medicine (Baltimore). 2022 Sep 9;101(36):e30216. doi: 10.1097/MD.0000000000030216.

ABSTRACT

Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn disease (CD), has emerged as a global disease with an increasing incidence in developing and newly industrialized regions such as South America. This global rise offers the opportunity to explore the differences and similarities in disease presentation and outcomes across different genetic backgrounds and geographic locations. Our study includes 265 IBD patients. We performed an exploratory analysis of the databases of Chilean and North American IBD patients to compare the clinical phenotypes between the cohorts. We employed an unsupervised machine-learning approach using principal component analysis, uniform manifold approximation, and projection, among others, for each disease. Finally, we predicted the cohort (North American vs Chilean) using a random forest. Several unsupervised machine learning methods have separated the 2 main groups, supporting the differences between North American and Chilean patients with each disease. The variables that explained the loadings of the clinical metadata on the principal components were related to the therapies and disease extension/location at diagnosis. Our random forest models were trained for cohort classification based on clinical characteristics, obtaining high accuracy (0.86 = UC; 0.79 = CD). Similarly, variables related to therapy and disease extension/location had a high Gini index. Similarly, univariate analysis showed a later CD age at diagnosis in Chilean IBD patients (37 vs 24; P = .005). Our study suggests a clinical difference between North American and Chilean IBD patients: later CD age at diagnosis with a predominantly less aggressive phenotype (39% vs 54% B1) and more limited disease, despite fewer biological therapies being used in Chile for both diseases.

PMID:36086782 | DOI:10.1097/MD.0000000000030216

Medicine (Baltimore). 2022 Sep 9;101(36):e30328. doi: 10.1097/MD.0000000000030328.

ABSTRACT

BACKGROUND: Exposure to excessive heat can impact kidney health. Climate change is projected to aggravate this impact. An analysis of articles published between 1958 and 2021 was conducted to explore the progress of the research on this issue.

METHODS: This study included a bibliometric analysis wherein Web of Science was used to generate a list of all published articles related to the impact of heat on kidney health. Basic information about the articles, such as titles, authors’ names, keywords, and citations, were recorded and analyzed.

RESULTS: A total of 226 published articles related to the impact of heat on kidney health were identified as of November 20, 2021. Most of these articles (93%) were published within the last decade. The United States was the most prominent country in terms of research productivity and collaboration. Researchers from the United States were well represented among the top 20 contributors of published articles on the study issue. The productivity of the top 20 authors varied between 6 and 32 articles each. A total of 25 common words used by the authors were identified. The most frequently used keywords were chronic kidney disease, heat stress, acute kidney injury, Mesoamerican nephropathy, and climate change. Keyword analysis revealed 3 distinct major research clusters in the existing scientific research on the impact of heat on kidney health: chronic kidney disease of unknown etiology, heat stress and renal physiology, and the effect of climate change on kidney health.

CONCLUSIONS: Research on heat-related kidney injury has witnessed rapid development in recent decades, motivated by the emergence of chronic kidney disease of unknown etiology and climate change. Developing countries in hot regions must increase their productivity in this research area through international collaboration and partnerships.

PMID:36086778 | DOI:10.1097/MD.0000000000030328

Medicine (Baltimore). 2022 Sep 9;101(36):e29290. doi: 10.1097/MD.0000000000029290.

ABSTRACT

Based on Pinnacle39.10 treatment planning system (TPS) automatic planning module, we investigated the effect of minimum segmentation area (MSA) parameters on Auto-Plan Intensity Modulated Radiotherapy (AP-IMRT) without affecting the dose distribution of the target and the Organ at Risk (OAR). The results provided the basis for the ideal MSA parameters in the design of AP-IMRT plan. Ten patients with cervical cancer in our hospital were selected randomly for AP-IMRT design. Each patient was devised with 10 AP-IMRT plans. The prescription dose of PTV was 50 Gy/25 fractions. The radiotherapy plans of all patients were adopted with 7 field-averaged fixed fields. The MSA was set to 4 cm2, 9 cm2, 14 cm2, 20 cm2, 25 cm2, 40 cm2, 50 cm2, 60 cm2, 80 cm2, and 100 cm2. Plan quality and delivery efficiency were evaluated based on dose-volume histograms (DVHs), control points, monitor units (MUs), dosimetric measurement verification results, and plan delivery time. Except for the small difference in monitor units, the number of segmentations and target dose coverage, there were no statistically significant differences between the other dosimetric parameters in the planning target volumes. With the increase of MSA, the total number of MUs in AP-IMRT decreased from (649 ± 32) MUs to (312 ± 26) MUs, and the total number of segmentations decreased from (69 ± 1) to (28 ± 3). There was no statistical significance in the dose distribution of AP-IMRT target area with the MSA of 4-50 cm2 (P > .05). There was no significant difference in OAR dose between AP-IMRT plans with different MSA (P > .05). The calculated gamma indices using the 3% /3 mm and 2%/2 mm criteria. Both of the gamma pass rate and DTA pass rate all ≥95% under the condition of MSA are greater than 4 cm2, and the difference was no statistically significant (P > .05). The plan delivery times decreased with increasing MSA (P < .05). When using Pinnacle3 9.10 TPS to design AP-IMRT plan for cervical cancer, the parameter of MSA can be increased appropriately. Increasing the MSA allows for improved plan delivery accuracy and efficiency without significantly affecting the AP-IMRT plan quality. The MSA in the range of 14 to 50 cm2 can obtain a more reasonable dose distribution in the target area while the dose of target area and OAR had no significant changes. It is important to improve the plan quality, delivery accuracy, and efficiency for cervical AP-IMRT radiation therapy.

PMID:36086767 | DOI:10.1097/MD.0000000000029290

Medicine (Baltimore). 2022 Sep 9;101(36):e30426. doi: 10.1097/MD.0000000000030426.

ABSTRACT

Acute myocardial infarction (AMI) complicated by cardiogenic shock has high mortality and remains challenging even in the revascularization era. We conducted this study to understand patients’ outcomes. We retrospectively analyzed electronic medical records data from 1175 patients with AMI complicated by cardiogenic shock that developed within 3 days of admission to a multicenter medical care system between January 1, 2000, and July 31, 2018. Patients with AMI were classified into the ST-segment elevation MI (STEMI) group or the non-ST-segment elevation MI (NSTEMI) group. The short-term and 1-year mortality and adverse events after index admission were analyzed via logistic regression and a Cox proportional hazards model. When compared with NSTEMI, patients with STEMI tended to be younger (65.68 ± 14.05 years vs 70.70 ± 12.99 years, P < .001), men (73.29% vs 60.87%, P < .001), and have fewer underlying chronic diseases. Short-term mortality at index hospitalization was 14.83% in the STEMI group and 21.30% in the NSTEMI group; long-term mortality was 17.06% for the STEMI group and 24.13% for the NSTEMI group. No difference was observed between the 2 groups for patients who developed a cerebral vascular accident during the admission period. However, the major and gastrointestinal bleeding rates were higher in the STEMI group (2.66% vs 0.22%, P = .014; 3.36% vs 0.22%, P = .007, respectively). Age and respiratory failure were the most significant risk factors for short-term mortality. Revascularization may be beneficial for the short-term outcome but did not reach significance in multivariable analysis. In patients with AMI with cardiogenic shock, NSTEMI was associated with a significantly higher mortality rate in short-term results.

PMID:36086759 | DOI:10.1097/MD.0000000000030426