Tag: statistics

Int J Comput Assist Radiol Surg. 2022 Apr 29. doi: 10.1007/s11548-022-02626-y. Online ahead of print.

ABSTRACT

PURPOSE: In craniomaxillofacial (CMF) surgery planning, a preoperative reconstruction of the CMF reference model is crucial for surgical restoration, especially the reconstruction of bilateral defects. Current reconstruction algorithms mainly generate reference models from the image analysis aspect, however, clinical indicators of the CMF reference model mostly consider the distribution of anatomical landmarks. Generating a reference model with optimal clinical evaluation helps promote the feasibility of an algorithm.

METHODS: We first build a dataset with 100 normal skull models and then calculate a statistical shape model (SSM) and the distribution of normal cephalometric values, which indicate the statistical features of a population. To further generate personalized reference models, we apply non-rigid registration to align the SSM with the defect skull model. An evaluation standard to select the optimal reference model considers both global performance and anatomical evaluation. Moreover, we develop a landmark detection network to improve the automatic level of the algorithm.

RESULTS: The proposed method performs better than methods including Iterative Closest Point and SSM. From a global evaluation aspect, the results show that the RMSE between the reference model and the ground truth is [Formula: see text] mm, the percentage of vertices with error below 2 mm is [Formula: see text]% and the average faces distance is [Formula: see text] mm (better than the state-of-the-art method). From the anatomical evaluation aspect, the target registration error between the landmark pairs is [Formula: see text] mm. In addition, the clinical application confirms that the reference model can meet clinical requirements.

CONCLUSION: To the best of our knowledge, we propose the first CMF reconstruction method considering the global performance of reconstruction and anatomically local evaluation from clinical experience. Simulated experiments and clinical cases prove the general applicability and strength of the method.

PMID:35486302 | DOI:10.1007/s11548-022-02626-y

Community Ment Health J. 2022 Apr 29. doi: 10.1007/s10597-022-00976-0. Online ahead of print.

ABSTRACT

Lack of access to primary and behavioral healthcare is prevalent in communities experiencing systematically greater obstacles to healthcare. This study describes the implementation of the Coordinated Care Model in a nurse-led primary care clinic and identifies the essential factors for sustained integration. A mixed-methods explanatory sequential study design was used to collect and analyze quantitative and qualitative data. Participants reported an overall statistically significant mean increase (M = 2.47, SD ± 2.01, p < 0.001) in the level of integration pre-and post-integration. Qualitative results indicated that the optimization and accentuation of team strengths, the Lundeen model of holistic care, and addressing physical and psychological barriers lead to sustained level of integration. Integrated practices are essential in assessing and supporting the holistic needs of individuals, families, and communities. Future studies should examine facilitators or impediments to integrated practice in other healthcare settings, long-term health outcomes of clients in integrated care, and the cost-effectiveness of integration.

PMID:35486305 | DOI:10.1007/s10597-022-00976-0

Obes Surg. 2022 Apr 29. doi: 10.1007/s11695-022-06069-x. Online ahead of print.

ABSTRACT

PURPOSE: Little is known about the consequences of COVID-19 lockdowns on physical activity (PA), eating behavior, and mental health in post-bariatric surgery (BS) patients. We aimed to analyze the relations between changes in PA during COVID-19 lockdowns and changes in body weight and a comprehensive set of lifestyle and psychological outcomes in patients who have undergone BS.

MATERIAL AND METHODS: In April-May 2020 (lockdown#1), we performed an online survey in a cohort of 937 adults who underwent BS and were followed-up at our university medical center for at least one year. We assessed changes in PA, eating behavior, body weight, fatigue, and depression (PHQ-9). In November-December 2020 (lockdown#2), we recorded body weight in 280 patients who had reported decreased PA during lockdown #1.

RESULTS: During lockdown #1 (N = 420 patients included, 44% response rate), decreased PA was reported by 67% patients. Compared to those who reported increased or unchanged PA, patients with decreased PA were more likely to report a ≥ 5% weight gain (OR (95% CI): 3.15 (1.46-7.65), increased fatigue (2.08 (1.36-3.23)), a worsening of eating behavior (2.29 (1.47-3.58)), and moderate-to-severe depressive symptoms (4.74 (2.14-11.76)). During lockdown #2 (N = 225 patients, 80% response rate), significant weight gain since before lockdown #1 was reported (+ 2.8 (95% CI: 1.7-3.8) kg, p < 0.001), with 36% patients reporting a ≥ 5% weight gain.

CONCLUSIONS: PA may counteract detrimental effects of COVID-19 lockdown on post-BS weight trajectories and mental health outcomes. Follow-up measures are needed in this setting to assess the long-term impact of lockdown.

PMID:35486289 | DOI:10.1007/s11695-022-06069-x

Obes Surg. 2022 Apr 29. doi: 10.1007/s11695-022-06076-y. Online ahead of print.

ABSTRACT

BACKGROUND: Obesity not only affects physical and mental conditions, but also influences cognitive function. Endocrine hormones may influence the risk of obesity and severe obesity. Our study investigated the influences of changes in levels of endocrine hormones on cognitive function in patients with obesity and severe obesity.

METHODS: We used the MATRICS Consensus Cognitive Battery (MCCB) to evaluate cognitive function in the groups of healthy control (HC), obesity (OB), and severe obesity (SOB). We detected the levels of endocrine hormones and cortisol at 8:00 am in the three groups. We statistically analyzed differences in cognitive function and levels of endocrine hormones among the three groups, and performed linear correlation analysis of cortisol level and cognitive function. Using mediation analysis, we assessed the influences of body mass index (BMI) on endocrine levels and cognitive function.

RESULTS: Our findings revealed that OB and SOB groups exhibited a lower level of cortisol than HC group. Among the three groups, we found significant differences in verbal learning (F = 4.433, P = 0.014), social cognition (F = 4.778, P = 0.010), and total cognition (F = 2.989, P = 0.008). After post hoc Bonferroni correction, we noted that SOB group had worse scores in the above-mentioned three areas than OB and HC groups. Moreover, except for working memory and visual cognition, we identified that the degree of cognitive impairment in SOB group was more severe than that in OB group. In our study, mediation analysis showed a mediating effect of BMI on cortisol level and verbal learning. We also found correlations between cortisol level and attention/alertness (r = 0.277, P = 0.003), between cortisol level and verbal learning (r = 0.205, P = 0.030), and between BMI and verbal learning (r = – 0.192, P = 0.043).

CONCLUSION: In our study, patients in both OB and SOB groups experienced a widespread cognitive impairment. We also found that patients with severe obesity had more severe cognitive impairment. Cognitive impairment could be mediated by abnormal cortisol metabolism, and BMI could be a mediating factor in regulation of cortisol level.

PMID:35486288 | DOI:10.1007/s11695-022-06076-y

J Gastrointest Cancer. 2022 Apr 29. doi: 10.1007/s12029-022-00828-w. Online ahead of print.

ABSTRACT

PURPOSE: The present study aimed to investigate the clinical implications of apical lymph node metastasis (ALNM) after curative resection of stage III colorectal cancer.

METHODS: A retrospective study was conducted of 1403 consecutive colorectal cancer patients who underwent surgical resection at a single institution between April 2008 and January 2020. The characteristics of ALNM, the recurrence status and the relapse-free survival (RFS) were examined.

RESULTS: The numbers of patients with stage ≤ I, II, III, and IV disease were 350, 437, 476, and 140 patients, respectively. Among these patients with stage III disease, ALNM was seen in 21 patients (4.4% of stage III patients). Among them, curative resection was performed in 19 patients. Recurrence was observed in 68% (13/19) of the patients with ALNM who received curative resection. The first sites of recurrence included the lymph nodes 53.8% (7/13), liver 30.8% (4/13), lung 15.4% (2/13), brain 7.7% (1/13), bone 7.7% (1/13), and peritoneum 7.7% (1/13). There was no significant difference in the RFS of patients with ALNM who were managed with or without adjuvant chemotherapy (P = 0.207). Furthermore, the RFS of the group managed without adjuvant chemotherapy and the group that received adjuvant chemotherapy with/without oxaliplatin did not differ to a statistically significant extent (P = 0.318). In stage III colorectal cancer patients with ALNM, recurrence was observed significantly more frequently in comparison to stage III colorectal cancer patients without ALNM (P = 0.007). The first site of recurrence in patients with ALNM was most frequently seen in the distant lymph nodes (P = 0.004).

CONCLUSION: Our findings suggest that ALNM is strongly associated with recurrence in the distant lymph nodes and that it may lead to the development of systemic disease. The current regimen for stage III colorectal cancer may therefore not be sufficient for patients with stage III ALNM.

PMID:35486262 | DOI:10.1007/s12029-022-00828-w

Bull Math Biol. 2022 Apr 29;84(6):61. doi: 10.1007/s11538-022-01019-1.

ABSTRACT

Although great progress has been made in the prevention and mitigation of TB in the past 20 years, China is still the third largest contributor to the global burden of new TB cases, accounting for 833,000 new cases in 2019. Improved mitigation strategies, such as vaccines, diagnostics, and treatment, are needed to meet goals of WHO. Given the huge variability in the prevalence of TB across age-groups in China, the vaccination, diagnostic techniques, and treatment for different age-groups may have different effects. Moreover, the statistics data of TB cases show significant seasonal fluctuations in China. In view of the above facts, we propose a non-autonomous differential equation model with age structure and seasonal transmission rate. We derive the basic reproduction number, [Formula: see text], and prove that the unique disease-free periodic solution, [Formula: see text] is globally asymptotically stable when [Formula: see text], while the disease is uniformly persistent and at least one positive periodic solution exists when [Formula: see text]. We estimate that the basic reproduction number [Formula: see text] ([Formula: see text]), which means that TB is uniformly persistent. Our results demonstrate that vaccinating susceptible individuals whose ages are over 65 and between 20 and 24 is much more effective in reducing the prevalence of TB, and each of the improved vaccination strategy, diagnostic strategy, and treatment strategy leads to substantial reductions in the prevalence of TB per 100,000 individuals compared with current approaches, and the combination of the three strategies is more effective. Scenario A (i.e., coverage rate [Formula: see text], diagnosis rate [Formula: see text], relapse rate [Formula: see text]) is the best and can reduce the prevalence of TB per 100,000 individuals by [Formula: see text] and [Formula: see text] in 2035 and 2050, respectively. Although the improved strategies will significantly reduce the incidence rate of TB, it is challenging to achieve the goal of WHO in 2050. Our findings can provide guidance for public health authorities in projecting effective mitigation strategies of TB.

PMID:35486232 | DOI:10.1007/s11538-022-01019-1

Eur J Orthop Surg Traumatol. 2022 Apr 29. doi: 10.1007/s00590-022-03258-3. Online ahead of print.

ABSTRACT

INTRODUCTION: Civilian gun violence is a public health crisis in the USA that will be an economic burden reported to be as high as $17.7 billion with over half coming from US taxpayers dollars through Medicaid-related costs. The purpose of this study is to review the epidemiology of upper extremity firearm injuries in the USA and the associated injury burden.

METHODS: The Inter-university Consortium for Political and Social Research’s Firearm Injury Surveillance Study database, collected from the National Electronic Injury Surveillance System, was queried from 1993 to 2015. The following variables were reviewed: patient demographics, date of injury, diagnosis, injury location, firearm type (if provided), incident classification, and a descriptive narrative of the incident. We performed chi-square testing and complex descriptive statistics, and binomial logistic regression model to predict factors associated with hospital admission.

RESULTS: From 1993 to 2015, an estimated 314,369 (95% CI: 291,528-337,750; 16,883 unweighted) nonfatal firearm upper extremity injuries with an average incidence rate of 4.76 per 100,000 persons (SD: 0.9; 03.77-7.49) occurred. The demographics most afflicted with nonfatal gunshot wound injuries were black adolescent and young adult males (ages 15-24 years). Young adults aged 25-34 were the second largest estimate of injuries by age group. Hands were the most commonly injured upper extremity, (55,014; 95% CI: 75,973-89,667) followed by the shoulder, forearm, and upper arm. Patients who underwent amputation (OR: 28.65; 95% CI: 24.85-33.03) or with fractures (OR: 26.20; 95% CI: 23.27-29.50) experienced an increased likelihood for hospitalization. Patients with a shoulder injury were 5.5× more likely to be hospitalized than those with a finger injury (OR:5.57; 95% CI:5.35-5.80). The incidence of upper extremity firearm injuries has remained steady over the last decade ranging between 4 and 5 injuries per 100,000 persons. Patients with proximal injuries or injuries involving the bone were more likely to require hospital admission. This study should bring new information to the forefront for policy makers regarding gun violence.

PMID:35486233 | DOI:10.1007/s00590-022-03258-3

Pol Przegl Chir. 2021 Nov 8;94(2):19-26. doi: 10.5604/01.3001.0015.4874.

ABSTRACT

&lt;b&gt;Introduction:&lt;/b&gt; Adenomatous polyps are pivotal to the development of colorectal cancer. The risk of colorectal carcinogenesis can be reduced through polypectomy and close surveillance of the disease. Early-stage polyps can be detected and removed endoscopically, therefore, reducing the incidence of carcinoma. The identification of CSC in colon polyps allows for assessment of their potential malignancy. Therefore, it is very relevant to study the prognostic significance of the prevalence of stem cells in colorectal polyps in early detection and prevention of cancer. &lt;/br&gt;&lt;/br&gt; &lt;b&gt; Method:&lt;/b&gt; Previously pathologically evaluated adenomatous tumors (60M, 40F) at Azerbaijan Medical University were reevaluated in Meram Medical Faculty Pathology Department. Hematoxylin-Eosin-stained slides were examined and cases with and without dysplasia were determined. New sections were taken from paraffin blocs. Prominin-1 staining was performed immunohistochemically on these sections. Stained slides were examined by an image analysis system. Prominin-1-positive cells were automatically counted with the same image analysis system. The cases that developed malignancy after polypectomy were determined. The relationship between CD133 expression of dysplasia and malignancy was statistically analyzed. &lt;/br&gt;&lt;/br&gt; &lt;b&gt; Results:&lt;/b&gt; Statistically significant prominin-1 expression was detected in cases with dysplasia and malignancy. &lt;/br&gt;&lt;/br&gt; &lt;b&gt; Conclusion:&lt;/b&gt; The investigation of prominin-1 expression in colorectal polyps may be important to determine malignancy development.

PMID:35485315 | DOI:10.5604/01.3001.0015.4874

Anat Histol Embryol. 2022 Apr 29. doi: 10.1111/ahe.12805. Online ahead of print.

ABSTRACT

In this study, atomic force microscopy (AFM), microtomography (MCT-2D and MCT-3D) and energy-dispersive X-ray fluorescence spectrometry (EDXRF) were used to generate parameters of the microstructure of the hoof capsule of pigmented and partial albino buffaloes. Seventy-two digits of adult pigmented buffaloes and 16 of partial albino buffaloes were used and equally divided into thoracic and pelvic limbs and medial and lateral claws. Fragments of 10 mm × 10 mm of the dorsal wall, abaxial wall and pre-bulbar sole were collected. The parametric assumptions were tested using a Shapiro-Wilk test (normality). The independent t-test was used to compare the means at a 5% significance level. AFM demonstrated that the hoof surface of pigmented buffaloes presented with higher average surface roughness (Ra) and root mean square roughness (Rms) (p < 0.05) than the hoof surface of partial albino buffaloes. MCT-2D revealed that pigmented buffaloes had extra tubular keratin with a higher density than intratubular keratin. No pores were observed in the hoof capsule of the buffalo digits. MCT-3D demonstrated that pigmented buffaloes have a higher percentage of large and intermediate horn tubules than partial albino buffaloes. However, this difference was not statistically significant. Partial albino buffaloes showed a statistically higher number of horn tubules/mm² than pigmented buffaloes (p < 0.05). EDXRF revealed a higher amount of sulphur (S) in the hoof capsule of pigmented buffaloes, and the partial albino buffaloes presented a higher number of minerals such as calcium (Ca), potassium (K), zinc (Zn) and copper (Cu).

PMID:35485276 | DOI:10.1111/ahe.12805

Mol Med Rep. 2022 Jun;25(6):206. doi: 10.3892/mmr.2022.12722. Epub 2022 Apr 29.

ABSTRACT

As the understanding of cancer grows, new therapies have been proposed to improve the well-known limitations of current therapies, whose efficiency relies mostly on early detection, surgery and chemotherapy. Mesenchymal stem cells (MSCs) have been introduced as a promissory and effective therapy. This fact is due to several useful features of MSCs, such as their accessibility and easy culture and expansion in vitro, and their remarkable ability for ‘homing’ towards tumors, allowing MSCs to exert their anticancer effects directly into tumors. Additionally, MSCs offer the practicability of being genetically engineered to carry anticancer genes, increasing their specificity and efficacy for fighting tumors. In the present study, the antitumoral efficacy and post-implant survival of mice bearing lymphomas implanted intratumorally were determined using mouse bone marrow-derived (BM)-MSCs transduced with soluble TRAIL (sTRAIL), full length TRAIL (flTRAIL), or interferon β (IFNβ), naïve BM-MSCs, or combinations of these. The percentage of surviving mice was determined once all not-implanted mice succumbed. It was found that the percentage of surviving mice implanted with the combination of MSCs-sTRAIL and MSCs-IFN-β was 62.5%. Lymphoma model achieved 100% fatality in the non-treated group by day 41. On the other hand, the percentage of surviving mice implanted with MSCs-sTRAIL was 50% and with MSCs-INFβ 25%. All the aforementioned differences were statistically significant (P<0.05). In conclusion, all implants exhibited tumor size reduction, growth delay, or apparent tumor clearance. MSCs proved to be effective anti-lymphoma agents; additionally, the combination of soluble TRAIL and IFN-β resulted in the most effective antitumor and life enlarging treatment, showing an additive antitumoral effect compared with individual treatments.

PMID:35485288 | DOI:10.3892/mmr.2022.12722