Tag: statistics

Zhonghua Shao Shang Za Zhi. 2021 Jul 20;37(7):647-653. doi: 10.3760/cma.j.cn501120-20200417-00231.

ABSTRACT

Objective: To establish mechanical stress-induced hypertrophic scar mouse models, and to examine the roles of interleukin-6/signal transduction and activator of transcription 3 (IL-6/STAT3) pathway and β-catenin. Methods: The experimental research method was used. Sixteen female C57/BL6 mice of 12-week-old were collected and two straight full-thickness skin incisions of 2 cm in length were inflicted on the back of each mouse. On the fourth day post injury, the two wounds on the back of each mouse were divided into mechanical traction group and blank control group according to the random number table method, with 16 wounds in each group. The wounds in mechanical traction group were given continuous mechanical traction for 14 days, while the wounds in blank control group were given no treatment. After 14 days of mechanical traction for wounds in mechanical traction group, the appearances of the scar tissue in wounds of 2 groups were visually observed, and the areas of scars were measured; the morphological changes of the scar tissue in wounds of 2 groups were observed by hematoxylin-eosin staining, and the cross-sectional areas of scars were measured; the content of IL-6 in supernatant of the scar tissue in wounds of 2 groups was detected by enzyme-linked immunosorbent assay; the protein expression of phosphorylated STAT3 (p-STAT3) of the scar tissue in wounds of 2 groups was detected by Western blotting; and the expression of β-catenin of the scar tissue in wounds of 2 groups was detected by immunohistochemistry. Data were statistically analyzed with paired sample t test. Results: Red hairless area similar to human scar tissue formed in wounds of mechanical traction group after 14 days of mechanical traction, with large area of scar, thickened local area, hardened texture, and some even slightly raised, while scar in wounds of blank control group was linear and not obvious. After 14 days of mechanical traction for wounds in mechanical traction group, the scar area of wounds in mechanical traction group was (5.65±0.95) mm², which was significantly larger than (1.07±0.28) mm² in blank control group (t=26.333, P<0.01). After 14 days of mechanical traction for wounds in mechanical traction group, the skin appendages of scar tissue were absent, and the dermis hyperplasia was active and obviously thickened, while skin appendages of scar tissue of wounds in blank control group were still present, with unconspicuous dermis hyperplasia; the cross-sectional area of scar in wounds of mechanical traction group was (0.82±0.23) mm², which was significantly larger than (0.29±0.07) mm² of blank control group (t=8.879, P<0.01). After 14 days of mechanical traction for wounds in mechanical traction group, the content of IL-6 in the supernatant of scar tissue and the protein expression of p-STAT3 in scar tissue of wounds in mechanical traction group were significantly higher than those in blank control group (t=37.552, 25.863, P<0.01). The expression of β-catenin was high in the scar tissue of wounds in mechanical traction group after 14 days of mechanical traction, while that in blank control group was low. Conclusions: The study successfully establishes mechanical stress-induced hypertrophic scar mouse models. Mechanical stress can participate in wound healing and induce scar hyperplasia of mice wounds through continuous or overexpression of IL-6/STAT3 pathway, and β-catenin can also promote the formation of hypertrophic scar.

PMID:34304405 | DOI:10.3760/cma.j.cn501120-20200417-00231

Zhonghua Yu Fang Yi Xue Za Zhi. 2021 Jul 6;55(7):811-817. doi: 10.3760/cma.j.cn112150-20210530-00524.

ABSTRACT

Objective: To translate and revise the Karitane Parenting Confidence Scale (KPCS),which can be used to evaluate the parenting confidence of 0-12 months infant caregivers in China, and evaluate the reliability and validity test of Chinese version of KPCS. Methods: Form a Chinese version of Karitane Parenting Confidence Scale through translation, back translation and expert review. Mothers of 3-month-old infants were recruited from two Maternal and Child Health Hospitals in Beijing and Ma’anshan in April 2019. A total of 165 mothers responded the survey invitations. They were surveyed with self-administered questionnaires, the Chinese version of KPCS, the Parenting Sense of Competence Scale (PSOC) and Self-efficacy in Infant Care Scale (SICS). Item analysis was conducted to select items by using critical value and correlation coefficient. The construct validity was assessed by exploratory factor analysis, confirmatory factor analysis. The criterion validity was assessed by being compared with PSOC and SICS. The reliability analysis was assessed by Cronbach’s α the split-half reliability coefficient and rest-retest reliability coefficient. Results: The scores of 15 items were all correlated with the total score of the Chinese version of KPCS with r ranging from -0.283 to 0.643 (P<0.001). The difference of critical values of all items of KPCS among the low and high score groups were statistically significant (P<0.001). Three factors labeled parenting, support, and sense of competence, were obtained by exploratory factor analysis which accounting for 49.52% of the total variance and the factor loading values of all items are more than 0.4. The confirmatory factor analysis confirmed the hypothesized three-factor structure. The total score of KPCS was significantly correlated with the total score of PSOC and SICS(r=0.381, 0.345, P<0.001). The Cronbach’s α of the Chinese version of KPCS was 0.769, and each dimension of Cronbach’s α were 0.332-0.800, the test-retest reliability coefficient was 0.817, and the split-half reliability coefficient was 0.789. Conclusion: The Chinese version of the Karitane parenting confidence scale has a good reliability and validity among the 0-12 month-old infants’ mothers, which can be used to evaluate the parenting confidence of infant caregivers.

PMID:34304416 | DOI:10.3760/cma.j.cn112150-20210530-00524

Eur J Prosthodont Restor Dent. 2021 Jul 12. doi: 10.1922/EJPRD_2306No-Cortes06. Online ahead of print.

ABSTRACT

The purpose of this in-vitro study was to compare trueness, 3D deviation, production time and costs of milled and 3D-printed resin single crowns. A total of 20 CAD-CAM resin single crowns were fabricated from 10 digital wax patterns designed on 10 tooth preparations available in a reference model. Standardized control linear measurements were performed with a CAD software. Each STL file was then used to fabricate two resins crowns – one milled and one 3D-printed. All crowns underwent physical linear measurements using a digital caliper. The crowns were then scanned using an intraoral scanner for assessing 3D deviation. Finally, time to produce a single crown, as well as costs and production rates of both methods were also compared. Both CAM methods did not present statistically significant differences in linear measurements, as compared to controls (P⟩.05). Furthermore, 3D-printed crowns had significantly greater deviations in cervical margins (P=.032) and occlusal surfaces (P=.041), as compared with milled crowns. Finally, 3D-printing took significantly longer to produce one single crown (P=.001), but with a cheaper and higher production rate than milling. These findings suggest that milling devices produce resin single crowns with smaller 3D deviations but more expensive costs, as compared with low-cost 3D printers.

PMID:34304395 | DOI:10.1922/EJPRD_2306No-Cortes06

Zhonghua Shao Shang Za Zhi. 2021 Jul 20;37(7):640-646. doi: 10.3760/cma.j.cn501120-20200416-00227.

ABSTRACT

Objective: To investigate the expression and phosphorylation level change of adenosine monophosphate activated protein kinase (AMPK) in skeletal muscle of severely scald rats and its roles in skeletal muscle atrophy in severely scalded rats. Methods: The experimental research method was applied. Totally 100 6-week-old male Wistar rats were divided into sham injury group and scald group according to the random number table, with 50 rats in each group. After weighing the body weight, rats in scald group were inflicted with full-thickness scald of 30% total body surface area on the back, and rats in sham injury group were simulated with scald. At 6 h and on 1, 3, 5, and 7 d post injury, 10 rats in each group were taken to measure their body weights and weights of extensor digitorum longus and soleus muscle. At 6 h and on 1, 3, 5, and 7 d post injury, the tibialis anterior muscles were collected, the mRNA expressions of muscle atrophy F-box protein (MAFbx) and muscle-specific RING finger protein 1 (MuRF1) were detected by real-time fluorescent quantitative reverse transcription polymerase chain reaction; the content of adenosine monophosphate (AMP), adenosine diphosphate, and adenosine triphosphate (ATP) were detected by high performance liquid chromatography, and AMP/ATP ratio and energy charge were calculated; the protein expressions of AMPK-α and phosphorylated AMPK-α (p-AMPK-α) were detected by Western blotting, and the p-AMPK-α/AMPK-α ratio was calculated, with sample number of 4 in each time point of each group. Data were statistically analyzed with analysis of variance for factorial design and least significant difference test. Results: The body weights of rats in 2 groups before injury and at each time point post injury were close (P>0.05). At 6 h post injury, the weight of extensor digitorum longus of rats in scald group was (0.107±0.007) g, which was significantly heavier than (0.086±0.0607) g of sham injury group (P<0.01). On 3 d post injury, the weight of extensor digitorum longus of rats in scald group was (0.083±0.016) g, which was significantly lighter than (0.102±0.005) g of sham injury group (P<0.01). The weight of soleus of rats in 2 groups were close at each time point post injury (P>0.05). Compared with those of sham injury group, the mRNA expression of MAFbx in tibialis anterior muscle of rats in scald group was significantly up-regulated at 6 h post injury (P<0.01), and the mRNA expressions of MuRF1 in tibial anterior muscle of rats in scald group were significantly up-regulated at 6 h and on 1 d post injury (P<0.01). At 6 h and on 7 d post injury, compared with those of false injury group, the AMP/ATP ratios of the tibial anterior muscle of rats in scald group were significantly increased (P<0.05 or P<0.01), and energy charges of the tibial anterior muscle of rats in scald group were significantly decreased (P<0.01). At each time point post injury, the protein expressions of AMPK-α of the tibial anterior muscle of rats in 2 groups were close (P>0.05). The p-AMPK-α/AMPK-α ratios of the tibial anterior muscle of rats in scald group at 6 h and on 7 d post injury were significantly higher than those in sham injury group (P<0.05 or P<0.01). Conclusions: The decrease in energy charge and increase in AMP/ATP ratio of skeletal muscle of rats after severe scald activate AMPK. The activation of AMPK in the early stage of injury is consistent with the up-regulation of MAFbx and MuRF1 expressions and down-regulation of skeletal muscle weight. The above-mentioned changes may be one of the molecular mechanisms of skeletal muscle atrophy in rats with severe scald.

PMID:34304404 | DOI:10.3760/cma.j.cn501120-20200416-00227

Dysphagia. 2021 Jul 24. doi: 10.1007/s00455-021-10343-y. Online ahead of print.

ABSTRACT

Head and neck cancer patients are at high risk of developing dysphagia from undergoing cancer treatment. It is essential for medical and dental practitioners to recognize speech-language pathologists’ role and dysphagia symptoms to provide a timely referral to speech-language pathologists. This study aims to determine the level of awareness, knowledge, and involvement of medical and dental practitioners in dysphagia management. A total of 391 medical and dental practitioners from 22 government hospitals across Malaysia participated in this cross-sectional study. Participants completed the questionnaire specifically on the level of involvement, knowledge, awareness regarding the role of SLP and dysphagia symptoms. The results revealed a statistically significant relationship between the level of awareness of the role of SLP, χ² (4, 391) = 9.87, p = 0.043 and the level of involvement of medical and dental practitioners, χ² (8, 391) = 27.68, p = 0.001 and percentage of referring head and neck cancer patients. The odds of referring head and neck cancer patients for pre-treatment assessment increased three times for each one unit of the participation of medical and dental practitioners [OR] 3.65 (1.56, 8.51) p = 0.003 among those who are already highly involved in dysphagia management. These findings compel healthcare practitioners in head and neck cancer to revisit their collaborative practices. Head and neck cancer patients should receive swallowing management from speech-language pathologists to improve their swallowing function and avoid further complications such as dehydration, malnutrition, and death.

PMID:34304329 | DOI:10.1007/s00455-021-10343-y

Jpn J Radiol. 2021 Jul 25. doi: 10.1007/s11604-021-01181-x. Online ahead of print.

ABSTRACT

PURPOSE: To examine the computed tomography (CT) images of patients with a diagnosis of gastric tumor by texture analysis and to investigate its place in differential diagnosis.

MATERIALS AND METHODS: Contrast enhanced venous phase CT images of 163 patients with pathological diagnosis of gastric adenocarcinoma (n = 125), gastric lymphoma (n = 12) and gastrointestinal stromal tumors (n = 26) were retrospectively analyzed. Pixel size adjustment, gray-level discretization and gray-level normalization procedures were applied as pre-processing steps. Region of interest (ROI) was determined from the axial slice that represented the largest lesion area and a total of 40 texture features were calculated for each patient. Texture features were compared between the tumor subtypes and between adenocarcinoma grades. Statistically significant texture features were combined into a single parameter by logistic regression analysis. The sensitivity and specificity of these features and the combined parameter were measured to differentiate tumor subtypes by receiver-operating characteristic curve (ROC) analysis.

RESULTS: Classifications between adenocarcinoma versus lymphoma, adenocarcinoma vs. gastrointestinal stromal tumor (GIST) and well-differentiated adenocarcinoma versus poorly differentiated adenocarcinoma using texture features yielded successful results with high sensitivity (98, 91, 96%, respectively) and specificity (75, 77, 80%, respectively).

CONCLUSIONS: CT texture analysis is a non-invasive promising method for classifying gastric tumors and predicting gastric adenocarcinoma differentiation.

PMID:34304383 | DOI:10.1007/s11604-021-01181-x

Arch Gynecol Obstet. 2021 Jul 25. doi: 10.1007/s00404-021-06147-y. Online ahead of print.

ABSTRACT

PURPOSE: To investigate and propose a new simple tridimensional (3D) ultrasonographic method to diagnose a T-shaped uterus (Class U1a).

METHODS: A multicenter non-experimental case-control diagnostic accuracy study was conducted between January 2018 and December 2019, including 50 women (cases) diagnosed with T-shaped uterus (U1a class) and 50 women with a “normal uterus” (controls). All the enrolled women underwent 3D ultrasound, drawing four lines and recording the length of three of them as follow: draw and measure the interostial line (R0); draw from the midpoint of R0 a perpendicular line length 20 mm; draw and measure in the uterine cavity a line parallel to R0 at 10 mm below R0 (R10) and a second line parallel to R0 at 20 mm below R0 (R20). The diagnostic performance of all sonographic parameters statistically significantly different between T-shaped and normal uteri was estimated using the receiver operator characteristic (ROC) curve analysis.

RESULTS: R10 and R20 were statistically significantly shorter in the T-shaped than the normal uterus. R10 reported the highest diagnostic accuracy with an area under the ROC curve of 0.973 (95% CI 0.940-1.000). R10 length maximizing the Youden’s J statistic was 10.5 mm. Assuming R10 length equal to or shorter than 10 mm as the cut off value for defining a woman as having a T-shaped uterus, the new ultrasonographic method following the proposed protocol (R0, R10, and R20) reported sensitivity for T-shaped uterus of 91.1% (95% CI 0.78-0.97%) and a specificity of 100% (95% CI 0.89-100%). The positive likelihood ratio was higher than 30, and the negative likelihood ratio was 0.09 (95% CI 0.04-0.26).

CONCLUSIONS: Measuring the length of the intracavitary line parallel to the interostial line at 10 mm from it and using a length ≤ of 10 mm as cut off value (the “Rule of 10”) appears a simple and accurate 3D ultrasonographic method for the diagnosis of a T-shaped uterus.

PMID:34304295 | DOI:10.1007/s00404-021-06147-y

Eur Arch Otorhinolaryngol. 2021 Jul 25. doi: 10.1007/s00405-021-07016-9. Online ahead of print.

ABSTRACT

PURPOSE: Narrow band imaging (NBI) enhances mucosal vasculature and could help in the identification of recurrences. We assessed the effectiveness of NBI with flexible video-endoscope in the early detection of recurrence after treatment of head and neck squamous cell carcinoma, its diagnostic advantage over high-definition white-light (HD WL) endoscopy, also in relation to recurrence site, and the influence of previous radiotherapy (RT) or chemotherapy (CT). Moreover, we investigated the association between index tumor site and the risk of developing recurrence, and the relation between index tumor site and recurrence site.

METHODS: From January 2018 to November 2020, 160 patients previously treated with surgery and/or RT ± CT were evaluated using NBI with flexible video-endoscope. Sensitivity, specificity, positive/negative predictive value, and accuracy were calculated for NBI and HD WL, and compared using the McNemar test. The Fisher exact test was used to compare the other associations investigated.

RESULTS: The difference between NBI and HD WL sensitivity was statistically significant (p < 0.001). The NBI diagnostic advantage was 62.5%, highest in the hypopharynx (p = 0.05), and was not influenced by previous RT or CT (p = 0.49). Index tumor site statistically related with recurrence site (p < 0.001), but not with the risk of developing recurrence (p = 0.81).

CONCLUSION: NBI with flexible video-endoscope could represent a valid option to detect recurrence early during the follow-up, especially in a difficult-to-visualize site such as the hypopharynx.

PMID:34304298 | DOI:10.1007/s00405-021-07016-9

Ann Surg Oncol. 2021 Jul 24. doi: 10.1245/s10434-021-10443-x. Online ahead of print.

ABSTRACT

BACKGROUND: Sentinel lymph node biopsy (SLNB) has been the standard of care for clinically node-negative women with invasive breast cancer (IBC); however, there is less agreement on whether to perform SLNB when the risk of metastasis is low or when it does not affect survival or locoregional control.

METHODS: An Institutional Review Board-approved survey was sent to members of the American Society of Breast Surgeons asking in which scenarios surgeons would recommend SLNB. Descriptive statistics and multivariable analysis were performed using SPSS software.

RESULTS: There was a 23% response rate; 68% identified as breast surgical oncologists, 6% as surgical oncologists, 24% as general surgeons, and 2% as other. The majority practiced in a community setting (71%) versus an academic setting (29%). In a healthy female with clinical T1N0 hormone receptor-positive (HR+) IBC, 83% favored SLNB if the patient was 75 years of age, versus 35% if the patient was 85 years of age. Academic surgeons were less likely to perform axillary staging in a healthy 75-year-old (odds ratio [OR] 0.51 [0.32-0.80], p = 0.004) or a healthy 85-year-old (OR 0.48 [0.31-0.74], p = 0.001). For DCIS, 32% endorsed SLNB in women undergoing lumpectomy, with breast surgical oncologists and academic surgeons being less likely to endorse this procedure (OR 0.54 [0.36-0.82], p = 0.028; and OR 0.53 [0.34-0.83], p = 0.005, respectively).

CONCLUSIONS: Despite studies showing that omitting SLNB in older patients with HR+ IBC does not impact regional control or survival, most surgeons are still opting for axillary staging. In addition, one in three are performing SLNB for lumpectomies for DCIS. Breast surgical oncologists and academic surgeons were more likely to be practicing based on recent data and guidelines. Practice patterns are changing but there is still room for improvement.

PMID:34304312 | DOI:10.1245/s10434-021-10443-x

Support Care Cancer. 2021 Jul 25. doi: 10.1007/s00520-021-06415-2. Online ahead of print.

ABSTRACT

PURPOSE: Endometrial cancer is strongly linked to obesity and inactivity; however, increased physical activity has important benefits even in the absence of weight loss. Resistance (strength) training can deliver these benefits; yet few women participate in resistance exercise. The purpose of this study was to describe both physiological and functional changes following a home-based strength training intervention.

METHODS: Forty post-treatment endometrial cancer survivors within 5 years of diagnosis were enrolled in a pilot randomized trial, comparing twice-weekly home-based strength exercise to wait list control. Participants conducted the exercises twice per week for 10 supervised weeks with 5 weeks of follow-up. Measures included DXA-measured lean mass, functional fitness assessments, blood biomarkers, and quality of life outcomes.

RESULTS: On average, participants were 60.9 years old (SD = 8.7) with BMI of 39.9 kg/m² (SD = 15.2). At baseline, participants had 51.2% (SD = 6.0) body fat, which was not different between groups. Improvements were seen in the 30-s chair sit to stand (d = .99), the 30-s arm curl (d = .91), and the 8-ft up-and-go test (d = .63). No changes were measured for HbA1c or C-reactive protein. No changes were observed for flexibility (chair sit and reach, back scratch tests), 6-min walk test, maximum handgrip test, anxiety, depression, fatigue, or self-efficacy for exercise.

CONCLUSIONS: Home-based muscle-strengthening exercise led to favorable and clinically relevant improvements in 3 of 7 physical function assessments. Physical function, body composition, blood biomarkers, and patient-reported outcomes were feasible to measure. These fitness improvements were observed over a relatively short time frame of 10 weeks.

PMID:34304292 | DOI:10.1007/s00520-021-06415-2