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Clinical outcomes of endoscopic papillectomy of ampullary adenoma: A multi-center study

World Journal of Gastroenterology 2022年第17期28卷 1845-1859页

作者： Seong Ji Choi Hong Sik Lee Jiyeong Kim Jung Wan Choe Jae Min Lee Jong Jin Hyun Jai Hoon Yoon Hyo Jung Kim Jae Seon Kim Ho Soon Choi Department of Internal Medicine Hanyang University College of MedicineSeoul 04763South Korea Division of Gastroenterology and Hepatology Department of Internal MedicineKorea University College of MedicineSeoul 02841South Korea Lab of biostatistical Consulting and Research Medical Research Collaborating CenterIndustry-University Cooperation FoundationHanyang UniversitySeoul 04763South Korea

BACKGROUND Ampullary adenoma is a rare premalignant lesion,but its incidence is *** papillectomy has become the first treatment of choice for ampullary adenomas due to its safety and effectiveness,thereby replacing surgical ***,recurrence rates and adverse events after endoscopic papillectomy were reported in up to 30%of *** To review the long-term outcomes of endoscopic papillectomy and investigate the factors that affect these *** We retrospectively analyzed the data of patients who underwent endoscopic papillectomy for ampullary adenoma at five tertiary hospitals between 2013 and *** evaluated clinical outcomes and their risk *** definitions of outcomes were as follow:(1)curative resection:complete endoscopic resection without recurrence;(2)endoscopic success:treatment of ampullary adenoma with endoscopy without surgical intervention;(3)early recurrence:reconfirmed adenoma at the first endoscopic surveillance;and(4)late recurrence:reconfirmed adenoma after the first endoscopic *** A total of 106 patients were included for *** the included patients,81(76.4%)underwent curative resection,99(93.4%)had endoscopic success,showing that most patients with noncurative resection were successfully managed with *** patients(15.1%)had piecemeal resection,22 patients(20.8%)had shown positive/uncertain resection margin,11 patients(16.1%)had an early recurrence,13 patients(10.4%)had a late recurrence,and 6 patients(5.7%)had a *** multivariate analysis,a positive/uncertain margin[Odds ratio(OR)=4.023,P=0.048]and piecemeal resection(OR=6.610,P=0.005)were significant risk factors for early and late recurrence,*** resection was also a significant risk factor for non-curative resection(OR=5.424,P=0.007).Twenty-six patients experienced adverse events(24.5%).CONCLUSION Endoscopic papillectomy is a safe and effective treatment for ampullary ***

关键词： Endoscopic papillectomy Ampullary adenoma Clinical outcome Recurrence Adverse event

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Carotid Intima-media Thickness Measurements： Relations with Atherosclerosis, Risk of Cardiovascular Disease and Application in Randomized Controlled Trials

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Chinese Medical Journal 2016年第2期129卷 215-226页

作者： Michiel L Bots Gregory W Evans Charles H Tegeler Rudy Meijer Julius center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht The Netherlands Department of biostatistical Sciences and Neurology Wake Forest School of Medicine Winston-Salem NC USA Department of Neuiology Ward A Riley Ultrasound Center Wake Forest School of Medicine Medical Center Boulevard Winston-Salem NC USA

Cardiovascular disease （CVD） is the leading cause of death worldwide and contributes considerably to morbidity The underlying cause is atherosclerosisThe development of new preventive therapies is one of the steps to control the CVD epidemic. It is increasingly demanded that promising therapies be evaluated in trials using cardiovascular （CV） morbidity and mortality （M and M） as a primary outcome.

关键词： Atherosclerosis Cardiovascular Disease Prevention Trials

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Statistical models for predicting number of involved nodes in breast cancer patients

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Health 2010年第7期2卷 641-651页

作者： Alok Kumar Dwivedi Sada Nand Dwivedi Suryanarayana Deo Rakesh Shukla center for biostatistical Services Department of Environmental Health College of Medicine University of Cincinnati Cincinnati USA.

Clinicians need to predict the number of involved nodes in breast cancer patients in order to ascertain severity, prognosis, and design subsequent treatment. The distribution of involved nodes often displays over-dispersion—a larger variability than expected. Until now, the negative binomial model has been used to describe this distribution assuming that over-dispersion is only due to unobserved heterogeneity. The distribution of involved nodes contains a large proportion of excess zeros (negative nodes), which can lead to over-dispersion. In this situation, alternative models may better account for over-dispersion due to excess zeros. This study examines data from 1152 patients who underwent axillary dissections in a tertiary hospital in India during January 1993-January 2005. We fit and compare various count models to test model abilities to predict the number of involved nodes. We also argue for using zero inflated models in such populations where all the excess zeros come from those who have at some risk of the outcome of interest. The negative binomial regression model fits the data better than the Poisson, zero hurdle/inflated Poisson regression models. However, zero hurdle/inflated negative binomial regression models predicted the number of involved nodes much more accurately than the negative binomial model. This suggests that the number of involved nodes displays excess variability not only due to unobserved heterogeneity but also due to excess negative nodes in the data set. In this analysis, only skin changes and primary site were associated with negative nodes whereas parity, skin changes, primary site and size of tumor were associated with a greater number of involved nodes. In case of near equal performances, the zero inflated negative binomial model should be preferred over the hurdle model in describing the nodal frequency because it provides an estimate of negative nodes that are at “high-risk” of nodal involvement.

关键词： Nodal Involvement Count Models Breast Cancer

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Successful use of closed-loop allostatic neurotechnology for post-traumatic stress symptoms in military personnel： self-reported and autonomic improvements

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Military Medical Research 2018年第1期5卷 1-12页

作者： Catherine L.Tegeler Lee Gerdes Hossam A.Shaltout Jared F.Cook Sean L.Simpson Sung W.Lee Charles H.Tegeler Department of Neurology Wake Forest School of Medicine Medical Center Boulevard Winston-Salem NC 27157 USA Brain State Technologies LLC 15150 North Hayden Road Scottsdale AZ 85260USA Hypertension and Vascular Research center Wake Forest School of Medicine Medical Center Boulevard Winston-Salem NC 27157USA Department of biostatistical Sciences Wake Forest School of Medicine Medical Center Boulevard Winston-Salem NC 27157 USA

Background:Military-related post-traumatic stress(PTS)is associated with numerous symptom clusters and diminished autonomic cardiovascular ***,relational,resonance-based,electroencephalic mirroringis a noninvasive,closed-loop,allostatic,acoustic stimulation neurotechnology that produces realtime translation of dominant brain frequencies into audible tones of variable pitch and timing to support the autocalibration of neural *** report clinical,autonomic,and functional effects after the use offor symptoms of military-related ***:Eighteen service members or recent veterans(15 active-duty,3 veterans,most from special operations,1 female),with a mean age of 40.9(SD=6.9)years and symptoms of PTS lasting from 1 to 25 years,undertook19.5(SD=1.1)sessions over 12 *** for symptoms of PTS(Posttraumatic Stress Disorder Checklist–Military version,PCL-M),insomnia(Insomnia Severity Index,ISI),depression(center for Epidemiologic Studies Depression Scale,CES-D),and anxiety(Generalized Anxiety Disorder 7-item scale,GAD-7)were collected before(Visit1,V1),immediately after(Visit2,V2),and at 1 month(Visit3,V3),3(Visit4,V4),and 6(Visit5,V5)months after intervention *** measures only taken at V1 and V2 included blood pressure and heart rate recordings to analyze heart rate variability(HRV)and baroreflex sensitivity(BRS),functional performance(reaction and grip strength)testing,blood and saliva for biomarkers of stress and inflammation,and blood for epigenetic *** t-tests,Wilcoxon signed-rank tests,and a repeated-measures ANOVA were ***:Clinically relevant,significant reductions in all symptom scores were observed at V2,with durability through *** were significant improvements in multiple measures of HRV and BRS[Standard deviation of the normal beat to normal beat interval(SDNN),root mean square of the successive differences(rMSSD),high frequency(HF),low frequency(LF),and total power,HF alpha,

关键词： Neurotechnology Allostasis Autonomic Heart rate variability Baroreflex sensitivity Closed-loop Acoustic stimulation Military Post-traumatic stress disorder HIRREM

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A systematic review and meta-analysis of clinical trials implementing aromatase inhibitors to treat male infertility

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Asian Journal of Andrology 2020年第4期22卷 360-367页

作者： Francesco Del Giudice Gian Maria Busetto Ettore De Berardinis Isabella Sperduti Matteo Ferro Martina Maggi Martin S Gross Alessandro Sciarra Michael L Eisenberg Department of Urology Sapienza Rome UniversityPoliclinico Umberto IRome 00161Italy biostatistical Unit IRCCSRegina Elena National Cancer InstituteRome 00128Italy Division of Urology European Institute of OncologyMilan 20141Italy Section of Urology Dartmouth-Hitchcock Medical CenterLebanonNH 03766USA Department of Urology Stanford UniversitySchool of MedicineStanfordCA 94305USA

Aromatase activity has commonly been associated with male infertility characterized by testicular dysfunction with low serum testosterone and/or testosterone to estradiol *** this subset of patients,and particularly in those with hypogonadism,elevated levels of circulating estradiol may establish a negative feedback on the hypothalamic–pituitary–testicular axis by suppressing follicle-stimulating hormone(FSH)and luteinizing hormone(LH)production and impaired *** manipulation via different agents such as selective estrogen modulators or aromatase inhibitors to increase endogenous testosterone production and improve spermatogenesis in the setting of infertility is an off-label option for *** carried out a systematic review and meta-analysis of the literature of the past 30 years in order to evaluate the benefits of the use of aromatase inhibitors in the medical management of infertile/hypoandrogenic ***,eight original articles were included and critically *** steroidal(Testolactone)or nonsteroidal(Anastrozole and Letrozole)aromatase inhibitors were found to statistically improve all the evaluated hormonal and seminal outcomes with a safe tolerability *** the evidence is promising,future prospective randomized placebo-controlled multicenter trials are necessary to better define the efficacy of these medications.

关键词： aromatase inhibitor hypogonadism male infertility meta-analysis systematic review

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ARGs-OAP v3.0:Antibiotic-Resistance Gene Database Curation and Analysis Pipeline Optimization

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Engineering 2023年第8期27卷 234-241页

作者： Xiaole Yin Xiawan Zheng Liguan Li An-Ni Zhang Xiao-Tao Jiang Tong Zhang Environmental Microbiome Engineering and Biotechnology Laboratory Center for Environmental Engineering ResearchDepartment of Civil Engineeringthe University of Hong KongHong Kong 999077China

Antibiotic resistance,which is encoded by antibiotic-resistance genes(ARGs),has proliferated to become a growing threat to public health around the *** technical advances,especially in the popularization of metagenomic sequencing,scientists have gained the ability to decipher the profiles of ARGs in diverse samples with high accuracy at an accelerated *** analyze thousands of ARGs in a highthroughput way,standardized and integrated pipelines are *** new version(v3.0)of the widely used ARGs online analysis pipeline(ARGs-OAP)has made significant improvements to both the reference database-the structured ARG(SARG)database-and the integrated analysis *** has been enhanced with sequence curation to improve annotation reliability,incorporate emerging resistance genotypes,and determine rigorous mechanism *** database has been further organized and visualized online in the format of a tree-like structure with a *** has also been divided into sub-databases for different application *** addition,the ARGs-OAP has been improved with adjusted quantification methods,simplified tool implementation,and multiple functions with userdefined reference ***,the online platform now provides a diverse biostatistical analysis workflow with visualization packages for the efficient interpretation of ARG *** ARGs-OAP v3.0 with an improved database and analysis pipeline will benefit academia,governmental management,and consultation regarding risk assessment of the environmental prevalence of ARGs.

关键词： SARG database ARGs-OAP Antibiotic-resistance genes Environmental metagenome Quantification

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Magnifying endoscopy for the diagnosis of specialized intestinal metaplasia in short-segment Barrett's esophagus

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World Journal of Gastroenterology 2013年第41期19卷 7089-7096页

作者： Nam Seok Ham Jae Young Jang Sung Woo Ryu Ji Hye Kim Eui Ju Park Woong Cheul Lee Kwang Yeun Shim Soung Won Jeong Hyun Gun Kim Tae Hee Lee Sung Ran Jeon Jun Hyung Cho Joo Young Cho So Young Jin Ji Sung Lee Institution for Digestive Research Digestive Disease CenterDepartment of Internal MedicineSoonchunhyang University HospitalSeoul 140-743South Korea Department of Pathology Soonchunhyang University HospitalSeoul 140-743South Korea biostatistical Consulting Unit Soonchunhyang University HospitalSeoul 140-743South Korea

AIM:To determine whether magnified observation of short-segment Barrett’s esophagus(BE)is useful for the detection of specialized intestinal metaplasia(SIM).METHODS:Thirty patients with suspected short-segment BE underwent magnifying endoscopy up to×*** magnified images were analyzed with respect to their pit-patterns,which were simultaneously classified into five epithelial types[Ⅰ(small round),Ⅱ(straight),Ⅲ(long oval),Ⅳ(tubular),Ⅴ(villous)]by Endo’s ***,a 0.5%solution of methylene blue(MB)was sprayed over columnar *** patterns of the magnified image and MB staining were *** were obtained from the regions previously observed by magnifying endoscopy and MB ***:Three of five patients with a typeⅤ(villous)epithelial pattern had SIM,whereas 21 patients with a non-typeⅤepithelial patterns did not have *** sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of pit-patterns in detecting SIM were 100%,91.3%,92.3%,60%and100%,respectively(P=0.004).Three of the 12 patients with positive MB staining had SIM,whereas 14patients with negative MB staining did not have *** sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MB staining in detecting SIM were 100%,60.9%,65.4%,25%and100%,respectively(P=0.085).The specificity and accuracy of pit-pattern evaluation were significantly superior compared with MB staining for detecting SIM by comparison with the exact McNemar’s test(P=0.0391).CONCLUSION:The magnified observation of a shortsegment BE according to the mucosal pattern and its classification can be predictive of SIM.

关键词： Short-segment Barrett’s esophagus Magnifying endoscopy Methylene blue chromoendoscopy Specialized intestinal metaplasia Dysplasia Esophageal adenocarcinoma Diagnosis

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Structure of Personality at Intrapsychic and Interpersonal Levels and Depression of Caregivers of Patients Affected by Alzheimer’s Disease: Which Psychotherapeutic Approach?

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Advances in Alzheimer's Disease 2018年第4期7卷 103-118页

作者： Giulietti Maria Velia Anna Vespa Stefano Berti Guido Gori Marica Ottaviani Cristina Meloni Paolo Fabbietti Giuseppe Pelliccioni Lucia Paciaroni Roberta Spatuzzi Department of Research INRCA-IRCCS National Institute of Science and Health for Aging Ancona Italy Department of Research Scientific and Technological Area INRCA-IRCCS National Institute of Science and Health for Aging Anco-na Italy Health Promotion Department Ancona Alzheimer Daily center Florence Italy biostatistical center INRCA-IRCCS National Institute of Health and Science on Aging Ancona Italy U.O.C. Hospice/Palliative Care Departments Potenza Italy

Background: Many studies have underlined as caregiving for people with Alzheimer’s disease (AD) is highly stressful and has significant negative consequences. Objectives: The study of the structure of personality, can help to understand the association between depression, intrapsychic and interpersonal processes of caregivers of Alzheimer’s disease patients and what kind of intervention can be planned to favor the stress burden management. Methods: Case group: Caregivers (CG) (n = 75);control group, Subjects not Caregivers (nCG) (n. 104). Tests: SASB questionnaire (Structural Analysis of Interpersonal Behavior) describing intrapsychic and interpersonal processes of the structure of personality validated on the basis of DSMIV;CDQ questionnaires—depression. Results: Intrapsychic level: From the results it emerged that CGs had lower autonomy in their choices, and lower acceptance of their own feelings, and exercised greater self-control exhausting themselves toward predetermined goals, and more depression compared to the control group. They may be not able to achieve psychic equilibrium in the presence of stress: they may likely become disoriented and engage in behaviors that may be self-defeating. SASB-Cl = Autonomy (p 0.001);SASB-Cl2-Autonomy and Love (p 0.001), SASB-CL3-Love (p 0.001);SASB-Cl4 Love and control (p 0.001), SASB-CL5-Control (p = 0.015), SASB-Cl6-Control and hate (p 0.001), SASB-Cl7-Hate (p Conclusions: Intrapsychic characteristics such as tendency to depression, inability to being in contact with their own feelings, excessive self-control may be linked to difficulties in facing burden of care and indicate serious difficulties to adaptation to burden condition. The knowledge of these modalities could allow to plan a psychotherapeutic and multidisciplinary intervention aimed at facing and overcoming the psychological distress of the caregiver.

关键词： Caregiver Alzheimer Depression Intrapsychic Behaviours Interpersonal Behaviours Personality

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An epidemiological study on delay in treatment initiation of cancer patients

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Health 2012年第2期4卷 66-79页

作者： Alok Kumar Dwivedi Sada Nand Dwivedi Suryanarayana Deo Rakesh Shukla Arvind Pandey Durgesh Kumar Dwivedi center for biostatistical Services Division of Biostatistics and Epidemiology Department of Environmental Health College of Medicine University of Cincinnati Cincinnati USA Department of Biostatistics All India Institute of Medical Sciences New Delhi India Department of NMR & MRI Facility All India Institute of Medical Sciences New Delhi India Department of Surgical Oncology All India Institute of Medical Sciences New Delhi India National Institute of Medical Statistics Indian Council of Medical Research New Delhi India

Early diagnosis and timely initiation of treatment of cancer patients may improve survival and quality of life. Various measures of delay can be made during diagnosis and treatment initiation. Most of the studies were based on single type of cancer with different definitions and measurements of delay in diagnosis and treatment. Thus, it has been difficult to synthesize results and generalize to other types of cancer. The study proposes to measure total duration between onsets of symptom to start of treatment into three components, namely primary, secondary and tertiary delays. Primary delay is defined as onset of symptoms to contacting the first medical person, secondary delay is from first medical contact to confirmed diagnosis, and tertiary delay is from confirmed diagnosis to treatment initiation. The aim of this study is to determine factors associated with primary, secondary and tertiary delays in cancer patients. This study was planned as a cross-sectional study. Data was collected from patients admitted to the surgical wards of Department of Surgical Oncology, Institute Rotary Cancer Hospital, New Delhi during 2006-2007. Gamma regression and quantile regressions at 25th, 50th and 75th percentile of each of the delays were used to determine related factors. A total of 403 patients were included in the analysis. The median tertiary delay was found almost two folds (59;Interquartile range: 26 - 101 days) than the primary and secondary delays. Extremity cancer patients had longest primary, secondary and tertiary delays. Shortest primary, secondary and tertiary delays were observed for gastrointestinal cancer, breast and genitourinary cancer respectively. There is an urgent need and scope to reduce delay at each level primary, secondary and tertiary delay. Intervention studies are needed through information, education and communication/screening programs to reduce the diagnostic and treatment delays in cancer patients.

关键词： Delay Cancer Log Gamma Regression Quantile Regression

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biostatistical PROFILES OF INDIVIDUALS SEEKING ACUPUNCTURE TREATMENT IN THE UNITED STATES

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中华医学杂志(英文版) 1985年第11期98卷 835-840页

作者： HC Dung PhD Department of Cellular and Structural Biology The University of Texas Health Science Center at San Antonio San Antonio

This is a record of biostatistical data collected during the years 1981-84 at a clinic in the United States, from patients who came to seek acupuncture treatment. The records consist of patient referral, age, sex, main problem, and clinical diagnosis. The information obtained from such records may be of interest to other acupuncture practitioners. It is also hoped that this report will provide useful data in comparing the profiles of those patients in the East and West who seek acupuncture treatment.

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