With the rapidly growing literature across the surgical disciplines, there is a corresponding need to critically appraise and summarize the currently available evidence so they can be applied appropriately to patient care. The interpretation of systematic reviews is particularly challenging in cases where few robust clinical trials have been performed to address a particular question. However, risk of bias can be minimized and potentially useful conclusions can be drawn if strict review methodology is adhered to, including an exhaustive literature search, quality appraisal of primary studies, appropriate statistical methodology, assessment of confidence in estimates and risk of bias. Therefore, the following article aims to: (Ⅰ) summarize to the important features of a thorough and rigorous systematic review or meta-analysis for the surgical literature; (Ⅱ) highlight several underused statistical approaches which may yield further interesting insights compared to conventional pair-wise data synthesis techniques; and (Ⅲ) propose a guide for thorough analysis and presentation of results.
In this paper , the statistic significance and clinical application of forest plots in a meta-analysis have been fully discussed. If the horizontal line represents the 95% confidence interval of the indexes including odds ratio, relative risk, weighted mean difference, and standard mean difference crosses the vertical line, the effect of test group is not signficant with that of control group; if the horizontal line lies to the right of the vertical line, it indicates that the test group is significantly effctive. If the horizontal line lies to the left of the vertical line, it indicates that the control group is more effective. In addition, it doesn’t mean that clinical application is more beneficial, if the treatment study has more effect, because experimental factor can be positive or negative.
Predicting the termination of paroxysmal atrial fibrillation (AF) may provide a signal to decide whether there is a need to intervene the AF timely. We proposed a novel RdR RR intervals scatter plot in our study. The abscissa of the RdR scatter plot was set to RR intervals and the ordinate was set as the difference between successive RR intervals. The RdR scatter plot includes information of RR intervals and difference between successive RR intervals, which captures more heart rate variability (HRV) information. By RdR scatter plot analysis of one minute RR intervals for 50 segments with non-terminating AF and immediately terminating AF, it was found that the points in RdR scatter plot of non-terminating AF were more decentralized than the ones of immediately terminating AF. By dividing the RdR scatter plot into uniform grids and counting the number of non-empty grids, non-terminating AF and immediately terminating AF segments were differentiated. By utilizing 49 RR intervals, for 20 segments of learning set, 17 segments were correctly detected, and for 30 segments of test set, 20 segments were detected. While utilizing 66 RR intervals, for 18 segments of learning set, 16 segments were correctly detected, and for 28 segments of test set, 20 segments were detected. The results demonstrated that during the last one minute before the termination of paroxysmal AF, the variance of the RR intervals and the difference of the neighboring two RR intervals became smaller. The termination of paroxysmal AF could be successfully predicted by utilizing the RdR scatter plot, while the predicting accuracy should be further improved.
To accurately capture and effectively integrate the spatiotemporal features of electroencephalogram (EEG) signals for the purpose of improving the accuracy of EEG-based emotion recognition, this paper proposes a new method combining independent component analysis-recurrence plot with an improved EfficientNet version 2 (EfficientNetV2). First, independent component analysis is used to extract independent components containing spatial information from key channels of the EEG signals. These components are then converted into two-dimensional images using recurrence plot to better extract emotional features from the temporal information. Finally, the two-dimensional images are input into an improved EfficientNetV2, which incorporates a global attention mechanism and a triplet attention mechanism, and the emotion classification is output by the fully connected layer. To validate the effectiveness of the proposed method, this study conducts comparative experiments, channel selection experiments and ablation experiments based on the Shanghai Jiao Tong University Emotion Electroencephalogram Dataset (SEED). The results demonstrate that the average recognition accuracy of our method is 96.77%, which is significantly superior to existing methods, offering a novel perspective for research on EEG-based emotion recognition.
ObjectiveTo investigate the association between tumor necrosis factor (TNF)-α gene polymorphism and susceptibility to chronic obstructive pulmonary disease (COPD) in eastern Heilongjiang province.MethodsA total of 347 COPD patients in the Department of Respiratory Medicine, the First Affiliated Hospital of Jiamusi University, were enrolled from January 2016 to January 2017. In the same period, 338 healthy subjects in the hospital physical examination center were selected as controls. The genotype of the two groups was analyzed by high resolution melting (HRM) and gene sequencing. The genotype and allele probability of the two groups were compared and analyzed by the SHEsis genetic imbalance haplotype analysis.ResultsBoth TNF-a –308 G/A co-dominant model and recessive model have significant differences between COPD patients and healthy subjects (P=0.036, OR 1.512, 95%CI 1.023 – 2.234; P=0.027, OR 1.202, 95%CI 1.024 – 1.741). –850G/A co-dominant model (P=0.000, OR 1.781, 95%CI 1.363 – 2.329), dominant model (P=0.000, OR 0.391 7, 95%CI 1.363 – 2.329) and hyper-dominant model (P=0.000, OR 2.680, 95%CI 1.728 – 4.156) in the two groups were statistically different. The haploid analysis and haploid genotype analysis showed statistically significant differences (all P<0.05, OR>1, 95%CI>1) at +489, –308, –850 sites by allele A, G, A, respectively between the two groups. There was a significant difference in the lung function between the –308G/A, –863C/A mutant genome and the wild type (P=0.038, P=0.02) in COPD patients according to the classification of lung function.ConclusionsA allele in TNF-α –308 and G allele in TNF-α –850 locus may be risk factors for COPD in the eastern Heilongjiang Province, and the risk of homozygous genotype is higher. +489A, –308G and –850A respectively may be the predisposing factor of COPD while the three genotypes of AGA patients were at higher risk. TNF-α –308 A allele and –863 A allele are related to lung function deterioration, and the two sites with A allele in patients with COPD indicate poor lung function.
Deep brain stimulation (DBS), which usually utilizes high frequency stimulation (HFS) of electrical pulses, is effective for treating many brain disorders in clinic. Studying the dynamic response of downstream neurons to HFS and its time relationship with stimulus pulses can reveal important mechanisms of DBS and advance the development of new stimulation modes (e.g., closed-loop DBS). To exhibit the dynamic neuronal firing and its relationship with stimuli, we designed a two-dimensional raster plot to visualize neuronal activity during HFS (especially in the initial stage of HFS). Additionally, the influence of plot resolution on the visualization effect was investigated. The method was then validated by investigating the neuronal responses to the axonal HFS in the hippocampal CA1 region of rats. Results show that the new design of raster plot is able to illustrate the dynamics of indexes (such as phase-locked relationship and latency) of single unit activity (i.e., spikes) during periodic pulse stimulations. Furthermore, the plots can intuitively show changes of neuronal firing from the baseline before stimulation to the onset dynamics during stimulation, as well as other information including the silent period of spikes immediately following the end of HFS. In addition, by adjusting resolution, the raster plot can be adapted to a large range of firing rates for clear illustration of neuronal activity. The new raster plot can illustrate more information with a clearer image than a regular raster plot, and thereby provides a useful tool for studying neuronal behaviors during high-frequency stimulations in brain.
Subpopulation treatment effect pattern plot (STEPP) method is a method for examining the relationship between treatment effects and continuous covariates and is characterized by dividing the study population into multiple overlapping subpopulations to be analyzed based on continuous covariate values. STEPP method has a different purpose than traditional subgroup analyses, and STEPP has a clear advantage in exploring the relationship between treatment effects and continuous covariates. In this study, the concepts, advantages, and subpopulation delineation methods of the STEPP method are introduced, and the specific operation process and result interpretation methods of STEPP method analysis using the STEPP package in R language are presented with examples.
Lorenz plot (LP) method which gives a global view of long-time electrocardiogram signals, is an efficient simple visualization tool to analyze cardiac arrhythmias, and the morphologies and positions of the extracted attractors may reveal the underlying mechanisms of the onset and termination of arrhythmias. But automatic diagnosis is still impossible because it is lack of the method of extracting attractors by now. We presented here a methodology of attractor extraction and recognition based upon homogeneously statistical properties of the location parameters of scatter points in three dimensional LP (3DLP), which was constructed by three successive RR intervals as X, Y and Z axis in Cartesian coordinate system. Validation experiments were tested in a group of RR-interval time series and tags data with frequent unifocal premature complexes exported from a 24-hour Holter system. The results showed that this method had excellent effective not only on extraction of attractors, but also on automatic recognition of attractors by the location parameters such as the azimuth of the points peak frequency (APF) of eccentric attractors once stereographic projection of 3DLP along the space diagonal. Besides, APF was still a powerful index of differential diagnosis of atrial and ventricular extrasystole. Additional experiments proved that this method was also available on several other arrhythmias. Moreover, there were extremely relevant relationships between 3DLP and two dimensional LPs which indicate any conventional achievement of LPs could be implanted into 3DLP. It would have a broad application prospect to integrate this method into conventional long-time electrocardiogram monitoring and analysis system.
Objective To detect the single nucleotide polymorphisms ( SNPs) in the upstream promoter region of chemokine like factor ( CKLF) gene and analyze their possible associations with asthma and asthma-related phenotypes. Methods Direct Sequence of the 1553bp upstream promoter region of CKLF gene was performed in 245 Chinese Han human genomic DNAs ( 119 asthmatics and 126 controls) .The frequencies of alleles, genotypes, and haplotypes were determined and the association of these SNPs with asthma were further analyzed. Results Four novel SNPs, SNP88 ( T gt; C) , SNP196 ( T gt; C) , SNP568 ( C gt;G) , and SNP1047 ( C gt; G) were found in the promoter region of CKLF. The frequency of rare allele was 0. 168 ( SNP88C) , 0. 168 ( SNP196C) , 0. 352 ( SNP568G) and 0. 167 ( SNP1047G) , respectively.Haplotypes, their frequencies and the linkage disequilibrium coefficients between SNPs were constructed.Complete linkage disequilibrium( LDs) were observed between SNP88 and SNP196, SNP88 and SNP1047,as well as SNP196 and SNP1047, respectively ( D′=1. 000, r2 = 1. 000) . SNP568 was in partial LD with the other three SNPs ( r2 = 0. 366) . No association between asthma and the SNPs was observed. Conclusions Four SNPs in the regulatory region of CKLF in Chinese Han population were firstly identified. Although no significant correlation with asthma was revealed, the SNP and haplotype information is useful for other disease association studies in the future.
ObjectiveTo review recent literature on three-dimensional (3-D) plotting as a rapid prototyping method for the manufacturing of patient specific biomaterial scaffolds and tissue engineering constructs. MethodsLiterature review and description of own recent work. ResultsIn contrast to many other rapid prototyping technologies which can be used only for the processing of distinct materials, 3-D plotting can be utilized for all pasty biomaterials and therefore opens up many new options for the manufacturing of bi- or multiphasic scaffolds or even tissue engineering constructs, containing e. g. living cells. Conclusion3-D plotting is a rapid prototyping technology of growing importance which provides flexibility concerning choice of material and allows integration of sensitive biological components.