A robust calibration-assisted method for linear mixed effects model under cluster-specific nonignorable missingness

We propose a method for linear mixed effects models when the covariates are completely observed but the outcome of interest is subject to missing under cluster-specific nonignorable (CSNI) missingness. Our strategy is to replace missing quantities in the full-data objective function with unbiased predictors derived from inverse probability weighting and calibration technique. The proposed approach can be applied to estimating equations or likelihood functions with modified E-step, and does not require numerical integration as do previous methods. Unlike usual inverse probability weighting, the proposed method does not require correct specification of the response model as long as the CSNI assumption is correct, and renders inference under CSNI without a full distributional assumption. Consistency and asymptotic normality are shown with a consistent variance estimator. Simulation results and a data example are presented

Determining Relative Dynamic Stability of Cell States Using Boolean Network Model.

Cell state transition is at the core of biological processes in metazoan, which includes cell differentiation, epithelial-to-mesenchymal transition (EMT) and cell reprogramming. In these cases, it is important to understand the molecular mechanism of cellular stability and how the transitions happen between different cell states, which is controlled by a gene regulatory network (GRN) hard-wired in the genome. Here we use Boolean modeling of GRN to study the cell state transition of EMT and systematically compare four available methods to calculate the cellular stability of three cell states in EMT in both normal and genetically mutated cases. The results produced from four methods generally agree but do not totally agree with each other. We show that distribution of one-degree neighborhood of cell states, which are the nearest states by Hamming distance, causes the difference among the methods. From that, we propose a new method based on one-degree neighborhood, which is the simplest one and agrees with other methods to estimate the cellular stability in all scenarios of our EMT model. This new method will help the researchers in the field of cell differentiation and cell reprogramming to calculate cellular stability using Boolean model, and then rationally design their experimental protocols to manipulate the cell state transition

Neuropathic Pain after Spinal Surgery

Neuropathic pain after spinal surgery, the so-called failed back surgery syndrome (FBSS), is a frequently observed troublesome disease entity. Although medications may be effective to some degree, many patients continue experiencing intolerable pain and functional disability. Only gabapentin has been proven effective in patients with FBSS. No relevant studies regarding manipulation or physiotherapy for FBSS have been published. Spinal cord stimulation (SCS) has been widely investigated as a treatment option for chronic neuropathic pain, including FBSS. SCS was generally accepted to improve chronic back and leg pain, physical function, and sleep quality. Although the cost effectiveness of SCS has been proved in many studies, its routine application is limited considering that it is invasive and is associated with safety issues. Percutaneous epidural adhesiolysis has also shown good clinical outcomes; however, its effects persisted for only a short period. Because none of the current methods provide absolute superiority in terms of clinical outcomes, a multidisciplinary approach is required to manage this complex disease. Further studies concerning the etiology, diagnosis, treatment, and cost effectiveness of FBSS are warranted to deepen our understanding of this condition

An Updated Overview of Low Back Pain Management in Primary Care

Currently, guidelines for lower back pain (LBP) treatment are needed. We reviewed the current guidelines and high-quality articles to confirm the LBP guidelines for the Korean Society of Spine Surgery. We searched available databases for high-quality articles in English on LBP published from 2000 to the present year. Literature searches using these guidelines included studies from MEDLINE, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and Embase. We analyzed a total of 132 randomized clinical trials, 116 systematic reviews, 9 meta-analyses, and 4 clinical guideline reviews. We adopted the SIGN checklist for the assessment of article quality. Data were subsequently abstracted by a reviewer and verified. Many treatment options exist for LBP, with a variety of recommendation grades. We assessed the recommendation grade for general behavior, pharmacological therapy, psychological therapy, and specific exercises. This information should be helpful to physicians in the treatment of LBP patients

Comparative Study of Human Age Estimation with or without Preclassification of Gender and Facial Expression

Age estimation has many useful applications, such as age-based face classification, finding lost children, surveillance monitoring, and face recognition invariant to age progression. Among many factors affecting age estimation accuracy, gender and facial expression can have negative effects. In our research, the effects of gender and facial expression on age estimation using support vector regression (SVR) method are investigated. Our research is novel in the following four ways. First, the accuracies of age estimation using a single-level local binary pattern (LBP) and a multilevel LBP (MLBP) are compared, and MLBP shows better performance as an extractor of texture features globally. Second, we compare the accuracies of age estimation using global features extracted by MLBP, local features extracted by Gabor filtering, and the combination of the two methods. Results show that the third approach is the most accurate. Third, the accuracies of age estimation with and without preclassification of facial expression are compared and analyzed. Fourth, those with and without preclassification of gender are compared and analyzed. The experimental results show the effectiveness of gender preclassification in age estimation

Stress-induced Alterations in Mast Cell Numbers and Proteinase-activated Receptor-2 Expression of the Colon: Role of Corticotrophin-releasing Factor

This study was performed in order to assess whether acute stress can increase mast cell and enterochromaffin (EC) cell numbers, and proteinase-activated receptor-2 (PAR2) expression in the rat colon. In addition, we aimed to investigate the involvement of corticotrophin-releasing factor in these stress-related alterations. Eighteen adult rats were divided into 3 experimental groups: 1) a saline-pretreated non-stressed group, 2) a saline-pretreated stressed group, and 3) an astressin-pretreated stressed group. The numbers of mast cells, EC cells, and PAR2-positive cells were counted in 6 high power fields. In proximal colonic segments, mast cell numbers of stressed rats tended to be higher than those of non-stressed rats, and their PAR2-positive cell numbers were significantly higher than those of non-stressed rats. In distal colonic segments, mast cell numbers and PAR2-positive cell numbers of stressed rats were significantly higher than those of non-stressed rats. Mast cell and PAR2-positive cell numbers of astressin-pretreated stressed rats were significantly lower than those of saline-pretreated stressed rats. EC cell numbers did not differ among the three experimental groups. Acute stress in rats increases mast cell numbers and mucosal PAR2 expression in the colon. These stress-related alterations seem to be mediated by release of corticotrophin-releasing factor

Low Skeletal Muscle Mass and Clinical Outcomes in Chronic Obstructive Pulmonary Disease

Background In patients with chronic obstructive pulmonary disease (COPD), decreased muscle mass is a frequently encountered comorbidity in clinical practice. However, the evaluation of muscle mass in patients with COPD in real-world practice is rare. Methods We retrospectively reviewed the electronic medical records of all patients with COPD who underwent bioelectrical impedance analysis at least once between January 2011 and December 2021 in three hospitals. Then, we analyzed the performance rate of muscle mass measurement in the patients and the correlation between muscle mass, clinical parameters, and COPD prognosis. Results Among the 24,502 patients with COPD, only 270 (1.1%) underwent muscle mass measurements. The total skeletal muscle mass index was significantly correlated with albumin, alanine transaminase, and creatinine to cystatin C ratio in patients with COPD (r=0.1614, p=0.011; r=0.2112, p=0.001; and r=0.3671, p=0.001, respectively). Acute exacerbation of COPD (AE COPD) was significantly correlated with muscle mass, especially the truncal skeletal muscle mass index (TSMI) in males (r=–0.196, p=0.007). In the multivariate analysis, TSMI and cystatin C were significant risk factors for AE COPD (hazard ratio, 0.200 [95% confidence interval, CI, 0.048 to 0.838] and 4.990 [95% CI, 1.070 to 23.278], respectively). Conclusion Low muscle mass negatively affects the clinical outcomes in patients with COPD. Despite its clinical significance, muscle mass measurement is performed in a small proportion of patients with COPD. Therefore, protocols and guidelines for the screening of sarcopenia in patients with COPD should be established

Review: Evolution of Fractional Hot Deck Imputation for Curing Incomplete Data – From Small to Ultra Large Sizes

Machine learning (ML) advancements hinge upon data - the vital ingredient for training. Statistically-curing the missing data is called imputation, and there are many imputation theories and tools. Butthey often require difficult statistical and/or discipline-specific assumptions, lacking general tools capable of curing large data. Fractional hot deck imputation (FHDI) can cure data by filling nonresponses with observed values (thus, "hot-deck") without resorting to assumptions. The review paper summarizes how FHDI evolves to ultra data-oriented parallel version (UP-FHDI).Here, "ultra" data have concurrently large instances (big-n) and high dimensionality (big-p). The evolution is made possible with specialized parallelism and fast variance estimation technique. Validations with scientific and engineering data confirm that UP-FHDI can cure ultra data(p >10,000& n > 1M), and the cured data sets can improve the prediction accuracy of subsequent ML. The evolved FHDI will help promote reliable ML with "cured" big data.This proceeding is published as Cho, In Ho & Kim, Jae-Kwang & Yang, Yicheng & Kwon, Yonghyun & Chapagain, Ashish. (2023). Review: Evolution of Fractional Hot Deck Imputation for Curing Incomplete Data-From Small to Ultra Large Sizes. 191-204. doi: http://dx.doi.org/10.5121/csit.2023.131315. © 2023 AIRCC Publishing Corporation. This article is published under the Creative Commons Attribution (CC BY) license

Endovascular Treatment for Intracranial Aneurysms: A Nationwide Survey in Korea

Purpose In Korea, endovascular treatment (EVT) for intracranial aneurysms (IAs) has increased steadily. We conducted a nationwide survey to evaluate the current status of EVT for IAs and to identify treatment preference in the real world.Materials and Methods A Google online survey was distributed to representative clinicians at hospitals treating IAs, where members of Korean Society of Interventional Neuroradiology (KSIN). The data was collected from October 2017 to December 2017. The responding hospitals were divided into 2 groups (tertiary and non-tertiary hospitals). And variable factors involved in decision making for treatment were evaluated. Results In total, 73 hospitals (tertiary: 37, non-tertiary: 36) responded to the survey. Most hospitals that responded had over 100 cases of diagnostic angiography (93%) and over 50 cases of EVT for IAs (74%) performed in 2016. The proportion of EVT for ruptured aneurysms in non-tertiary hospitals was significantly higher than tertiary hospitals (49% vs. 9%). The proportion of EVT for unruptured aneurysms at non-tertiary hospitals was significantly higher than tertiary hospitals (66% vs. 44%). Most physicians tended to make decision for treatment on location, shape, and size of unruptured IAs and patients’ age, more than the results from previous clinical trials for unruptured IAs. Although EVT was preferred for older patients (age >70) with unruptured IAs (99%), surgical clipping was still considered as the first treatment of choice for younger patients (age 30 to 50 years) at considerable rates (56%). Over two-thirds of respondents preferred surgical clipping for middle cerebral artery aneurysms, while EVT was preferred initially at other locations. Conclusion This nationwide survey showed that EVT is considered as the first treatment modality for IAs and there is a discrepancy between current guidelines and real-world practice for decision making of treatment options