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    Assessment of death risk of breast cancer patients with joint frailty models
    (SAUDI MED J, 2020) Pasin, Özge; Dirican, Ahmet; Ankarali, Handan; Dişçi, Rian; Karanlık, Hasan
    Objectives: To investigate the effects of risk factors on recurrence and death in breast cancer patients, taking into account the dependence between recurrence and death as well as the heterogeneity among individuals. The other aim of this study was to make predictions of death risks with a dynamic model that includes patient's history and different horizons. Methods: The data of 465 patients who had undergone surgery at the Istanbul University Oncology Institute, Istanbul, Turkey, between 2009 and 2016 were used. For data analysis in this retrospective study, the authors applied the joint frailty model, and the predictions were obtained using dynamic prediction methods that consider the patient's history. The Brier score was used to evaluate the accuracy of the estimations. Results: A positive relationship was found between recurrence and death, and heterogeneity was found among patients (p<0.001, p=1.008, p=2.945). The effects of Cerb-B2, tumor type, remaining lymph nodes, neoadjuvant chemotherapy, and surgery type were statistically significant for death and recurrence (p<0.05, relative risk [death, recurrence] = [2.5, 11.86], [2.065, 2.798], [1.852, 3.113], [4.211, 9.366], [1.521,1.991]). The Brier score values used in the evaluation of the predictions obtained by the dynamic prediction methods were found to be below 0.30. Conclusion: The use of joint frailty models is recommended for the detection of heterogeneity effects and dependence between recurrence and death. Through models in survival analysis, researchers can obtain more accurate parameter estimates. A significant variance of frailty indicates different death risks for the same characteristics.
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    Therapeutic potential of stromal vascular fraction in enhancing wound healing: a preclinical study
    (Springer, 2024) Hekimoğlu, Emine Rümeysa; Eşrefoğlu, Mukaddes; Çimen, Fatma Bedia Karakaya; Pasin, Özge; Dedeakayoğulları, Huri
    BackgroundAdipose tissue provides an abundant source of stromal vascular fraction (SVF) cells for immediate administration. It can also give rise to many multipotent adipose-derived stromal cells. SVF is the population of cells obtained from mechanical or enzymatic digestion of lipoaspirate with no necessity for cell culture or expansion. Recently, the heterogeneous cell population found in the SVF gained wide-ranging translational significance in regenerative medicine.MethodsForty-eight male rats were randomly divided into two main groups, including the control and SVF groups. Each group was further divided into four groups as follows: 0th-, 3rd-, 7th-, and 10th-day groups. A skin excision of 1 x 1 cm covering the epidermis and dermis was performed on the back skin. Just after the wound was created, a subepidermal injection of SVF was applied. SVF was obtained from human adipose tissue using Lipocube SVFTM. On the 0th (1 h after the injections), 3rd, 7th, and 10th days, rats were killed, and skin excisions from the wound areas tissues were performed. Histopathological, biochemical, and western blotting analyses were performed on tissues.ResultsOur data showed that SVF obtained from a healthy woman improved wound healing in healthy rats. SVF has promoted wound healing mainly because of its antioxidant, antiapoptotic, and fibroblast/myofibroblast stimulating effects. SVF stimulated collagen production and contraction of the wound lips, supporting the closure.ConclusionsOur study provides additional data about the efficacy and pathophysiological and molecular mechanisms of the action of SVF on wound healing in healthy subjects. Our study is an experimental animal study.No Level AssignedThis journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.