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Nevin Manimala Statistics

Differential diagnosis between acinic cell carcinoma and pleomorphic adenoma using the quantitative parameters of contrast-enhanced ultrasound

Eur Rev Med Pharmacol Sci. 2021 Feb;25(4):1936-1943. doi: 10.26355/eurrev_202102_25093.

ABSTRACT

OBJECTIVE: To investigate the value of differential diagnosis between acinic cell carcinoma (ACC) and pleomorphic adenoma (PA) using the quantitative parameters of contrast-enhanced ultrasound (CEUS).

PATIENTS AND METHODS: Twenty-two ACC and 98 PA were retrospectively analyzed. These patients had been examined via routine pre-surgical two-dimensional ultrasound and CEUS. The examination results were confirmed by biopsy pathology. Qontrast 4.0 imaging analysis software was applied to obtain the maximum intensity (PEAK), time to peak (TTP), regional blood volume (RBV), regional blood flow (RBF), maximum signal intensity (SImax) and mean signal intensity (SImean) through quantitative analysis. The differences between ACC and PA were compared regarding the conventional ultrasound images and the quantitative parameters of CEUS. ROC curves were drawn to evaluate the diagnostic value of these parameters.

RESULTS: There were no statistically significant differences between salivary gland ACC and PA in the manifestations of conventional two-dimensional ultrasound examination regarding morphology, internal echo and the boundary (p > 0.05). However, there were significant differences in PEAK, RBV, RBF, SImax and SImean between ACC and PA (p < 0.05). Additionally, the five quantitative parameters of CEUS were all highly accurate diagnostic indicators. The maximum area under the curve of each parameter was 0.888, sensitivity 72.6%, specificity 90.9% and accuracy 81.8%.

CONCLUSIONS: The quantitative parameters of CEUS are helpful for differentially diagnosing salivary ACC and PA.

PMID:33660803 | DOI:10.26355/eurrev_202102_25093

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Nevin Manimala Statistics

Restricted mean survival time in advanced non-small cell lung cancer treated with immune checkpoint inhibitors

Eur Rev Med Pharmacol Sci. 2021 Feb;25(4):1881-1889. doi: 10.26355/eurrev_202102_25083.

ABSTRACT

OBJECTIVE: The purpose of this study was to review the effectiveness of immune checkpoint inhibitors (ICIs) in the first-line treatment of advanced non-small cell lung carcinoma with wild-type epidermal grow factor receptor (EGFR) or anaplastic lymphoma kinase.

MATERIALS AND METHODS: After a standard literature search, we identified all randomized studies published on this issue. Our first inclusion criterion was the use of pembrolizumab, nivolumab, atezolizumab or durvalumab in the treatment arm versus chemotherapy in the control arm. The second criterion was the availability of information on overall survival at 2 years. The restricted mean survival time (RMST) was used to analyze the survival curves and rank the treatments.

RESULTS: From the eligible studies, we selected 5 randomized trials that met our inclusion criteria. These trials studied a total of 11 cohorts of patients in whom the treatment arm received ICI as monotherapy (n=3) or in combination with either chemotherapy (n=2) or other monoclonal antibodies (n=1). All the control groups (n=5) received chemotherapy. Pembrolizumab (alone or in combination) showed improvement in overall survival compared with controls, but with borderline statistical significance. Nivolumab, atezolizumab and durvalumab failed to demonstrate any survival advantage. Overall, the RMSTs provided more conservative results than those previously reported using the hazard ratio. In comparing the values of RMST across treatments, pembrolizumab combined with chemotherapy ranked first.

CONCLUSIONS: Our results summarized the efficacy of these treatments and showed that only pembrolizumab can have a role as the first-line treatment of NSCLC. These findings are at variance with those previously reported using the hazard ratio as the outcome measure.

PMID:33660798 | DOI:10.26355/eurrev_202102_25083

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Nevin Manimala Statistics

iLearnPlus: a comprehensive and automated machine-learning platform for nucleic acid and protein sequence analysis, prediction and visualization

Nucleic Acids Res. 2021 Feb 28:gkab122. doi: 10.1093/nar/gkab122. Online ahead of print.

ABSTRACT

Sequence-based analysis and prediction are fundamental bioinformatic tasks that facilitate understanding of the sequence(-structure)-function paradigm for DNAs, RNAs and proteins. Rapid accumulation of sequences requires equally pervasive development of new predictive models, which depends on the availability of effective tools that support these efforts. We introduce iLearnPlus, the first machine-learning platform with graphical- and web-based interfaces for the construction of machine-learning pipelines for analysis and predictions using nucleic acid and protein sequences. iLearnPlus provides a comprehensive set of algorithms and automates sequence-based feature extraction and analysis, construction and deployment of models, assessment of predictive performance, statistical analysis, and data visualization; all without programming. iLearnPlus includes a wide range of feature sets which encode information from the input sequences and over twenty machine-learning algorithms that cover several deep-learning approaches, outnumbering the current solutions by a wide margin. Our solution caters to experienced bioinformaticians, given the broad range of options, and biologists with no programming background, given the point-and-click interface and easy-to-follow design process. We showcase iLearnPlus with two case studies concerning prediction of long noncoding RNAs (lncRNAs) from RNA transcripts and prediction of crotonylation sites in protein chains. iLearnPlus is an open-source platform available at https://github.com/Superzchen/iLearnPlus/ with the webserver at http://ilearnplus.erc.monash.edu/.

PMID:33660783 | DOI:10.1093/nar/gkab122

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Nevin Manimala Statistics

Addressing the uncertainty of DFT-determined hydrogenation mechanisms over coinage metal surfaces

Faraday Discuss. 2021 Mar 4. doi: 10.1039/c9fd00122k. Online ahead of print.

ABSTRACT

Density functional theory (DFT) has been considered as a powerful tool for the identification of reaction mechanisms. However, it is still unclear whether the error of DFT calculations would lead to mis-identification of mechanisms. Here, taking the hydrogenation of acetylene and 1,3-butadiene as model reactions and employing a well-trained Bayesian error estimation functional with van der Waals correlation (BEEF-vdW), we try to estimate the error of DFT calculation results statistically, and therefore predict the reliability of the hydrogenation mechanisms identified. With an ensemble of 2000 functionals obtained around the BEEF-vdW functional as well as a descriptor developed to represent the possibility of different mechanisms, we found that the non-Horiuti-Polanyi mechanism is preferred on Ag(211) and Au(211), while the Horiuti-Polanyi mechanism is dominant on Cu(211). We further discovered that the descriptor is linearly correlated with the adsorption energies of reaction intermediates during acetylene and butadiene hydrogenation, and the hydrogenation of strongly adsorbed species are more likely to follow the Horiuti-Polanyi mechanism. We found the probability of following the non-HP mechanism obeys the order Cu(211) < Au(211) < Ag(211). Our work gives a more comprehensive explanation for the mechanisms of coinage metal catalyzed hydrogenation reactions, and also provides more theoretical insights into the development of new high-performance catalysts for selective hydrogenation reactions.

PMID:33660703 | DOI:10.1039/c9fd00122k

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Coagulations Studies Do Not Correlate With Each Other or With Hematologic Complications During Pediatric Extracorporeal Membrane Oxygenation

Pediatr Crit Care Med. 2021 Mar 5. doi: 10.1097/PCC.0000000000002698. Online ahead of print.

ABSTRACT

OBJECTIVES: Anticoagulation plays a key role in the management of children supported with extracorporeal membrane oxygenation. However, the ideal strategy for monitoring anticoagulation remains unclear. Our objective was to evaluate the utility of laboratory measures of anticoagulation in pediatric extracorporeal membrane oxygenation.

DESIGN: Retrospective cohort study.

SETTING: Quaternary care academic children’s hospital.

PATIENTS: Children in a noncardiac PICU cannulated to extracorporeal membrane oxygenation in 2010-2016.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: Demographic data, laboratory values, and heparin doses were extracted from the enterprise data warehouse. Primary diagnoses, indications for cannulation, hemorrhagic and thrombotic complications, and survival outcomes were abstracted from the local registry used for Extracorporeal Life Support Organization reporting. Statistical models accounting for repeated measures using generalized estimating equations were constructed to evaluate correlations between heparin doses and laboratory values; among laboratory values; and between heparin dose or laboratory values and clinical outcomes. One hundred thirty-three unique patients-78 neonates and 55 older patients-were included in the study. There was no significant association between antifactor Xa level, activated partial thromboplastin time, activated clotting time, or heparin dose with hemorrhage or thrombosis (odds ratio ≅ 1 for all associations). There was weak-to-moderate correlation between antifactor Xa, activated partial thromboplastin time, and activated clotting time in both neonates and older pediatric patients (R2 < 0.001 to 0.456). Heparin dose correlated poorly with laboratory measurements in both age groups (R2 = 0.010-0.063).

CONCLUSIONS: In children supported with extracorporeal membrane oxygenation, heparin dose correlates poorly with common laboratory measures of anticoagulation, and these laboratory measures correlate poorly with each other. Neither heparin dose nor laboratory measures correlate with hemorrhage or thrombosis. Further work is needed to identify better measures of anticoagulation in order to minimize morbidity and mortality associated with extracorporeal membrane oxygenation.

PMID:33660700 | DOI:10.1097/PCC.0000000000002698

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Analysis of the F-18 FDG PET/CT features of pulmonary sclerosing pneumocytoma

Nucl Med Commun. 2021 Mar 1. doi: 10.1097/MNM.0000000000001374. Online ahead of print.

ABSTRACT

PURPOSE: This retrospective study aimed to analyzed the F-18 fluorodeoxyglucose PET/computed tomography (F-18 FDG PET/CT) features of pulmonary sclerosing pneumocytoma (PSP) to improve the understanding and preoperative diagnostic efficacy of this rare disorder.

METHODS: FDG PET/CT images from 11 patients with 22 lesions (including one patient with 12 lesions) proven PSP in our hospital were reviewed. We summarized the PET/CT features of PSP and analyzed the correlation between FDG uptake and tumor size.

RESULTS: PET/CT imaging revealed all tumors located in each lobe of the two lungs randomly. All 22 tumors were round or oval nodules; 15 had smooth margins, six were lobulated, six were calcified, and one had a ground-glass halo sign. The mean diameter of these tumors was 19.2 ± 7.8 mm (range: 8-34 mm); the mean maximum standardized uptake value (SUVmax) was 2.8 ± 1.3 (range: 1.1-7.4). Sixteen of the lesions exhibited mild to moderate FDG uptake (mean SUVmax 2.3 ± 0.6), and six of the lesions exhibited intense FDG uptake (mean SUVmax 4.3 ± 1.6). A positive correlation was observed between FDG uptake and tumor size (P <0.05).

CONCLUSION: Single round or ovoid soft-tissue lesions with smooth margins, and mild to moderate FDG uptake on PET/CT images in middle-aged females, suggest a possible diagnosis of PSP. For some atypical cases with intense FDG uptake, a diagnosis of PSP also can be considered. A statistically significant positive correlation was found between SUVmax and PSP lesion size in our study.

PMID:33660695 | DOI:10.1097/MNM.0000000000001374

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18F-choline PET-computed tomography for the prediction of early treatment responses to transarterial radioembolization in patients with hepatocellular carcinoma

Nucl Med Commun. 2021 Mar 1. doi: 10.1097/MNM.0000000000001383. Online ahead of print.

ABSTRACT

BACKGROUND: Transarterial radioembolization (TARE) is widely used for the treatment of hepatocellular carcinoma (HCC), but early treatment response can be very difficult to assess. The aim was to evaluate 18F-fluorocholine PET/computed tomography (CT) to assess the treatment response in patients with intermediate or locally advanced HCC.

METHODS: Between March 2019 and July 2020, nine HCC patients treated with TARE, who underwent PET/CT at baseline and 1 month after treatment, were enrolled. The maximum, mean (SUVmean), and peak (SUVpeak) standardized uptake value (SUV), SUV normalized by lean body mass (SUL), and total lesion glycolysis (TLG) were measured. Statistical analysis used the Mann-Whitney test to evaluate the differences in parameters between responders (partial and complete response) and nonresponders (stable or progressive disease) at the 6-month follow-up, according to the modified Response Evaluation Criteria in Solid Tumors.

RESULTS: Three patients were nonresponders (progressive disease and stable disease) and six were responders. Delta SUVmean, delta SUL, and delta TLG could predict an early response (P = 0.02, P = 0.04, and P = 0.02, respectively). None of the pre-therapeutic parameters were correlated with the response. Post-therapeutic SUL, SUVmean, TLG, and SUVpeak were also predictive of the response.

CONCLUSIONS: Our preliminary results showed that changes in certain metabolic parameters (from baseline PET to 1-month PET) are predictive of the response to TARE in HCC (Delta SUVmean, delta TLG, and delta SUL). The absence of post-treatment inflammation could lead to a better prediction than MRI evaluation. This study suggests that 1-month 18F-choline PET/CT could modify the clinical management predicting responders.

PMID:33660694 | DOI:10.1097/MNM.0000000000001383

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The Association Between Admission Anemia and Poststroke Depression

J Nerv Ment Dis. 2021 Mar 2. doi: 10.1097/NMD.0000000000001314. Online ahead of print.

ABSTRACT

Poststroke depression (PSD) is the most frequent and important neuropsychiatric problem afflicting these patients. Anemia is common in many of these individuals presenting with acute stroke. This study determined whether there is a relationship between anemia on hospital admission and PSD. Two hundred eighty-four acute stroke patients were included in the study. Among them, there were 88 PSD patients, whereas another 196 were non-PSD patients. Clinical depression symptoms were diagnosed according to DSM-4 (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) criteria and a HAMD-17 (the 17-item Hamilton Depression Scale) score ≥8 at 1 month after stroke. In the PSD patients, 27.3% of them presented with anemia, whereas only 12.8% of the non-PSD patients had this condition. There was a negative correlation between hemoglobin level and HAMD-17 score in all patients. A binary logistic regression analysis revealed that anemia was independently associated with PSD after adjustment for sex, National Institutes of Health Stroke Scale scores, mRS (modified Rankin Scale) scores, BI (Barthel Index) scores, RBC (red blood cell), and hematocrit. In conclusion, anemia at admission is associated with PSD seen in these patients 1 month later. Therefore, anemia is a possible predictor of PSD.

PMID:33660687 | DOI:10.1097/NMD.0000000000001314

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Evaluation of a Novel Ostomy Barrier Ring with Assisted Flow for Individuals with an Ileostomy

Adv Skin Wound Care. 2021 Mar 2. doi: 10.1097/01.ASW.0000734368.48756.20. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the performance and user experience of a novel ostomy barrier ring over a 4-week period.

METHODS: This single-arm investigation conducted across three clinical sites included 25 adult participants with an ileostomy for 3 months or longer. The participants used their standard ostomy pouching appliance along with a novel barrier ring for a period of 4 weeks. Skin condition was assessed using the Ostomy Skin Tool. Change in skin condition over the study period was recorded for each participant. The participants’ experience in using the novel barrier ring was measured using a five-point Likert-type scale.

RESULTS: Twenty of the 25 participants (80%) completed the trial. Of those participants, the median Ostomy Skin Tool score at both the beginning (range, 0-8) and end was 0 (range, 0-6). In terms of skin condition, 7 participants experienced an improvement in skin condition, 11 experienced no change, and 2 got worse. A median score of 5 out of 5 was recorded for all questions relating to user experience.

CONCLUSIONS: Although not statistically significant, there was a clear trend toward improvements in peristomal skin condition using the novel barrier ring, even for participants who were already using a barrier ring. User feedback was positive with respect to comfort, device handling, and the perception of the device’s ability to protect the skin. Further, most participants who already used a barrier ring indicated that the novel barrier ring would result in a longer wear time.

PMID:33660660 | DOI:10.1097/01.ASW.0000734368.48756.20

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Epidemiological characteristics of malaria in Henan Province from 1950 to 2019

Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2020 Nov 20;33(1):62-65. doi: 10.16250/j.32.1374.2020150.

ABSTRACT

OBJECTIVE: To analyze the epidemiological characteristics of malaria in Henan Province from 1950 to 2019, so as to provide the scientific evidence for consolidating malaria elimination achievements in the province.

METHODS: The epidemiological situation of malaria and demographic data in Henan Province from 1950 to 2019 were collected, and the statistical analyses were performed using a descriptive epidemiological method. The spatial temporal distribution of malaria cases was identified using the software ArcGIS version 10.3.

RESULTS: During the period from 1950 through 2019, the progress of malaria elimination was divided into 4 stages in Henan Province, including the baseline-survey and key-control stage, morbidity-control and incidence-reduction stage, basic-eradication and achievement-consolidation stage and elimination stage. The spatial distribution of malaria cases shifted from south of the Huai River and the plain regions between the Yellow River and Taihang Mountain to the Huang-Huai-Hai Plain and Nanyang Basin, then was concentrated in eastern part of southern Huai River where Anopheles anthropophagus was distributed, and finally was gradually under control following malaria outbreak in Eastern Henan Plain. In addition, the species of Plasmodium changed from P. vivax, P. falciparum and P. malariae co-endemics to a single P. vivax infection, and the current co-endemics of 5 invasive malaria parasites, and the malaria vectors shifted from co-existence of Anopheles sinensis and An. anthropophagus to An. sinensis alone.

CONCLUSIONS: There has been a large change in the epidemiological characteristics of malaria in Henan Province from 1950 to 2019. Although malaria has been eliminated in Henan Province, the consolidation of the malaria elimination achievements remain a great challenge due to overseas imported malaria.

PMID:33660476 | DOI:10.16250/j.32.1374.2020150