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Nevin Manimala Statistics

Efficacy and safety of neoadjuvant combination immunotherapy in surgically resectable malignant solid tumors: a systematic review and meta-analysis

Expert Rev Anticancer Ther. 2024 Mar 4:1-13. doi: 10.1080/14737140.2024.2325404. Online ahead of print.

ABSTRACT

OBJECTIVES: Neoadjuvant immunotherapy has emerged as a prominent research focus recently. For potentially operable patients, neoadjuvant therapy serves as a primary method to reduce tumor load and facilitate surgical interventions.

METHODS: We retrieved articles from PubMed, Embase, Cochrane Library, American Society of Clinical Oncology, and European Society of Medical Oncology websites from inception to December 2023. Statistical analyses were performed using the R software. Primary outcomes assessed included major pathological response (MPR), pathological complete response (pCR), and treatment-related adverse events (trAEs).

RESULTS: 29 studies encompassing 1163 patients were included. The MPR rate of neoadjuvant combination immunotherapy was 38% (95% confidence interval [CI]: 25%-52%), and the pCR rate was 33% (95%CI: 25%-42%). These values were significantly higher than those obtained with single agent immunotherapy (p < 0.001). The pooled incidence of overall trAEs was 83% (95%CI: 73%-92%), and grade (G) 3-4 trAEs was 22% (95%CI: 15%-29%), both significantly higher than those observed with single agent immunotherapy (p < 0.05).

CONCLUSION: This study demonstrated the efficacy of neoadjuvant combination immunotherapy. Given that the majority of the included trials were phase II with small sample sizes, further multicenter phase III randomized controlled trials should be conducted to validate the findings of the review.

PMID:38436076 | DOI:10.1080/14737140.2024.2325404

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Non-invasive vascular measures as prognostic predictors for older patients with non-ST elevation acute coronary syndrome

Coron Artery Dis. 2024 Mar 4. doi: 10.1097/MCA.0000000000001352. Online ahead of print.

ABSTRACT

BACKGROUND: Adverse cardiac events are common in older patients with non-ST elevation acute coronary syndrome (NSTEACS), yet prognostic predictors are still lacking. This study investigated the long-term prognostic significance of non-invasive measures including endothelial function, carotid intima-media thickness (CIMT), and vascular stiffness in older NSTEACS patients referred for invasive treatment.

METHODS: NSTEACS patients aged 75 years and older recruited to a multicentre cohort study (NCT01933581) were assessed for baseline endothelial function using endoPAT logarithm of reactive hyperemia index (LnRHI), CIMT using B-mode ultrasound, and vascular stiffness using carotid-femoral pulse wave velocity (cfPWV). Long-term outcomes included major adverse cardiovascular events (MACE), a composite of death, reinfarction, urgent revascularization, stroke/transient ischemic attack, and significant bleeding.

RESULTS: Recruitment resulted in 214 patients assessed for LnRHI, 190 patients assessed for CIMT and 245 patients assessed for cfPWV. For LnRHI group (median follow-up 4.73 years [IQR: 1.41-5.00]), Cox regression analysis revealed a trend towards increased risk of MACE (HR: 1.24 [95% CI: 0.80-1.93]; P = 0.328) and mortality (HR: 1.49 [95% CI: 0.86-2.59]; P = 0.157), but no significance was reached. No difference for other components of MACE was found. For CIMT group (median follow up 4.74 years [IQR: 1.55-5.00]), no statistically significant difference in MACE was found (HR: 0.92 [95% CI: 0.53-1.59]; P = 0.754). Similarly, for cfPWV group (median follow-up 4.96 years [IQR: 1.55-5.00]), results did not support prognostic significance (for MACE, HR: 0.95 [95% CI: 0.65-1.39]; P = 0.794).

CONCLUSION: Endothelial function, CIMT and vascular stiffness were proven unsuitable as strong prognostic predictors in older patients with NSTEACS.

CLINICAL TRIAL REGISTRATION: NCT01933581.

PMID:38436050 | DOI:10.1097/MCA.0000000000001352

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Sex Differences in Quadriceps Atrophy After Anterior Cruciate Ligament Tear

Sports Health. 2024 Mar 4:19417381241230612. doi: 10.1177/19417381241230612. Online ahead of print.

ABSTRACT

BACKGROUND: Female athletes lag behind their male counterparts in recovery from anterior cruciate ligament (ACL) injury. Quadriceps muscle size and strength are crucial factors for regaining function after ACL injury, but little is known about how these metrics vary due to biological sex.

HYPOTHESIS: Female patients have reduced vastus lateralis fiber cross-sectional area (CSA) and lower quadriceps strength after ACL injury than male patients.

STUDY DESIGN: Cross-sectional study.

LEVEL OF EVIDENCE: Level 4.

METHODS: A total of 60 participants with recent ACL tear were evaluated for vastus lateralis muscle fiber CSA, isometric quadriceps peak torque, and quadriceps rate of torque development. Linear mixed models were fit to determine differences across sex and limb for each variable of interest.

RESULTS: The female group averaged almost 20% atrophy between limbs (P < 0.01), while the male group averaged just under 4% (P = 0.05). Strength deficits between limbs were comparable between female and male groups.

CONCLUSION: Immediately after ACL injury, female patients have greater between-limb differences in muscle fiber CSA but between-limb strength deficits comparable with those of male patients.

CLINICAL RELEVANCE: These results indicate that the underpinnings of strength loss differ based on biological sex, and thus individual patients could benefit from a sex-specific treatment approach to ACL injury.

PMID:38436049 | DOI:10.1177/19417381241230612

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The toxicity assessment of phosmet on development, reproduction, and gene expression in Daphnia magna

PeerJ. 2024 Feb 28;12:e17034. doi: 10.7717/peerj.17034. eCollection 2024.

ABSTRACT

The use of pesticides to control pests, weeds, and diseases or to regulate plant growth is indispensable in agricultural production. However, the excessive use of these chemicals has led to significant concern about their potential negative impacts on health and the environment. Phosmet is one such pesticide that is commonly used on plants and animals against cold moth, aphids, mites, suckers, and fruit flies. Here, we investigated the effects of phosmet on a model organism, Daphnia magna using acute and chronic toxicity endpoints such as lethality, mobility, genotoxicity, reproduction, and gene expression. We performed survival experiments in six-well plates at seven different concentrations (0.01, 0.1, 1, 10, 25, 50, 100 μM) as well as the control in three replicates. We observed statistically significant mortality rates at 25 µM and above upon 24 h of exposure, and at 1 µM and above following 48 h of exposure. Genotoxicity analysis, reproduction assay and qPCR analysis were carried out at concentrations of 0.01 and 0.1 μM phosmet as these concentrations did not show any lethality. Comet assay showed that exposure to phosmet resulted in significant DNA damage in the cells. Interestingly, 0.1 μM phosmet produced more offspring per adult compared to the control group indicating a hormetic response. Gene expression profiles demonstrated several genes involved in different physiological pathways, including oxidative stress, detoxification, immune system, hypoxia and iron homeostasis. Taken together, our results indicate that phosmet has negative effects on Daphnia magna in a dose- and time-dependent manner and could also induce lethal and physiological toxicities to other aquatic organisms.

PMID:38436013 | PMC:PMC10908259 | DOI:10.7717/peerj.17034

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Estimation of the percentile of Birnbaum-Saunders distribution and its application to PM2.5 in Northern Thailand

PeerJ. 2024 Feb 29;12:e17019. doi: 10.7717/peerj.17019. eCollection 2024.

ABSTRACT

The Birnbaum-Saunders distribution plays a crucial role in statistical analysis, serving as a model for failure time distribution in engineering and the distribution of particulate matter 2.5 (PM2.5) in environmental sciences. When assessing the health risks linked to PM2.5, it is crucial to give significant weight to percentile values, particularly focusing on lower percentiles, as they offer a more precise depiction of exposure levels and potential health hazards for the population. Mean and variance metrics may not fully encapsulate the comprehensive spectrum of risks connected to PM2.5 exposure. Various approaches, including the generalized confidence interval (GCI) approach, the bootstrap approach, the Bayesian approach, and the highest posterior density (HPD) approach, were employed to establish confidence intervals for the percentile of the Birnbaum-Saunders distribution. To assess the performance of these intervals, Monte Carlo simulations were conducted, evaluating them based on coverage probability and average length. The results demonstrate that the GCI approach is a favorable choice for estimating percentile confidence intervals. In conclusion, this article presents the results of the simulation study and showcases the practical application of these findings in the field of environmental sciences.

PMID:38436012 | PMC:PMC10909348 | DOI:10.7717/peerj.17019

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Regional trends in the moderate-to-vigorous intensity physical activity and screen time of Canadians before and during the COVID-19 pandemic

PeerJ. 2024 Feb 29;12:e16913. doi: 10.7717/peerj.16913. eCollection 2024.

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, public health approaches and disease-transmission varied widely across Canadian regions. This may have led to different trajectories for moderate-to-vigorous intensity physical activity (MVPA) and screen time during this period. The purpose of this investigation was to describe age- and gender-specific regional trends in MVPA and screen time for Canadian youth (ages 12-17 years) and adults (ages 18+) from 2018 to 2021.

METHODS: Data was collected using the Canadian Community Health Survey, which includes representative data for 5 distinct regions: Atlantic Canada, Québec, Ontario, the Prairie Provinces, and British Columbia (BC). Participants aged 12+ in each region self-reported their total daily screen time, as well as MVPA in 5 domains: overall, recreational, school, occupational/household and active transportation. Results were compared for 2018 (pre-pandemic), January-March of 2020, September-December of 2020, and 2021 using repeated measures t-tests.

RESULTS: Among youth, all regions except for Atlantic Canada and BC experienced significant reductions in the proportion of youth meeting MVPA recommendations in the fall of 2020 (all p < 0.001), although these had returned to baseline for all regions except Ontario by 2021. Trends varied across regions among adults aged 18-64 years. In Québec, there was 7-percentage point reduction in the proportion of males meeting the MVPA recommendations in the fall of 2020 compared to 2018, while there was a 4-percentage point increase among females in 2021 (all p < 0.05). In Ontario and the Prairie provinces, males saw a 4-percentage point decrease in activity recommendation adherence in 2021, when compared to 2018 (p < 005). There were no other significant differences for any region when comparing the fall of 2020 or 2021 with 2018 (all p > 0.05). Among adults aged 65+ years, significant increases in MVPA were observed in Atlantic Canada and the Prairies in the fall of 2020, and in Atlantic Canada, Québec and the Prairies in 2021 (all p < 0.05). With limited exceptions, self-reported screen time increased significantly across regions and age groups for both males and females (all p < 0.05).

CONCLUSIONS: MVPA levels of Canadians during the COVID-19 pandemic varied both by region and age group. Self-reported MVPA of Canadian youth dropped in most regions in the fall of 2020, before returning to pre-pandemic levels in 2021. Activity levels of Canadians aged 18-64 years were relatively stable during the pandemic and increased for Canadians aged 65+ in most regions. Differences in trajectories across genders observed at the national level were often less apparent in individual regions. Recreational screen use increased across all regions, ages and genders with very few exceptions. These results highlight the differences and similarities in activity and screen time trajectories across the Canadian population and suggest the need for additional research to identify best practices for promoting healthy movement behaviours during future pandemics.

PMID:38436001 | PMC:PMC10909361 | DOI:10.7717/peerj.16913

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Proportions and characteristics of interval cancer in annual fecal immunochemical test screening and postcolonoscopy colorectal cancer: Results from a Japanese multicenter prospective study using questionnaires, the C-DETECT study

Dig Endosc. 2024 Mar 3. doi: 10.1111/den.14772. Online ahead of print.

ABSTRACT

OBJECTIVES: There are several types of colorectal cancer (CRC) according to the detection methods and intervals, including interval CRC (iCRC) and postcolonoscopy CRC (PCCRC). We aimed to examine their proportions and characteristics.

METHODS: We conducted a multicenter prospective study using questionnaires in Japan (“C-DETECT study”), in which differences in CRC characteristics according to detection methods and intervals were examined from consecutive adult patients. Because the annual fecal immunochemical test (FIT) was used in population-based screening, the annual FIT-iCRC was assessed.

RESULTS: In total, 1241 CRC patients (1064 with invasive CRC) were included. Annual FIT-iCRC (a), 3-year PCCRC (b), and CRC detected within 1 year after a positive FIT with noncompliance to colonoscopy (c) accounted for 4.5%, 7.0%, and 3.9% of all CRCs, respectively, and for 3.9%, 5.4%, and 4.3% of invasive CRCs, respectively. The comparison among these (a, b, c) and other CRCs (d) demonstrated differences in the proportions of ≥T2 invasion ([a] 58.9%, [b] 44.8%, [c] 87.5%, [d] 73.0%), metastasis ([a] 33.9%, [b] 21.8%, [c] 54.2%, [d] 43.9%), right-sided CRC ([a] 42.9%, [b] 40.2%, [c] 18.8%, [d] 28.6%), and female sex ([a] 53.6%, [b] 49.4%, [c] 27.1%, [d] 41.6%). In metastatic CRC, (a) and (b) showed a higher proportions of BRAF mutations ([a] [b] 12.0%, [c] [d] 3.1%).

CONCLUSIONS: Annual FIT-iCRC and 3-year PCCRC existed in nonnegligible proportions. They were characterized by higher proportions of right-sided tumors, female sex, and BRAF mutations. These findings suggest that annual FIT-iCRC and 3-year PCCRC may have biological features different from those of other CRCs.

PMID:38433322 | DOI:10.1111/den.14772

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Accuracy of maxillary full-arch digital impressions of tooth and implant models made by two intraoral scanners

Clin Exp Dent Res. 2024 Apr;10(2):e857. doi: 10.1002/cre2.857.

ABSTRACT

OBJECTIVES: Limited studies are available on the accuracy of intraoral scanners (IOSs) for full-arch implant and tooth models. This study aimed to assess the accuracy of maxillary full-arch digital impressions of tooth and implant models made by two IOSs.

MATERIALS AND METHODS: This in vitro, experimental study was conducted on two maxillary dentiform models: one with six prepared natural teeth and the other with six implants at the site of canine, first premolar, and first molar teeth, bilaterally. A highly accurate industrial scanner was used for actual measurements on the models that served as the reference scan. TS (Trios3) and CO (CEREC Omnicam) IOSs were then used to scan each model 10 times according to the manufacturer’s instructions. All scans were saved in STL format. The GOM Inspect software was used according to the best-fit algorithm to compare the accuracy of measurements in the groups with the reference scan. The trueness and precision were calculated. Statistical analyses were carried out using SPSS by one-way analysis of variance and t-test (α = .05).

RESULTS: TS showed a significantly higher trueness than CO for both tooth and implant models (p < .05). TS also revealed significantly higher precision than CO for the tooth model; however, the difference in precision for the implant model was not significant between the two IOSs (p > .05).

CONCLUSIONS: TS showed higher accuracy than CO in both tooth and implant models.

PMID:38433306 | DOI:10.1002/cre2.857

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Evaluation of the modified 3Mix-Simvastatin combination in non-instrumental endodontic therapy of necrotic primary molars: A two-arm randomized controlled trial

Clin Exp Dent Res. 2024 Apr;10(2):e860. doi: 10.1002/cre2.860.

ABSTRACT

OBJECTIVE: This study aimed to assess the clinical and radiographic outcomes of non-instrumentation endodontic treatment (NIET) using a modified antibiotic mix of cefixime, ciprofloxacin and metronidazole with simvastatin (an anti-inflammatory, bone regeneration drug) on necrotic primary molars compared to conventional pulpectomy to help preservation of necrotic primary teeth until its natural exfoliation.

MATERIALS AND METHODS: Forty mandibular primary second molars with necrotic pulp tissue from 38 healthy patients aged between 4 and 8 years were randomly assigned to two groups with a 1:1 allocation ratio. Group A teeth underwent conventional root canal treatment. The procedure involved a two-visit approach, employing k-files and h-files during the initial visit, followed by the application of calcium hydroxide paste as canal dressing between visits, while Group B teeth were treated with 3Mixtatin. All teeth were clinically evaluated after 1, 3, 6, and 12 months, and radiographically at 3, 6, and 12 months. Two external examiners assessed the results. Data analysis was conducted using a chi-square test at a 0.05 significance level.

RESULTS: At the end of the follow-up interval, 90% of teeth in each group exhibited no clinical signs or symptoms. Additionally, inter-radicular radiolucency healing occurred in 75% of cases in the NIET group and 89.5% in the conventional pulpectomy group. However, no statistically significant difference was found between the two groups.

CONCLUSION: NIET using 3Mixtatin seems to be a good alternative choice to conventional pulpectomy, offering a less complex treatment approach that may help avoid the complications associated with traditional pulpectomy and could be suitable for teeth with shorter roots.

PMID:38433296 | DOI:10.1002/cre2.860

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Behaviors, hygiene habits, and sources of care among removable complete and partial dentures wearers: A multicenter cross-sectional study

Clin Exp Dent Res. 2024 Apr;10(2):e867. doi: 10.1002/cre2.867.

ABSTRACT

OBJECTIVES: There is a lack of data regarding the hygiene practices and sources of care among individuals in Yemen who wear removable complete and partial dentures. The purpose of this study was to explore the behaviors, hygiene habits, and sources of care information among patients who utilize complete and partial dentures in Yemen.

MATERIALS AND METHODS: A descriptive cross-sectional research design was utilized, and a sample of 217 consecutive participants who wore removable complete and/or partial dentures were enlisted. A questionnaire was employed to collect data on demographic information, educational attainment, denture habits, denture cleaning practices, and encountered difficulties. Statistical analysis was conducted using SPSS software, and significance was determined using chi-square tests, with a significance level of .05.

RESULTS: The data analysis revealed that a majority of the participants were male (72.4%) and had an average age of 65.14 years. Fifty-three percent of the participants wore partial dentures, while 34.6% wore complete dentures. Only 6.5% of the participants wore both complete and partial dentures, and 6% wore overdentures. The majority of participants (88.47%) had dentures made of acrylic material. Additionally, 43% of participants wore dentures while sleeping, and 61.3% stored their dentures in dry places without a water-filled container when not in use. The most commonly reported cleaning methods were water only (24.4%), followed by water and soap (19.4%). Furthermore, a large portion of the participants (59.4%) received denture care information from dentists. However, the majority (59%) did not visit a dentist for regular denture maintenance or any denture-related issues. The data analysis did not reveal any significant association between age or education level and denture cleaning methods.

CONCLUSION: This cross-sectional survey provides insight into the hygiene knowledge and practices of removable denture wearers in Yemen. The findings underscore the necessity for enhanced oral hygiene education and awareness within this population. The study offers valuable insights for oral health professionals to design targeted interventions and educational initiatives aimed at promoting proper denture care and maintenance. These efforts have the potential to enhance the oral health and overall well-being of removable denture wearers.

PMID:38433293 | DOI:10.1002/cre2.867