Category: Statistics

Clin Exp Med. 2024 Aug 24;24(1):197. doi: 10.1007/s10238-024-01467-0.

ABSTRACT

The Sysmex XN series haematopoietic progenitor cell (XN-HPC) is a novel tool for assessing stem cell yield before allogeneic haematopoietic stem cell transplantation. This study aimed to establish a reference interval (RI) for XN-HPC in peripheral blood allogeneic transplant donors following granulocyte colony-stimulating factor (G-CSF) stimulation and determine its clinical significance. All specimens were analysed using Sysmex XN-20. Samples were collected and analysed using non-parametric percentile methods to define the RIs. Quantile regression was used to explore the dependency of the RIs on sex and age. Samples were included in clinical decision limits for apheresis based on receiver operating characteristic curve analysis. The non-parametrically estimated RI for XN-HPC was 623.50 (90% confidence interval [CI90%] 510.00-657.00) to 4,144.28 (CI90% 3,761.00-4,547.00). The RIs for the XN-HPC were not age-dependent but were sex-dependent. The RI for males was 648.40 (CI90% 582.00-709.00)-4,502.60 (CI90% 4,046.00-5,219.00) and for females was 490.90 (CI90% 311.00-652.00)-3,096.90 (CI90% 2,749.00-3,782.00). Comparisons based on XN-HPC values between the poor and less-than-optimal groups, good and less-than-optimal groups, and good and non-good groups had areas under the curve of 0.794 (P < 0.001), 0.768 (P < 0.001), and 0.806 (P < 0.001), respectively, indicating a good predictive value for mobilisation effectiveness. XN-HPC data exceeding 3974 × 10⁶/L suggested that a sufficient number of stem cells could be collected clinically. Values > 5318 < 10⁶/L indicated 100% mobilisation effectiveness. We established an RI for XN-HPC in peripheral blood allogeneic transplant donors following G-CSF stimulation and determined clinical decision thresholds for mobilisation efficiency.

PMID:39180670 | DOI:10.1007/s10238-024-01467-0

Ir J Med Sci. 2024 Aug 24. doi: 10.1007/s11845-024-03791-6. Online ahead of print.

ABSTRACT

BACKGROUND: People with metabolic syndrome (MetS) are at a higher risk of coronary artery disease, diabetes mellitus, stroke, osteoarthritis, and some types of cancers. Finding markers which are available and inexpensive are most useful for the prediction of MetS. The present study aimed to determine the relationship between atherogenic index and anthropometric indicators and the 10-year risk of MetS.

METHODS: During the 10-year follow-up on Mashhad stroke and heart atherosclerotic disorder (MASHAD study), 4684 subjects who did not MetS at baseline were recruited in this study. The anthropometric indices and atherogenic index including atherogenic index of plasma (AIP), Castelli’s risk index I and II (CRI-I, CRI-I), and atherogenic coefficient (AC) were measured. SPSS-23 was used for all statistical analyses.

RESULT: Among subjects who did not have MetS at baseline 1599 cases (34.1%) developed MetS. The anthropometric and lipid indices were significantly elevated in patients with MetS compared to the healthy ones (p < 0.001). It was revealed that an increase of one unit in AIP and AC can raise the risk of MetS 22.7% (OR: 1.227 (95% CI, 1.166-1.291)) and 37.7% (OR: 1.377 (95% CI, 1.291-1.468)), respectively. Moreover, increasing one unit of WHtR decreases the risk of MetS by 8.5% (OR: 0.915 (95% CI, 0.886-0.946)).

CONCLUSION: The results of this longitudinal study showed that increasing AC and AIP could enhance the risk of MetS. The present study also indicated that AC and AIP are useful predictors in the clinical setting for identifying individuals with MetS in the Iranian adult population.

PMID:39180637 | DOI:10.1007/s11845-024-03791-6

Indian J Gastroenterol. 2024 Aug 24. doi: 10.1007/s12664-024-01648-5. Online ahead of print.

ABSTRACT

INTRODUCTION: The beneficial effects of using antidepressants in improving functional dyspepsia (FD) symptoms have been reported in previous meta-analyses; however, the results have not been conclusive. The aim was to perform an updated meta-analysis coupled with trial sequential analysis (TSA) to assess the efficacy of the use of any antidepressants in the treatment of FD in adults.

METHODS: Electronic databases were searched up to March 2024 for randomized controlled trials (RCTs) recruiting adults with FD. Data of overall symptoms improved between the antidepressants and placebo groups was pooled to obtain risk ratio (RR) employing the random-effects model. The effect of random errors was evaluated with TSA. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence. Analyses were performed using STATA version 16.0.

RESULTS: Nine RCTs with 924 patients met the eligible criteria. The RRs of FD symptoms improving with any antidepressants, tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors were (n = 9, RR = 1.30 [95% CI, 1.02-1.67]), (n = 5, RR = 1.41 [95% CI, 1.07-1.85]) and (n = 2, RR = 0.97 [95% CI, 0.72-1.29]), respectively. TSA demonstrated conclusive evidence for the beneficial effect of TCAs. The number needed to treat (NNT) with any depressants and TCAs were 11 (95% CI, 7-36) and 6 (95% CI, 4-15), respectively. The certainty of the evidence for an effect of TCAs was that of moderate GRADE quality. The benefit, however, was limited to the western population (n = 3, RR = 1.43 [95% CI, 1.04-1.96]) and did not extend to the Asian population (n = 2, RR = 1.32 [95% CI, 0.75-2.32]). Conversely, antidepressant-using patients experienced adverse events more frequently. However, no statistically significant association was found between TCAs and any adverse events (n = 3; RR = 1.36 [95% CI, 0.91-2.04]).

CONCLUSION: Evidence was obtained suggesting TCAs can be an effective alternative in the treatment of FD, but more evidence from high-quality large trials is required to support their use, especially in the Asian population.

PMID:39180628 | DOI:10.1007/s12664-024-01648-5

Lifetime Data Anal. 2024 Aug 24. doi: 10.1007/s10985-024-09632-z. Online ahead of print.

ABSTRACT

This paper discusses regression analysis of current status data with dependent censoring, a problem that often occurs in many areas such as cross-sectional studies, epidemiological investigations and tumorigenicity experiments. Copula model-based methods are commonly employed to tackle this issue. However, these methods often face challenges in terms of model and parameter identification. The primary aim of this paper is to propose a copula-based analysis for dependent current status data, where the association parameter is left unspecified. Our method is based on a general class of semiparametric linear transformation models and parametric copulas. We demonstrate that the proposed semiparametric model is identifiable under certain regularity conditions from the distribution of the observed data. For inference, we develop a sieve maximum likelihood estimation method, using Bernstein polynomials to approximate the nonparametric functions involved. The asymptotic consistency and normality of the proposed estimators are established. Finally, to demonstrate the effectiveness and practical applicability of our method, we conduct an extensive simulation study and apply the proposed method to a real data example.

PMID:39180601 | DOI:10.1007/s10985-024-09632-z

Breast Cancer Res Treat. 2024 Aug 24. doi: 10.1007/s10549-024-07466-9. Online ahead of print.

ABSTRACT

PURPOSE: To assess the association between tumor-infiltrating lymphocytes (TILs) in ductal carcinoma in situ (DCIS) samples and disease recurrence.

METHODS: This retrospective cohort study included women aged 18 years and older who underwent treatment between January 2007 and December 2020. Male patients, individuals diagnosed with invasive or microinvasive disease based on anatomopathological examination of surgical specimens, and those with a personal history of any other cancers were excluded. Additionally, the presence of “touching TILs” (lymphocytes in direct contact with tumor cells) and periductal desmoplasia were evaluated as complementary methods to represent the immunological microenvironment. The primary outcome was relapse-free survival based on TIL quantification adjusted for potential confounders. Pathologists assessed TILs in the sample with the highest tumor representation and quantified them as a percentage. Survival was evaluated using Kaplan‒Meier curves, log-rank tests, and Cox regression models.

RESULTS: A total of 191 patients met the eligibility criteria. The mean follow-up duration was 77.2 months, with a recurrence rate of 9.2%. Patients with TILs ≥ 17% had a greater risk of recurrence (HR 2.97, 95% CI 1.17-7.51; p = 0.02). Additionally, focal necrosis (HR 6.4, 95% CI 1.39-34.71; p = 0.018) or comedonecrosis (HR 4.53, 95% CI 1.34-15.28; p = 0.015) were associated with increased recurrence risk. According to the multivariate model, comedonecrosis and TILs ≥ 17% were significantly associated with recurrence (p = 0.034 and p = 0.035, respectively). Regarding the evaluations of “touching TILs” and periductal desmoplasia, no statistical significance was found when assessing their association with disease recurrence.

CONCLUSION: In our cohort, a high percentage of TILs (≥ 17%) and the presence of comedonecrosis were independently associated with DCIS recurrence.

PMID:39180593 | DOI:10.1007/s10549-024-07466-9

Arch Dermatol Res. 2024 Aug 24;316(8):574. doi: 10.1007/s00403-024-03306-4.

ABSTRACT

Alopecia areata (AA) is an autoimmune disease driven by cytokine dysregulation resulting in hair loss, and recent data suggests inflammation may be occurring systemically. This systemic increase in inflammatory cytokines may increase the incidence of thrombotic events, including deep vein thrombosis, stroke, myocardial infarction, and pulmonary embolism. As the use of JAK inhibitors for AA becomes more common, it is important to further investigate this potential relationship to prevent exacerbation of such events. The purpose of this case-control study was to determine if there is an increased association between thrombotic events and alopecia areata using the All of Us database. We matched 926 patients with AA 4:1 to controls without any alopecia, and we found that there was a statistically significant increase in the incidence of venous thromboembolism (VTE) in patients with AA (p = 0.009). Multivariable conditional logistic regression was then used to estimate the odds of AA in relation to VTE, controlling for common hypercoagulable factors (atrial fibrillation, estrogen replacement, obesity, malignancy, pregnancy, and smoking history). We found that after controlling for these risk factors, there was no significant difference in the incidence in VTE between those with and without AA (OR: 1.549, CR 95% (0.862, 2.783)). While recent reports have suggested alopecia areata to be significantly associated with venous thromboembolisms, we did not observe a significant association after controlling for hypercoagulable factors.

PMID:39180570 | DOI:10.1007/s00403-024-03306-4

Arch Gynecol Obstet. 2024 Aug 24. doi: 10.1007/s00404-024-07630-y. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the existing evidence regarding the comparison between 2 and 3D systems in Total Laparoscopic Hysterectomy (TLH) in terms of surgical outcomes.

METHODS: A systematic review of electronic databases, including PubMed/MEDLINE and Web of Science, was conducted to identify relevant studies comparing 2D and 3D systems in TLH. The search employed a combination of Medical Subject Headings (MeSH) terms and keywords related to the topic. Studies meeting predefined criteria were included, while case reports and studies not directly comparing 2D and 3D systems were excluded. Two independent reviewers evaluated study eligibility and performed quality assessment. The quantitative synthesis was conducted using meta-analysis techniques.

RESULTS: A statistically significant longer operation time in the 2D group compared to the 3D group (7 studies, mean difference [MD]: 13.67, 95% confidence interval [CI] 9.35-18.00, I² = 16%). However, no statistically significant differences were found between the groups in terms of vaginal cuff closure time (2 studies, MD: 3.22, CI – 6.58-13.02, I² = 96%), complication rate (7 studies, odds ratio [OD]: 1.74, CI 0.70-4.30, I² = 0%), blood loss (3 studies, MD: 2.92, CI – 15.44-21.28, I² = 0%), and Hb drop (3 studies, MD: 0.17, CI – 0.08-0.42, I² = 1%).

CONCLUSION: Our results revealed a significant difference favoring 3D systems in operation time, while clinical outcomes between the two systems were found to be comparable in TLH. However, further research, particularly prospective studies with larger cohorts and longer-term follow-up, along with economic analyses, is needed to provide clinicians and healthcare decision-makers with essential guidance for practice and resource allocation.

PMID:39180564 | DOI:10.1007/s00404-024-07630-y

Arch Dermatol Res. 2024 Aug 24;316(8):579. doi: 10.1007/s00403-024-03290-9.

ABSTRACT

OBJECTIVE: This research was aimed at ascertaining the clinical effects of 595 nm pulsed dye laser (PDL) in combination with supramolecular salicylic acid (SSA) in the treatment of rosacea.

METHODS: Eighty-four patients with rosacea were selected, of which 42 patients treated with PDL alone were considered as the control group, and 42 patients treated with 595 nm PDL in combination with 30% SSA were regarded as the observation group. The treatment continued for 4 months in the two groups. Clinical symptom scores, skin barrier function indicators, serum inflammatory factors, Acne⁃QOL scores and adverse reactions between the two groups were compared.

RESULTS: After treatment, levels of inflammatory factors, clinical symptom scores, transdermal water loss, and oil volume were decreased, and epidermal water content and Acne-QOL scores were increased in both groups (all P < 0.05), and the changes in the observation group were more pronounced versus the control group (all P < 0.05). The difference in the incidence of adverse reactions was not statistically significant between the two groups (P > 0.05).

CONCLUSION: 595 nm PDL in combination with SSA is safe in the treatment of rosacea.

PMID:39180560 | DOI:10.1007/s00403-024-03290-9

Skeletal Radiol. 2024 Aug 24. doi: 10.1007/s00256-024-04776-3. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the frequency of elongated morphology of osteoid osteoma (OO) in children compared to adolescents and to determine if this elongated morphology is associated with radiofrequency ablation treatment failure.

MATERIALS AND METHODS: Retrospective review of first-time CT-guided radiofrequency ablation performed for presumed OO in patients < 21 years old between 1990 and 2023. Children were considered 0 to 10 years old, and adolescents were considered 11 to 20 years old. Treatment failure was considered symptomatic recurrence requiring follow-up intervention. The largest tumor dimensions in three orthogonal planes were measured using multiplanar reformatted technology. Maximum tumor dimension, tumor volume, and eccentricity index were calculated. Elongated morphology criteria were (a) largest dimension > 10 mm and (b) eccentricity index ≥ 3. Lesion locations were recorded. Statistical analyses included the chi-square test, Fisher’s exact test, nonparametric Wilcoxon rank-sum test, receiver operating characteristic analysis, and Spearman’s nonparametric rank correlation.

RESULTS: Of 366 included patients (median 15 years, IQR 11-18 years, 254 male), there were 86 (23.5%) children, 280 (76.5%) adolescents, and 24 (6.6%) cases of treatment failure. Elongated morphology was more common in children (19.7%) than adolescents (8.6%) (p = 0.004) and associated with younger age (p = 0.009). Elongated morphology was associated with treatment failure in children (p = 0.045) but not adolescents (p > .99) or all patients (p = 0.17). Treatment failure was not associated with age, largest dimension, eccentricity index, volume, or location.

CONCLUSION: Elongated morphology of OO is associated with younger age and radiofrequency ablation treatment failure in children. Identifying this morphology may assist with counseling and treatment planning.

PMID:39180558 | DOI:10.1007/s00256-024-04776-3

Arch Dermatol Res. 2024 Aug 24;316(8):570. doi: 10.1007/s00403-024-03318-0.

NO ABSTRACT

PMID:39180553 | DOI:10.1007/s00403-024-03318-0