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Nevin Manimala Statistics

Superb microvascular imaging (SMI) and elastosonography in thyroid nodule: diagnostic value in a real-time cohort

J Ultrasound. 2024 Jul 5. doi: 10.1007/s40477-024-00898-5. Online ahead of print.

ABSTRACT

PURPOSE: In clinical practice, thyroid nodules are classified according to TI-RADS by B-mode and color-flow Doppler study. The aim of the study is to evaluate the possible added value of Superb microvascular imaging (SMI) and elastosonography in the stratification of malignancy risk of thyroid nodules.

METHODS: All patients with thyroid nodules who were candidates for needle aspiration were enrolled. Experienced operators performed a standard examination with TI-RADS calculation, followed by SMI and elastosonography on the nodules. The needle aspiration outcome was used as the gold standard. Statistical analysis calculated the ROC curves of the techniques applied individually and serially.

RESULTS: In this prospective study, we analysed 260 nodules, found in 251 patients (mean age 58.6 yo ± 14). 11.2% were TI-RADS 1, 18.9% TI-RADS 2, 41.1% TI-RADS 3, 28.1% TI-RADS 4, and 0.8% TI-RADS 5. The SMI technique showed an AUC of 0.57 (95% CI 0.49; 0.66) while elastosonography had an AUC of 0.58 (95% CI 0.49; 0.67) when used individually. SMI together with elastosonography had AUC of 0.62 (95% CI 0.52; 0.71). TI-RADS had AUC of 0.67 (95% CI 0.59; 0.75). SMI and elastosonography applied together with TI-RADS had AUC of 0.69 (95% CI 0.61; 0.77).

CONCLUSION: In the real-world cohort of patients, the SMI technique and elastosonography slightly increase the AUC of TI-RADS. Taken individually, SMI and elastosonography do not have a very strong AUC.

PMID:38967880 | DOI:10.1007/s40477-024-00898-5

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Nevin Manimala Statistics

Disabled from work and depressed: cognitive factors associated with exacerbated or attenuated depression over the COVID-19 pandemic

Qual Life Res. 2024 Jul 5. doi: 10.1007/s11136-024-03700-5. Online ahead of print.

ABSTRACT

BACKGROUND: People who were disabled from working reported substantially worse depression in recent research [1] despite adjustment for demographic covariates, cognitive-appraisal processes, and COVID-specific stressors, thus motivating the present work.

OBJECTIVE: This study sought to “drill down” to understand employment-group differences (employed, retired, unemployed, disabled) in cognitive factors, and how these factors played into paths to depression during COVID early in the pandemic and depression trajectories over 15.5 months of follow-up.

METHODS: This longitudinal cohort study (n = 771) included chronically ill and general-population samples in the United States, characterized into the same depression-trajectory groups as the earlier study [1]. The Quality-of-Life Appraisal Profilev2 Short-Form assessed cognitive-appraisal processes. COVID-specific scales assessed hardship, worry, and social support. Chi-square, Analysis of Variance, classification and regression tree, and random effects modeling investigated factors associated with reported depression over time specifically by employment group, rather than in the whole sample which was the focus of the earlier study.

RESULTS: Disabled participants were disproportionately represented in the stably depressed trajectory group, reporting more hardship and worry, and lower social support than employed and retired participants (p < 0.0001). They were more likely to focus on health goals, problem goals, and emphasizing the negative (p < 0.001). They had different paths and cut-points to depression than employed/unemployed/retired participants. Even mild endorsement of emphasizing the negative and recent changes predicted higher depression. COVID-specific stressors and cognitive-appraisal processes were less implicated in depression among disabled participants compared to others.

CONCLUSIONS: Disabled participants were at greater risk of stable depression during the COVID pandemic. Small increases in emphasizing the negative were a path to worse depression, and disabled participants’ depression may be less reactive to external circumstances or ways of thinking.

PMID:38967871 | DOI:10.1007/s11136-024-03700-5

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Nevin Manimala Statistics

Characterizing the Linkage of Systemic Hypoxia and Angiogenesis in High-Grade Glioma to Define the Changes in Tumor Microenvironment for Predicting Prognosis

J Mol Neurosci. 2024 Jul 5;74(3):63. doi: 10.1007/s12031-024-02240-4.

ABSTRACT

High-grade gliomas (HGG) comprising WHO grades 3 and 4 have a poor overall survival (OS) that has not improved in the past decade. Herein, markers representing four components of the tumor microenvironment (TME) were identified to define their linked expression in TME and predict the prognosis in HGG, namely, interleukin6 (IL6, inflammation), inducible nitric oxide synthase(iNOS), heat shock protein-70 (HSP70, hypoxia), vascular endothelial growth receptor (VEGF), and endothelin1 (ET1) (angiogenesis) and matrix metalloprotease-14 (MMP14) and intercellular adhesion molecule1 (ICAM1, extracellular matrix). To establish a non-invasive panel of biomarkers for precise prognostication in HGG. Eighty-six therapy-naive HGG patients with 45 controls were analyzed for the defined panel. Systemic expression of extracellular/secretory biomarkers was screened dot-immune assay (DIA), quantified by ELISA, and validated by immunocytochemistry (ICC). Expression of iNOS, HSP70, IL-6, VEGF, ET1, MMP14, and ICAM1 was found to be positively associated with grade. Quantification of circulating levels of the markers by ELISA and ICC presented a similar result. The biomarkers were observed to negatively correlate with OS (p < 0.0001). Cox-regression analysis yielded all biomarkers as good prognostic indicators and independent of confounders. On applying combination statistics, the biomarker panel achieved higher sensitivity than single markers to define survival. The intra-association of all seven biomarkers was significant, hinting of a cross-talk between the TME components and a hypoxia driven systemic inflammation upregulating the expression of other components. This is a first ever experimental study of a marker panel that can distinguish between histopathological grades and also delineate differential survival using liquid biopsy, suggesting that markers of hypoxia can be a cornerstone for personalized therapy. The panel of biomarkers of iNOS, HSP70, IL-6, VEGF, ET1, MMP14, and ICAM1 holds promise for prognostication in HGG.

PMID:38967861 | DOI:10.1007/s12031-024-02240-4

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Nevin Manimala Statistics

New Paradigm of Identifiable General-response Cognitive Diagnostic Models: Beyond Categorical Data

Psychometrika. 2024 Jul 5. doi: 10.1007/s11336-024-09983-4. Online ahead of print.

ABSTRACT

Cognitive diagnostic models (CDMs) are a popular family of discrete latent variable models that model students’ mastery or deficiency of multiple fine-grained skills. CDMs have been most widely used to model categorical item response data such as binary or polytomous responses. With advances in technology and the emergence of varying test formats in modern educational assessments, new response types, including continuous responses such as response times, and count-valued responses from tests with repetitive tasks or eye-tracking sensors, have also become available. Variants of CDMs have been proposed recently for modeling such responses. However, whether these extended CDMs are identifiable and estimable is entirely unknown. We propose a very general cognitive diagnostic modeling framework for arbitrary types of multivariate responses with minimal assumptions, and establish identifiability in this general setting. Surprisingly, we prove that our general-response CDMs are identifiable under Q -matrix-based conditions similar to those for traditional categorical-response CDMs. Our conclusions set up a new paradigm of identifiable general-response CDMs. We propose an EM algorithm to efficiently estimate a broad class of exponential family-based general-response CDMs. We conduct simulation studies under various response types. The simulation results not only corroborate our identifiability theory, but also demonstrate the superior empirical performance of our estimation algorithms. We illustrate our methodology by applying it to a TIMSS 2019 response time dataset.

PMID:38967857 | DOI:10.1007/s11336-024-09983-4

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Nevin Manimala Statistics

Top 20 dermatologic conditions affecting adult patients of color in the United States: insights from an All of Us Database analysis

Arch Dermatol Res. 2024 Jul 5;316(7):459. doi: 10.1007/s00403-024-03198-4.

NO ABSTRACT

PMID:38967855 | DOI:10.1007/s00403-024-03198-4

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Nevin Manimala Statistics

Geopolymer concrete containing nanomaterials-a step toward sustainable construction

Environ Sci Pollut Res Int. 2024 Jul 5. doi: 10.1007/s11356-024-34172-2. Online ahead of print.

ABSTRACT

Geopolymer concrete (GPC) utilizes industrial wastes such as fly ash, bottom, ash, and slag instead of conventional Portland cement as the primary binder, and thus promote a sustainable solution for bulk concrete works. Nanomaterials (NMs) have often been linked with developing these sustainable high-strength mixes. Furthermore, NMs have been proven to imbibe enhanced physio-mechanical properties, often eliminating the need for thermal curing. This not only reduces total energy demand for concrete production but also offers enhanced durability due to denser inter-particle packing of the mix. This review meticulously summarizes the performance of GPCs dosed with different types of NMs including nano-silica (NS), nano-alumina (NA), nano-titanium di oxide (NT), nano-clay (NC), nano-graphene oxide (NG), and carbon nanotubes (CNT). The reported findings of previous studies were carefully studied and compiled in a systematic manner in terms of physio-mechanical, durability, and microstructural properties. It was observed that addition of NM, in general, leads to a slight reduction in the mix’s workability; however, the same can be counteracted by use of suitable superplasticizers. Furthermore, inclusion of NMs in GPC offers the distinct advantage of high density and impermeability, resulting in enhanced mechanical and durability characteristics. Two distinct multi-criteria decision making (MCDM) techniques were employed in this study to statistically analyze the most preferred NM for GPC. It was found that addition of NS (2%) yields the most desirable outcomes. Finally, limitations and challenges associated with production of NM dosed GPC along with scopes for future works are presented toward the end of this review.

PMID:38967851 | DOI:10.1007/s11356-024-34172-2

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Nevin Manimala Statistics

Wait times for surgery of cutaneous malignancies following the COVID-19 pandemic: a retrospective cohort analysis

Arch Dermatol Res. 2024 Jul 5;316(7):452. doi: 10.1007/s00403-024-03200-z.

NO ABSTRACT

PMID:38967839 | DOI:10.1007/s00403-024-03200-z

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Nevin Manimala Statistics

Global burden of skin and subcutaneous diseases and its association with socioeconomic status in children and adolescents: an analysis of the Global Burden of Diseases Study 2019

Arch Dermatol Res. 2024 Jul 5;316(7):457. doi: 10.1007/s00403-024-03212-9.

ABSTRACT

Skin and subcutaneous diseases are one of the most common problems affecting the health of children and adolescents. The purpose of this study was to investigate the burden of skin and subcutaneous diseases among children and adolescents and its association with socioeconomic status. Data was obtained from the Global Burden of Disease Study 2019. The number of cases, incidence rate, number of deaths, and death rate in 204 countries and territories from 1990 to 2019 were extracted and stratified by age, sex, and socioeconomic status. In 2019, the global incidence and death rates of skin and subcutaneous diseases in children and adolescents were 57966.98 (95% Uncertainty Interval [UI] 53776.15 to 62521.24) per 100,000 and 0.21 (95% UI 0.13 to 0.26) per 100,000, respectively. From 1990 to 2019, the global incidence rate increased by 5.80% (95% UI 4.82-6.72%) and the death rate decreased by 43.68% (95% UI 23.04-65.27%). The incidence and death rates were negatively correlated with socioeconomic status. Incidence rates were not different between females and males, but death rates were higher among females than males. The highest incidence and death rates were found in the 1-4-year age group and < 1-year age group, respectively. The global burden of skin and subcutaneous diseases in children and adolescents was characterized by regional imbalances. The global burden of skin and subcutaneous diseases in children and adolescents from poorer regions requires more attention. This study provides strong evidence for global policymaking for childhood and adolescent diseases.

PMID:38967834 | DOI:10.1007/s00403-024-03212-9

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Nevin Manimala Statistics

Trends by race and ethnicity in incidence and mortality of acral lentiginous melanoma: analysis of Surveillance, Epidemiology, and End Results 2000-2020

Arch Dermatol Res. 2024 Jul 5;316(7):456. doi: 10.1007/s00403-024-03167-x.

ABSTRACT

Limited data describe the epidemiology and risk factors of acral lentiginous melanoma (ALM). In this retrospective analysis, we examined trends in incidence and mortality of ALM among racial and ethnic minoritized populations. We queried 22 Surveillance, Epidemiology, and End Results registries for cases of ALM among Hispanics, non-Hispanic Asians or Pacific Islanders (NHAPIs), non-Hispanic Blacks (NHBs), and non-Hispanic Whites (NHWs) from 2000 through 2020. Age-adjusted incidence and annual percentage changes (APCs) were estimated. Kaplan-Meier curves were stratified by race and ethnicity and compared with log-rank tests. Cox proportional hazard regression models were adjusted for age, sex, race, ethnicity, income, urban-rural residence, stage, and treatment. Of 4188 total cases of ALM with complete data, our study cohort was comprised of 792 (18.9%) Hispanics, 274 (6.5%) NHAPIs, 336 (8.0%) NHBs, and 2786 (66.5%) NHWs. The age-adjusted incidence of ALM increased by 2.48% (P < 0.0001) annually from 2000 to 2020, which was driven by rising rates among Hispanics (APC 2.34%, P = 0.001) and NHWs (APC 2.69%, P < 0.0001). Incidence remained stable among NHBs (APC 1.15%, P = 0.1) and NHAPIs (APC 1.12%, P = 0.4). From 2000 through 2020, 765 (18.3%) patients died from ALM. Compared to NHWs, Hispanics, NHAPIs, and NHBs had significantly increased ALM-specific mortality (all P < 0.0001). Unadjusted and adjusted cause-specific mortality modeling revealed significantly elevated risk of ALM-specific mortality among Hispanics (hazard ratio [HR] 1.46, 95% confidence interval [CI] 1.22-1.75; adjusted hazard ratio [aHR] 1.38, 95% CI 1.14-1.66), NHAPIs (HR 1.80, 95% CI 1.41-2.32; aHR 1.58, 95% CI 1.23-2.04), and NHBs (HR 1.98, 95% CI 1.59-2.47; aHR 2.19, 95% CI 1.74-2.76) (all P < 0.001). Our study finds rising incidence of ALM among Hispanics and NHWs along with elevated risk of ALM-specific mortality among racial and ethnic minoritized populations. Future strategies to mitigate health inequities in ALM are warranted.

PMID:38967822 | DOI:10.1007/s00403-024-03167-x

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Nevin Manimala Statistics

Accuracy of navigation guided implant surgery for immediate loading complete arch restorations: Prospective clinical trial

Clin Implant Dent Relat Res. 2024 Jul 5. doi: 10.1111/cid.13360. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess navigation accuracy for complete-arch implant placement with immediate loading of digitally prefabricated provisional.

MATERIALS AND METHODS: Consecutive edentulous and terminal dentition patients requiring at least one complete-arch FDP were treated between December 2020 and January 2022. Accuracy was evaluated by superimposing pre-operative and post-operative cone beam computed tomography (CBCT), recording linear (mm) and angular (degrees) deviations. T-tests were performed to investigate the potential effect of the registration algorithm (fiducial-based vs. fiducial-free), type of references for the fiducial-free algorithm (teeth vs. bone screws), site characteristic (healed vs. post-extractive), implant angulation (axial vs. tilted), type of arch (maxilla vs. mandible) on the accuracy with p-value <0.05.

RESULTS: Twenty-five patients, 36 complete-arches, and 161 implants were placed. The overall mean angular deviation was 2.19° (SD 1.26°). The global platform and apex mean deviations were 1.17 mm (SD 0.57 mm), and 1.30 mm (SD 0.62 mm). Meaningful global platform (p = 0.0009) and apical (p = 0.0109) deviations were experienced only between healed and post-extraction sites. None of the analyzed variables significantly influenced angular deviation. Minor single-axis deviations were reported for the type of jaw (y-axis at implant platform and apex), registration algorithm (y-axis platform and z-axis deviations), and type of references for the fiducial-free algorithm. No statistically significant differences were found in relation to implant angulation.

CONCLUSIONS: Within the study limitations navigation was reliable for complete-arch implant placement with immediate loading digitally pre-fabricated FDP. AI-driven surface anatomy identification and calibration protocol made fiducial-free registration as accurate as fiducial-based, teeth and bone screws equal as references. Implant site characteristics were the only statistically significant variable with healed sites reporting higher accuracy compared to post-extractive. Live-tracked navigation surgery enhanced operator performance and accuracy regardless of implant angulation and type of jaw. A mean safety room of about 1 mm and 2° should be considered.

PMID:38967100 | DOI:10.1111/cid.13360