Category: Statistics

JAMA Netw Open. 2024 Aug 1;7(8):e2428444. doi: 10.1001/jamanetworkopen.2024.28444.

ABSTRACT

IMPORTANCE: Abiraterone acetate and enzalutamide are recommended as preferred treatments for metastatic castration-resistant prostate cancer (mCRPC), but differences in their relative efficacy are unclear due to a lack of head-to-head clinical trials. Clear guidance is needed for making informed mCRPC therapeutic choices.

OBJECTIVE: To compare clinical outcomes in patients with mCRPC treated with abiraterone acetate or enzalutamide.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective, multicenter cohort study included patients with mCRPC in the US Department of Veterans Affairs health care system who initiated treatment with abiraterone acetate or enzalutamide between January 1, 2014, and October 30, 2022.

EXPOSURES: Abiraterone acetate or enzalutamide.

MAIN OUTCOMES AND MEASURES: The study used inverse probability of treatment weighting to balance baseline characteristics between patients initiating abiraterone acetate or enzalutamide and evaluated restricted mean survival time (RMST) differences in overall survival (OS), prostate cancer-specific survival (PCS), time to next treatment switching or death (TTS), and time to prostate-specific antigen (PSA) response (TTR) at different time points after treatment initiation.

RESULTS: The study included 5779 patients (median age, 74.42 years [IQR, 68.94-82.14 years]). Median follow-up was between 38 and 60 months. Patients initiating enzalutamide on average had longer OS than those initiating abiraterone acetate, with RMSTs of 24.29 months (95% CI, 23.58-24.99 months) and 23.38 months (95% CI, 22.85-23.92 months), respectively, and a difference in RMST of 0.90 months (95% CI, 0.02-1.79 months) at 4 years. Similarly, TTS and TTR were improved in patients initiating enzalutamide, with an RMST at 4 years of 1.95 months (95% CI, 0.92-2.99 months) longer for TTS and 3.57 months (95% CI, 1.76-5.38 months) shorter for TTR. For PCS, the RMST at 2 years was 0.48 months (95% CI, 0.01-0.95 months) longer. An examination of subgroups identified that enzalutamide initiation was associated with longer RMST in OS among patients without prior docetaxel treatment (1.14 months; 95% CI, 0.19-2.10 months) and in those with PSA doubling time of 3 months or longer (2.23 months; 95% CI, 0.81-3.66 months) but not among patients with prior docetaxel (-0.25 months; 95% CI, -2.59 to 2.09 months) or with PSA doubling time of less than 3 months (0.05 months; 95% CI, -1.05 to 1.15 months).

CONCLUSIONS AND RELEVANCE: In this cohort study of patients with mCRPC, initiation of enzalutamide was associated with small but statistically significant improvements in OS, PCS, TTS, and TTR compared with initiation of abiraterone acetate. The improvements were more prominent in short-term outcomes, including TTS and TTR, and in patient subgroups without prior docetaxel or with PSA doubling time longer than 3 months.

PMID:39150709 | DOI:10.1001/jamanetworkopen.2024.28444

JAMA Netw Open. 2024 Aug 1;7(8):e2428680. doi: 10.1001/jamanetworkopen.2024.28680.

ABSTRACT

IMPORTANCE: Households with children and minoritized racial and ethnic groups experience a disproportionate burden of food hardship. During the COVID-19 pandemic, the US federal government implemented emergency allotments in the Supplemental Nutrition Assistance Program (SNAP), increasing the amount of food purchasing assistance received by many participating households.

OBJECTIVE: To examine the association of implementing emergency allotments in SNAP with food hardship among households with children overall and for households with Black, Hispanic, and White children by comparing income-eligible households that did and did not participate in SNAP.

DESIGN, SETTING, AND PARTICIPANTS: This ecologic cross-sectional study used 2016-2022 National Survey of Children’s Health data and a difference-in-differences approach to compare changes in the risk of food hardship from before implementation of emergency allotments in SNAP (2016-2019) to during implementation (2020-2022). Households with children younger than 18 years and incomes 130% or less of the federal poverty level (FPL) in all 50 states and Washington, DC, were included.

EXPOSURE: Implementation of emergency allotments in SNAP.

MAIN OUTCOME AND MEASURES: The primary outcome was caregiver report of household food hardship during the past 12 months.

RESULTS: Of 44 753 households with incomes 130% or less of the FPL, a weighted 23.4% had Black children, 56.7% had White children, and 19.9% had children of other races. More than one-third of households (37.8%) had Hispanic children, and 31.8% had young children aged 0 to 5 years. The percentage of households that experienced food hardship decreased from 2016 to 2021 (from 62.9% to 48.2% among SNAP-participating households and from 44.3% to 38.9% among income-eligible nonparticipating households) but increased in 2022 (to 58.0% among SNAP-participating households and to 47.5% among nonparticipating households). Adjusting for confounders, implementing emergency allotments in SNAP was associated with a decreased risk of food hardship among SNAP-participating compared with nonparticipating households (risk ratio [RR], 0.88; 95% CI, 0.81-0.96). Implementing emergency allotments in SNAP was associated with a decreased risk of food hardship among SNAP-participating households with Hispanic (RR, 0.86; 95% CI, 0.72-1.02) and White (RR, 0.85; 95% CI, 0.76-0.94) children compared with nonparticipating households but not among households with Black children (RR, 1.04; 95% CI, 0.87-1.23).

CONCLUSIONS AND RELEVANCE: In this ecologic cross-sectional study, implementing emergency allotments in SNAP was associated with a decreased risk of food hardship among households with children. Efforts are needed to ensure that all populations benefit from economic policies.

PMID:39150708 | DOI:10.1001/jamanetworkopen.2024.28680

Eur J Cancer Prev. 2024 Jul 31. doi: 10.1097/CEJ.0000000000000913. Online ahead of print.

ABSTRACT

Considering that carbohydrates play an important role in supplying the body with energy and exhibit diverse mechanisms that can either prevent or stimulate cancer, we hypothesize that the quality of carbohydrate intake may be associated with cancer risk, including lung cancer. This hospital-based case-control study was conducted on 135 newly diagnosed lung cancer patients, and 237 healthy age- and sex-matched hospitalized controls. We used a valid and reliable 148-item Food Frequency Questionnaire to collect the dietary intake of subjects. Multivariate logistic regression was used to estimate the association between carbohydrate quality indices and the odds of lung cancer. After adjustment for confounding variables, the high glycemic index appears to be an increased risk factor for lung cancer [odds ratio (OR) = 2.51, 95% confidence interval (CI): 1.28-4.91]. No statistically significant association was found between glycemic load and lung cancer (OR = 2.51, 95% CI: 0.98-6.43). In contrast, the carbohydrate quality index (OR = 0.23, 95% CI: 0.11-0.48) and low-carbohydrate diet score (OR = 0.17, 95% CI: 0.08-0.36), were associated with a decrease in the risk of lung cancer. In summary, our study showed that a high glycemic index is a risk factor for lung cancer, however carbohydrate quality index and low-carbohydrate diet score is a dietary approach to reduce the risk of lung cancer.

PMID:39150686 | DOI:10.1097/CEJ.0000000000000913

J Gen Intern Med. 2024 Aug 16. doi: 10.1007/s11606-024-09005-0. Online ahead of print.

NO ABSTRACT

PMID:39150679 | DOI:10.1007/s11606-024-09005-0

Dermatol Ther (Heidelb). 2024 Aug 16. doi: 10.1007/s13555-024-01251-8. Online ahead of print.

ABSTRACT

INTRODUCTION: This pilot study investigated the effects of a 12-week administration of a nutritional supplement containing special collagen peptides on the structural and molecular properties of the collagen fiber network in the human skin. For the assessments, the suction blister method and electron microscopical comparisons were used.

METHODS: Three suction blisters were generated on the inner forearm of each test subject before and after the 12-week administration of the nutritional supplement. High-resolution scanning electron microscopy (SEM) was employed to meticulously investigate the structural characteristics of the skin’s collagen network, including the length and diameter of collagen fibers within the suction blister roof. Furthermore, the analysis included immunohistochemistry and fluorescence light microscopy to study hyaluronic acid within the extracellular matrix. Additional assessments encompassed changes in various epidermal parameters. Nine female participants within the age range of 43.7-61.8 years (mean: 52.5 ± 5.9 years) completed the study in accordance with the study protocol.

RESULTS: Compared with baseline, the 12-week supplementation regimen led to a statistically significant average increase in the collagen fiber network size of 34.56% (p < 0.0001). Additionally, collagen fiber cross-linking and fiber length were substantially increased. The ingestion of the supplement also resulted in an 18.08% elevation in epidermal hyaluronic acid concentration (p < 0.0001). No adverse events were recorded during the study.

CONCLUSION: Using an innovative approach, this study demonstrated the ability of a targeted nutritional supplement to effectively restore the ultrastructural integrity of the dermal collagen network, which is typically disrupted by the natural aging process of the skin. These findings not only corroborate existing data regarding the positive effects of oral collagen peptides on skin structure and function but also contribute to our understanding of ultrastructural morphological aspects of changes in the skin’s collagen network. Supplementation can induce regeneration of the collagen fiber network in the human skin.

TRIAL REGISTRATION NUMBER: German Clinical Trials Register, DRKS-ID DRKS00034161- Date of registration: 06.05.2024, retrospectively registered.

PMID:39150674 | DOI:10.1007/s13555-024-01251-8

Environ Sci Pollut Res Int. 2024 Aug 16. doi: 10.1007/s11356-024-34654-3. Online ahead of print.

ABSTRACT

In this paper, it is aimed, for the first time, at deriving simple models, leveraging the trend analysis in order to estimate the future greenhouse gas emissions associated with coal combustion. Due to the expectations of becoming the center of global economic development in the future, BRICS-T (Brazil, the Russian Federation, India, China, South Africa, and Turkiye) countries are adopted as cases in the study. Following the models’ derivation, their statistical validations and estimating accuracies are also tested through various metrics. In addition, the future greenhouse gas emissions associated with coal combustion are estimated by the derived models. The results demonstrate that the derived models can be successfully used as a tool for estimating the greenhouse gas emissions associated with coal combustions with accuracy ranges from at least 90% to almost 98%. Moreover, the estimating results show that the total amount of greenhouse gas emissions associated with coal combustions in the relevant countries and in the world will increase to 14 BtCO_2eq and 19 BtCO_2eq by 2035, with an annual growth of 2.39% and 1.71%, respectively. In summary, the current study’s findings affirm the usefulness of trend analysis in deriving models to estimate greenhouse gas emissions associated with coal combustion.

PMID:39150668 | DOI:10.1007/s11356-024-34654-3

J Interv Card Electrophysiol. 2024 Aug 16. doi: 10.1007/s10840-024-01857-0. Online ahead of print.

ABSTRACT

BACKGROUND: We sought to evaluate the anatomic and functional lesion development over time at different atrial sites immediately following delivery of pulsed field ablation (PFA).

METHODS: Using a porcine model, PFA ablations were performed in the superior vena cava (SVC), right atrial lateral wall (RA), left atrial appendage (LAA), and right superior pulmonary vein (RSPV) using four different PFA profiles. Mapping was done sequentially in 5-20-min increments up to 280-min post lesion delivery for low voltage area (LVA) assessment and conduction velocity. Lesion characteristics were noted with voltage mapping immediately post ablation and at the serial time points.

RESULTS: In 9 animals, 33 sites were ablated. None of the four different profiles across all sites showed any statistical difference on acute lesion formation or persistence. Higher tissue contact was observed in the SVC and RSPV and lower tissue contact was observed in the LAA and RA locations. Higher contact areas were noted to have higher density electroanatomic low voltage area (LVA) (12/14 vs 5/18, p = 0.01) and larger lesions on gross pathology (2 /14 vs 6/16, p = 0.01) compared to lower contact areas. Lesion regression occurred in 16/33 sites. Sustained lesions were significantly more prevalent in higher versus lower contact sites (65% vs 38%, p = 0.037).

CONCLUSION: The development of significant and durable lesions for PFA in a porcine model appears to be dependent on tissue proximity and contact.

PMID:39150656 | DOI:10.1007/s10840-024-01857-0

Eat Weight Disord. 2024 Aug 16;29(1):52. doi: 10.1007/s40519-024-01676-2.

ABSTRACT

The study was conducted in order to study breakfast skipping (BKS) frequency, factors associated with, health consequence and undergraduate students academic performance during Covid-19 pandemic as earliest studies focusing on this area. A cross-sectional study was carried out among 2225 of undergraduate students. The study was carried between the period of 15/1/2020 to 3/4/2020 using an online self-report Breakfast Eating Habit Survey (BEHS). The BEHS survey was divided into two sections. The first sections included sociodemographic information (gender, BMI, age, smoking, residency, parental education, family income, studying system and stage (public or private), and studying institution (university or institute) academic performance. The second part included questions regarding breakfast eating habits including frequency of skipping meals, factors related to BKS health consequences and types of snacks. Logistic regression is a common technique used for modeling outcomes that fall into the range of 1 and 0. For this purpose, a logistic regression was performed to find adjusted odds ratio and crude odds ratio. The results showed that the majority of participants were female (1238, 55.7%). Out of 2,224 students, 2059 are aged between 18 to 24 years. Most of the participants were from first level (26.5%), second level (32.8%), third level (17.6%) or the fourth level (21.3%). Over 92% of participants were single and about 68% came from families of medium income families. The statistical analysis showed that the odds of BKS is reduced among students who live in accommodation by 54% (odds ratio = 54%, CI (41-71%), p value = 0.000). It seems that students with low income and normal or higher BMI are more likely to skip breakfast more regularly. The odds of skipping breakfast among students with BMI of 18-24.9 is reduced by 41% (odds ratio = 59%, CI (27%-93%), p value = 0.027) and the odds of BKS is reduced among students with BMI of 25-29.9 by 45% (odds ratio = 55%, CI (31-95%). Additionally, students with medium or high incomes are more likely to skip breakfast as much as twofold in comparison with students with low income (medium income (odds ratio = 1.85, CI (1.08-3.17), p-value = 0.024), high income (odds ratio = 1.98, CI (1.12-3.51), p-value = 0.019). The most common reasons for skipping breakfast included include time constraint, not hungry, breakfast is not ready, afraid to be overweight and lack of appetite. The consequences of skipping breakfast were feeling hungry throughout the day, feeling tired, and not paying attention in class and low academic performance. To concluded, BKS during Covid-19 is more common among students with higher BMI, higher income and living in accommodation. The main reason is time constraint and the most common health problems are being tired and luck of attention.

PMID:39150632 | DOI:10.1007/s40519-024-01676-2

Int Urol Nephrol. 2024 Aug 16. doi: 10.1007/s11255-024-04184-5. Online ahead of print.

ABSTRACT

PURPOSE: The use of topical corticosteroids (TCSs) has become an efficient, less-invasive treatment for phimosis. Whether any significant difference in efficacy exists between TCSs based on their potency is unclear.

METHODS: Electronic databases were searched up to March 2024 for randomised controlled trials (RCTs) comparing the use of any type or concentration of TCSs with placebo or no treatment in boys with any degree of physician diagnosed phimosis. A random-effects network meta-analysis (NMA) using a consistency model within a frequentist approach was employed. The primary outcome was partial or complete resolution of phimosis reported as a pooled risk ratio (RR) with 95% CI. Relative ranking was assessed with surface under the cumulative ranking curve (SUCRA) probabilities.

RESULTS: Seventeen RCTs, containing 2057 participants were identified. NMA suggested that, compared with control, the high (RR 3.19 (95% CI 1.42 to 7.16), moderate (RR 2.68 (95% CI 1.87 to 3.83) and low (RR 3.05 (95% CI 1.63 to 5.71) potency TCSs statistically significantly increased complete or partial clinical resolution of phimosis. The SUCRA plot revealed that high potency (SUCRA = 0.76) was ranked first followed by low and moderate TCSs. When we assessed comparative efficacy among TCSs based on potency, none of the classes were superior to others. The certainty of the evidence for an effect of moderate potent TCSs was that of moderate GRADE quality.

CONCLUSION: Moderate to low potency TCSs are of comparable therapeutic effect in the treatment of phimosis to that of highly potent formulations. More high-quality RCTs are warranted.

PMID:39150601 | DOI:10.1007/s11255-024-04184-5

Arch Dermatol Res. 2024 Aug 16;316(8):522. doi: 10.1007/s00403-024-03280-x.

NO ABSTRACT

PMID:39150584 | DOI:10.1007/s00403-024-03280-x