Category: Statistics

BMC Med Imaging. 2023 Jun 19;23(1):85. doi: 10.1186/s12880-023-01044-z.

ABSTRACT

BACKGROUND AND AIM: Ultrasound-guided radiofrequency ablation (RFA) is a minimally invasive therapy for thyroid nodules (TNs). Understanding the determinants of RFA efficacy can improve treatment and prognosis. This study aims to investigate the relationship between ultrasound parameters of benign TNs and the efficacy of RFA.

METHODS: A pretest-posttest interventional study was conducted in 2021 on 250 randomly sampled patients with benign TNs, receiving RFA. For this purpose, the volume reduction (VR) and the VR ratio (VRR) of the nodules were measured at the 1-, 3-, 6-, and 12-month follow-up periods after the RFA completion. The technical success rate (TSR) of this procedure was then categorized into four states, including low (VRR < 25%), moderate (VRR = 25-49%), high (VRR = 50-74%), and very high (VRR ≥ 75). Ordered logistic regression (OLR) was further utilized to investigate the effect of the ultrasound parameters of TNs on the TSR. The analyses were notably performed using Stata 14.2.

RESULTS: The VRR at the 1-, 3-, 6-, and 12-month follow-up periods were 38.7%, 53.6%, 59.3%, and 59.9%, respectively. The mean VR was also statistically significant at all follow-ups (p < 0.001). At the 1-, 3-, and 6-month follow-up periods, the VR of over 50% was observed in 28.2%, 52.1%, and 65.2% of the nodules, respectively. The odds ratios (ORs) of the RFA success were found to be 4.3 times higher for the nodules in the left lobe compared to the right lobe (OR: 4.31, p = 0.002), 6.3 times greater for isoechoic nodules compared to hyperechoic nodules (OR: 6.39, p < 0.001), 6.2 times higher for hyper-vascular nodules compared to hypo-vascular nodules (OR: 6.25, p = 0.005), and 2.3 times greater for mixed nodules compared to solid ones (OR: 2.37, p = 0.049).

CONCLUSION: The ultrasound parameters of TNs had a statistically significant effect on the efficacy of RFA. Small-sized, isoechoic, and hyper-vascular nodules, as well as those with mixed tissue, were observed to respond better to RFA, leading to a better prognosis in terms of VR after treatment.

PMID:37337132 | DOI:10.1186/s12880-023-01044-z

J Cosmet Dermatol. 2023 Jun 19. doi: 10.1111/jocd.15864. Online ahead of print.

ABSTRACT

BACKGROUND: Gluconolactone (GLA) exhibits antioxidant and moisturizing effects. It also presents soothing effects, protects elastin fibers from UV-induced degradation, and improves the function of the skin barrier.

AIMS: Evaluation of skin parameters such as pH, transepidermal water loss (TEWL), sebum levels before, during, and after a series of applications of 10% and 30% GLA chemical peel in a split-face model.

MATERIALS AND METHODS: The study involved 16 female subjects. Three split-face procedures were performed using two concentrations of GLA solution applied on two sides of the face. The skin parameters were measured before treatments and 7 days after the last procedure at four measurement sites on either side of the face, that is, on the forehead, around the eye, on the cheek, and on the nose wing.

RESULTS: Measurement of sebum demonstrated some statistically significant changes between sebum levels in the cheeks after a series of treatments. The pH measurement showed that the pH value was reduced after each treatment at all measurement points. The level of TEWL after treatments was significantly lower around the eyes, on the left forehead, and on the right cheek. There were no significant differences between the use of different concentrations of the GLA solution.

CONCLUSIONS: The results of the study show that GLA has a significant influence on lowering skin pH and TEWL. GLA also has seboregulatory properties.

PMID:37335807 | DOI:10.1111/jocd.15864

J Behav Addict. 2023 Jun 19. doi: 10.1556/2006.2023.00027. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Gambling in adolescents is a public health concern. This study sought to examine patterns of gambling among Connecticut high-school students using seven representative samples covering a 12-year period.

METHODS: Data were analyzed from N = 14,401 participants in cross-sectional surveys conducted every two years based on random sampling from schools in the state of Connecticut. Anonymous self-completed questionnaires included socio-demographic data, current substance use, social support, and traumatic experiences at school. Chi-square tests were used to compare socio-demographic characteristics between gambling and non-gambling groups. Logistic regressions were used to assess changes in the prevalence of gambling over time and effects of potential risk factors on the prevalence, adjusted for age, sex, and race.

RESULTS: Overall, the prevalence of gambling largely decreased from 2007 to 2019, although the pattern was not linear. After steadily declining from 2007 to 2017, 2019 was associated with increased rates of gambling participation. Consistent statistical predictors of gambling were male gender, older age, alcohol and marijuana use, higher levels of traumatic experiences at school, depression, and low levels of social support.

DISCUSSION AND CONCLUSION: Among adolescents, older males may be particularly vulnerable to gambling that relates importantly to substance use, trauma, affective concerns, and poor support. Although gambling participation appears to have declined, the recent increase in 2019 that coincides with increased sports gambling advertisements, media coverage and availability warrants further study. Our findings suggest the importance of developing school-based social support programs that may help reduce adolescent gambling.

PMID:37335777 | DOI:10.1556/2006.2023.00027

Expert Rev Mol Diagn. 2023 Jun 19:1-12. doi: 10.1080/14737159.2023.2224505. Online ahead of print.

ABSTRACT

INTRODUCTION: Exportin 1 (XPO1) is overexpressed in several solid tumors, and is associated with poor prognosis. Here, we aimed to evaluate the implication of XPO1 expression in solid tumors through a meta-analysis.

METHODS: PubMed, Web of Science, and Embase databases were searched for articles published until February 2023. Statistical data of the patients, odds ratios and hazard ratios (HRs), together with their corresponding 95% confidence intervals (CIs) were pooled to assess clinicopathological features and survival outcomes. Besides, the Cancer Genome Atlas (TCGA) was used to explore the prognostic significance of XPO1 in solid tumors.

RESULTS: A total of 22 works, comprising 2595 patients were included in this study. The results suggested that increased XPO1 expression was associated with a higher tumor grade, more lymph node metastasis, advanced tumor stage, and progressively worse total clinical stage. Additionally, high XPO1 expression was associated with worse overall survival (OS) (HR = 1.43, 95% CI = 1.12-1.81, P = 0.004) and shorter progression-free survival (HR = 1.40, 95% CI = 1.07-1.84, P = 0.01). An analysis using the TCGA dataset showed that high XPO1 expression was associated with poor OS and disease-free survival.

CONCLUSIONS: XPO1 is a promising prognostic biomarker and may constitute a therapeutic target for solid tumors.PROSPERO registration number: CRD42023399159.

PMID:37335774 | DOI:10.1080/14737159.2023.2224505

J Speech Lang Hear Res. 2023 Jun 19:1-30. doi: 10.1044/2023_JSLHR-22-00266. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to characterize test-retest reliability of discourse measures across a battery of common tasks in individuals with aphasia and prospectively matched adults without brain damage.

METHOD: We collected spoken discourse during five monologue tasks at two timepoints (test and retest; within 2 weeks apart) in an aphasia group (n = 23) and a peer group with no brain damage (n = 24). We evaluated test-retest reliability for percentage of correct information units, correct information units per minute, mean length of utterance, verbs per utterance, noun/verb ratio, open/closed class word ratio, tokens, sample duration (seconds), propositional idea density, type-token ratio, and words per minute. We explored reliability’s relationship with sample length and aphasia severity.

RESULTS: Rater reliability was excellent. Across tasks, both groups demonstrated discourse measures with poor, moderate, and good reliability, with the aphasia group having measures demonstrating excellent test-retest reliability. When evaluating measures within each task, test-retest reliability again ranged from poor to excellent for both groups. Across groups and task, measures that appeared most reliable appeared to reflect lexical, informativeness, or fluency information. Sample length and aphasia severity impacted reliability, and this differed across and by task.

CONCLUSIONS: We identified several discourse measures that were reliable across and within tasks. Test-retest statistics are intimately linked to the specific sample, emphasizing the importance of multiple baseline studies. Task itself should be considered an important variable, and it should not be assumed that discourse measures found to be reliable across several tasks (averaged) are likewise reliable for a single task.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23298032.

PMID:37335766 | DOI:10.1044/2023_JSLHR-22-00266

Diabetes Technol Ther. 2023 Jun 19. doi: 10.1089/dia.2023.0199. Online ahead of print.

ABSTRACT

BACKGROUND: Adolescents and young adults (AYA) from diverse and marginalized backgrounds with type 1 diabetes (T1D) generally have higher HbA1c levels and less frequent continuous glucose monitor (CGM) use than AYA from more privileged backgrounds. Further, scant data address the impact of virtual peer groups (VPG) on health-related outcomes for ethnically and racially-diverse AYA with T1D.

METHODS: CoYoT1 to California was a 15-month randomized controlled trial for AYA ages 16-25 years. In this study, AYA were randomized to receive Standard Care (n=28), or CoYoT1 Care (n=40), which consisted of person-centered provider visits and bimonthly VPG. VPG were AYA-driven discussions. AYA completed the Diabetes Distress Scale (DDS), Center for Epidemiologic Studies Depression (CES-D), and Diabetes Empowerment Scale-Short Form (DES-SF) scales at baseline and all study visits.

RESULTS: Participants were 50% Latinx and 75% publicly insured. Among CoYoT1 Care participants, 19 attended at least one VPG session (VPG Attendees) and 21 did not attend any VPG sessions. VPG attendees participated in 4.1 VPG sessions on average. VPG Attendees had a relative reduction in HbA1C (treatment effect -1.08%, ES=-0.49, p=0.04) and increase in CGM use (treatment effect +47%, ES=1.00, p=0.02) compared to Standard Care. VPG participation was not associated with statistically significant changes in DDS, CES-D, and DES-SF scores.

CONCLUSIONS: In a 15-month randomized controlled trial, AYA with T1D who participated in VPG reported significant improvements in HbA1c and CGM use. Peer interactions may support unmet needs of AYA with T1D from diverse and marginalized backgrounds.

PMID:37335751 | DOI:10.1089/dia.2023.0199

Medicine (Baltimore). 2023 May 19;102(20):e33675. doi: 10.1097/MD.0000000000033675.

ABSTRACT

Chronic kidney dysfunction is associated with increased mortality in multiple cancer types. Preliminary evidence suggests the same to be true for B-large cell lymphomas (B-LCL). To analyze the relationship of glomerular filtration rate (GFR) and outcome of B-LCL in detail we collected data on outcomes of 285 consecutive patients with newly diagnosed B-LCL treated at our institution with standard rituximab-containing regimens who did not have preexisting kidney disease or urinary tract obstruction at presentation. Median age was 59, range 18 to 87, 145 were male and 140 females. Forty-four had GFR < 60 mL/min, 123 had 60 to 90 mL/min, and 118 > 90 mL/min. Median follow-up of surviving patients was 49 months and estimated 3-year survival 76%. In univariate analysis age (P < .001), GFR (P = .014), stage (P < .001), performance status (P = .044), chemotherapy regimen (P < .01), and international prognostic index (IPI) (P < .001) were statistically significant prognostic factors. In multivariate analysis, age and GFR remained the only independent prognostic factors. Subtracting 1 from the IPI score of patients who had GFR > 90 mL/min and IPI > 1 resulted in a prognostic index that divides patients into 3 prognostic groups (low risk = 0-1, intermediate risk = 2-3 and high risk = 4-5) with an acceptable patient distribution frequency (38%, 39%, and 23%, respectively) and improved statistical significance and separation in comparison to IPI (5-year survival rates of 92%, 74%, and 42%, respectively). GFR is an important independent prognostic factor for B-LCL that should be taken into account in clinical decision making and data analysis and probably be incorporated in prognostic indices.

PMID:37335743 | DOI:10.1097/MD.0000000000033675

Medicine (Baltimore). 2023 May 19;102(20):e33810. doi: 10.1097/MD.0000000000033810.

ABSTRACT

BACKGROUND: Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients face several hematological abnormalities. Of these abnormalities, anemia is the most common one. Africa has a high prevalence of HIV/AIDS, especially in the East and South African region, which is heavily affected by the virus. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of anemia among patients with HIV/AIDS in East Africa.

METHODS: This systematic review and meta-analysis was conducted based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. PubMed, Google Scholar, Science Direct, Dove Press, Cochrane Online, and African journals online were searched systematically. The quality of the included studies was assessed by 2 independent reviewers using the Joanna Briggs Institute critical appraisal tools. Data were extracted into an Excel sheet and then exported to STATA version 11 for analysis. A random-effect model was fitted to estimate the pooled prevalence and Higgins I2 test statistics were done to test the heterogeneity of studies. Funnel plots analysis and Egger-weighted regression tests were done to detect publication bias.

RESULTS: The pooled prevalence of anemia among HIV/AIDS patients in East Africa was 25.35% (95% CI: 20.69-30.03%). A subgroup analysis by highly active antiretroviral therapy (HAART) status showed that the prevalence of anemia among HAART naive HIV/AIDS patients was 39.11% (95% CI: 29.28-48.93%) whereas the prevalence among HAART experienced was 36.72% (95% CI: 31.22-42.22%). A subgroup analysis by the study population showed that the prevalence of anemia among adult HIV/AIDS patients was 34.48% (95% CI: 29.52-39.44%) whereas the pooled prevalence among children was 36.17% (95% CI: 26.68-45.65%).

CONCLUSION: This systematic review and meta-analysis revealed that anemia is among the most common hematological abnormalities in HIV/AIDS patients in East Africa. It also underscored the importance of taking diagnostic, preventive, and therapeutic measures for the management of this abnormality.

PMID:37335739 | DOI:10.1097/MD.0000000000033810

Medicine (Baltimore). 2023 May 19;102(20):e33821. doi: 10.1097/MD.0000000000033821.

ABSTRACT

To investigate the potential role of COVID-19 in relation to Behcet’s disease (BD) and to search for relevant biomarkers. We used a bioinformatics approach to download transcriptomic data from peripheral blood mononuclear cells (PBMCs) of COVID-19 patients and PBMCs of BD patients, screened the common differential genes between COVID-19 and BD, performed gene ontology (GO) and pathway analysis, and constructed the protein-protein interaction (PPI) network, screened the hub genes and performed co-expression analysis. In addition, we constructed the genes-transcription factors (TFs)-miRNAs network, the genes-diseases network and the genes-drugs network to gain insight into the interactions between the 2 diseases. We used the RNA-seq dataset from the GEO database (GSE152418, GSE198533). We used cross-analysis to obtain 461 up-regulated common differential genes and 509 down-regulated common differential genes, mapped the PPI network, and used Cytohubba to identify the 15 most strongly associated genes as hub genes (ACTB, BRCA1, RHOA, CCNB1, ASPM, CCNA2, TOP2A, PCNA, AURKA, KIF20A, MAD2L1, MCM4, BUB1, RFC4, and CENPE). We screened for statistically significant hub genes and found that ACTB was in low expression of both BD and COVID-19, and ASPM, CCNA2, CCNB1, and CENPE were in low expression of BD and high expression of COVID-19. GO analysis and pathway analysis was then performed to obtain common pathways and biological response processes, which suggested a common association between BD and COVID-19. The genes-TFs-miRNAs network, genes-diseases network and genes-drugs network also play important roles in the interaction between the 2 diseases. Interaction between COVID-19 and BD exists. ACTB, ASPM, CCNA2, CCNB1, and CENPE as potential biomarkers for 2 diseases.

PMID:37335738 | DOI:10.1097/MD.0000000000033821

Medicine (Baltimore). 2023 May 19;102(20):e33824. doi: 10.1097/MD.0000000000033824.

ABSTRACT

To search whether or not the severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) messenger ribonucleic acid (mRNA) vaccine affects the fertility of women at the 6th months by using AMH, which is an ovarian reserve test. Our study, designed as a prospective case-control study, included 104 women who presented to the GOP EAH obstetrics and gynecology outpatient clinic in January and February 2022. The study group included 74 women who presented to the outpatient clinic and planned to be vaccinated and 30 women who refused to be vaccinated as the control group. Anti-COVID-19 antibody levels in all participants were checked before participation in the study, and participants who were positive were excluded from the study. Blood was taken from the participants in both control and study groups to evaluate their AMH levels before the 2 doses of vaccination. After 2 doses of the vaccine, they were called for follow-up, and serological tests were performed to check whether they were positive for anti-COVID-19 antibodies. Participants in both groups were referred for follow-up after 6 months, samples were taken again for AMH, and the data were recorded. The mean age of the study group was 27.6 ± 5.3 years, and the mean age of the control group was 28.65 ± 5.25 years (P = .298). There was no statistically significant difference between the vaccinated and nonvaccinated groups in terms of AMH levels measured at the 6th month (P = .970). When the vaccinated group was compared in terms of AMH values at the first visit before vaccination and at the 6th month after vaccination, no statistically significant difference was found between them (p:0.127) mRNA vaccination to protect against SARS-CoV-2 does not adversely affect ovarian reserve, which is an indirect indicator of fertility. mRNA vaccines continue to be the most important method of protection against epidemics. Carefully and accurately informing women who are hesitant to get vaccinated is of great importance for the success of the fight against the epidemic.

PMID:37335728 | DOI:10.1097/MD.0000000000033824