Category: Statistics

J Cancer Educ. 2022 Aug 19. doi: 10.1007/s13187-022-02204-5. Online ahead of print.

ABSTRACT

Access to electronic medical record (EMR) patient portals made it easier for patients to quickly acquire the results of their radiology studies. However, there is little research on how well oncology patients understand the findings of radiology reports presented in the online portal without patient-physician discussion. This study assessed oncology patients’ confidence and accuracy in interpreting radiology reports either with or without layman translations. A survey based on a radiology report was administered to oncology patients and caregivers. Two versions of the radiological report were randomly distributed, either a standard report or one with layman translations to evaluate participant understanding and accuracy of interpreting radiological results. Among 85 participants, a majority (67.8%) reported wanting patient portal access to radiological reports, yet less than a quarter (21.2%) felt confident in reading and interpreting radiological reports. Univariate binary logistic regression models showed that participants who read the lay report were 8 times more likely to find the radiology report easy to read. This research demonstrated that the inclusion of layman translation of standard radiology reports improves oncology patients’ and caregivers’ understanding of such reports with statistically significant and clinically meaningful increases in readability.

PMID:35984630 | DOI:10.1007/s13187-022-02204-5

Dermatol Ther (Heidelb). 2022 Aug 19. doi: 10.1007/s13555-022-00789-9. Online ahead of print.

ABSTRACT

INTRODUCTION: Tildrakizumab 200 mg/2 mL pre-filled syringe is a new preparation of tildrakizumab that is developed to facilitate patients’ compliance. This phase I clinical trial compares the local tolerability, safety, and subjects’ preferred method of administration of tildrakizumab when administered as a new single 200 mg/2 mL subcutaneous injection or as two 100 mg/1 mL subcutaneous injections in healthy subjects.

METHODS: Visual analogue scores were used to self-assess injection site pain immediately (< 1 min) after each administration and at 1 h and 48 h after each administration. Treatment injection site reactions were assessed at 1 h and 48 h after each administration. Treatment safety was monitored throughout the study period. Subjects’ preferred method of administration was assessed 4 weeks after the last administration (day 56).

RESULTS: No statistically significant difference in visual analogue scores and injection site reactions was detected between the two treatments. Treatment-emergent adverse events were mild, and there were no deaths or serious adverse events. Most subjects (61.5%) preferred the treatment when administered as a single 200 mg/2 mL subcutaneous injection rather than as two 100 mg/mL subcutaneous injections.

CONCLUSIONS: Administration of 200 mg tildrakizumab as a single 2 mL subcutaneous injection was safe, well tolerated, and preferred over two separate 100 mg/1 mL subcutaneous injections by healthy subjects. Eudract No. 2020-000183-37.

PMID:35984626 | DOI:10.1007/s13555-022-00789-9

Mem Cognit. 2022 Aug 19. doi: 10.3758/s13421-022-01351-w. Online ahead of print.

ABSTRACT

The consistency effect, prevalent in the text comprehension literature, comprises longer reading times for inconsistent than equivalent consistent text continuations. It is widely interpreted as reflecting readers’ effective “validation” of text coherence. However, there are also numerous phenomena of readers’ deficient validation, sometimes collectively labelled “misinformation effects.” This study asked whether readers become consciously aware of the text discrepancies diagnosed by the consistency effect. Experiment 1 scrutinized (a) conspicuous conceptual inconsistencies and (b) character-trait inconsistencies. It replicated the consistency effect both at a critical target sentence and at a subsequent sentence (spillover). Experiment 2 replaced self-paced reading with consistency judgments about the target sentences. The subjects overlooked almost half of the inconsistencies, thus denying that readers reliably become aware of consistency-effect discrepancies. In Experiment 3, the former target sentences were reframed as explicit questions. Accuracy for inconsistencies was statistically indistinguishable from accuracy for consistent targets, favoring the interpretation that Experiment 2 subjects overlooked known, encoded discrepancies. The results are interpreted with reference to Kintsch’s (Psychological Review, 95, 163-182, Kintsch, 1988; Comprehension. New York: Cambridge University Press, Kintsch, 1998) construction-integration model, a refinement of which adds an immediate, passive stage of validation processing to construction and integration. It is proposed that passive validation affords the detection of text inconsistencies that do not reach the level of readers’ conscious awareness.

PMID:35984623 | DOI:10.3758/s13421-022-01351-w

Endocrine. 2022 Aug 19. doi: 10.1007/s12020-022-03164-y. Online ahead of print.

ABSTRACT

PURPOSE: Delayed hyponatremia can occur after pituitary surgery, resulting in prolonged hospitalization. However, the influence of surgical factors after such a procedure has not been well established. The impact of surgery and related factors on delayed hyponatremia was investigated.

METHODS: This was a retrospective analysis of 137 consecutive patients who underwent transsphenoidal surgery for a nonfunctioning pituitary adenoma between 2008 and 2019. Preoperative (demographics, comorbidities), intraoperative (resection extent, operation time, blood loss volume, cerebrospinal fluid leak, tumor consistency), and postoperative [hematoma, meningitis, diabetes insipidus (DI), hormonal assessment] data were collected, with statistical analysis of each factor performed.

RESULTS: Among the 137 patients, delayed hyponatremia occurred in 31 (22.6%). Multivariate analysis revealed that those with hypertension had a significantly higher likelihood of avoiding delayed hyponatremia (p = 0.004). Although no correlations of direct surgical factors with delayed hyponatremia were found, multivariate analysis of indirect surgical factors showed that presence of a firm tumor, transient DI, and meningitis were significantly associated with delayed hyponatremia (p = 0.014, 0.001, and 0.047, respectively). There was also a significant association of severe hyponatremia with appearance of symptoms (p = 0.002).

CONCLUSION: There was a tendency for hypertension to be associated with delayed hyponatremia avoidance, with indirect surgical factors including tumor consistency, transient DI, and meningitis found to have an influence on delayed hyponatremia. It was concluded that attention should be given to non-hypertensive patients with a firm tumor, transient DI, or meningitis after pituitary surgery, as delayed hyponatremia may occur.

PMID:35984619 | DOI:10.1007/s12020-022-03164-y

Musculoskelet Surg. 2022 Aug 19. doi: 10.1007/s12306-022-00758-7. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the influence of short versus long stems implanted through a Direct Anterior Approach (DAA) on clinical and radiological outcomes in THA at medium-term follow-up (average follow-up of 44.8 months).

METHODS: 167 consecutive total hip arthroplasties treating patients affected by primary hip osteoarthritis were retrospectively evaluated. A standard-length stem (H-MAXs) was used in 70 patients, while a short metaphyseal-fitting femoral stem (MINIMA) was used in 97 patients. The Harris Hip Score (HHS) and Forgotten Joint Score-12 (FJS) were used as outcomes measurements. Post-operatively, Engh’s score and Brooker classification were analyzed at 6 months, 1 year and every 2 years until the final FU. The correct size of the implant was evaluated determining the canal fill index (CFI), and all undersized stems were classified according to Magra classification.

RESULTS: The average HHS was 83 ± 13.4 in the standard stems group and 87 ± 14.1 for short stems group (p = 0.148). The average FJS was 87.9 ± 15.2 for patients in the standard stems group and 84.5 ± 17.7 with no significant differences (p = 0.327). None of the stems showed radiographic signs of instability (standard stems mean Engh’s score: 19.25 versus short stems mean Engh’s score: 19.50-p = 0.41). According to Brooker classification, no significant difference in severity was found using different stems (p = 0.715). A high rate of undersized stems was found (standard stems 24%-short stems 25%) but without statistical difference between groups (p = 0.078), while a different trend in malposition following the recent classification proposed by Magra et al. was observed evaluating all undersized stems (p = 0.0387).

CONCLUSIONS: Both groups achieved good and comparable patient-reported outcome measurements (PROMs) and radiographic stability with fixation observed by bone ingrowth. A high rate of undersized stems was found with a correlation between femoral stem length and specific pattern of malposition. Malalignment in Varus was frequent in shorter stems in contact proximally with medial calcar and distally with lateral cortex, while a uniform undersizing was observed for longer ones with a continuous margin around the stem. However, the stems never presented progressive radiolucent lines over the whole surface of the stem.

PMID:35984610 | DOI:10.1007/s12306-022-00758-7

Orig Life Evol Biosph. 2022 Aug 19. doi: 10.1007/s11084-022-09627-6. Online ahead of print.

ABSTRACT

To understand chiral symmetry breaking on the molecular level, we developed a method to efficiently investigate reaction kinetics of single molecules. The model systems include autocatalysis as well as a reaction cascade to gain further insight into the prebiotic origin of homochirality. The simulated reactions start with a substrate and only a single catalyst molecule, and the occurrence of symmetry breaking was examined for its degree of dependence on randomness. The results demonstrate that interlocking processes, which e.g., form catalysts, autocatalytic systems, or reaction cascades that build on each other and lead to a kinetic acceleration, can very well amplify a statistically occurring symmetry breaking. These results suggest a promising direction for the experimental implementation and identification of such processes, which could have led to a shift out of thermodynamic equilibrium in the emergence of life.

PMID:35984585 | DOI:10.1007/s11084-022-09627-6

Breast Cancer Res Treat. 2022 Aug 19. doi: 10.1007/s10549-022-06698-x. Online ahead of print.

ABSTRACT

PURPOSE: BluePrint (BP) is an 80-gene molecular subtyping test that classifies early-stage breast cancer (EBC) into Basal, Luminal, and HER2 subtypes. In most cases, breast tumors have one dominant subtype, representative of a single activated pathway. However, some tumors show a statistically equal representation of more than one subtype, referred to as dual subtype. This study aims to identify and examine dual subtype tumors by BP to understand their biology and possible implications for treatment guidance.

METHODS: The BP scores of over 15,000 tumor samples from EBC patients were analyzed, and the differences between the highest and the lowest scoring subtypes were calculated. Based upon the distribution of the differences between BP scores, a threshold was determined for each subtype to identify dual versus single subtypes.

RESULTS: Approximately 97% of samples had one single activated BluePrint molecular subtype, whereas ~ 3% of samples were classified as BP dual subtype. The most frequently occurring dual subtypes were the Luminal-Basal-type and Luminal-HER2-type. Luminal-Basal-type displays a distinct biology from the Luminal single type and Basal single type. Burstein’s classification of the single and dual Basal samples showed that the Luminal-Basal-type is mostly classified as ‘luminal androgen receptor’ and ‘mesenchymal’ subtypes, supporting molecular evidence of AR activation in the Luminal-Basal-type tumors. Tumors classified as Luminal-HER2-type resemble features of both Luminal-single-type and HER2-single-type. However, patients with dual Luminal-HER2-type have a lower pathological complete response after receiving HER2-targeted therapies in addition to chemotherapy in comparison with patients with a HER2-single-type.

CONCLUSION: This study demonstrates that BP identifies tumors with two active functional pathways (dual subtype) with specific transcriptional characteristics and highlights the added value of distinguishing BP dual from single subtypes as evidenced by distinct treatment response rates.

PMID:35984580 | DOI:10.1007/s10549-022-06698-x

CJEM. 2022 Aug 19. doi: 10.1007/s43678-022-00363-4. Online ahead of print.

ABSTRACT

PURPOSE: We examined changes in annual paramedic transport incidence over the ten years prior to COVID-19 in comparison to increases in population growth and emergency department (ED) visitation by walk-in.

METHODS: We conducted a population-level cohort study using the National Ambulatory Care Reporting System from January 1, 2010 to December 31, 2019 in Ontario, Canada. We included all patients triaged in the ED who arrived by either paramedic transport or walk-in. We clustered geographical regions using the Local Health Integration Network boundaries. Descriptive statistics, rate ratios (RR), and 95% confidence intervals were calculated to explore population-adjusted changes in transport volumes.

RESULTS: Overall incidence of paramedic transports increased by 38.3% (n = 264,134), exceeding population growth fourfold (9.4%) and walk-in ED visitation threefold (13.4%). Population-adjusted transport rates increased by 26.2% (rate ratio 1.26, 95% CI 1.26-1.27) compared to 3.4% for ED visit by walk-in (rate ratio 1.03, 95% CI 1.03-1.04). Patient and visit characteristics remained consistent (age, gender, triage acuity, number of comorbidities, ED disposition, 30-day repeat ED visits) across the years of study. The majority of transports in 2019 had non-emergent triage scores (60.0%) and were discharged home directly from the ED (63.7%). The largest users were persons aged 65 or greater (43.7%). The majority of transports occurred in urbanized regions, though rural and northern regions experienced similar paramedic transport growth rates.

CONCLUSION: There was a substantial increase in the demand for paramedic transportation. Growth in paramedic demand outpaced population growth markedly and may continue to surge alongside population aging. Increases in the rate of paramedic transports per population were not bound to urbanized regions, but were province-wide. Our findings indicate a mounting need to develop innovative solutions to meet the increased demand on paramedic services and to implement long-term strategies across provincial paramedic systems.

PMID:35984572 | DOI:10.1007/s43678-022-00363-4

Radiol Med. 2022 Aug 19. doi: 10.1007/s11547-022-01533-1. Online ahead of print.

ABSTRACT

PURPOSE: To compare the characteristics detected by 7Tesla (7 T) MR and the histological composition of ex-vivo specimens from lesions diagnosed at preoperative CT scan as Pancreatic Ductal Adenocarcinoma (PDAC).

MATERIALS AND METHODS: Ten pancreatic specimens were examined. The 7 T imaging protocol included both morphologic and quantitative sequences; the latter was acquired by conventional methods and a novel multiparametric method, the magnetic resonance fingerprinting (MRF) sequence. Two radiologists reviewed the images to: (1) evaluate the quality of the morphological and quantitative sequences by assigning an “image consistency score” on a 4-point scale; (2) identify the lesion, recording its characteristics; (3) perform the quantitative analysis on “target lesion” and “non target tissue”. Finally, the specimen was analysed by two pathologists.

RESULTS: Seven out of 10 lesions were PDAC, 2/10 were biliary carcinomas, whereas one lesion was an ampullary adenocarcinoma. The quality of the morphological sequences was judged “excellent”. The “image consistency score” for the conventional quantitative sequences and MRF were 2.8 ± 0.42 and 2.9 ± 0.57; the “overall MR examination score” was 3.5 ± 0.53. A statistical correlation was found between the relaxation time values of conventional and MRF T1-weighted sequences (p < 0.0001), as well as between conventional and MRF fat- and water-fraction maps (p < 0.05). The “target lesion” and “non target tissue” relaxation time values were statistically different according to conventional T1-, T2-weighted, and MRF T1-weighted sequences.

CONCLUSIONS: Conventional T1-, T2-weighted sequences and MRF derived relaxometries may be useful in differentiating between tumour and non-target pancreatic tissue. Moreover, the MRF sequence can be used to obtain reliable relaxation time data.

PMID:35984559 | DOI:10.1007/s11547-022-01533-1

Eur J Health Econ. 2022 Aug 19. doi: 10.1007/s10198-022-01506-1. Online ahead of print.

ABSTRACT

The COVID-19 pandemic has brought many changes into people’s lives. Fear, job insecurity, changes in their financial stability, concerns about their future lives have changed the entire lives of people and have affected the cognitive well-being of individuals. The purpose of the present analysis is to measure how the COVID-19 pandemic, along with financial factors, has affected the perceived level of well-being of individuals. We are also interested whether there are differences between life before COVID-19, life now with COVID-19, and life after the COVID-19 pandemic, in terms of future expectations. To address this objective, we performed an ANOVA approach and a GLM estimate on repeated measures for a large sample (1572 respondents) from 43 worldwide countries, during the period May 2020 and July 2021. Our results show that financial factors reflected by both the size of income and changes in personal or family income affect the levels of happiness. Robustness checks using stress as an alternative estimator for happiness have consolidated our results. Additionally, we find that well-being during COVID-19 compared to the previous period decreased, while in future, people expect to be happier, but not more than in the past when they did not know about the existence of this virus. This is one of the first studies to investigate the relationship between happiness and income before, during, and after COVID-19. These findings are important for policymakers to improve the conditions of living in the areas of health and financial stability.

PMID:35984544 | DOI:10.1007/s10198-022-01506-1