Category: Statistics

Vet Comp Oncol. 2021 Aug 24. doi: 10.1111/vco.12766. Online ahead of print.

ABSTRACT

The invasive, locally aggressive nature of feline injection-site sarcomas (FISS) pose a unique challenge for surgeons to obtain complete margins with surgical excision. Optical coherence tomography (OCT), an imaging technology that uses light waves to generate real-time views of tissue architecture, provides an emerging solution to this dilemma by allowing fast, high-resolution scanning of surgical margins. The purpose of this study was to use OCT to assess surgical margins of FISS and to evaluate the diagnostic accuracy of OCT for detecting residual cancer using six evaluators of varying experience. Five FISS were imaged with OCT to create a training set of OCT images that were compared with histopathology. Next, 25 FISS were imaged with OCT prior to histopathology. Six evaluators of varying experience participated in a training session on OCT imaging after which each of the evaluators was given a dataset that included OCT images and videos to score on a scale from cancerous to non-cancerous. Diagnostic accuracy statistics were calculated. The overall sensitivity and specificity for classification of OCT images by evaluators was 78.9% and 77.6%, respectively. Correct classification rate of OCT images was associated with experience, while individual sensitivities and specificities had more variation between experience groups. This study demonstrates the ability of evaluators to correctly classify OCT images with overall low levels of experience and training, and also illustrates areas where increased training can improve accuracy of evaluators in interpretation of OCT surgical margin images.

PMID:34427379 | DOI:10.1111/vco.12766

Mol Inform. 2021 Aug 24:e2100025. doi: 10.1002/minf.202100025. Online ahead of print.

ABSTRACT

Interleukin-1 Receptor-Associated Kinase 4 (IRAK-4) has crucial functions in inflammation, innate immunity, and malignancy. Structure-based pharmacophore modeling integrated with validated QSAR analysis was implemented to discover structurally novel IRAK-4 inhibitors from natural products database. The QSAR model combined molecular descriptors with structure-based pharmacophore capable of explaining bioactivity variation of structurally diverse IRAK-4 inhibitors. Manually built pharmacophore model, validated with receiver operating characteristic curve, and selected using the statistically optimum QSAR equation, was applied as a 3D-search query to mine AnalytiCon Discovery database of natural products. Experimental in vitro testing of highest-ranked hits identified uvaretin, saucerneol, and salvianolic acid B as active IRAK-4 inhibitors with IC₅₀ values in low micromolar range.

PMID:34427398 | DOI:10.1002/minf.202100025

Health Promot Chronic Dis Prev Can. 2021 Jul-Aug;41(7-8):211-221. doi: 10.24095/hpcdp.41.7/8.02.

ABSTRACT

INTRODUCTION: Canada’s opioid crisis has taken thousands of lives, increasing awareness of poisoning-related injuries as an important public health issue. However, in British Columbia (BC), where overdose mortality rates are the highest in Canada, studies have not yet identified which demographic populations most often visit emergency departments (ED) due to all poisonings, nor which substances are most commonly involved. The aim of this study was to explore these gaps, after developing a methodology for calculating ED visit rates in BC.

METHODS: Poisoning-related ED visit rates during fiscal years 2012/13 to 2016/17, inclusive, were calculated by sex, age group, poisoning substance and socioeconomic status, using a novel methodology developed in this study. ED data were sourced from the National Ambulatory Care Reporting System and population data from Statistics Canada’s 2016 (or 2011) census profiles.

RESULTS: During the study period, there were an estimated 81 463 poisoning-related ED visits (351.2 per 100 000 population). Infants, toddlers, youth and those aged 20-64 years had elevated risks of poisoning-related ED visits. Rates were highest among those in neighbourhoods with the greatest material (607.8 per 100 000 population) or social (484.2 per 100 000 population) deprivation. Over time, narcotics and psychodysleptics became increasingly common poisoning agents, while alcohol remained problematic.

CONCLUSION: A methodology for estimating ED visit rates in BC was developed and applied to determine poisoning-related ED visit rates among various demographic groups within BC. British Columbians most vulnerable to poisoning have been identified, emphasizing the need for efforts to limit drug overdoses and excessive alcohol intoxication to reduce rates of these preventable injuries.

PMID:34427419 | DOI:10.24095/hpcdp.41.7/8.02

J Magn Reson Imaging. 2021 Aug 24. doi: 10.1002/jmri.27867. Online ahead of print.

ABSTRACT

BACKGROUND: We have developed hybrid nanoparticles (NPs) by co-loading copper sulfide (CuS) NPs and glucose oxidase (GOD) (CuS@GOD NPs) to explore their antitumor properties.

PURPOSE: To investigate the feasibility of using multiparametric magnetic resonance imaging (MRI) including intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and R₂ * mapping to quantitatively assess the early antitumor effect of CuS@GOD NPs.

STUDY TYPE: Prospective.

ANIMAL MODEL: The orthotopic BALB/c mice 4 T1 breast cancer model. The 4 T1 xenografts in group 1 mice received normal saline, group 2 received CuS@GOD NPs, group 3 received CuS NPs plus laser, and group 4 received CuS@GOD NPs plus laser (n = 28 for each group).

FIELD STRENGTH/SEQUENCE: A 3.0 T/IVIM-DWI MRI single-shot echo-planar imaging, R₂ * mapping spoiled gradient recalled echo (SPGR) sequence, T2-weighted images (T2WI) and T1-weighted images (T1WI) fast spin echo (FSE) sequence.

ASSESSMENT: The IVIM-DWI and R₂ * mapping were performed before and after treatment at 0 hour, 0.5 hour, 1 hour, 2 hours, 4 hours, and 24 hours in four groups and the MRI parameters were obtained. Correlation analysis between the MRI parameters and histological analyses was conducted.

STATISTICAL TESTS: One-way ANOVA, Pearson’s correlation analysis, two independent samples t test, intraclass correlation coefficient. P < 0.05 was considered to be statistically significant.

RESULTS: In group 4, the tumoral D value was significantly higher than that of group 2 at 24 hours (0.541 ± 0.065 vs. 0.492 ± 0.051). The f value of group 4 was significantly lower than that of groups 1 and 2 at 2 hours (10.83 ± 2.16 vs. 14.28 ± 1.86, 16.67 ± 3.53, respectively). The R₂ * value was significantly increased at 0 hour in group 4 compared to that of groups 1 and 2 (64.552 ± 4.663 vs. 42.441 ± 1.516, 43.165 ± 1.709, respectively). D, f, and R₂ * were correlated with the histological staining results (r = 0.695-0.970).

DATA CONCLUSION: The IVIM-DWI-derived D and f and R₂ * mapping-derived R₂ * could monitor early response to CuS@GOD NPs treatment in vivo.

EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 2.

PMID:34427359 | DOI:10.1002/jmri.27867

Neuromodulation. 2021 Aug 24. doi: 10.1111/ner.13524. Online ahead of print.

ABSTRACT

OBJECTIVES: Spinal cord stimulation (SCS) can reduce the need for opioids; however, the influence on the full spectrum of pain medication is less known. The aims of this study were to explore general prescription practices for patients scheduled for SCS, potential differences in prescriptions between Belgium and United Kingdom, and the influence of SCS on pain medication.

MATERIALS AND METHODS: Individual patient data from the TRIAL-STIM study in the United Kingdom and DISCOVER in Belgium were pooled. Medication use was collected before SCS and three months after SCS from 180 chronic pain patients. The Medication Quantification Scale III (MQS) was used to calculate a total score for medication use, as well as subscores for several classes. Differences in prescription practices between United Kingdom and Belgium were evaluated with two-sided Wilcoxon tests. To evaluate differences in medication use after three months of SCS between United Kingdom and Belgium, Tweedie-generalized linear models were calculated.

RESULTS: There was a statistically significant difference (-6.40 [95% CI from -3.40 to -9.10]) between the median total MQS score in United Kingdom and Belgium before SCS. Additionally, a significant difference was found for nonsteroidal anti-inflammatory drugs (NSAIDs) (-3.40 [95% CI -3.40 to -6.80]), neuropathic agents (-2.30 [95% CI -0.40 to -3.80]), and benzodiazepines (1.83e^-05 [95% CI 2.64^-05 to 7.45^-05 ]) between United Kingdom and Belgium, before SCS. Tweedie-generalized models revealed a statistically significant interaction between country and time for MQS, neuropathic agents, and opioids.

CONCLUSIONS: Our combined analysis revealed differences in prescription practice in patients scheduled for SCS implantation between Belgium and United Kingdom. NSAIDs and neuropathic mood agents are more frequently used in the United Kingdom, presumably due to easier access to repeat prescriptions and over the counter medications. After three months of SCS, a decrease in medication use is observed in both countries, with higher reductions in Belgium, presumably due to strict regulations concerning reimbursement criteria.

PMID:34427369 | DOI:10.1111/ner.13524

Br J Educ Psychol. 2021 Aug 24:e12456. doi: 10.1111/bjep.12456. Online ahead of print.

ABSTRACT

BACKGROUND: Parent involvement in school is a consistent predictor of educational success. However, research has been inconsistent in addressing how parent involvement ought to be defined and measured, which has led to varied findings across schools and educational systems.

AIMS: Attending to the multidimensionality of the construct, this study adopted a person-centred approach to identify subpopulations of school-based parent involvement. Subsequently, profile differences were investigated in relation to student engagement and three antecedent variables (gender, socio-economic status, and authoritative parenting).

SAMPLE: Data were obtained from primary (10-year old; N = 4,284) and secondary (14-year old; N = 3,346) school students in Singapore.

METHODS: Latent profile analysis was conducted on student-rated surveys of multiple parent involvement behaviours in school and their perceptions. Subsequently, the manual BCH method was employed to concurrently model covariates and outcomes on the latent profile model. Pairwise comparisons between profiles were examined for statistical significance.

RESULTS: Consistent across both cohorts, four distinct profiles emerged that revealed high, moderate, selective, and low parent involvement patterns. High parent involvement reflected high ratings across multiple activities, combined with positive perceptions of parental involvement. These profiles differed significantly in terms of their antecedent characteristics, particularly, authoritative parenting, and in relation to their impact on student engagement.

CONCLUSION: Results from this study clarify relations between multi-faceted dimensions of parent involvement in school. Additionally, there is a case for continued school-family partnerships among secondary students as students remain academically engaged when parents are involved in school and students relate positively to their involvement.

PMID:34427322 | DOI:10.1111/bjep.12456

CA Cancer J Clin. 2021 Aug 24. doi: 10.3322/caac.21693. Online ahead of print.

ABSTRACT

Brain and other central nervous system (CNS) tumors are among the most fatal cancers and account for substantial morbidity and mortality in the United States. Population-based data from the Central Brain Tumor Registry of the United States (a combined data set of the National Program of Cancer Registries [NPCR] and Surveillance, Epidemiology, and End Results [SEER] registries), NPCR, National Vital Statistics System and SEER program were analyzed to assess the contemporary burden of malignant and nonmalignant brain and other CNS tumors (hereafter brain) by histology, anatomic site, age, sex, and race/ethnicity. Malignant brain tumor incidence rates declined by 0.8% annually from 2008 to 2017 for all ages combined but increased 0.5% to 0.7% per year among children and adolescents. Malignant brain tumor incidence is highest in males and non-Hispanic White individuals, whereas the rates for nonmalignant tumors are highest in females and non-Hispanic Black individuals. Five-year relative survival for all malignant brain tumors combined increased between 1975 to 1977 and 2009 to 2015 from 23% to 36%, with larger gains among younger age groups. Less improvement among older age groups largely reflects a higher burden of glioblastoma, for which there have been few major advances in prevention, early detection, and treatment the past 4 decades. Specifically, 5-year glioblastoma survival only increased from 4% to 7% during the same time period. In addition, important survival disparities by race/ethnicity remain for childhood tumors, with the largest Black-White disparities for diffuse astrocytomas (75% vs 86% for patients diagnosed during 2009-2015) and embryonal tumors (59% vs 67%). Increased resources for the collection and reporting of timely consistent data are critical for advancing research to elucidate the causes of sex, age, and racial/ethnic differences in brain tumor occurrence, especially for rarer subtypes and among understudied populations.

PMID:34427324 | DOI:10.3322/caac.21693

J Postgrad Med. 2021 Jul-Sep;67(3):139-145. doi: 10.4103/jpgm.JPGM_1270_20.

ABSTRACT

CONTEXT: Previous studies on the association between atopic dermatitis (AD) and systemic lupus erythematosus (SLE) have yielded inconsistent results.

AIMS: To investigate the relationship between atopic dermatitis and systemic lupus erythematosus.

SETTINGS AND DESIGN: Systematic review and meta-analysis.

MATERIALS AND METHODS: A systematic review was conducted on EMBASE and MEDLINE databases from inception to March 2020 using a search strategy that consisted of terms related to AD and SLE. Eligible study must be either cohort or case-control study. For cohort studies, they must include patients with AD and comparators without AD, then follow them for incident SLE. For case-control studies, they must include cases with SLE and controls without SLE and examine their prior history of AD.

STATISTICAL ANALYSIS USED: Meta-analysis of the studies was performed using a random-effect, generic inverse variance method to combine effect estimate and standard error. Funnel plot was used to assess publication bias.

RESULTS: A total of 21,486 articles were retrieved. After two rounds of review by three investigators, six case-control studies were qualified for the meta-analysis. The case-control study meta-analysis found a significantly increased odds of SLE among patients with AD with the pooled odds ratio of 1.46 (95% CI, 1.05-2.04).

CONCLUSIONS: A significant association between AD and increased odds of SLE was observed by this systematic review and meta-analysis.

PMID:34427279 | DOI:10.4103/jpgm.JPGM_1270_20

Br J Educ Psychol. 2021 Aug 24:e12455. doi: 10.1111/bjep.12455. Online ahead of print.

ABSTRACT

BACKGROUND: To date, studies that have investigated the bonds between students and their institution have emphasized the importance of student-staff relationships. Measuring the quality of those relationships (i.e., relationship quality) appears to help with investigating the relational ties students have with their higher education institutions. Growing interest has arisen in further investigating relationship quality in higher education, as it might predict students’ involvement with the institution (e.g., student engagement and student loyalty). So far, most studies have used a cross-sectional design, so that causality could not be determined.

AIMS: The aim of this longitudinal study was twofold. First, we investigated the temporal ordering of the relation between the relationship quality dimensions of trust (in benevolence and honesty) and affect (satisfaction, affective commitment, and affective conflict). Second, we examined the ordering of the paths between relationship quality, student engagement, and student loyalty. Our objectives were to gain a deeper understanding of the relationship quality construct in higher education and its later outcomes.

SAMPLE: Participants (N = 1649) were students from three Dutch higher education institutions who were studying in a technology economics or social sciences program.

METHODS: Longitudinal data from two time points were used to evaluate two types of cross-lagged panel models. In the first analysis, we could not assume measurement invariance for affective conflict over time. Therefore, we tested an alternative model without affective conflict, using the latent variables of trust and affect, the student engagement dimensions and student loyalty. In the second type of model, we investigated the manifest variables of relationship quality, student engagement, and student loyalty. The hypotheses were tested by evaluating simultaneous comparisons between estimates.

RESULTS: Results indicated that the relation between relationship quality at Time 1 with student engagement and loyalty at Time 2 was stronger than the reverse ordering in the first model. In the second model, results indicated that cross-lagged relations between trust in benevolence and trust in honesty at Time 1 and affective commitment, affective conflict, and satisfaction at Time 2 were more likely than the reverse ordering. Furthermore, cross-lagged relations from relationship quality at Time 1 to student engagement and student loyalty at Time 2 also supported our hypothesis.

CONCLUSIONS: This study contributes to the existing higher education literature, indicating that students’ trust in the quality of their relationship with faculty/staff is essential for developing students’ affective commitment and satisfaction and for avoiding conflict over time. Second, relationship quality factors positively influence students’ engagement in their studies and their loyalty towards the institution. A relational approach to establishing (long-lasting) bonds with students appears to be fruitful as an approach for educational psychologists and for practitioners’ guidance and strategies. Recommendations are made for future research to further examine relationship quality in higher education in Europe and beyond.

PMID:34427320 | DOI:10.1111/bjep.12455

Indian J Ophthalmol. 2021 Sep;69(9):2507-2510. doi: 10.4103/ijo.IJO_792_21.

ABSTRACT

PURPOSE: To evaluate practice patterns in the treatment of corneal ulcer by ophthalmologists during COVID-19 pandemic in the Indian subcontinent.

METHODS: This was an online questionnaire-based survey circulated via google form to reach ophthalmologists practising cornea as a subspeciality between January 4, 2021 and February 3, 2021. The survey comprised of 21 questions to evaluate the prevailing practice patterns in corneal ulcer management during pandemic.

RESULTS: In total, 39.3% of government ophthalmology clinics and 41.5% of private ophthalmology clinics reported an average delay of 2 weeks in presenting to the hospital after the onset of symptoms. Totally, 60.5% of participants reported that the clinical outcomes of infectious keratitis cases during the COVID-19 pandemic were worse than before. In total, 61.3 and 41.1% of ophthalmologists in private and government sectors, respectively, were routinely performing corneal scrapings for corneal ulcer patients. The procedures were performed with adequate protective measures. In total, 68.5% participants mentioned decreased availability of donor cornea during the pandemic, and 44.4% reported compromised cornea practice due to the limited availability of essentials (tissue adhesives, BCLs, medications, etc.). A statistically significant difference of effect of pandemic on cost of services was noted between government and private hospitals. In total, 51% participants from private hospitals reported hike in outpatient department services and surgical charges, and 78.6% from government hospitals mentioned no hike in the charges (P value <0.001).

CONCLUSION: This study provides an overview on modified strategies in corneal ulcer management during pandemic without compromising patient safety and quality care.

PMID:34427254 | DOI:10.4103/ijo.IJO_792_21