Category: Statistics

Histopathology. 2021 Apr 10. doi: 10.1111/his.14384. Online ahead of print.

ABSTRACT

BACKGROUND: Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is an uncommon hepatic malignancy with a poor outcome. The 2019 WHO classification modified the definition and discarded the subtypes harboring stem cell features. However, the differences among cHCC-CCA, hepatocellular carcinoma (HCC), HCC with stem cell features (HCCscf) and intrahepatic cholangiocarcinoma (iCCA) remain undetermined. The aim of the study is to investigate the characteristics of cHCC-CCA in comparisons with other primary liver cancers utilizing the updated WHO classification.

METHODS AND RESULTS: We retrospectively analyzed 64 cHCC-CCA and 55 HCCscf patients from Dec2007 to May2018. A propensity score matching was conducted to compare with HCC and iCCA patients. Clinicopathological characteristics, event-free (EFS) and overall survival (OS) were evaluated with multivariate Cox proportional hazard regression. In a median follow-up of 55.9 months, patients with cHCC-CCA had a significantly poor survival as compared with HCCscf and an intermediate survival outcome between HCC and iCCA. HBV infection and high tumor infiltrating lymphocytes (TILs) were associated with a favorable survival in cHCC-CCA. In the multivariate analysis, poor hepatic reserve, absence of HBV infection, stage IV disease and low TILs were significant negative prognostic factors in cHCC-CCA. After pooling with other primary liver cancers, tumor type of cHCC-CCA and iCCA predicted the worse survival results.

CONCLUSION: cHCC-CCA have an intermediate survival between HCC and iCCA and HBV infection and high TILs predict the favorable survival. Our study provides clinical correlations for the new 2019 WHO classification.

PMID:33837585 | DOI:10.1111/his.14384

Trop Med Int Health. 2021 Apr 10. doi: 10.1111/tmi.13587. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the effectiveness of nanopermethrin as a potential new formulation for pest and vector control.

METHODS: Permethrin nanoparticles were prepared by the ionic gelation method and its structure and the formulations were designed using Box-Behnken statistical technique. The effect of independent variables (Chitosan/Permethrin ratio, tripolyphosphate quantity, sonication time) on the properties of nanoparticles was investigated to determine the optimal formulation.

RESULTS: The size of the nanoparticles ranged from 135.27±5.88 to 539.5±24.01nm and the insecticide entrapment efficiency percent (EE%) ranged from 7.72±1.36 to 63.59±3.17%. Anopheles stephensi larvae were then bioassayed with the nanopermethrin and compared with the results of the bioassay with the mother molecule of permethrin using a standard WHO recommended mosquito larval bioassay kit. LC₅₀ with permethrin and nanopermethrin on larvae of An. stephensi were 0.125 and 0.026 ppm showing a 4.8 times difference. The LC₅₀ for permethrin and nanopermethrin on Cx. pipiens were 0.003 and 0.00032 ppm respectively showing a 9.4-fold difference.

CONCLUSION: Nanopermethrin is much more potent than its mother molecule against larvae of An. stephensi and Cx. pipiens.

PMID:33837621 | DOI:10.1111/tmi.13587

J Occup Health. 2021 Jan;63(1):e12215. doi: 10.1002/1348-9585.12215.

ABSTRACT

OBJECTIVE: We aimed to analyse age-standardised mortality trends in Japan among blue- and white-collar male workers aged 25-64 years, by major causes of mortality from 1980 to 2015.

METHODS: Five-yearly mortality data were extracted from occupation-specific vital statistics maintained by the Japanese Ministry of Health, Labour and Welfare. A time series study was conducted among employed men aged 25-64 years. Age-standardised mortality trends by occupational category were calculated separately for all cancers, ischaemic heart disease, cerebrovascular disease and suicide. Poisson regression analysis was performed to analyse mortality trends by occupational category for each cause.

RESULTS: Mortality rates for all cancers and ischaemic heart disease were higher among white-collar workers than blue-collar workers throughout the 35-year study period. The gap in the mortality rates for all four causes of death among blue- and white-collar workers widened in 2000 after Japan’s economic bubble burst in the late 1990s. Simultaneously, suicide mortality rates among white-collar workers increased sharply and have remained higher than among blue-collar workers.

CONCLUSIONS: White-collar male workers in Japan have a higher risk of mortality than male blue-collar workers. However, despite substantial differences, significant progress has been made in recent years in reducing mortality across all occupations in Japan.

PMID:33837627 | DOI:10.1002/1348-9585.12215

Med Phys. 2021 Apr 10. doi: 10.1002/mp.14878. Online ahead of print.

ABSTRACT

PURPOSE: To show that intrinsic radiosensitivity varies greatly for protons and carbon (C) ions in addition to photons, and that DNA repair capacity remains important in governing this variability.

METHODS: We measured or obtained from the literature clonogenic survival data for a number of human cancer cell lines exposed to photons, protons (9.9 keV/μm), and C-ions (13.3-77.1 keV/μm). We characterized their intrinsic radiosensitivity by the dose for 10% or 50% survival (D_10% or D_50% ), and quantified the variability at each radiation quality by the coefficient of variation (COV) in D_10% and D_50% . We also treated cells with DNA repair inhibitors prior to irradiation to assess how DNA repair capacity affects their variability.

RESULTS: We found no statistically significant differences in the COVs of D_10% or D_50% between any of the radiation qualities investigated. The same was true regardless of whether the cells were treated with DNA repair inhibitors, or whether they were stratified into histologic subsets. Even within histologic subsets, we found remarkable differences in radiosensitivity for high LET C-ions that were often greater than the variations in RBE, with brain cancer cells varying in D_10% (D_50% ) up to 100% (131%) for 77.1 keV/μm C-ions, and non-small cell lung cancer and pancreatic cancer cell lines varying up to 55% (76%) and 51% (78%), respectively, for 60.5 keV/μm C-ions. The cell lines with modulated DNA repair capacity had greater variability in intrinsic radiosensitivity across all radiation qualities.

CONCLUSIONS: Even for cell lines of the same histologic type, there are remarkable variations in intrinsic radiosensitivity, and these variations do not differ significantly between photon, proton or C-ion radiation. The importance of DNA repair capacity in governing the variability in intrinsic radiosensitivity is not significantly diminished for higher LET radiation.

PMID:33837540 | DOI:10.1002/mp.14878

J Gastroenterol Hepatol. 2021 Apr 9. doi: 10.1111/jgh.15517. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: The current prevalence of hepatitis C virus infection and hepatitis C virus-associated mortality in Japan falls short of the World Health Organization goal of viral hepatitis elimination by 2030. We aimed to evaluate the trends in hepatitis C virus-associated mortality in Japan.

METHODS: This nationwide observational study used the Japanese Vital Statistics from 1998 to 2017 and included all Japanese hepatitis C virus-associated deaths (84,936) of adults aged ≥40 years. We calculated the crude and age-standardized mortality rates per 100,000 persons by age and sex. Joinpoint regression analysis was used to identify significant changing points in trends and to estimate the annual percentage changes and the average annual percentage changes for the entire study period.

RESULTS: The crude mortality rate per 100,000 persons (annual death number) increased from 5.5 (3,548) in 1998 to 7.0 (4,843) in 2005 and decreased to 4.0 (3,095) in 2017. By 2017, the crude mortality rates per 100,000 persons among men and women had dropped to 3.6 and 4.3, respectively. The age-standardized mortality rate was higher in women than in men. The average annual percentage change was -3.8% (95% confidence interval: -5.0 to -2.5). The declining trend was more rapid in men (-4.5%, 95% confidence interval: -5.3 to -3.6) than in women (-2.7%, 95% confidence interval: -3.8 to -1.6).

CONCLUSIONS: Trends in hepatitis C virus-associated mortality rates have declined in an accelerating manner in Japan, especially among men.

PMID:33837565 | DOI:10.1111/jgh.15517

Biom J. 2021 Apr 9. doi: 10.1002/bimj.202000207. Online ahead of print.

ABSTRACT

In a paper published in 1939 in The Annals of Mathematical Statistics, Wald and Wolfowitz discussed the possible validity of a probability inequality between one- and two-sided coverage probabilities for the empirical distribution function. Twenty-eight years later, Vandewiele and Noé proved this inequality for Kolmogorov-Smirnov type goodness of fit tests. We refer to this type of inequality as one-two inequality. In this paper, we generalize their result for one- and two-sided union-intersection tests based on positively associated random variables and processes. Thereby, we give a brief review of different notions of positive association and corresponding results. Moreover, we introduce the notion of one-two dependence and discuss relationships with other dependence concepts. While positive association implies one-two dependence, the reverse implication fails. Last but not least, the Bonferroni inequality and the one-two inequality yield lower and upper bounds for two-sided acceptance/rejection probabilities which differ only slightly for significance levels not too large. We discuss several examples where the one-two inequality applies. Finally, we briefly discuss the possible impact of the validity of a one-two inequality on directional error control in multiple testing.

PMID:33837570 | DOI:10.1002/bimj.202000207

Int J Gynaecol Obstet. 2021 Apr 10. doi: 10.1002/ijgo.13702. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the influence of cancer on ovarian response and oocyte quality in controlled ovarian hyperstimulation (COH).

METHODS: This prospective study conducted at the Physiopathology of Reproduction and Andrology Unit of Sandro Pertini Hospital enrolled 82 cancer patients undergoing controlled ovarian stimulation (COH) cycles for fertility preservation, and age- and date-matched controls undergoing COH for in vitro fertilization (IVF) for male-factor infertility from June 2016 to November 2019. The interventions performed were COH, oocyte retrieval, and quality evaluation. Main outcome measures were maximal estradiol levels on the day of human chorionic gonadotropin administration, duration of stimulation, total amount of gonadotropins administered, number of oocytes retrieved, and rates of metaphase 2 oocytes and abnormal oocytes. All data were analyzed using the Statistical Package for the Social Sciences (SPSS) 22.0 – SPSS Chicago, IL, USA.

RESULTS: Intergroup comparisons (82 cancer patients and 180 patients in control group) showed a significant difference in ovarian response, especially for a significant higher number of abnormal oocytes in cancer patients (P < 0.0001). Regression analysis to assess the influence of the neoplastic process, regardless of the type, on ovarian response showed an effect on the main outcome measured due to cancer itself.

CONCLUSION: Cancer influences the ovarian response, particularly the oocyte quality, during COH performed for fertility preservation.

PMID:33837528 | DOI:10.1002/ijgo.13702

J Anim Ecol. 2021 Apr 10. doi: 10.1111/1365-2656.13492. Online ahead of print.

ABSTRACT

1. Neonicotinoid insecticides are the most widely used class of insecticides in the world and can have both lethal and sub-lethal effects on non-target organisms in agricultural areas. Monarch butterflies (Danaus plexippus) have experienced dramatic declines in recent decades and, given that a large proportion of milkweed on the landscape grows in agricultural areas, there is concern about the negative effects of neonicotinoids on this non-target insect. 2. In the field, we exposed common milkweed (Asclepias syriaca), an obligate host plant of monarch butterflies, to agriculturally-realistic levels of clothianidin, a widely used neonicotinoid insecticide. We tested whether this treatment influenced the number of eggs laid and larval survival over two years. 3. Milkweeds were transplanted into 60 experimental plots alongside a corn crop planted with a clothianidin seed-coat and 60 control plots alongside an untreated corn crop. The number of eggs, larvae at each stage (first-fifth instar), and presence of other arthropods were recorded weekly from June to the end of August and survival from egg to fifth instar was estimated using a Bayesian state-space statistical model. 4. We counted more eggs in treated plots compared to control plots, suggesting a preference for treated milkweed. The number of plots with arthropods did not differ between treatments, but within treated plots, there was a greater decrease in the number of arthropods throughout the season. There was no evidence that monarchs selected plots with fewer arthropods for oviposition. Larval survival was lower in clothianidin-treated plots compared to control plots. 5. Our results suggest milkweed near clothianidin-treated crops can reduce larval survival of monarch butterflies. While we provide some evidence that clothianidin could also act as an ecological trap for this species, further work is needed to identify additional components of fitness, including individual egg-laying rates and survival beyond the pupal stage. Our findings add to a growing body of evidence that neonicotinoids can negatively affect non-target organisms.

PMID:33837530 | DOI:10.1111/1365-2656.13492

Contact Dermatitis. 2021 Apr 9. doi: 10.1111/cod.13856. Online ahead of print.

ABSTRACT

BACKGROUND: Data regarding teledermatology for patch testing are limited.

OBJECTIVES: Compare patch test readings and final interpretation by 2 in-person dermatologists (IPDs) with 8 teledermatologists (TDs).

METHODS: Patch tested patients had photographs taken of 70 screening series allergens at 48-hour (48H) and second (2nd) readings. 8 TDs reviewed photos and graded reactions (negative, irritant, doubtful, +, ++, +++) at 48H and 2nd readings; in addition, they coded a final interpretation (allergic, indeterminant, irritant, negative) for each reaction. TDs rated overall image quality and confidence level for each patient and patch test reaction, respectively. Percentage of TD-IPD agreement based on clinical significance (success, indeterminate, and failure) were calculated. Primary outcome was agreement at 2^nd reading.

RESULTS: Data were available for 99, 101, and 66 participants at 48H, 2^nd reading, and final interpretation, respectively. Pooled failure (+/++/+++ vs negative) at 2^nd reading was 13.6% (range 7.9-20.4%). Pooled failure at 48H and final interpretation was 5.4% (range 2.9-6.8%) and 24.6% (range 10.2-36.8%). Confidence in readings was statistically correlated to quality of images and disagreement.

CONCLUSION: For patch testing, teledermatology has significant limitations including clinically significant pooled failure percentages of 13.6% for 2^nd readings and 24.6% for final interpretation. This article is protected by copyright. All rights reserved.

PMID:33837533 | DOI:10.1111/cod.13856

J Am Geriatr Soc. 2021 Apr 10. doi: 10.1111/jgs.17155. Online ahead of print.

ABSTRACT

BACKGROUND/OBJECTIVES: Certified nursing assistants (CNAs) who work in nursing homes (NHs) face significant work and personal stress. Self-compassion training has been shown to decrease stress postintervention in previous studies among healthcare providers and those in helping professions. This study examines the feasibility, acceptability, and preliminary outcomes of self-compassion training to address CNA stress and well-being.

DESIGN: Pre-post intervention.

SETTING: Three mid-size, nonprofit NHs in North Carolina.

PARTICIPANTS: Thirty CNAs, with a mean age of 49, 96% of whom were female, and 83% black/African American.

INTERVENTION: In one NH, participants received an 8-week, 2.5-h/session (20 h total) group intervention. At the time of recruitment for NHs 2 and 3, a briefer format (6-week, 1-h/session; 6 h total) became available and was preferred by CNAs, thus both NHs 2 and 3 participants received a 6-h group intervention. All interventions occurred in meeting rooms within participating NHs during shift changes.

MEASUREMENTS: Intervention attendance, retention, and acceptability; self-compassion, stress, burnout, depression, and attitudes toward residents with dementia, and job satisfaction pre-, post-, 3-month post-, and 6-month postintervention were assessed.

RESULTS: Attendance and program satisfaction were high, and attrition was low for both training formats. Self-compassion was significantly improved at all time periods (p < 0.001), and stress and depression improved significantly through 3 months (p < 0.05), but not 6 months. No statistically significant change in job satisfaction was noted.

CONCLUSION: Self-compassion interventions are feasible and acceptable for CNAs working in NHs and show promise for managing stress and improving well-being and compassion toward residents. The briefer 6-h format may maximize participation, while still providing benefits.

PMID:33837539 | DOI:10.1111/jgs.17155