Category: Statistics

Leuk Res. 2021 Sep 25;110:106715. doi: 10.1016/j.leukres.2021.106715. Online ahead of print.

ABSTRACT

BACKGROUND: The prognostic value of platelet count in diffuse large B-cell lymphoma (DLBCL) has not been extensively investigated. We aimed to examine the association of pretreatment platelet count with disease features, and further examine the prognostic significance of platelet count in DLBCL treated with the R-CHOP regimen.

METHODS: Patients with DLBCL diagnosed between Jan 1 st, 2005 and Dec 31 st, 2018 at Cancer Hospital, Chinese Academy of Medical Sciences were retrospectively analyzed. Propensity score matching (PSM) was used to balance confounding factors.

RESULTS: A total of 1007 eligible patients who received frontline R-CHOP or R-CHOP-like regimens were included in this study. The optimal cutoff value of platelet count was 157 × 10⁹/L, as determined by the Maximally Selected Rank Statistics method. Patients with the platelet count ≤157 × 10⁹/L had significantly inferior overall survival (OS) (5-year OS, 44.4 % vs. 74.9 %, P < 0.001) and progression-free survival (PFS) (5-year PFS, 35.5 % vs. 65.9 %, P < 0.001) than those with the platelet count >157×10⁹/L. Multivariate analyses showed that pretreatment platelet count ≤ 157 × 10⁹/L was an adversely independent prognostic factor for OS (hazard ratio [HR] 1.960, 95 % confidence interval [CI] 1.418-2.709, P<0.001) and PFS (HR 1.443, 95 %CI 1.080-1.927, P = 0.013). The PSM analysis and subgroup analyses further confirmed the significantly negative impact of low platelet count on OS and PFS.

CONCLUSION: The pretreatment platelet count may be a simple, cost-effective and useful prognostic factor in DLBCL patients treated with frontline R-CHOP regimens. Further investigation is warranted to elucidate the biologic mechanism underlying the prognostic significance of platelet count in DLBCL.

PMID:34598076 | DOI:10.1016/j.leukres.2021.106715

Horm Behav. 2021 Sep 28;136:105063. doi: 10.1016/j.yhbeh.2021.105063. Online ahead of print.

ABSTRACT

Contemporary moral psychology explores the biological underpinnings of morality, including how neuromodulators influence moral judgment and decision making. Some studies suggest that higher circulating testosterone is associated with increased acceptance of sacrificial harm, such as killing one person to save five lives, consistent with utilitarian ethics and inconsistent with deontological ethics. However, most studies employ conventional analytic techniques that conflate concern about outcomes with reduced concern about sacrificial harm, many are statistically underpowered, and none examine potential regulating effects of cortisol. Therefore, we examined whether salivary concentrations of testosterone and cortisol jointly predict sacrificial dilemma judgments among a large sample of undergraduates (n = 199). We utilized an advanced cognitive modeling technique (process dissociation) to independently assess sensitivity to causing harm and maximizing outcomes, preregistering the prediction that higher testosterone would predict reduced harm-rejection rather than increased concern for outcomes, especially among people low in cortisol. However, neither testosterone, nor cortisol, nor their interaction predicted sacrificial dilemma response tendencies. Such findings raise questions about the robustness of past evidence suggesting links between testosterone and sacrificial dilemma judgments.

PMID:34598057 | DOI:10.1016/j.yhbeh.2021.105063

Cancer Treat Res Commun. 2021 Sep 25;29:100464. doi: 10.1016/j.ctarc.2021.100464. Online ahead of print.

ABSTRACT

INTRODUCTION: Cutaneous malignant melanoma (CMM) incidence has risen rapidly in the last 50 years. Poor progression and high mortality characterize CMM, making a thorough understanding of progression and associated factors essential for optimizing care.

AIMS: We assessed the association between the Neutrophil-to-Lymphocyte Ratio (NLR) and mortality in adults with CMM from an entirely mixed-race Hispanic population during 12 consecutive years of extensive follow-up.

MATERIAL & METHODS: We performed a retrospective cohort study in a tertiary hospital in Peru. NLR was categorized with a cutoff value higher or equal than 3. We collected demographic variables, laboratory results and treatments at baseline of follow-up. Cox regression analysis was performed, and we calculated crude and adjusted hazard ratios (HR) and their 95% confidence interval (95%CI).

RESULTS: The analysis was from 615 CMM cases, and there were 378 deaths. Most melanomas (63.6%) were acral lentiginous. The crude analysis showed that high NLR is a risk factor for mortality, HR = 2.52; 95%CI (2.03-3.14). High NRL ratio remains statistically significant after adjusting for confounding variables, aHR = 1.61; 95%CI (1.16-2.24). Other risk factors for mortality were clinical stages III and IV, older than 60 years, females and greater Breslow thickness.

CONCLUSIONS: We concluded that high NRL ratio is a risk factor for mortality and should be monitored in every patient who is diagnosed with malignant melanoma during their first blood count. It should then be carried out in follow-up controls for patients of clinical stage III and IV only, or in patients who present a relapse.

PMID:34598061 | DOI:10.1016/j.ctarc.2021.100464

J Psychosom Res. 2021 Sep 25;150:110629. doi: 10.1016/j.jpsychores.2021.110629. Online ahead of print.

ABSTRACT

BACKGROUND: The aims of this study were to investigate the stability of alexithymia from adolescence to young adulthood, as well as the association between alexithymia, peer relationships, and symptoms of depression and dissociation.

METHODS: The participants (n = 755, aged 13-18 years) were assessed with self-rated questionnaires and the 20-item Toronto Alexithymia Scale (TAS-20) at baseline in 2005 and on follow-up in 2011.

RESULTS: The changes in the TAS-20 total score (t = -12.26) and the scores for its subscales, difficulty identifying feelings (DIF) (t = -4.04), difficulty describing feelings (DDF) (t = -5.10), and externally oriented thinking (EOT) (t = -18.23), were statistically significant (p < 0.001). Effect sizes (Cohen’s d) for the change indicating absolute stability were small for DIF (-0.15) and DDF (-0.19), medium for TAS-20 total (-0.45), and large for EOT (-0.66) scores. Moderate correlations in test-retests with Spearman’s ρ (TAS-20 total 0.46, DIF 0.41, DDF 0.39, EOT 0.43) indicated relative stability, whereas low intraclass correlation coefficients (ICCs) (respectively 0.41, 0.39, 0.37, 0.37) indicated poor reliability of test-retests. In regression analyses, poor relationships with peers, loneliness, and symptoms of depression and dissociation at baseline associated with alexithymia at baseline and on follow-up. Unlike EOT, increases in the TAS-20 total, DIF, and DDF scores during the 6-year follow-up associated with baseline symptoms of depression and dissociation.

CONCLUSIONS: Alexithymia in adolescence is not always a reliable predictor of alexithymia in young adulthood. Mental health symptoms appear to affect the consistency of alexithymia during adolescent development.

PMID:34598049 | DOI:10.1016/j.jpsychores.2021.110629

J Neurol Sci. 2021 Sep 27;430:120009. doi: 10.1016/j.jns.2021.120009. Online ahead of print.

ABSTRACT

INTRODUCTION: Parkinson’s disease (PD) ranks the second most common neurodegenerative disease. Aside from genetic predisposition, many external factors such as traumatic brain injury and exposure of substances including pesticides also contribute to PD’s pathogenesis. Many previous studies observed the association between the use of β-adrenoceptor acting agents and risk of PD.

OBJECTIVE: To conduct systematic review and meta-analysis to summarize whether the use of β-agonist and β-antagonist agents were associated with risk of PD.

METHOD: We independently searched for published studies from EMBASE and MEDLINE databases from inception to February 2021. This meta-analysis includes 9 case-control studies and 1 cohort study meeting the eligibility criteria, with a total of 380,105 participants.

RESULTS: Overall β-antagonists use appeared to associate with increase PD risk with an odd ratio (OR) of 1.2 (95% CI 1.07-1.34). Propranolol and metoprolol had a statistically significant association with higher risk of PD: pooled OR was 1.67 (95% CI 1.22-2.29) and 1.07 (95% CI 1.03-1.1), respectively. On the other hand, β-agonists significantly inverse association with PD risk with OR of 0.88 (95% CI 0.85-0.92). Salbutamol unexpectedly showed no statistical significance in reduced risk of PD with a pooled risk ratio of 1.0 (95% CI 0.87-1.16).

CONCLUSION: Overall β-antagonists, including propranolol and metoprolol, were associated with an increased risk of PD, in contrast to β-agonists, which were associated with decreased the risk.

PMID:34598055 | DOI:10.1016/j.jns.2021.120009

Sante Ment Que. 2021 Spring;46(1):203-227.

ABSTRACT

Objectives Despite the existence of several online treatments for people with posttraumatic stress disorder (PTSD), few studies have examined usage data for such interventions. Given the potential of the online modality to alleviate barriers limiting access to psychological help, it is important to document users’ interactions with these tools in relation to the improvement of targeted symptoms. The objective of this study is to document usage data of the online treatment platform RESILIENT by people evacuated from the Fort McMurray, Alberta (Canada) fires, and to examine their association with the effectiveness of treatment on symptoms of posttraumatic stress disorder (PTSD), insomnia and depression, and adherence to treatment, as measured by the number of modules accessed by participants. Methods Ninety-seven people evacuated from the Fort McMurray fires with symptoms of PTSD, insomnia and depression were included in this study. Participants were invited to use the RESILIENT platform, an online therapist-assisted self-help treatment program that targets PTSD symptoms, sleep and mood, and includes 12 modules offering evidence-based cognitive-behavioural therapy (CBT) strategies. Both objective (e.g., number of modules accessed) and subjective (e.g., level of effort invested) usage data were collected. Results In order to predict the reduction in PTSD, depression and insomnia symptoms, as well as the number of modules accessed by participants, sequential regression models were conducted, with statistical control for pretreatment symptoms, age and gender. The final models revealed that a reduction in PTSD, depression and insomnia symptoms was significantly predicted by the number of modules accessed (β = -.41; -.53; -.49 respectively, all p <.001) as well as the mean self-reported level of effort at module 7 (midway) (β = -.43; p <.001; β = -.38; p = .005 and β = -.36; p = .007 respectively). The number of modules accessed, on the other hand, was significantly predicted by the number of words in the 4th module (β = .34; p <.001) and 7th module (β = .44; p <.001) and the number of sleep diary entries (β = .28; p <.001). Conclusion These results confirmed that increased interaction with the platform positively influences treatment effectiveness and that increased use at the beginning of treatment appears to be a good predictor of treatment completion. This study confirms the importance of sustaining participants’ commitment to online treatment in order to optimize its effectiveness.

PMID:34597495

Mol Ecol Resour. 2021 Oct 1. doi: 10.1111/1755-0998.13522. Online ahead of print.

ABSTRACT

The software program STRUCTURE is one of the most cited tools for determining population structure. To infer the optimal number of clusters from STRUCTURE output, the ΔK method is often applied. However, a recent study relying on simulated microsatellite data suggested that this method has a downward bias in its estimation of K and is sensitive to uneven sampling. If this finding holds for empirical datasets, conclusions about the scale of gene flow may have to be revised for a large number of studies. To determine the impact of method choice, we applied recently described estimators of K to re-estimate genetic structure in 41 empirical microsatellite datasets; 15 from a broad range of taxa and 26 focused on a diverse phylogenetic group, coral. We compared alternative estimates of K (Puechmaille statistics) with traditional (ΔK and posterior probability) estimates and found widespread disagreement of estimators across datasets. Thus, one estimator alone is insufficient for determining the optimal number of clusters regardless of study organism or evenness of sampling scheme. Subsequent analysis of molecular variance (AMOVA) between clustering solutions did not necessarily clarify which solution was best. To better infer population structure, we suggest a combination of visual inspection of STRUCTURE plots and calculation of the alternative estimators at various thresholds in addition to ΔK. Differences between estimators could reveal patterns with important biological implications, such as the potential for more population structure than previously estimated, as was the case for many studies reanalyzed here.

PMID:34597471 | DOI:10.1111/1755-0998.13522

Dent Med Probl. 2021 Jul-Sep;58(3):311-319. doi: 10.17219/dmp/133514.

ABSTRACT

BACKGROUND: It has been proposed that epithelial-mesenchymal transition (EMT) is responsible for the pathogenesis of several diseases. However, the relationship between the EMT process and the severity of periodontitis has not been previously investigated.

OBJECTIVES: This study aimed to localize and quantitatively assess the expression of transforming growth factor-beta 1 (TGF-β1), vimentin and E-cadherin in correlation with the EMT process in human gingiva of periodontally diseased patients in comparison with halthy individuals.

MATERIAL AND METHODS: Gingival tissue samples from 36 participants were divided into 2 groups: the healthy (control) group (n = 9); and the periodontitis group (n = 27). The periodontitis group was further subclassified into mild, moderate and severe periodontitis subgroups (9 patients in each subgroup). The samples were subjected to histological staining, the histomorphometric analysis and the quantitative real-time polymerase chain reaction (RT‑PCR) analysis for TGF-β, vimentin and E-catherin. Statistical and correlation analyses were performed.

RESULTS: The hematoxylin and eosin (H&E) stain sections from both the moderate and severe periodontitis subgroups showed epithelial hyperplasia, perinuclear haloing and a marked increase in the inflammatory cell count as compared to the control group. The highest mean TGF-β1 and vimentin expression values were recorded in the severe periodontitis subgroup, whereas the lowest mean values were recorded in the control gingiva. On the contrary, the expression of E-catherin had the highest mean value in the control gingiva, whereas the lowest mean value was recorded in the severe periodontitis subgroup. All results were found to be statistically significant. The correlation analysis revealed a statistically significant positive correlation between the severity of periodontitis and the expression of TGF-β and vimentin, while a statistically significant inverse correlation was found between the expression of E-catherin and the severity of periodontitis.

CONCLUSIONS: There is a direct correlation between the severity of periodontitis and the expression of the EMT process markers (TGF-β and vimentin). This correlation indicates that EMT plays an important role in the pathogenesis and prognosis of periodontal disease. The data presented in this study could open the door for using anti-EMT agents in treating periodontal disease.

PMID:34597477 | DOI:10.17219/dmp/133514

Health Expect. 2021 Oct 1. doi: 10.1111/hex.13367. Online ahead of print.

ABSTRACT

BACKGROUND: Guillain-Barré syndrome (GBS) is a rare inflammatory peripheral nerve disorder with variable recovery. Evidence is lacking on experiences of people with GBS and measurement of these experiences.

OBJECTIVE: We aimed to develop and validate an instrument to measure experiences of people with GBS.

DESIGN: We used a cross-sectional design and online self-administered questionnaire survey. Question domains, based on a previous systematic review and qualitative study, covered experiences of GBS, symptom severity at each stage, healthcare and factors supporting or hindering recovery. Descriptive, exploratory factor and reliability analyses and multivariable regression analysis were used to investigate the relationships between variables of interest, explore questionnaire reliability and validity and identify factors predicting recovery.

SETTING AND PARTICIPANTS: People with a previous diagnosis of GBS were recruited through a social media advert.

RESULTS: A total of 291 responders, of different sexes, and marital statuses, were included, with most diagnosed between 2015 and 2019. Factor analysis showed four scales: symptoms, information provided, factors affecting recovery and care received. Positive social interactions, physical activity including physiotherapy and movement, changes made at home and immunoglobulin treatment were important for recovery. Multivariable models showed that immunoglobulin and/or plasma exchange were significant predictors of recovery. Employment and recovery factors (positive interactions, work support and changes at work or home, physical activity and therapy), though associated with recovery, did not reach statistical significance.

CONCLUSION: The questionnaire demonstrated good internal reliability of scales and subscales and construct validity for people following GBS.

PATIENT CONTRIBUTION: Patients were involved in developing and piloting the questionnaire.

PMID:34597442 | DOI:10.1111/hex.13367

Trop Med Int Health. 2021 Oct 1. doi: 10.1111/tmi.13682. Online ahead of print.

ABSTRACT

OBJECTIVE: The clinical and serological characteristics of spotted fever group rickettsial (SFGR) infections in South Asia are poorly understood. We studied the clinical presentation and the IgM/IgG response in cases enrolled at two health care centres in South India.

METHOD: We enrolled 77 patients. 57 of these were recruited at a tertiary care centre, the remaining 20 at a community hospital (secondary care level). Diagnostic tests included IgM and IgG ELISA, and PCR. Over a period of one year, 41 cases were followed up for repeated sero-analysis.

RESULTS: Median age was 9 years (range 1 to 79). A rash was present in 74% of cases (57/77). In cases aged <15 years rash was present in 94% (44/47) vs 43% (13/30) in cases aged ≥15 years. An eschar was found in two cases (3%). Severe infection or complications occurred in 10 cases (13%). These included central nervous system infection (6/77, 8%), kidney injury (3/77, 4%), shock (3/77, 4%), lung involvement (2/77, 3%) and peripheral gangrene (2/77, 3%). IgM antibody levels increased faster after fever onset than IgG antibodies, peaking at 50 and 60 days respectively. After the peak, IgM and IgG levels showed a slow decline over one year with less than 50% of cases showing persistent IgG antibody levels.

CONCLUSION: SFGR infections in South India may be under-diagnosed, as many cases may not develop a rash. The proportion of cases developing severe infection seems lower than for scrub typhus in this region. IgG sero-prevalence may substantially under-estimate the proportion in a population with past SFGR infection.

PMID:34597443 | DOI:10.1111/tmi.13682