Category: Statistics

Oncology. 2021 Aug 2:1-7. doi: 10.1159/000517738. Online ahead of print.

ABSTRACT

INTRODUCTION: Heterogeneous tumor response has been reported in cancer patients treated with immune checkpoint inhibitors (ICIs). This study investigated whether the tumor site is associated with the response to ICIs in patients with recurrent or metastatic esophageal squamous cell carcinoma (ESCC).

METHODS: Patients with ESCC who had measurable tumors in the liver, lung, or lymph node (LN) according to the response evaluation criteria in solid tumors (RECIST) 1.1 and received ICIs at 2 medical centers in Taiwan were enrolled. In addition to RECIST 1.1, tumor responses were determined per individual organ basis according to organ-specific criteria modified from RECIST 1.1. Fisher test or χ2 test was used for statistical analysis.

RESULTS: In total, 37 patients were enrolled. The overall response rate per RECIST 1.1 was 13.5%. Measurable tumors in the LN, lung, and liver were observed in 26, 17, and 13 patients, respectively. The organ-specific response rates were 26.9%, 29.4%, and 15.4% for the LN, lung, and liver tumors, respectively (p = 0.05). The organ-specific disease control rates were 69.2%, 52.9%, and 21.1% for the LN, lung, and liver tumors, respectively (p = 0.024). Five (27.8%) among 18 patients harboring at least 2 involved organs had heterogeneous tumor response.

CONCLUSION: The response and disease control to ICIs may differ in ESCC tumors located at different metastatic sites, with a lesser likelihood of response and disease control in metastatic liver tumors than in tumors located at the LNs and lung.

PMID:34340231 | DOI:10.1159/000517738

Gerontology. 2021 Aug 2:1-14. doi: 10.1159/000517659. Online ahead of print.

ABSTRACT

Youth, working age and the elderly: On a timeline, chronological age (CA) and biological age (BA) may dissociate; nosological entities manifest themselves at different BAs. In determining which disease corresponds to a given age decade, statistical registries of causes of death are unreliable and this does not change with SARS CoV-2 infection. Beyond adolescence, ageing metrics involve estimations of changes in fitness, including prediction models to estimate the number of remaining years left to live. A substantial disparity in biomarker levels and health status of ageing can be observed: the difference in CA and BA in the large cohorts under consideration is glaring. Here, we focus more closely on ageing and senescence metrics in order to make information available for risk analysis non the least with COVID-19, including the most recent risk factors of ABO blood type and 3p21.31 chromosome cluster impacting on C5a and SC5b-9 plasma levels. From the multitude of routine medical laboratory assays, a potentially meaningful set of assays aimed to best reflect the stage of individual senescence; hence risk factors the observational prospective SENIORLABOR study of 1,467 healthy elderly performed since 2009 and similar approaches since 1958 can be instantiated as a network to combine a set of elementary laboratory assays quantifying senescence.

PMID:34340235 | DOI:10.1159/000517659

J Natl Compr Canc Netw. 2021 Jul;19(7):xliii. doi: 10.6004/jnccn.2021.7063.

NO ABSTRACT

PMID:34340213 | DOI:10.6004/jnccn.2021.7063

J Neural Eng. 2021 Aug 2. doi: 10.1088/1741-2552/ac19d3. Online ahead of print.

ABSTRACT

OBJECTIVE: Impaired trunk stability is frequent in spinal cord injury (SCI), but there is a lack of quantitative measures for assessing trunk function. Our objectives were to: 1) evaluate trunk muscle activity and movement patterns during a reaching task in SCI patients, 2) compare the impact of cervical (cSCI) and thoracic (tSCI) injuries in trunk function, and 3) investigate the effects of a startling acoustic stimulus (SAS) in these patients.

APPROACH: Electromyographic (EMG) and smartphone accelerometer data were recorded from 15 cSCI patients, 9 tSCI patients, and 24 healthy controls, during a reaching task requiring trunk tilting. We calculated the response time (RespT) until pressing a target button, EMG onset latencies and amplitudes, and trunk tilt, lateral deviation, and other movement features from accelerometry. Statistical analysis was applied to analyze the effects of group (cSCI, tSCI, control) and condition (SAS, non-SAS) in each outcome measure.

MAIN RESULTS: SCI patients, especially those with cSCI, presented significantly longer RespT and EMG onset latencies than controls. Moreover, in SCI patients, forward trunk tilt was accompanied by significant lateral deviation. RespT and EMG latencies were remarkably shortened by the SAS (the so-called StartReact effect) in tSCI patients and controls, but not in cSCI patients, who also showed higher variability.

SIGNIFICANCE: The combination of EMG and smartphone accelerometer data can provide quantitative measures for the assessment of trunk function in SCI. Our results show deficits in postural control and compensatory strategies employed by SCI patients, including delayed responses and higher lateral deviations, possibly to improve sitting balance. This is the first study investigating the StartReact responses in trunk muscles in SCI patients and shows that the SAS significantly accelerates RespT in tSCI, but not in cSCI, suggesting an increased cortical control exerted by these patients.

PMID:34340222 | DOI:10.1088/1741-2552/ac19d3

J Anxiety Disord. 2021 Jul 9;83:102450. doi: 10.1016/j.janxdis.2021.102450. Online ahead of print.

ABSTRACT

Individuals with dental anxiety show biased attentional processing of threat- and dental-related information. Disgust sensitivity and anxiety sensitivity are both associated with dental fears and attentional biases. Whereas disgust sensitivity is generally associated with attentional avoidance (Armstrong et al., 2014), anxiety sensitivity may be associated with attentional engagement (Keogh et al., 2001a). Elucidating the role of these constructs in dental anxiety-relevant attentional biases could inform theoretical models and/or intervention recommendations. Participants (N = 51) with high dental anxiety completed a Posner paradigm to assess attentional biases to dental versus neutral stimuli. We examined whether disgust sensitivity and anxiety sensitivity moderated degree of attentional bias. Results indicated that both disgust sensitivity (mutilation subscale) and anxiety sensitivity (physical concerns subscale) statistically moderated degree of attentional bias at trend level, and in opposite directions. Simple effects analyses further indicated that disgust sensitivity regarding mutilation was associated with less attentional bias toward dental relative to neutral stimuli, potentially indicating attentional avoidance, and remained so when adjusting for anxiety sensitivity. In contrast, simple effects analysis indicated that anxiety sensitivity regarding physical concerns was not associated with magnitude of attentional bias. If replicated, findings highlight the potential role of disgust in dental anxiety.

PMID:34340171 | DOI:10.1016/j.janxdis.2021.102450

Nurse Educ Today. 2021 Jul 24;106:105080. doi: 10.1016/j.nedt.2021.105080. Online ahead of print.

ABSTRACT

BACKGROUND: Patient deterioration should be detected early and responded appropriately for patient safety. It is necessary to strengthen situational awareness regarding patient deterioration. Inattentional blindness is a major factor that hinders situational awareness about patient deterioration in the clinical setting.

OBJECTIVES: To analyze the impact of patient deterioration simulation using inattentional blindness (PDS-IB) on situational awareness and patient safety competency-attitude among final year nursing students.

DESIGN: A randomized controlled trial.

PARTICIPANTS: Final year nursing students at a university in South Korea.

METHODS: Students were randomly assigned to an experimental or control group. The experimental group (n = 47) was given a PDS-IB. The control group (n = 44) received a simple patient deterioration simulation. Situational awareness and patient safety competency-attitude were measured at baseline, post intervention, and at 2 weeks follow-up. Data were analyzed using a two-way repeated measures ANOVA.

RESULTS: There were statistically significant group effects, time effects, and group and time interaction effects in situational awareness and patient safety competency-attitude.

CONCLUSION: PDS-IB is an effective educational strategy that increases situational awareness and patient safety competency-attitude in final year nursing students.

PMID:34340194 | DOI:10.1016/j.nedt.2021.105080

Animal. 2021 Jul 30;15(9):100317. doi: 10.1016/j.animal.2021.100317. Online ahead of print.

ABSTRACT

Mosaicism is frequently observed in aquaculture practices, and it adversely affects the production as well as the restoration programme of the sturgeon. The purpose of the present study was the induction of 2n/3n mosaic in sterlet, Acipenser ruthenus L., and compare their embryonic and larval development with diploid control sterlet. Microsatellite DNA loci genotyping was conducted for the identification of the genotypes and parentage analysis. Embryonic development was monitored in experimental groups at every 24 h interval. Identification of individual stages of embryonic development was recorded based on a 36-degree scale of development. Additionally, the BW and body length (LT) of experimental fishes were taken during 110 days of the rearing period. The Fulton’s condition coefficient (F), length-weight parameters, and specific growth rate (SGR) coefficient were calculated. The analysis of embryonic development of the 2n/3n mosaic and the diploid control group did not show differences. However, higher mortality (88%) was observed in 2n/3n mosaic groups in comparison to the diploid control groups (55%). BW and body length of 2n/3n mosaic sterlet were slightly lower than the diploid control sterlet, but the differences were not statistically significant. F analysis did not confirm a lower growth performance of the fishes in the 2n/3n mosaic group. Microsatellite DNA loci genotyping confirmed both the incidence of polyspermy and retention of the second polar body. This paper presents the first report on embryonic development and growth performance of 2n/3n mosaic sturgeons.

PMID:34340140 | DOI:10.1016/j.animal.2021.100317

Am J Emerg Med. 2021 Jul 9;50:111-119. doi: 10.1016/j.ajem.2021.07.013. Online ahead of print.

ABSTRACT

OBJECTIVE: To derive and characterize the performance of various metrics of emergency transport time in assessing for sociodemographic disparities in the setting of residential segregation. Secondarily to characterize racial disparities in emergency transport time of suspected stroke patients in Austin, Texas.

DATA SOURCES: We used a novel dataset of 2518 unique entries with detailed spatial and temporal information on all suspected stroke transports conducted by a public emergency medical service in Central Texas between 2010 and 2018.

STUDY DESIGN: We conducted one-way ANOVA tests with post-hoc pairwise t-tests to assess how mean hospital transport times varied by patient race. We also developed a spatially-independent metric of emergency transport urgency, the ratio of expected duration of self-transport to a hospital and the measured transport time by an ambulance.

DATA COLLECTION/EXTRACTION: We calculated ambulance arrival and destination times using sequential temporospatial coordinates. We excluded any entries in which patient race was not recorded. We also excluded entries in which ambulances’ routes did not pass within 100 m of either the patient’s location or the documented hospital destination.

PRINCIPAL FINDINGS: We found that mean transport time to a hospital was 2.5 min shorter for black patients compared to white patients. However, white patients’ transport times to a hospital were found to be, on average, 4.1 min shorter than expected compared to 3.4 min shorter than expected for black patients. One-way ANOVA testing for the spatially-independent index of emergency transport urgency was not statistically significant, indicating that average transport time did not vary significantly across racial groups when accounting for variations in transport distance.

CONCLUSIONS: Using a novel transport urgency index, we demonstrate that these findings represent race-based variation in spatial distributions rather than racial bias in emergency medical transport. These results highlight the importance of closely examining spatial distributions when utilizing temporospatial data to investigate geographically-dependent research questions.

PMID:34340164 | DOI:10.1016/j.ajem.2021.07.013

Int J Drug Policy. 2021 Jul 30;98:103383. doi: 10.1016/j.drugpo.2021.103383. Online ahead of print.

ABSTRACT

BACKGROUND: Naloxone distribution, a key global strategy to prevent fatal opioid overdose, has been a recent target of legislation in the U.S., but there is insufficient empirical evidence from causal inference methods to identify which components of these policies successfully reduce opioid-related harms. This study aimed to examine expert consensus on the effectiveness and implementability of various state-level naloxone policies.

METHODS: We used the online ExpertLens platform to conduct a three-round modified-Delphi process with a purposive sample of 46 key stakeholders (advocates, healthcare providers, human/social service practitioners, policymakers, and researchers) with naloxone policy expertise. The Effectiveness Panel (n = 24) rated average effects of 15 types of policies on naloxone pharmacy distribution, opioid use disorder (OUD) prevalence, nonfatal opioid-related overdoses, and opioid-related overdose mortality. The Implementation Panel (n = 22) rated the same policies on acceptability, feasibility, affordability, and equitability. We compared ratings across policies using medians and inter-percentile ranges, with consensus measured using the RAND/UCLA Appropriateness Method Inter-Percentile Range Adjusted for Symmetry technique.

RESULTS: Experts reached consensus on all items. Except for liability protections and required provision of education or training, experts perceived all policies to generate moderate-to-large increases in naloxone pharmacy distribution. However, only three policies were expected to yield substantive decreases on fatal overdose: statewide standing/protocol order, over-the-counter supply, and statewide “free naloxone.” Of these, experts rated only statewide standing/protocol orders as highly affordable and equitable, and unlikely to generate meaningful population-level effects on OUD or nonfatal opioid-related overdose. Across all policies, experts rated naloxone prescribing mandates relatively lower in acceptability, feasibility, affordability, and equitability.

CONCLUSION: Experts believe statewide standing/protocol orders are an effective, implementable, and equitable policy for addressing opioid-related overdose mortality. While experts believe many other broad policies are effective in reducing opioid-related harms, they also believe these policies face implementation challenges related to cost and reaching vulnerable populations.

PMID:34340167 | DOI:10.1016/j.drugpo.2021.103383

Chemosphere. 2021 Jul 24;286(Pt 2):131637. doi: 10.1016/j.chemosphere.2021.131637. Online ahead of print.

ABSTRACT

Quantitative image analysis (QIA) was used for monitoring the morphology of activated sludge (AS) during a granulation process and, thus, to define and quantify, unequivocally, structural changes in microbial aggregates correlated with the sludge properties and granulation rates. Two sequencing batch reactors fed with acetate at organic loading rates of 1.1 ± 0.6 kg_COD m^-3 d^-1 (R1) and 2.0 ± 0.2 kg_COD m^-3 d^-1 (R2) and three minimal imposed sludge settling velocities (0.27 m h^-1, 0.53 m h^-1, and 5.3 m h^-1) induced distinct granulation processes and rates. QIA results evidenced the turning point from flocculation to granulation processes by revealing the differences in the aggregates’ stratification patterns and quantifying the morphology of aggregates with equivalent diameter (Deq) of 200 μm ≤ Deq ≤ 650 μm. Multivariate statistical analysis of the QIA data allowed to distinguish the granulation status in both systems, by clustering the observations according to the sludge aggregation and granules maturation status, and successfully predicting the sludge volume index measured at 5 min (SVI₅) and 30 min (SVI₃₀). These results evidence the possibility of defining unequivocally the granulation rate and anticipating the sludge settling properties at early stages of the process using QIA data. Hence, QIA could be used to predict episodes of granules disruption and hindered settling ability in aerobic granulation sludge processes.

PMID:34340113 | DOI:10.1016/j.chemosphere.2021.131637