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Nevin Manimala Statistics

Morphometric assessment of the mesorectal fat in Chinese Han population: A clinical MRI study

Sci Prog. 2021 Apr-Jun;104(2):368504211016214. doi: 10.1177/00368504211016214.

ABSTRACT

The study aimed to analyze morphometric assessment of the mesorectal fat thickness and its correlation with body mass index in Chinese Han population. The anterior, posterior, right lateral, and left lateral mesorectal fat thickness were measured using MRI T2-weighted images. The mean distance from the rectal wall to the mesorectal fascia were 3.8, 8.4, 11.3, and 11.7 mm in anterior, posterior, right lateral, and left lateral portion, respectively. The mesorectal area, rectal area, mesorectal fat thickness area, and rectal height were 2395.3 ± 691.1 mm2, 709.6 ± 403.5 mm2, 1685.7 ± 525.3 mm2, and 9.1 ± 0.8 cm. BMI was found to be directly proportional to and statistically significant to the mesorectal fat area (p = 0.01). Since the mean mesorectal fat thickness was found to be <12 mm, T3d staged rectal cancer is less likely to be found in an average Chinese population that may affect the overall-survival and progression-free survival in rectal cancer patients. Anterior portion of the rectum was least thick compared to all other sides. Therefore, extra-caution should be taken in handling tumors on the anterior part of the rectum.

PMID:33960865 | DOI:10.1177/00368504211016214

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Extraperitoneal Laparoscopic Versus Transperitoneal Robot-Assisted Laparoscopic Approaches for Extended Pelvic Lymph Node Dissection During Radical Prostatectomy

J Laparoendosc Adv Surg Tech A. 2021 May 6. doi: 10.1089/lap.2021.0174. Online ahead of print.

ABSTRACT

Background: We aim to directly compare the feasibility and safety of extended pelvic lymph node dissection (PLND) during transperitoneal robotic-assisted radical prostatectomy (Tp-RARP) and extraperitoneal laparoscopic radical prostatectomy (Ep-LRP). Materials and Methods: We retrospectively identified the prospectively maintained database records of 162 patients diagnosed with prostate cancer (PC) who underwent Ep-LRP or Tp-RARP with extended PLND. Patients with risk of nodal metastases over 5% according to Briganti nomogram received extended PLND. All data analyzed in this study were based on the documentation in our PC database including age, body mass index, Charlson comorbidity index score, preoperative prostate-specific antigen, history of abdominal surgery, biopsy Gleason score, total operation time, postoperative pelvic drainage time, pathological results, lymph node yield (LNY), percentage lymph node involvement (%LNI), and perioperative complications. Patients were followed up for biochemical recurrence in the postoperative period. Results: Eighty-two of the 162 enrolled patients were in group 1 (Ep-LRP+PLND) and 80 were in group 2 (Tp-RARP+PLND). There were no statistically significant differences between the groups regarding preoperative demographics and clinical characteristics. The median LNY was 17 (range 8-27) and 17.5 (range 10-29) in groups 1 and 2, respectively, and no statistically significant difference was found. There was no significant difference between the groups in terms of biochemical recurrence-free survival with mean follow-up of 44.8 months after radical surgery. Conclusion: Our results support the view that extended PLND through the Ep-LRP approach is a feasible and safe procedure without compromising oncological efficacy compared with a similar template attempted during Tp-RARP. Clinical Trial Registration number is 01/21-2.

PMID:33960836 | DOI:10.1089/lap.2021.0174

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Nevin Manimala Statistics

Technology-Assisted Psychosocial Interventions for Childhood, Adolescent, and Young Adult Cancer Survivors: A Systematic Review and Meta-Analysis

J Adolesc Young Adult Oncol. 2021 May 6. doi: 10.1089/jayao.2021.0012. Online ahead of print.

ABSTRACT

Purpose: Technology-assisted interventions are essential in supporting cancer survivors’ psychosocial outcomes, especially for childhood, adolescent, and young adult (AYA) cancer survivors, a tech-savvy generation. This study aims to systematically evaluate review and meta-analyze technology-assisted interventions for childhood and AYA cancer survivors. Methods: Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, the study team used a pre-set of key words and searched studies across 11 electronic databases and 4 professional websites, and conducted a manual search of reference lists from published reviews. Meta-analysis of small sample size corrected Hedges’ g was conducted using meta-regression with robust variance estimation. Results: Final analysis included a total of 28 clinical trials, including 237 effect sizes reported an overall statistically significant treatment effect of technology-assisted psychosocial interventions for childhood and AYA cancer survivors, g = 0.382, 95% confidence interval (CI) 0.243 to 0.521, p < 0.0001. Subgroup analysis revealed that distraction-based interventions and interventions for psychosocial and emotional health were overall statistically significant, whereas interventions for childhood and AYA cancer survivors’ cancer knowledge outcomes and physical and functional health outcomes were statistically nonsignificant. Moderator analysis found intervention target was a significant moderator. Conclusions: Technology-assisted interventions for childhood and AYA cancer survivors were overall effective across domains of survivorship outcomes. Favorable evidence was found primarily for childhood cancer survivors with limited support for AYA cancer survivors. Implications for Cancer Survivors: Although existing technology-assisted interventions are overall promising, research support for cancer survivors from different age groups and with different psychosocial challenges varies and should be considered individually.

PMID:33960845 | DOI:10.1089/jayao.2021.0012

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Nevin Manimala Statistics

Multiple imputation in data that grow over time: a comparison of three strategies

Multivariate Behav Res. 2021 May 7:1-17. doi: 10.1080/00273171.2021.1912582. Online ahead of print.

ABSTRACT

Multiple imputation is a recommended technique to deal with missing data. We study the problem where the investigator has already created imputations before the arrival of the next wave of data. The newly arriving data contain missing values that need to be imputed. The standard method (RE-IMPUTE) is to combine the new and old data before imputation, and re-impute all missing values in the combined data. We study the properties of two methods that impute the missing data in the new part only, thus preserving the historic imputations. Method NEST multiply imputes the new data conditional on each filled-in old data m2>1 times. Method APPEND is the special case of NEST with m2=1, thus appending each filled-in data by single imputation. We found that NEST and APPEND have the same validity as RE-IMPUTE for monotone missing data-patterns. NEST and APPEND also work well when relations within waves are stronger than between waves and for moderate percentages of missing data. We do not recommend the use of NEST or APPEND when relations within time points are weak and when associations between time points are strong.

PMID:33960858 | DOI:10.1080/00273171.2021.1912582

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SHAPE Directed Discovery of New Functions in Large RNAs

Acc Chem Res. 2021 May 7. doi: 10.1021/acs.accounts.1c00118. Online ahead of print.

ABSTRACT

ConspectusRNA lies upstream of nearly all biology and functions as the central conduit of information exchange in all cells. RNA molecules encode information both in their primary sequences and in complex structures that form when an RNA folds back on itself. From the time of discovery of mRNA in the late 1950s until quite recently, we had only a rudimentary understanding of RNA structure across vast regions of most messenger and noncoding RNAs. This deficit is now rapidly being addressed, especially by selective 2′-hydroxyl acylation analyzed by primer extension (SHAPE) chemistry, mutational profiling (MaP), and closely related platform technologies that, collectively, create chemical microscopes for RNA. These technologies make it possible to interrogate RNA structure, quantitatively, at nucleotide resolution, and at large scales, for entire mRNAs, noncoding RNAs, and viral RNA genomes. By applying comprehensive structure probing to diverse problems, we and others are showing that control of biological function mediated by RNA structure is ubiquitous across prokaryotic and eukaryotic organisms.Work over the past decade using SHAPE-based analyses has clarified key principles. First, the method of RNA structure probing matters. SHAPE-MaP, with its direct and one-step readout that probes nearly every nucleotide by reaction at the 2′-hydroxyl, gives a more detailed and accurate readout than alternatives. Second, comprehensive chemical probing is essential. Focusing on fragments of large RNAs or using meta-gene or statistical analyses to compensate for sparse data sets misses critical features and often yields structure models with poor predictive power. Finally, every RNA has its own internal structural personality. There are myriad ways in which RNA structure modulates sequence accessibility, protein binding, translation, splice-site choice, phase separation, and other fundamental biological processes. In essentially every instance where we have applied rigorous and quantitative SHAPE technologies to study RNA structure-function interrelationships, new insights regarding biological regulatory mechanisms have emerged. RNA elements with more complex higher-order structures appear more likely to contain high-information-content clefts and pockets that bind small molecules, broadly informing a vigorous field of RNA-targeted drug discovery.The broad implications of this collective work are twofold. First, it is long past time to abandon depiction of large RNAs as simple noodle-like or gently flowing molecules. Instead, we need to emphasize that nearly all RNAs are punctuated with distinctive internal structures, a subset of which modulate function in profound ways. Second, structure probing should be an integral component of any effort that seeks to understand the functional nexuses and biological roles of large RNAs.

PMID:33960770 | DOI:10.1021/acs.accounts.1c00118

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Changes in High Weight-for-Length among Infants Enrolled in Special Supplemental Nutrition Program for Women, Infants, and Children during 2010-2018

Child Obes. 2021 May 6. doi: 10.1089/chi.2021.0055. Online ahead of print.

ABSTRACT

Background: Infants and young children with high weight-for-length are at increased risk for obesity in later life. This study describes prevalence of high weight-for-length and examines changes during 2010-2018 among 11,366,755 infants and young children 3-23 months of age in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Methods: Children’s weights and lengths were measured. High weight-for-length was defined as ≥2 standard deviations above sex and age-specific median on World Health Organization growth charts. Adjusted prevalence differences (APDs) between years were calculated as 100 times marginal effects from logistic regression models. APD was statistically significant if 95% confidence interval did not include 0. Results: Adjusted prevalence of high weight-for-length decreased from 2010 to 2014, and leveled off through 2018 overall, in boys and girls, those 6-11 and 18-23 months of age, and non-Hispanic whites, non-Hispanic blacks, Hispanics, and Asians/Pacific Islanders. For 12-17 months old and American Indian/Alaska Native infants and young children, adjusted prevalence decreased from 2010 to 2014, and then increased slightly through 2018. Among 56 WIC state or territorial agencies, 33 had significant decreases between 2010 and 2018, whereas 8 had significant increases. Between 2014 and 2018, prevalence decreased significantly in 12 agencies and increased significantly in 23. Conclusions: The results indicate overall declines in prevalence of high weight-for-length from 2010 to 2018, with a prevalence stabilization since 2014. Continued surveillance is needed. Obesity prevention strategies in WIC and multiple settings are important for ensuring healthy child growth.

PMID:33960827 | DOI:10.1089/chi.2021.0055

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Nevin Manimala Statistics

Parameter Identifiability for a Profile Mixture Model of Protein Evolution

J Comput Biol. 2021 May 6. doi: 10.1089/cmb.2020.0315. Online ahead of print.

ABSTRACT

A profile mixture (PM) model is a model of protein evolution, describing sequence data in which sites are assumed to follow many related substitution processes on a single evolutionary tree. The processes depend, in part, on different amino acid distributions, or profiles, varying over sites in aligned sequences. A fundamental question for any stochastic model, which must be answered positively to justify model-based inference, is whether the parameters are identifiable from the probability distribution they determine. Here, using algebraic methods, we show that a PM model has identifiable parameters under circumstances in which it is likely to be used for empirical analyses. In particular, for a tree relating 9 or more taxa, both the tree topology and all numerical parameters are generically identifiable when the number of profiles is less than 74.

PMID:33960831 | DOI:10.1089/cmb.2020.0315

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Masks use and facial dermatitis during COVID-19 outbreak: is there a difference between CE and non-CE approved masks? Multi-center, real-life data from a large Italian cohort

Ital J Dermatol Venerol. 2021 Apr;156(2):220-225. doi: 10.23736/S2784-8671.21.06895-4.

ABSTRACT

BACKGROUND: During the recent COVID-19 outbreak, masks became mandatory and shortages frequent, therefore the prevalence of non-CE (European Conformity Mark) approved masks increased in the general population. We aimed to quantify the prevalence of mask-related cutaneous side effects and the differences between CE and non-CE approved masks.

METHODS: In this multicenter prospective observational study conducted from March 20, 2020 to May 12, 2020(during and after quarantine), patients attending emergency departments for a dermatological consult were clinically assessed and their masks were inspected to detect CE marks and UNI (Italian National Unification Entity) norms. Patients with history of facial dermatoses or under current treatment for facial dermatoses were excluded.

RESULTS: We enrolled 412 patients (318 during quarantine and 94 after quarantine). CE-approved masks were observed 52.8% vs. 24.5%, whilst subsets of non-CE approved masks were 9.7% vs. 14.9% (Personal protective equipment (PPE)-masks), 16.4% vs. 12.8% (surgical masks [SM]), and 21.1% vs. 47.9%(non-PPE) and (non-SM masks), respectively during and after quarantine. Remarkably, non-CE-approved masks resulted in patients displaying a statistically significant higher incidence of facial dermatoses and irritant contact dermatitis compared to CE-approved masks, and these differences were mainly driven by non-PPE non-SM masks. Comparing quarantine and after quarantine periods, no statistically significant differences were found for CE-approved masks, whilst differences were detected in non-CE-approved masks regarding incidence of facial dermatoses (P<0.0001)and irritant contact dermatitis (P=0.0041).

CONCLUSIONS: Masks are essential to prevent COVID-19 but at the same time higher awareness regarding mask specifications should be promoted in the general population. Non-PPE and non-SM masks should undergo more rigorous testing to prevent the occurrence of cutaneous side effects and future patients’ lawsuit damages.

PMID:33960753 | DOI:10.23736/S2784-8671.21.06895-4

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Dupilumab rapidly improves asthma control in predominantly anti-IL5/IL5R pretreated Austrian real-life severe asthmatics

Immun Inflamm Dis. 2021 May 7. doi: 10.1002/iid3.434. Online ahead of print.

ABSTRACT

Dupilumab is a monoclonal antibody against the IL-4 receptor alpha which has shown efficacy in T2 high severe asthmatics in phase 3 randomized controlled trials. The purpose of this real-life study is to demonstrate the real-life effectiveness of dupilumab in Austrian severe asthma patients. We retrospectively analyzed all patients receiving dupilumab at our severe asthma clinic. Thirteen patients have so far received dupilumab at our center. The primary outcome, asthma control questionnaire 6-item scale at 2 weeks, improved by 0.57 points (p = .014), which is statistically and clinically significant. Similarly, the asthma control test at 4 weeks improved by 3.91 points (p = .024), also statistically and clinically significant. Improvements in forced expiratory volume in 1 s at 2 weeks were neither statistically, nor clinically significant. Improvements at 4 weeks (+220 ml, p = .041), and 3 months (+229 ml, p = .006), were statistically significant and clinically borderline significant. No severe adverse events or hypereosinophilia were observed. No adverse events led to treatment discontinuation. Most patients (85%) had previously received monoclonal antibody treatment for severe asthma. Previous monoclonal antibody treatment had been discontinued in these patients due to a lack of clinical response. Dupilumab is effective and safe in Austrian real-life severe asthmatics. It provides a possible treatment strategy for T2 high severe asthmatics who do not qualify for anti-immunoglobulin E or anti-IL5/IL5R monoclonal antibody treatments or do not adequately respond to these.

PMID:33960689 | DOI:10.1002/iid3.434

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Patient-provider discussion about emotional and social needs, mental health outcomes, and benefit finding among U.S. Adults living with cancer

Cancer Med. 2021 May 7. doi: 10.1002/cam4.3918. Online ahead of print.

ABSTRACT

BACKGROUND: A discussion about patient’s nonmedical needs during treatment is considered a crucial component of high-quality patient-provider communication. We examined whether having a patient-provider discussion about cancer patients’ emotional and social needs is associated with their psychological well-being.

METHODS: Using the 2016-2017 Medical Expenditure Panel Survey-Experiences with Cancer Survivorship Supplement (MEPS-ECSS) data, we identified the cancer survivors in the United States (US) who reported having a detailed discussion about emotional and social needs during cancer care. We used multivariable logistic regression to assess the association between having a patient-provider discussion and the patients’ psychological well-being outcomes (depressive symptoms, severe psychological distress, and worrying about cancer recurrence/worsening condition) and benefit finding experience after a cancer diagnosis.

RESULTS: Among 1433 respondents (equivalent to 13.8 million cancer survivors in the US), only 33.6% reported having a detailed patient-provider discussion about their emotional and social needs. Having a discussion was associated with 55% lower odds (odds ratio [OR], 0.45; 95% confidence interval [CI], 0.26-0.77) of having depressive symptoms and 97% higher odds (OR, 1.97; 95% CI, 1.46-2.66) of having benefit finding experience. There was no statistically significant association between patient-provider discussion and psychological distress or worrying about cancer recurrence/worsening.

CONCLUSION: Detailed patient-provider discussion about the cancer patients’ emotional and social needs was associated with a lower likelihood of depressive symptoms and a higher likelihood of experiencing benefit finding. These findings stress the importance of improving the patient-provider discussion about psychosocial needs in cancer survivorship.

PMID:33960716 | DOI:10.1002/cam4.3918