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Nevin Manimala Statistics

Association between pelvic lymph node dissection and survival among patients with prostate cancer treated with radical prostatectomy

Prostate Int. 2024 Jun;12(2):70-78. doi: 10.1016/j.prnil.2024.01.002. Epub 2024 Feb 7.

ABSTRACT

INTRODUCTION: Although the clinical benefits of pelvic lymph node dissection (PLND) at the time of radical prostatectomy for prostate cancer remain uncertain, major guidelines recommend PLND based on risk profile. Thus, the objective of this study was to examine the association between PLND and survival among patients undergoing RP stratified by Gleason grade group (GG) with the aim of allowing patients and physicians to make more informed care decisions about the potential risks and benefits of PLND.

MATERIALS AND METHODS: From the SEER-17 database, we examined overall (OS) and prostate cancer-specific (PCSS) survival of prostate cancer patients who underwent RP from 2010 to 2015 stratified by GG. We applied propensity score matching to balance pre-operative characteristics including race, age, PSA, household income, and housing status (urban/rural) between patients who did and did not undergo PLND for each GG. Statistical analyses included log-rank test and Kaplan-Meier curves.

RESULTS: We extracted a matched cohort from 80,287 patients with GG1-5 who underwent RP. The median PSA value was 6.0 ng/mL, and the median age was 62-years-old. 49,453 patients underwent PLND (61.60%), while 30,834 (38.40%) did not. There was no difference in OS and PCSS between patients who received PLND and those who did not for all Gleason GG (OS-GG1: P = 0.20, GG2: P = 0.34, GG3: P > 0.05, GG4: P = 0.55, GG5: P = 0.47; PCSS-GG1: P = 0.11, GG2: P = 0.96, GG3: P = 0.81, GG4: P = 0.22, GG5: P = 0.14).

CONCLUSIONS: In this observational study, PLND at the time of RP was not associated with improved OS or PCSS among patients with cGS of 3 + 3, 3 + 4, 4 + 3, 4 + 4, 4 + 5, and 5 + 4. These findings suggest that until definitive clinical trials are completed, prostate cancer patients who have elected RP should be appropriately counseled on the potential risks and lack of proven survival benefit of PLND.

PMID:39036758 | PMC:PMC11255894 | DOI:10.1016/j.prnil.2024.01.002

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Nevin Manimala Statistics

Does androgenic alopecia aggravate the risk of prostate cancer? Evidence from Mendelian randomization

Prostate Int. 2024 Jun;12(2):110-115. doi: 10.1016/j.prnil.2024.04.001. Epub 2024 Apr 19.

ABSTRACT

BACKGROUND: Epidemiological reports indicate a potential association between androgenic alopecia (AGA) and increased prostate cancer (PC) prevalence, but conflicting reports also exist. This study aims to elucidate the causality of AGA on PC risk using Mendelian randomization (MR) analysis.

MATERIALS AND METHODS: Two-sample MR analyses utilized public genome-wide association studies summary data for single-nucleotide polymorphisms associated with AGA. Four statistical methods were used: inverse variance weighted (IVW), MR-Egger, weighted median, and weighted mode, with IVW as the preliminary estimation method. Additionally, sensitivity analyses were conducted to address pleiotropic bias.

RESULTS: Genetically proxied AGA did not demonstrate a causal effect on PC risk (IVW P > 0.05). Consistently, complementary methods yielded results aligned with IVW.

CONCLUSIONS: Our MR analysis indicates no causal relationship between genetically predicted AGA and PC risk, suggesting that observed associations in epidemiological studies may not be causal.

PMID:39036755 | PMC:PMC11255885 | DOI:10.1016/j.prnil.2024.04.001

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Nevin Manimala Statistics

The impact of obesity and sexual behavior on prostate cancer risk is mediated by testosterone levels: a mendelian randomization study and mediation analysis

Prostate Int. 2024 Jun;12(2):96-103. doi: 10.1016/j.prnil.2024.03.003. Epub 2024 Mar 26.

ABSTRACT

BACKGROUND: The relationship between obesity, sexual behavior, and prostate cancer (PCa) has been widely debated, contributing to a lack of understanding of its potential mechanisms and hindering the development of effective prevention measures.

PURPOSE: The aim of this study was to examine the causal effect of body mass index (BMI), age at first sexual intercourse (AFS), and bioavailable testosterone levels on PCa while also quantifying the potential roles of mediators.

METHOD: We conducted a Mendelian randomization (MR) study using summary statistics from genome-wide associations of BMI (152,893 European males), AFS (182,791 European males), bioavailable testosterone (184,205 European males), and PCa (79,148 cases, 61,106 controls, European ancestry). Inverse-variance weighted method, weighted median method, MR-Egger regression, Least Absolute Shrinkage and Selection Operator (LASSO), and outlier test were used for MR analyses. Reverse MR and mediation analysis were performed. Data analyses were conducted from December 2022 to July 2023.

RESULTS: The results showed that genetic liability to BMI was protective of PCa (OR, 0.82; 95% CI: 0.74-0.91; P = 3.29 × 10-4). Genetic liability to later AFS (OR, 1.28; 95% CI: 1.08-1.53; P = 5.64 × 10-3) and higher bioavailable testosterone levels (OR = 1.11, 95% CI: 1.01-1.24, P = 0.04) were associated with an increased risk of PCa. All of these potential causal effects could only be forwarded and were not affected by prostate specific antigen (PSA) screening. After controlling for bioavailable testosterone levels, the causal impact of BMI and AFS on PCa was no longer significant. The mediation analysis suggested that the causal influence of AFS/BMI on PCa relied on bioavailable testosterone levels.

CONCLUSION: In conclusion, the difference between the univariable and multivariable MR results suggested that the causal influence of BMI and AFS on PCa relied on bioavailable testosterone levels. Further work is needed to identify other risk factors and to elucidate the specific mechanisms that underlie this causal pathway.

PMID:39036754 | PMC:PMC11255935 | DOI:10.1016/j.prnil.2024.03.003

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Nevin Manimala Statistics

Uncovering the hidden risk of metastatic cutaneous basal cell carcinoma by molecular profiling: A retrospective review

JAAD Int. 2024 May 24;16:189-191. doi: 10.1016/j.jdin.2024.05.004. eCollection 2024 Sep.

NO ABSTRACT

PMID:39036739 | PMC:PMC11260329 | DOI:10.1016/j.jdin.2024.05.004

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Nevin Manimala Statistics

Measuring Sex Differences in the Corpus Callosum by Undergraduates at a Small and a Large Institution

J Undergrad Neurosci Educ. 2022 Oct 1;20(3):A391-A396. doi: 10.59390/FULX3501. eCollection 2022 Spring.

ABSTRACT

Neuroscience students often seem more responsive to laboratory exercises that involve human brains. Here we describe a lab that utilizes human brain MRIs to evaluate a long-standing debate over the presence of sex differences in the human brain, specifically the corpus callosum. Students at both Widener and UCLA measured corpus callosum subregions that were already marked-off as described by Witelson (1989) or by Hofer and Frahm (2006). Statistical analyses revealed sex differences using both schemes after correcting for the size of the midsagittal cortex. Widener students, however, uncovered more sex differences than the UCLA students. Lab instruction for UCLA students occurred during the COVID-19 pandemic. So, lab sessions were completely online. In contrast, Widener students had the benefit of in-person lab instruction. Nonetheless, both the data obtained from the images of the corpus callosi as well as measures of pedagogical efficacy were similar between the two institutions, suggesting that distance learning may be a valuable and viable option. Further, when in person learning is not an option, such as during a pandemic, digital databases serve as invaluable resources for online learning. When these databases are utilized in a hypothesis driven research setting, they can serve as the basis for course-based undergraduate research experiences (CUREs), which are known to benefit students-improving retention in science fields.

PMID:39036716 | PMC:PMC11256376 | DOI:10.59390/FULX3501

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Nevin Manimala Statistics

The Opioid Epidemic and Children’s Living Arrangements in the United States, 2000-2018

Ann Am Acad Pol Soc Sci. 2022 Sep;703(1):162-187. doi: 10.1177/00027162221142648. Epub 2023 Mar 20.

ABSTRACT

Although the detrimental effects of the opioid epidemic on health and wellbeing have been well documented, we know little about how it has affected the family contexts in which children live. Using data from the 2000 Census, the 2005-2018 American Community Survey (ACS) and restricted Vital Statistics, we assess how the opioid epidemic, as measured by a rise in the opioid overdose death rate, affected the rates of children living in different family arrangements: two married parents, two cohabiting parents, single mother, single father, or another configuration. According to local fixed-effects models, a higher opioid overdose death rate is associated with fewer children living with two married parents and an increase in children living in family structures that tend to be less stable, such as those led by cohabiting parents or a single father. These changes in family arrangements have potential long-term implications for the wellbeing of future generations.

PMID:39036709 | PMC:PMC11259247 | DOI:10.1177/00027162221142648

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Nevin Manimala Statistics

The landscape of rare genetic variants in familial Waldenström macroglobulinemia

Blood Neoplasia. 2024 Jun;1(2):100013. doi: 10.1016/j.bneo.2024.100013. Epub 2024 Apr 12.

ABSTRACT

Waldenström macroglobulinemia (WM) is a rare hematological malignancy. Risk for WM is elevated 20-fold among first-degree relatives of patients with WM. However, the list of variants and genes that cause WM remains incomplete. In this study we analyzed exomes from 64 WM pedigrees for evidence of genetic susceptibility for this malignancy. We determined the frequency of pathogenic (P) or likely pathogenic (LP) variants among patients with WM; performed variant- and gene-level association analyses with the set of 166 WM cases and 681 unaffected controls; and examined the segregation pattern of deleterious variants among affected members in each pedigree. We identified P/LP variants in TREX1 and SAMHD1 (genes that function at the interface between innate immune response, genotoxic surveillance, and DNA repair) segregating in patients with WM from 2 pedigrees. There were additional P/LP variants in cancer-predisposing genes (eg, POT1, RECQL4, PTPN11, PMS2). In variant- and gene-level analyses, no associations were statistically significant after multiple testing correction. On a pathway level, we observed involvement of genes that play a role in telomere maintenance (q-value = 0.02), regulation of innate immune response (q-value = 0.05), and DNA repair (q-value = 0.08). Affected members of each pedigree shared multiple deleterious variants (median, n = 18), but the overlap between the families was modest. In summary, P/LP variants in highly penetrant genes constitute a modest proportion of the deleterious variants; each pedigree is largely unique in its genetic architecture, and multiple genes are likely involved in the etiology of WM.

PMID:39036705 | PMC:PMC11258892 | DOI:10.1016/j.bneo.2024.100013

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Nevin Manimala Statistics

Seroprevalence of COVID-19 among voluntary blood donors

Asian J Transfus Sci. 2024 Jan-Jun;18(1):97-101. doi: 10.4103/ajts.ajts_91_23. Epub 2023 Nov 7.

ABSTRACT

CONTEXT: COVID-19 usually presents with mild symptoms. No cases of transfusion – transmission of COVID-19 had been reported. Assessing the prevalence of viral infections among blood donors is essential to frame blood safety strategies.

AIM: The main aim of this study is to assess the seroprevalence of SARS-CoV-2 antibodies among healthy and asymptomatic voluntary blood donors by enzyme-linked immunosorbent assay (ELISA).

SETTING AND DESIGN: This cross-sectional study was conducted among voluntary blood donors using a consecutive sampling technique in the Department of Transfusion Medicine, the Tamil Nadu Dr. M.G.R. Medical University, Guindy, Chennai, for 18 months.

METHODS: Adhering to COVID-19 pandemic guidelines and donor eligibility criteria, blood samples collected from 500 asymptomatic unvaccinated voluntary blood donors were tested for SARS-CoV-2 (IgG + IgM + IgA and IgG) antibodies by ELISA. Adding IgA to a conventional IgM and IgG serological test improves sensitivity.

STATISTICAL ANALYSIS USED: The collected donor data were analyzed with IBM SPSS Statistics software. Pearson’s Chi-square test and Fisher’s exact test were used. P = 0.05 was considered statistically significant.

RESULTS: IgG seropositivity among the donors was 58.8%, and IgM + IgA seropositivity was 29.6%. There was no statistically significant difference in the COVID-19 IgG/IgM + IgA seropositivity status with age, gender, blood group, occupation, or socioeconomic status. The IgG and IgM/IgA/IgG ELISA kits showed a difference of 13 cases which could be attributed to the higher sensitivity of IgG alone ELISA kit. This increased the seroprevalence by 3%.

CONCLUSION: The majority of donors were either IgG or IgM and IgA positive, despite remaining asymptomatic. The seropositivity rate coincided with the COVID-19 surge among population.

PMID:39036700 | PMC:PMC11259330 | DOI:10.4103/ajts.ajts_91_23

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Nevin Manimala Statistics

Estimation of serum calcium levels in apheresis platelet donors

Asian J Transfus Sci. 2024 Jan-Jun;18(1):62-66. doi: 10.4103/ajts.ajts_20_22. Epub 2023 May 11.

ABSTRACT

INTRODUCTION: Apheresis is practiced widely to collect single donor platelets (SDPs). This procedure utilizes an anticoagulant acid citrate dextrose to prevent clotting of blood in the extracorporeal circuit which chelates divalent ions like calcium. This alters the calcium homeostasis resulting in hypocalcemia causing acute adverse events.

AIM: The study aimed to know the calcium homeostasis in apheresis platelet donors.

MATERIALS AND METHODS: This cross-sectional study was conducted from January 2020 to December 2020 in the department of transfusion medicine. The sample size was 50. Donors who walk in for voluntary SDP donation were selected. Total and ionized calcium, pH, and serum albumin for all the donors at baseline and ionic calcium at the end of the procedure and 30 min after the procedure were measured.

RESULTS: According to statistical analysis of the ionic calcium level at pre procedure, immediate post procedure and 30 minutes post procedure, there was decrease in the value immediate post procedure and values returned to baseline within 30 minutes. The levels of pH change were analyzed. On comparing the preprocedure and immediate postprocedure values, there was a significant lowering of pH value from the baseline (P = 0.5), indicating acute lowering of pH immediate postprocedure. Hence, most of the citrate metabolism can be achieved within 30 min after completion of the apheresis procedure.

CONCLUSION: SDP collection is essentially a safe procedure with minimal adverse effects. Toxicity of citrate is not much pronounced. Recovery of calcium levels is within 30 min of completion of plateletpheresis.

PMID:39036698 | PMC:PMC11259349 | DOI:10.4103/ajts.ajts_20_22

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Nevin Manimala Statistics

The effect of blood transfusion on serum hepcidin levels in chronically transfused patients of β-thalassemia major: An observational study in a tertiary care centre in Western Maharashtra

Asian J Transfus Sci. 2024 Jan-Jun;18(1):73-78. doi: 10.4103/ajts.ajts_160_22. Epub 2023 Aug 2.

ABSTRACT

INTRODUCTION: Hepcidin is the key regulator of systemic iron homeostasis. In iron-loading anemias, hepcidin levels are regulated by opposite forces of erythropoiesis and iron overload. In β-thalassemia major patients, transfusions are the predominant cause of iron overload; in such chronically transfused patients, hepcidin concentrations are significantly higher than nontransfused patients, due to both increased iron load of transfusions and the suppression of ineffective erythropoiesis.

AIM: This study aims to evaluate the effect of blood transfusions on serum hepcidin levels in chronically transfused patients of β-thalassemia major and correlate with hemoglobin and serum ferritin levels of pre- and posttransfusion.

MATERIALS AND METHODS: Thirty-three β-thalassemia major patients requiring monthly transfusions were included in the study. Blood samples, collected pretransfusion and 7 days posttransfusion, were evaluated for hemoglobin, serum ferritin, and serum hepcidin using enzyme immunoassay.

STATISTICAL ANALYSIS: Data were statistically analyzed through SPSS software and P < 0.05 is considered statically significant.

RESULTS: Posttransfusion levels of hemoglobin, serum ferritin, and serum hepcidin increased. Posttransfusion levels of hepcidin were near normal levels. Pre- and posttransfusion hepcidin concentrations were significantly associated with hemoglobin levels.

CONCLUSION: Serum hepcidin concentrations vary depending on the degree of erythropoiesis drive and level of anemia. We found that the serum hepcidin levels decrease over the inter-transfusion interval and transfusions cause suppression of ineffective erythropoiesis by the increase in hemoglobin. Posttransfusion values of hepcidin in our study were closer to normal levels which may be due to lower erythropoietic drive posttransfusion. We suggest that the measurement of serum hepcidin in chronically transfused β-thalassemia patients can be used as a follow-up investigation for better management of these patients.

PMID:39036689 | PMC:PMC11259346 | DOI:10.4103/ajts.ajts_160_22