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Nevin Manimala Statistics

Bayesian hierarchical models for adaptive basket trial designs

Pharm Stat. 2023 Jan 10. doi: 10.1002/pst.2289. Online ahead of print.

ABSTRACT

Basket trials evaluate a single drug targeting a single genetic variant in multiple cancer cohorts. Empirical findings suggest that treatment efficacy across baskets may be heterogeneous. Most modern basket trial designs use Bayesian methods. These methods require the prior specification of at least one parameter that permits information sharing across baskets. In this study, we provide recommendations for selecting a prior for scale parameters for adaptive basket trials by using Bayesian hierarchical modeling. Heterogeneity among baskets attracts much attention in basket trial research, and substantial heterogeneity challenges the basic assumption of exchangeability of Bayesian hierarchical approach. Thus, we also allowed each stratum-specific parameter to be exchangeable or nonexchangeable with similar strata by using data observed in an interim analysis. Through a simulation study, we evaluated the overall performance of our design based on statistical power and type I error rates. Our research contributes to the understanding of the properties of Bayesian basket trial designs.

PMID:36625301 | DOI:10.1002/pst.2289

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Nevin Manimala Statistics

The Effect of Naloxone Access Laws on Fatal Synthetic Opioid Overdose Fatality Rates

J Prim Care Community Health. 2023 Jan-Dec;14:21501319221147246. doi: 10.1177/21501319221147246.

ABSTRACT

BACKGROUND: Increases in fatal synthetic opioid overdoses over the past 8 years have left states scrambling for effective means to curtail these deaths. Many states have implemented policies and increased service capacity to address this rise. To better understand the effectiveness of policy level interventions we estimated the impact of the presence of naloxone access laws (NALs) on synthetic opioid fatalities at the state level.

METHODS: A multivariable longitudinal linear mixed model with a random intercept was used to determine the relationship between the presence of NALs and synthetic opioid overdose death rates, while controlling for, Good Samaritan laws, opioid prescription rate, and capacity for medication for opioid use disorder (MOUD), utilizing a quadratic time trajectory. Data for the study was collected from the National Vital Statistics System using multiple cause-of-death mortality files linked to drug overdose deaths.

RESULTS: The presence of an NAL had a significant (univariate P-value = .013; multivariable p-value = .010) negative relationship to fentanyl overdose death rates. Other significant controlling variables were quadratic time (univariate and multivariable P-value < .001), MOUD (univariate P-value < .001; multivariable P-value = .009), and Good Samaritan Law (univariate P-value = .033; multivariable P-value = .018).

CONCLUSION: Naloxone standing orders are strongly related to fatal synthetic opioid overdose reduction. The effect of NALs, MOUD treatment capacity, and Good Samaritan laws all significantly influenced the synthetic opioid overdose death rate. The use of naloxone should be a central part of any state strategy to reduce overdose death rate.

PMID:36625264 | DOI:10.1177/21501319221147246

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Nevin Manimala Statistics

Influence of surface viscosities on the electrodeformation of a prolate viscous drop

Soft Matter. 2023 Jan 10. doi: 10.1039/d2sm01307j. Online ahead of print.

ABSTRACT

Contaminants and other agents are often present at the interface between two fluids, giving rise to rheological properties such as surface shear and dilatational viscosities. The dynamics of viscous drops with interfacial viscosities has attracted greater interest in recent years, due to the influence of surface rheology on deformation and the surrounding flows. We investigate the effects of shear and dilatational viscosities on the electro-deformation of a viscous drop using the Taylor-Melcher leaky dielectric model. We use a large deformation analysis to derive an ordinary differential equation for the drop shape. Our model elucidates the contributions of each force to the overall deformation of the drop and reveals a rich range of dynamic behaviors that show the effects of surface viscosities and their dependence on rheological and electrical properties of the system. We also examine the physical mechanisms underlying the observed behaviors by analyzing the surface dilatation and surface deformation.

PMID:36625263 | DOI:10.1039/d2sm01307j

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Nevin Manimala Statistics

Ex vivo evaluation of a percutaneous thread-transecting technique for desmotomy of normal palmar/plantar annular ligaments in horses

Vet Surg. 2023 Jan 10. doi: 10.1111/vsu.13932. Online ahead of print.

ABSTRACT

OBJECTIVE: To develop and describe a minimally invasive, ultrasound-guided, percutaneous technique for the desmotomy of equine palmar/plantar annular ligaments (PALs) using a transecting thread.

STUDY DESIGN: Ex vivo study.

SAMPLE POPULATION: Twenty-one normal equine distal limb specimens.

METHODS: Under ultrasonographic guidance, a surgical thread was percutaneously placed around the PAL through 2 skin punctures (proximal and distal) using a 18 gauge spinal needle in equine limbs (11 forelimbs, 10 hindlimbs) with normal PALs. The ligament was transected by a back-and-forth motion of the thread until the loop emerged from the proximal skin puncture site. Each specimen was dissected and assessed for completeness of transection and iatrogenic damage under direct visualization. Descriptive statistics were reported.

RESULTS: The PAL was completely transected in 17/21 limbs. The mean duration of the procedure was 16 minutes. Superficial needle puncture or subtle abrasion of the superficial digital flexor tendon was noticed in 4 limbs. No iatrogenic injury to other intrathecal structures was identified. After PAL division, the needle entry and exit points had a mean diameter of 1.2 and 1 mm, respectively.

CONCLUSION: Desmotomy of normal PALs in equine limb specimens was performed effectively using the percutaneous thread-transecting technique with minimal iatrogenic damage to adjacent structures.

CLINICAL SIGNIFICANCE: Information from this study will allow refinement of the technique for use in equine clinical cases either in standing or anesthetized horses.

PMID:36625237 | DOI:10.1111/vsu.13932

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Nevin Manimala Statistics

Gender differences contribute to variability of serum lipid biomarkers for Alzheimer’s disease

Biomark Med. 2023 Jan 10. doi: 10.2217/bmm-2022-0462. Online ahead of print.

ABSTRACT

Background: Alzheimer’s disease (AD) cannot currently be diagnosed by a blood test. One reason may be gender differences. Another may be the statistical methods used. The authors evaluate these possibilities. Objective: The authors applied serum lipidomics to find AD biomarkers in men and women. They hypothesized that AD biomarkers would differ between genders and that machine-learning algorithms would improve diagnostic performance. Methods: Serum lipids were analyzed by mass spectrometry for a training set of AD cases and controls and in a blinded test set. Statistical analyses considered gender differences. Results: Lipids best classifying AD subjects differed significantly between men and women. Robust statistical algorithms did not improve diagnostic performance. Conclusion: Poor performance of AD biomarkers appears to be due primarily to inherent variability in AD patients.

PMID:36625236 | DOI:10.2217/bmm-2022-0462

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Nevin Manimala Statistics

The Efficacy of Reminiscence Therapy in Cancer-Related Symptom Management: A Systematic Review and Meta-Analysis

Integr Cancer Ther. 2023 Jan-Dec;22:15347354221147499. doi: 10.1177/15347354221147499.

ABSTRACT

BACKGROUND: At present, simple reminiscence has been widely used in the field of neurocognitive disorders, life review/life review therapy has been widely used in the field of cancer, and both simple reminiscence and life review/life review therapy are suitable for psychological disorders such as depression and anxiety. However, the efficacy of reminiscence in treating cancer-related symptom has not been fully assessed.

OBJECTIVES: To evaluate the effect of reminiscence therapy (RT) on relieving cancer-related symptoms such as anxiety and depression in cancer survivals.

METHODS: China National Knowledge Infrastructure (CNKI), VIP database, Wanfang Data Knowledge Service Platform, China Biomedical Database, PubMed, Cochrane Library, Embase, EBSCO, Scopus, and Ovid databases were searched. To collect clinical randomized controlled trials (RCT) on RT and cancer-related studies published from the establishment of the database to October 05, 2021. Two researchers independently evaluated the articles that met the inclusion criteria, meta-analysis was performed using RevMan5.4 software.

RESULTS: A total of 20 RCTs published in 2010 to 2021 were included, with a total of 1853 cancer patients. Meta-analysis results showed that the anxiety scale (HADS-A and HAMA and SAS) and depression scale (HADS-D and HAMD and SDS) scores of the RT group were significantly lower than those of the control group (HADS-A: P = .0002; HAMA: P < .00001; SAS: P = .0010; HADS-D: P = .01; HAMD: P < .00001; SDS: P = .0001). Meta-analysis results showed that RT can improve overall quality of life of cancer patients of RT group to a certain extent hope (P < .00001). Meta-analysis results showed that the scores on the hope and dignity were significantly increased, and the difference were statistically significant (P < .001).

CONCLUSION: This review indicates that RT has significant efficacy on cancer-related symptoms such as anxiety and depression. RT for cancer survivals can effectively improve quality of life, self-hope, and self-esteem. The findings of this meta-analysis can provide direction for future symptom management research.

PMID:36625232 | DOI:10.1177/15347354221147499

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Nevin Manimala Statistics

The relationship between dysphagia and the localisation of brain lesion in stroke: is the involvement of the pons and medulla important?

Somatosens Mot Res. 2023 Jan 10:1-8. doi: 10.1080/08990220.2023.2165058. Online ahead of print.

ABSTRACT

OBJECTIVES: The presence of dysphagia in stroke is associated with mortality and morbidity. The aim of this retrospective study is to present the relationship between dysphagia and the demographic characteristics of the patient, and the type and localisation of brain lesion in the acute period in stroke patients with dysphagia.

MATERIALS AND METHODS: The data of 284 patients who had stroke-related dysphagia, had a disease duration 1-3 months, had no history of swallowing dysfunction before the event, and had their brain MRI/CT reports in the hospital were included.

RESULTS: The rate of tube-dependent oral areas was higher in the lesions located in the pons and the medulla than in the lesions located in the MCA cortex, the basal ganglia, and the cerebellum (p ˂ 0.001, p = 0.032 and p = 0.011, respectively) and the percentage of those fed with NG + TPN + PEG was statistically significantly higher (p = 0.002, p = 0.032 and p = 0.011, respectively). History of pneumonia was found to be statistically significantly higher in the lesions located in the pons and the medulla than in the lesions located in the MCA cortex, ACA cortex, PCA cortex, the basal ganglia, periventricular white matter, the thalamus, the cerebellum, and the midbrain (p ˂ 0.001, p = 0.005, p = 0.023, p ˂ 0.001, p = 0.023, p = 0.001, p = 0.011 and p = 0.023, respectively).

CONCLUSION: In conclusion, although lesion localisation in the acute period in patients with dysphagia varied in terms of clinical swallowing evaluation findings, weight loss, pneumonia history, the rate of tube-dependent intake, were shown to be higher in patients who had lesions in the pons and the medulla, which is a finding that should be considered in the clinical follow-up of acute stroke patients with lesions in the pons and the medulla.

PMID:36625230 | DOI:10.1080/08990220.2023.2165058

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Nevin Manimala Statistics

Negotiating the second mesiobuccal canal: A comparison of nickel titanium files through the experience of undergraduate dental students

J Dent Educ. 2023 Jan 10. doi: 10.1002/jdd.13165. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this study was to compare the ability of undergraduate students to reach working length (WL) in second mesiobuccal root canals (MB2) of maxillary first molars (n = 210) by using Reciproc Blue without glide path preparation, and One Curve with glide path preparation.

METHODS: The students (n = 105) attended theoretical and practical courses. The first group (n = 53) shaped MB2 root canals using the One Curve system and then Reciproc Blue; the second group (n = 52) shaped MB2 root canals following the reverse sequence. Participants completed a questionnaire. The chi-square and Mann-Whitney U test were used for statistical analysis using significance of p < 0.05.

RESULTS: The full WL was reached and shaping procedures were completed without complications in Reciproc Blue and One Curve groups at rates of 86.67% and 82.85%, respectively (p > 0.05). Treatment time was shorter in Reciproc Blue (p < 0.05). More (62.9%) students felt the One Curve system safer, while 61% felt the Reciproc Blue system faster.

CONCLUSIONS: Within the limitations of this study, instrument kinematics and glide path preparation did not interfere with undergraduate students’ ability to achieve the WL in MB2 root canals.

PMID:36625222 | DOI:10.1002/jdd.13165

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Nevin Manimala Statistics

Ultrasound-guided interfascial blocks of the trapezius muscle for cervicogenic headache

Agri. 2023 Jan;35(1):16-21. doi: 10.14744/agri.2021.21957.

ABSTRACT

OBJECTIVES: Disorders in the cervical muscles, such as myofascial trigger points and tightness, are common factors in patients with cervicogenic headache (CEH). We aimed to evaluate the effectiveness of ultrasound-guided interfascial blocks of the trapezius muscle in patients with CEH who showed tenderness in the upper cervical muscle groups.

METHODS: A total of 23 patients were evaluated in the prospective observational trial. The injection was performed between the trapezius muscle and levator scapula muscle fascia with a disposable 25-gauge, 10-cm Quincke-tip spinal needle. 10 mL of 0.125% bupivacaine was injected between the muscle fascia. Numeric rating scale (NRS), neck disability index (NDI), pain frequency, and analgesic consumption in the pre-treatment and post-treatment period were evaluated.

RESULTS: The NRS scores at 10 min, 1 week, 2 weeks, and 4 weeks after treatment were significantly better than the pre-treatment NRS score. The NDI scores at 1, 2, and 4 weeks after treatment were significantly better than the pre-treatment NDI score. The pain frequency at 1 and 2 weeks after treatment was significantly lower than that recorded in the pre-treatment period. Statistically significant reductions were observed in analgesic consumption at 1, 2, and 4 weeks after treatment, in comparison with consumption in the pre-treatment period.

CONCLUSION: We suggest that an ultrasound-guided interfascial block of the trapezius muscle is effective for the treatment of CEH caused by muscle disorders.

PMID:36625186 | DOI:10.14744/agri.2021.21957

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Nevin Manimala Statistics

Widening Social Inequalities in Cancer Mortality of Children Under 5 Years in Korea

J Korean Med Sci. 2023 Jan 9;38(2):e20. doi: 10.3346/jkms.2023.38.e20.

ABSTRACT

BACKGROUND: To investigate the effect of parental social class on cancer mortality in children under 5 in Korea, two birth cohorts were constructed by linking national birth data to under-5 death data from the Statistics Korea for 1995-1999 (3,323,613 births) and 2010-2014 (2,297,876 births).

METHODS: The Cox proportional hazards model adjusted for covariates was used in this study.

RESULTS: Social inequalities of under-5 cancer mortality risk in paternal education and paternal employment status were greater in 2010-2014 than in 1995-1999. The gap of hazard ratio (HR) of under-5 cancer mortality between lower (high school or below) and higher (university or higher) paternal education increased from 1.23 (95% confidence interval, 1.041.46) in 1995-1999 to 1.45 (1.11-1.97) in 2010-2014; the gap of HR between parents engaged in manual work and non-manual work increased from 1.32 (1.12-1.56) in 1995-1999 to 1.45 (1.12-1.89) in 2010-2014 for fathers, and from 1.18 (0.7-1.98) to 1.69 (1.03-2.79) for mothers. When the parental social class was lower, the risk of under-5 cancer mortality was higher in not only adverse but normal births.

CONCLUSION: Social inequalities must be addressed to reduce the disparity in cancer mortality of children under 5 years old.

PMID:36625176 | DOI:10.3346/jkms.2023.38.e20