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Nevin Manimala Statistics

A Model-Strengthened Imaging Biomarker for Survival Prediction in EGFR-Mutated Non-small-cell Lung Carcinoma Patients Treated with Tyrosine Kinase Inhibitors

Bull Math Biol. 2021 May 8;83(6):68. doi: 10.1007/s11538-021-00902-7.

ABSTRACT

Non-small-cell lung carcinoma is a frequent type of lung cancer with a bad prognosis. Depending on the stage and genomics, several therapeutical approaches are used. Tyrosine Kinase Inhibitors (TKI) may be successful for a time in the treatment of EGFR-mutated non-small cells lung carcinoma. Our objective is here to introduce a survival assessment as their efficacy in the long run is challenging to evaluate. The study includes 17 patients diagnosed with EGFR-mutated non-small cell lung cancer and exposed to an EGFR-targeting TKI with 3 computed tomography (CT) scans of the primary tumor (one before the TKI introduction and two after). An imaging biomarker based on evolution of texture heterogeneity between the first and the third exams is derived and computed from a mathematical model and patient data. Defining the overall survival as the time between the introduction of the TKI treatment and the patient death, we obtain a statistically significant correlation between the overall survival and our imaging marker ([Formula: see text]). Using the ROC curve, the patients are separated into two populations and the comparison of the survival curves is statistically significant ([Formula: see text]). The baseline exam seems to have a significant role in the prediction of response to TKI treatment. More precisely, our imaging biomarker defined using only the CT scan before the TKI introduction allows to determine a first classification of the population which is improved over time using the imaging marker as soon as more CT scans are available. This exploratory study leads us to think that it is possible to obtain a survival assessment using only few CT scans of the primary tumor.

PMID:33966172 | DOI:10.1007/s11538-021-00902-7

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Nevin Manimala Statistics

An investigation of early radiation damage in rainbow trout eye-lenses

Radiat Environ Biophys. 2021 May 8. doi: 10.1007/s00411-021-00913-x. Online ahead of print.

ABSTRACT

As part of the wider interest in the effects of ionizing radiation on non-human biota, this investigation was carried out to study early radiation damage to the eye-lenses of rainbow trout. Lenses were cultured and irradiated to doses of 1.1 Gy and 2.2 Gy with low-energy X-rays of 40 kV. Laser focal analysis was used to track changes in focal lengths across the lenses post-irradiation. Changes in focal length variability (FLV) were measured to determine whether this could give an indication of the early effects of radiation on lens health. No statistically significant differences in FLV between the control and irradiated lenses within 10 days post-irradiation were observed. FLV was found to be 0.09 ± 0.02 mm for 2.2 Gy lenses, 0.06 ± 0.01 mm for 1.1 Gy lenses, and 0.11 ± 0.02 mm for control lenses at the end of the observation period.

PMID:33966106 | DOI:10.1007/s00411-021-00913-x

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Safety and sedation-associated adverse event reporting among patients undergoing endoscopic cholangiopancreatography: a comparative systematic review and meta-analysis

Surg Endosc. 2021 May 8. doi: 10.1007/s00464-020-08210-2. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: There is wide variation in choice of sedation and airway management for endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to perform a systematic review and meta-analysis to investigate safety outcomes of deep sedation with monitored anesthesia care (MAC) versus general endotracheal anesthesia (GETA).

METHODS: Individualized search strategies were performed in accordance with PRISMA and MOOSE guidelines. This meta-analysis was performed by calculating pooled proportions using random effects models. Measured outcomes included procedure success, all-cause and anesthesia-associated adverse events, and post-procedure recovery time. Heterogeneity was assessed with I2 statistics and publication bias by funnel plot and Egger regression testing.

RESULTS: Five studies (MAC: n = 1284 vs GETA: n = 615) were included. Patients in the GETA group were younger, had higher body mass index (BMI), and higher mean ASA scores (all P < 0.001) with no difference in Mallampati scores (P = 0.923). Procedure success, all-cause adverse events, and anesthesia-associated events were similar between groups [OR 1.16 (95% CI 0.51-2.64); OR 1.16 (95% CI 0.29-4.70); OR 1.33 (95% CI 0.27-6.49), respectively]. MAC resulted in fewer hypotensive episodes [OR 0.32 (95% CI 0.12-0.87], increased hypoxemic events [OR 5.61 (95% CI 1.54-20.37)], and no difference in cardiac arrhythmias [OR 0.48 (95% CI 0.13-1.78)]. Procedure time was decreased for MAC [standard difference – 0.39 (95% CI – 0.78-0.00)] with no difference in recovery time [standard difference – 0.48 (95% CI – 1.04-0.07)].

CONCLUSIONS: This study suggests MAC may be a safe alternative to GETA for ERCP; however, MAC may not be appropriate in all patients given an increased risk of hypoxemia.

PMID:33966121 | DOI:10.1007/s00464-020-08210-2

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Laboratory prognostic score for predicting 14-day mortality in terminally ill patients with gynecologic malignancy

Int J Clin Oncol. 2021 May 9. doi: 10.1007/s10147-021-01923-x. Online ahead of print.

ABSTRACT

BACKGROUND: There are few studies developing a scoring system for short-term survival of patients with gynecologic malignancy.

METHODS: Seventy-three terminally ill patients with gynecologic malignancy who were admitted to our palliative care unit (PCU) from June 2009 to February 2018 were included. We accumulated routine blood data within 3 months before PCU discharge. Receiver-operating characteristic analysis was performed on each blood factor, and area under the curve (AUC) was calculated to determine the predictive value for 14-day survival after the blood test. Multivariable logistic regression analysis was performed to identify significant independent prognostic factors of 14-day mortality. To develop a scoring system for 14-day mortality, laboratory prognostic score for gynecologic malignancy (G-LPS) was calculated using the sum of indices of the independent prognostic factors.

RESULTS: Multivariable analysis showed that 6 of 24 indices, namely, C-reactive protein ≥ 13.3 mg/dL, total bilirubin ≥ 1.1 mg/dL, sodium < 131 mEq/L, blood urea nitrogen ≥ 28 mg/dL, white blood cell count ≥ 17.7 × 103/μL, and eosinophil level < 0.2%, were significant independent factors of 14-day survival. G-LPS was obtained from the sum of the six indices. The AUC was 0.7977 at the optimal cut-off value of G-LPS 3. G-LPS 3 predicted death within 14 days with a sensitivity of 72% and a specificity of 79%.

CONCLUSIONS: Six of the 24 laboratory indices were identified as independent prognostic factors of 14-day mortality in terminally ill patients with gynecologic malignancy. G-LPS showed acceptable ability of predicting 14-day survival.

PMID:33966125 | DOI:10.1007/s10147-021-01923-x

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Comparative Clinical and Neuropsychological Characteristics in Schizophrenia and Schizophrenia-Obsessive-Compulsive Disorder Patients

J Nerv Ment Dis. 2021 May 6. doi: 10.1097/NMD.0000000000001337. Online ahead of print.

ABSTRACT

The present study aimed to compare neuropsychological characteristics of patients with schizophrenia and patients with schizophrenia-obsessive-compulsive disorder (OCD). A total of 78 patients were included in the study, with 32 patients diagnosed with schizophrenia and 46 patients diagnosed with schizophrenia-OCD according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria. Two groups of the patients were compared with each other in terms of demographic data, psychotic symptoms, and clinical and neuropsychological characteristics. In this study, the schizophrenia-OCD relationship was seen at a higher rate in male patients, and this group has worse clinical features. In addition, there was no significant difference among sociodemographics, clinical characteristics, and social and neuropsychological functionality between the two groups. According to our results, patients with schizophrenia-OCD experience more depression and anxiety that are related to poorer quality of life. Longitudinal and more homogeneous patient groups are needed for further studies to reveal whether schizophrenia accompanied by OCD is a comorbidity, a subtype of schizophrenia, or a different disorder.

PMID:33966017 | DOI:10.1097/NMD.0000000000001337

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Current State of Evidence on Kidney Transplantation: How Fragile Are the Results?

Transplantation. 2021 May 6. doi: 10.1097/TP.0000000000003805. Online ahead of print.

ABSTRACT

BACKGROUND: The study aims is to use the fragility index (FI) to examine the strength of evidence of randomized controlled trials (RCTs) published in the last decade on kidney transplantation.

METHODS: We searched MEDLINE for studies on kidney transplantation. We included the RCTs that compared 2 groups with 1:1 randomization and reported significant P-values (<0.05) for a dichotomous outcome and were published in the top 10 transplant journals. We calculated the FI; a calculation used to determine the minimum number of subjects needed to change from a nonevent to an event to make the study results nonsignificant (P-value >0.05).

RESULTS: 57 RCTs met our inclusion criteria. The median sample size was 100 participants in each arm, the median number of events was 16(IQR 8-30) in the intervention group. Among the included trials, 79% were industry-funded, 93% involved medications, and the majority were open-label. The median FI was 3 (IQR 1-11). In 43% of the trials, the number of patients reported lost to follow-up was higher than or equal to the FI. Only 4% of the RCTs imputed a value for the missing dichotomous outcome. Furthermore, the median number of subjects who discontinued the trial due to adverse effects was 21, which was greater than the FI in 60% of the RCTs.

CONCLUSION: The arbitrary classification of results into “significant” and “nonsignificant” based on p-value <0.05 should perhaps be interpreted with the help of other statistical parameters and FI is one of them.

PMID:33966022 | DOI:10.1097/TP.0000000000003805

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Correlation between BNT162b2 mRNA Covid-19 vaccine-associated hypermetabolic lymphadenopathy and humoral immunity in patients with hematologic malignancy

Eur J Nucl Med Mol Imaging. 2021 May 8. doi: 10.1007/s00259-021-05389-x. Online ahead of print.

ABSTRACT

PURPOSE: Vaccine-associated hypermetabolic lymphadenopathy (VAHL) is frequently observed on [18F]FDG PET-CT following BNT162b2 administration. Recent data suggest a prominent B cell germinal-center (GC) response elicited by mRNA vaccines in draining lymph nodes. Thus, in this study we aimed to explore the correlation between VAHL and humoral immunity as reflected by post-vaccination serologic testing and by comparing the incidence of VAHL between lymphoma patients treated recently with B cell depleting therapy and those that were not.

METHODS: A total of 137 patients with hematologic malignancy that had post-vaccination [18F]FDG PET-CT were included (All-PET group), 86 received both vaccine doses before imaging (PET-2 group). Their VAHL status and grade on imaging were recorded. Among 102 lymphoma patients, 34 (33.3%) were treated during the year prior vaccination with anti-CD20 antibody containing therapy. A subgroup of 54 patients also underwent serologic testing 2-3 weeks after the booster dose, and their anti-spike titers were recorded and graded as well.

RESULTS: The overall incidence of VAHL in patients with hematologic malignancy was 31.4%. The 34 lymphoma patients treated during the year prior vaccination with anti-CD20 antibody containing therapy had significantly lower rates of VAHL comparted with all other lymphoma patients (8.8 versus 41.2% in all-PET patients, Pv < 0.01). VAHL rates were 10% in patients with negative serology, 31.3% in patients with low anti-spike titers, and 72.2% in patients with high anti-spike titers. The positive predictive values of VAHL were 90 and 93.3% in all-PET and PET-2 patients, respectively. A positive statistically significant correlation was found between VAHL and serology ranks in All-PET patients (rs = 0.530, Pv < 0.001), and stronger correlation was found in PET-2 patients (rs = 0.642, Pv < 0.001).

CONCLUSION: VAHL on [18F]FDG PET-CT of patients with hematologic malignancy may reflect GC B cell proliferation and an effective humoral response elicited by BNT162b2 vaccine.

PMID:33966088 | DOI:10.1007/s00259-021-05389-x

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Apolipoprotein E4 Allele in Subjects with COVID-19

Gerontology. 2021 May 7:1-3. doi: 10.1159/000516200. Online ahead of print.

NO ABSTRACT

PMID:33965962 | DOI:10.1159/000516200

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NORMALIZING EFFECT OF ELECTROMAGNETIC STIMULATION ON BLOOD QUANTITATIVE INDICES IN DEPRESSED RATS ON THE BACKGROUND OF OXYTOCIN

Georgian Med News. 2021 Mar;(312):100-104.

ABSTRACT

Depression is linked to systemic inflammation. There is an association between blood cell count and/or hematological inflammatory markers with depression symptoms. Oxytocin reduces the activity of brain regions that produce anxiety and might involve in the rehabilitation of depressive-like behavior. Repetitive EMS is used in the treatment of moderate depression. So, the goal of this investigation was to study the quantitative characteristics of blood cells after EMS on the background of oxytocin premedication of in depressed rats. In the implementation of the project the depressed rats (250-450 g) were used (n=20). For each task two groups of the animal were conducted: experimental group (with EMS) and control group (without EMS). For repetitive (10-days) EMF exposure, the following parameters were used: 10000 -15000 Hz frequency, 1,5 m/Tesla, for 15 min. An animal model of depression was received by subcutaneous injection of Clomipramine from 8 to 21 days of neonatal development. The blood counts were performed 2 months later after clomipramine injection using blood HumaCount 30 TS. This analyzer allows quantifying the number of red blood cells, white blood cells (agranulocytes and granulocytes), platelets, hemoglobin, the hematocrit in 1 ml blood of rats. The hematological analysis was performed 2 weeks later after oxytocin (4 mcg/per animal during 10 days) injection and EMS. The obtained results were processed using an adequate statistical program. In clomipramine -induced depressed rats, EMS independently or with simultaneous injection of Oxytocin caused normalization of blood cells count (Red blood cells, white blood cells and Platelets). More important was the simultaneous impact of EMS and oxytocin. In depressed rats, the oxytocin alone, or together with EMS can restore the blood cell imbalance.

PMID:33964836

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Association of food insecurity with dietary intakes and nutritional biomarkers among US children, National Health and Nutrition Examination Survey (NHANES) 2011-2016

Am J Clin Nutr. 2021 May 8:nqab113. doi: 10.1093/ajcn/nqab113. Online ahead of print.

ABSTRACT

BACKGROUND: Food insecurity is associated with poorer nutrient intakes from food sources and lower dietary supplement use. However, its association with total usual nutrient intakes, inclusive of dietary supplements, and biomarkers of nutritional status among US children remains unknown.

OBJECTIVE: The objective was to assess total usual nutrient intakes, Healthy Eating Index-2015 (HEI-2015) scores, and nutritional biomarkers by food security status, sex, and age among US children.

METHODS: Cross-sectional data from 9147 children aged 1-18 y from the 2011-2016 NHANES were analyzed. Usual energy and total nutrient intakes and HEI-2015 scores were estimated using the National Cancer Institute method from 24-h dietary recalls.

RESULTS: Overall diet quality was poor, and intakes of sodium, added sugars, and saturated fat were higher than recommended limits, regardless of food security status. Food-insecure girls and boys were at higher risk of inadequate intakes for vitamin D and magnesium, and girls also had higher risk for inadequate calcium intakes compared with their food-secure counterparts, when total intakes were examined. Choline intakes of food-insecure children were less likely to meet the adequate intake than those of their food-secure peers. No differences by food security status were noted for folate, vitamin C, iron, zinc, potassium, and sodium intakes. Food-insecure adolescent girls aged 14-18 y were at higher risk of micronutrient inadequacies than any other subgroup, with 92.8% (SE: 3.6%) at risk of inadequate intakes for vitamin D. No differences in biomarkers for vitamin D, folate, iron, and zinc were observed by food security status. The prevalence of iron deficiency was 12.7% in food-secure and 12.0% in food-insecure adolescent girls.

CONCLUSIONS: Food insecurity was associated with compromised intake of some micronutrients, especially among adolescent girls. These results highlight a need for targeted interventions to improve children’s overall diet quality, including the reduction of specific nutrient inadequacies, especially among food-insecure children. This study was registered at clinicaltrials.gov as NCT03400436.

PMID:33964856 | DOI:10.1093/ajcn/nqab113