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Nevin Manimala Statistics

Genomic comparison of malignant melanoma and atypical Spitz tumor in the pediatric population

Pediatr Dermatol. 2022 Feb 22. doi: 10.1111/pde.14935. Online ahead of print.

ABSTRACT

BACKGROUND/OBJECTIVES: The diagnostic distinction between atypical Spitz tumor (AST) and malignant melanoma (MM) in pediatric tumors is challenging. Molecular tests are increasingly used to characterize these neoplasms; however, limited studies are available in pediatric patients. This study aimed to provide a genomic comparison of pediatric MM and AST in the context of comprehensive clinical annotation.

METHODS: Pediatric patients diagnosed with MM (n=11) and AST (n=12) were compared to a cohort of 693 adult melanoma patients. DNA next-generation sequencing assessed kinase gene fusions, tumor mutational burden, sequence variants, copy number alterations, structural variants, microsatellite instability, and mutational signatures.

RESULTS: Seven AST cases and eight MM cases were successfully sequenced. Kinase gene fusions were identified in both the MM and AST cohorts (NTRK1, ROS1, and MET). MM cases had TERT, BRAF, and CDKN2A alterations, which were not identified in the AST cohort. Tumor mutational burden (TMB) analysis showed pediatric ASTs had an average of 2.82 mutations/Mb, pediatric MM had an average of 5.7 mutations/Mb, and adult MM cases averaged 18.8 mut/Mb. One pediatric MM case had an elevated TMB of 15 mutations/Mb and a UV mutational signature.

CONCLUSIONS: These data expand our understanding of pediatric malignant melanoma. The differences between the molecular signatures for AST and MM are not statistically significant, and histopathology remains the gold standard for the diagnosis of pediatric AST and MM at this time. With more data, molecular studies may provide additional support for diagnosis and targeted therapeutics.

PMID:35194848 | DOI:10.1111/pde.14935

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Nevin Manimala Statistics

Simulating denial increases false memory rates for abuse unrelated information

Behav Sci Law. 2022 Feb 22. doi: 10.1002/bsl.2566. Online ahead of print.

ABSTRACT

Victims of abuse might deny their traumatic experiences. We studied mnemonic effects of simulating false denial of a child sexual abuse narrative. Participants (N = 127) read and empathized with the main character of this narrative. Next, half were instructed to falsely deny abuse-related information while others responded honestly in an interview. One week later, participants received misinformation for the narrative and interview. In a final source memory task, participants’ memory for the narrative and interview was tested. Participants who falsely denied abuse-related information endorsed more abuse-unrelated misinformation about the event than honest participants. Abuse-related false memory rates did not statistically differ between the groups, and false denials were not related to omission errors about (1) the interview and (2) narrative. Hence, victim’s memory for abuse-related information related to their experience might not be affected by a false denial, and inconsistencies surrounding the abuse-unrelated information are more likely to take place.

PMID:35194828 | DOI:10.1002/bsl.2566

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Nevin Manimala Statistics

Evidence-based lifestyle medicine interventions to enhance the mental health of law enforcers in Hong Kong: A pilot randomized controlled trial

Behav Sci Law. 2022 Feb 22. doi: 10.1002/bsl.2565. Online ahead of print.

ABSTRACT

Law enforcers are stressed, but they may be reluctant to seek psychological support due to the stigmatization of mental illness in the law enforcement culture. Given the relatively stigma-free lifestyle medicine intervention, a two-arm pilot randomized controlled trial was conducted in the Hong Kong police force to examine the efficacy of integrated lifestyle medicine practices in enhancing the mental health of law enforcers. A total of 18 participants were randomly assigned to the intervention and waitlist control groups. The intervention group attended a 6-week lifestyle medicine program consisting of five lifestyle factors. On analyzing the results of the Patient Health Questionnaire using a paired sample t-test, a statistically significant intervention effect was found. This implies that participants had significantly better general psychological well-being after the intervention in this pilot study. In conclusion, the present findings provide preliminary support to promote the relatively stigma-free lifestyle medicine interventions in law enforcement. Nevertheless, further research effort with a larger sample size is warranted to provide empirical support for the efficacy of integrated lifestyle medicine programme.

PMID:35194818 | DOI:10.1002/bsl.2565

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Nevin Manimala Statistics

Obstructive sleep apnea in patients with acute aortic dissection

Clin Cardiol. 2022 Feb 23. doi: 10.1002/clc.23790. Online ahead of print.

ABSTRACT

BACKGROUND: Obstructive sleep apnea (OSA) imposes an afterload burden on the left ventricle and increases the pressure gradient across the aortic wall. Thus, OSA may increase the risk for aortic dissection (AD).

METHODS: This study enrolled 40 subjects with acute AD from four institutions; 37 completed the modified Berlin Questionnaire and 31 underwent attended overnight polysomnography. Aortic diameter was measured on a computed tomography scan at seven locations from the sinotubular junction to the diaphragm.

RESULTS: Twenty-seven subjects had type A dissection; 13 had type B. In those who had polysomnography apnea-hypopnea index (AHI) ranged from 0.7 to 89. Prevalence of OSA (AHI ≥ 5) was 61%. Nocturnal presentation (10 p.m.-7 a.m.) did not differ by presence/absence of OSA. The modified Berlin Questionnaire was not predictive of the presence of OSA. Among type A subjects with polysomnography (n = 23), aortic diameters at all locations were greater in the OSA group though differences were not statistically significant. Summating aortic diameters at the seven locations also yielded a numerically larger mean value in the OSA group versus the non-OSA group.

CONCLUSIONS: In this sample of patients with acute dissection, OSA was prevalent but was not associated with a nocturnal presentation. The presence of underlying OSA may be associated with larger aortic diameters at the time of dissection compared to patients without OSA. Though differences did not meet statistical significance the current series is limited by small numbers.

PMID:35194820 | DOI:10.1002/clc.23790

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Nevin Manimala Statistics

Neural alterations in working memory of mild-moderate TBI: An fMRI study in Malaysia

J Neurosci Res. 2022 Feb 22. doi: 10.1002/jnr.25023. Online ahead of print.

ABSTRACT

Working memory (WM) encompasses crucial cognitive processes or abilities to retain and manipulate temporary information for immediate execution of complex cognitive tasks in daily functioning such as reasoning and decision-making. The WM of individuals sustaining traumatic brain injury (TBI) was commonly compromised, especially in the domain of WM. The current study investigated the brain responses of WM in a group of participants with mild-moderate TBI compared to their healthy counterparts employing functional magnetic resonance imaging. All consented participants (healthy: n = 26 and TBI: n = 15) performed two variations of the n-back WM task with four load conditions (0-, 1-, 2-, and 3-back). The respective within-group effects showed a right hemisphere-dominance activation and slower reaction in performance for the TBI group. Random-effects analysis revealed activation difference between the two groups in the right occipital lobe in the guided n-back with cues, and in the bilateral occipital lobe, superior parietal region, and cingulate cortices in the n-back without cues. The left middle frontal gyrus was implicated in the load-dependent processing of WM in both groups. Further group analysis identified that the notable activation changes in the frontal gyri and anterior cingulate cortex are according to low and high loads. Though relatively smaller in scale, this study was eminent as it clarified the neural alterations in WM in the mild-moderate TBI group compared to healthy controls. It confirmed the robustness of the phenomenon in TBI with the reproducibility of the results in a heterogeneous non-Western sample.

PMID:35194817 | DOI:10.1002/jnr.25023

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Nevin Manimala Statistics

CORRECTION

Stat Med. 2022 Feb 28;41(5):932. doi: 10.1002/sim.9263.

NO ABSTRACT

PMID:35194816 | DOI:10.1002/sim.9263

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Nevin Manimala Statistics

Commentary on training and education in medical statistics, in celebration of 40 years of statistics in medicine and 50 years of the MSc medical statistics at LSHTM

Stat Med. 2022 Feb 28;41(5):835-837. doi: 10.1002/sim.9292.

NO ABSTRACT

PMID:35194814 | DOI:10.1002/sim.9292

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Nevin Manimala Statistics

Statistical advising: Professional development opportunities for the biostatistician

Stat Med. 2022 Feb 28;41(5):847-859. doi: 10.1002/sim.9290.

NO ABSTRACT

PMID:35194815 | DOI:10.1002/sim.9290

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Nevin Manimala Statistics

Incidence and predictive factors for recurrent clear cell ovarian carcinoma: results from a single center in Thailand

Obstet Gynecol Sci. 2022 Feb 23. doi: 10.5468/ogs.21313. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to study the incidence and predictive factors of recurrent clear cell ovarian carcinoma (CCC) and evaluate the oncological outcomes after recurrence.

METHODS: This was a retrospective study of 134 CCC cases diagnosed between 2005 and 2020. Clinicopathological data and oncological outcomes were extracted and evaluated. Patients with co-malignancy, mixed pathological type, or incomplete data were excluded. Descriptive statistics, univariate and multivariable analyses, and Kaplan-Meier survival probability estimates were completed. A proportional hazards model was used to assess the association between the prognostic factors with progression-free survival (PFS), overall survival (OS), and post-recurrence survival.

RESULTS: A total of 134 patients with CCC were enrolled. The incidence of recurrent CCC was 33.6% (45/134). The median PFS was 12.8 months (95% confidence interval [CI], 9.66-18.9) in the recurrence group and 3.3 months (95% CI, 1.15-4.4) in the refractory group. Residual tumor from surgical outcome, ascites cytology, and lymphovascular space invasion (LVSI) were independent prognostic factors for PFS. The significant variables were residual tumor (sub-optimal surgery vs. optimal surgery) (hazard ratio [HR], 2.68; 95% CI, 1.48-4.87; P=0.002), ascites cytology (positive vs. negative) (HR, 2.8; 95% CI, 1.58-4.98; P=0.002), and LVSI (positive vs. negative) (HR, 2.14; 95% CI, 1.18-3.86; P=0.04). The median post-recurrence survival was 13.96 months (95% CI, 10.61-26.2) in the recurrence group.

CONCLUSION: CCC has a high rate of recurrence. Sub-optimal surgery, positive ascites cytology, and LVSI indicated a worse prognosis for PFS. Optimal cytoreductive surgery is an important part of primary treatment to improve survival in patients with CCC.

PMID:35193175 | DOI:10.5468/ogs.21313

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Nevin Manimala Statistics

Short report: Characterizing HIV care among a clinical sample of transgender women living with HIV

HIV Med. 2022 Feb 22. doi: 10.1111/hiv.13261. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to characterize and identify factors associated with HIV care among transgender (trans) women living with HIV (TWLWH) in two urban centres in Canada.

METHODS: Retrospective data were collected from clinic charts of TWLWH aged 16 years and older across seven family medicine, endocrinology and/or HIV clinics in Montreal and Toronto, Canada, from 2018 to 2019 (n = 86). We assessed the proportion of individuals being ever engaged in HIV care [defined as having any recorded antiretroviral therapy (ART) regimen and/or viral load], current ART use, and most recent viral load (suppressed [<200 copies/ml] vs. unsuppressed) overall and compared across subgroups using χ2 tests.

RESULTS: All TWLWH in our sample [100.0%, 95% confidence interval (CI): 95.8-100.0%] were engaged in HIV care; most (93.0%, 95% CI: 85.4-97.4%) were currently using ART and most (93.4%, 95% CI: 85.3-97.8%) with complete data (n = 71/76) were virally suppressed. A higher proportion of trans women of colour (100.0%) reported current ART use compared with white trans women (76.9%, p = 0.017). A higher proportion of those with no documented history of injection drug use (IDU; 96.6%) were virally suppressed compared with those with a history of IDU (66.7%, p = 0.022). Although not statistically significant, 96.2% of those currently reporting feminizing hormone use were virally suppressed, compared with 85.0% of those not reporting use (p = 0.202).

CONCLUSIONS: Once engaged in HIV care, TWLWH in Canada appear to have excellent ART use and viral suppression. Findings can be leveraged to identify target populations to enhance HIV care and to further explore the relationship between gender-affirming medical care and HIV care.

PMID:35193172 | DOI:10.1111/hiv.13261