Tag: pubmed

Breast. 2021 Aug 3;59:327-338. doi: 10.1016/j.breast.2021.07.021. Online ahead of print.

ABSTRACT

BACKGROUND: Premenopausal women with early hormone-receptor positive (HR+) breast cancer receive 5-10 years of adjuvant endocrine therapy (ET) during which pregnancy is contraindicated and fertility may wane. The POSITIVE study investigates the impact of temporary ET interruption to allow pregnancy.

METHODS: POSITIVE enrolled women with stage I-III HR + early breast cancer, ≤42 years, who had received 18-30 months of adjuvant ET and wished to interrupt ET for pregnancy. Treatment interruption for up to 2 years was permitted to allow pregnancy, delivery and breastfeeding, followed by ET resumption to complete the planned duration.

FINDINGS: From 12/2014 to 12/2019, 518 women were enrolled at 116 institutions/20 countries/4 continents. At enrolment, the median age was 37 years and 74.9 % were nulliparous. Fertility preservation was used by 51.5 % of women. 93.2 % of patients had stage I/II disease, 66.0 % were node-negative, 54.7 % had breast conserving surgery, 61.9 % had received neo/adjuvant chemotherapy. Tamoxifen alone was the most prescribed ET (41.8 %), followed by tamoxifen + ovarian function suppression (OFS) (35.4 %). A greater proportion of North American women were <35 years at enrolment (42.7 %), had mastectomy (59.0 %) and received tamoxifen alone (59.8 %). More Asian women were nulliparous (81.0 %), had node-negative disease (76.2%) and received tamoxifen + OFS (56.0 %). More European women had received chemotherapy (69.3 %).

INTERPRETATION: The characteristics of participants in the POSITIVE study provide insights to which patients and doctors considered it acceptable to interrupt ET to pursue pregnancy. Similarities and variations from a regional, sociodemographic, disease and treatment standpoint suggest specific sociocultural attitudes across the world.

PMID:34390999 | DOI:10.1016/j.breast.2021.07.021

Dev Cogn Neurosci. 2021 Aug 8;51:101001. doi: 10.1016/j.dcn.2021.101001. Online ahead of print.

ABSTRACT

Longitudinal models have become increasingly popular in recent years because of their power to test theoretically derived hypotheses by modeling within-person processes with repeated measures. Growth models constitute a flexible framework for modeling a range of complex trajectories across time in outcomes of interest, including non-linearities and time-varying covariates. However, these models can be expanded to include the effects of multiple growth processes at once on a single outcome. Here, I outline such an extension, showing how multiple growth processes can be modeled as a specific case of the general ability to include time-varying covariates in growth models. I show that this extension of growth models cannot be accomplished by statistical models alone, and that study design plays a crucial role in allowing for proper parameter recovery. I demonstrate these principles through simulations to mimic important theoretical conditions where modeling the effects of multiple growth processes can address developmental theory including, disaggregating the effects of age and practice or treatment in repeated assessments and modeling age- and puberty-related effects during adolescence. I compare how these models behave in two common longitudinal designs, cohort and accelerated, and how planned missingness in observations is key to parameter recovery. I conclude with directions for future substantive research using the method outlined here.

PMID:34391004 | DOI:10.1016/j.dcn.2021.101001

Sleep Med. 2021 Jul 20;85:309-312. doi: 10.1016/j.sleep.2021.07.018. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the differences in clinical efficacy of different courses of repetitive transcranial magnetic stimulation (rTMS) in the treatment of intractable insomnia and the duration of clinical efficacy after cessation of treatment.

METHOD: 70 patients with intractable insomnia were randomly divided into 1 treatment course group and 2 treatment courses group. The rTMS course consisted of daily sessions of 1200 stimuli for the r-DLPFC at a frequency of 1 Hz and 800 stimuli for parietal lobe (CPZ) at a frequency of 1 Hz. The pitchburg sleep index (PSQI), Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), and cardiopulmonary coupled sleep (CPC) were assessed for 35 patients in each group at baseline, at 2 weeks, and at 1 and 3 months after treatment.

RESULT: The scores of PSQI, HAMD and HAMA in the 2 groups were significantly improved after 1 month of follow-up after rTMS treatment (p < 0.01). The long-term effect of different treatment courses is different. After 2 consecutive courses of treatment, there was still a significant difference between the 3-month follow-up and the pre-treatment period (p < 0.05). However, there was no statistical difference between the 3-month follow-up of one course of treatment and the pre-treatment period. The results of CPC test showed that the improvement of total sleep time (TST), and deep sleep time (DST) was basically consistent with the assessment of PSQI, HAMD and HAMA that the clinical efficacy of the 3-month follow-up was better than that of one course of treatment after 2 consecutive courses of treatment.

CONCLUSION: The treatment of refractory insomnia by rTMS is effective, and the duration of the curative effect is related to the course of treatment. 2 consecutive courses of treatment still have a certain effect after 3 months, which is worthy of clinical promotion.

PMID:34391006 | DOI:10.1016/j.sleep.2021.07.018

Micron. 2021 Aug 8;150:103135. doi: 10.1016/j.micron.2021.103135. Online ahead of print.

ABSTRACT

A detailed numerical study of the formation of metallic silver thin films ranged from 8 up to 50 nm on thickness is presented. The topography of these films was imaged by Atomic Force Microscopy, and starting from these images, some surface parameters were obtained. We characterized the root mean square roughness evolution by a simple power-law model with a coefficient α=0.74±0.01 consistent with the theoretical results of Family and Vicsek (1985), Family (1990). Additionally, we considered different models to describe the distributions of the grains’ heights and sizes, and analyzed them via Bayesian statistics and a Markov Chain Monte Carlo numerical method. This Bayesian analysis has been significantly helpful in this work for allowing the study of the models that represent our data best and considering the experimental errors as instrumental data. The results of this analysis suggest an individual grains’ growth followed by a collapse between neighboring grains.

PMID:34390976 | DOI:10.1016/j.micron.2021.103135

Ecotoxicol Environ Saf. 2021 Aug 11;223:112604. doi: 10.1016/j.ecoenv.2021.112604. Online ahead of print.

ABSTRACT

The demand for the effective traceability of hazardous chemicals is crucial for preventing and controlling chemical spills and other accidents involving hazardous chemicals. The aim of the study was to investigate the correlation between the geographical location of ethanol-producing industrial sites and the carbon, hydrogen, and oxygen stable isotope ratios of the Chinese-manufactured ethanol using statistical classification analysis to enable the traceability of the ethanol. The isotopic data of 54 ethanol samples obtained from 18 different ethanol manufacturing plants in China between 2019 and 2020. The results of the statistical analysis demonstrated that the δ¹⁸O values of the ethanol positively correlated with latitudes of the production plants but negatively correlated with the δ¹³C values of the ethanol. A small number of samples derived from sites that were geographically close to each other could not be visually distinguished by PCA and HCA. However, by applying and comparing the results of classification by LDA, K-NN and Ensemble, an optimal classification model was obtained. Upon application of these models, 96.3% of the ethanol samples were correctly classified based on their geographical origin, indicating that the combination of isotopic ratios and latitude data is practical and effective for measuring the traceability of ethanol.

PMID:34390986 | DOI:10.1016/j.ecoenv.2021.112604

Drug Alcohol Depend. 2021 Jul 28;227:108943. doi: 10.1016/j.drugalcdep.2021.108943. Online ahead of print.

ABSTRACT

BACKGROUND: Continuing care following inpatient addiction treatment is an important component in the continuum of clinical services. Mutual help, including 12-step groups like Alcoholics Anonymous, is often recommended as a form of continuing care. However, the effectiveness of 12-step groups is difficult to establish using observational studies due to the risks of selection bias (or confounding).

OBJECTIVE: To address this limitation, we used both conventional and machine learning-based propensity score (PS) methods to examine the effectiveness of 12-step group involvement following inpatient treatment on substance use over a 12-month period.

METHODS: Using data from the Recovery Journey Project – a longitudinal, observational study – we followed an inpatient sample over 12-months post-treatment to assess the effect of 12-step involvement on substance use at 12-months (n = 254). Specifically, PS models were constructed based on 34 unbalanced confounders and four PS-based methods were applied: matching, inverse probability weighting (IPW), doubly robust (DR) with matching, and DR with IPW.

RESULTS: Each PS-based method minimized the potential of confounding from unbalanced variables and demonstrated a significant effect (p < 0.001) between high 12-step involvement (i.e., defined as having a home group; having a sponsor; attending at least one meeting per week; and, being involved in service work) and a reduced likelihood of using substances over the 12-month period (odds ratios 0.11 to 0.32).

CONCLUSIONS: PS-based methods effectively reduced potential confounding influences and provided robust evidence of a significant effect. Nonetheless, results should be considered in light of the relatively high attrition rate, potentially limiting their generalizability.

PMID:34390964 | DOI:10.1016/j.drugalcdep.2021.108943

Int J Drug Policy. 2021 Aug 11;95:103398. doi: 10.1016/j.drugpo.2021.103398. Online ahead of print.

ABSTRACT

BACKGROUND: Individuals who initiate injection drug use often receive assistance from an injection-knowledgeable peer. Persons who assist peers in injection initiation events often inject frequently, which heightens overdose risk. As such, overdose and injection initiation events may be correlated. To explore a potential relationship, we assessed temporal associations between experiencing a non-fatal overdose and assisting others in initiating injection drug use among persons who inject drugs in two North American cities – Vancouver, Canada and Tijuana, Mexico.

METHODS: From 2014 to 2018, this retrospective cohort study included people who inject drugs from Vancouver (n=1332) and Tijuana (n=666) who completed a baseline and six-month follow-up interview. Within each site, we assessed bidirectional temporal associations using two separate multivariable logistic regression models: for model 1, recent provision of injection initiation assistance (at six months) was the outcome and recent overdose (at baseline) was the exposure; for model 2, recent overdose (at six months) was the outcome and recent provision of injection initiation assistance (at baseline) was the exposure. Both models adjusted for potential confounders.

RESULTS: Vancouver-based participants reporting overdose at baseline had 163% greater odds of reporting provision of injection initiation assistance at follow-up (adjusted Odds Ratio [aOR] 2.63; 95% Confidence Interval [CI] 1.41-4.90); while participants reporting provision of injection initiation assistance at baseline had 89% greater odds of reporting a non-fatal overdose at follow-up (aOR 1.89; 95% CI 1.00-3.57). Among Tijuana-based participants, we did not observe a statistically significant association in either direction.

CONCLUSION: Findings in Vancouver suggest that injection initiation assistance and overdose are bidirectionally-associated phenomena. The present findings highlight the need for interventions that ensure that persons who provide injection initiation assistance are given overdose prevention support, both for themselves and for those they assist to initiate injection drug use. While our Tijuana-based results did not suggest a bidirectional relationship, preventative approaches should nonetheless be undertaken.

PMID:34390966 | DOI:10.1016/j.drugpo.2021.103398

Comput Methods Programs Biomed. 2021 Jul 29;209:106322. doi: 10.1016/j.cmpb.2021.106322. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: We present and analyze a nonstandard numerical method to solve an epidemic model with memory that describes the propagation of Ebola-type diseases. The epidemiological system contemplates the presence of sub-populations of susceptible, exposed, infected and recovered individuals, along with nonlinear interactions between the members of those sub-populations. The system possesses disease-free and endemic equilibrium points, whose stability is studied rigorously.

METHODS: To solve the epidemic model with memory, a nonstandard approach based on Grünwald-Letnikov differences is used to discretize the problem. The discretization is conveniently carried out in order to produce a fully explicit and non-singular scheme. The discrete problem is thus well defined for any set of non-negative initial conditions.

RESULTS: The existence and uniqueness of the solutions of the discrete problem for non-negative initial data is thoroughly proved. Moreover, the positivity and the boundedness of the approximations is also theoretically elucidated. Some simulations confirm the validity of these theoretical results. Moreover, the simulations prove that the computational model is capable of preserving the equilibria of the system (both the disease-free and the endemic equilibria) as well as the stability of those points.

CONCLUSIONS: Both theoretical and numerical results establish that the computational method proposed in this work is capable of preserving distinctive features of an epidemiological model with memory for the propagation of Ebola-type diseases. Among the main characteristics of the numerical integrator, the existence and the uniqueness of solutions, the preservation of both positivity and boundedness, the preservation of the equilibrium points and their stabilities as well as the easiness to implement it computationally are the most important features of the approach proposed in this manuscript.

PMID:34390936 | DOI:10.1016/j.cmpb.2021.106322

J Psychosom Res. 2021 Jul 31;149:110591. doi: 10.1016/j.jpsychores.2021.110591. Online ahead of print.

ABSTRACT

BACKGROUND: Depression is a major cause of the global disease burden and globally affects 350-400 million persons making it the largest contributor to years lived with disability. Among of patients with chronic physical illnesses like tuberculosis, depression affects up to 25-33% of individuals. There are limited studies on the comorbidity of depressive illness and tuberculosis in the Ugandan setting. Our aim was to determine the prevalence and factors associated with depressive illness in patients with tuberculosis in Mulago Hospital, Uganda.

METHODS: This was a cross sectional study involving 308 consecutively sampled participants aged 18 years and above diagnosed with tuberculosis attending the tuberculosis clinic in Mulago Hospital, Uganda. Consecutive sampling was done for a sample size of 308 participants. Participants had the following instruments administered to them; the Socio-demographic questionnaire, the Mini Neuropsychiatric Interview (MINI) to diagnose depressive illness and the Patient Health Questionnaire- 9 to rate the severity of depression. Data was entered using Epi-Data. Descriptive, bivariate and multivariate analyses were done with the Statistical Package for Social Sciences (SPSS).

RESULTS: the prevalence of depressive illness was 23.7% (95% confidence interval 19.3-28.9). Depressive illness was independently associated with low education level (AOR = 0.39, 95%CI = 0.21-0.72, p = 0.003), being in the intensive phase of TB treatment (AOR = 2.34, 95%CI = (1.27-4.33), p = 0.007) and family history of depressive illness (AOR = 5.42, 95%CI = 2.02-14.54, p = 0.001). On the PHQ, 60.3% had moderate to severe depression.

CONCLUSION: Depressive illnesses should be screened and managed among patients with TB.

RECOMMENDATION: Depression should be routinely screened and managed among patients with Tuberculosis.

PMID:34390942 | DOI:10.1016/j.jpsychores.2021.110591

Andrology. 2021 Aug 14. doi: 10.1111/andr.13094. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with cancer are treated with chemotherapeutics that cause adverse effects, including erectile dysfunction (ED).

OBJECTIVES: We investigated erectile function in rats after the administration of anticancer agents based on data retrieved through mining of the US Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) database.

MATERIALS AND METHODS: The statistical signal strength for the association between anticancer drugs and ED was calculated using the reporting odds ratio (ROR). A drug-event combination was detected when the lower limit of the 95% confidence interval (CI) of the ROR exceeded 1.00. Rats were administered anticancer agents detected in the FDA AERS analysis. Erectile function was assessed using intracavernous pressure (ICP) and mean arterial pressure (MAP) analysis after electrical stimulation of the cavernous nerve. Statistical significance was determined using Welch’s t-test or two-way ANOVA.

RESULTS: Melphalan (L-PAM; ROR = 4.72, 95% CI = 2.78-8.00), vincristine (VCR; ROR = 2.47, 95% CI = 1.54-3.97), docetaxel (DTX; ROR = 2.25, 95% CI = 1.28-3.95), methotrexate (MTX; ROR = 1.96, 95% CI = 1.39-2.75), and doxorubicin (DOX; ROR = 1.82, 95% CI = 1.07-3.19) enhanced ED risk. L-PAM and MTX decreased the ICP/MAP ratio 1 week after administration. VCR and DOX decreased erectile function 4 weeks after administration. DTX decreased erectile function at all assessed time points.

DISCUSSION AND CONCLUSION: Certain anticancer agents should be considered risk factors for ED. Our results provide possible treatment strategies for maintaining erectile function in cancer survivors, including careful erectile function monitoring after treatment. This article is protected by copyright. All rights reserved.

PMID:34390622 | DOI:10.1111/andr.13094