Tag: statistics

J Med Internet Res. 2024 Oct 14. doi: 10.2196/57458. Online ahead of print.

ABSTRACT

BACKGROUND: The prevalence of overweight and obesity is increasing at an alarming rate in children and adolescents worldwide. Given the dimension of the problem, treatments of childhood obesity are recognized as of extreme importance. Current evidence indicates that behavioural and cognitive behavioural strategies combined with diet and physical activity approaches may assist in reducing adolescent obesity.

OBJECTIVE: The purpose of this systematic review is to evaluate the use of extrinsic motivators in improving the BMI of obese or overweight adolescents.

METHODS: The inclusion criteria were as follows: 1) overweight or obese adolescents, 2) intervention using extrinsic motivators, 3) outcome variables related to weight status. The exclusion criteria were associated chronic disease. The search process was conducted in PubMed and Web of Science (last searched on 23/04/2023). The risk of bias was evaluated independently by two authors with the Cochrane’s tools: RoB2 (RCT), ROBINS-I and ROBINS-E.

RESULTS: From 3,163 studies identified, 20 articles (corresponding to 18 studies) were included in the analysis. The studies differ in study design, sample size, follow-up duration, outcomes reported, and extrinsic motivators used. Most of the studies had videogames or apps as intervention. Nine studies (50%) showed a statistically significant decrease of BMI. The most used extrinsic motivators were “Motivation” (n=13), “Feedback” (n=10) and “Rewards” (n=9), and the ones that seem to have a higher impact on decreasing BMI are “Reminders” (100%) and “Peer-support” (80%).

CONCLUSIONS: The heterogeneity of studies makes analysis difficult. No study has evaluated the extrinsic motivators in isolation. Most of the studies have a moderate or high risk of bias. The extrinsic motivators that seem to be more useful are “Reminders” and “Peer-support”, but more studies are needed, namely well designed RCTs, homogeneity in BMI measure and extrinsic motivators definitions, and longer duration to better understand long-term impact of extrinsic motivators on weight management success.

PMID:39576963 | DOI:10.2196/57458

JCO Clin Cancer Inform. 2024 Nov;8:e2400071. doi: 10.1200/CCI.24.00071. Epub 2024 Nov 22.

ABSTRACT

PURPOSE: Neoadjuvant chemotherapy (NAC) is increasingly used in breast cancer. Predictive modeling is useful in predicting pathologic complete response (pCR) to NAC. We test machine learning (ML) models to predict pCR in breast cancer and explore methods of handling missing data.

METHODS: Four hundred and ninety-nine patients with breast cancer treated with NAC in two centers in Singapore (National Cancer Centre Singapore [NCCS] and KK Hospital) between January 2014 and December 2017 were included. Eleven clinical features were used to train five different ML models. Listwise deletion and imputation were evaluated on handling missing data. Model performance was evaluated by AUC and calibration (Brier score). Feature importance from the best performing model in the external testing data set was calculated using Shapley additive explanations.

RESULTS: Seventy-two (24.6%), 18 (24.7%), and 31 (24.8%) patients attained pCR in NCCS training, NCCS testing, and KK Women’s and Children’s Hospital (KKH) testing data sets, respectively. The random forest (RF) base and imputed models have the highest AUCs in the KKH cohort of 0.794 (95% CI, 0.709 to 0.873) and 0.795 (95% CI, 0.706 to 0.871), respectively, and were the best calibrated with the lowest Brier score. No statistically significant difference was noted between AUCs of the base and imputed models in all data sets. The imputed model had a larger positive predictive value (PPV; 98.2% v 95.1%) and negative predictive value (NPV; 96.7% v 90.0%) than the base model in the KKH data set. Estrogen receptor intensity, human epidermal growth factor 2 intensity, and age at diagnosis were the three most important predictors.

CONCLUSION: ML, particularly RF, demonstrates reasonable accuracy in pCR prediction after NAC. Imputing missing fields in the data can improve the PPV and NPV of the pCR prediction model.

PMID:39576956 | DOI:10.1200/CCI.24.00071

J Clin Oncol. 2024 Nov 22:JCO2400979. doi: 10.1200/JCO.24.00979. Online ahead of print.

ABSTRACT

PURPOSE: To investigate whether intermittent treatment after an induction phase of first-line schedule of fluorouracil, leucovorin, and irinotecan (FOLFIRI) plus panitumumab (PAN) prevents or delays the onset of resistance and improves safety and compliance with treatment in patients with unresectable RAS/BRAF wild-type (wt) metastatic colorectal cancer (mCRC).

PATIENTS AND METHODS: IMPROVE (ClinicalTrials.gov identifier: NCT04425239) was an open-label, multicenter, randomized phase II noncomparative trial. Patients with unresectable RAS/BRAF wt mCRC were randomly assigned (1:1) to receive FOLFIRI plus PAN continuously until progression (arm A) or intermittently, with treatment-free intervals (arm B) until progression on treatment, toxicity, or death. The primary end point was progression-free survival on treatment (PFSot) at 12 months. Assuming a null hypothesis of median PFSot time ≤7 months and target PFSot ≥10 months, 65 patients per arm were needed to achieve 80% power and 10% type I error, according to the binomial test.

RESULTS: Between May 2018 and June 2021, 69 patients were randomly assigned to arm A and 68 to arm B. The median number of treatment cycles was 13 in arm A and 16 in arm B. At a median follow-up of 43.2 months (IQR, 35.0-50.5), median PFSot was 11.2 and 17.5 months with 12-month PFSot rates of 45.7% and 58.5%, for arms A and B, respectively. The overall response rates were 68.1% and 61.2%, and median overall survival rates were 36.3 and 35.1 months in arms A and B, respectively. The overall rate of grade >2 skin PAN-related adverse events was 30.3% in arm A and 17.9% in arm B.

CONCLUSION: Intermittent FOLFIRI plus PAN after the induction phase was feasible, and the primary end point was met with reduced toxicity while allowing patients more time off treatment.

PMID:39576946 | DOI:10.1200/JCO.24.00979

Rev Med Inst Mex Seguro Soc. 2024 Sep 2;62(5):1-6. doi: 10.5281/zenodo.12668053.

ABSTRACT

BACKGROUND: Acute respiratory distress syndrome (ARDS) secondary to COVID-19 crowded intensive care units in the world with high mortality. Mechanical ventilation was fundamental in the treatment; however, the evidence of ventilatory markers associated with mortality is not entirely clear. In 2021 it was described the linear power, which was superior to other markers. At the moment its possible utility in patients with ARDS due to COVID-19 has not been described.

OBJECTIVE: To evaluate linear power as a risk factor for mortality in patients with ARDS due to COVID-19 in intensive care.

MATERIAL AND METHODS: Retrospective cohort study in patients admitted to intensive care with ARDS secondary to COVID-19. Linear power was calculated for patients who died and patients who survived in intensive care. Mann-Whitney U test and multivariable Cox regression (hazard ratio [HR] with 95% confidence intervals [95% CI]) were performed.

RESULTS: 60 patients were studied with a mortality of 43.3%. Those who died had a higher linear power (89.5 vs. 78, p = 0.031) and the best cut-off point was 84 cmH2O/rpm (AUC 0.663, p = 0.031, LR 2.02); in addition, those with linear power < 84 (p = 0.050) had a better cumulative survival.

CONCLUSIONS: Linear power is a possible risk factor for mortality in patients with ARDS secondary to COVID-19 in intensive care.

PMID:39576935 | DOI:10.5281/zenodo.12668053

Phys Rev Lett. 2024 Nov 8;133(19):196302. doi: 10.1103/PhysRevLett.133.196302.

ABSTRACT

Many-body localization (MBL) hinders the thermalization of quantum many-body systems in the presence of strong disorder. In this Letter, we study the MBL regime in bond-disordered spin-1/2 XXZ spin chain, finding the multimodal distribution of entanglement entropy in eigenstates, sub-Poissonian level statistics, and revealing a relation between operators and initial states required for examining the breakdown of thermalization in the time evolution of the system. We employ a real space renormalization group scheme to identify these phenomenological features of the MBL regime that extend beyond the standard picture of local integrals of motion relevant for systems with disorder coupled to on-site operators. Our results pave the way for experimental probing of MBL in bond-disordered spin chains.

PMID:39576929 | DOI:10.1103/PhysRevLett.133.196302

Phys Rev Lett. 2024 Nov 8;133(19):191002. doi: 10.1103/PhysRevLett.133.191002.

ABSTRACT

We present the first measurement of nuclear recoils from solar ^{8}B neutrinos via coherent elastic neutrino-nucleus scattering with the XENONnT dark matter experiment. The central detector of XENONnT is a low-background, two-phase time projection chamber with a 5.9 t sensitive liquid xenon target. A blind analysis with an exposure of 3.51 t×yr resulted in 37 observed events above 0.5 keV, with (26.4_{-1.3}^{+1.4}) events expected from backgrounds. The background-only hypothesis is rejected with a statistical significance of 2.73σ. The measured ^{8}B solar neutrino flux of (4.7_{-2.3}^{+3.6})×10^{6} cm^{-2} s^{-1} is consistent with results from the Sudbury Neutrino Observatory. The measured neutrino flux-weighted CEνNS cross section on Xe of (1.1_{-0.5}^{+0.8})×10^{-39} cm^{2} is consistent with the Standard Model prediction. This is the first direct measurement of nuclear recoils from solar neutrinos with a dark matter detector.

PMID:39576901 | DOI:10.1103/PhysRevLett.133.191002

ACS Appl Bio Mater. 2024 Nov 22. doi: 10.1021/acsabm.4c01301. Online ahead of print.

ABSTRACT

Pancreatic ductal adenocarcinoma (PDAC) is a cancer of the epithelia comprising the ductal network of the pancreas. During disease progression, PDAC tumors recruit fibroblasts that promote fibrosis, increasing local tissue stiffness and subjecting epithelial cells to increased compressive forces. Previous in vitro studies have documented cytoskeletal and nuclear adaptation following compressive stresses in two-dimensional (2D) and three-dimensional (3D) environments. However, a comparison of the responses of normal and tumor-derived ductal epithelia to physiologically relevant confinement remains underexplored, especially in 3D organoids. Here we control confinement with an engineered 3D microenvironment composed of Matrigel mixed with a low yield stress granular microgel. Normal and tumor-derived murine pancreas organoids (normal and tumor) were cultured for 48 h within this composite 3D environment or in pure Matrigel to investigate the effects of confinement on morphogenesis and lumen expansion. In confinement, tumor organoids (mT) formed a lumen that expanded rapidly, whereas normal organoids (mN) expanded more slowly. Moreover, a majority of normal organoids in more-confined conditions exhibited an inverted apicobasal polarity compared to those in less-confined conditions. Tumor organoids exhibited a collective “pulsing” behavior that increased in confinement. These pulses generated forces sufficient to locally overcome the yield stress of the microgels in the direction of organoid expansion. Normal organoids more commonly exhibit unidirectional rotation. Our in vitro microgel confinement platform enabled the discovery of two distinct modes of collective force generation in organoids that may shed light on the mutual interactions between tumors and the microenvironment. These insights into in vitro dynamics may deepen our understanding of how the confinement of healthy cells within a fibrotic tumor niche disrupts tissue organization and function in vivo.

PMID:39576883 | DOI:10.1021/acsabm.4c01301

Sci Adv. 2024 Nov 22;10(47):eadr9891. doi: 10.1126/sciadv.adr9891. Epub 2024 Nov 22.

ABSTRACT

The subthalamic nucleus (STN) modulates basal ganglia output and plays a fundamental role in the pathophysiology of Parkinson’s disease (PD). Blockade/ablation of the STN improves motor signs in PD. We assessed the topography of focused ultrasound subthalamotomy (n = 39) by voxel-based lesion-symptom mapping to identify statistically validated brain voxels with the optimal effect against each cardinal feature and their respective cortical connectivity patterns by diffusion-weighted tractography. Bradykinesia and rigidity amelioration were associated with ablation of the rostral motor STN subregion connected to the supplementary motor and premotor cortices, whereas antitremor effect was explained by lesioning the posterolateral STN projection to the primary motor cortex. These findings were corroborated prospectively in another PD cohort (n = 12). This work concurs with recent deep brain stimulation findings that suggest different corticosubthalamic circuits underlying each PD cardinal feature. Our results provide sound evidence in humans of segregated anatomy of subthalamic-cortical connections and their distinct role in PD pathophysiology and normal motor control.

PMID:39576853 | DOI:10.1126/sciadv.adr9891

PLoS One. 2024 Nov 22;19(11):e0314133. doi: 10.1371/journal.pone.0314133. eCollection 2024.

ABSTRACT

The purpose of this study is to explore nonlinear and threshold effects of traffic statuses and road geometries, as well as their interactions, on traffic accident severity. In contrast to earlier research that primarily defined road alignment qualitatively as straight or curved, flat or slope, this study focused on the design elements of road geometry at accident locations. Additionally, this study considers the traffic conditions on the day of the accident, rather than the average annual traffic data as previous studies have done. To achieve this, we collected road design documents, traffic-related data, and 2023 accident data from the Suining section of the G42 Expressway in China. Using this dataset, we tested the classification performance of four machine learning models, including eXtreme Gradient Boosting, Gradient Boosted Decision Tree, Random Forest, and Light Gradient Boosting Machine. The optimal Random Forest model was employed to identify the key factors infulencing traffic accident severity, and the partial dependence plot was introduced to visualize the relationship between severity and various single and two-factor variables. The results indicate that the percentage of trucks, daily traffic volume, slope length, road grade, curvature, and curve length all exhibit significant nonlinear and threshold effects on accident severity. This reveals sepecific road and traffic features associated with varying levels of accident severity along the highway section examined in this study. The findings of this study will provide data-driven recommendations for highway design and daily safety management to reduce the severity of traffic accidents.

PMID:39576833 | DOI:10.1371/journal.pone.0314133

Genomics Proteomics Bioinformatics. 2024 Nov 22:qzae083. doi: 10.1093/gpbjnl/qzae083. Online ahead of print.

ABSTRACT

Mass spectrometry (MS) is a technique widely employed for the identification and characterization of proteins, with personalized medicine, systems biology, and biomedical applications. The application of MS-based proteomics advances our understanding of protein function, cellular signaling, and complex biological systems. MS data analysis is a critical process that includes identifying and quantifying proteins and peptides and then exploring their biological functions in downstream analysis. To address the complexities associated with MS data analysis, we developed ProtPipe to streamline and automate the processing and analysis of high-throughput proteomics and peptidomics datasets with DIA-NN preinstalled. The pipeline facilitates data quality control, sample filtering, and normalization, ensuring robust and reliable downstream analyses. ProtPipe provides downstream analyses, including protein and peptide differential abundance identification, pathway enrichment analysis, protein-protein interaction analysis, and Major histocompatibility complex (MHC) -peptide binding affinity analysis. ProtPipe generates annotated tables and visualizations by performing statistical postprocessing and calculating fold changes between predefined pairwise conditions in an experimental design. It is an open-source, well-documented tool available online at https://github.com/NIH-CARD/ProtPipe, with a user-friendly web interface.

PMID:39576693 | DOI:10.1093/gpbjnl/qzae083