Tag: statistics

World Neurosurg. 2023 Sep 4:S1878-8750(23)01237-8. doi: 10.1016/j.wneu.2023.08.125. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to investigate the effectiveness and safety of various adjuvant regimens in patients with low-grade gliomas, and to further explore the optimal adjuvant treatment for patients with low-grade gliomas and the differences in the efficacy of each treatment regimens in different tumor types.

METHODS: A comprehensive search of the PubMed, Cochrane Library, Ovid, Embase, and Web of Science databases was conducted to screen randomized and nonrandomized controlled trials related to adjuvant therapy in patients with low-grade gliomas. The Cochrane quality assessment method and the Newcastle-Ottawa scale were used to assess the quality of the included randomized and nonrandomized controlled trials, respectively. The data from previous studies were extracted using Excel and GetData Graph Digitizer 2.26 software, and network meta-analysis was performed using RevMan 5.3 and Stata 16.0 statistical software.

RESULTS: The specific ranking of 5-year progression-free survival (PFS) for each treatment regimen from best to the worst in patients with low-grade gliomas was surgery combined with procarbazine, lomustine, and vincristine (S + PCV), surgery combined with standard radiotherapy and PVC multidrug chemotherapy (S + RT + PCV), surgery combined with standard radiotherapy and temozolomide monotherapy (S + RT + TMZ), surgery combined with enhanced radiotherapy (S + H-RT), surgery combined with standard radiotherapy (S + RT), surgery combined with TMZ (S + TMZ), and S. The 5-year overall survival (OS) ranking was S + RT + TMZ, S + RT + PCV, S + H-RT + TMZ, S + H-RT, S + RT, and S. The 2-year PFS ranking was S + RT + TMZ, S + PCV, S + RT, S + RT + PCV, S + TMZ, S + H -RT, and S. The 2-year OS ranking was S + RT + TMZ, S + H-RT + TMZ, S + RT, S + RT + PCV, S + H – RT, and S. The incidence of adverse events (AEs ≥ 3) was ranked from highest to lowest as follows: S + RT + PCV, S + RT + TMZ, S + PCV, S + H-RT, S + TMZ, and S + RT. In the IDHmt/noncoder group, the S + RT + PCV and S + H – RT regimens had better 5-year PFS and 5-year OS. In the IDHmt/coder group, the 5-year PFS of each treatment regimen ranked from the best to the worst was S + RT + TMZ, S + RT + PCV, S + H-RT, S + RT, S + TMZ, and S. The order of 5-year OS from best to worst was S + H-RT, S + RT + TMZ, S + RT + PCV, S + RT, and S. In the IDHwt group, the S + H-RT and S + TMZ regimens had better 5-year PFS.

CONCLUSIONS: This study revealed that both the S + RT + TMZ and S + RT + PCV regimens might be effective therapies for treating patients with low-grade gliomas. Among these, the S + RT + TMZ regimen seemed to be safer, but might lead to tumor deterioration. In the IDHmt/coder type, the S + RT + TMZ scheme might have a significant advantage. In the IDHmt/noncoder type, the S + RT + PCV scheme might be more dominant, while in the IDHwt type, the S + H – RT and S + TMZ schemes also might be good treatment options.

PMID:37673325 | DOI:10.1016/j.wneu.2023.08.125

J Affect Disord. 2023 Sep 4:S0165-0327(23)01123-0. doi: 10.1016/j.jad.2023.08.140. Online ahead of print.

ABSTRACT

BACKGROUND: The use of specific dietary patterns to alleviate depressive symptoms has gained increasing recognition. The Composite Dietary Antioxidant Index (CDAI) is a crucial criterion for assessing antioxidant diets. We examined the relationship between CDAI and depression among overweight and obese adults through a cross-sectional study conducted in the United States.

METHODS: We used weighted multivariate logistic regression models with subgroup analysis to study the relationship between CDAI and depression. Generalized additive models were used to determine whether there was a nonlinear association between them. We developed a two-piece linear regression model to calculate the inflection point utilizing a recursive strategy.

RESULTS: After adjusting for confounding variables, the odds ratios (ORs; 95 % CI) for the correlation between CDAI and depression were 0.75 (0.67, 0.84). A saturation effect emerged for the overweight group, following which we calculated the inflection point for the overweight population, which displayed ORs (95 % CI) of 0.62 (0.47, 0.80) before the inflection point of 0.83 and the ORs (95 % CI) of 1.01 (0.77, 1.31) after 0.83. The interaction was statistically significant in the sex stratification of the obese population.

CONCLUSIONS: Our study highlighted a negative association between CDAI and depression among overweight and obese adults. Saturation effects and sex differences were observed in the overweight population.

PMID:37673289 | DOI:10.1016/j.jad.2023.08.140

J Am Pharm Assoc (2003). 2023 Sep 4:S1544-3191(23)00293-5. doi: 10.1016/j.japh.2023.08.022. Online ahead of print.

ABSTRACT

BACKGROUND: Community health workers (CHWs) are health professionals who are experts in linking patients to health resources. Although CHWs are employed in a variety of health institutions, access to their services may be challenging for patients in underserved locations. Community pharmacies are uniquely positioned to mitigate this barrier as they provide readily accessible care for patients residing in these areas.

OBJECTIVES: To 1) quantify and report the CHW services provided by CPhTs in an underserved population and 2) provide an initial framework for the implementation of CHW services in community pharmacies or similar healthcare settings.

METHODS: This prospective cohort study reports the findings of training CPhTs as CHWs in three independent community pharmacies from January 1, 2021 to July 1, 2021. CPhT-CHWs conducted monthly visits by phone, patient home, or pharmacy and documented services using a standardized assessment form. Descriptive statistics were used to summarize the baseline characteristics of the patient population, service codes, types of services, and referrals made, and time spent per visit by CPhT-CHWs.

RESULTS: A total of 198 patient visits by phone, patient home, or at the pharmacy were completed in a six-month timespan. During these visits, the CPhT-CHW provided 351 services (203 primary services and 149 secondary services) and completed 51 referrals. The average time spent per visit (standard deviation) was 15.5 (11.5) 68.9 (35.4), and 30.6 (16.8) minutes for phone, home, and pharmacy visits, respectively. Patient home visits resulted in the highest average primary services per visit, longest time spent with the patient, and accounted for a majority of social services.

CONCLUSIONS: CPhT-CHWs were able to use various methods to contact these patients to further develop patient-to-provider and patient-to-pharmacy relationships. Training CPhTs as CHWs can be an effective way to increase patient contact and provide additional health services.

PMID:37673283 | DOI:10.1016/j.japh.2023.08.022

Sci Total Environ. 2023 Sep 4:166727. doi: 10.1016/j.scitotenv.2023.166727. Online ahead of print.

ABSTRACT

Temperature anomalies and changes in the diurnal temperature range (DTR) are expected to pose physiological challenges to biota; hence, both spatial and temporal variations in DTR provide important insights into temperature-induced stress in humans, animals, and vegetation. Furthermore, vegetation could dampen temperature variability. Here, we use the Moderate Resolution Imaging Spectroradiometer (MODIS) remote sensing data of Land Surface Temperature (LST) to evaluate the global variation in DTR and its rate of change in spatial and temporal scales for the two decades spanning from 2001 to 2020. We show that North America, Africa, and Antarctica, as well as the global mean, experienced statistically significant DTR rates of change over the last 20 years in either summer, winter, or the annual mean. The rates were all negative, indicating the day-night temperature differences are decreasing in those regions because night temperatures are increasing at a faster rate than day temperatures. MODIS data of the Normalized Difference Vegetation Index (NDVI) revealed a strongly negative correlation with DTR, with a spatial correlation coefficient of -0.61. This correlation demonstrates a prominent dampening effect of vegetation on diurnal temperature oscillations. For future DTR projections, we used 19 models in the Coupled Model Intercomparison Project 6 (CMIP6) to predict global DTR trends from 2021 to 2050 with low and high CO₂ concentration scenarios. The high CO₂ emission scenario projects significant decreases in DTR in circumpolar regions, central Africa, and India compared to the low CO₂ scenario. This difference in the two scenarios underscores the substantial influence of increased global temperatures and elevated CO₂ concentration on DTR and, consequently, on the ecosystems in certain regions.

PMID:37673261 | DOI:10.1016/j.scitotenv.2023.166727

Am J Public Health. 2023 Oct;113(10):1116-1119. doi: 10.2105/AJPH.2023.307355.

ABSTRACT

Objectives. To assess geographic and sociodemographic variations in prevalence of mental health symptoms among US youths. Methods. We analyzed data from the Household Pulse Survey, phases 3.5 and 3.6, between June 1 and November 14, 2022. The sample included 103 296 households with an estimated 190 017 youths younger than 18 years. We defined mental health symptoms based on parental responses and estimated prevalence by state and subgroups, including race/ethnicity, parental education, household income, housing tenure, household food sufficiency, and health insurance coverage. All analyses incorporated sampling weight. Results. An estimated 34.5% (95% confidence interval [CI] = 33.7%, 35.3%) of youths had parent-reported mental health symptoms. The prevalence of symptoms varied across states, ranging from 27.9% (95% CI = 23.8%, 32.0%) in Florida to 46.4% (95% CI = 41.9%, 50.9%) in New Hampshire. We observed variations by subgroup, with youths in households that did not pay rent reporting a prevalence of 43.8% (95% CI = 39.3%, 48.4%) and those experiencing food insufficiency reporting a prevalence of 56.0% (95% CI = 50.9%, 61.2%). Conclusions. There is an urgent need for attention to mental health challenges among youths, taking into account geographic and sociodemographic variations. (Am J Public Health. 2023;113(10):1116-1119. https://doi.org/10.2105/AJPH.2023.307355).

PMID:37672739 | DOI:10.2105/AJPH.2023.307355

J Phys Chem B. 2023 Sep 6. doi: 10.1021/acs.jpcb.3c02498. Online ahead of print.

ABSTRACT

Many biological molecules respond to external stimuli that can cause their conformational states to shift from one steady state to another. Single-molecule FRET (Fluorescence Resonance Energy Transfer) is of particular interest to not only define the steady-state conformational ensemble usually averaged out in the ensemble of molecules but also characterize the dynamics of biomolecules. To study steady-state transitions, i.e., non-equilibrium transitions, a data analysis methodology is necessary to analyze single-molecule FRET photon trajectories, which contain mixtures of contributions from two steady-state statuses and include non-equilibrium transitions. In this study, we introduce a novel methodology called WAVE (Wasserstein distance Analysis in steady-state Variations in smFRET) to detect and locate non-equilibrium transition positions in FRET trajectories. Our method first utilizes a combined STaSI-HMM (Stepwise Transitions with State Inference Hidden Markov Model) algorithm to convert the original FRET trajectories into discretized trajectories. We then apply Maximum Wasserstein Distance analysis to differentiate the FRET state compositions of the fitting trajectories before and after the non-equilibrium transition. Forward and backward algorithms, based on the Minimum Description Length (MDL) principle, are used to find the refined positions of the non-equilibrium transitions. This methodology allows us to observe changes in experimental conditions in chromophore-tagged biomolecules or vice versa.

PMID:37672727 | DOI:10.1021/acs.jpcb.3c02498

Inflamm Bowel Dis. 2023 Sep 6:izad192. doi: 10.1093/ibd/izad192. Online ahead of print.

ABSTRACT

BACKGROUND: Multidisciplinary teams (MDT) aid the diagnosis and management of patients with inflammatory bowel disease (IBD) and improve patient outcomes. The direct impact of a gastrointestinal expert pathologist on MDT care of IBD patients is unknown.

METHODS: A retrospective chart review was conducted evaluating all cases (N = 289) discussed at the IBD MDT conference at Carilion Roanoke Memorial Hospital from June 1, 2013, through December 31, 2019. Cases were discussed between 1 and 6 times at the conference. Data collected included demographics, diagnosis before and after conference, reason for diagnostic change, endoscopy findings, medications, surgeries, and clinical follow-up.

RESULTS: Approximately 15% to 42% of patients had a change in diagnosis after the first 3 conferences. The majority of diagnostic changes after the first (84%), second (73%), and third (67%) conferences were due to expert pathologist interpretation. Indeterminate colitis was the most frequently changed diagnosis, and Crohn’s disease was the most common new diagnosis after conference. Among patients with a diagnostic change, 28.6% to 38.5% of patients had a change in their IBD medication regimen, and 7.7% to 10.9% had a surgical intervention after the first 2 conferences. Approximately 54.2% to 60% of patients reported clinical improvement or remission within 6 months of the first 3 conferences.

CONCLUSION: The majority of diagnostic changes made at the multidisciplinary IBD conference were due to histopathologic re-interpretation. A change in diagnosis at times led to significant modifications in medical or surgical management. An expert gastrointestinal pathologist is an essential MDT member for IBD management.

PMID:37672726 | DOI:10.1093/ibd/izad192

J Integr Complement Med. 2023 Sep 6. doi: 10.1089/jicm.2023.0043. Online ahead of print.

ABSTRACT

Objectives: Approximately 30% of children diagnosed with attention-deficit/hyperactivity disorder (ADHD), the most prevalent mental health disorder in children worldwide, do not respond to conventional pharmaceutical treatments. Previous studies of homeopathic treatment for ADHD have been inconclusive. The objectives of this study were to determine if there (a) is an overall effect of homeopathic treatment (homeopathic medicines plus consultation) in the treatment of ADHD; (b) are any specific effects the homeopathic consultation alone in the treatment of ADHD; and (c) are any specific effects of homeopathic medicines in the treatment of ADHD. Design: The design was a randomized double-blind placebo-controlled clinical trial. Setting/Location: Toronto, Canada. Subjects: Children aged 6-16 years diagnosed with ADHD. Interventions: Participants were randomized to one of three arms: Arm 1 (Remedy and Consultation); Arm 2 (Placebo and Consultation); or Arm 3 (Usual Care). Outcome Measures: Primary Outcome was the change of CGI-P T score between baseline and 28 weeks. Results: There was an improvement in ADHD symptoms as measured by the Conner 3 Global Index-Parent T-score in the two groups (Arms 1 and 2) that received consultations with a homeopathic practitioner when compared with the usual care control group (Arm 3). Parents of the children in the study who received homeopathic consultations (Arms 1 and 2) also reported greater coping efficacy compared with those receiving usual care (Arm 3). There was no difference in adverse events among the three study arms. Conclusions: In this study, homeopathic consultations provided over 8 months with the use of homeopathic remedy was associated with a decrease in ADHD symptoms in children aging 6-16 years when compared with usual treatment alone. Children treated with homeopathic consultations and placebo experienced a similar decrease in ADHD symptoms; however, this finding did not reach statistical significance when correcting for multiple comparisons. Homeopathic remedies in and of themselves were not associated with any change in ADHD symptoms. Clinical Trial Registration: This trial was registered on ClinicalTrials.gov; NCT02086864.

PMID:37672605 | DOI:10.1089/jicm.2023.0043

Eur J Prev Cardiol. 2023 Sep 6:zwad270. doi: 10.1093/eurjpc/zwad270. Online ahead of print.

ABSTRACT

AIMS: Heavy alcohol consumption is an established risk factor for atrial fibrillation (AF). However, the association between habitual changes in heavy habitual drinkers and incident AF remains unclear. The aim of this study was to evaluate whether absolute abstinence or reduced drinking decreases incident AF in heavy habitual drinkers.

METHODS AND RESULTS: Atrial fibrillation-free participants with heavy alcohol consumption registered in the Korean National Health Insurance Service database between 2005 and 2008 were enrolled. Habitual changes in alcohol consumption between 2009 and 2012 were classified as sustained heavy drinking, reduced drinking, and absolute abstinence. The primary outcome measure was new-onset AF during the follow-up. To minimize the effect of confounding variables on outcome events, inverse probability of treatment weighting (IPTW) analysis was performed. Overall, 19 425 participants were evaluated. The absolute abstinence group showed a 63% lower incidence of AF (IPTW hazard ratio: 0.379, 95% confidence interval: 0.169-0.853) than did the sustained heavy drinking group. Subgroup analysis identified that abstinence significantly reduced incident AF in participants with normal body mass index and without hypertension, diabetes, dyslipidaemia, heart failure, stroke, chronic kidney disease, or coronary artery disease (all P-value <0.05). There was no statistical difference in incident AF in participants with reduced drinking compared with sustained heavy alcohol group.

CONCLUSION: Absolute abstinence could reduce the incidence of AF in heavy alcohol drinkers. Comprehensive clinical measures and public health policies are warranted to motivate alcohol abstinence in heavy drinkers.

PMID:37672594 | DOI:10.1093/eurjpc/zwad270

Sci Adv. 2023 Sep 8;9(36):eadg1261. doi: 10.1126/sciadv.adg1261. Epub 2023 Sep 6.

ABSTRACT

Complex disordered matter is of central importance to a wide range of disciplines, from bacterial colonies and embryonic tissues in biology to foams and granular media in materials science to stellar configurations in astrophysics. Because of the vast differences in composition and scale, comparing structural features across such disparate systems remains challenging. Here, by using the statistical properties of Delaunay tessellations, we introduce a mathematical framework for measuring topological distances between general three-dimensional point clouds. The resulting system-agnostic metric reveals subtle structural differences between bacterial biofilms as well as between zebrafish brain regions, and it recovers temporal ordering of embryonic development. We apply the metric to construct a universal topological atlas encompassing bacterial biofilms, snowflake yeast, plant shoots, zebrafish brain matter, organoids, and embryonic tissues as well as foams, colloidal packings, glassy materials, and stellar configurations. Living systems localize within a bounded island-like region of the atlas, reflecting that biological growth mechanisms result in characteristic topological properties.

PMID:37672580 | DOI:10.1126/sciadv.adg1261