Tag: statistics

J Vis. 2023 Jun 1;23(6):13. doi: 10.1167/jov.23.6.13.

ABSTRACT

Clinical trials typically analyze multiple endpoints for signals of efficacy. To improve signal detection for treatment effects using the high-dimensional data collected in trials, we developed a hierarchical Bayesian joint model (HBJM) to compute a five-dimensional collective endpoint (CE5D) of contrast sensitivity function (CSF) and visual acuity (VA). The HBJM analyzes row-by-row CSF and VA data across multiple conditions, and describes visual functions across a hierarchy of population, individuals, and tests. It generates joint posterior distributions of CE5D that combines CSF (peak gain, peak frequency, and bandwidth) and VA (threshold and range) parameters. The HBJM was applied to an existing dataset of 14 eyes, each tested with the quantitative VA and quantitative CSF procedures in four Bangerter foil conditions. The HBJM recovered strong correlations among CE5D components at all levels. With 15 qVA and 25 qCSF rows, it reduced the variance of the estimated components by 72% on average. Combining signals from VA and CSF and reducing noises, CE5D exhibited significantly higher sensitivity and accuracy in discriminating performance differences between foil conditions at both the group and test levels than the original tests. The HBJM extracts valuable information about covariance of CSF and VA parameters, improves precision of the estimated parameters, and increases the statistical power in detecting vision changes. By combining signals and reducing noise from multiple tests for detecting vision changes, the HBJM framework exhibits potential to increase statistical power for combining multi-modality data in ophthalmic trials.

PMID:37378989 | DOI:10.1167/jov.23.6.13

JAMA Psychiatry. 2023 Jun 28. doi: 10.1001/jamapsychiatry.2023.1691. Online ahead of print.

ABSTRACT

IMPORTANCE: Tobacco smoking drives markedly elevated cardiovascular disease risk and preventable death in persons with serious mental illness, and these risks are compounded by the high prevalence of overweight/obesity that smoking cessation can exacerbate. Guideline-concordant combined pharmacotherapy and behavioral smoking cessation treatment improves abstinence but is not routinely offered in community settings, particularly to those not seeking to quit smoking immediately.

OBJECTIVE: To determine the effectiveness of an 18-month pharmacotherapy and behavioral smoking cessation intervention incorporating weight management and support for physical activity in adults with serious mental illness interested in quitting smoking within 1 or 6 months.

DESIGN, SETTING, AND PARTICIPANTS: This was a randomized clinical trial conducted from July 25, 2016, to March 20, 2020, at 4 community health programs. Adults with serious mental illness who smoked tobacco daily were included in the study. Participants were randomly assigned to intervention or control, stratified by willingness to try to quit immediately (within 1 month) or within 6 months. Assessors were masked to group assignment.

INTERVENTIONS: Pharmacotherapy, primarily varenicline, dual-form nicotine replacement, or their combination; tailored individual and group counseling for motivational enhancement; smoking cessation and relapse prevention; weight management counseling; and support for physical activity. Controls received quitline referrals.

MAIN OUTCOME AND MEASURES: The primary outcome was biochemically validated, 7-day point-prevalence tobacco abstinence at 18 months.

RESULTS: Of the 298 individuals screened for study inclusion, 192 enrolled (mean [SD] age, 49.6 [11.7] years; 97 women [50.5%]) and were randomly assigned to intervention (97 [50.5%]) or control (95 [49.5%]) groups. Participants self-identified with the following race and ethnicity categories: 93 Black or African American (48.4%), 6 Hispanic or Latino (3.1%), 90 White (46.9%), and 9 other (4.7%). A total of 82 participants (42.7%) had a schizophrenia spectrum disorder, 62 (32.3%) had bipolar disorder, and 48 (25.0%) had major depressive disorder; 119 participants (62%) reported interest in quitting immediately (within 1 month). Primary outcome data were collected in 183 participants (95.3%). At 18 months, 26.4% of participants (observed count, 27 of 97 [27.8%]) in the intervention group and 5.7% of participants (observed count, 6 of 95 [6.3%]) in the control group achieved abstinence (adjusted odds ratio [OR], 5.9; 95% CI, 2.3-15.4; P < .001). Readiness to quit within 1 month did not statistically significantly modify the intervention’s effect on abstinence. The intervention group did not have significantly greater weight gain than the control group (mean weight change difference, 1.6 kg; 95% CI, -1.5 to 4.7 kg).

CONCLUSIONS AND RELEVANCE: Findings of this randomized clinical trial showed that in persons with serious mental illness who are interested in quitting smoking within 6 months, an 18-month intervention with first-line pharmacotherapy and tailored behavioral support for smoking cessation and weight management increased tobacco abstinence without significant weight gain.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02424188.

PMID:37378972 | DOI:10.1001/jamapsychiatry.2023.1691

Asian Pac J Cancer Prev. 2023 Jun 1;24(6):2135-2139. doi: 10.31557/APJCP.2023.24.6.2135.

ABSTRACT

OBJECTIVE: the aim of this study is evaluation of Topo IIa expression in laryngeal squamous cell carcinomas and correlation of this expression with various clinicopathological parameters.

METHODS: ninety cases of laryngeal squamous cell carcinoma archived paraffin blocks were collected in the form of total laryngectomies. Each paraffin block was re-cut by rotatory microtome at 4 μm thickness and stained by hematoxylin and eosin for routine histopathological examination and on charged slides for immunohistochemistry using an automated staining system with antibodies against Topo IIa. Mainly nuclear and slightly cytoplasmic staining was considered positive. Percentage of positive Topo IIa cells was graded then grouped into low expression and overexpression.

RESULTS: Topo IIa overexpression was seen in 91.1% of cases, while low expression was noticed in the remaining 8.9% of cases. There were statistically significant correlations between Topo IIa expression and tumor histological grade, lymph node metastasis and T stage as well as statistically significant positive correlation between Topo IIa expression as we progress from normal to dysplastic/in situ up to malignant transformation.

CONCLUSION: High expression of Topo IIa may indicate more aggressive tumor and may play a role in tumorogenesis in laryngeal squamous cell carcinoma.

PMID:37378945 | DOI:10.31557/APJCP.2023.24.6.2135

Asian Pac J Cancer Prev. 2023 Jun 1;24(6):2121-2127. doi: 10.31557/APJCP.2023.24.6.2121.

ABSTRACT

BACKGROUND: Gastric cancer (GC) is the second most common cause of cancer-related death worldwide. Multiple malignancies overexpress CD90, making it a helpful diagnostic and prognostic marker. CD133 is suggested to be related to poor prognosis in GC. Tropomyosin-1 (TPM1) tumor-suppressor gene low expression may predict poor survival in GC. Our study aimed to investigate CD90, CD133, and TPM1 immunohistochemical expression in GC in relation to diagnosis, prognosis, and Helicobacter pylori (H. pylori) infection.

METHODS: 144 paraffin blocks containing gastric cancerous (108 cases), and non-cancerous (36 cases) tissue were analyzed histopathologically for the type of lesion, grade, and stage of malignancy and by using an immunohistochemical assay for studying the expression of CD90, CD133, and TPM1. Data analysis was carried out using the Statistical Package for the Social Sciences (SPSS) version 20.0.

RESULTS: The obtained results showed a significantly higher expression of CD90 and CD133 while showing a significantly lower expression of TPM1 in malignant samples compared to benign ones. CD90 was significantly higher in grade-3, stage-3, and N3 (p<0.05), with no significant difference concerning positive and negative H. pylori samples. CD133 percentage and H-score were significantly higher in grade-2 and stage-4 tumors than in other grades and stages, while being insignificantly higher in N3 and H. pylori-positive cases. TPM1 expression levels were significantly downregulated in GC and H. pylori-positive cases (p<0.05). TPM1 downregulation was associated with grade progression, increased depth of invasion, and tumor node metastasis.

CONCLUSION: CD90, CD133, and TPM1 immunohistochemical expression in the gastric biopsy are related firmly to grades and stages of GC as well as H. pylori infection, so they could be of prognostic value. Further studies on a larger sample size are recommended.

PMID:37378943 | DOI:10.31557/APJCP.2023.24.6.2121

Asian Pac J Cancer Prev. 2023 Jun 1;24(6):2083-2088. doi: 10.31557/APJCP.2023.24.6.2083.

ABSTRACT

PURPOSE: This study aimed to determine the difference between the level of sexual satisfaction in breast cancer patients with Modified Radical Mastectomy (MRM) and Breast Conserving Surgery (BCS).

METHODS: This study used a cross-sectional study using a validated Female Sexual Function Index questionnaire. This study was conducted from 2020 until 2021. Data were collected and analyzed using the chi-square test for bivariate variables and logistic regression for multivariate variables.

RESULTS: Patients with BCS were more satisfied with their sexual activity than patients undergoing modified radical mastectomy (p = 0.0001, OR 6.25, CI = 2.78 – 14.01). Other factors having effect on sexual satisfactions were: age that showed a statistically effect on sexual satisfaction (patients <55 years were more satisfied than patients ≥55 years ( p = 0.004, OR = 3.23, CI 1.44 – 7.22), the period after operation (<5 years vs >5 years) showed a statistically significant difference in sexual satisfaction ( p = 0.087, OR=0.53, CI = 0.25-1.10), Having chemotherapy treatment showed statistically significant risk for sexual satisfaction (p = 0.003, OR=7.39, CI= 1.62-33.83). Factors having no statistically significant effect on sexual satisfactions were: Radiotherapy treatment (p = 0.133, OR=1.75 and CI = 0.84 -3.64), length of marriage as defined with <10 years and > 10 years (p = 0.616, OR=1.39 and CI = 0.38-5.09), marital status (p = 0.082, OR =0.39, CI=0,13 – 1.16), educational status (p = 0.778, OR = 1.18, CI = 0.37 – 3.75), and work at home vs outside home (p = 0.117, OR=1.8, and CI = 0.86 – 3.78).

CONCLUSION: BCS as surgical therapy option is the most dominant factor related to sexual satisfaction followed by age group, and chemotherapy group.

PMID:37378939 | DOI:10.31557/APJCP.2023.24.6.2083

Asian Pac J Cancer Prev. 2023 Jun 1;24(6):2061-2072. doi: 10.31557/APJCP.2023.24.6.2061.

ABSTRACT

AIM: To examine computed tomography (CT) radiomic feature stability on various texture patterns during pre-processing utilizing the Credence Cartridge Radiomics (CCR) phantom textures.

MATERIALS AND METHODS: Imaging Biomarker Explorer (IBEX) expansion for the abbreviation IBEX extracted 51 radiomic features of 4 categories from 11 textures image regions of interest (ROI) of the phantom. 19 software pre-processing algorithms processed each CCR phantom ROI. All ROI texture processed image features were retrieved. Pre-processed CT image radiomic features were compared to non-processed features to measure its textural influence. Wilcoxon T-tests measured the pre-processing relevance of CT radiomic features on various textures. Hierarchical cluster analysis (HCA) was performed to cluster processer potency and texture impression likeness.

RESULTS: The pre-processing filter, CT texture Cartridge, and feature category affect the CCR phantom CT image’s radiomic properties. Pre-processing is statistically unaltered by Gray Level Run Length Matrix (GLRLM ) expansion for the abbreviation GLRLM and Neighborhood Intensity Difference matrix (NID) expansion for the abbreviation NID feature categories. The 30%, 40%, and 50% honeycomb are regular directional textures and smooth 3D-printed plaster resin, most of the image pre-processing feature alterations exhibited significant p-values in the histogram feature category. The Laplacian Filter, Log Filter, Resample, and Bit Depth Rescale Range pre-processing algorithms hugely influenced histogram and Gray Level Co-occurrence Matrix (GLCM) image features.

CONCLUSION: We found that homogenous intensity phantom inserts, CT radiomic feature, are less sensitive to feature swaps during pre-processing than normal directed honeycomb and regular projected smooth 3D-printed plaster resin CT image textures. Because they lose fewer information during image enhancement, This feature concentration empowerment of the images also enhances texture pattern recognition.

PMID:37378937 | DOI:10.31557/APJCP.2023.24.6.2061

Asian Pac J Cancer Prev. 2023 Jun 1;24(6):2055-2059. doi: 10.31557/APJCP.2023.24.6.2055.

ABSTRACT

BACKGROUND: MiR27a plays an important role in carcinogenesis, cell proliferation, apoptosis, invasion, migration and angiogenesis. Several studies have identified an important role of pre-miR27a (rs895819) A>G polymorphism in several types of cancer. This research aims to investigate the association of pre-miR27a (rs895819) A>G and breast cancer susceptibility, clinicopathological data and survival. Blood DNA samples of 143 Thai breast cancer patients and 100 healthy Thai women were studied for pre-miR27a (rs895819) A>G polymorphism using polymerase chain reaction-restriction fragment-length polymorphism (PCR-RFLP).

RESULTS: The results revealed that the frequency of pre-miR27a (rs895819) A>G genotypes was not statistically significant different between breast cancer patient and normal control subjects. The rs895819 A>G genotype was significantly associated with clinicopathological parameter of grade III differentiation (P = 0.006), progesterone receptor (P = 0.011) and triple negative (P = 0.031) in breast cancer patients, but not with breast cancer susceptibility.

CONCLUSION: The pre-miR27a (rs895819) A>G genotype was significantly associated with poorly differentiated, progesterone receptor and triple-negative in breast cancer patients. Therefore, pre-miR27a (rs895819) A>G may be used as a biomarker for poor prognosis.

PMID:37378936 | DOI:10.31557/APJCP.2023.24.6.2055

Asian Pac J Cancer Prev. 2023 Jun 1;24(6):2043-2053. doi: 10.31557/APJCP.2023.24.6.2043.

ABSTRACT

OBJECTIVE: Patients with triple-negative breast cancer (TNBC) frequently develop resistance to chemotherapy. Studies have shown that microRNAs (miRNAs) are often aberrantly expressed in TNBC and are associated with drug resistance. However, a prognostic strategy that correlates miRNAs with chemotherapy resistance remains largely unknown.

METHODS: To identify breast cancer chemoresistance-associated miRNAs, the miRNA microarray dataset GSE71142 was downloaded from the Gene Expression Omnibus database. Differentially expressed miRNAs (DE-miRNAs) in chemoresistant groups were identified using the LIMMA package in R. Potential target genes were predicted using the miRTarBase 9. Functional and pathway enrichment analyses was done using WebGestalt. A protein-protein interaction network was visualized using Cytoscape software. The top six hub genes regulated by DE-miRNAs were identified using the random forest model. The chemotherapy resistance index (CRI) in TNBC was defined as sum of the median expression levels of the top six hub genes. The association of CRI with distant relapse risk was evaluated using point-biserial correlation coefficient in the validation cohorts of patients with TNBC. The correlation between CRI and cumulative hazard rate was estimated using the Cox model, and the predicted rate of distant relapse was obtained from the Breslow-type estimator of the survival function. All statistical computations were performed using Origin2019b.

RESULTS: A total of 12 DE-miRNAs were screened, including six upregulated and six downregulated miRNAs in chemoresistant breast cancer tissues compared with chemosensitive tissues. Based on fold changes, miR-214-3p, miR-4758-3p, miR-200c-3p, miR-4254, miR-140-3p, and miR-24-3p were the top six most upregulated miRNAs, whereas miR-142-5p, miR-146-5p, miR-1268b, miR-1275, miR-4447, and miR-4472 were the top six most downregulated miRNAs. The top three hub genes for upregulated miRNAs were RAC1, MYC, and CCND1 and for downregulated miRNAs were IL-6, SOCS1, and PDGFRA. CRI was significantly associated with the risk of distant relapse.

CONCLUSION: CRI predicted survival benefits with reduced hazard rate.

PMID:37378935 | DOI:10.31557/APJCP.2023.24.6.2043

Stroke. 2023 Jun 28. doi: 10.1161/STROKEAHA.123.043547. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to investigate whether socioeconomic status (SES) was associated with functional outcome in patients with ischemic stroke treated with reperfusion therapy (intravenous thrombolysis and/or thrombectomy).

METHODS: This nationwide cohort study included reperfusion-treated patients with ischemic stroke ≥18 years registered in the Danish Stroke Registry between 2015 and 2018. Functional outcome was determined by the modified Rankin Scale score 90 days after stroke. SES was defined by educational attainment, family income, and employment status before stroke. SES data were available from Statistics Denmark and linked on the individual level with data from the Danish Stroke Registry. Uni- and multivariable ordinal logistic regression was performed for each socioeconomic parameter individually (education, income, and employment) to estimate the common odds ratios (cORs) for lower 90-day modified Rankin Scale scores.

RESULTS: A total of 5666 patients were included. Mean age was 68.7 years (95% CI, 68.3-69.0), and 38.4% were female. Low SES was associated with lower odds for achieving lower 90-day modified Rankin Scale score: Low versus high education, cOR, 0.69 (95% CI, 0.61-0.79), low versus high income, cOR, 0.59 (95% CI, 0.53-0.67), and unemployed versus employed, cOR, 0.70 (95% CI, 0.58-0.83). Inequalities were reduced after adjusting for age, sex, and immigrant status, except for unemployed versus employed patients, adjusted cOR, 0.66 (95% CI, 0.54-0.80). No statistically significant differences remained after adjusting for potentially mediating variables (eg, stroke severity, prestroke modified Rankin Scale, and smoking).

CONCLUSIONS: Socioeconomic inequalities were observed in functional outcome after reperfusion treated ischemic stroke. In particular, prestroke unemployment was negatively associated with good functional outcome. A more adverse prognostic profile among patients with low SES appeared to explain the majority of these inequalities.

PMID:37377030 | DOI:10.1161/STROKEAHA.123.043547

Acta Orthop. 2023 Jun 27;94:300-306. doi: 10.2340/17453674.2023.12359.

ABSTRACT

BACKGROUND AND PURPOSE: Mesenchymal stem cells (MSCs), both endogenous and exogenous, enhance chondrocyte proliferation by stimulating collagen type II. Secretome, an MSC derivate, has shown to also provide this mechanism through a paracrine effect. We aimed to evaluate the use of secretome and MSC in the management of early osteoarthritis (OA).

ANIMALS AND METHODS: 19 (1 control) male sheep (Ovies aries), which were operated on with total lateral meniscectomy to induce knee OA, were divided into 3 groups: the secretome group, hyaluronic acid group, and MSC group. Each group was injected with the respective substances and was evaluated macroscopically and microscopically. The Osteoarthritis Research Society International (OARSI) score was calculated for all subjects and a descriptive and comparative statistical analysis was undertaken.

RESULTS: The macroscopic analysis of the treated groups revealed better OARSI score in the secretome group compared with the other 2 groups. The secretome group showed a significantly better microscopic score compared with the hyaluronic acid group (mean difference [MD] 6.0, 95% confidence interval [CI] 0.15-12), but no significant difference compared with the MSC group (MD 1.0, CI -4.8 to 6.8).

CONCLUSION: Intra-articular injection of secretome is effective in managing early-stage osteoarthritis in the animal model compared with hyaluronic acid and has similar efficacy to MSC injection.

PMID:37377012 | DOI:10.2340/17453674.2023.12359