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Nevin Manimala Statistics

Immunoscore Is Prognostic in Low-Risk and High-Risk Stage III Colon Carcinomas Treated With Adjuvant Infusional Fluorouracil, Leucovorin, and Oxaliplatin in a Phase III Trial

JCO Precis Oncol. 2022 Aug;6:e2200010. doi: 10.1200/PO.22.00010.

ABSTRACT

PURPOSE: The recommended duration of adjuvant fluoropyrimidine and oxaliplatin chemotherapy for patients with stage III colon cancer is based on tumor classification into clinically low-risk (T1-3 N1) and high-risk (T4 or N2) groups. We determined whether Immunoscore can enhance prognostication within these risk groups.

MATERIALS AND METHODS: Patients with stage III colon carcinomas (N = 600) were randomly selected from the infusional fluorouracil, leucovorin, and oxaliplatin arm of adjuvant trial NCCTG N0147 (Alliance for Clinical Trials in Oncology). Tumors were evaluated for Immunoscore that quantifies CD3+ and CD8+ T-cell densities in the tumor center and invasive margin by digital image analysis. Disease-free survival (DFS) by Immunoscore was analyzed using a multivariable Cox regression model in each risk group with adjustment for covariates including KRAS, BRAFV600E, and mismatch repair status.

RESULTS: Of 559 cancers with Immunoscore data, 299 (53.5%) were classified as clinically low-risk (T1-3 N1) and 260 (46.5%) as clinically high-risk (T4 and/or N2). Among patients with low-risk tumors, those with Immunoscore-Low versus Immunoscore-High tumors had significantly worse 5-year DFS rates (77.5% v 91.8%; hazard ratio, 1.70; 95% CI, 1.03 to 2.79; P = .037). Among patients with high-risk tumors, those with Immunoscore-Low versus Immunoscore-High tumors also had significantly worse DFS (55.3% v 70.3%; hazard ratio, 1.65; 95% CI, 1.11 to 2.47; P = .013). Tumors that were low-risk/Immunoscore-Low had similar outcomes as did tumors that were high-risk/Immunoscore-High (P = .174). Prognostication was significantly improved in multivariable models where Immunoscore was added to clinical risk parameters and limited biomarkers (likelihood ratio test P = .0003).

CONCLUSION: Immunoscore can refine patient prognosis beyond clinical risk group classification, suggesting its potential utility for adjuvant decision making.

PMID:35952316 | DOI:10.1200/PO.22.00010

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Nevin Manimala Statistics

Ultrasound-guided Targeted vs. Regional Flooding: A Comparative Study for Improving the Clinical Outcome in Soft Tissue Filler Vascular Adverse Event Management

Aesthet Surg J. 2022 Aug 11:sjac227. doi: 10.1093/asj/sjac227. Online ahead of print.

ABSTRACT

BACKGROUND: Adverse vascular event management following hyaluronic acid-based aesthetic injections relies on the administration of hyaluronidase which is capable to enzymatically degrade the injected product and to improve clinical symptoms. Two protocols are currently available to manage such complications: “ultrasound guided targeted” and “flooding”.

OBJECTIVES: To compare the 2 protocols by means of amount of hyaluronidase volume utilized, and onset and degree of clinical improvement.

METHODS: A comparative case series of 39 patients was retrospectively evaluated which were initially treated with the “flooding” protocol and then treated with the “ultrasound guided targeted” due to no or little improvement.

RESULTS: The “ultrasound-guided targeted” protocol utilized a total of 122.5 iu (34) whereas the “flooding” protocol utilized 1519.4 iu (1137) which represents a statistically significant reduced amount of injected hyaluronidase with p = 0.028. There was no clinical improvement in 92.3% and only little improvement in 7.7% of the treated patients following the first applied “flooding” protocol but there was a 100% immediate improvement when treated with the “ultrasound-guided targeted” protocol. Ultrasound imaging revealed that the application of hyaluronidase normal blood flow was restored both in the perivascular space and in the superficially located subdermal soft tissues.

CONCLUSIONS: Despite its limitations in study design, this retrospectively evaluated case series revealed that the ultrasound guided targeted protocol utilized less hyaluronidase material and restored faster clinically visible symptoms. The effect of this protocol is best explained by the perforasome concept which will need to be investigated further in future studies.

PMID:35951759 | DOI:10.1093/asj/sjac227

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Nevin Manimala Statistics

Mobilization with reduced cyclophosphamide for autologous stem cell transplantation is feasible in patients with systemic sclerosis

Rheumatology (Oxford). 2022 Aug 11:keac455. doi: 10.1093/rheumatology/keac455. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the feasibility of reduced cyclophosphamide dosing in the setting of mobilization chemotherapy prior high dose chemotherapy and autologous stem cell transplantation in patients with systemic sclerosis. The primary end point was the occurrence of ‘poor mobilization’ when using different cyclophosphamide dosing. The second end point was to analyze potential risk factors for difficult stem cell mobilization in this cohort of patients with systemic sclerosis.

METHODS: This single-center study retrospectively reviewed 32 patients with systemic sclerosis who underwent autologous stem cell transplantation. We analyze the occurrence of ‘poor mobilization’ (defined as CD34+ progenitor cell count < 2 x 106/kg body weight, the use of increasing G-CSF dose, the use of plerixafor, or leukapheresis on > 2 consecutive days) in different cyclophosphamide mobilization regimens: We herein compared low dose (2×1-1.5g/m2) cyclophosphamide vs high dose (2x2g/m2) for mobilization.

RESULTS: Higher dosing of cyclophosphamide seems not to be beneficial regarding stem cell collection as there was no significant difference in stem cell yield between high dose and reduced dose cyclophosphamide (6.2 vs 5.2 x106/kg bodyweight after CD34+ enrichment). Furthermore, higher doses of cyclophosphamide might be associated with more side effects, this difference was however not statistically significant. Lower bodyweight and BMI (p< 0.001) as well as Rituximab pre-therapy (p< 0.05) and cardiac involvement (p< 0.01) might negatively impact stem cell collection independently from the chosen regimen.

CONCLUSION: Our data demonstrate that a reduced cyclophosphamide mobilization regimen seems to be feasible. Risk factors for poor mobilization might be low bodyweight, prior rituximab therapy and cardiac involvement.

PMID:35951758 | DOI:10.1093/rheumatology/keac455

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Nevin Manimala Statistics

Approximations to the expectations and variances of ratios of tree properties under the coalescent

G3 (Bethesda). 2022 Aug 11:jkac205. doi: 10.1093/g3journal/jkac205. Online ahead of print.

ABSTRACT

Properties of gene genealogies such as tree height (H), total branch length (L), total lengths of external (E) and internal (I) branches, mean length of basal branches (B), and the underlying coalescence times (T) can be used to study population-genetic processes and to develop statistical tests of population-genetic models. Uses of tree features in statistical tests often rely on predictions that depend on pairwise relationships among such features. For genealogies under the coalescent, we provide exact expressions for Taylor approximations to expected values and variances of ratios Xn/Yn, for all 15 pairs among the variables {Hn, Ln, En, In, Bn, Tk}, considering n leaves and 2 ≤ k ≤ n. For expected values of the ratios, the approximations match closely with empirical simulation-based values. The approximations to the variances are not as accurate, but they generally match simulations in their trends as n increases. Although En has expectation 2 and Hn has expectation 2 in the limit as n → ∞, the approximation to the limiting expectation for En/Hn is not 1, instead equaling π2/3-2 ≈ 1.28987. The new approximations augment fundamental results in coalescent theory on the shapes of genealogical trees.

PMID:35951748 | DOI:10.1093/g3journal/jkac205

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Nevin Manimala Statistics

The effect of group-based cognitive behavioural therapy for insomnia in patients with rheumatoid arthritis: A randomised controlled trial

Rheumatology (Oxford). 2022 Aug 11:keac448. doi: 10.1093/rheumatology/keac448. Online ahead of print.

ABSTRACT

OBJECTIVES: The primary objective was to compare the effect of cognitive behavioural therapy for insomnia (CBT-I) to usual care on sleep efficiency, measured by polysomnography (PSG) immediately after the intervention at week 7. Secondary objectives included comparing the longer-term effect on sleep- and RA-related outcomes at week 26.

METHODS: In a randomised controlled trial using a parallel group design, the experimental intervention was six weeks’ nurse-led group-based CBT-I; the comparator was usual care. Analyses were based on the intention-to-treat (ITT) principle; missing data were statistically modelled using repeated-measures linear mixed effects models adjusted for the level at baseline.

RESULTS: The ITT population consisted of 62 patients (89% women), with an average age of 58 years and an average sleep efficiency of 83.1%. At primary end point, sleep efficiency was 88.7% in the CBT-I group, compared with 83.7% in the control group (difference: 5.03 [95% CI -0.37-10.43]; p = 0.068) measured by PSG at week 7. Key secondary outcomes measured with PSG had not improved at week 26. However, for all the patient-reported key secondary sleep- and RA-related outcomes, there were statistically highly significant differences between CBT-I and usual care (p < 0.0001), e.g. insomnia (Insomnia Severity Index: -9.85 [95% CI -11.77 to -7.92]), and the RA impact of disease (RAID: -1.36 [95% CI-1.92 to -0.80]) at week 26.

CONCLUSION: Nurse-led group-based CBT-I did not lead to an effect on sleep efficiency objectively measured with PSG. However, CBT-I showed improvement on all patient-reported key secondary sleep- and RA-related outcomes measured at week 26.Trial registrationClinicalTrials.gov, https://clinicaltrials.gov, NCT03766100.

PMID:35951745 | DOI:10.1093/rheumatology/keac448

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Nevin Manimala Statistics

Virulence and Biofilm Inhibition of 3-Methoxycinnamic Acid against Agrobacterium tumefaciens

J Appl Microbiol. 2022 Aug 11. doi: 10.1111/jam.15774. Online ahead of print.

ABSTRACT

AIMS: In the current study the anti-virulence and anti-biofilm activities of the cinnamic acid derivative, 3-methoxycinnamic acid, was investigated against Agrobacterium tumefaciens.

METHODS AND RESULTS: Based on the disc diffusion test and β-galactosidase activity assay, 3-methoxycinnamic acid was shown to interfere with the quorum sensing (QS) system of A. tumefaciens. Crystal violet staining assay, phenol-sulfuric acid method, Bradford protein assay and confocal laser scanning microscopy (CLSM) revealed that the biofilm formation of A. tumefaciens was inhibited after the treatment of 3-methoxycinnamic acid. Employing high performance liquid chromatography (HPLC) analysis of culture supernatant revealed that the production of 3-oxo-octanoylhomoserine lactone (3-oxo-C8-HSL) decreased concentration-dependently after treatment with 3-methoxycinnamic acid. Swimming and chemotaxis assays also indicated that 3-methoxycinnamic acid had a good effect on reducing the motility and chemotaxis of A. tumefaciens. In addition, the RT-qPCR, molecular docking and simulations further demonstrated that 3-methoxycinnamic acid could competitively inhibit the binding of 3-oxo-C8-HSL to TraR and down-regulate virulence-related genes.

CONCLUSIONS: 3-Methoxycinnamic acid is proved to have good anti-virulence and anti-biofilm activities against A. tumefaciens.

SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first study that investigates the anti-virulence and anti-biofilm activities of 3-methoxycinnamic acid against A. tumefaciens. With its potential QS-related virulence and biofilm inhibitory activities, 3-methoxycinnamic acid is expected to be developed as a potent pesticide or adjuvant for the prevention and treatment of crown gall caused by A. tumefaciens.

PMID:35951737 | DOI:10.1111/jam.15774

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Nevin Manimala Statistics

Nested epistasis enhancer networks for robust genome regulation

Science. 2022 Aug 11:eabk3512. doi: 10.1126/science.abk3512. Online ahead of print.

ABSTRACT

Mammalian genomes possess multiple enhancers spanning an ultralong distance (>megabases) to modulate important genes, yet it is unclear how these enhancers coordinate to achieve this task. Here, we combine multiplexed CRISPRi screening with machine learning to define quantitative enhancer-enhancer interactions. We find that the ultralong distance enhancer network possesses a nested multi-layer architecture that confers functional robustness of gene expression. Experimental characterization reveals that enhancer epistasis is maintained by three-dimensional chromosomal interactions and BRD4 condensation. Machine learning prediction of synergistic enhancers provides an effective strategy to identify non-coding variant pairs associated with pathogenic genes in diseases beyond Genome-Wide Association Studies (GWAS) analysis. Our work unveils nested epistasis enhancer networks, which can better explain enhancer functions within cells and in diseases.

PMID:35951677 | DOI:10.1126/science.abk3512

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Nevin Manimala Statistics

Color Vision and Microperimetry Changes in Nonexudative Age-Related Macular Degeneration After Risuteganib Treatment: Exploratory Endpoints in a Multicenter Phase 2a Double-Masked, Randomized, Sham-Controlled, Crossover Clinical Trial

Ophthalmic Surg Lasers Imaging Retina. 2022 Aug;53(8):430-438. doi: 10.3928/23258160-20220725-02. Epub 2022 Aug 1.

ABSTRACT

BACKGROUND AND OBJECTIVE: To explore the association between best-corrected visual acuity (BCVA) improvement and changes in microperimetry (MP) and color vision in patients with nonexudative age-related macular degeneration following administration of two 1.0-mg intravitreal doses of risuteganib.

PATIENTS AND METHODS: In a phase 2a, prospective, double-masked, sham-controlled study, eyes with nonexudative age-related macular degeneration and Early Treatment Diabetic Retinopathy Study BCVA between 20/40 and 20/200 were randomized to intravitreal risuteganib (1.0 mg) or sham injection. The risuteganib group received a second 1.0-mg dose, and patients in the sham group crossed over to receive 1.0 mg of risuteganib at week 16. Exploratory endpoints included changes in color vision and mesopic MP.

RESULTS: Thirty-nine patients (risuteganib, n = 25; sham, n = 14) completed the study. There was a significant (P < .05) correlation between BCVA and the total error score (TES) for both Lanthony and Hue Style. Confusion index was close to the criterion for significance (P = .056) in the risuteganib group. All color vision metrics demonstrated a trend toward improvement in risuteganib responders (BCVA letter gain ≥8 letters) and no change in the nonresponders, with significant differences seen in confusion index between the risuteganib and control group (P = .0493) and between responders and nonresponders (P = .0478). MP showed that risuteganib responders improved in mean sensitivity and change in number of loci ≤11 dB and ≤0 dB, whereas nonresponders worsened.

CONCLUSION: All color vision and MP parameters tested trended toward improvement in risuteganib-treated patients and risuteganib responders. Statistically significant improvement was evident in two metrics: confusion index (in risuteganib-treated patients and responders) and number of loci with decreased sensitivity (in responders). A significant correlation between BCVA and both TES Lanthony and TES Hue Style in risuteganib patients provides concurrent evidence of objective and subjective improvement of retinal function. [Ophthalmic Surg Lasers Imaging Retina 2022;53:430-438.].

PMID:35951718 | DOI:10.3928/23258160-20220725-02

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Nevin Manimala Statistics

Multi-mode movement decisions across widely ranging behavioral processes

PLoS One. 2022 Aug 11;17(8):e0272538. doi: 10.1371/journal.pone.0272538. eCollection 2022.

ABSTRACT

Movement of organisms plays a fundamental role in the evolution and diversity of life. Animals typically move at an irregular pace over time and space, alternating among movement states. Understanding movement decisions and developing mechanistic models of animal distribution dynamics can thus be contingent to adequate discrimination of behavioral phases. Existing methods to disentangle movement states typically require a follow-up analysis to identify state-dependent drivers of animal movement, which overlooks statistical uncertainty that comes with the state delineation process. Here, we developed population-level, multi-state step selection functions (HMM-SSF) that can identify simultaneously the different behavioral bouts and the specific underlying behavior-habitat relationship. Using simulated data and relocation data from mule deer (Odocoileus hemionus), plains bison (Bison bison bison) and plains zebra (Equus quagga), we illustrated the HMM-SSF robustness, versatility, and predictive ability for animals involved in distinct behavioral processes: foraging, migrating and avoiding a nearby predator. Individuals displayed different habitat selection pattern during the encamped and the travelling phase. Some landscape attributes switched from being selected to avoided, depending on the movement phase. We further showed that HMM-SSF can detect multi-modes of movement triggered by predators, with prey switching to the travelling phase when predators are in close vicinity. HMM-SSFs thus can be used to gain a mechanistic understanding of how animals use their environment in relation to the complex interplay between their needs to move, their knowledge of the environment and navigation capacity, their motion capacity and the external factors related to landscape heterogeneity.

PMID:35951664 | DOI:10.1371/journal.pone.0272538

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Nevin Manimala Statistics

Boosting k-means clustering with symbiotic organisms search for automatic clustering problems

PLoS One. 2022 Aug 11;17(8):e0272861. doi: 10.1371/journal.pone.0272861. eCollection 2022.

ABSTRACT

Kmeans clustering algorithm is an iterative unsupervised learning algorithm that tries to partition the given dataset into k pre-defined distinct non-overlapping clusters where each data point belongs to only one group. However, its performance is affected by its sensitivity to the initial cluster centroids with the possibility of convergence into local optimum and specification of cluster number as the input parameter. Recently, the hybridization of metaheuristics algorithms with the K-Means algorithm has been explored to address these problems and effectively improve the algorithm’s performance. Nonetheless, most metaheuristics algorithms require rigorous parameter tunning to achieve an optimum result. This paper proposes a hybrid clustering method that combines the well-known symbiotic organisms search algorithm with K-Means using the SOS as a global search metaheuristic for generating the optimum initial cluster centroids for the K-Means. The SOS algorithm is more of a parameter-free metaheuristic with excellent search quality that only requires initialising a single control parameter. The performance of the proposed algorithm is investigated by comparing it with the classical SOS, classical K-means and other existing hybrids clustering algorithms on eleven (11) UCI Machine Learning Repository datasets and one artificial dataset. The results from the extensive computational experimentation show improved performance of the hybrid SOSK-Means for solving automatic clustering compared to the standard K-Means, symbiotic organisms search clustering methods and other hybrid clustering approaches.

PMID:35951672 | DOI:10.1371/journal.pone.0272861