Tag: statistics

Dig Liver Dis. 2021 Aug 21:S1590-8658(21)00388-1. doi: 10.1016/j.dld.2021.07.018. Online ahead of print.

ABSTRACT

BACKGROUND: Although several risk factors have been identified for the development of pancreatic cancer, the effects of fruit and vegetables on the disease remains controversial.

METHODS: Individuals without cancer at baseline, who underwent national health examinations during 2008, were enrolled and followed-up to 2017. Vegetable intake was measured by assessing the intake of daily vegetables (types). Fruit intake was also assessed on a weekly basis. We evaluated the risk of pancreatic cancer using adjusted hazard ratio (aHR) and 95% confidence interval (95% CI).

RESULTS: Of 3,605,959 individuals (44% men), pancreatic cancer occurred in 10,469 subjects (5,384 men) during the 9 year follow-up. In adjusted analyses, the daily intake of more than five vegetable types reduced pancreatic cancer compared to no vegetable intake (aHR = 0.82; 95% CI, 0.71-0.94). Using sex-specific analyses, vegetable intake markedly reduced pancreatic cancer in women (aHR = 0.84 for 1-2 vegetable types, 0.84 for 3-4 and 0.69 for ≥ 5), but no effects were observed in men. Sex-specific analyses revealed that fruit intake reduced pancreatic cancer in men (aHR = 0.87 for 3-4 servings/week, and 0.84 for ≥ 7), but no effects were observed in women.

CONCLUSIONS: High intakes of dietary vegetables and fruit reduce pancreatic cancer development in women and men, respectively.

PMID:34429267 | DOI:10.1016/j.dld.2021.07.018

Eur Urol Focus. 2021 Aug 21:S2405-4569(21)00218-2. doi: 10.1016/j.euf.2021.08.003. Online ahead of print.

ABSTRACT

CONTEXT: Retzius sparing robot-assisted radical prostatectomy (RS-RARP) is increasingly being used, but results of pertinent studies on perioperative, functional, and oncological outcomes comparing the Retzius sparing approach with standard robot-assisted radical prostatectomy (RARP) remain inconsistent.

OBJECTIVE: To evaluate the effectiveness of RS-RARP compared with standard RARP, in terms of perioperative, functional, and oncological outcomes.

EVIDENCE ACQUISITION: We performed a systematic search using multiple databases (PubMed, MEDLINE, EMBASE, and Cochrane Central) until March 2021. Only randomized controlled trials (RCTs) and prospective studies were eligible for study inclusion. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were respected. Studies were critically appraised for the risk of bias. Primary outcomes were continence/potency recovery, as well as positive surgical margin (PSM) rates. Secondary outcomes included total intra- and perioperative complication rates.

EVIDENCE SYNTHESIS: Four RCTs and six prospective observational studies were included in this systematic review. The meta-analysis revealed that PSM rates in ≤pT2 tumors were statistically significantly higher, following RS-RARP as compared with RARP (risk ratio [RR]=1.39; 95% confidence interval [CI]=[1.01-1.91]). PSM rates in ≥pT3 tumors tended to be higher following RS-RARP (RR=1.36; 95% CI=[0.74-2.50]), although statistical significance was not reached. Immediate continence recovery was higher and significantly advantageous for RS-RARP (RR=1.81; 95% CI=[1.26-2.60]). Continence recovery also tended to be higher at 3 and 6 mo in the RS-RARP group (RR=1.57; 95% CI=[0.69-3.58] and RR=1.22; 95% CI=[0.89-1.66], respectively). The urinary continence recovery at 12 mo was similar in both groups (RR=1.14; 95% CI=[0.98-1.32]). A meta-analysis of included studies showed no significant difference concerning the return of erectile function and major complication rates between RS-RARP and RARP (RR=1.05; 95% CI=[0.76-1.45] and (RR=0.79; 95% CI=[0.07-8.74], respectively).

CONCLUSIONS: Available data suggest a statistically significant advantage in favor of RS-RARP in terms of immediate urinary continence recovery. PSM rates in localized ≤pT2 tumors are statistically significantly higher following RS-RARP. Potency and serious complication rates appear to be similar.

PATIENT SUMMARY: Our meta-analysis of the current evidence shows a significant advantage for Retzius sparing robot-assisted radical prostatectomy (RS-RARP) over robot-assisted radical prostatectomy in terms of immediate urinary continence recovery, but positive cancer margins are higher following RS-RARP. There was no significant difference in the preservation of erectile function and overall postoperative complication rates between both the techniques.

PMID:34429272 | DOI:10.1016/j.euf.2021.08.003

J Foot Ankle Surg. 2021 Jun 21:S1067-2516(21)00219-2. doi: 10.1053/j.jfas.2021.06.010. Online ahead of print.

ABSTRACT

Arthrodesis of the first metatarsal phalangeal joint (MTPJ) is a widely utilized surgical procedure for a wide array of metatarsal pathologies. This study aims to explore the functional limitations following first MTPJ arthrodesis, overall satisfaction and patient’s abilities to achieve activities of daily living (ADL). This prospective cohort study assessed functional limitations as well as footwear and lifestyle restrictions using several questionnaires. One hundred and three participants who had a first MTPJ arthrodesis under the care of a single surgeon were recruited. Pre- and postoperative patient-reported outcome measures were recorded. The American Orthopaedic Foot and Ankle Score (AOFAS) and the Manchester-Oxford Foot Questionnaire were also used to further examine functional status. Hallux valgus angle (HVA) and intermetatarsal angle (IMA) were compared using preoperative and postoperative weightbearing radiographs and successful fusion was recorded. Complications were documented and are discussed in detail. The duration of follow-up was more than 12 months. There was one nonunion in the cohort while 2 patients experienced delay to fusion. Approximately 97% of patients were very satisfied with the procedure and their ability to achieve ADLs post operatively. A further 82.5% of patients were able to return to wearing nonadaptive footwear. The mean reduction in HVA and IMA was 21.78° and 6.84°, respectively. This study demonstrates the safe and successful use of a compression screw/locking plate construct for arthrodesis of the first MTPJ. Furthermore, the study provides clear evidence of high levels of functionality after the procedure with statistically significant differences (p value <.05) in all 4 facets of the AOFAS questionnaire as well as several notable differences in activity levels and footwear restrictions pre and postoperatively.

PMID:34429264 | DOI:10.1053/j.jfas.2021.06.010

Semin Cell Dev Biol. 2021 Aug 21:S1084-9521(21)00211-1. doi: 10.1016/j.semcdb.2021.08.007. Online ahead of print.

ABSTRACT

The three-dimensional structure of the human genome has been proven to have a significant functional impact on gene expression. The high-order spatial chromatin is organised first by looping mediated by multiple protein factors, and then it is further formed into larger structures of topologically associated domains (TADs) or chromatin contact domains (CCDs), followed by A/B compartments and finally the chromosomal territories (CTs). The genetic variation observed in human population influences the multi-scale structures, posing a question regarding the functional impact of structural variants reflected by the variability of the genes expression patterns. The current methods of evaluating the functional effect include eQTLs analysis which uses statistical testing of influence of variants on spatially close genes. Rarely, non-coding DNA sequence changes are evaluated by their impact on the biomolecular interaction network (BIN) reflecting the cellular interactome that can be analysed by the classical graph-theoretic algorithms. Therefore, in the second part of the review, we introduce the concept of BIN, i.e. a meta-network model of the complete molecular interactome developed by integrating various biological networks. The BIN meta-network model includes DNA-protein binding by the plethora of protein factors as well as chromatin interactions, therefore allowing connection of genomics with the downstream biomolecular processes present in a cell. As an illustration, we scrutinise the chromatin interactions mediated by the CTCF protein detected in a ChIA-PET experiment in the human lymphoblastoid cell line GM12878. In the corresponding BIN meta-network the DNA spatial proximity is represented as a graph model, combined with the Proteins-Interaction Network (PIN) of human proteome using the Gene Association Network (GAN). Furthermore, we enriched the BIN with the signalling and metabolic pathways and Gene Ontology (GO) terms to assert its functional context. Finally, we mapped the Single Nucleotide Polymorphisms (SNPs) from the GWAS studies and identified the chromatin mutational hot-spots associated with a significant enrichment of SNPs related to autoimmune diseases. Afterwards, we mapped Structural Variants (SVs) from healthy individuals of 1000 Genomes Project and identified an interesting example of the missing protein complex associated with protein Q6GYQ0 due to a deletion on chromosome 14. Such an analysis using the meta-network BIN model is therefore helpful in evaluating the influence of genetic variation on spatial organisation of the genome and its functional effect in a cell.

PMID:34429265 | DOI:10.1016/j.semcdb.2021.08.007

Reprod Biomed Online. 2021 Jul 22:S1472-6483(21)00350-3. doi: 10.1016/j.rbmo.2021.07.010. Online ahead of print.

ABSTRACT

RESEARCH QUESTION: Is ovarian stimulation and pregnancy in women with familial adenomatous polyposis (FAP)-associated desmoid tumours safe?

DESIGN: The study included women with FAP-associated desmoid tumours who underwent fertility treatments at the authors’ tertiary medical centre between the years 2011 and 2021. Data were collected from the fertility unit’s charts and from the oncological registries. The main outcome measures were the number of vitrified oocytes and embryos, and the number of live births in preimplantation genetic testing for monogenic/single gene defects (PGT-M) cycles.

RESULTS: Overall, 17 women were identified suitable for this study. A total of 117 mature oocytes were vitrified for fertility preservation and 106 embryos were submitted to PGT-M. One patient returned to claim her cryopreserved oocytes, and five patients who underwent PGT-M embryo transfer reported three live births. A statistically significant decrease in selected fertility cycle parameters was observed in one woman who co-administered sorafenib (a multikinase inhibitor) during her first cycles of treatment, as the mean number of oocytes before and after was 2.7 (±1.3) versus 13.2 (±3.3) (P = 0.02), the mean number of metaphase II oocytes was 2.2 (±2.1) versus 7.7 (±2.6) (P = 0.007), and the mean number of two-pronuclei oocytes was 0.5 (±1.1) versus 3.5 (±1.7) (P = 0.09). Three patients had a median desmoid tumour growth on magnetic resonance imaging of 6.2 (2.9-7.2) cm when compared with prior ovarian stimulation imaging.

CONCLUSIONS: Ovarian stimulation for women with desmoid tumours was characterized in some patients with an acceleration in tumour growth, regardless of the use of aromatase inhibitors. The use of sorafenib should be carefully considered during the course of fertility treatment.

PMID:34429254 | DOI:10.1016/j.rbmo.2021.07.010

Trends Cogn Sci. 2021 Aug 21:S1364-6613(21)00182-0. doi: 10.1016/j.tics.2021.07.012. Online ahead of print.

ABSTRACT

Recent research formalizes cooperative communication as belief transport using the mathematical theory of optimal transport. This formalization allows rigorous a priori analysis of the statistical and ecological properties of models of cooperative communication, unification of prior models and analysis of their differences, and promising directions for future research.

PMID:34429256 | DOI:10.1016/j.tics.2021.07.012

Acad Radiol. 2021 Aug 21:S1076-6332(21)00327-5. doi: 10.1016/j.acra.2021.07.019. Online ahead of print.

ABSTRACT

BACKGROUND: Diagnosis of diffuse parenchymal lung diseases (DPLD) on high resolution CT (HRCT) is difficult for non-expert radiologists due to varied presentation for any single disease and overlap in presentation between diseases.

RATIONALE AND OBJECTIVES: To evaluate whether a pattern-based training algorithm can improve the ability of non-experts to diagnosis of DPLD.

MATERIALS AND METHODS: Five experts (cardiothoracic-trained radiologists), and 25 non-experts (non-cardiothoracic-trained radiologists, radiology residents, and pulmonologists) were each assigned a semi-random subset of cases from a compiled database of DPLD HRCTs. Each reader was asked to create a top three differential for each case. The non-experts were then given a pattern-based training algorithm for identifying DPLDs. Following training, the non-experts were again asked to create a top three differential for each case that they had previously evaluated. Accuracy between groups was compared using Chi-Square analysis.

RESULTS: A total of 400 and 1450 studies were read by experts and non-experts, respectively. Experts correctly placed the diagnosis as the first item on the differential versus having the correct diagnosis as one of their top three diagnoses at an overall rate of 48 and 64.3%, respectively. Pre-training, non-experts achieved a correct diagnosis/top three of 32.5 and 49.7%, respectively. Post-training, non-experts demonstrated a correct diagnosis/top three of 41.2 and 65%, a statistically significant increase (p < 0.0001). In addition, post training, there was no difference between non-experts and experts in placing the correct diagnosis within their top three differential.

CONCLUSION: The diagnosis of DPLDs by HRCT imaging alone is relatively poor. However, use of a pattern-based teaching algorithm can improve non-expert interpretation and enable non-experts to include the correct diagnosis within their differential diagnoses at a rate comparable to expert cardiothoracic trained radiologists.

PMID:34429261 | DOI:10.1016/j.acra.2021.07.019

Clin Colorectal Cancer. 2021 Jul 31:S1533-0028(21)00073-6. doi: 10.1016/j.clcc.2021.07.008. Online ahead of print.

ABSTRACT

BACKGROUND: Regorafenib is a key agent in metastatic colorectal cancer (mCRC), but no validated factors predicting longer survival are available.

PATIENTS AND METHODS: REALITY was a retrospective multicenter trial in regorafenib-treated mCRC patients with overall survival (OS) ≥ 6 months. We aimed to assess the association between clinical parameters and outcome to define a panel identifying long term survivors among regorafenib candidates. Primary and secondary endpoints were OS and progression free survival (PFS), respectively. Statistical analysis was performed with MedCalc (survival distribution: Kaplan-Meier; survival comparison: log-rank test; independent role of significant variables at univariate analysis: logistic regression).

RESULTS: Hundred regorafenib-treated mCRC patients with OS ≥ 6 months were enrolled. Median OS was 11.5 m (95%CI:9.60-12.96); median PFS was 4.2 months (95% CI:3.43-43.03). The absence of liver progression and of dose and/or schedule changes during the first 4 cycles (mainly for good tolerability) were independently correlated at multivariate analysis with OS (Exp(b)1.8869, P= .0277and Exp(b)2.2000, P = .0313) and PFS (Exp(b)2.1583, P = .0065 and Exp(b)2.3036, P= .0169). Patients with neither of these variables had a significantly improved OS (n = 14, 20.8 months; 95% CI:12.967-55.267) versus others (n = 86, 10 months; 95% CI:8.367-12.167; HR = 0.4902, P = .0045) and PFS (11.3 months, 95%CI:4.267-35.8 vs. 3.9 months, 95% CI:3.167-43.033; HR = 0.4648, P = .0086).

CONCLUSION: These 2 factors might allow clinicians to better identify patients more likely to benefit from regorafenib. Toxicity management remains crucial.

PMID:34429245 | DOI:10.1016/j.clcc.2021.07.008

Eur J Paediatr Neurol. 2021 Apr 15:S1090-3798(21)00087-8. doi: 10.1016/j.ejpn.2021.04.001. Online ahead of print.

NO ABSTRACT

PMID:34429249 | DOI:10.1016/j.ejpn.2021.04.001

Soc Sci Res. 2021 Sep;99:102595. doi: 10.1016/j.ssresearch.2021.102595. Epub 2021 Jun 12.

ABSTRACT

Although debates over guns and gun control have roiled the contemporary political scene, the role of religion has received only limited attention from scholars. We contribute to this literature by developing a series of theoretical arguments linking one specific facet of religion -belief in supernatural evil (i.e., the Devil/Satan, Hell, and demons)-and a range of gun policy attitudes. Relevant hypotheses are then tested using data from the 2014 Baylor Religion Survey (n = 1572). Results show that belief in supernatural evil is a robust predictor of support for policies that expand gun rights. Overall, the estimated net effects of belief in supernatural evil withstand statistical controls for a host of sociodemographic covariates, and, importantly, political ideology. Very few other aspects of religion are associated with any of these gun policy attitudes. Implications and study limitations are discussed, and promising directions for future research on religion and guns are identified.

PMID:34429212 | DOI:10.1016/j.ssresearch.2021.102595