Tag: statistics

J Natl Cancer Inst. 2021 Mar 23:djab049. doi: 10.1093/jnci/djab049. Online ahead of print.

ABSTRACT

Today, there are more than 16.9 million cancer survivors in the United States; this number is projected to grow to 22.2 million by 2030. While much progress has been made in understanding cancer survivors needs and in improving survivorship care since the seminal 2006 Institute of Medicine report From Cancer Patient to Cancer Survivor: Lost in Transition, there is a need to identify evidence gaps and research priorities pertaining to cancer survivorship. Thus, in April 2019, the National Cancer Institute convened grant-funded extramural cancer survivorship researchers, representatives of professional organizations, cancer survivors, and advocates for a one-day in-person meeting. At this meeting, and in a subsequent webinar aimed at soliciting input from the wider survivorship community, evidence gaps and ideas for next steps in the following six areas, identified from the 2006 Institute of Medicine report, were discussed: surveillance for recurrence and new cancers, management of long-term and late physical effects, management of long-term and late psychosocial effects, health promotion, care coordination, and financial hardship. Identified evidence gaps and next steps across the areas included the need to understand and address disparities among cancer survivors, to conduct longitudinal studies as well as longer-term (>5 years post-diagnosis) follow-up studies, to leverage existing data, and to incorporate implementation science strategies to translate findings into practice. Designing studies to address these broad evidence gaps, as well as those identified in each area, will expand our understanding of cancer survivors’ diverse needs, ultimately leading to the development and delivery of more comprehensive evidence-based quality care.

PMID:33755126 | DOI:10.1093/jnci/djab049

Am J Clin Oncol. 2021 Apr 1;44(4):143-149. doi: 10.1097/COC.0000000000000800.

ABSTRACT

OBJECTIVE: The objective of this study was to examine patterns of care and outcomes of female cancer patients treated for sexual and menopausal symptoms following pelvic radiotherapy (PRT) at our institution’s multidisciplinary Sexuality, Intimacy, and Menopause (SIMS) Program.

MATERIALS AND METHODS: We performed a retrospective review of 69 female patients who received PRT for gynecologic or gastrointestinal malignancies and were referred for SIMS Program intervention. Indications for referral and treatment patterns were summarized. Preintervention and postintervention, patients were screened at follow-up visits, and symptoms were recorded. Statistics were performed using Stata 13.1.

RESULTS: Cancer types included cervical (53.6%), endometrial (31.9%), anorectal (5.8%), and vulvar/vaginal (8.7%). The median age was 48 years (interquartile range: 38 to 58 y). Patients were educated on vaginal lubricants, moisturizers, and dilator therapy both before and after PRT. Reasons for SIMS referral included persistent menopausal symptoms (50.7%), dyspareunia (40.6%), vaginal dryness (37.7%), decreased libido (17.4%), intimacy concerns (17.4%), and/or physical examination alterations (27.5%). SIMS interventions included vaginal estrogen (77.3%), nonhormonal climacteric interventions (53%), systemic hormone therapy (31.8%), dehydroepiandrosterone (4.6%), testosterone cream (4.6%), and/or psychological pharmacotherapy or counseling (13.6%). With a median follow-up of 36 months (interquartile range: 18 to 58 mo), sexual symptoms improved or were stable in 83.6%, while menopausal symptoms improved or were stable in 80.5%.

CONCLUSIONS: This study highlights the importance of multidisciplinary care in improving the sexual and menopausal symptoms of women after PRT. Future work examining the impact of intervention timing with respect to PRT and measures of patient satisfaction is warranted.

PMID:33755031 | DOI:10.1097/COC.0000000000000800

Invest Ophthalmol Vis Sci. 2021 Mar 1;62(3):32. doi: 10.1167/iovs.62.3.32.

ABSTRACT

PURPOSE: New lasers with a continuous wave power exceeding 15 W are currently investigated for retinal therapies, promising highly localized effects at and close to the Retinal Pigment Epithelium (RPE). The goal of this work is to evaluate mechanisms and thresholds for RPE cell damage by means of pulse durations up to 50 µs.

METHODS: A diode laser with a wavelength of 514 nm, a power of 15 W, and adjustable pulse durations between 2 µs and 50 µs was used. Porcine RPE-choroidal explants (ex vivo) and chinchilla bastard rabbits (in vivo) were irradiated to determine threshold radiant exposures for RPE damage ({bar H_{Cell}}) by calcein vitality staining and fluorescence angiography, respectively. Thresholds for microbubble formation (MBF) ({bar H_{MBF}}) were evaluated by time-resolved optoacoustics. Exemplary histologies support the findings.

RESULTS: ({bar H_{{{MBF}}}}) is significantly higher than ({bar H_{Cell}}) at pulse durations ≥ 5 µs (P < 0.05) ex vivo, while at 2 µs, no statistically significant difference was found. The ratios between ({bar H_{{{MBF}}}}) and ({bar H_{Cell}}) increase with pulse duration from 1.07 to 1.48 ex vivo and 1.1 to 1.6 in vivo, for 5.2 and 50 µs.

CONCLUSIONS: Cellular damage with and without MBF related disintegration are both present and very likely to play a role for pulse durations ≥ 5 µs. With the lower µs pulses, selective RPE disruption might be possible, while higher values allow achieving spatially limited thermal effects without MBF. However, both modi require a very accurate real-time dosing control in order to avoid extended retinal disintegration in this power range.

PMID:33755044 | DOI:10.1167/iovs.62.3.32

Asian J Surg. 2021 Mar 20:S1015-9584(21)00118-4. doi: 10.1016/j.asjsur.2021.02.011. Online ahead of print.

ABSTRACT

BACKGROUND: D3 lymph node dissection is becoming the standard procedure for the treatment of advanced right colon cancer and has shown increasing evidence of its oncologic benefit. However, a clear indication for its application is lacking and data on this topic is unsatisfactory. Thus, the necessity for D3 lymph node dissection in clinical stage I right colon cancer remains controversial.

METHODS: We retrospectively analyzed data from clinical stage I right colon cancer patients who underwent radical surgery at three hospitals of Korea university medical center between January 2015 and June 2018. We compared surgical complications and short-term oncologic outcomes between D2 and D3 lymph node dissections in these patients.

RESULTS: Among 512 patients, 122 (23.8%) were clinical stage I. Of these, 88 and 34 patients received D2 and D3 lymph node dissection, respectively. There were no statistically significant differences in clinicopathologic variables and surgical outcomes between the two groups. Upstaging occurred in 16 patients (47.1%) in the D3 group and 23 patients (26.1%) in the D2 group. There were four recurrences in the D2 group but no recurrence in the D3 group. Log-rank tests showed no statistically significant difference in disease-free survival rates between the two groups (p = 0.210).

CONCLUSION: There was no significant difference in disease-free survival rates between D2 and D3 lymph node dissection in clinical stage I right colon cancer patients. However, recurrence occurred in the D2 group. Efforts to improve the accuracy of clinical staging are required and more studies with better quality are needed.

PMID:33752988 | DOI:10.1016/j.asjsur.2021.02.011

Transfus Apher Sci. 2021 Mar 13:103121. doi: 10.1016/j.transci.2021.103121. Online ahead of print.

ABSTRACT

BACKGROUND: Blood donors are prone to have iron deficiency. The aim of this study was to determine utility of serum hepcidin as an indicator of iron deficiency in blood donors.

METHODS: A total of 200 voluntary, healthy blood donors were included in the study. Donors were categorized into four groups according to the donation frequency. Group I: (n = 50) who donated for the first time, or those who have not donated in the past 2 years (reactivated donors). Group II: (n = 50), who donated blood for the second time and had donated once in the previous 12 months. Group III: (n = 50), who donated blood for third time and had donated twice in the previous 12 months. Group IV: (n = 50) who donated blood for the fourth time and had donated thrice in the previous 12 months. Sera of study participants were evaluated for serum ferritin and serum hepcidin levels based on enzyme linked immunosorbent assay.

RESULTS: Serum hepcidin concentration ranged 2.36-15734 pg/mL. Serum hepcidin and serum ferritin were found to be lowest in group IV donors. When serum ferritin concentration of less than 15 ng/mL was considered as gold standard for diagnosing iron deficiency, AUCROC for serum hepcidin as a diagnostic test of iron deficiency was found to be 0.715. Serum hepcidin showed statistical significant correlation with donation frequency(p = 0 .005) and serum ferritin (p = 0.01). Sensitivity and specificity of serum hepcidin was found to be 77.8 %, 79.6 % respectively.

CONCLUSION: Effectiveness of Serum hepcidin as a diagnostic marker of iron deficiency still needs to be determined.

PMID:33752992 | DOI:10.1016/j.transci.2021.103121

Arch Bronconeumol. 2021 Feb 24:S0300-2896(21)00070-3. doi: 10.1016/j.arbres.2021.01.037. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of this study was to develop a surgical risk prediction model in patients undergoing anatomic lung resections from the registry of the Spanish Video-Assisted Thoracic Surgery Group (GEVATS).

METHODS: Data were collected from 3,533 patients undergoing anatomic lung resection for any diagnosis between December 20, 2016 and March 20, 2018. We defined a combined outcome variable: death or Clavien Dindo grade IV complication at 90 days after surgery. Univariate and multivariate analyses were performed by logistic regression. Internal validation of the model was performed using resampling techniques.

RESULTS: The incidence of the outcome variable was 4.29% (95% CI 3.6-4.9). The variables remaining in the final logistic model were: age, sex, previous lung cancer resection, dyspnea (mMRC), right pneumonectomy, and ppo DLCO. The performance parameters of the model adjusted by resampling were: C-statistic 0.712 (95% CI 0.648-0.750), Brier score 0.042 and bootstrap shrinkage 0.854.

CONCLUSIONS: The risk prediction model obtained from the GEVATS database is a simple, valid, and reliable model that is a useful tool for establishing the risk of a patient undergoing anatomic lung resection.

PMID:33752924 | DOI:10.1016/j.arbres.2021.01.037

Rev Gastroenterol Mex. 2021 Mar 19:S0375-0906(21)00014-8. doi: 10.1016/j.rgmx.2020.04.010. Online ahead of print.

ABSTRACT

INTRODUCTION: Clinical practice guidelines on the diagnosis and treatment of acute pancreatitis (CPGDTAP) have been designed in an effort to reduce the morbidity and mortality of that severe disease.

AIM: To identify the knowledge acquired from CPGDTAP in hospitals in Veracruz.

MATERIALS AND METHODS: A descriptive, observational, multicenter study was conducted at four hospitals in Veracruz, through the application of a survey to evaluate the knowledge of attending physicians and residents that treat patients with acute pancreatitis. Descriptive statistics were employed to analyze the results.

RESULTS: A total of 74 physicians were surveyed: 55.41% of whom were attending physicians and 44.59% of whom were resident physicians. The majority of physicians (67.57%) were familiar with CPGDTAP from the Asociación Mexicana de Gastroenterología (AMG), followed by those of the General Health Council of the Mexican Department of Health (CENETEC, the Spanish acronym) (54.05%) and the American College of Gastroenterology (ACG) (48.65%). A total of 97.30% of the physicians routinely use a nasogastric tube, 79.73% considered early enteral nutrition to be very important, as did 98.65% regarding generous fluid replacement, 85.14% did not routinely use antimicrobials, 63.51% ordered a CAT scan at 72h or later, and 87.84% answered that infected necrosis was the indication for surgery, preferably after the third week.

DISCUSSION AND CONCLUSIONS: In our hospital environment, the CPGDTAP issued by the AMG and CENETEC were the most well-known, but their recommended measures were given importance by under 85% of the physicians surveyed. Therefore, the diffusion of the knowledge they contain is advisable to guarantee optimal results in acute pancreatitis management.

PMID:33752942 | DOI:10.1016/j.rgmx.2020.04.010

Cognition. 2021 Mar 19:104653. doi: 10.1016/j.cognition.2021.104653. Online ahead of print.

ABSTRACT

Perceptual attunement to the native phonetic repertoire occurs over the first year of life: an infant’s discrimination of non-native phonetic contrasts declines while their discrimination of native phonetic contrasts improves, with the timing of change consistent with sensitive periods. The statistics of speech sound distributions is one source of input used to collapse non-native phonetic category boundaries, while sharpening native ones. Distributional learning can be a domain-general mechanism, yet given the timing of perceptual attunement, we hypothesized that this learning mechanism may be maturationally delimited in the content domain of phonetic categories. Here, we assessed whether sensitivity to the distribution of speech sounds in the environment declines as the period of perceptual attunement closes. We used electroencephalography (EEG) to investigate whether neuronal responses to native ‘ra’ and ‘la’ phones are modulated differently in older vs young infants by exposure to either a bimodal or unimodal sound distribution spanning the [r] ~ [l] phoneme space. The native contrast, ra-la, is discriminable at all three ages, ensuring that we were testing the distributional learning mechanism, rather than confounding it with a decline in discrimination to a non-native distinction. English monolingual infants (n = 131) at 5-, 9- and 12-months-old were familiarized to either a unimodal or bimodal distribution of /ra/-/la/ speech sounds. Immediately following familiarization, an ERP oddball task was used to assess discrimination. Results showed that brief exposure to a bi- vs uni-modal distribution is sufficient to alter neuronal responses to subsequent /ra/ vs /la/ speech sounds at 5-months and 9-months, but not at 12-months. These results are the first to capture a progressive decline in sensitivity to distributional statistics in the environment. A potential mechanistic explanation based on critical period biology is discussed.

PMID:33752869 | DOI:10.1016/j.cognition.2021.104653

Rev Colomb Psiquiatr. 2021 Mar 19:S0034-7450(21)00036-6. doi: 10.1016/j.rcp.2020.12.011. Online ahead of print.

ABSTRACT

OBJECTIVE: To establish the factors associated with burnout syndrome in dental specialists working in the city of Bucaramanga and its metropolitan area.

METHODS: A cross-sectional study was conducted in which the validated version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) questionnaire was applied to 117 dental specialists. The variables analysed were the scores obtained in the three dimensions of the instrument – sociodemographic and job-related characteristics, professional environment, and habits. Spearman’s correlation coefficient and the Mann Whitney or Kruskal-Wallis U test were used in the bivariate analysis, and a logistic regression was performed in the multivariate analysis. A value of p<0.05 was considered statistically significant. Each participant accepted their inclusion in the study after the Informed Consent process was done.

RESULTS: The average age was 44.0±7.8 years, and 57.3% were women. It was observed that 3.4%, 4.3% and 4.3% of respondents scored highly in emotional exhaustion, depersonalisation and lack of personal achievement, respectively. Cigarette smoking presented a direct association with the dimensions of depersonalisation (p=0.031) and lack of personal achievement (p=0.025). On the other hand, having completed the postgraduate degree 10 years or more ago showed a negative association in these two dimensions (p=0.049 and p=0.045, respectively).

CONCLUSIONS: The results suggest that burnout syndrome is not a frequent problem in dental specialists who work in Bucaramanga and its metropolitan area. However, it is important to keep in mind that a relationship was observed between the syndrome and smoking, and the years after graduating in the specialty.

PMID:33752891 | DOI:10.1016/j.rcp.2020.12.011

Curr Probl Cancer. 2021 Mar 6:100728. doi: 10.1016/j.currproblcancer.2021.100728. Online ahead of print.

ABSTRACT

Both chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) are common hematological malignancies originating from mature B cells of different differentiation stage. However, it is quite rare that MM could develop after CLL diagnosed. We reported a 66-year-old female progressed forward myeloma 3 years after she was diagnosed as CLL and conducted an analysis to investigate the epidemiology and clinical features among these patients based on the Surveillance, Epidemiology, and End Results (SEER) database. Our data demonstrated that CLL patients were 19% less likely to develop myeloma than general U.S. population (standardized incidence ratio 0.81; 95% confidence interval 0.62-1.03), although without statistical difference. The median overall survival from CLL diagnosed was 90 (58.1-121.9) months, which was the same as general CLL patients according to historical data. But the outcomes of secondary MM was much poorer than general MM patients. Age and gender were independent factors that impact the survival among these patients.

PMID:33752897 | DOI:10.1016/j.currproblcancer.2021.100728