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Nevin Manimala Statistics

Association of early bevacizumab interruption with efficacy of atezolizumab plus bevacizumab for advanced hepatocellular carcinoma: A landmark analysis

Hepatol Res. 2022 Jan 25. doi: 10.1111/hepr.13748. Online ahead of print.

ABSTRACT

AIM: The present study focused on the association of early bevacizumab (Bev) interruption with the clinical outcome of atezolizumab plus bevacizumab (Atez/Bev).

METHODS: This retrospective study included 239 advanced hepatocellular carcinoma (HCC) patients receiving Atez/Bev from September 2020 and June 2021 at 16 different institutions in Japan. We conducted a nine-week landmark analysis to investigate the association of Bev interruption due to adverse events with the therapeutic efficacy.

RESULTS: The median age was 73.0 (68.0-80.0) years old, with 195 (81.6%) men. The objective response rate was significantly higher in patients without Bev interruption than in those with it (34.5% vs. 17.3%, p=0.038). The median progression-free survival (PFS) was 6.5 months (95% confidence interval [CI] 4.5-9.7) and 9.0 months (95% CI 7.1-not applicable) in patients with and without Bev interruption, respectively, with statistical significance (p=0.021). The 12-month overall survival (OS) rates in patients with and without Be% CI 27.7%-67.9%) and 82.2% (95% CI 70.3%-89.6%), respectively, showing a significant difference (p=0.004). The presence of Bev interruption was a significant factor associated with the PFS (p=0.021), and OS (p=0.008). A multivariate analysis showed that mALBI 2b (p<0.001) and later-line treatment (p=0.018) were unfavorable factors associated with Bev interruption. Liver injury, appetite loss, protein urea, and ascites or hepatic edema were more frequently found in patients with Bev interruption than in those without it.

CONCLUSIONS: Early Bev interruption was an unfavorable factor associated with the PFS and OS. The good liver function and treatment settings may be associated with maintaining Bev treatment. This article is protected by copyright. All rights reserved.

PMID:35080087 | DOI:10.1111/hepr.13748

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Nevin Manimala Statistics

Pridopidine modifies disease phenotype in a SOD1 mouse model of Amyotrophic Lateral Sclerosis

Eur J Neurosci. 2022 Jan 25. doi: 10.1111/ejn.15608. Online ahead of print.

ABSTRACT

Amyotrophic lateral sclerosis (ALS) is a lethal and incurable neurodegenerative disease due to the loss of upper and lower motor neurons, which leads to muscle weakness, atrophy, and paralysis. Sigma-1 receptor (σ-1R) is a ligand-operated protein that exhibits pro-survival and anti-apoptotic properties. In addition, mutations in its codifying gene are linked to development of juvenile ALS pointing to an important role in ALS. Here, we investigated the disease-modifying effects of pridopidine, a σ-1R agonist, using a delayed onset SOD1 G93A mouse model of ALS. Mice were administered a continuous release of pridopidine (3.0 mg/kg/day) for four weeks starting before the appearance of any sign of muscle weakness. Mice were monitored weekly and several behavioral tests were used to evaluate muscle strength, motor coordination and gait patterns. Pridopidine-treated SOD1 G93A mice showed genotype-specific effects with the prevention of cachexia. In addition, these effects exhibited significant improvement of motor behavior five weeks after treatment ended. However, the survival of the animals was not extended. In summary, these results show that pridopidine can modify the disease phenotype of ALS-associated cachexia and motor deficits in a SOD1 G93A mouse model.

PMID:35080077 | DOI:10.1111/ejn.15608

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Nevin Manimala Statistics

Combining information to estimate adherence in studies of pre-exposure prophylaxis for HIV prevention: Application to HPTN 067

Stat Med. 2022 Jan 25. doi: 10.1002/sim.9321. Online ahead of print.

ABSTRACT

In trials of oral HIV pre-exposure prophylaxis (PrEP), multiple approaches have been used to measure adherence, including self-report, pill counts, electronic dose monitoring devices, and biological measures such as drug levels in plasma, peripheral blood mononuclear cells, hair, and/or dried blood spots. No one of these measures is ideal and each has strengths and weaknesses. However, accurate estimates of adherence to oral PrEP are important as drug efficacy is closely tied to adherence, and secondary analyses of trial data within identified adherent/non-adherent subgroups may yield important insights into real-world drug effectiveness. We develop a statistical approach to combining multiple measures of adherence and show in simulated data that the proposed method provides a more accurate measure of true adherence than self-report. We then apply the method to estimate adherence in the ADAPT study (HPTN 067) in South African women.

PMID:35080038 | DOI:10.1002/sim.9321

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Virtual Reality Distraction during Upper Gastrointestinal Endoscopy: a Randomized Controlled Trial

J Gastroenterol Hepatol. 2022 Jan 26. doi: 10.1111/jgh.15786. Online ahead of print.

ABSTRACT

BACKGROUND: Virtual reality (VR) is an established and effective tool in reducing autonomic and somatic pain. We aimed to examine the analgesic effects of VR distraction during esophagogastroduodenoscopy (EGD).

METHODS: We conducted a randomized controlled trial and enrolled patients who had indication for unsedated EGD with topical anesthesia. Patients were randomly assigned to use Oculus GO with three-dimensional specific software content (Standalone VR headset), sham VR or without VR during EGD. The primary outcome was patient pain scores during EGD.

RESULTS: A total of 96 patients undergoing diagnostic EGD were randomized to receive VR (n=32), sham VR (n=32) and no VR defined as the control group (n=32). Patients in all groups reported no statistically different pain during esophageal intubation. The mean pain score was 2.7±2.4 in the VR group, 2.7±2.5 in the sham VR and 2.3±2.3 in the control group, (p-value=0.751). No significant difference was observed in heart rate and blood pressure, and the endoscopists reported higher overall satisfaction scores in VR (4.3 ± 0.5) compared with the control group (4 ± 0.8) but without significance (p-value = 0.156).

CONCLUSION: VR assisted anesthesia during EGD did not significantly reduce patient pain during esophageal intubation. There was no superiority in using VR distraction regarding patient’s and endoscopist’s satisfaction compared to standard EGD without VR Further studies are required to detect any true clinical advantage of VR distraction during EGD.

PMID:35080055 | DOI:10.1111/jgh.15786

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Attention control in a trial of an online psychoeducational intervention for caregivers

Res Nurs Health. 2022 Jan 25. doi: 10.1002/nur.22208. Online ahead of print.

ABSTRACT

In reports of randomized controlled trials, thorough description of the attention control condition has been recommended, yet is frequently lacking. The Tele-Savvy Caregiver program for informal caregivers of persons living with dementia was tested in a randomized controlled trial with an attention control condition. The purpose of this trial was to test Tele-Savvy’s efficacy in reducing the negative effects of caregiving on caregivers, promoting quality of life for persons living with dementia, and improving caregiver mastery. We describe the design and implementation of and examine the outcomes associated with the attention control condition. Caregivers were randomized to the immediate Tele-Savvy (active condition), Healthy Living (attention control), or waitlist. The attention control content was focused on healthy lifestyle and was not intended to affect the outcomes that Tele-Savvy targeted. The attention control group was similar to Tele-Savvy in the intervention structure and duration: it consisted of seven weekly group videoconferences and 36 video lessons. Data on outcomes of caregivers and persons living with dementia were collected at baseline and 3 and 6 months postbaseline. Multilevel mixed effects models were used to determine changes in the outcomes. One hundred and eleven caregivers were randomized to the attention control condition (attrition 21.6%). Eighteen formative assessment interviews focusing on caregivers’ experience in the attention control condition were conducted. The attention control condition completers had no statistically significant changes in the variables that Tele-Savvy targeted. These results may be used in the design and implementation of attention control conditions in behavioral intervention research.

PMID:35080016 | DOI:10.1002/nur.22208

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Prevalence and factors associated with gynoid lipodystrophy in Brazilian adolescent girls: a cross-sectional study

Int J Dermatol. 2022 Jan 26. doi: 10.1111/ijd.16061. Online ahead of print.

ABSTRACT

BACKGROUND: Gynoid lipodystrophy (GLD), or female cellulitis, is a chronic multifactorial disorder characterized by the irregular appearance of the skin surface on the thighs and gluteal regions, which affects 80-90% of women after puberty. No curative treatments are available, and there is a paucity of epidemiological studies related to its prevalence, quality of life impact, and risk factors. We aimed to identify the prevalence and factors associated with the development of GLD in Brazilian adolescent girls.

METHODS: A cross-sectional study examined adolescent girls from São Paulo, Brazil. The explored factors were grouped: familial history, gynecological and hormonal characteristics, exercise practice, nutrition and diet, anthropometric measures, body mass index, and body composition, according to GLD severity assessed through multivariate hierarchic statistics.

RESULTS: In total, 184 girls, aged from 12 to 18 years, were included in the study. The overall prevalence of GLD was 77.7% (CI 95% 71.7-82.1%); moderate and severe categories of GLD occurred in 56.5% (CI 95% 48.9-62.5%) of the sample. An impact on the quality of life was identified in 39.7% of the girls. GLD was independently associated with higher body mass index, early menarche, higher carbohydrate intake, lower water consumption, menstrual irregularity, familial report of GLD, and less exercise practice.

CONCLUSION: Gynoid lipodystrophy is a multifactorial disorder; its onset in adolescent girls is associated with familial occurrence, body composition, diet habits, exercise, and hormonal factors. These results support further interventions for GLD prevention and treatment.

PMID:35080006 | DOI:10.1111/ijd.16061

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Distance-based logistic model for cross-classified categorical data

Br J Math Stat Psychol. 2022 Jan 25. doi: 10.1111/bmsp.12264. Online ahead of print.

ABSTRACT

Logistic regression models are a powerful research tool for the analysis of cross-classified data in which a categorical response variable is involved. In a logistic model, the effect of a covariate refers to odds, and the simple relationship between the coefficients and the odds ratio often makes these the parameters of interest due to their easy interpretation. In this article we present a distance-based logistic model that allows a simple graphical interpretation of the association coefficients using the odds ratio in a contingency table. Two configurations are estimated, one for the rows and one for the columns, as the categories of a polytomous predictor and a nominal response variable respectively, such that the local odds ratio and the distances between the predictor and response categories are inversely related. The associations in terms of the odds ratios, or the ratios of the odds to their geometric means, are interpreted through distances for the most common coding schemes of the predictor variable, and the relationship between the distances related to different codings is investigated in its full dimension. The performance of the estimation procedure is analysed with a Monte Carlo experiment. The interpretation of the model and its performance, as well as its comparison with a two-step procedure involving first a logistic regression and then unfolding, is illustrated using real data sets.

PMID:35080009 | DOI:10.1111/bmsp.12264

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Photocatalytic removal of diazinon from aqueous solutions: a quantitative systematic review

Environ Sci Pollut Res Int. 2022 Jan 25. doi: 10.1007/s11356-022-18743-9. Online ahead of print.

ABSTRACT

Diazinon is a widely used pesticide that can be effectively degraded in aqueous solutions via photocatalytic oxidation. This quantitative systematic review was conducted to shed light on the various aspects of photocatalytic diazinon removal based on evidence. A systematic search was performed in Scopus, PubMed, Web of Science, Embase, and Ovid databases with keywords including diazinon, photocatalysis, and their equivalents. The search was limited to original articles in English published between January 1, 2010, and March 25, 2021. The results were expressed by descriptive statistics including mean, SD, median, and percentiles, among others. The initial electronic and manual search retrieved 777 articles, among which 41 studies comprising 49 trials were qualified for data synthesis. The reported diazinon degradation rate ranged from 2 to 100%, with a mean ± SD of 59.17 ± 28.03%. Besides, ZnO/UV, WO3/UV, TiO2/UV, and TiO2/Vis, in sequence, were the most widely used processes with the highest efficacies. Solution pH in the range of 5-8, catalyst dose below 600 mg/L, diazinon initial concentration below 40 mg/L, and contact time of 20-140 min could be the optimum conditions. Diazinon degradation obeyed the first-order kinetic model with kobs between 0.0042 and 1.86 min-1 and consumed energy of 38.93-350.36 kWh/m3. Diazoxon and IMP were the most detected by-products of diazinon degradation although bioassay data were scarce. Based on the results, photocatalytic processes are very efficient in removing diazinon from aqueous solutions although more elaborate studies are needed to assess the mineralization rate and effluent toxicity.

PMID:35079967 | DOI:10.1007/s11356-022-18743-9

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Evaluation of the Nurses’ Utilization of the Pain Management Information System Based on the Information System Success Model

Hu Li Za Zhi. 2022 Feb;69(1):63-72. doi: 10.6224/JN.202202_69(1).09.

ABSTRACT

BACKGROUND: Pain records provide important data to medical teams to guide their provision of pain management interventions. Incomplete records and records that do not integrate pain data will affect patient safety. Use of information technology helps facilitate communication within the medical team and improve quality of care.

PURPOSE: This study was designed to evaluate the effectiveness of a pain management information system.

METHODS: The questionnaire survey method was employed in this study. The system-evaluation questionnaire was designed based on the six dimensions of the information system success model (ISSM), including system quality, information quality, service quality, intention to use, user satisfaction, and net benefits. Three months after the pain management system was implemented, the opinions of 282 nurses from a medical center in central Taiwan were collected. Research data were analyzed using descriptive and inferential statistical methods.

RESULTS: Of the six dimensions, “information quality” received the highest average score (4.71). The two dimensions of “intention to use” and “user satisfaction” had the highest correlation with “net benefits”. “User satisfaction” was found to have the highest predictive power for the “net benefits” of the system, with an explanatory power of about 81.2%.

CONCLUSIONS: The pain management system considered in this study was shown to provide complete and accurate pain management information, which is an important factor affecting nurses’ intention to use and satisfaction. The evaluation results based on the ISSM show the pain management system to be a good information system that generates accurate information and has a high intention-to-use rate and high rate of user satisfaction.

PMID:35079999 | DOI:10.6224/JN.202202_69(1).09

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Awareness of environmental legislation as a deterrent for wildlife crime: A case with Masaai pastoralists, poison use and the Kenya Wildlife Act

Ambio. 2022 Jan 25. doi: 10.1007/s13280-021-01695-8. Online ahead of print.

ABSTRACT

Illegal wildlife crime is a global phenomenon, accelerating the ongoing biodiversity crisis. In the Old World, and particularly in Africa, illegal use of poisons to eliminate carnivores is the main driver of the continental vulture crisis. Knowledge about the underlying source and drivers of this threat is lacking for most areas, including Kenya, a global vulture and biodiversity hotspot. An extensive questionnaire survey of over 1300 respondents was run, using a specialized questioning technique and quantitative analytical approaches. Results show that, while pastoralists have a positive attitude towards vultures, over 20% of them use poisons to eliminate predators. Poisoning was largely driven by livestock losses to predators, and by negative attitude towards predators. Poisoning was less prevalent among respondents aware of the Kenya Wildlife Act. Overall, we suggest that a combination of top-down, e.g. legislation, and bottom-up (such as corrals or compensation) along with awareness campaigns may help reduce poisoning on the ground.

PMID:35079963 | DOI:10.1007/s13280-021-01695-8