Association between XRCC1 Arg399Gln polymorphism with prognosis of head and neck squamous cell carcinomas: A meta-analysis.

Objective: The X-ray repair cross complementing group 1 (XRCC1) gene is involved in DNA repair. Defects in DNA repair may lead to head and neck squamous cell carcinomas (HNSCCs). Several researches have focused on relationship between XRCC1 Arg399Gln genetic polymorphism with HNSCC's prognosis with conflicting results. So, the aim of the present meta-analysis was evaluation of relationship between XRCC1 Arg399Gln polymorphism with HNSCC's prognosis. Methods: Published articles up to July 2022 were systematically searched through international databases like PubMed, Web of Science, Scopus, etc. I2 test was applied to assess the heterogeneity. Data were analyzed using random effects model. Funnel plots and Egger test were applied for assessing publication biases. The hazard ratios (HRs) and 95 % confidence intervals (CIs) were calculated for evaluation of relationship between the polymorphism with HNSCC's prognosis. Results: Fifteen articles were included for the systematic review. Six of those articles were considered for inclusion in meta-analysis. The different forms of XRCC1 Arg399Gln polymorphism had not significant association with overall survival (OS) under varied genetic models (heterozygous: Ln (HR) = 0.02, 95 % CI= (-0.33,0.37), p-value = 0.90; homozygous: Ln (HR) = 0.33, 95 % CI= (-0.03,0.69), p-value = 0.07 and dominant: Ln (HR) = 0.06, 95 % CI = (-0.17,0.28), p-value = 0.62). Analysis showed that variants of the polymorphism had no significant relationship with OS in Asian and Caucasian ethnicity under dominant model (Ln (HR) = 0.14, 95 % CI= (-0.13,0.40), p-value = 0.31; Ln (HR) = -0.01, 95 % CI= (-0.41,0.38), p-value = 0.96). Conclusion: Different forms of XRCC1 Arg399Gln polymorphism had no significant relationship with HNSCC's prognosis under varied genetic models and based on different ethnicity.

Joint Modeling of Longitudinal Outcome and Competing Risks: Application to HIV/AIDS Data.

BACKGROUND: Tuberculosis (TB) and human immunodeficiency virus (HIV) are major public health challenges globally, and the number of TB infections and death caused by HIV are high because of HIV/ TB co-infection. On the other hand, CD4 count plays a significant role in TB/HIV co-infections. We used a joint model of longitudinal outcomes and competing risks to identify the potential risk factors and the effect of CD4 cells on TB infection and death caused by HIV in HIV-infected patients. STUDY DESIGN: This was a retrospective cohort study. METHODS: The current study was performed on 1436 HIV+patients referred to Behavioral Diseases Counseling Centers in Kermanshah Province during 1998-2019. In this study, joint modeling was used to identify the effect of potential risk factors and CD4 cells on TB and death caused by HIV. RESULTS: The results demonstrated that the decreasing CD4 cell count was significantly associated with an increased risk of death, while it had no significant relation with the risk of TB. In addition, patients with TB were at a higher risk of death. Based on the results, a significant relationship was found between CD4 count and sex, marital status, education level, antiretroviral therapy (ART), time, and the interaction between time and ART. Further, people infected with HIV through sexual relationships were at higher risk of TB, while those with a history of imprisonment who received ART or were infected with HIV through drug injection had a lower risk of TB. CONCLUSION: The findings revealed that the decreasing CD4 count had a significant association with an increased risk of death caused by HIV. However, it was not significantly related to the risk of TB. Finally, patients with TB were at higher risk of death caused by HIV.

The differences between normal and obese patient handling: re- structural analysis of two questionnaires.

BACKGROUND: Precise causes of musculoskeletal complaints among nurses are not known well, but many studies have pointed to manual patient handling tasks. Subjective judgment and decision-making process for patient lifting is crucial for gathering data regards patient handling. The aim of this study was to consider reliability and validity and re-structure of two special tools for patient handling's tasks. METHODS: In this cross- sectional study 249 nurses were fully participated. As recommended by literature for cultural adaptation of instruments, forward/backward translation method was applied. Reliability of the translated version was assessed by Cronbach's alpha coefficient. Validity testing for the two scales was based on content validity index/ratio analysis and also Exploratory Factor Analysis was run to extract latent factors. RESULTS: Reliability estimated by internal consistency reached a Cronbach's Alpha of above 0.7 for all subscales of two questionnaires. After testing the validity, the final version of questionnaires was remained by 14 and 15 questions respectively. CONCLUSIONS: These instruments evaluated for manual handling of normal and obese patients had acceptable validity and reliability in Iranian Nursing context. So, these tools can be used in further studies with the same cultures.

The XRCC1 Arg194Trp polymorphism was associated with the risk of head and neck squamous cell carcinoma development: Results from a systematic review and meta-analysis.

BACKGROUND: The X-ray repair cross complementing group 1 (XRCC1) is a DNA repair gene. Various studies have examined the association between XRCC1 Arg194Trp polymorphism and head and neck squamous cell carcinoma (HNSCC) susceptibility with contradictory results. So, this systematic review and meta-analysis aimed to assess whether variants of this polymorphism increase the HNSCC risk or not. RECENT FINDINGS: Thirty three studies consisting of 14282 subjects (6012 cases and 8270 controls) were included in this meta-analysis. Variants of XRCC1 Arg194Trp polymorphism were associated with increased HNSCC risk and the associations were significant based on heterozygous and dominant models (heterozygous model: OR = 1.182, 95%CI = 1.015-1.377, P = 0.032; homozygous model: OR = 1.274, 95%CI = 0.940-1.727, P = 0.119; dominant model: OR = 1.194, 95%CI = 1.027-1.388, P = 0.021; recessive model: OR = 1.181, 95%CI = 0.885-1.576, P = 0.119). There were significant associations between variants of this polymorphism and HNSCC risk based on Asian ethnicity under dominant model, hospital control source under different genetic models, PCR-RFLP genotyping method under dominant model and oral cavity tumor site under heterozygous and dominant models. OBJECTIVE: The X-ray repair cross complementing group 1 (XRCC1) is a DNA repair gene. Various studies have examined the association between XRCC1 Arg194Trp polymorphism and head and neck squamous cell carcinoma (HNSCC) susceptibility with contradictory results. So, this systematic review and meta-analysis aimed to assess whether variants of this polymorphism increase the HNSCC risk or not. METHODS: A systematic search of the literatures published till April 2022 was conducted using Google Scholar, Scopus, PubMed, Web of Science, Cochrane Library and Embase databases. The heterogeneity was assessed with the I-Square statistic. A random effects model or fixed effects model was used to analyze the data. Data were reported by odds ratio (OR) and 95% confidence interval (CI). The p value was considered significant if p < .05. RESULTS: Thirty three studies consisting of 14 282 subjects (6012 cases and 8270 controls) were included in this meta-analysis. Variants of XRCC1 Arg194Trp polymorphism were associated with increased HNSCC risk and the associations were significant based on heterozygous and dominant models (heterozygous model: OR = 1.182, 95%CI = 1.015-1.377, p = .032; homozygous model: OR = 1.274, 95%CI = 0.940-1.727, p = .119; dominant model: OR = 1.194, 95%CI = 1.027-1.388, p = .021; recessive model: OR = 1.181, 95%CI = 0.885-1.576, p = .119). There were significant associations between variants of this polymorphism and HNSCC risk based on Asian ethnicity under dominant model, hospital control source under different genetic models, PCR-RFLP genotyping method under dominant model and oral cavity tumor site under heterozygous and dominant models. CONCLUSION: Variants of XRCC1 Arg194Trp polymorphism were significantly associated with increased risk of HNSCC development based on heterozygous and dominant genetic models.

Prediction the survival of patients with breast cancer using random survival forests for competing risks.

Objectives: Breast cancer (BC) is the most common cause of cancer death in Iranian women. Sometimes death from other causes precludes the event of interest and makes the analysis complicated. The purpose of this study was to identify important prognostic factors associated with survival duration among patients with BC using random survival forests (RSF) model in presence of competing risks. Also, its performance was compared with cause-specific hazard model. Methods: This retrospective cohort study assessed 222 patients with BC who were admitted to Ayatollah Khansari hospital in Arak, a major industrial city and the capital of Markazi province in Iran. The cause-specific Cox proportional hazards and RSF models were employed to determine the important risk factors for survival of the patients. Results: The mean and median survival duration of the patients were 90.71 (95%CI: 83.8-97.6) and 100.73 (95%CI: 89.2-121.5) months, respectively. The cause-specific model indicated that type of surgery and HER2 had statistically significant effects on the risk of death of BC. Moreover, the RSF model identified that HER2 was the most important variable for the event of interest. Conclusion: According to the results of this study, the performance of the RSF model was better than the cause-specific hazard model. Moreover, HER2 was the most important variable for death of BC in both of the models.

Investigating factors affecting the interval between a burn and the start of treatment using data mining methods and logistic regression.

BACKGROUND: Burn is a tragic event for an individual, the family, and community. It can cause irreparable physical, mental, economic, and social injury. Researches well documented that a quick visit to a healthcare center can greatly reduce burn injuries. Therefore, the aim of this study is to identify the effective factors in the interval between a burn and start of treatment in burn patients by comparing three classification data mining methods and logistic regression. METHODS: This cross-sectional study conducted on 389 hospitalized patients in Imam Khomeini Hospital of Kermanshah city since 2012 to 2015. The data collection instrument was a three-part questionnaire, including demographic information, geographical information, and burn information. Four classification methods (decision tree (DT), random forest (RF), support vector machine (SVM) and logistic regression (LR)) were used to identify the effective factors in the interval between burn and start of treatment (less than two hours and equal or more than two hours). RESULTS: The mean total accuracy of all models is higher than 0.8. The DT model has the highest mean total accuracy (0.87), sensitivity (0.44), positive likelihood ratio (14.58), negative predictive value (0.89) and positive predictive value (0.71). However, the specificity of the SVM model and RF model (0.99) was higher than other models, and the mean negative likelihood ratio (0.98) of the SVM model are higher than other models. CONCLUSIONS: The results of this study shows that DT model performed better that data mining models in terms of total accuracy, sensitivity, positive likelihood ratio, negative predictive value and positive predictive value. Therefore, this method is a promising classifier for investigating the factors affecting the interval between a burn and the start of treatment in burn patients. Also, key factors based on DT model were location of transfer to hospital, place of occurrence, time of accident, religion, history and degree of burn, income, province of residence, burnt limbs and education.

Application of data mining techniques and logistic regression to model drug use transition to injection: a case study in drug use treatment centers in Kermanshah Province, Iran.

BACKGROUND: Drug injection has been increasing over the past decades all over the world. Hepatitis B and C viruses (HBV and HCV) are two common infections among people who inject drugs (PWID) and more than 60% of new human immunodeficiency virus (HIV) cases are PWID. Thus, investigating risk factors associated with drug use transition to injection is essential and was the aim of this research. METHODS: We used a database from drug use treatment centers in Kermanshah Province (Iran) in 2013 that included 2098 records of people who use drugs (PWUD). The information of 29 potential risk factors that are commonly used in the literature on drug use was selected. We employed four classification methods (decision tree, neural network, support vector machine, and logistic regression) to determine factors affecting the decision of PWUD to transition to injection. RESULTS: The average specificity of all models was over 84%. Support vector machine produced the highest specificity (0.9). Also, this model showed the highest total accuracy (0.91), sensitivity (0.94), positive likelihood ratio [1] and Kappa (0.94) and the smallest negative likelihood ratio (0). Therefore, important factors according to the support vector machine model were used for further interpretation. CONCLUSIONS: Based on the support vector machine model, the use of heroin, cocaine, and hallucinogens were identified as the three most important factors associated with drug use transition injection. The results further indicated that PWUD with the history of prison or using drug due to curiosity and unemployment are at higher risks. Unemployment and unreliable sources of income were other suggested factors of transition in this research.

Detecting and Accommodating Outliers in Meta-Analysis for Evaluating Effect of Albendazole on Ascaris lumbricoides Infection.

BACKGROUND: Meta-analysis is a statistical technique in which the results of two or more independent studies, with similar objectives, are mathematically combined in order to improve the reliability of the results. The outliers, which may exist even in random models, can affect the validity and strength of meta-analysis results. OBJECTIVES: The current study uses "random effects variance shift model" to evaluate and correct the outliers in performing a meta-analysis study of the effect of albendazole in treating patients with Ascaris lumbricoides infection. PATIENTS AND METHODS: The study used data from 14 clinical trials; each article was composed of two groups, a treatment group and a placebo group. These articles compared the effect of single dose intakes of 400 mg albendazole in treating two groups of patients with Ascaris lumbricoides infection. The articles were published in a number of internationally indexed journals between 1983 to 2013. For both groups in each article, the total number of participants, the number of those with Ascaris lumbricoides infection, and the number of those recovered following the intake of albendazole were identified and recorded. The relative risk (RR) and variance were computed for each article individually. Then, using meta-analysis, the RR was computed for all the articles together. In order to detect outliers the "random effects variance shift model" and "likelihood ratio test" (LRT) were used. Adopting the bootstrap method, the accuracy rates for sampling distribution of the tests, which were used for multiple testing, were obtained and the relevant graphs were depicted. For data analysis, STATA and R software were used. RESULTS: According to meta-analysis results, the estimate for RR was 2.91, with a 95% confidence interval of 2.6 to 3.25. According to the method used in this study, three articles (articles number 4, 7, and 12) were outliers and, as such, they were detected in the graphs. CONCLUSIONS: We can detect and accommodate outliers in meta-analysis by using random effects variance shift model and likelihood ratio test.