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Nevin Manimala Statistics

Inequities in Indirect Cost Rates Between Historically Black Colleges and Universities and Other Institutions

Acad Med. 2024 Mar 25. doi: 10.1097/ACM.0000000000005717. Online ahead of print.

ABSTRACT

PURPOSE: Federal research grants provide support for the indirect costs (IDCs) of research infrastructure that are not specific to particular research projects but are nonetheless essential to enable research. Institutions independently negotiate IDC rates. The authors sought to identify whether inequities exist in negotiated IDC rates between historically Black colleges and universities (HBCUs) and other universities (non-HBCUs).

METHOD: In 2023, the authors analyzed mean negotiated IDC rates between the top 20 HBCUs (in fiscal year [FY] 2021 research expenditures) and 3 non-HBCU comparison groups: the top 40 non-HBCUs in FY 2021 research expenditures, metropolitan statistical area (MSA)-matched non-HBCUs (among the top 200 institutions by FY 2021 research expenditures), and FY 2021 research expenditure-matched non-HBCUs.

RESULTS: The authors found that the top 20 HBCUs’ mean IDC rates (50.0%) were, after adjustment, 8.5 percentage points (95% confidence interval [CI] 5.7, 11.2) lower than those of the top 40 non-HBCUs (58.5%). The mean IDC rates of top HBCUs (n = 14, 48.4%) were, after adjustment, 6.3 percentage points (95% CI 3.1, 9.4) lower than those of MSA-matched non-HBCUs (n = 23, 55.3%). There was no statistically significant difference in the mean IDC rates between the top 20 HBCUs (50.0%) and expenditure-matched non-HBCUs (n = 31; 48.2%).

CONCLUSIONS: Inequities in negotiated IDC rates between top HBCUs and non-HBCUs likely both reflect and may contribute to the persistence of institution-level inequities in federally funded research. Proactive investments in HBCUs’ research infrastructures are likely needed to ameliorate these funding inequities and support the role of HBCUs in providing opportunity for underrepresented groups in biomedical sciences.

PMID:38526962 | DOI:10.1097/ACM.0000000000005717

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Nevin Manimala Statistics

Informal Family Care Partner Well-Being Is Diminished in End-Stage Liver Disease

Nurs Res. 2024 Mar 25. doi: 10.1097/NNR.0000000000000740. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic liver disease is a significant global neglected public health problem. End-stage liver disease is associated with substantial symptom complexity, disability, and care needs that require assistance from informal family care partners. Research on these care partners’ caregiver burden or strain, symptoms, and quality of life is sparse and has not focused on these variables as co-occurring or in the context of the quality of the relationship care partners have with the patients.

OBJECTIVES: The purpose of this study was to provide a collective presentation of patterns and determinants of well-being as measured by caregiver strain, depression, sleep, and quality of life in a cohort of informal family care partners for adult outpatients with end-stage liver disease.

METHODS: Care partners (age > 18 years) were recruited from two liver clinics within two tertiary health care systems and invited to complete a cross-sectional survey. They completed the Multidimensional Caregiver Strain Index, Patient Health Questionnaire, Pittsburgh Sleep Quality Index, Short Form Health Survey, and Mutuality Scale. Descriptive statistics and latent class mixture modeling were used to analyze these data.

RESULTS: The sample was predominantly female and White. The well-being of care partners was diminished. Three distinct classes of well-being were identified: mildly diminished (53.2%), moderately diminished (39.0%), and severely diminished (7.8%). Those at greater risk of worse well-being were younger, spouses, and had poorer relationship quality with the patients.

DISCUSSION: To improve the well-being of care partners in moderately and severely diminished classes, assessing and addressing caregiver strain and co-occurring symptoms is essential. Addressing this strain and symptoms has the potential to maintain or optimize care partners’ ability to provide care to patients. Future researchers should include longitudinal and dyadic studies to examine how patients’ disease progression and symptoms may affect family care partners well-being and vice versa.

PMID:38526959 | DOI:10.1097/NNR.0000000000000740

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Nevin Manimala Statistics

Corpus callosum and cerebellum participate in semantic dysfunction of Parkinson’s disease: a diffusion tensor imaging-based cross-sectional study

Neuroreport. 2024 Mar 11. doi: 10.1097/WNR.0000000000002015. Online ahead of print.

ABSTRACT

Language dysfunction is common in Parkinson’s disease (PD) patients, among which, the decline of semantic fluency is usually observed. This study aims to explore the relationship between white matter (WM) alterations and semantic fluency changes in PD patients. 127 PD patients from the Parkinson’s Progression Markers Initiative cohort who received diffusion tensor imaging scanning, clinical assessment and semantic fluency test (SFT) were included. Tract-based special statistics, automated fiber quantification, graph-theoretical and network-based analyses were performed to analyze the correlation between WM structural changes, brain network features and semantic fluency in PD patients. Fractional anisotropy of corpus callosum, anterior thalamic radiation, inferior front-occipital fasciculus, and uncinate fasciculus, were positively correlated with SFT scores, while a negative correlation was identified between radial diffusion of the corpus callosum, inferior longitudinal fasciculus, and SFT scores. Automatic fiber quantification identified similar alterations with more details in these WM tracts. Brain network analysis positively correlated SFT scores with nodal efficiency of cerebellar lobule VIII, and nodal local efficiency of cerebellar lobule X. WM integrity and myelin integrity in the corpus callosum and several other language-related WM tracts may influence the semantic function in PD patients. Damage to the cerebellum lobule VIII and lobule X may also be involved in semantic dysfunction in PD patients.

PMID:38526949 | DOI:10.1097/WNR.0000000000002015

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Nevin Manimala Statistics

DNA methylation markers for risk of metastasis in a cohort of men with localized prostate cancer

Epigenetics. 2024 Dec;19(1):2308920. doi: 10.1080/15592294.2024.2308920. Epub 2024 Mar 25.

ABSTRACT

Accurately identifying life-threatening prostate cancer (PCa) at time of diagnosis remains an unsolved problem. We evaluated whether DNA methylation status of selected candidate genes can predict the risk of metastasis beyond clinical risk factors in men with untreated PCa. A nested case-control study was conducted among men diagnosed with localized PCa at Kaiser Permanente California between 01/01/1997-12/31/2006 who did not receive curative treatments. Cases were those who developed metastasis within 10 years from diagnosis. Controls were selected using density sampling. Ninety-eight candidate genes were selected from functional categories of cell cycle control, metastasis/tumour suppressors, cell signalling, cell adhesion/motility/invasion, angiogenesis, and immune function, and 41 from pluripotency genes. Cancer DNA from diagnostic biopsy blocks were extracted and analysed. Associations of methylation status were assessed using CpG site level and principal components-based analysis in conditional logistic regressions. In 215 cases and 404 controls, 27 candidate genes were found to be statistically significant in at least one of the two analytical approaches. The agreement between the methods was 25.9% (7 candidate genes, including 2 pluripotency markers). The DNA methylation status of several candidate genes was significantly associated with risk of metastasis in untreated localized PCa patients. These findings may inform future risk prediction models for PCa metastasis beyond clinical characteristics.

PMID:38525786 | DOI:10.1080/15592294.2024.2308920

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Nevin Manimala Statistics

A One Health Platform for Future Epidemic Preparedness

Infect Dis Rep. 2024 Mar 20;16(2):281-288. doi: 10.3390/idr16020023.

ABSTRACT

Here, we introduce the EpiConnect Intelligence Platform (ECIP), a platform facilitating rapid, transparent data sharing and analysis to support researchers and public health officials in Europe, with a focus on Italy. ECIP provides reliable, concise, machine-readable data to aid in epidemiological understanding, standardize case characteristics, and estimate key parameters. The platform adheres to FAIR (findable, accessible, interoperable, reusable) principles, offering easily accessible and downloadable datasets for researchers’ endeavors. Future enhancements include involving national public health authorities, expanding data streams, and fostering collaboration between experts and users for improved epidemic risk monitoring. Shared standards among diverse surveillance systems are advocated to achieve common strategic goals, emphasizing the need for forward-looking policies to empower professionals to analyze disease dynamics in the context of evolving health crises. The recent emergencies underscore the importance of collective efforts towards shared strategic goals, highlighting the necessity for coordinated action to address mutual concerns affecting everyone’s lives.

PMID:38525770 | DOI:10.3390/idr16020023

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Nevin Manimala Statistics

Pulmonary Involvement in Recurrent Respiratory Papillomatosis: A Systematic Review

Infect Dis Rep. 2024 Feb 28;16(2):200-215. doi: 10.3390/idr16020016.

ABSTRACT

Recurrent respiratory papillomatosis (RRP) is a non-malignant disease, characterized by the production of wart-like growths in the respiratory tract, affecting both young people and adults (juvenile-onset recurrent respiratory papillomatosis, JORRP, and adult-onset recurrent respiratory papillomatosis, AORRP, respectively). Infection caused by human papillomavirus (HPV) is known as the main factor involved in RRP development. Complications of RRP may rarely occur, including lung involvement and malignant transformation. The present systematic review aimed to evaluate the prevalence of severe complications, such as lung involvement and lung tumor in JORRP and AORRP patients, and assess the role of HPV genotypes in the progression of disease severity following the guideline for reporting systematic reviews and meta-analysis (PRISMA Statement). A total of 378 studies were found on PubMed and Scopus using the following MESH terms: “recurrent respiratory papillomatosis and lung tumor” and “pulmonary tumor and recurrent respiratory papillomatosis”. Basing on inclusion and exclusion criteria, a total of 11 studies were included in the systematic review. We found a pooled prevalence of 8% (95% CI: 4-14%; I2: 87.5%) for lung involvement in RRP patients. In addition, we found a pooled risk difference of 5% in lung involvement between JORRP and AORRP (95% CI: -7-18%; I2: 85.6%, p-value: 0.41). Among patients with lung involvement, we observed a pooled prevalence of lung tumor of 4% (95% CI:1-7%; I2: 67.1%) and a pooled prevalence mortality for this group of 4% (95% CI:2-6%; I2: 0%). Overall, the positivity rate for HPV-6 and -11 in patients with RRP was 91%. Considering only cases with pulmonary involvement, the pooled prevalence for HPV-11 was 21% (95% CI: 5-45%; I2: 77.2%). Our results evidenced a low/middle risk of pulmonary involvement and lung tumor in JORRP and AORRP patients, with an increased risk for HPV-11-positive patients. Further studies should be performed to improve knowledge and adopt preventive measures to contrast the progression to severe diseases in RRP patients.

PMID:38525763 | DOI:10.3390/idr16020016

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Nevin Manimala Statistics

Dietary Adherence and Cognitive Performance in Older Adults by Nativity Status: Results from the National Health and Nutrition Examination Survey (NHANES), 2011-2014

Geriatrics (Basel). 2024 Feb 25;9(2):25. doi: 10.3390/geriatrics9020025.

ABSTRACT

Although adherence to dietary guidelines is associated with better cognitive performance, there may be differences by nativity status. This study aimed to investigate the association between adherence to the healthy eating index (HEI) and cognitive performance (CP) among United States (US)-born and foreign-born older adults (60+ years). Data were obtained from the 2011-2014 NHANES (n = 3065). Dietary adherence was assessed with HEI quintiles. CP (adequate vs. low) was examined using word listing (CERAD), animal naming (AFT), and the digit symbol substitution test (DSST). Weighted multivariable logistic regressions were used to examine associations. The US-born participants in higher dietary quintiles had adequate CP when compared to foreign-born participants. In adjusted models, the US-born participants in the highest HEI quintile had increased odds of adequate DSST scores (odds ratio: 1.95, 95% confidence interval: 1.15-3.28) compared with those in the lowest quintile. Patterns of association were generally reversed for foreign-born participants and were non-statistically significant. Future research should consider the influence of diets in delaying or preventing decline in cognition and evaluate nutritional factors that contribute to cognitive outcomes for the foreign-born population.

PMID:38525742 | DOI:10.3390/geriatrics9020025

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Nevin Manimala Statistics

Epigenetic Features in Newborns Associated with Preadolescence Lung Function and Asthma Acquisition during Adolescence

Epigenomes. 2024 Mar 22;8(2):12. doi: 10.3390/epigenomes8020012.

ABSTRACT

The association between newborn DNA methylation (DNAm) and asthma acquisition (AA) during adolescence has been suggested. Lung function (LF) has been shown to be associated with asthma risk and its severity. However, the role of LF in the associations between DNAm and AA is unclear, and it is also unknown whether the association between DNAm and AA is consistent with that between DNAm and LF. We address this question through assessing newborn epigenetic features of preadolescence LF and of AA during adolescence, along with their biological pathways and processes. Our study’s primary medical significance lies in advancing the understanding of asthma’s early life origins. By investigating epigenetic markers in newborns and their association with lung function in preadolescence, we aim to uncover potential early biomarkers of asthma risk. This could facilitate earlier detection and intervention strategies. Additionally, exploring biological pathways linking early lung function to later asthma development can offer insights into the disease’s pathogenesis, potentially leading to novel therapeutic targets.

METHODS: The study was based on the Isle of Wight Birth cohort (IOWBC). Female subjects with DNAm data at birth and with no asthma at age 10 years were included (n = 249). The R package ttScreening was applied to identify CpGs potentially associated with AA from 10 to 18 years and with LF at age 10 (FEV1, FVC, and FEV1/FVC), respectively. Agreement in identified CpGs between AA and LF was examined, along with their biological pathways and processes via the R function gometh. We tested the findings in an independent cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC), to examine overall replicability.

RESULTS: In IOWBC, 292 CpGs were detected with DNAm associated with AA and 1517 unique CpGs for LF (514 for FEV1, 436 for FVC, 408 for FEV1/FVC), with one overlapping CpG, cg23642632 (NCKAP1) between AA and LF. Among the IOWBC-identified CpGs, we further tested in ALSPAC and observed the highest agreement between the two cohorts in FVC with respect to the direction of association and statistical significance. Epigenetic enrichment analyses indicated non-specific connections in the biological pathways and processes between AA and LF.

CONCLUSIONS: The present study suggests that FEV1, FVC, and FEV1/FVC (as objective measures of LF) and AA (incidence of asthma) are likely to have their own specific epigenetic features and biological pathways at birth. More replications are desirable to fully understand the complexity between DNAm, lung function, and asthma acquisition.

PMID:38525738 | DOI:10.3390/epigenomes8020012

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Nevin Manimala Statistics

Leveraging Large Data, Statistics, and Machine Learning to Predict the Emergence of Resistant E. coli Infections

Pharmacy (Basel). 2024 Mar 22;12(2):53. doi: 10.3390/pharmacy12020053.

ABSTRACT

Drug-resistant Gram-negative bacterial infections, on average, increase the length of stay (LOS) in U.S. hospitals by 5 days, translating to approximately $15,000 per patient. We used statistical and machine-learning models to explore the relationship between antibiotic usage and antibiotic resistance over time and to predict the clinical and financial costs associated with resistant E. coli infections. We acquired data on antibiotic utilization and the resistance/sensitivity of 4776 microbial cultures at a Kaiser Permanente facility from April 2013 to December 2019. The ARIMA (autoregressive integrated moving average), neural networks, and random forest time series algorithms were employed to model antibiotic resistance trends. The models’ performance was evaluated using mean absolute error (MAE) and root mean squared error (RMSE). The best performing model was then used to predict antibiotic resistance rates for the year 2020. The ARIMA model with cefazolin, followed by the one with cephalexin, provided the lowest RMSE and MAE values without signs of overfitting across training and test datasets. The study showed that reducing cefazolin usage could decrease the rate of resistant E. coli infections. Although piperacillin/tazobactam did not perform as well as cefazolin in our time series models, it performed reasonably well and, due to its broad spectrum, might be a practical target for interventions in antimicrobial stewardship programs (ASPs), at least for this particular facility. While a more generalized model could be developed with data from multiple facilities, this study acts as a framework for ASP clinicians to adopt statistical and machine-learning approaches, using region-specific data to make effective interventions.

PMID:38525733 | DOI:10.3390/pharmacy12020053

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Nevin Manimala Statistics

Polypharmacy Is Associated with Sociodemographic Factors and Socioeconomic Status in United States Adults

Pharmacy (Basel). 2024 Mar 12;12(2):49. doi: 10.3390/pharmacy12020049.

ABSTRACT

A thorough understanding of polypharmacy is required to create public health initiatives that minimize the potential for adverse outcomes. This study aimed to investigate the relationship between sociodemographic factors, socioeconomic status (SES), and polypharmacy risk in United States (US) individuals between 1999-2000 and 2017-2018. The cross-sectional National Health and Nutrition Examination Survey dataset covered ten cycles between 1999-2000 and 2017-2018. All individuals aged ≥18 years were included. The simultaneous use of at least five medications by one person is known as polypharmacy. Multivariable logistic regression showed that there was a statistically significant association between polypharmacy sociodemographic factors (such as age between 45 and 64 (odds ratio [OR] = 3.76; 95% confidence interval [CI] = 3.60-3.92; p < 0.0001) and age of 65 years or above (OR = 3.96; 95% CI = 3.79-4.13; p < 0.0001), especially women (OR = 1.09; 95% CI = 1.06-1.13; p < 0.0001), non-Hispanic blacks (OR = 1.66; 95% CI = 1.51-1.83; p < 0.0001), and veterans (OR = 1.27; 95% CI = 1.22-1.31; p < 0.0001)) and SES (such as being married (OR = 1.14; 95% CI = 1.08-1.19; p = 0.031), widowed, divorced, or separated (OR = 1.21; 95% CI = 1.15-1.26; p < 0.0001), a college graduate or above (OR = 1.21, 95% CI = 1.15-1.27, p < 0.0001), and earning > USD 55,000 per year (OR = 1.86; 95% CI = 1.79-1.93; p < 0.0001)). Individuals aged 45 years and above, women, and non-Hispanic blacks with higher educational levels and yearly incomes were more likely to experience polypharmacy in the US between 1999-2000 and 2017-2018.

PMID:38525729 | DOI:10.3390/pharmacy12020049