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Nevin Manimala Statistics

Association of urinary or blood heavy metals and mortality from all causes, cardiovascular disease, and cancer in the general population: a systematic review and meta-analysis of cohort studies

Environ Sci Pollut Res Int. 2022 Aug 2. doi: 10.1007/s11356-022-22353-w. Online ahead of print.

ABSTRACT

Amounting epidemiological evidence has shown detrimental effects of heavy metals on a wide range of diseases. However, the effect of heavy metal exposure on mortality in the general population remains unclear. The primary objective of this study was to clarify the associations between heavy metals and mortality from all causes, cardiovascular disease (CVD), and cancer based on prospective studies. We comprehensively searched Pubmed, Embase, and Web of Science electronic databases to identify studies published from their inception until 1 March 2022. Investigators identified inclusion criteria, extracted study characteristics, and assessed the methodological quality of included studies according to standardized guidelines. Meta-analysis was conducted if the effect estimates of the same outcome were reported in at least three studies. Finally, 42 original studies were identified. The results of meta-analysis showed that cadmium and lead exposure was significantly associated with mortality from all causes, CVD, and cancer in the general population. Moderate evidence suggested there was a link between arsenic exposure and mortality. The adverse effects of mercury and other heavy metals on mortality were inconclusive. Epidemiological evidence for the joint effect of heavy metal exposure on mortality was still indeterminate. In summary, our study provided compelling evidence that exposure to cadmium, lead, and arsenic were associated with mortality from all causes, CVD, and cancer, while the evidence on other heavy metals, for example mercury, was insignificant or indeterminate. Nevertheless, further prospective studies are warranted to explore the joint effects of multiple metal exposure on mortality.

PMID:35917074 | DOI:10.1007/s11356-022-22353-w

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Nevin Manimala Statistics

Racial/Ethnic Differences in Psychometric Properties of Alcohol-Related Behaviors in the USA

J Racial Ethn Health Disparities. 2022 Aug 2. doi: 10.1007/s40615-022-01379-3. Online ahead of print.

ABSTRACT

OBJECTIVE: Alcohol-related behaviors are often examined using surveys assessing participants’ self-report of attitudes/actions. However, racial/ethnic differences exist in scale construction and evaluation, and surveys evaluating alcohol behaviors lack invariance across ethnic groups. These dissimilarities may be due to deep-rooted differences in ethnic classification of unhealthy substance use behaviors.

METHODS: We examined factor structure of “Number of days per month drank alcohol in past 12 months,” “Number of days had one or more drinks in past 30 days,” and “Number of days had four/five or more drinks in past 30 days,” administered during the 2017 National Survey on Drug Use and Health. Factorial invariance was examined across 12- to 17-year-old White, Black/African American, Asian American, and Hispanic/Latinx boys and girls endorsing alcohol use. A multigroup confirmatory factor analysis statistically determined whether the factor structure was invariant across groups.

RESULTS: The alcohol scale lacked invariance across all groups, indicating racial/ethnic group identification is related to alcohol-related cognitions.

CONCLUSIONS: Psychometric properties of scales assessing alcohol-related behaviors generalized across racial/ethnic groups require evaluation.

PMID:35917062 | DOI:10.1007/s40615-022-01379-3

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Nevin Manimala Statistics

Adjusting Overall Survival Estimates of Macitentan in Pulmonary Arterial Hypertension After Treatment Switching: Results from the SERAPHIN Study

Adv Ther. 2022 Aug 1. doi: 10.1007/s12325-022-02253-8. Online ahead of print.

ABSTRACT

INTRODUCTION: Evaluating overall survival in randomized controlled trials (RCTs) can often be confounded by bias introduced by treatment switching. SERAPHIN was a large RCT that evaluated the effects of long-term treatment with the endothelin receptor antagonist macitentan in patients with pulmonary arterial hypertension. In an intent-to-treat (ITT) analysis, a non-significant decrease in the risk of all-cause mortality up to study closure was reported with macitentan 10 mg versus placebo. As patients could switch treatment when experiencing symptoms of disease progression, this analysis attempts to adjust for the confounding effects on overall survival.

METHODS: The inverse probability of censoring weighted (IPCW) and rank-preserving structural failure time (RPSFT) models were used to estimate the treatment effect on overall mortality had there been no treatment switching in SERAPHIN. Time to all-cause death was evaluated up to study closure. Treatment switching was defined as patients in the placebo group switching to open-label macitentan 10 mg, and patients in the macitentan 10 mg group prematurely discontinuing macitentan.

RESULTS: By study closure, 73.2% (183/250) of patients in the placebo group had switched to macitentan 10 mg. Among these patients, exposure time to macitentan 10 mg represented 28.2% of total study treatment exposure (cumulative exposure 134.6 patient-years). At study closure, 24.8% (60/242) of patients in the macitentan 10 mg group were not receiving open-label macitentan; mean time not receiving macitentan was 44.3 weeks. The adjusted hazard ratios (HR) for overall survival using the IPCW and RPSFT methods were lower (HR 0.42, 95% confidence interval [CI] 0.22, 0.81; p = 0.009, and HR 0.33, 95% CI 0.04, 2.83, respectively) than the ITT unadjusted HR (0.80, 95% CI 0.51, 1.24).

CONCLUSION: These results from the current analyses indicate that in SERAPHIN, the standard ITT analysis was confounded by treatment switching resulting in an underestimation of the benefit of macitentan 10 mg on overall survival. By adjusting for switching, the IPCW and RPSFT models estimated a 58% and 67% reduction in risk of mortality, respectively, with macitentan 10 mg versus placebo.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00660179.

PMID:35917059 | DOI:10.1007/s12325-022-02253-8

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Nevin Manimala Statistics

The impact of continuous wireless monitoring on adverse device effects in medical and surgical wards: a review of current evidence

J Clin Monit Comput. 2022 Aug 2. doi: 10.1007/s10877-022-00899-x. Online ahead of print.

ABSTRACT

Novel technologies allow continuous wireless monitoring systems (CWMS) to measure vital signs and these systems might be favorable compared to intermittent monitoring regarding improving outcomes. However, device safety needs to be validated because uncertain evidence challenges the clinical implementation of CWMS. This review investigates the frequency of device-related adverse events in patients monitored with CWMS in general hospital wards. Systematic literature searches were conducted in PubMed and Embase. We included trials of adult patients in general hospital wards monitored with CWMS. Our primary outcome was the frequency of unanticipated serious adverse device effects (USADEs). Secondary outcomes were adverse device effects (ADEs) and serious adverse device effects (SADE). Data were extracted from eligible studies and descriptive statistics were applied to analyze the data. Seven studies were eligible for inclusion with a total of 1485 patients monitored by CWMS. Of these patients, 54 patients experienced ADEs (3.6%, 95% CI 2.8-4.7%) and no USADEs or SADEs were reported (0%, 95% CI 0-0.31%). The studies of the SensiumVitals® patch, the iThermonitor, and the ViSi Mobile® device reported 28 (9%), 25 (5%), and 1 (3%) ADEs, respectively. No ADEs were reported using the HealthPatch, WARD 24/7 system, or Coviden Alarm Management. Current evidence suggests that CWMS are safe to use but systematic reporting of all adverse device effects is warranted.

PMID:35917046 | DOI:10.1007/s10877-022-00899-x

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Nevin Manimala Statistics

Developing and Validating Risk Algorithm for Hypertension in South Africa: Results from a Nationally Representative Cohort (2008-2017)

High Blood Press Cardiovasc Prev. 2022 Aug 2. doi: 10.1007/s40292-022-00534-5. Online ahead of print.

ABSTRACT

INTRODUCTION: There is compelling evidence of significant country-level disparities where African countries, particularly South Africa, have the highest hypertension rates in the world.

AIM: To develop and validate a simple risk scoring algorithm for hypertension in a large cohort (80,270) of South African men and women.

METHODS: Multivariable logistic regression models were used to build our hypertension risk scoring algorithm and validated externally and internally using the standard statistical techniques. We also compared our risk scores with the results from the Framingham risk prediction model for hypertension.

RESULTS: Six factors were identified as the significant correlates of hypertension: age, education, obesity, smoking, alcohol intake and exercise. A score of ≥ 25 (out of 57) for men and ≥ 35 (out of 75) for women were selected as the optimum cut-points with 82% (43%) and 83% (49%) sensitivity (specificity) for males and females, respectively in the development datasets. We estimated probabilities of developing hypertension using the Framingham risk prediction model, which were higher among those with higher scores for hypertension.

CONCLUSIONS: Identifying, targeting and prioritising individuals at highest risk of hypertension will have significant impact on preventing severe cardiometabolic diseases by scaling up healthy diet and life-style factors. Our six-item risk scoring algorithm may be included as part of hypertension prevention and treatment programs by targeting older individuals with high body fat measurements who are at highest risk of developing hypertension.

PMID:35917033 | DOI:10.1007/s40292-022-00534-5

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Nevin Manimala Statistics

Cross-Informant Compatibility of Depression Symptoms in Children: A Network Approach

Child Psychiatry Hum Dev. 2022 Aug 2. doi: 10.1007/s10578-022-01403-x. Online ahead of print.

ABSTRACT

Utilizing multiple informants to assess children’s depressive symptoms increases diagnostic accuracy, reliability, and validity of inferences. However, previous studies have found low to moderate agreement among informants. We applied network statistics to gain insight into children and their mothers’ differential perceptions of depressive symptoms. The sample included children and mother dyads (n = 185) who applied to psychotherapy services at an outpatient university clinic. Mothers filled out the Child Behavior Checklist, which includes a depression subscale, and children filled out the Children’s Depression Inventory. We computed association networks for thirteen depressive symptoms separately for children and mothers using the graphical LASSO. Sadness had the highest strength centrality in the networks of both children and mothers, but the pattern of connectivity and centrality of other symptoms differed. We discussed our findings within the framework of network theory.

PMID:35916982 | DOI:10.1007/s10578-022-01403-x

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Nevin Manimala Statistics

Gender disparities in incidence and projections of lung cancer in China and the United States from 1978 to 2032: an age-period-cohort analysis

Cancer Causes Control. 2022 Aug 2. doi: 10.1007/s10552-022-01597-4. Online ahead of print.

ABSTRACT

PURPOSE: Lung cancer incidences tend to be higher among males than females in both China and the United States, yet secular incidence patterns are different due to distinct population and environmental exposures. We examined long-term and future trends of lung cancer incidence, as well as the associations of age, period, and cohort effects with gender disparities.

METHODS: Using data from the Cancer Incidence in Five Continents from 1978 to 2012, we calculated age-standardized, age-specific incidence, and male-to-female incidence rate ratios (IRR), and conducted an age-period-cohort analysis. The average annual percentage change (AAPC) of the trends was obtained by Joinpoint Regression. Bayesian age-period-cohort analysis was also conducted to project incidences to 2032.

RESULTS: In China, age-standardized incidence revealed a decreasing trend among males, but showed increasing trends among the younger age groups (30-54 years) in females. Age-standardized incidence rates of males decreased but remained stable among females from 1972 to 2012 in the United States. Male-to-female incidence rate ratios narrowed in both countries and reversed among younger birth cohorts in the United States. Gender disparities are expected to continue to diminish in both countries, and incidence among females appears to exceed that of males in the United States by around 2023-2027.

CONCLUSION: Gender disparities in lung cancer incidence persist and will continue into the future in both countries, but our findings suggested that smoking may play different roles in gender disparities in lung cancer incidence between the two countries. Further population-based epidemiological studies among females in China are imperative.

PMID:35916964 | DOI:10.1007/s10552-022-01597-4

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Nevin Manimala Statistics

A Psycholinguistic Look at the Role of Field Dependence/Independence in Receptive/Productive Vocabulary Knowledge: Does it Draw a Line?

J Psycholinguist Res. 2022 Aug 2. doi: 10.1007/s10936-022-09905-4. Online ahead of print.

ABSTRACT

The thrust of this study was to investigate the impact of learning styles in general and Field dependence/Independence (FD/I) in particular on the receptive/productive lexical performance of language learners. It aimed to check whether FD/I learners perform differently on receptive and productive vocabulary tests. To achieve this, first, 94 Iranian language learners were given the Group Embedded Figure Test (GEFT) to determine their learning style; and second, they were put into two groups and were asked to take a receptive and a productive vocabulary test. Having collected and analyzed the data, the study revealed that first, with regard to the receptive test, although FI learners outperformed the FD ones, this outperformance was not significant statistically. Second, for the productive test, a significant difference was found between FIs and FDs with FI learners having a better performance. Third, FI learners acted significantly better in the productive test compared with receptive test. Finally, FD learners performed almost similarly in both receptive and productive tests. The pertinent implications are also discussed.

PMID:35916955 | DOI:10.1007/s10936-022-09905-4

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Nevin Manimala Statistics

Hospitalizations for major osteoporotic fractures in Switzerland: a long-term trend analysis between 1998 and 2018

Osteoporos Int. 2022 Aug 2. doi: 10.1007/s00198-022-06481-0. Online ahead of print.

ABSTRACT

Between 1998 and 2018, the number of hospitalizations for major osteoporotic fractures increased. After standardization for age, these numerical increases translated into a reduced incidence of hospitalizations for hip fractures and an increased incidence of hospitalizations for spine, proximal humerus, and distal radius fractures in both sexes.

INTRODUCTION: The longterm epidemiological trends of hospitalizations for major osteoporotic fractures (MOF) between 1998 and 2018 in Switzerland are unknown.

METHODS: The absolute number of acute hospitalizations for MOF (hip fractures and fractures of the spine, proximal humerus, and distal radius) and related length of acute hospital stay were extracted from the medical database of the Swiss Federal Office of Statistics. Age-standardized incidence rates were calculated using 1998 as the reference year.

RESULTS: Hospitalizations for MOF increased from 4483 to 7542 (+ 68.2%) in men and from 13,242 to 19,362 (+ 46.2%) in women. The age-standardized incidence of hospitalizations for MOF increased by 5.7% in men (p = 0.002) and by 5.1% in women (p = 0.018). The age-standardized incidence of hip fractures decreased by 15.3% in men (p < 0.001) and by 21.5% in women (p < 0.001). In parallel, the age-standardized incidence of MOF other than hip fractures increased by 31.8% in men (p < 0.001) and by 40.1% in women (p < 0.001). The mean length of acute hospital stays for MOF decreased from 16.3 to 8.5 days in men and from 16.9 to 8.1 days in women.

CONCLUSION: Between 1998 and 2018, the number of hospitalizations for MOF increased significantly by a larger extent than expected based on the ageing of the Swiss population alone. This increase was solely driven by an increased incidence of MOF other than hip fractures as incident hip fractures decreased over time in both sexes, more so in women than in men.

PMID:35916908 | DOI:10.1007/s00198-022-06481-0

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Nevin Manimala Statistics

Improving survival in metastatic renal cell carcinoma (mRCC) patients: do elderly patients benefit from expanded targeted therapeutic options?

World J Urol. 2022 Aug 2. doi: 10.1007/s00345-022-04110-3. Online ahead of print.

ABSTRACT

INTRODUCTION: Treatment advances in metastatic renal cell carcinoma (mRCC) have improved overall survival (OS) in mRCC patients over the last two decades. This single center retrospective analysis assesses if the purported survival benefits are also applicable in elderly mRCC patients.

METHODS: 401 patients with mRCC treated at Hannover Medical School from 01/2003-05/2016 were identified and evaluated by chart review. Treatment periods were defined as 01.01.2003-31.12.2009 (P1) and 01.01.2010-31.05.2016 (P2). Age groups were defined according to WHO classes (≤ 60 years: younger, > 60-75 years: elderly and > 75 years: old). Descriptive statistics, Kaplan-Meier analysis and logistic regression were performed.

RESULTS: Median OS improved from 35.1 months in P1 to 59.1 months in P2. Sub-division into the respective age groups revealed median survival of 38.1 (95%-CI: 28.6-47.6) months in younger patients, 42.9 (95%-CI: 29.5-56.3) months among elderly patients and 27.3 (95%-CI: 12.8-41.8) months among old patients. Risk reduction for death between periods was most evident among old patients (young: HR 0.71 (95%-CI: 0.45-1.13, p = 0.2); elderly: HR 0.62 (95%-CI: 0.40-0.97, p = 0.04); old: HR 0.43 (95%-CI: 0.18-1.05, p = 0.06)). Age ≥ 75 years was an independent risk factor for death in P1 but not in P2.

CONCLUSION: Improved OS in the targeted treatment period was confirmed. Surprisingly elderly and old patients seem to profit the most form expansion of therapeutic armamentarium, within the TKI-dominated observation period.

PMID:35916904 | DOI:10.1007/s00345-022-04110-3