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Nevin Manimala Statistics

Behavioral Activation in Nursing Homes to Treat Depression (BAN-Dep): Results From a Clustered, Randomized, Single-Blinded, Controlled Clinical Trial

Am J Geriatr Psychiatry. 2022 May 18:S1064-7481(22)00416-X. doi: 10.1016/j.jagp.2022.05.009. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine if behavioral activation (BA) delivered by trained staff decreases prevalence of clinically significant symptoms of depression among older adults living in residential aged care facilities (RACFs).

METHODS: Clustered, randomized, single-blinded, controlled trial of BA for adults aged over 60 years living permanently in a RACF with symptoms of depression (Patient Health Questionnaire, PHQ-9 ≥ 5). BA was delivered over 8-12 weeks using a structured workbook. The proportion of residents with PHQ-9 ≥ 10 at weeks 12, 26, and 52, as well as anxiety symptoms (GAD-7), physical (PCS), and mental (MCS) quality of life, loneliness, and loss to follow-up were main outcomes of interest RESULTS: We recruited 54 RACFs (26 intervention) and 188 of their residents (89 intervention). Participants were aged 61-100 years and 132 (70.2%) were women. PHQ-9 ≥ 10 interacted with BA at week 12 (OR = 0.34, 95%CI = 0.11-1.07), but differences between the groups were not statistically significant at any time-point. GAD-7 ≥ 10 interacted with BA at week 26 (OR = 0.12, 95%CI = 0.02-0.58), but not at any other time-point. Overall, the intervention had no effect on the scores of the PHQ-9, GAD-7, PCS, MCS, and loneliness scale. Loss to follow-up was similar between groups. Adherence to all stages of the intervention was poor (36.2%).

CONCLUSIONS: Disruption by the COVID-19 pandemic and staffing issues in RACFs undermined recruitment and adherence. In such a context, a BA program delivered by RACF staff was not associated with better mental health outcomes for residents over 52 weeks.

PMID:35680539 | DOI:10.1016/j.jagp.2022.05.009

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Nevin Manimala Statistics

Impacts of altered exercise volume, intensity, and duration on the activation of AMPK and CaMKII and increases in PGC-1α mRNA

Semin Cell Dev Biol. 2022 Jun 6:S1084-9521(22)00173-2. doi: 10.1016/j.semcdb.2022.05.016. Online ahead of print.

ABSTRACT

The purpose of this review is to explore and discuss the impacts of augmented training volume, intensity, and duration on the phosphorylation/activation of key signaling protein – AMPK, CaMKII and PGC-1α – involved in the initiation of mitochondrial biogenesis. Specifically, we explore the impacts of augmented exercise protocols on AMP/ADP and Ca2+ signaling and changes in post exercise PGC – 1α gene expression. Although AMP/ADP concentrations appear to increase with increasing intensity and during extended durations of higher intensity exercise AMPK activation results are varied with some results supporting and intensity/duration effect and others not. Similarly, CaMKII activation and signaling results following exercise of different intensities and durations are inconsistent. The PGC-1α literature is equally inconsistent with only some studies demonstrating an effect of intensity on post exercise mRNA expression. We present a novel meta-analysis that suggests that the inconsistency in the PGC-1α literature may be due to sample size and statistical power limitations owing to the effect of intensity on PGC-1α expression being small. There is little data available regarding the impact of exercise duration on PGC-1α expression. We highlight the need for future well designed, adequately statistically powered, studies to clarify our understanding of the effects of volume, intensity, and duration on the induction of mitochondrial biogenesis by exercise.

PMID:35680515 | DOI:10.1016/j.semcdb.2022.05.016

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Nevin Manimala Statistics

Micro-computed tomography evaluation of bone architecture in various forms of unilateral condylar hyperplasia

Int J Oral Maxillofac Surg. 2022 Jun 6:S0901-5027(22)00221-1. doi: 10.1016/j.ijom.2022.05.008. Online ahead of print.

ABSTRACT

Condylar hyperplasia is one of the causes of facial asymmetry and malocclusion, characterized by enlargement of the lower jaw due to excessive condyle growth activity. The aim of this study was to use micro-computed tomography (micro-CT) to evaluate the bone architecture of the condylar head and determine whether there are differences between patients with various forms of unilateral condylar hyperplasia (UCH): hemimandibular hyperplasia, elongation, and mixed form. The cohort consisted of 28 patients with a mean age of 21.9 years. All patients underwent surgical treatment (condylar shaving) for active pathological growth activity. The portion of the condylar head removed was imaged by micro-CT and subsequently evaluated. Micro-CT imaging and semiquantitative and quantitative evaluation of the bone structure (percentage bone volume, surface density, trabecular thickness, trabecular separation, degree of anisotropy, and porosity of the subchondral bone) did not reveal significant differences between the individual types of condylar hyperplasia (P > 0.05). There were no significant differences in bone structure between the anterior and posterior portions of the condylar head. No statistically significant differences between individual groups of UCH were found in the micro-CT evaluation of the condylar head bone architecture.

PMID:35680482 | DOI:10.1016/j.ijom.2022.05.008

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Nevin Manimala Statistics

Response surface model comparison and combinations for remifentanil and propofol in describing response to esophageal instrumentation and adverse respiratory events

J Formos Med Assoc. 2022 Jun 6:S0929-6646(22)00216-9. doi: 10.1016/j.jfma.2022.05.011. Online ahead of print.

ABSTRACT

BACKGROUND: The primary aim of this essay was to explore the best fitting model in remifentanil-propofol combined administrations during esophageal instrumentation (EI) from five distinct response surface models. The secondary aim was to combine the models to give appropriate effect-site drug concentrations (Ces) range with maximal comfort and safety.

METHODS: The Greco, reduced Greco, Minto, Scaled C50 Hierarchy and Fixed C50 Hierarchy models were constructed to fit four drug effects: loss of response to esophageal instrumentation (LREI), loss of response to esophageal instrumentation revised (LREIR), intolerable ventilatory depression (IVD) and respiratory compromise (RC). Models were tested by chi-square statistical test and evaluated with Akaike Information Criterion (AIC). Model prediction performance were measured by successful prediction rate (SPR) and three prediction errors.

RESULTS: The reduced Greco model was the best fitting model for LREI and RC, and the Minto model was the best fitting model for LREIR and IVD. The SPRs of reduced Greco model for LREI and RC were 81.76% and 79.81%. The SPRs of Minto model for LREIR and IVD were 80.32% and 80.12%. Overlay of the reduced Greco model for LREI and Minto model for IVD offered visual aid for guidance in drug administration.

CONCLUSIONS: Using proper response surface model to fit different drug effects will describe the interactions between anesthetic drugs better. Combining response surface models to select the more reliable effect-site drug concentrations range can be used to guide clinical drug administration with greater safety and provide an improvement of anesthesia precision.

PMID:35680472 | DOI:10.1016/j.jfma.2022.05.011

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Nevin Manimala Statistics

New directions in tropical phenology

Trends Ecol Evol. 2022 Jun 6:S0169-5347(22)00112-4. doi: 10.1016/j.tree.2022.05.001. Online ahead of print.

ABSTRACT

Earth’s most speciose biomes are in the tropics, yet tropical plant phenology remains poorly understood. Tropical phenological data are comparatively scarce and viewed through the lens of a ‘temperate phenological paradigm’ expecting phenological traits to respond to strong, predictably annual shifts in climate (e.g., between subfreezing and frost-free periods). Digitized herbarium data greatly expand existing phenological data for tropical plants; and circular data, statistics, and models are more appropriate for analyzing tropical (and temperate) phenological datasets. Phylogenetic information, which remains seldom applied in phenological investigations, provides new insights into phenological responses of large groups of related species to climate. Consistent combined use of herbarium data, circular statistical distributions, and robust phylogenies will rapidly advance our understanding of tropical – and temperate – phenology.

PMID:35680467 | DOI:10.1016/j.tree.2022.05.001

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Nevin Manimala Statistics

Post-operative ventilation strategies after surgical repair in neonates with esophageal atresia: A retrospective cohort study

J Pediatr Surg. 2022 May 20:S0022-3468(22)00367-0. doi: 10.1016/j.jpedsurg.2022.05.012. Online ahead of print.

ABSTRACT

BACKGROUND: Infants affected by Esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) may require non-invasive ventilation (NIV) in the post-operative period after elective extubation, especially if born preterm. The aim of the paper is to evaluate the role of different ventilation strategies on anastomotic complications, specifically on anastomotic leak (AL).

MATERIALS AND METHODS: Retrospective single Institution study, including all consecutive neonates affected by EA with or without TEF in a 5-year period study (from 2014 to 2018). Only infants with a primary anastomosis were included in the study. All infants were mechanically ventilated after surgery and electively extubated after 6-7 days. The duration of invasive ventilation was decided on a case-by-case basis after surgery, based on the pre-operative esophageal gap and intraoperative findings. The need for non-invasive ventilation (NCPAP, NIPPV, and HHHFNC) after extubation and extubation failure with the need for mechanical ventilation in the post-operative period were assessed. The primary outcome evaluated was the rate of anastomotic leak.

RESULTS: 102 EA/TEF infants were managed in the study period. Sixty-seven underwent primary anastomosis. Of these, 29 (43.3%) were born preterm. Patients who required ventilation (n = 32) had a significantly lower gestational age as well as birthweight (respectively p = 0.007 and p = 0.041). 4/67 patients had an AL after surgical repair, with no statistical differences among post-operative ventilation strategies.

CONCLUSION: We found no significant differences in the rate of anastomotic leak (AL) according to post-operative ventilation strategies in neonates operated on for EA/TEF.

PMID:35680465 | DOI:10.1016/j.jpedsurg.2022.05.012

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Nevin Manimala Statistics

National Trends in the Expenditure and Utilization of Chiropractic Care in U.S. Children and Adolescents From the 2007-2016 Medical Expenditure Panel Survey: A Cross Sectional Study

J Manipulative Physiol Ther. 2022 Jun 6:S0161-4754(22)00004-5. doi: 10.1016/j.jmpt.2022.02.002. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of this study was to examine the trends in the expenditure and utilization of chiropractic care in a representative sample of children and adolescents in the United States (US) aged <18 years.

METHODS: We evaluated serial cross-sectional data (2007-2016) from the Medical Expenditure Panel Survey. Weighted descriptive statistics were conducted to derive national estimates of expenditure and utilization, and linear regression was used to determine trends over time. Sociodemographic and clinical characteristics of chiropractic users were also reported.

RESULTS: A statistically significant increasing trend was observed for the number of children receiving chiropractic care (P <.05) and chiropractic utilization rate (P < .05). Increases in chiropractic expenditure and the number of chiropractic visits were also observed over time but were not statistically significant (P > .05). The mean annual number of visits was 6.4 visits, with a mean expenditure of $71.49 US dollars (USD) per visit and $454.08 USD per child. Children and adolescent chiropractic users in the United States were primarily 14 to 17 years old (39.6%-61.6%), White (71.5%-76.9%), male (50.6%-51.3%), and privately insured (56.7%-60.8%). Chiropractic visits in this population primarily involved low back conditions (52.4%), spinal curvature (14.0%), and head and neck complaints (12.8%).

CONCLUSION: The number of children visiting a chiropractor and percent utilization showed a statistically significant, increasing trend from 2007 to 2016; however, total expenditure and the number of chiropractic visits did not significantly differ during this period. These findings provide novel insight into the patterns of chiropractic utilization in this understudied age group.

PMID:35680457 | DOI:10.1016/j.jmpt.2022.02.002

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Nevin Manimala Statistics

A Statistical Non-Parametric data analysis for COVID-19 incidence data

ISA Trans. 2022 Jun 1:S0019-0578(22)00261-0. doi: 10.1016/j.isatra.2022.05.027. Online ahead of print.

ABSTRACT

BACKGROUND: The impact of COVID-19 on the Global scale is tremendously drastic. There are several types of research going on across the world simultaneously to understand and overcome this dire pandemic outbreak. This paper is purely a statistical study on a distinct set of datasets regarding COVID-19 in India. The motivation of this study is to provide an insight into the rapid growth of confirmed COVID-19 cases in India.

METHODS: The rapid growth of COVID-19 cases in India started in March 2020. The main objective of this paper is to provide a solid statistical model for the policymaker to handle this kind of pandemic situation in the near future with nonlinear data. In this paper, the data was got from 1st April to 29th November 2020. To come up with a solid statistical model, various nonlinear data such as confirmed COVID-19 cases, maximum temperature, minimum temperature, the total population (state-wise), the total area in km2 (state-wise), and the total rural and urban population count (state-wise) have been analyzed. In this paper, six different Generalized Additive Models (GAM) was identified after a thorough analysis of other researchers’ (Xie and Zhu, 2020; Prata et al., 2020) findings.

RESULTS: In all perspectives, the results were identified and analyzed. The GAM model regarding total COVID-19 confirmed cases, total population, and the total rural population provides the best average fit of R2 value of 0.934. As the population value is quite high, the author has concise it using logarithm to provide the best p-value of 0.000542 and 0.001407 for a relation between the total number of COVID-19 cases regarding the total population and total rural population respectively.

PMID:35680452 | DOI:10.1016/j.isatra.2022.05.027

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Nevin Manimala Statistics

Retrospective study of consecutive rib fracture patients treated by open reduction internal fixation in a single major trauma centre, UK

Injury. 2022 Jun 6:S0020-1383(22)00379-5. doi: 10.1016/j.injury.2022.05.055. Online ahead of print.

ABSTRACT

INTRODUCTION: Rib fractures are a common presentation in both patients presenting with high impact poly-trauma and as a result of low energy falls in the elderly. This injury can lead to various complications including prolonged hospital admission, pneumonia, need for ventilation and in admission to intensive care unit. There is much controversy around the management of this injury in the literature, with favourable outcomes for patients treated non-operatively as well as surgically.

METHODS: We collated a database for all rib fracture fixations between 2014 and 2019 that took place at the major trauma centre in Liverpool. The decision to undergo surgical fixation was after discussion with multidisciplinary team at trauma meeting. Following British Orthopaedic Association Standards for Trauma and Orthopaedics (BOASTs), these injuries should ideally be operated on within 48 h.

RESULTS: Overall, a total of 220 patients were included in the study (143 male and 77 female). 142 (64%) patients were operated on within 48 h of admission. A total of 101 (45%) patients required admission to ITU. Those in the early surgical fixation group had a statistically significant decrease in their hospital length of stay (12.8 days compared to 15.5 days, p=<0.001). Mean length of ITU stay was shorter in the early surgical group with no statistical significance (p = 0.1). Those patients that required mechanical ventilation in turn stayed in hospital for a longer period compared to those who did not (p=<0.001). There is no statistical difference in survival between the 2 patient groups (p = 0.3).

DISCUSSION: To our knowledge, this is the largest data set published in the rib fracture fixation cohort. Our results agree with previous studies which have demonstrated that those who undergo ORIF tend require fewer days of hospital stay, less ventilatory support and overall have better outcomes in terms of pain when compared to those treated non-operatively. Our study adds that patients who receive treatment within 48-hours as per BOAST guidelines have better outcomes, specifically reducing hospital length of stay by nearly 4 days (p = 0.014).

CONCLUSION: Early surgical fixation of rib fractures leads to significantly favoured outcomes.

PMID:35680436 | DOI:10.1016/j.injury.2022.05.055

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Nevin Manimala Statistics

Use of hypnotics among women diagnosed with cervical cancer – A population-based cohort study

Gynecol Oncol. 2022 Jun 6:S0090-8258(22)00330-4. doi: 10.1016/j.ygyno.2022.05.019. Online ahead of print.

ABSTRACT

OBJECTIVE: Previous studies suggest that sleeping problems are frequent after cervical cancer. However, the evidence on the use of hypnotics is sparse. We investigated if women diagnosed with cervical cancer have an increased risk of using hypnotics and identified risk factors for prolonged use.

METHODS: In this nationwide register-based cohort study, 4264 women diagnosed with cervical cancer from 1997 to 2013 and 36,632 cancer-free women were followed in registers until 2016. Prolonged use of hypnotics was defined as more than three prescriptions with no more than three months in between. Data were analysed using Cox proportional hazards regression models and multistate Markov models separately for women with localized and advanced cervical cancer.

RESULTS: The rate of first use of hypnotics was substantially increased during the first year after cervical cancer diagnosis compared to cancer-free women (HRlocalized 4.4, 95% CI 3.9-5.1; HRadvanced 8.9, 95% CI 7.5-10.6) and remained markedly increased for up to five years after diagnosis. Dependent on stage of disease and age, 1.4 to 4.7 excess women per 100 with cervical cancer were prolonged users of hypnotics compared to cancer-free women one year after diagnosis. Risk factors for prolonged use of hypnotics were higher age, short education, previous use of antidepressants or anxiolytics, and advanced disease.

CONCLUSIONS: Women diagnosed with cervical cancer are at increased risk of prolonged use of hypnotics. For the majority, treatment with hypnotics is initiated within the first year after cancer diagnosis, but the rate of first use is increased for up to five years.

PMID:35680430 | DOI:10.1016/j.ygyno.2022.05.019