Category: Nevin Manimala

Int J Biostat. 2024 Nov 4. doi: 10.1515/ijb-2023-0004. Online ahead of print.

ABSTRACT

In epidemiological studies, the measurements of disease outcomes are carried out by different evaluators. In this paper, we propose a two-stage procedure for detecting outlier evaluators. In the first stage, a regression model is fitted to obtain the evaluators’ effects. Outlier evaluators have different effects than normal evaluators. In the second stage, stepwise hypothesis tests are performed to detect outlier evaluators. The true positive rate and true negative rate of the proposed procedure are assessed in a simulation study. We apply the proposed method to detect potential outlier audiologists among the audiologists who measured hearing threshold levels of the participants in the Audiology Assessment Arm of the Conservation of Hearing Study, which is an epidemiological study for examining risk factors of hearing loss.

PMID:39485244 | DOI:10.1515/ijb-2023-0004

Environ Sci Process Impacts. 2024 Nov 1. doi: 10.1039/d4em00374h. Online ahead of print.

ABSTRACT

The Bioconcentration Factor (BCF) is used to evaluate the bioaccumulation potential of chemical substances in reference organisms, and it directly correlates with ecotoxicity. Traditional in vivo BCF estimation methods are costly, time-consuming, and involve animal sacrifice. Many in silico technologies are used to avoid the problems associated with in vivo testing. This study aims to develop a quantitative read across structure-property relationship (q-RASPR) model using a structurally diverse dataset consisting of 1303 compounds by combining quantitative structure-property relationship (QSPR) and read-across (RA) algorithms. The model incorporates simple, interpretable, and reproducible 2D molecular descriptors along with RASAR descriptors. The PLS-based q-RASPR model demonstrated robust performance with internal validation metrics (R² = 0.727 and Q²_(LOO) = 0.723) and external validation metrics (Q²_F1 = 0.739, Q²_F2 = 0.739, and CCC = 0.858). These results indicate that the q-RASPR model is statistically superior to the corresponding QSPR model. Furthermore, screening of 1694 compounds from the Pesticide Properties Database (PPDB) was performed using the PLS-based q-RASPR model for assessing the eco-toxicological bioaccumulative potential of various compounds, ensuring the external predictability of the developed model and confirming the real-world application of the developed model. This model offers a reliable tool for predicting the BCF of new or untested compounds, thereby helping to develop safe and environment-friendly chemicals.

PMID:39485241 | DOI:10.1039/d4em00374h

J Anim Sci. 2024 Nov 1:skae335. doi: 10.1093/jas/skae335. Online ahead of print.

ABSTRACT

Feline obesity puts many cats at risk for comorbidities such as hepatic lipidosis, diabetes mellitus, urinary tract diseases, and others. Restricted feeding of specially formulated diets may improve feline health and safely support weight loss while maintaining lean mass. The objective of this study was to determine the effects of restricted intake of weight control diets on weight loss, body composition, voluntary physical activity, serum metabolic and inflammatory markers, and fecal metabolites and microbiota of obese cats. Twenty-four obese adult domestic shorthair cats [body weight (BW) = 5.51 ± 0.92 kg; body condition score (BCS) = 8.44 ± 0.53] were used. A leading grocery brand diet was fed during a 4-wk baseline to identify intake needed to maintain BW. After baseline (wk 0), cats were allotted to one of two weight control diets (DRY or CAN) and fed to lose 1.5% BW per wk for 18 wk. At baseline and 6, 12, 18 wk after weight loss, dual-energy x-ray absorptiometry scans were performed, blood and fecal samples were collected, and voluntary physical activity was measured. Change from baseline data were analyzed statistically using the Mixed Models procedure of SAS, with P<0.05 being significant and P<0.10 being trends. BW was reduced by 1.54 ± 0.51% per wk. Restricted feeding of both diets led to BW (P<0.01) and fat mass loss (P<0.01), reduced BCS (P<0.01), reduced leptin (P<0.01) and insulin (P<0.01) concentrations, and increased superoxide dismutase (P<0.01) and active ghrelin (P<0.01) concentrations. Change from baseline fecal scores were reduced (P<0.01) with restricted feeding and weight loss, while total short-chain fatty acid, acetate, and propionate concentration reductions were greater (P<0.05) in cats fed CAN than those fed DRY. Fecal bacterial alpha diversity measures increased (P<0.01) with restricted feeding and weight loss. Fecal bacterial beta diversity was altered by time in all cats, with wk 0 being different (P<0.05) than wk 6, 12, and 18. Change from baseline relative abundances of 3 fecal bacterial phyla and over 30 fecal bacterial genera were impacted (P<0.05) or tended to be impacted (P<0.10) by dietary treatment. Our data demonstrate that restricted feeding of both weight control diets was an effective means for weight loss in obese adult domestic cats. Some changes were also impacted by diet, highlighting the importance of diet formulation and format, and nutrient composition in weight control diets.

PMID:39485233 | DOI:10.1093/jas/skae335

Quintessence Int. 2024 Nov 1;0(0):0. doi: 10.3290/j.qi.b5809024. Online ahead of print.

ABSTRACT

OBJECTIVE: This clinical trial aimed to evaluate and compare the effectiveness of diode laser gingivectomy, conventional gingivectomy, and nonsurgical periodontal treatment (NSPT) in the management of gingival enlargement (GE) during orthodontic treatment.

MATERIALS AND METHODS: forty-five healthy, orthodontic patients with labial gingival enlargement on the 6 anterior teeth were selected and randomly assigned to one of the groups (Conventional, Laser, and NSPT). Clinical parameters including clinical crown length (CCL) , periodontal pocket depth (PPD), and vertical gingival overgrowth index (vGOi) were recorded at baseline, 1 month, 3 months, and 6 months. Postoperative pain was evaluated at 1,3, and 7 days. Esthetic satisfaction and acceptance of the procedure were recorded on day 10 and repeated after 6 months.

RESULTS: Statistically significant results were obtained for mean reduction in PPD for conventional, laser, and NSPT groups (-1.43, -.1.75, and -0.9 mm, respectively; P < 0.001), CCL gain (1.45, 1.7, and 0.38 mm, respectively; P<0.001) and mean vGOi score (-1.14, -1.29 and -0.76, respectively; P<0.001) over 6 months. Both test groups showed greater statistically significant changes in clinical parameters over 6 months compared to NSPT (P<0.001). There was a gradual decrease in postoperative pain for all three groups over 7 days, with conventional group showing statistical difference in mean pain score on days 1 and 3 compared to other groups.

CONCLUSION: Both conventional and laser gingivectomies were more effective in controlling enlargement over non-surgical periodontal treatment alone at 1, 3, and 6 months.

CLINICAL SIGNIFICANCE: laser and conventional gingivectomies as adjunctive treatments achieved superior results when compared to NSPT alone in the treatment of GE and gingival inflammation during orthodontic treatment, with no significant clinical differences between the two treatments.

PMID:39485147 | DOI:10.3290/j.qi.b5809024

Chaos. 2024 Nov 1;34(11):111102. doi: 10.1063/5.0235846.

ABSTRACT

We propose a mutual information statistic to quantify the information encoded by a partition of the state space of a dynamical system. We measure the mutual information between each point’s symbolic trajectory history under a coarse partition (one with few unique symbols) and its partition assignment under a fine partition (one with many unique symbols). When applied to a set of test cases, this statistic demonstrates predictable and consistent behavior. Empirical results and the statistic’s formulation suggest that partitions based on trajectory history, such as the ordinal partition, perform best. As an application, we introduce the weighted ordinal partition, an extension of the popular ordinal partition with parameters that can be optimized using the mutual information statistic, and demonstrate improvements over the ordinal partition in time series analysis. We also demonstrate the weighted ordinal partition’s applicability to real experimental datasets.

PMID:39485135 | DOI:10.1063/5.0235846

Chaos. 2024 Nov 1;34(11):113108. doi: 10.1063/5.0228472.

ABSTRACT

This article is concerned with the existence and spectral stability of pulses in singularly perturbed two-component reaction-diffusion systems with slowly mixed nonlinearity. In this paper, the slow nonlinearity is referred to be “mixed” in the sense that it is generated by a trigonometric function multiplied by a power function. We demonstrate via geometric singular perturbation theory that this model can support both the single-pulse and the double-hump solutions. The presence of the slowly mixed nonlinearity complicates the stability analysis on pulses, since the conditions that govern their stability can no longer be explicitly computed. We remove this difficulty by introducing the hypergeometric functions followed by a comparison theorem. By doing so, the “slow-fast” eigenvalues can be determined via the nonlocal eigenvalue problem method. We prove that the double-hump solution is always unstable, while the single-pulse solution can be stable under certain parameter conditions.

PMID:39485130 | DOI:10.1063/5.0228472

Acad Med. 2024 Oct 31. doi: 10.1097/ACM.0000000000005908. Online ahead of print.

ABSTRACT

PURPOSE: Virtual patients (VPs) are increasingly used in health care professions education to support clinical reasoning (CR) development. However, the extent to which feedback is given across CR components is unknown, and guidance is lacking on how VPs can optimize CR development. This systematic review sought to identify how VPs provide feedback on CR.

METHOD: Seven databases (MEDLINE, EMBASE, CINAHL, ERIC, PsycINFO, Scopus, and ProQuest Dissertations) were searched in March 2023 using terms (e.g., medical education, virtual patient, case-based learning, computer simulation) adapted from a previous systematic review. All studies that described VP use for developing CR in medical professionals and provided feedback on at least 1 CR component were retrieved. Screening, data extraction, and quality assessment were performed. Narrative synthesis was performed to describe the approaches used to measure and provide feedback on CR.

RESULTS: A total of 6,526 results were identified from searches, of which 72 met criteria, but only 35 full-text articles were analyzed because the reporting of interventions in abstracts (n = 37) was insufficient. The most common CR components developed by VPs were leading diagnosis (23 [65.7%]), management or treatment plan (23 [65.7%]), and information gathering (21 [60%]). The CR components were explored by various approaches, from redefined questions to free text and concept maps.

CONCLUSIONS: Studies describing VP use for giving CR feedback have mainly focused on easy-to-assess CR components, whereas few studies have described VPs designed for assessing CR components, such as problem representation, hypothesis generation, and diagnostic justification. Despite feedback being essential for learning, few VPs provided information on the learner’s use of self-regulated learning processes. Educators designing or selecting VPs for CR use must consider the needs of learner groups and how different CR components can be explored and should make the instructional design of VPs explicit in published work.

PMID:39485118 | DOI:10.1097/ACM.0000000000005908

J Magn Reson Imaging. 2024 Nov 1. doi: 10.1002/jmri.29648. Online ahead of print.

ABSTRACT

BACKGROUND: Although improvement of cognitive function after liver transplantation has been demonstrated in several neuropsychological studies, there is limited research on longitudinal changes in the cirrhotic patients’ brain structure before and after transplantation.

PURPOSE: To investigate longitudinal changes of brain microstructure in cirrhotic patients using diffusion kurtosis imaging (DKI).

STUDY TYPE: Prospective.

SUBJECTS: A total of 153 cirrhosis patients, comprising 60 hepatic encephalopathy (HE) patients (16 females/44 males) and 93 no-HE patients (35 females/58 males), along with 93 healthy controls (HCs) (53 females/40 males) were enrolled. Subsequently, 58 recipients completed 1-month postoperative follow-up, 29 patients completed 1-, 3-months, and 17 patients completed 1-, 3-, 6-month follow-up.

SEQUENCE: Spin-echo single-shot echo-planar sequence using a 3.0 T scanner.

ASSESSMENT: Diffusion kurtosis estimator software was used to estimate the DKI parameter maps by a MR imaging physicist (Y.-Y.C. with 12 years of experience).

STATISTICAL TESTS: The diffusion metrics (eg, radial kurtosis [RK], mean kurtosis, fractional anisotropy, mean diffusivity) of the patients before transplantation were compared with those of the HCs using voxel-wise analysis of variance (ANOVA), along with t tests for post hoc analysis. Linear mixed-effects models were applied to the longitudinal data. We imposed a cluster level Family Wise Error (FWE) correction rate of P_FWE = 0.05 with voxel-wise cutoff of P = 0.001 together with a cluster-size cutoff of N ≥ 56, and generated smoothness estimates from the preprocessed data using the mixed-model autocorrelation function.

RESULTS: The RK metrics of the patients decreased significantly in the anterior cingulate cortex (HE/no-HE < HC, ANOVA-F = 21.91). After transplantation, the RK of the pallidum showed a continuous upward trend (time effect T = 11.26); whereas the RK of the right postcentral gyrus showed a continuous downward trend (time effect T = -9.56). In addition, the RK in superior longitudinal fasciculus showed new-onset decrease after transplantation.

DATA CONCLUSION: Longitudinal changes in DKI metrics reveal the course of brain microstructural changes before and after transplantation in cirrhotic patients, potentially associated with cognitive alterations after surgery.

LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 4.

PMID:39485115 | DOI:10.1002/jmri.29648

J Gastroenterol Hepatol. 2024 Nov 1. doi: 10.1111/jgh.16794. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: The simulation-based mastery learning (SBML) method holds promise for improving the efficiency and effectiveness of endoscopy training. However, further study is required to establish its advantages over the traditional method. We aim to prospectively compare outcomes between gastrointestinal endoscopy trainees taught using SBML and those trained using conventional apprenticeship methods for upper endoscopy.

METHODS: We performed a blinded, stepwise, comparative study with SBML participants deliberately practicing deconstructed steps of upper endoscopy and apprenticeship participants observing procedures. Three blinded trainers assessed trainees’ skills using a validated esophagogastroduodenoscopy (EGD) tool pre-and post-training. The minimum pass standard (MPS) was set at a score > 2. We compared MPS of the groups using standard statistics and paired t-test.

RESULTS: Six trainees were enrolled in the SBML group, and six in the conventional group. All trainees in the SBML group passed the minimum standard compared with the conventional group (P = 0.06). All trainees in the SBML group obtained significantly higher scores in overall basic GI endoscopic skills, esophageal, stomach, and duodenal observation skills than those of the conventional apprenticeship group (P < 0.05). The SBML curriculum led to three times more learning (Cohen’s d = 6.5) than the conventional method (Cohen’s d = 1.8).

CONCLUSION: This prospective study supports SBML for upper endoscopy training compared with the traditional apprentice-based method. SBML resulted in a steeper learning curve, as trainees learned three times more during the same period. Furthermore, trainees developed a uniform competency level at the end of training.

PMID:39484698 | DOI:10.1111/jgh.16794

Euro Surveill. 2024 Oct;29(44). doi: 10.2807/1560-7917.ES.2024.29.44.2400680.

ABSTRACT

COVID-19 vaccination recommendations include healthcare workers (HCWs). We measured COVID-19 vaccine effectiveness (CVE) of the autumn 2023 dose against laboratory-confirmed SARS-CoV-2 infection in a prospective cohort study of 1,305 HCWs from 13 European hospitals. Overall CVE was 22% (95% CI: -17 to 48), 49% (95% CI: -8 to 76) before and -11% (95% CI: -84 to 34) after the start of BA.2.86/JN.1 predominant circulation. Autumn 2023 COVID-19 vaccination led to a moderate-to-low reduction in SARS-CoV-2 infection incidence in HCWs. Monitoring of CVE is crucial for COVID-19 prevention.

PMID:39484687 | DOI:10.2807/1560-7917.ES.2024.29.44.2400680