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Nevin Manimala Statistics

Homozygotes NAT2*5B slow acetylators are highly associated with hepatotoxicity induced by anti-tuberculosis drugs

Mem Inst Oswaldo Cruz. 2022 Apr 27;117:e210328. doi: 10.1590/0074-02760210328. eCollection 2022.

ABSTRACT

BACKGROUND: Distinct N-acetyltransferase 2 (NAT2) slow acetylators genotypes have been associated with a higher risk to develop anti-tuberculosis drug-induced hepatotoxicity (DIH). However, studies have not pointed the relevance of different acetylation phenotypes presented by homozygotes and compound heterozygotes slow acetylators on a clinical basis.

OBJECTIVES: This study aimed to investigate the association between NAT2 genotypes and the risk of developing DIH in Brazilian patients undergoing tuberculosis treatment, focusing on the discrimination of homozygotes and compound heterozygotes slow acetylators.

METHODS/FINDINGS: The frequency of NAT2 genotypes was analysed by DNA sequencing in 162 patients undergoing tuberculosis therapy. The mutation analyses revealed 15 variants, plus two new NAT2 mutations, that computational simulations predicted to cause structural perturbations in the protein. The multivariate statistical analysis revealed that carriers of NAT2*5/*5 slow acetylator genotype presented a higher risk of developing anti-tuberculosis DIH, on a clinical basis, when compared to the compound heterozygotes presenting NAT2*5 and any other slow acetylator haplotype [aOR 4.97, 95% confidence interval (CI) 1.47-16.82, p = 0.01].

CONCLUSION: These findings suggest that patients with TB diagnosis who present the NAT2*5B/*5B genotype should be properly identified and more carefully monitored until treatment outcome in order to prevent the occurrence of anti-tuberculosis DIH.

PMID:35588539 | DOI:10.1590/0074-02760210328

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Nevin Manimala Statistics

Differing Bilateral Benefits for Spatial Release From Masking and Sound Localization Accuracy Using Bone Conduction Devices

Ear Hear. 2022 May 19. doi: 10.1097/AUD.0000000000001234. Online ahead of print.

ABSTRACT

OBJECTIVES: Normal binaural hearing facilitates spatial hearing and therefore many everyday listening tasks, such as understanding speech against a backdrop of competing sounds originating from various locations, and localization of sounds. For stimulation with bone conduction hearing devices (BCD), used to alleviate conductive hearing losses, limited transcranial attenuation results in cross-stimulation so that both cochleae are stimulated from the position of the bone conduction transducer. As such, interaural time and level differences, hallmarks of binaural hearing, are unpredictable at the level of the inner ears. The aim of this study was to compare spatial hearing by unilateral and bilateral BCD stimulation in normal-hearing listeners with simulated bilateral conductive hearing loss.

DESIGN: Bilateral conductive hearing loss was reversibly induced in 25 subjects (mean age = 28.5 years) with air conduction and bone conduction (BC) pure-tone averages across 0.5, 1, 2, and 4 kHz (PTA4) <5 dB HL. The mean (SD) PTA4 for the simulated conductive hearing loss was 48.2 dB (3.8 dB). Subjects participated in a speech-in-speech task and a horizontal sound localization task in a within-subject repeated measures design (unilateral and bilateral bone conduction stimulation) using Baha 5 clinical sound processors on a softband. For the speech-in-speech task, the main outcome measure was the threshold for 40% correct speech recognition when masking speech and target speech were both colocated (0°) and spatially and symmetrically separated (target 0°, maskers ±30° and ±150°). Spatial release from masking was quantified as the difference between colocated and separated masking and target speech thresholds. For the localization task, the main outcome measure was the overall variance in localization accuracy quantified as an error index (0.0 = perfect performance; 1.0 = random performance). Four stimuli providing various spatial cues were used in the sound localization task.

RESULTS: The bilateral BCD benefit for recognition thresholds of speech in competing speech was statistically significant but small regardless if the masking speech signals were colocated with, or spatially and symmetrically separated from, the target speech. Spatial release from masking was identical for unilateral and bilateral conditions, and significantly different from zero. A distinct bilateral BCD sound localization benefit existed but varied in magnitude across stimuli. The smallest benefit occurred for a low-frequency stimulus (octave-filtered noise, CF = 0.5 kHz), and the largest benefit occurred for unmodulated broadband and narrowband (octave-filtered noise, CF = 4.0 kHz) stimuli. Sound localization by unilateral BCD was poor across stimuli.

CONCLUSIONS: Results suggest that the well-known transcranial transmission of BC sound affects bilateral BCD benefits for spatial processing of sound in differing ways. Results further suggest that patients with bilateral conductive hearing loss and BC thresholds within the normal range may benefit from a bilateral fitting of BCD, particularly for horizontal localization of sounds.

PMID:35588503 | DOI:10.1097/AUD.0000000000001234

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Nevin Manimala Statistics

Biologic vs Synthetic Mesh for Parastomal Hernia Repair: Post Hoc Analysis of a Multicenter Randomized Controlled Trial

J Am Coll Surg. 2022 May 17. doi: 10.1097/XCS.0000000000000275. Online ahead of print.

ABSTRACT

BACKGROUND: Parastomal hernias are often repaired with mesh to reduce recurrences, but the presence of an ostomy increases the wound class from clean to clean-contaminated/contaminated and makes the choice of mesh more controversial than in a strictly clean case. We aimed to compare the outcomes of biologic and synthetic mesh for parastomal hernia repair.

STUDY DESIGN: This is a post hoc analysis of parastomal hernia repairs in a randomized trial comparing biologic and synthetic mesh in contaminated ventral hernia repairs. Outcomes included rates of surgical site occurrences requiring procedural intervention (SSOPI), reoperations, stoma/mesh-related adverse events, parastomal hernia recurrence rates (clinical, patient-reported, and radiographic) at 2 years, quality of life (EQ-5D, EQ-5D Visual Analog Scale, and Hernia-Related Quality of Life Survey), and hospital costs up to 30 days.

RESULTS: A total of 108 patients underwent parastomal hernia repair (57 biologic (53%) and 51 synthetic (47%)). Demographic and hernia characteristics were similar between the two groups. No significant differences in SSOPI rates or reoperations were observed between mesh types. Four mesh erosions into an ostomy requiring reoperations (2 biologic vs 2 synthetic) occurred. At 2 years, parastomal hernia recurrence rates were similar for biologic and synthetic mesh (17 (29.8%) vs 13 (25.5%), respectively; P=.77). Overall and hernia-related quality of life improved from baseline and were similar between the two groups at 2 years. Median total hospital cost and median mesh cost were higher for biologic compared to synthetic mesh.

CONCLUSION: Biologic and synthetic mesh have similar wound morbidity, reoperations, 2-year hernia recurrence rates, and quality of life in parastomal hernia repairs. Cost should be considered in mesh choice for parastomal hernia repairs.

PMID:35588504 | DOI:10.1097/XCS.0000000000000275

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Nevin Manimala Statistics

Efficacy of the use of chondroitin sulphate and glucosamine for the treatment of temporomandibular joint dysfunction: A systematic review and meta-analysis

Cranio. 2022 May 19:1-10. doi: 10.1080/08869634.2022.2076796. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the efficacy of chondroitin sulfate (CS) and glucosamine (GS), the most relevant drugs of “Symptomatic Slow Acting Drug for Osteoarthritis” (SYSADOA), in the functional and symptomatic improvement of temporomandibular dysfunction. Although, controversy exists regarding their benefit.

METHODS: An electronic search was conducted to retrieve randomized controlled clinical trials (RCTs). The risk of bias assessment was evaluated using the Cochrane Collaboration’s tool. Data were meta-analyzed with a random effect model whenever possible.

RESULTS: Three RCTs were included. Qualitative results showed a decrease in pain, joint noise, and inflammatory biomarkers in synovial fluid and an improvement in maximum mouth opening without significant adverse effects. Meta-analysis showed a significant increase in maximum mouth opening with the use of CS-GS (p = 0.19). No statistically significant differences were found in pain reduction compared to tramadol.

CONCLUSION: CS-GS is effective and safe in the symptomatic and functional improvement of patients with TMD.

PMID:35588467 | DOI:10.1080/08869634.2022.2076796

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Nevin Manimala Statistics

Estimates of economic and environmental damages from tipping points cannot be reconciled with the scientific literature

Proc Natl Acad Sci U S A. 2022 May 24;119(21):e2117308119. doi: 10.1073/pnas.2117308119. Epub 2022 May 19.

NO ABSTRACT

PMID:35588449 | DOI:10.1073/pnas.2117308119

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Nevin Manimala Statistics

Association of hypertension with helicobacter pylori: A systematic review and meta‑analysis

PLoS One. 2022 May 19;17(5):e0268686. doi: 10.1371/journal.pone.0268686. eCollection 2022.

ABSTRACT

BACKGROUND AND AIMS: The number of hypertensive population rises year by year recently, and their age becomes more youthful. For a long time, hypertension has long been regarded as a multi-factorial disease. In addition to smoking, genetics, diet and other factors, helicobacter pylori (H. pylori) had been regarded as a potential risk factor for hypertension in recent years. However, most studies had certain limitations and their results were inconsistent. Thus, it is necessary for us to assess the impact of H. pylori on hypertension through meta-analysis.

METHODS: We searched all published relevant literature through multiple databases by July 23, 2021. Pooled results were calculated under the random effect model. Heterogeneity was evaluated by the Q statistic and the I2 statistic. The risk of bias was evaluated via ROBINS-I tool. Publication bias was evaluated by the Egger test and Begg funnel plot.

RESULTS: 6 eligible studies involving 11317 hypertensive patients and 12765 controls were selected from 20767 retrieval records. Our research confirmed that H. pylori significantly increased the probability of suffering from hypertension in the random effect model (OR:1.34, 95% CI:1.10-1.63, P = 0.002, I2 = 74%). The same results were also found in both Asian population and developing country (OR:1.28, 95%CI:1.05-1.55, P = 0.003, I2 = 78.5%).

CONCLUSIONS: Our results confirmed that H. pylori was a vital risk factor for hypertension. H. pylori-infected people were 13.4% higher risk for hypertension than uninfected individuals. In addition, it will be a new method to prevent and treat hypertension by eradicating H. pylori.

TRIAL REGISTRATION: The registration number for systematic review in PROSPERO CRD42021279677.

PMID:35588432 | DOI:10.1371/journal.pone.0268686

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Nevin Manimala Statistics

Marginal structural models using calibrated weights with SuperLearner: application to type II diabetes cohort

IEEE J Biomed Health Inform. 2022 May 19;PP. doi: 10.1109/JBHI.2022.3175862. Online ahead of print.

ABSTRACT

As different scientific disciplines begin to converge on machine learning for causal inference, we demonstrate the application of machine learning algorithms in the context of longitudinal causal estimation using electronic health records. Our aim is to formulate a marginal structural model for estimating diabetes care provisions in which we envisioned hypothetical (i.e. counterfactual) dynamic treatment regimes using a combination of drug therapies to manage diabetes: metformin, sulfonylurea and SGLT-2i. The binary outcome of diabetes care provisions was defined using a composite measure of chronic disease prevention and screening elements [27] including (i) primary care visit, (ii) blood pressure, (iii) weight, (iv) hemoglobin A1c, (v) lipid, (vi) ACR, (vii) eGFR and (viii) statin medication. We used several statistical learning algorithms to describe causal relationships between the prescription of three common classes of diabetes medications and quality of diabetes care using the electronic health records contained in National Diabetes Repository. In particular, we generated an ensemble of statistical learning algorithms using the SuperLearner framework based on the following base learners: (i) least absolute shrinkage and selection operator, (ii) ridge regression, (iii) elastic net, (iv) random forest, (v) gradient boosting machines, and (vi) neural network. Each statistical learning algorithm was fitted using the pseudo-population generated from the marginalization of the time-dependent confounding process. Covariate balance was assessed using the longitudinal (i.e. cumulative-time product) stabilized weights with calibrated restrictions. Our results indicated that the treatment drop-in cohorts (with respect to metformin, sulfonylurea and SGLT-2i) may have improved diabetes care provisions in relation to treatment naive (i.e. no treatment) cohort. As a clinical utility, we hope that this article will facilitate discussions around the prevention of adverse chronic outcomes associated with type II diabetes through the improvement of diabetes care provisions in primary care.

PMID:35588417 | DOI:10.1109/JBHI.2022.3175862

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Nevin Manimala Statistics

Analysis of a double Poisson model for predicting football results in Euro 2020

PLoS One. 2022 May 19;17(5):e0268511. doi: 10.1371/journal.pone.0268511. eCollection 2022.

ABSTRACT

First developed in 1982, the double Poisson model, where goals scored by each team are assumed to be Poisson distributed with a mean depending on attacking and defensive strengths, remains a popular choice for predicting football scores, despite the multitude of newer methods that have been developed. This paper examines the pre-tournament predictions made using this model for the Euro 2020 football tournament. These predictions won the Royal Statistical Society’s prediction competition, demonstrating that even this simple model can produce high-quality results. Moreover, the paper also presents a range of novel analytic results which exactly quantify the conditions for the existence and uniqueness of the solution to the equations for the model parameters. After deriving these results, it provides a novel examination of a potential problem with the model-the over-weighting of the results of weaker teams-and illustrates the effectiveness of ignoring results against the weakest opposition. It also compares the predictions with the actual results of Euro 2020, showing that they were extremely accurate in predicting the number of goals scored. Finally, it considers the choice of start date for the dataset, and illustrates that the choice made by the authors (which was to start the dataset just after the previous major international tournament) was close to optimal, at least in this case. The findings of this study give a better understanding of the mathematical behaviour of the double Poisson model and provide evidence for its effectiveness as a match prediction tool.

PMID:35588428 | DOI:10.1371/journal.pone.0268511

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Nevin Manimala Statistics

Visual Data Exploration as a Statistical Testing Procedure: Within-view and Between-view Multiple Comparisons

IEEE Trans Vis Comput Graph. 2022 May 19;PP. doi: 10.1109/TVCG.2022.3175532. Online ahead of print.

ABSTRACT

A fundamental problem in visual data exploration concerns whether observed patterns are true or merely random noise. This problem is especially pertinent in visual analytics, where the user is presented with a barrage of patterns, without any guarantees of their statistical validity. Recently this problem has been formulated in terms of statistical testing and the multiple comparisons problem. In this paper, we identify two levels of multiple comparisons problems in visualization: the within-view and the between-view problem. We develop a statistical testing procedure for interactive data exploration that controls the family-wise error rate on both levels. The procedure enables the user to determine the compatibility of their assumptions about the data with visually observed patterns. We present use-cases where we visualize and evaluate patterns in real-world data.

PMID:35588414 | DOI:10.1109/TVCG.2022.3175532

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Nevin Manimala Statistics

Addiction and human male fertility: A systematic review and a critical appraisal

Andrology. 2022 May 19. doi: 10.1111/andr.13196. Online ahead of print.

ABSTRACT

BACKGROUND: Addiction is a global problem that has many negative consequences on human health as well as the quality of life.

OBJECTIVES: This review aimed to assess the effect of addiction on human male fertility.

METHODS: A systematic review was conducted on various electronic sites.

RESULTS: The initial literature search identified a total of 5239 articles in all searched databases. After removing duplicates and application of inclusion/exclusion criteria,177 were potential articles, 112 were omitted because no direct relevance was encountered. Finally, 65 studies were retained for review. They were classified according to the type of addiction into; opioids and cannabinoids (18 articles), alcohol (7 articles), cocaine (2 articles), Androgenic Anabolic steroids AAS (15 articles), tobacco (10 articles) and caffeine (13 articles). Most of these recruited articles demonstrated a negative impact of the addressed substance on male fertility with variable levels of evidence.

CONCLUSIONS: It was concluded that addiction harms human male fertility that should be put into consideration. More future studies are needed after a proper methodological and statistical approach, including logistic regression analysis, to predict the effect of a specific substance on human male fertility. This article is protected by copyright. All rights reserved.

PMID:35588397 | DOI:10.1111/andr.13196