Category: Nevin Manimala

Georgian Med News. 2023 Mar;(336):6-12.

ABSTRACT

The ACL is the primary stabilizer of the knee joint. The injury leads to instability of the knee joint, which is a trigger for the subsequent destructive changes of the intra-articular structures such as menisci and cartilage of the joint surfaces. The most affected group is people of an active age, engaged in amateur sports. Also, this pathology is an occupational hazard in the military. In this community, ACL injuries have reached 3.24% in men and 3.51% in women, with increasing trends, especially among women. This data is derived from a study by Keller Army Hospital, West Point, New York. In this study we selected 2 groups of patients – operated with autograft and operated with allograft. The groups included 25 patients followed for a period of 18 months. The tissues used for ACL reconstruction were: 1) for allograft – BTB donor tissue / allograft / 2) for autologous transplantation – mm. Semitendinosus et Gracillis / autograft /. After the operation, the patients are placed in a rehabilitation program in five interconnected phases. The way they are performed allows the principle of gradual loading and constant feedback between the patient and the physiotherapist to be observed. Each of the phases has specific goals in the rehabilitation cycle, which has a certain approximate duration. After completion of the rehabilitation process, the clinical outcomes of both groups were compared using the International Documentation Committee (IKDC), Lysholm, and three in-house diagnostic methods. Our own diagnostic methods are Power test (a strength simulator is used, which directly examines the strength of the limb in flexion and extension in real life test. The results from IKDC were in favor of the autograft group (92.82) and from Lischolm of the allograft group (92.24). In terms of the power test the results were in favor of the allograft group. The result from the Power 1 test clearly shows statistically significant difference in symmetry of power in flexion and extension which is better in the allograft group compared to the autograft group. In our research we did not come across such a test in other studies. In conclusion we proved that the development of a single strict rehabilitation protocol focusing on the principle of gradual increase in workloads achieves comparable results in the frequency of re-rupture in both the allograft and auto-graft groups.

PMID:37166871

Psychol Aging. 2023 May 11. doi: 10.1037/pag0000752. Online ahead of print.

ABSTRACT

Organizing information is beneficial to episodic memory performance. Among several possible organizational strategies, two consist of organizing the information in semantic clusters (semantic organization) or self-organizing the information based on new associations that do not exist in semantic memory (subjective organization). Here, we investigated in a single study how these two organizational behaviors were underlined by different controlled processes and whether these relations were subjected to age-related differences. We tested 123 younger adults (n = 63) and older adults (n = 60) on two episodic memory tasks, one where the words were organizable and another where the words were not organizable, allowing for semantic and subjective organization, respectively. Additionally, participants were tested on three cognitive control tasks (Wisconsin Card Sorting Test, Stroop Test and Trail Making Test) and three working memory tasks (Backward Digit Span, Alpha Span and N-back test). Results revealed well-established age-related differences in terms of recall performance and organizational strategy implementation. More importantly, we found evidence that the different cognitive tests statistically yielded two different latent factors, a cognitive control factor and a working memory factor. Based on this dissociation, we found that only cognitive control contributed to semantic organization in all age groups whereas only working memory contributed to subjective organization, also in all age groups. These results shed new lights on our understanding of how controlled processes differently contribute to organizational behaviors in episodic memory. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37166861 | DOI:10.1037/pag0000752

Psychol Methods. 2023 May 11. doi: 10.1037/met0000559. Online ahead of print.

ABSTRACT

Researcher degrees of freedom refer to arbitrary decisions in the execution and reporting of hypothesis-testing research that allow for many possible outcomes from a single study. Selective reporting of results (p-hacking) from this “multiverse” of outcomes can inflate effect size estimates and false positive rates. We studied the effects of researcher degrees of freedom and selective reporting using empirical data from extensive multistudy projects in psychology (Registered Replication Reports) featuring 211 samples and 14 dependent variables. We used a counterfactual design to examine what biases could have emerged if the studies (and ensuing meta-analyses) had not been preregistered and could have been subjected to selective reporting based on the significance of the outcomes in the primary studies. Our results show the substantial variability in effect sizes that researcher degrees of freedom can create in relatively standard psychological studies, and how selective reporting of outcomes can alter conclusions and introduce bias in meta-analysis. Despite the typically thousands of outcomes appearing in the multiverses of the 294 included studies, only in about 30% of studies did significant effect sizes in the hypothesized direction emerge. We also observed that the effect of a particular researcher degree of freedom was inconsistent across replication studies using the same protocol, meaning multiverse analyses often fail to replicate across samples. We recommend hypothesis-testing researchers to preregister their preferred analysis and openly report multiverse analysis. We propose a descriptive index (underlying multiverse variability) that quantifies the robustness of results across alternative ways to analyze the data. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37166859 | DOI:10.1037/met0000559

Psychol Methods. 2023 May 11. doi: 10.1037/met0000571. Online ahead of print.

ABSTRACT

R-squared measures of explained variance are easy to understand, naturally interpretable, and widely used by substantive researchers. In mediation analysis, however, despite recent advances in measures of mediation effect, few effect sizes have good statistical properties. Also, most of these measures are only available for the simplest three-variable mediation model, especially for R²-type measures. By decomposing the mediator into two parts (i.e., the part related to the predictor and the part unrelated to the predictor), this article proposes a systematic framework to develop new effect-size measures of explained variance in mediation analysis. The framework can be easily extended to more complex mediation models and provides more delicate R² measures for empirical researchers. A Monte Carlo simulation study is conducted to examine the statistical properties of the proposed R² effect-size measure. Results show that the new R2 measure performs well in approximating the true value of the explained variance of the mediation effect. The use of the proposed measure is illustrated with empirical examples together with program code for its implementation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37166856 | DOI:10.1037/met0000571

Psychol Methods. 2023 May 11. doi: 10.1037/met0000582. Online ahead of print.

ABSTRACT

Cognitive models provide a substantively meaningful quantitative description of latent cognitive processes. The quantitative formulation of these models supports cumulative theory building and enables strong empirical tests. However, the nonlinearity of these models and pervasive correlations among model parameters pose special challenges when applying cognitive models to data. Firstly, estimating cognitive models typically requires large hierarchical data sets that need to be accommodated by an appropriate statistical structure within the model. Secondly, statistical inference needs to appropriately account for model uncertainty to avoid overconfidence and biased parameter estimates. In the present work, we show how these challenges can be addressed through a combination of Bayesian hierarchical modeling and Bayesian model averaging. To illustrate these techniques, we apply the popular diffusion decision model to data from a collaborative selective influence study. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37166854 | DOI:10.1037/met0000582

Ann Am Thorac Soc. 2023 Feb 27. doi: 10.1513/AnnalsATS.202209-814OC. Online ahead of print.

ABSTRACT

RATIONALE: Little is known about the safety of infusing vasopressors through a midline catheter.

OBJECTIVES: To evaluate safety outcomes following vasopressor administration though a midline.

METHODS: We conducted a cohort study of adults admitted to 39 hospitals in Michigan (December 2017 – March 2022) who received vasopressors while either a midline or peripherally inserted central catheter (PICC) was in place. Patients receiving vasopressors through a midline were compared to those receiving vasopressors through a PICC and, separately, to those with midlines in place but who received vasopressors through a different catheter. We used descriptive statistics to characterize and compare cohort characteristics. Multivariable mixed effects logistic regression models were fit to determine the association between vasopressor administration through a midline with outcomes, primarily catheter-related complications (bloodstream infection, superficial thrombophlebitis, exit site infection, or catheter occlusion).

RESULTS: Our cohort included 287 patients with midlines through which vasopressors were administered, 1660 with PICCs through which vasopressors were administered, and 884 patients with midlines who received vasopressors through a separate catheter. Age (median [interquartile range]: 68.7 [58.6-75.7], 66.6 [57.1-75.0], and 67.6 [58.7-75.8] years) and gender (percent female: 50.5%, 47.3%, and 43.8%) were similar in all groups. The frequency of catheter-related complications was lower in patients with midlines used for vasopressors than PICCs used for vasopressors (5.2% vs. 13.4%, p<0.001), but similar to midlines with vasopressor administration through a different device (5.2% vs. 6.3%, p=0.49). Following adjustment, administration of vasopressors through a midline was not associated with catheter-related complications compared to PICCs with vasopressors (adjusted odds ratios [aOR] 0.65 [95% confidence interval, 0.31-1.33], p=0.23), nor midlines with vasopressors elsewhere (aOR 0.85 [0.46-1.58], p=0.59). Midlines used for vasopressors were associated with greater risk of systemic thromboembolism (vs PICCs with vasopressors: (aOR 2.69 [1.31,5.49] , p=0.008; vs midlines with vasopressors elsewhere: aOR 2.42 [1.29,4.54], p=0.008) yet not thromboses restricted to the ipsilateral upper extremity (vs PICCs with vasopressors: aOR 2.35 [0.83,6.63], p=0.10; model did not converge for vs midlines with vasopressors elsewhere).

CONCLUSIONS: We found no significant association of vasopressor administration though a midline with catheter-related complications. However, we identified an increased odds of systemic (but not ipsilateral upper extremity) venous thromboembolism warranting further evaluation.

PMID:37166852 | DOI:10.1513/AnnalsATS.202209-814OC

Psychol Assess. 2023 May 11. doi: 10.1037/pas0001218. Online ahead of print.

ABSTRACT

The Hierarchical Taxonomy of Psychopathology (HiTOP; Kotov et al., 2017, 2021) is offered as a dimensional alternative to traditional categorical diagnostic nosologies such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD). HiTOP researchers have recently published an open-source assessment system for clinical implementation, the HiTOP Digital Assessment and Tracker (Jonas et al., 2021). Here, we argue that the Minnesota Multiphasic Personality Inventory-3 (MMPI-3; Ben-Porath & Tellegen 2020a), given its structural similarities to HiTOP, can augment these efforts to shift the diagnostic paradigm, with the additional strength of being comprehensively validated, standardized, and normed. Sellbom et al. (2021) examined the factor structure of the MMPI-3 Specific Problems Scales (plus RC6 and RC8), finding a pattern of latent factors much like those proposed by HiTOP in both a general mental health sample and a prisoner sample. The present study is a partial replication of Sellbom et al. (2021) with a primary medical care outpatient sample (n = 164) and a college student sample (n = 529). A sequential factoring approach yielded emergent structures that are comparable to the HiTOP model. These findings with different and important samples support the generalizability of the MMPI-3 in assessing HiTOP constructs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37166849 | DOI:10.1037/pas0001218

J Consult Clin Psychol. 2023 May 11. doi: 10.1037/ccp0000820. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the efficacy of different approaches to personalization in psychological therapy.

METHOD: This was a systematic review and meta-analysis of randomized controlled trials that compared the mental health outcomes of personalized treatment with standardized treatment and other control groups. Eligible studies were identified through three databases (Scopus, APA PsycInfo, and Web of Science). We conducted a narrative synthesis and random effects meta-analysis of available outcomes date, including subgroup analyses to investigate sources of effect size heterogeneity. The review protocol was preregistered in the Open Science Framework.

RESULTS: Seventeen studies (N = 7,617) met inclusion criteria for the review, nine of which (N = 5,134) provided sufficient data for inclusion in meta-analysis. Eight studies were classed as having high risk of bias, eight had moderate risk, and one had low risk. There was no significant evidence of publication bias. A statistically significant effect size was found in favor of personalized treatment relative to standardized treatment (d = 0.22, 95% CI [0.05, 0.39], p = .011). When studies with a high risk of bias were removed, this effect size was smaller but remained statistically significant (d = 0.14, 95% CI [0.08, 0.20], p < .001).

CONCLUSION: Current evidence indicates that personalization is an effective strategy to improve outcomes from psychological therapy, and the seemingly small effect size advantage of personalization could have an important impact at a clinical population level. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37166831 | DOI:10.1037/ccp0000820

Emotion. 2023 May 11. doi: 10.1037/emo0001218. Online ahead of print.

ABSTRACT

The ability to measure emotional states in daily life using mobile devices has led to a surge of exciting new research on the temporal evolution of emotions. However, much of the potential of these data still remains untapped. In this paper, we reanalyze emotion measurements from seven openly available experience sampling methodology studies with a total of 835 individuals to systematically investigate the modality (unimodal, bimodal, and more than two modes) and skewness of within-person emotion measurements. We show that both multimodality and skewness are highly prevalent. In addition, we quantify the heterogeneity across items, individuals, and measurement designs. Our analysis reveals that multimodality is more likely in studies using an analog slider scale than in studies using a Likert scale; negatively valenced items are consistently more skewed than positive valenced items; and longer time series show a higher degree of modality in positive and a higher skew in negative items. We end by discussing the implications of our results for theorizing, measurement, and time series modeling. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37166827 | DOI:10.1037/emo0001218

JAMA Oncol. 2023 May 11. doi: 10.1001/jamaoncol.2023.0646. Online ahead of print.

ABSTRACT

IMPORTANCE: Combination of chemotherapy with (dual) ERBB2 blockade is considered standard in hormone receptor (HR)-positive/ERBB2-positive early breast cancer (EBC). Despite some promising data on endocrine therapy (ET) combination with dual ERBB2 blockade in HR-positive/ERBB2-positive BC, to our knowledge, no prospective comparison of neoadjuvant chemotherapy vs ET plus ERBB2 blockade in particular with focus on molecular markers has yet been performed.

OBJECTIVE: To determine whether neoadjuvant de-escalated chemotherapy is superior to endocrine therapy, both in combination with pertuzumab and trastuzumab, in a highly heterogeneous HR-positive/ERBB2-positive EBC.

DESIGN, SETTING, AND PARTICIPANTS: This prospective, multicenter, neoadjuvant randomized clinical trial allocated 207 patients with centrally confirmed estrogen receptor-positive and/or progesterone receptor-positive (>1%) HR-positive/ERBB2-positive EBC to 12 weeks of standard ET (n = 100) vs paclitaxel (n = 107) plus trastuzumab and pertuzumab. A total of 186 patients were required to detect a statistically significant difference in pathological complete response (pCR) (assumptions: 19% absolute difference in pCR; power, ≥80%; 1-sided Fisher exact test, 2.5% significance level).

INTERVENTIONS: Standard ET (aromatase inhibitor or tamoxifen) or paclitaxel, 80 mg/m2, weekly plus trastuzumab and pertuzumab every 21 days.

MAIN OUTCOMES AND MEASURES: The primary end point was pCR (ypT0/is, ypN0). Secondary end points included safety, translational research, and health-related quality of life. Omission of further chemotherapy was allowed in patients with pCR. PAM50 analysis was performed on baseline tumor biopsies.

RESULTS: Of the 207 patients included (median [range] age, 53 [25-83] years), 121 (58%) had cT2 to cT4 tumors, and 58 (28%) had clinically node-positive EBC. The pCR rate in the ET plus trastuzumab and pertuzumab arm was 23.7% (95% CI, 15.7%-33.4%) vs 56.4% (95% CI, 46.2%-66.3%) in the paclitaxel plus trastuzumab and pertuzumab arm (odds ratio, 0.24; 95% CI, 0.12-0.46; P < .001). Both immunohistochemical ERBB2 score of 3 or higher and ERBB2-enriched subtype were independent predictors for pCR in both arms. Paclitaxel was superior to ET only in the first through third quartiles but not in the highest ERBB2 quartile by messenger RNA. In contrast with the paclitaxel plus trastuzumab and pertuzumab arm, no decrease in health-related quality of life after 12 weeks was observed in the ET plus trastuzumab and pertuzumab arm.

CONCLUSIONS AND RELEVANCE: The WSG-TP-II randomized clinical trial is, to our knowledge, the first prospective trial comparing 2 neoadjuvant de-escalation treatments in HR-positive/ERBB2-positive EBC and demonstrated an excellent pCR rate after 12 weeks of paclitaxel plus trastuzumab and pertuzumab that was clearly superior to the pCR rate after ET plus trastuzumab and pertuzumab.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03272477.

PMID:37166817 | DOI:10.1001/jamaoncol.2023.0646