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Nevin Manimala Statistics

Causes and length of stay of readmission among individuals with traumatic spinal cord injury: a prospective observational cohort study

Spinal Cord. 2023 Feb 25. doi: 10.1038/s41393-023-00874-6. Online ahead of print.

ABSTRACT

BACKGROUND: Secondary conditions may reduce function and participation in individuals with chronic Spinal Cord Injury (SCI). The knowledge of reasons for readmission to the hospital may be enlightening to prevent them and remodel the health services.

STUDY DESIGN: Multicenter prospective observational study of all consecutive readmissions of persons with SCI after rehabilitation completion.

OBJECTIVES: To explore the characteristics of individuals with SCI readmitted to the hospital, the reasons for readmissions and the burden on hospitalization in terms of length of stay (LoS) for different conditions.

SETTING: 31 Italian specialized SCI centers.

METHODS: Data on people with traumatic SCI readmitted to SCI centers were recorded about: age, sex, SCI level and severity group, geographical origin, readmission causes, clinical interventions during hospitalization, LoS and discharge destination. Linear and multiple logistic regression analyses were performed considering LoS (days) as dependent variable for correlations with independent variables. All tests were two-sided.

RESULTS: Among 1039 persons with traumatic SCI enrolled (mean age 46, males 85%, tetraplegia 43%), 59.09% of the readmissions were caused by urological problems, 39.74% by pressure injury and 35.41% by spasticity (68% readmitted for ≥2 causes, associated with longer LoS). The mean LoS was 48 days: pressure injury, rehabilitative needs, sexual, bowel, and pain problems were associated with longer and urological problems with shorter LoS. People from the South of the country were frequently (68%) readmitted to the northern centers.

CONCLUSIONS: Urological problems, pressure injury and spasticity were the most frequent causes of re-hospitalization in individuals with traumatic SCI. The migration trend seeking SCI-specific treatments suggests geographic areas to which health care organizations need to pay more attention.

PMID:36841915 | DOI:10.1038/s41393-023-00874-6

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Nevin Manimala Statistics

Clinical outcomes for grades III-V acromioclavicular dislocations favor double-button fixation compared to clavicle hook plate fixation: a systematic review and meta-analysis

Eur J Orthop Surg Traumatol. 2023 Feb 25. doi: 10.1007/s00590-023-03492-3. Online ahead of print.

ABSTRACT

INTRODUCTION: The purpose of this study was to perform a systematic review and meta-analysis of both randomized controlled and observational studies comparing double-button suture fixation to hook plate fixation for types III-IV acromioclavicular joint dislocation.

METHODS: Systematic review of Medline, Embase, Scopus, and Google Scholar, including all levels 1-3 studies from 2000 to 2022. Clinical outcome scores, range of motion, and complications were included. Risk of bias was assessed using the Cochrane Collaboration’s ROB2 tool and ROBINs-I tool. MINORS and modified Coleman Methodology Score (CMS) were used to assess within study quality. The GRADE system was used to assess the overall quality of the body of evidence. Heterogeneity was assessed using χ2 and I2 statistics.

RESULTS: Fifteen studies were included. Three of the four included LOE II and eleven of the LOE III studies had a high risk of bias. Study quality was considered poor and fair for 67% by MINORS criteria and 93% for CMS criteria. The pooled estimate (SMD 0.662) for all clinical outcomes was statistically significant and in favor of button repair (p = 0.0001). The pooled estimate (SMD 0.662) for all VAS pain scores was statistically significant, again in favor of button repair (p = 0.001).

CONCLUSIONS: The results of this meta-analysis demonstrated significantly better outcomes of button repair for acute ACJ dislocations when compared to clavicle hook plate. Button repair is also associated with a 2.2 times lower risk for complications. However, risk of bias is high, and study quality within and between studies was low. These results, therefore, must be viewed with caution.

LEVEL OF EVIDENCE: Level III; systematic review and meta-analysis.

PMID:36841909 | DOI:10.1007/s00590-023-03492-3

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Nevin Manimala Statistics

Randomised controlled trial of breast cancer and multiple disease prevention weight loss programmes vs written advice amongst women attending a breast cancer family history clinic

Br J Cancer. 2023 Feb 25. doi: 10.1038/s41416-023-02207-z. Online ahead of print.

ABSTRACT

BACKGROUND: Overweight and obesity are common amongst women attending breast cancer Family History, Risk and Prevention Clinics (FHRPCs). Overweight increases risk of breast cancer (BC) and conditions including1 cardiovascular disease (CVD) and type-2 diabetes (T2D). Clinics provide written health behaviour advice with is likely to have minimal effects. We assessed efficacy of two remotely delivered weight loss programmes vs. written advice.

METHOD: 210 women with overweight or obesity attending three UK FHRPCs were randomised to either a BC prevention programme (BCPP) framed to reduce risk of BC (n = 86), a multiple disease prevention programme (MDPP) framed to reduce risk of BC, CVD and T2D (n = 87), or written advice (n = 37). Change in weight and health behaviours were assessed at 12-months.

RESULTS: Weight loss at 12 months was -6.3% (-8.2, -4.5) in BCPP, -6.0% (-7.9, -4.2) in MDPP and -3.3% (-6.2, -0.5) in the written group (p = 0.451 across groups). The percentage losing ≥10% weight in these groups were respectively 34%, 23% and 14% (p = 0.038 across groups).

DISCUSSION: BCPP and MDPP programmes resulted in more women achieving ≥10% weight loss, but no evidence of additional benefits of MDPP. A multicentre RCT to test the BCPP across UK FHRPCs is warranted. Clinical Trial Registration ISRCTN16431108.

PMID:36841908 | DOI:10.1038/s41416-023-02207-z

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Nevin Manimala Statistics

Revisiting prognostic factors in glioma with leptomeningeal metastases: a comprehensive analysis of clinical and molecular factors and treatment modalities

J Neurooncol. 2023 Feb 25. doi: 10.1007/s11060-022-04233-y. Online ahead of print.

ABSTRACT

PURPOSE: To comprehensively investigate prognostic factors, including clinical and molecular factors and treatment modalities, in adult glioma patients with leptomeningeal metastases (LM).

METHODS: Total 226 patients with LM (from 2001 to 2021 among 1495 grade 2 to 4 glioma patients, 88.5% of LM patients being IDH-wildtype) with complete information on IDH mutation, 1p/19q codeletion, and MGMT promoter methylation status were enrolled. Predictors of overall survival (OS) of entire patients were determined by time-dependent Cox analysis, including clinical, molecular, and treatment data. Subgroup analyses were performed for patients with LM at initial diagnosis and LM diagnosed at recurrence (herein, initial and recurrent LM). Identical analyses were performed in IDH-wildtype glioblastoma patients.

RESULTS: Median OS was 17.0 (IQR 9.7-67.1) months, with shorter median OS in initial LM than recurrent LM patients (12.2 vs 20.6 months, P < 0.001). In entire patients, chemotherapy and antiangiogenic therapy were predictors of longer OS, while male sex and initial LM were predictors of shorter OS. In initial LM, higher KPS, chemotherapy, and antiangiogenic therapy were predictors of longer OS, while male sex was a predictor of shorter OS. In recurrent LM, chemotherapy and longer interval between initial glioma and LM diagnoses were predictors of longer OS, while male sex was a predictor of shorter OS. A similar trend was observed in IDH-wildtype glioblastoma.

CONCLUSION: Active chemotherapy and antiangiogenic therapy demonstrated survival benefit in glioma patients with LM. There is consistent female survival advantage, whereas longer interval between initial glioma diagnosis and LM development suggests longer OS in recurrent LM.

PMID:36841906 | DOI:10.1007/s11060-022-04233-y

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Nevin Manimala Statistics

Micro-CT Imaging and Mechanical Properties of Ovine Ribs

Ann Biomed Eng. 2023 Feb 25. doi: 10.1007/s10439-023-03156-7. Online ahead of print.

ABSTRACT

The use of ovine animal models in the study of injury biomechanics and modeling is increasing, due to their favorable size and other physiological characteristics. Along with this increase, there has also been increased interest in the development of in silico ovine models for computational studies to compliment physical experiments. However, there remains a gap in the literature characterizing the morphological and mechanical characteristics of ovine ribs. The objective of this study therefore is to report anatomical and mechanical properties of the ovine ribs using microtomography (micro-CT) and two types of mechanical testing (quasi-static bending and dynamic tension). Using microtomography, young ovine rib samples obtained from a local abattoir were cut into approximately fourteen 38 mm sections and scanned. From these scans, the cortical bone thickness and cross-sectional area were measured, and the moment of inertia was calculated to enhance the mechanical testing data. Based on a standard least squares statistical model, the cortical bone thickness varied depending on the region of the cross-section and the position along the length of the rib (p < 0.05), whereas the cross-sectional area remained consistent (p > 0.05). Quasi-static three-point bend testing was completed on ovine rib samples, and the resulting force-displacement data was analyzed to obtain the stiffness (44.67 ± 17.65 N/mm), maximum load (170.54 ± 48.28 N) and displacement at maximum load (7.19 ± 2.75 mm), yield load (167.81 ± 48.12 N) and displacement at yield (6.10 ± 2.25 mm), and the failure load (110.90 ± 39.30 N) and displacement at failure (18.43 ± 2.10 mm). The resulting properties were not significantly affected by the rib (p > 0.05), but by the animal they originated from (p < 0.05). For the dynamic testing, samples were cut into coupons and tested in tension with an average strain rate of 18.9 strain/sec. The resulting dynamic testing properties of elastic modulus (5.16 ± 2.03 GPa), failure stress (63.29 ± 14.02 MPa), and failure strain (0.0201 ± 0.0052) did not vary based on loading rate (p > 0.05).

PMID:36841890 | DOI:10.1007/s10439-023-03156-7

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Nevin Manimala Statistics

Policy relevant health related liveability indicator datasets for addresses in Australia’s 21 largest cities

Sci Data. 2023 Feb 25;10(1):113. doi: 10.1038/s41597-023-02013-5.

ABSTRACT

Measuring and monitoring the spatial distribution of liveability is crucial to ensure that implemented urban and transport planning decisions support health and wellbeing. Spatial liveability indicators can be used to ensure these decisions are effective, equitable and tracked across time. The 2018 Australian National Liveability Study datasets comprise a suite of policy-relevant health-related spatial indicators of local neighbourhood liveability and amenity access estimated for residential address points and administrative areas across Australia’s 21 most populous cities. The indicators and measures encompass access to community and health services, social infrastructure, employment, food, housing, public open space, transportation, walkability and overall liveability. This national ‘baseline’ liveability indicators dataset for residential address points and areas can be further linked with surveys containing geocoded participant locations, as well as Census data for areas from the Australian Statistical Geography Standard. The datasets will be of interest to planners, policy makers and researchers interested in modelling and mapping the spatial distribution of urban environmental exposures and their relationship with health and other outcomes.

PMID:36841876 | DOI:10.1038/s41597-023-02013-5

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Nevin Manimala Statistics

Spatio-temporal visualization and forecasting of [Formula: see text] in the Brazilian state of Minas Gerais

Sci Rep. 2023 Feb 25;13(1):3269. doi: 10.1038/s41598-023-30365-w.

ABSTRACT

Air pollution due to air contamination by gases, liquids, and solid particles in suspension, is a great environmental and public health concern nowadays. An important type of air pollution is particulate matter with a diameter of 10 microns or less ([Formula: see text]) because one of the determining factors that affect human health is the size of particles in the atmosphere due to the degree of permanence and penetration they have in the respiratory system. Therefore, it is extremely interesting to monitor and understand the behavior of [Formula: see text] concentrations so that they do not exceed the established critical levels. In this work, we will study the [Formula: see text] concentrations in all available monitoring stations in the Brazilian state of Minas Gerais. To better understand its behavior, we will provide a spatio-temporal visualization of the [Formula: see text] concentrations. Besides the descriptive and visualization analysis, we consider six standard and advanced time series models that will be used to fit and forecast [Formula: see text] concentrations, with application to three locations, one in Belo Horizonte, the Minas Gerais state capital, and the monitoring stations with the lowest and highest average [Formula: see text] concentration levels.

PMID:36841859 | DOI:10.1038/s41598-023-30365-w

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Nevin Manimala Statistics

A fast privacy-preserving patient record linkage of time series data

Sci Rep. 2023 Feb 25;13(1):3292. doi: 10.1038/s41598-023-29132-8.

ABSTRACT

Recent advances in technology have led to an explosion of data in virtually all domains of our lives. Modern biomedical devices can acquire a large number of physical readings from patients. Often, these readings are stored in the form of time series data. Such time series data can form the basis for important research to advance healthcare and well being. Due to several considerations including data size, patient privacy, etc., the original, full data may not be available to secondary parties or researchers. Instead, suppose that a subset of the data is made available. A fast and reliable record linkage algorithm enables us to accurately match patient records in the original and subset databases while maintaining privacy. The problem of record linkage when the attributes include time series has not been studied much in the literature. We introduce two main contributions in this paper. First, we propose a novel, very efficient, and scalable record linkage algorithm that is employed on time series data. This algorithm is 400× faster than the previous work. Second, we introduce a privacy preserving framework that enables health institutions to safely release their raw time series records to researchers with bare minimum amount of identifying information.

PMID:36841850 | DOI:10.1038/s41598-023-29132-8

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Nevin Manimala Statistics

Variational quantum approximate support vector machine with inference transfer

Sci Rep. 2023 Feb 25;13(1):3288. doi: 10.1038/s41598-023-29495-y.

ABSTRACT

A kernel-based quantum classifier is the most practical and influential quantum machine learning technique for the hyper-linear classification of complex data. We propose a Variational Quantum Approximate Support Vector Machine (VQASVM) algorithm that demonstrates empirical sub-quadratic run-time complexity with quantum operations feasible even in NISQ computers. We experimented our algorithm with toy example dataset on cloud-based NISQ machines as a proof of concept. We also numerically investigated its performance on the standard Iris flower and MNIST datasets to confirm the practicality and scalability.

PMID:36841841 | DOI:10.1038/s41598-023-29495-y

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Nevin Manimala Statistics

Differential expression of interferon-induced protein with tetratricopeptide repeats 3 (IFIT3) in Alzheimer’s disease and HIV-1 associated neurocognitive disorders

Sci Rep. 2023 Feb 25;13(1):3276. doi: 10.1038/s41598-022-27276-7.

ABSTRACT

The United Nations projects that one in every six people will be over the age of 65 by the year 2050. With a rapidly aging population, the risk of Alzheimer’s disease (AD) becomes a major concern. AD is a multifactorial disease that involves neurodegeneration in the brain with mild dementia and deficits in memory and other cognitive domains. Additionally, it has been established that individuals with Human Immunodeficiency Virus-1 (HIV-1) experience a 5 to 10-year accelerated aging and an increased risk of developing HIV-associated neurocognitive disorders (HAND). Despite a significant amount of clinical evidence pointing towards a potential overlap between neuropathogenic processes in HAND and AD, the underlying epigenetic link between these two diseases is mostly unknown. This study is focused on identifying differentially expressed genes observed in both AD and HAND using linear regression models and a more robust significance analysis of microarray. The results established that the dysregulated type 1 and 2 interferon pathways observed in both AD and HAND contribute to the similar pathologies of these diseases within the brain. The current study identifies the important roles of interferon pathways in AD and HAND, a relationship that may be useful for earlier detection in the future.

PMID:36841839 | DOI:10.1038/s41598-022-27276-7