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Nevin Manimala Statistics

Complex Lymphatic Anomalies: Report on a Patient Registry Using the Latest Diagnostic Guidelines

Lymphat Res Biol. 2023 Jan 27. doi: 10.1089/lrb.2022.0041. Online ahead of print.

ABSTRACT

Objective: Generalized lymphatic anomaly (GLA), Gorham-Stout disease (GSD), kaposiform lymphangiomatosis (KLA), and central conducting lymphatic anomaly (CCLA) are rare, multisystem lymphatic disorders, referred to as complex lymphatic anomalies (CLAs). Their etiology remains poorly understood; however, somatic activating mutations have recently been discovered, and the results of targeted treatments are promising. This study aimed to elaborate on the phenotypic description of CLA. Methods: Thirty-six consecutive patients were recruited for the “GLA/GSD Registry” of the University Hospital of Freiburg, Germany (2015-2021). Clinical data were prospectively collected provided that a signed informed consent form was obtained. The latest proposed diagnostic guidelines were retrospectively applied. Results: Thirty-two patients (38% males) were included in the study; 15 GLA, 10 GSD, 3 KLA, and 4 CCLA patients were identified. Eighty-four percent already had symptoms by the age of 15 years. Osteolysis and periosseous soft-tissue infiltration were associated with GSD (p < 0.001 and p = 0.011, respectively), ascites and protein-losing enteropathy with CCLA (p = 0.007 and p = 0.004, respectively), and consumption coagulopathy with KLA (p = 0.006). No statistically significant differences were found in organ involvement, distribution of osteolytic lesions, number of affected bones and fractures. Twenty-five patients had complications; one patient with GLA died despite multimodal treatment. Spontaneous regression was seen in one patient with untreated KLA. Conclusions: CLA are rare, and their overlapping clinical presentations make differential diagnosis difficult. The characterization of our case series contributes to the phenotypic description and differentiation of these four clinical entities. A further understanding of their pathogenesis is crucial for evaluating targeted therapies and optimizing medical care.

PMID:36706428 | DOI:10.1089/lrb.2022.0041

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Nevin Manimala Statistics

Dissipation Mechanisms in Fermionic Josephson Junction

Phys Rev Lett. 2023 Jan 13;130(2):023003. doi: 10.1103/PhysRevLett.130.023003.

ABSTRACT

We characterize numerically the dominant dynamical regimes in a superfluid ultracold fermionic Josephson junction. Beyond the coherent Josephson plasma regime, we discuss the onset and physical mechanism of dissipation due to the superflow exceeding a characteristic speed, and provide clear evidence distinguishing its physical mechanism across the weakly and strongly interacting limits, despite qualitative dynamics of global characteristics being only weakly sensitive to the operating dissipative mechanism. Specifically, dissipation in the strongly interacting regime occurs through the phase-slippage process, caused by the emission and propagation of quantum vortices, and sound waves-similar to the Bose-Einstein condensation limit. Instead, in the weak interaction limit, the main dissipative channel arises through the pair-breaking mechanism.

PMID:36706420 | DOI:10.1103/PhysRevLett.130.023003

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Nevin Manimala Statistics

Development and Validation of a Model to Predict Who Will Develop Myopia in the Following Year as a Criterion to Define Premyopia

Asia Pac J Ophthalmol (Phila). 2023 Jan-Feb 01;12(1):38-43. doi: 10.1097/APO.0000000000000591. Epub 2023 Jan 11.

ABSTRACT

PURPOSE: To develop and validate models to predict who will develop myopia in the following year based on cycloplegic refraction or ocular biometry and to identify thresholds of premyopia.

METHODS: Prospective longitudinal data of nonmyopic children at baseline from the Guangzhou Twins Eye Study and the Guangzhou Outdoor Activity Longitudinal Study were used as the training set, and the Singapore Cohort Study of the Risk factors for Myopia study formed the external validation set. Age, sex, cycloplegic refraction, ocular biometry, uncorrected visual acuity, and parental myopia were integrated into 3 logistic regression models to predict the onset of myopia in the following year. Premyopia cutoffs and an integer risk score system were derived based on the identified risk.

RESULTS: In total, 2896 subjects with at least 2 visits were included. Cycloplegic refraction at baseline is a better predictor to identify the children with myopia onset [C-statistic=0.91, 95% confidence interval (CI), 0.87-0.94; C-statistic=0.92, 95% CI, 0.92-0.92 for internal and external validation, respectively], comparing to axial length, corneal curvature radius (CR) and anterior chamber depth (C-statistic=0.81, 95% CI, 0.73-0.88; C-statistic=0.80, 95% CI, 0.79-0.80, respectively), and axial length/CR (C-statistic=0.78, 95% CI, 0.71-0.85; C-statistic=0.76, 95% CI, 0.75-0.76). With a risk of >70%, the definitions of premyopia indicating approaching myopia onset were 0.00 D for 6-8 years and -0.25 D for ≥9 years in children with 2 myopic parents.

CONCLUSIONS: Either cycloplegic refraction or ocular biometry can predict 1-year risk of myopia. Premyopia can be successfully defined through risk assessments based on children’s age and predict who would require more aggressive myopia prophylaxis.

PMID:36706333 | DOI:10.1097/APO.0000000000000591

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Nevin Manimala Statistics

Development and Validation of a Multidimensional Short Version Zarit Burden Interview (ZBI-9) for Caregivers of Persons With Cognitive Impairment

Alzheimer Dis Assoc Disord. 2023 Jan 18. doi: 10.1097/WAD.0000000000000537. Online ahead of print.

ABSTRACT

BACKGROUND: There is a lack of appreciation of the full dimensionality of the original 22-item Zarit Burden Interview (ZBI) in the development of short versions. Existing short versions are premised upon a 1-factor or 2-factor structure or statistical techniques for item selection. Thus, there is a need for ZBI short versions that considers the multidimensional constructs of role strain, personal strain, and worry about performance (WaP) during item selection to provide a more holistic and comprehensive evaluation.

PURPOSE: To develop and validate a short version of ZBI through a combined quantitative and qualitative approach that incorporates the validated 4-factor structure of role strain demands; role strain-control; personal strain, and WaP.

PATIENTS: We studied 202 caregivers of patients with dementia (84.2%) or mild cognitive impairment (15.8%) attending a memory clinic in Singapore.

METHODS: Confirmatory factor analysis and qualitative considerations from expert consensus were used for item selection. Confirmatory factor analysis fit statistics support the 4-factor structure. The 9-item ZBI-9 showed good internal consistency (Cronbach’s α=0.87) and convergent validity with anxiety and depression (Pearson correlation: Hospital Anxiety and Depression sub-scales, r≥0.56, P<0.001; ZBI- 22, r=0.95, P<0.001). Using a cut-off score of ≥13, ZBI-9 displayed good discriminatory ability for depressive symptoms (area under curve=0.79, P<0.001; sensitivity=70%, specificity=75%). The ZBI-9 also displayed comparable performance to the 22-item full version and three 12-item short versions.

CONCLUSION: The ZBI-9 is a multidimensional short-version assessment tool for caregivers of persons with dementia and mild cognitive impairment that is reliable, valid, and discriminates depressive symptoms.

PMID:36706328 | DOI:10.1097/WAD.0000000000000537

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Nevin Manimala Statistics

Hidden in plain sight in the delivery room – The Apgar score is biased

J Perinat Med. 2023 Jan 30. doi: 10.1515/jpm-2022-0550. Online ahead of print.

ABSTRACT

OBJECTIVES: The objective of this study was to compare the maximum 5-min Apgar score of 10 among different U.S. races and Hispanic ethnicity.

METHODS: Retrospective population-based cohort study from the National Center for Health Statistics (NCHS), and Division of Vital Statistics natality online database. We included only deliveries where the race and Hispanic ethnicity of the father and mother were listed as either Black, White, Chinese, or Asian Indian and as Hispanic or Latino origin or other. Proportions of 5-Minute Apgar scores of 10 were compared among different races and Hispanic ethnicity for six groups each for mother and father: Non-Hispanic or Latino White, Hispanic or Latino White, Non-Hispanic or Latino Black, Hispanic or Latino Black, Chinese, and Asian Indian.

RESULTS: The study population consists of 9,710,066 mothers and 8,138,475 fathers from the US natality birth data 2016-2019. Black newborns had a less than 50% chance of having a 5-min Apgar score of 10 when compared to white newborns (OR 0.47 for Black mother and Black father; p<0.001). White babies (non-Hispanic and Hispanic) had the highest proportion of Apgar scores of 10 across all races and ethnicities.

CONCLUSIONS: The Apgar score introduces a bias by systematically lowering the score in people of color. Embedding skin color scoring into basic data and decisions of health care propagates race-based medicine. By removing the skin color portion of the Apgar score and with it’s racial and ethnic bias, we will provide more accuracy and equity when evaluating newborn babies worldwide.

PMID:36706313 | DOI:10.1515/jpm-2022-0550

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Nevin Manimala Statistics

Factors Associated With Sun Protection Behaviors Among Childhood Cancer Survivors

J Pediatr Hematol Oncol. 2023 Jan 10. doi: 10.1097/MPH.0000000000002618. Online ahead of print.

ABSTRACT

BACKGROUND: Childhood cancer survivors (CCS) are at increased risk of developing skin cancer. Engaging in sun-protective behaviors may ameliorate that risk, but prior work shows that survivors engage in suboptimal levels of sun-protective behaviors. Guided by the Health Belief Model (HBM), this study evaluated factors associated with sun-protective behavior among CCS.

METHODS: This is a secondary analysis of a survey study of 94 adult survivors of childhood cancer recruited from a long-term follow-up clinic. Participants reported their sun protection habits, skin type/sensitivity, barriers to sun protection, and perceived severity and susceptibility of getting skin cancer. Descriptive statistics were used to describe the prevalence of sun protection behaviors and hierarchical linear regression was used to evaluate predictors of sun protection behavior following the HBM.

RESULTS: On average, CCS engaged in moderate levels of sun-protective behaviors (M=2.53; SD=0.59). Hierarchical linear regression indicated that fair skin type (P=0.02) and higher perceived susceptibility relative to noncancer survivors (P=0.02) were associated with increased sun protection behaviors. Perceived barriers to sun protection were marginally significant (P=0.09), whereas other constructs from the HBM did not contribute significantly to the model.

CONCLUSIONS: Although CCS are at increased risk of developing skin cancer, they engage in suboptimal levels of sun protection behaviors. Findings suggest that interventions to educate survivors about their unique risk of skin cancer and effective prevention behaviors are needed.

PMID:36706312 | DOI:10.1097/MPH.0000000000002618

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Nevin Manimala Statistics

Covalent Library Screening by Targeted Mass Spectrometry for Rapid Binding Site Identification

Anal Chem. 2023 Jan 27. doi: 10.1021/acs.analchem.2c04967. Online ahead of print.

ABSTRACT

Interest in covalent drug discovery has surged in recent years, following the high-profile FDA approvals of covalent inhibitors that target BTK and KRAS G12C. High-throughput screening by intact protein mass spectrometry is a popular method for identifying lead matter from covalent fragment libraries. While the technique is proven in its capacity to confirm covalent binding, it does not provide binding site information on its own. Follow-up assays to identify binding sites can be time- and resource-intensive, potentially extending the hit confirmation timeline by weeks or months. Here, we describe the development of CoMPAS, a novel, targeted mass spectrometry-based covalent screening method that provides binding site information in the initial screen. The high sensitivity of targeted detection confers additional advantages over the intact protein method, including the ability to characterize more potent binders and reduced protein reagent requirements. Interpretation of the structure-activity relationship is simplified by enabling the use of binding site-specific EC50 values. To investigate higher-throughput screening beyond what is possible with standard liquid chromatography, we acquired data in parallel on an Agilent RapidFire system and compared the screening results by statistical analysis. To demonstrate the multiplexing capabilities of CoMPAS, we determined the target selectivity of screening hits against a pool of off-target kinases.

PMID:36706310 | DOI:10.1021/acs.analchem.2c04967

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Nevin Manimala Statistics

The Effects of Interactive Virtual Reality in Patients with Chronic Musculoskeletal Disorders: A Systematic Review and Meta-Analysis

Games Health J. 2023 Feb;12(1):1-12. doi: 10.1089/g4h.2022.0088.

ABSTRACT

Objective: Interactive virtual reality (iVR) has been widely used for treatment purposes in patients with chronic musculoskeletal disorders. However, no consensus has been reached on the effects of iVR on pain, psychological distress, and functional disability. Therefore, this study aims to investigate the effects of iVR on pain, psychological distress, and functional disability in patients with chronic musculoskeletal disorders compared with no rehabilitation and conventional rehabilitation. Methods: Five electronic databases (PubMed, Cochrane CENTRAL, Scopus, EMBASE, and Web of Science) were searched from January 2016 to December 2021. All randomized controlled trials using iVR for treating pain, psychological distress, and functional disability in patients with chronic musculoskeletal disorders were included. A subgroup analysis was conducted to compare the effects of nonimmersive and immersive types of iVR on the outcomes of interest. Results: Our study provides good quality evidence that iVR reduced overall pain by 9.28 points as compared with no rehabilitation and by 8.09 points as compared with conventional rehabilitation. In the subgroup analysis, nonimmersive iVR showed a reduction in psychological distress (standardized mean differences = -0.35) as compared with no rehabilitation. However, no statistically significant difference in the outcomes existed between nonimmersive and immersive iVR. Furthermore, there were no statistically significant differences in the outcomes of functional disability. Conclusions: iVR is recommended for reducing pain intensity more than no rehabilitation or conventional rehabilitation. Meanwhile, nonimmersive iVR has been proposed for psychological distress improvement, with effects similar to those of conventional rehabilitation. However, iVR may not be an effective intervention in the case of functional disability.

PMID:36706260 | DOI:10.1089/g4h.2022.0088

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Nevin Manimala Statistics

Differential climatic conditions drive Acacia tortilis tree growth in its opposite range edges in Africa and Asia

Am J Bot. 2023 Jan 27. doi: 10.1002/ajb2.16132. Online ahead of print.

ABSTRACT

PREMISE: Tree growth is a fundamental biological process that is essential to ecosystem functioning, as well as water and element cycling. Climate exerts a major impact on tree growth, with tree species often requiring a unique set of conditions to initiate growth and maintain it throughout a growing season. Still, little is known about the specific climatic factors that determine tree growth in savannah and desert tree species. Among global tree species, Acacia tortilis occupies one of the largest distribution ranges (crossing 6,500 km and 54 latitudes), spanning across large parts of Africa and into the Middle East and Asia.

METHODS: Here we measured climate and Acacia tortilis tree growth (continuous measurements of stem circumference) in its southern and northern range edges in South Africa (SA) and Israel (IL), respectively, aiming to elucidate whether the growth-climate interactions were similar in both edges.

KEY RESULTS: Growth occurred during the SA summer (between December and March), and in IL during early summer, and autumn (April-June and October-November, respectively). Surprisingly, annual growth was 40% higher in IL than in SA. Within the wide distribution range of Acacia tortilis, our statistical model showed that climatic drivers for tree growth differed between the two sites.

CONCLUSIONS: High temperatures facilitated growth in the hot and arid IL site, while high humidity permitted growth in the more humid SA site. Our results confer an additional understanding of tree growth adaptation to extreme conditions in Acacia’s world range edges, a major point of interest with ongoing climate change. This article is protected by copyright. All rights reserved.

PMID:36706279 | DOI:10.1002/ajb2.16132

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Nevin Manimala Statistics

Relationship between COVID-19 cases and vaccination rates in New York State counties

Ann Fam Med. 2022 Apr 1;(20 Suppl 1). doi: 10.1370/afm.20.s1.3134.

ABSTRACT

Context: The presence of new viral variants, in combination with the relaxation of social distancing and other preventative measures, has led to a spike in COVID-19 cases in the United States. The development of COVID-19 vaccinations may reduce the impact of these viral variants on case rates in the population. Objective: To determine the impact of COVID-19 vaccination rates on cases/100k population in each New York State (NYS) county. Study Design: Cross-sectional analysis of COVID-19 cases/100k population per NYS county, frozen at a single snapshot in time. Descriptive statistics and bivariate correlations were conducted to determine vaccination rates across 62 NYS counties, and linear regression was used to examine the effect of vaccination rates on cases/100k, controlling for size of county population. Dataset & Setting: Vaccination rates per county shared by the NYS Department of Health using data reported to the NYS Immunization Information System and the New York City Citywide Immunization Registry. COVID-19 case rates per county available through the John Hopkins University website. Population: NYS residents across 62 counties on March 31st, 2021. Outcome Measures: COVID-19 vaccination rates across counties at a single point in time were compared with cases/100k population. Results: Percentages with 1 dose and with 2 doses are highly correlated (r=.935, p<.001) with one another, and county population size was strongly correlated with cases per 100k (r=.715, p<.001). Both the 1 dose and 2 dose rates were negatively correlated with cases per 100k population, although not significantly. However, the two-dose vaccination rate was a significant negative predictor of cases per 100k population in NYS Counties (β= -.866, p=.031), with each percentage point of completed vaccination nearly equating to one case less in the daily count, when controlling for county population size (β =2.732, p<.001). Conclusion: While COVID-19 variants may impact vaccine effectiveness, current vaccination efforts are helping forestall some cases in NYS. Widespread vaccination is still an important goal. Primary care providers, public officials, and public health scientists should continue to urgently promote and support vaccination efforts.

PMID:36706247 | DOI:10.1370/afm.20.s1.3134