Category: Nevin Manimala

BMC Public Health. 2022 Nov 29;22(1):2215. doi: 10.1186/s12889-022-14628-1.

ABSTRACT

BACKGROUND: Verbal autopsy (VA) has emerged as an increasingly popular technique to assign cause of death in parts of the world where the majority of deaths occur without proper medical certification. The purpose of this study was to examine the key characteristics of studies that have attempted to validate VA cause of death against an established cause of death.

METHODS: A systematic review was conducted by searching the MEDLINE, EMBASE, Cochrane-library, and Scopus electronic databases. Included studies contained 1) a VA component, 2) a validation component, and 3) original analysis or re-analysis. Characteristics of VA studies were extracted. A total of 527 studies were assessed, and 481 studies screened to give 66 studies selected for data extraction.

RESULTS: Sixty-six studies were included from multiple countries. Ten studies used an existing database. Sixteen studies used the World Health Organization VA questionnaire and 5 studies used the Population Health Metrics Research Consortium VA questionnaire. Physician certification was used in 36 studies and computer coded methods were used in 14 studies. Thirty-seven studies used high level comparator data with detailed laboratory investigations.

CONCLUSION: Most studies found VA to be an effective cause of death assignment method and compared VA cause of death to a high-quality established cause of death. Nonetheless, there were inconsistencies in the methodologies of the validation studies, and many used poor quality comparison cause of death data. Future VA validation studies should adhere to consistent methodological criteria so that policymakers can easily interpret the findings to select the most appropriate VA method.

PROSPERO REGISTRATION: CRD42020186886.

PMID:36447199 | DOI:10.1186/s12889-022-14628-1

BMC Complement Med Ther. 2022 Nov 29;22(1):315. doi: 10.1186/s12906-022-03792-x.

ABSTRACT

BACKGROUND: Coronary angiography is the gold standard for the diagnosis of coronary artery disease. This intervention is nevertheless a source of anxiety for the patient both by its discomfort and by the consequences linked to the discovery of potential diseases.

OBJECTIVES: The aim of this study was to determine the effectiveness of hypnosis in reducing anxiety in patients undergoing coronary angiography.

METHODS: One hundred sixty-nine patients with planned coronary angiography and no history of coronary angiography were randomized to a hypnosis or control group. Patients in the hypnosis group underwent a hypnosis session with self-hypnosis posthypnotic suggestions, while those in the control group had a conversational interview with the hypnotherapist. The primary endpoint was pre-exam anxiety level assessed by the Spielberger State-Trait Anxiety Inventory (STAI-Y A).

RESULTS: Performing a hypnosis session did not result in a significant decrease in anxiety before the intervention. Age, high trait anxiety, high state anxiety the day before, and belief that hypnosis works in general were associated with increased anxiety before the procedure. No adverse events were reported after hypnosis. There was no statistically significant difference between the 2 groups for the occurrence of complications of the intervention.

CONCLUSION: In this study, performing a hypnosis session before coronary angiography did not reduce the state of anxiety measured just before the intervention. In all cases, the hypnotic experience appears to be positive for the patient, encouraging further research efforts.

TRIAL REGISTRATION: The research protocol has been registered on the ClinicalTrials.gov registry (NCT02818101; 29/06/2016) and with the ANSM (IDRCB 2016-A00205-46; 02/02/2016).

PMID:36447198 | DOI:10.1186/s12906-022-03792-x

Environ Health. 2022 Nov 29;21(1):119. doi: 10.1186/s12940-022-00937-w.

ABSTRACT

BACKGROUND: Studies showed that PM_2.5 might be associated with various neurogenic diseases such as Alzheimer’s Disease (AD). However, this topic had been little studied in Zhejiang province of China. METHODS: In 2018, we established a cohort of AD high-risk population with 1,742 elderly aged 60 and above. In 2020, the cohort was followed up, a total of 1,545 people participated the 2 surveys. Data collection included questionnaires and basic physical examinations. The average residential exposure to PM_2.5 for each participant, that in a 5-years period prior to the first survey, was estimated using a satellite-based spatial statistical model. We determined the association between PM_2.5 and AD prevalence by cox proportional hazards regression model. RESULTS: This study showed that an increase in the PM_2.5 level was an important associated risk factor that contributed to AD. The average PM_2.5 exposure levels among the study population ranged from 32.69 μg/m³ to 39.67 μg/m³ from 2013 to 2017, which were much higher than 5 μg/m³ that specified in the WHO air quality guidelines. There was an association between PM_2.5 exposure and AD, and the correlations between PM_2.5 and Mini-Mental State Examination, Montreal cognitive assessment scale scores were statistically significant. An increase in the PM_2.5 level by 10 μg/m³ elevated the risk of AD among residents by 2%-5% (HR _{model 2-model 4} = 1.02 to 1.05, CI _{model 2-model 4} = 1.01-1.10). The subgroups of male, with old age, with low education levels, used to work as farmers or blue-collar workers before retirement, overweight and obese were associated with a higher effect of PM_2.5.

CONCLUSIONS: Reducing PM_2.5 exposure might be a good way to prevent AD.

PMID:36447194 | DOI:10.1186/s12940-022-00937-w

BMC Cancer. 2022 Nov 29;22(1):1233. doi: 10.1186/s12885-022-10351-7.

ABSTRACT

BACKGROUND: Lung immune prognostic index (LIPI) is a prognostic marker of extensive-stage small cell lung cancer (ES-SCLC) patients received immunotherapy or chemotherapy. However, its ability in limited-stage SCLC (LS-SCLC) should be evaluated extensively.

METHODS: We retrospectively enrolled 497 patients diagnosed as LS-SCLC between 2015 and 2018, and clinical data included pretreatment lactate dehydrogenase (LDH), white blood cell count, and absolute neutrophil count levels were collected. According to the LIPI scores, the patients were stratified into low-risk (0 points) and high-risk (1-2 points). The correlations between LIPI and overall survival (OS) or progression-free survival (PFS) were analyzed by the Cox regression. Additionally, the propensity score matching (PSM) and inverse probability of treatment weight (IPTW) methods were used to reduce the selection and confounding bias. A nomogram was constructed using on multivariable Cox model.

RESULTS: Two hundred fifty and 247 patients were in the LIPI high-risk group and low-risk group, and their median OS was 14.67 months (95% CI: 12.30-16.85) and 20.53 months (95% CI: 17.67-23.39), respectively. In the statistical analysis, High-risk LIPI was significantly against worse OS (HR = 1.377, 95%CI:1.114-1.702) and poor PFS (HR = 1.338, 95%CI:1.1-1.626), and the result was similar after matching and compensating with the PSM or IPTW method. A novel nomogram based on LIPI has a decent level of predictive power.

CONCLUSION: LIPI stratification was a significant factor against OS or PFS of LS-SCLC patients.

PMID:36447193 | DOI:10.1186/s12885-022-10351-7

Cutis. 2022 Sep;110(3):150-154. doi: 10.12788/cutis.0607.

ABSTRACT

Mutations of the BRAF oncogene occur in both melanomas and several other cancers. Our objective was to determine if mutant BRAF V600E expression in a population-based cohort of patients with melanoma was associated with the development of a second primary malignancy of any type. Using the resources of the Rochester Epidemiology Project, we retrospectively identified 380 patients aged 18 to 60 years who were diagnosed with an incident melanoma from 1970 through 2009. We reviewed individual medical records to identify second primary malignancies. We evaluated mutant BRAF V600E expression from available melanoma tissue specimens and assessed its association with the development of a second primary malignancy. BRAF V600E expression in melanomas is associated with an increased risk for basal cell carcinoma (BCC).

PMID:36446115 | DOI:10.12788/cutis.0607

Cutis. 2022 Oct;110(4):215-219. doi: 10.12788/cutis.0626.

ABSTRACT

Approximately 4.5% of adults in the United States identify as members of the lesbian, gay, bisexual, transgender (LGBT) community, and this population has a variety of health care disparities. Dermatologists have the potential to greatly impact the health of this community, but learning experiences in dermatology residency are lacking. In this study, we investigated LGBT education in dermatologic residency from the residents’ perspective and assessed preparedness of dermatology residents to care for this community. An online survey was distributed to current US dermatology residents through program coordinator and program director listserves and postings on dermatology social media groups. Descriptive statistics and a Kruskal-Wallis rank test were used for analysis. There were 114 respondents. This study demonstrated that many dermatology residents are not effectively taught LGBT health topics and feel unprepared to treat this community. Most dermatology residents desired increased training. Further research is needed to determine the best strategies for increasing LGBT learning experiences in dermatology residency programs.

PMID:36446104 | DOI:10.12788/cutis.0626

JMIR Form Res. 2022 Nov 8. doi: 10.2196/40825. Online ahead of print.

ABSTRACT

BACKGROUND: Across each state. the emergence of the COVID-19 pandemic in the United States was marked by policies and rhetoric that often correspond to the political party in power. These diverging responses have sparked broad ongoing discussion about how the political leadership of a state may affect not only the COVID-19 case numbers in a given state, but also the subjective individual experience of the pandemic.

OBJECTIVE: This study leverages state-level data from Google Search Trends and CDC daily case data in order to investigate the temporal relationship between increases in relative search volume for COVID-19 symptoms and corresponding increases in case data. I aimed to identify whether there are state-level differences in patterns of lag time across each of the four spikes in the data (RQ1) and whether the political climate in a given state is associated with these differences (RQ2).

METHODS: Using publicly available data from Google Trends and the Centers for Disease Control and Prevention, linear mixed modeling was utilized to account for random state-level intercepts. Lag time was operationalized as number of days between a peak (a sustained increase before a sustained decline) in symptom search data and a corresponding spike in case data and was calculated manually for each of the four spikes in individual states. Google offers a dataset that tracks the relative search incidence of more than 400 potential COVID-19 symptoms, which is normalized on a 0-100 scale. I used the CDC’s definition of the eleven most common COVID-19 symptoms and created a single construct variable that operationalizes symptom searches. To measure political climate, I considered the proportion of 2020 Trump popular votes in a state as well as a dummy variable for the political party that controls the governorship and a continuous variable measuring proportional party control of federal Congressional representatives.

RESULTS: The strongest overall fit was for a linear mixed model that included proportion of 2020 Trump votes as the predictive variable of interest and included controls for mean daily cases and deaths as well as population. Additional political climate variables were discarded for lack of model fit. Findings indicated evidence that there are statistically-significant differences in lag time by state but that no individual variable measuring political climate was a statistically-significant predictor of these differences.

CONCLUSIONS: Given that there will likely be future pandemics within this political climate, it is important to understand how political leadership affects perceptions of and corresponding responses to public health crises. Although this study did not fully model this relationship, I believe that future research can build on the state-level differences that I identified by approaching the analysis with a different theoretical model, method for calculating lag time, and/or level of geographic modeling.

PMID:36446048 | DOI:10.2196/40825

JCO Precis Oncol. 2022 Nov;6:e2200133. doi: 10.1200/PO.22.00133.

ABSTRACT

PURPOSE: CONCORDE is the first phase I drug-radiotherapy (RT) combination platform in non-small-cell lung cancer, designed to assess multiple different DNA damage response inhibitors in combination with radical thoracic RT. Time-to-event continuous reassessment method (TiTE-CRM) methodology will inform dose escalation individually for each different DNA damage response inhibitor-RT combination and a randomized calibration arm will aid attribution of toxicities. We report in detail the novel statistical design and implementation of the TiTE-CRM in the CONCORDE trial.

METHODS: Statistical parameters were calibrated following recommendations by Lee and Cheung. Simulations were performed to assess the operating characteristics of the chosen models and were written using modified code from the R package dfcrm.

RESULTS: The results of the simulation work showed that the proposed statistical model setup can answer the research questions under a wide range of potential scenarios. The proposed models work well under varying levels of recruitment and with multiple adaptations to the original methodology.

CONCLUSION: The results demonstrate how TiTE-CRM methodology may be used in practice in a complex dose-finding platform study. We propose that this novel phase I design has potential to overcome some of the logistical barriers that for many years have prevented timely development of novel drug-RT combinations.

PMID:36446040 | DOI:10.1200/PO.22.00133

JCO Precis Oncol. 2022 Nov;6:e2200460. doi: 10.1200/PO.22.00460.

ABSTRACT

PURPOSE: Genetic studies of prostate cancer susceptibility have predominantly focused on non-Hispanic White men, despite the observation that Black men are more likely to develop prostate cancer and die from the disease. Therefore, we sought to identify genetic variants in Black patients diagnosed with early-onset prostate cancer.

METHODS: Whole-exome sequencing of germline DNA from a population-based cohort of Black men diagnosed with prostate cancer at age 62 years or younger was performed. Analysis was focused on a panel of DNA damage repair (DDR) genes and HOXB13. All discovered variants were ranked according to their pathogenic potential based upon REVEL score, evidence from existing literature, and prevalence in the cohort. Logistic regression was used to investigate associations between mutation status and relevant clinical characteristics.

RESULTS: Among 743 Black prostate cancer patients, we identified 26 unique pathogenic (P) or likely pathogenic (LP) variants in 14 genes (including HOXB13, BRCA1/2, BRIP1, ATM, CHEK2, and PALB2) among 30 men, or approximately 4.0% of the patient population. We also identified 33 unique variants of unknown significance in 16 genes among 39 men. Because of the rarity of these variants in the population, most associations between clinical characteristics did not achieve statistical significance. However, our results suggest that carriers for P or LP (P/LP) variants were more likely to have a first-degree relative diagnosed with DDR gene-associated cancer, have a higher prostate-specific antigen at time of diagnosis, and be diagnosed with metastatic disease.

CONCLUSION: Variants in DDR genes and HOXB13 may be important cancer risk factors for Black men diagnosed with early-onset prostate cancer, and are more frequently observed in men with a family history of cancer.

PMID:36446039 | DOI:10.1200/PO.22.00460

J Neurosurg Pediatr. 2022 Nov 11:1-10. doi: 10.3171/2022.10.PEDS22281. Online ahead of print.

ABSTRACT

OBJECTIVE: Pediatric patients are at risk of persistent hydrocephalus after posterior fossa tumor resection. The relationship between surgery-related factors and postoperative symptomatic hydrocephalus has not been elucidated. The objective of this study was to analyze features influencing postoperative hydrocephalus in Chinese children.

METHODS: The authors retrospectively evaluated 197 patients younger than 15 years of age who underwent posterior fossa tumor resection at their institution from January 2015 to June 2021. The outcome was whether children underwent CSF diversion within 6 months of resection. Preoperative characteristics, surgery-related factors, and postoperative features were included to identify independent prognosticators. A new logistic model containing independent prognosticators was developed and compared with the modified Canadian Preoperative Prediction Rule for Hydrocephalus (mCPPRH).

RESULTS: In this study, 30 patients (15.2%) underwent CSF diversion within 6 months after tumor resection. Tumor location and consistency, intracranial or spinal tumor metastasis determined by perioperative cerebral and spinal MRI, intraoperative blood loss, ventricular blood as determined on postoperative CT, and pathology were statistically significant variables in the univariate analysis. The only two independent predictors of postoperative symptomatic hydrocephalus were tumor metastasis (OR 3.463, 95% CI 1.137-10.549; p = 0.029) and postoperative ventricular blood (OR 4.212, 95% CI 1.595-11.122; p = 0.004). The final logistic model comprising tumor metastasis and postoperative ventricular blood was found to have better discrimination than the mCPPRH.

CONCLUSIONS: Tumor characteristics and surgery-related features were associated with postoperative symptomatic hydrocephalus. Tumor metastasis and postoperative ventricular blood were found to be important prognosticators of persistent hydrocephalus.

PMID:36446021 | DOI:10.3171/2022.10.PEDS22281