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Nevin Manimala Statistics

Predicting intention to vaccinate against COVID-19 in older Syrian refugees in Lebanon: Findings from a multi-wave study

Vaccine. 2024 Mar 13:S0264-410X(24)00213-5. doi: 10.1016/j.vaccine.2024.02.054. Online ahead of print.

ABSTRACT

BACKGROUND: COVID-19 vaccine acceptance among refugees in the Arab region remains low. This study aimed to examine the prevalence, reasons and predictors of intention to refuse the COVID-19 vaccine among older Syrian refugees in Lebanon.

METHODS: A nested cross-sectional study within a longitudinal study among older Syrian refugees in Lebanon. The sampling frame was a complete listing of beneficiary households of a humanitarian organization with at least one adult aged 50 years or older. Telephone surveys were completed at months 1 starting September 2020 (wave 1), months 2 (wave 2), months 5 (wave 3), months 6 (wave 4) and months 17 (wave 5) in March 2022. Logistic regression models were used to identify predictors of intention to refuse the COVID-19 vaccine. Models were internally validated using bootstrap methods and the models’ calibration and discrimination were presented.

FINDINGS: Of 3167 Syrian refugees, 61.3% intended to receive the COVID-19 vaccine, 31.3% refused, and 7.4% were undecided. Reasons for vaccine refusal were: preference to follow preventive measures (27.4%) and belief that the vaccine is not essential (20.7%). Furthermore, 57.1% of participants registered to take the COVID-19 vaccine in wave 5. Irrespective of vaccination intention, reasons for not registering included: not wanting to receive the vaccine, and being unsure whether to take it. Predictors of intention to refuse the COVID-19 vaccine included: being a female, older age, having elementary education or above, living outside informal tented settlements, perceiving COVID-19 as not severe and vaccines as not safe or effective, and using social media for information on COVID-19. After adjusting for optimization, the final model showed moderate discrimination (C-statistic: 0.651 (95% CI:0.630-0.672)) and good calibration (C-slope: 0.93 (95% CI: 0.823-1.065)).

CONCLUSIONS: This study developed a predictive model for vaccination intention with a moderate discriminative ability and good calibration. Prediction models in humanitarian settings can help identify refugees at higher risk of not intending to receive the COVID-19 vaccine for public health targeting.

PMID:38485642 | DOI:10.1016/j.vaccine.2024.02.054

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Nevin Manimala Statistics

Shots at goal in Australian Football: Historical trends, determinants of accuracy and common strategies

J Sci Med Sport. 2024 Mar 3:S1440-2440(24)00075-6. doi: 10.1016/j.jsams.2024.02.010. Online ahead of print.

ABSTRACT

OBJECTIVES: To understand the historical context of and relationships between, the characteristics of shots at goal and match outcome in the Australian Football League.

DESIGN: Observational.

METHODS: Descriptive statistics of shots at goal were calculated and compared across 20 seasons. The location, type, and outcome of all shots at goal (n = 43,254), by all teams (2017-19 & 21), were compared with match outcome.

RESULTS: The total number of shots per match and the accuracy of shots haven’t changed in two decades. Most teams win by having more shots at goal (Wilcoxon-r effect size 0.63) than their opponent (i.e. “majority strategy”) and of these, the number of open shots (0.48) is slightly more important than set shots (0.43), followed by shot accuracy (0.29). However, some teams (14 %) win by taking fewer shots at goal from field locations with a higher likelihood of scoring a goal (i.e. “minority strategy”). Arc angle and shot type can be used to predict the outcome of a shot at goal with 60.3 % classification accuracy. The novel shot-outcome prediction model reported here provides a better opportunity to evaluate goal kicking performance of teams and players, because it accounts for the type and difficulty of the shot.

CONCLUSIONS: Teams can evaluate the shot accuracy of their players more fairly, by accounting for shot location using the method reported here. Coaches can compare the two shot strategies identified and implement the one that suits the skill profile of their players and increase their likelihood of winning.

PMID:38485611 | DOI:10.1016/j.jsams.2024.02.010

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Nevin Manimala Statistics

Exploring the ADAM12 Expression in Clear Cell Renal Cell Carcinoma: A Radiogenomic Analysis on CT Imaging

Acad Radiol. 2024 Mar 13:S1076-6332(24)00123-5. doi: 10.1016/j.acra.2024.02.032. Online ahead of print.

ABSTRACT

RATIONALE AND OBJECTIVES: Radiogenomics of clear cell renal cell carcinoma (ccRCC) has been developed thanks to the availability of genomic data, both gene expressions and gene mutations, obtained through the sequencing of ccRCC genome. These data are collected in the Cancer Genome Atlas (TCGA) Research Network-work. Disintegrin and metalloproteinase domain-containing protein 12 (ADAM12) gene belongs to the family of genes coding for multidomain and multifunctional type I transmembrane proteins ADAMs. These proteins are fundamental for regulating cell adhesion and mediating proteolysis of a series of cell surface receptors and signal molecules extracellular domains. Recently, a correlation was detected between ADAM12 expression in ccRCC and tumor aggressiveness in terms of cell proliferation, migration, invasion, tumor progression, metastases, and poor prognosis, suggesting ADAM12 as a prognostic marker and therapeutic target in ccRCC. The computed tomography (CT) imaging phenotype of ADAM12 expression in ccRCC has never been studied. The aim of this study is to investigate the CT imaging phenotype of ADAM12 expression in ccRCC patients.

MATERIALS AND METHODS: In this retrospective study, we enrolled 202 ccRCC patients divided into two groups: ccRCC patients with ADAM12 expression (n = 35) and ccRCC patients without ADAM12 expression (n = 167). Different imaging features were evaluated on CT scan at first diagnosis. The statistical significance threshold was set at p < 0.05.

RESULTS: A statistically significant correlation was found with larger primary tumor size (p = 0.020), ill-defined tumor margins (p = 0.044), tumor necrosis (p = 0.011), and collecting system invasion (p = 0.014).

CONCLUSION: This study demonstrates CT imaging features associated to ADAM12 expression in ccRCC. These results could help delve into ADAM12 gene status through CT approach and to further investigate towards the development of targeted therapies in ccRCC.

PMID:38485610 | DOI:10.1016/j.acra.2024.02.032

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Nevin Manimala Statistics

Novel approach of plate assisted buttressing in Hoffa fracture

Chin J Traumatol. 2024 Feb 27:S1008-1275(24)00009-9. doi: 10.1016/j.cjtee.2024.02.003. Online ahead of print.

ABSTRACT

PURPOSE: Hoffa fracture is a femoral condyle fracture in the coronal plane. The lateral condyle is more commonly involved. The diagnosis is often difficult to detect with routine radiographs. Conservative management in this type of fracture resulted in nonunion, malunion, and other complications, such as stiff knee. Therefore, surgical management is mandatory in displaced fractures. Previous studies suggest only application of cancellous screw fixation, but these are not enough to counter vertical shear stress. Therefore, this study will evaluate the clinical outcomes of open reduction and internal fixation of Letenneur type I Hoffa fracture using cancellous screws with posterior buttressing plate.

METHOD: This was a prospective cohort study conducted from March 2017 to July 2022 in orthopaedics department of tertiary care center after approval of institutional ethical committee. The study included 36 patients with Letenneur type I fractures treated by open reduction and internal fixation using posterior buttress plate and cancellous screws. Radiographs and clinical outcomes, range of movement (ROM), bone union, and knee society score (KSS) of patients were assessed at the end of 4 and 12 months in the follow-ups. All statistical analysis was done using Epi info version 7.2.1.0.

RESULTS: In the 36 patients with Letenneur type I fracture, the majority belong to younger age group between 25 and 54 years with 22 males and 14 females. The modes of injury were road traffic accidents in 25 patients and fall from height in 11 patients. The right knee was involved in 21 cases and left was involved in 15 cases. Lateral condyle involvement was seen in 27 cases and medial condyle in 9 cases. All 36 patients with Letenneur type I Hoffa fracture were evaluated 4 months after surgical intervention. The notable improvements were observed in terms of ROM 120.4° ± 5.0° and KSS 85.0 ± 4.2. At the 12-month follow-up, considerably better outcomes were maintained regarding ROM 128.1° ± 5.2° and KSS 89.3 ± 4.8 with p < 0.05 which was statistically significant. At the final follow-up, all patients had routine fracture healing with a union time of (3.2 ± 3.4) months.

CONCLUSIONS: Fixation of Letenneur type I Hoffa fracture with cancellous screws and posterior buttress plate is effective, reliable and capable of providing adequate stability. Buttress plate assisted fixation is a valuable enhancement of the conventional technique of lag screw fixation of Hoffa fractures.

PMID:38485604 | DOI:10.1016/j.cjtee.2024.02.003

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Nevin Manimala Statistics

Clinical performance and patient-related outcome measures of digitally fabricated complete dentures: A systematic review and meta-analysis

J Prosthet Dent. 2024 Mar 13:S0022-3913(24)00107-0. doi: 10.1016/j.prosdent.2024.02.003. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: The demand to streamline workflow while increasing patient comfort and satisfaction in the manufacturing of removable complete dentures (CDs) is growing, and computer-aided design and computer-aided manufacturing (CAD-CAM) technology has gained prominence. However, a systematic review and meta-analysis of the clinical performance and patient-related outcome measures (PROMs) of digitally fabricated complete dentures is lacking.

PURPOSE: The purpose of this systematic review and meta-analysis was to determine whether digitally fabricated CDs improve the clinical performance and PROMs compared with conventionally fabricated CDs.

MATERIAL AND METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and was registered at the International Prospective Register of Systematic Reviews (CRD42023433909). This review aimed to address the question “Do digitally fabricated CDs improve clinical performance and PROMs compared with conventional CDs?” Two independent authors conducted electronic searches up to September 2023. Denture base retention and patient satisfaction were analyzed through the continuous outcome evaluated by mean difference and standard deviation, with 95% confidence intervals. The risk of bias in each study was assessed using the Risk of Bias In Non-randomized Studies of Interventions and the Risk of Bias based on the Cochrane risk of bias tool for randomized trials. The certainty of evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluation.

RESULTS: A total of 1505 articles were found during the search, and 16 were included in this review. The main outcomes were grouped into clinical performance (retention, adaptation or fit, clinician’s denture quality assessment, masticatory efficiency, and occlusal force) and PROMs (patient satisfaction, oral health related quality of life, final choice, and willingness-to-pay). In terms of denture base retention, between conventional CDs and printed CDs analyzes, conventional CDs exhibited better retention (P=.02), but no significant difference was found between the conventional CDs and milled CDs (P=.20). In terms of patient satisfaction, no statistically significant difference was found between the manufacturing methods of digitally fabricated CDs (printed CD, P=.55; milled CD, P=.08).

CONCLUSIONS: Digitally fabricated CDs showed similar or better clinical performance than conventional CDs, and different types of digital manufacturing processes for complete dentures did not influence PROMs.

PMID:38485595 | DOI:10.1016/j.prosdent.2024.02.003

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Nevin Manimala Statistics

Temporary increase in circulating replication-competent latent HIV-infected resting CD4+ T cells after switch to an integrase inhibitor based antiretroviral regimen

EBioMedicine. 2024 Mar 4:105040. doi: 10.1016/j.ebiom.2024.105040. Online ahead of print.

ABSTRACT

BACKGROUND: The principal barrier to an HIV cure is the presence of the latent viral reservoir (LVR), which has been understudied in African populations. From 2018 to 2019, Uganda instituted a nationwide rollout of ART consisting of Dolutegravir (DTG) with two NRTI, which replaced the previous regimen of one NNRTI and the same two NRTI.

METHODS: Changes in the inducible replication-competent LVR (RC-LVR) of ART-suppressed Ugandans with HIV (n = 88) from 2015 to 2020 were examined using the quantitative viral outgrowth assay. Outgrowth viruses were examined for viral evolution. Changes in the RC-LVR were analyzed using three versions of a Bayesian model that estimated the decay rate over time as a single, linear rate (model A), or allowing for a change at time of DTG initiation (model B&C).

FINDINGS: Model A estimated the slope of RC-LVR change as a non-significant positive increase, which was due to a temporary spike in the RC-LVR that occurred 0-12 months post-DTG initiation (p < 0.005). This was confirmed with models B and C; for instance, model B estimated a significant decay pre-DTG initiation with a half-life of 6.9 years, and an ∼1.7-fold increase in the size of the RC-LVR post-DTG initiation. There was no evidence of viral failure or consistent evolution in the cohort.

INTERPRETATION: These data suggest that the change from NNRTI- to DTG-based ART is associated with a significant temporary increase in the circulating RC-LVR.

FUNDING: Supported by the NIH (grant 1-UM1AI164565); Gilead HIV Cure Grants Program (90072171); Canadian Institutes of Health Research (PJT-155990); and Ontario Genomics-Canadian Statistical Sciences Institute.

PMID:38485563 | DOI:10.1016/j.ebiom.2024.105040

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Nevin Manimala Statistics

Identification of prognostic factors for survival in patients with metastatic gastric adenocarcinoma in a Mexican population

Rev Gastroenterol Mex (Engl Ed). 2024 Mar 13:S2255-534X(24)00005-7. doi: 10.1016/j.rgmxen.2023.07.007. Online ahead of print.

ABSTRACT

INTRODUCTION AND AIMS: Gastric adenocarcinoma is among the high-ranking tumors, with respect to frequency and mortality, worldwide. The inflammatory process and immune system activity are associated with oncologic control. Our aim was to identify whether the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and other variables are prognostic factors for survival in patients with metastatic gastric cancer in a Mexican population.

MATERIAL AND METHODS: Patients diagnosed with metastatic gastric adenocarcinoma, hospitalized within the time frame of December 2011 to 2021, were analyzed. The NLR, PLR, and albumin and hemoglobin levels obtained from blood samples were calculated. Functional status (ECOG and Karnofsky), sex, histology, and the presence of signet ring cells were also considered possible prognostic factors. Each factor’s prognostic value for overall survival was determined through univariate and multivariate analyses.

RESULTS: The study included 956 patients diagnosed with metastatic gastric cancer, of whom 494 (51.7%) were men and 462 (48.3%) were women. The main histologic finding was diffuse adenocarcinoma (n = 619, 64.7%), followed by intestinal adenocarcinoma (n = 293, 30.6%), and the presence of signet ring cells was found in 659 (68.9%) patients. Diagnostic laparoscopy was performed on 238 patients (24.9%) to confirm peritoneal carcinomatosis. The multivariate analysis showed that an NLR above 3.2 (HR 1.51, 95% CI 1.27-1.8; p < 0.001), albumin below 3.5 g/dl (HR 1.25, CI 1.06-1.47; p = 0.006), and an ECOG performance status of 2 or higher (HR 1.39, CI 1.10-1.76; p = 0.005) were independent factors that predicted a lower survival rate, whereas a Karnofsky score above 70% (HR 0.69, CI 0.53-0.91; p = 0.008) was associated with a better survival rate. Lastly, the PLR was not statistically significant in the multivariate analysis.

CONCLUSIONS: The NLR, nutritional status assessed through albumin measurement, and functional status can act as independent prognostic survival factors in hospitalized Mexican patients diagnosed with metastatic gastric adenocarcinoma and be taken into account during therapeutic decision-making.

PMID:38485560 | DOI:10.1016/j.rgmxen.2023.07.007

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Nevin Manimala Statistics

Stromal Type I Collagen in Breast Cancer: Correlation to Prognostic Biomarkers and Prediction of Chemotherapy Response

Clin Breast Cancer. 2024 Feb 21:S1526-8209(24)00053-3. doi: 10.1016/j.clbc.2024.02.015. Online ahead of print.

ABSTRACT

INTRODUCTION: Fibrillar collagens accumulate in the breast cancer stroma and appear as poorly defined spiculated masses in mammography imaging. The prognostic value of tissue type I collagen remains elusive in treatment-naïve and chemotherapy-treated breast cancer patients. Here, type I collagen mRNA and protein expression were analysed in 2 large independent breast cancer cohorts. Levels were related to clinicopathological parameters, prognostic biomarkers, and outcome.

METHOD: COL1A1 mRNA expression was analysed in 2509 patients with breast cancer obtained from the cBioPortal database. Type I collagen protein expression was studied by immunohistochemistry in 1395 women diagnosed with early invasive breast cancer.

RESULTS: Low COL1A1 mRNA and protein levels correlated with poor prognosis features, such as hormone receptor negativity, high histological grade, triple-negative subtype, node positivity, and tumour size. In unadjusted analysis, high stromal type I collagen protein expression was associated with improved overall survival (OS) (HR = 0.78, 95% CI = 0.61-0.99, p = .043) and trended towards improved breast cancer-specific survival (BCSS) (HR = 0.65, 95% CI = 0.42-1.01, P = 0.053), although these findings were lost after adjustment for other clinical variables. In unadjusted analysis, high expression of type I collagen was associated with better OS (HR = 0.70, 95% CI = 0.55-0.90, P = .006) and BCSS (HR = 0.55, 95% CI = 0.34-0.88, P = .014) among patients not receiving chemotherapy. Strikingly, the opposite was observed among patients receiving chemotherapy. There, high expression of type I collagen was instead associated with worse OS (HR = 1.83, 95% CI = 0.65-5.14, P = .25) and BCSS (HR = 1.72, 95% CI = 0.54-5.50, P = .357).

CONCLUSION: Low stromal type I collagen mRNA and protein expression are associated with unfavourable tumour characteristics in breast cancer. Stromal type I collagen might predict chemotherapy response.

PMID:38485557 | DOI:10.1016/j.clbc.2024.02.015

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Nevin Manimala Statistics

Underreporting of transfusion incidents

Hematol Transfus Cell Ther. 2024 Feb 29:S2531-1379(24)00034-8. doi: 10.1016/j.htct.2024.01.004. Online ahead of print.

ABSTRACT

BACKGROUND: Blood transfusion is an effective therapeutic practice. However, even adopting all procedures for transfusion safety, there are risks, one of which is immediate adverse reactions. The aim of this study was, by active search, to evaluate the occurrence of immediate adverse reactions estimating the occurrence rate within the first 24 h.

METHODS: An exploratory, descriptive, prospective study with quantitative analysis was carried out of patients undergoing surgery who received blood component transfusions during hospitalization from October 2018 to August 2019. Data on blood component request forms were collected from the transfusion agency by reviewing medical records and interviewing the patient or family members. Descriptive statistics and the chi-square test were used to analyze the association of demographic variables with the presence or absence of transfusion reactions.

RESULTS: A total of 1042 blood component units were transfused in 393 transfusions performed on 184 patients. The main transfused blood component was packed red blood cells. Seventeen reactions were identified in the medical records, using the active search method, none of which had been reported. The transfusion reaction rate was 16.3 occurrences per 1000 transfused units, while the notification rate for the 9389 blood component units transfused by the transfusion agency in the study period was 3.83/1000. There was no statistically significant association between the occurrences or not of transfusion reactions and demographic variables.

CONCLUSION: Through the active search method, it was possible to observe the underreporting of adverse reactions, showing inadequate compliance with current legislation, which is essential to minimize errors and increase transfusion safety.

PMID:38485548 | DOI:10.1016/j.htct.2024.01.004

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Nevin Manimala Statistics

Medical device-related pressure injuries in intensive care patients: A prospective and descriptive study

J Tissue Viability. 2024 Mar 9:S0965-206X(24)00028-7. doi: 10.1016/j.jtv.2024.03.003. Online ahead of print.

ABSTRACT

BACKGROUND: Treatment and care of patients in intensive care units require the use of many medical and technological instruments. Pressure injuries occur when medical devices, which are used more in intensive care patients and are in direct or indirect contact with the skin, cause focal and localized forces on the superficial or deep tissues.

OBJECTIVE: In this study, it was aimed to examine the risk factors, incidence and characteristics of medical device-related pressure injuries in intensive care patients.

METHODS: This study has a prospective and descriptive design. The study was carried out in the adult intensive care unit of a healthcare institution located in the western Turkey. 138 intensive care patients treated in the level 3 adult intensive care unit were enrolled in the study. The first observations and evaluations of intensive care patients in terms of pressure injuries were made within the first 24 h after admission to the clinic. Observations continued daily during the hospitalization period of the patient. Data were collected with the Intensive Care Patient Information Form, Glasgow Coma Scale, Braden Pressure Ulcer Risk Assessment Scale and Identification Form for Medical device-related Pressure Ulcers. Analysis of data was performed with descriptive statistical methods, Shapiro-Wilk Test, Mann-Whitney U Test and Chi-Square analysis.

RESULTS: Medical device-related pressure injury developed in 11.6% (n = 16) of intensive care patients. Anatomically, pressure injury occurred most frequently on the lip (37.5%) and most frequently due to the intubation tube (37.5%). Most of the developed wounds (75.0%) were found to be stage 2. Multinominal logistic regression analysis, which was performed to determine the effect of independent variables on medical device-related pressure injuries in intensive care patients, was found to be statistically significant (X2 = 37.098, p < 0.001). When the regression coefficients were examined, it was found that total hospitalization time in the intensive care unit (β = 0.948, p < 0.01) and PaCO2 level (β = 0.923, p < 0.01) had a positive, and duration of aerobic respiration with nasal cannula or mask (β = -0.920, p < 0.01) and Braden score (β = -0.948, p < 0.01) had a negative and significant effect on medical device-related pressure injuries.

CONCLUSIONS: In this study found that the MDRPIs development rate was lower than other studies. It was observed that pressure injuries due to medical devices developed more frequently in patients with longer hospitalization days, higher PaCO2 levels, shorter duration of oxygenated breathing with nasal cannula or mask, and lower Braden scores.

PMID:38485542 | DOI:10.1016/j.jtv.2024.03.003