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Nevin Manimala Statistics

Bias in vaccine effectiveness studies of clinically severe outcomes that are measured with low specificity: the example of COVID-19-related hospitalisation

Euro Surveill. 2024 Feb;29(7). doi: 10.2807/1560-7917.ES.2024.29.7.2300259.

ABSTRACT

Many vaccine effectiveness (VE) analyses of severe disease outcomes such as hospitalisation and death include ‘false’ cases that are not actually caused by the infection or disease under study. While the inclusion of such false cases inflate outcome rates in both vaccinated and unvaccinated populations, it is less obvious how they affect estimates of VE. Illustrating the main points through simple examples, this article shows how VE is underestimated when false cases are included as outcomes. Depending how the outcome indicator is defined, estimates of VE against severe disease outcomes, whose definition allows for the inclusion of false cases, will be biased downwards and may in certain circumstances approximate the same level as the VE against infection. The bias is particularly pronounced for vaccines that offer high levels of protection against severe disease outcomes but poor protection against infection. Analysing outcomes that are measured with low sensitivity generally does not cause bias in VE studies; defining outcome indicators that minimise the number of false cases rather than the number of missed cases is preferable in VE studies.

PMID:38362627 | DOI:10.2807/1560-7917.ES.2024.29.7.2300259

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Nevin Manimala Statistics

Arginase 1 does not affect RNA m6A methylation in mouse fetal lung

Birth Defects Res. 2024 Feb;116(2):e2318. doi: 10.1002/bdr2.2318.

ABSTRACT

BACKGROUND: Arginase 1 (Arg1) encodes a key enzyme that catalyzes the metabolism of arginine to ornithine and urea. In our recent study, we found that knockdown of Arg1 in the lungs of fetal mice induces apoptosis of epithelial cells and dramatically delays initiation of labor. As the most abundant internal mRNA modification, N6 -methyladenosine (m6 A) has been found to play important roles in lung development and cellular differentiation. However, if the knockdown of Arg1 affects the RNA m6A modification in fetal lungs remains unknown.

METHODS: In the current study, the RNA m6A levels and the expression of RNA m6A related enzymes were validated in 13.0 dpc fetal lungs that Arg1 was knocked down by adeno-associated virus carrying Arg1-shRNA, using western blot, immunofluorescence, and RT-qPCR.

RESULTS: No statistical differences were found in the expression of methyltransferase, demethylases, and binding proteins in the fetal lungs between AAV-shArg1-injected mice and AAV-2/9-injected mice. Besides, there is no significant change of overall RNA m6A level in fetal lungs from AAV-shArg1-injected mice, compared with that from AAV-2/9-injected mice.

CONCLUSIONS: These results indicate that arginase 1 does not affect RNA m6A methylation in mouse fetal lung, and the mechanisms other than RNA m6A modification underlying the effects of Arg1 knockdown on the fetal lung development and their interaction with labor initiation need to be further explored.

PMID:38362594 | DOI:10.1002/bdr2.2318

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Nevin Manimala Statistics

Tracheobronchial variations in Pneumoconiosis cases: multidetector computed tomography diagnosis

Malawi Med J. 2023 Dec;35(4):220-223. doi: 10.4314/mmj.v35i4.4.

ABSTRACT

BACKGROUND: Tracheobronchial variations (TBVs) are more common than previously believed due to the increasing use of multi-detector computed tomography (MDCT). This study aimed to assess TBVs in cases of pneumoconiosis, one of the oldest occupational diseases that still poses a threat to public health.

METHODS: This was a descriptive study that involved reviewing chest MDCT images of 34 cases of pneumoconiosis and 34 control cases retrospectively from January 2020 to April 2022. Variations in the trachea, right main bronchus, left main bronchus, lobar and segmental branches of the cases in the patient and control groups were evaluated according to Boyden’s nomenclature.

RESULTS: The frequency of TBV was 32.4% in pneumoconiosis cases. Although the frequency of TBV was higher in the patient group than in the control group, the difference was not statistically significant (p=0.086). Furthermore, there was no significant difference in terms of TBV classification between the patient and control groups (p=0.407). Additionally, the presence of TBV did not affect the distribution of International Labour Organization categories in pneumoconiosis cases (p=0.360).

CONCLUSIONS: Although our study provides initial insights into the occurrence of TBVs in pneumoconiosis cases, further research is needed to clarify the relationship between these variations and the disease.

PMID:38362566 | PMC:PMC10865055 | DOI:10.4314/mmj.v35i4.4

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Nevin Manimala Statistics

Kumanu Tāngata: the aftermatch study – protocol to examine the health outcomes of high-level male rugby union players using linked administrative data

BMJ Open Sport Exerc Med. 2024 Feb 14;10(1):e001795. doi: 10.1136/bmjsem-2023-001795. eCollection 2024.

ABSTRACT

There is increasing interest in the potential long-term outcomes of participation in contact and collision sports, driven by evidence of higher rates of neurodegenerative diseases among former athletes. Recent research has capitalised on large-scale administrative health data to examine health outcomes in contact sport athletes. However, there is limited research on outcomes associated with participation in rugby union, a contact sport with a relatively high incidence of head trauma and musculoskeletal injuries. Additionally, there is scope to investigate a greater range of health outcomes using large, population-based administrative data. The Kumanu Tāngata project is a retrospective cohort study that will use linked information from the New Zealand Rugby Register and health records within a comprehensive deidentified whole-population administrative research database known as the Integrated Data Infrastructure. First-class male rugby union players (N=13 227) will be compared with a general population comparison group (N=2 438 484; weighting will be applied due to demographic differences) on a range of mortality and morbidity outcomes (neurodegenerative diseases, musculoskeletal conditions, chronic physical conditions, mental health outcomes). A range of player-specific variables will also be investigated as risk factors. Analyses will consist primarily of Cox proportional hazards models. Ethics approval for the study has been granted by the Auckland Health Research Ethics Committee (Ref. AH23203). Primary research dissemination will be via peer-reviewed journal articles.

PMID:38362564 | PMC:PMC10868174 | DOI:10.1136/bmjsem-2023-001795

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Nevin Manimala Statistics

Community health workers lensed through a South African backdrop of two peri-urban communities in KwaZulu-Natal

Afr J Disabil. 2017 Aug 29;6:294. doi: 10.4102/ajod.v6i0.294. eCollection 2017.

ABSTRACT

BACKGROUND: As the South African government re-engineers primary healthcare (PHC), the need for additional information on stakeholders involved in the process has emerged. Of these are community health workers (CHWs), who have been identified as central to PHC success.

OBJECTIVES: To profile the current CHWs within KwaDabeka and Clermont in KwaZulu-Natal, to describe their roles and to explore the barriers and enablers influencing their service delivery.

METHOD: A convergent mixed methods design was employed with a sample of CHWs with the use of a survey (n = 53) and two focus groups (n = 10) and semi-structured interviews with four ward councillors (n = 4). Data were analysed statistically and thematically.

RESULTS: The profile of CHWs reflected only women with a mixed age range and a majority of 59% who had not completed formal schooling. General work experience as a CHW varied. There were diverse opinions expressed towards the CHW role which related to their job title and identity, supervision, remuneration, growth pathways and psychological and emotional issues. Whilst the National Community Health Worker Profile Framework was established for the CHW programme, there are several factors lacking in the current CHW programme such as a formal growth pathway or formal training to align the CHWs with the National Qualifications Framework.

CONCLUSION: The study findings are essential for the monitoring and evaluation as well as development and refinement of policies that will assist in ensuring adequate rollout of PHC with CHWs.

PMID:38362540 | PMC:PMC10867674 | DOI:10.4102/ajod.v6i0.294

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Nevin Manimala Statistics

Learning Lessons on Reproducibility and Replicability in Large Scale Genome-Wide Association Studies

Harv Data Sci Rev. 2020 Fall;2(4). doi: 10.1162/99608f92.33703976. Epub 2020 Dec 16.

ABSTRACT

Reproducibility and replicability play a pivotal role in science. The article reflects on reproducibility and replicability as they figure in large scale genome-wide association studies. Overall, we emphasize the importance of enhancing data reproducibility, analysis reproducibility, and result replicability. We make recommendations pertaining to the development of study designs that address 1) batch effects and selection bias, 2) the incorporation of discrete discovery and replication phases, and 3) the procurement of a large sample size. We emphasize the importance of systematic and transparent data generation, processing, and quality control pipelines, as well as a rigorous field-specific standardized analysis protocol, We offer guidance with respect to collaborative frameworks, open access analysis tools, and software, and the use of supporting mandates, infrastructure, and repositories for data and resource sharing. Finally, we identify the role of incentives and culture in fueling the production of reproducible and replicable research through partnerships of researchers, funding agencies, and journals.

PMID:38362534 | PMC:PMC10869125 | DOI:10.1162/99608f92.33703976

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Nevin Manimala Statistics

Growth performance, serum parameters, inflammatory responses, intestinal morphology and microbiota of weaned piglets fed 18% crude protein diets with different ratios of standardized ileal digestible isoleucine to lysine

Anim Nutr. 2023 Dec 4;16:313-325. doi: 10.1016/j.aninu.2023.11.008. eCollection 2024 Mar.

ABSTRACT

The present study was to explore the Ile requirement of piglets fed 18% crude protein (CP) diets. Two hundred and fifty 28-day-old Duroc × Landrace × Yorkshire piglets (8.37 ± 1.92 kg) were randomly divided into 5 dietary treatments (10 piglets per replicate, 5 barrows and 5 gilts per replicate) with 45%, 50%, 55%, 60%, 65% standardized ileal digestible (SID) Ile-to-Lys ratios, and the SID Lys was formulated to 1.19%. The experimental design consisted of two phases (d 1 to 14 and d 15 to 28). Results showed that average daily gain (ADG) had a tendency to quadratically increase as the SID Ile-to-Lys ratio increased (P = 0.09), and the optimum SID Ile-to-Lys ratios required to maximize ADG were 48.33% and 54.63% for broken-line linear model and quadratic polynomial model, respectively. Different SID Ile-to-Lys ratios had no significant effects on average daily feed intake and gain-to-feed ratio. Dry matter (P < 0.01), CP (P = 0.01), ether extract (P = 0.04), gross energy (P < 0.01) and organic matter (P < 0.01) digestibility increased quadratically. Serum total cholesterol levels decreased linearly (P = 0.01) and quadratically (P < 0.01); aspartate aminotransferase (P < 0.01), interleukin-1β (P = 0.01), and tumor necrosis factor-α (P < 0.01) levels decreased quadratically; immunoglobulin G (P = 0.03) and immunoglobulin M (P = 0.01) concentrations increased quadratically. Serum Ser levels decreased linearly (P < 0.01) and quadratically (P = 0.01); Glu (P = 0.02), Arg (P = 0.05), and Thr (P = 0.03) levels decreased quadratically; Gly (P < 0.01) and Leu (P = 0.01) levels decreased linearly; Ile (P < 0.01) concentration increased linearly. Duodenal villus height (P < 0.01) and villus height to crypt depth ratio (P < 0.01) increased quadratically. The deficiency or excess of Ile decreased short chain fatty acid-producing bacteria abundance and increased pathogenic bacteria abundance. Overall, taking ADG as the effect index, the optimum SID Ile-to-Lys ratios of piglets offered 18% CP diets were 48.33% and 54.63% based on two different statistical models, respectively, and the deficiency or excess of lle negatively affected piglet growth rates and health status.

PMID:38362516 | PMC:PMC10867559 | DOI:10.1016/j.aninu.2023.11.008

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Nevin Manimala Statistics

Three-Dimensional Reconstruction of Computed Tomography Imaging Is Not Reliable in Assessing Acetabular Rim Osteophytes or Acetabular Rim Pathology in Patients With Femoroacetabular Impingement

Arthrosc Sports Med Rehabil. 2024 Feb 9;6(2):100892. doi: 10.1016/j.asmr.2024.100892. eCollection 2024 Apr.

ABSTRACT

PURPOSE: To determine the reliability of 3-dimensional (3D) reconstruction of computed tomography (CT) imaging in evaluating acetabular rim morphology or acetabular rim osteophyte (ARO) existence and to group patients with femoroacetabular impingement (FAI) by ARO extent on coronal sections of CT and further compare clinical differences among groups.

METHODS: Patients who underwent primary hip arthroscopy for FAI by the same surgeon between August 2016 and December 2018 with minimum 2-year follow-up were enrolled. The ARO was evaluated both on the acetabular gross anatomy (AGA) and coronal sections of CT, for its position, width (unit: mm), area (unit: mm2), and CT value (unit: HU). Patients were divided into 4 groups based on the extent of ARO on coronal CT: group A (ARO anterior to 12 o’clock), group P (ARO posterior to 12 o’clock), group AP (ARO across 12 o’clock), and group N (no ARO). Inter- and intraobserver correlation was analyzed. Demographic data, FAI deformity indicators on imaging, quantitative measurements of ARO, and pre- and postoperative patient-reported outcomes were compared among groups.

RESULTS: There were 229 patients (229 hips) enrolled in total, 122 male (53.3%) and 107 female (46.7%), with a mean age of 37.2 ± 10.2 years. The correlation between 2 observers for grouping ARO using AGA was positive but poor (Kendall Tau-b coefficient = 0.157, P = .008). Moderate correlation was found between grouping based on AGA and coronal CT by the same observer (Kendall Tau-b coefficient = 0.482, P = .000). The patients were divided into 4 groups: 84 patients (36.7%) in group N, 2 patients (0.9%) in group A, 69 patients (30.1%) in group P, and 74 patients (32.3%) in group AP. Group N was younger in age (35.4 ± 10.7 years) than group P (39.6 ± 10.2 years) (P = 0.012) and had a larger proportion of women (57.1%) than group AP (36.5%) (χ2 = 6.869, P = .032). There was a greater proportion of positive posterior wall sign in group P (52.2%) than 48.6% for group AP and 33.3% for group N (χ2 = 6.397, P = .041). Group N had 61 (72.6%) Tönnis grade 0 hips compared with 37 (50%) in group AP (P = .014). No statistical significance was found among groups in pre- and postoperative α angle, lateral center-edge angle, and patient-reported outcomes. The widths of ARO in group AP for the 3 marked points from anterior to posterior were 3.88 ± 1.86, 4.84 ± 2.72, and 6.66 ± 3.18, separately (P<.001); 15.73 ± 21.46, 19.22 ± 18.86, and 29.96 ± 17.05 for area (P<.01); and 652.67 ± 214.12, 677.10 ± 274.81, and 728.84 ± 232.39 for CT value (P<.05). For the ARO posterior to 12 o’clock, the group AP showed a larger width (6.66 ± 3.18), area (29.96 ± 17.05), and CT value (728.84 ± 232.39) than group P of (4.70 ± 2.25), (20.15 ± 12.91), and (641.84 ± 183.33) (P<.001).

CONCLUSIONS: The evaluation of ARO on AGA is poor consistent with definite double-rim sign on coronal CT. There is a tendency of size-enlarging and density-increasing for ARO from anterior to posterior along the acetabular rim. Younger age, female gender, lower Tönnis grade, and negative posterior wall sign showed lower rate of ARO development.

LEVEL OF EVIDENCE: Level IV, diagnostic case series.

PMID:38362483 | PMC:PMC10867424 | DOI:10.1016/j.asmr.2024.100892

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Nevin Manimala Statistics

Diabetic peripheral neuropathy among adult type 2 diabetes patients in Adama, Ethiopia: health facility-based study

Sci Rep. 2024 Feb 15;14(1):3844. doi: 10.1038/s41598-024-53951-y.

ABSTRACT

Diabetic peripheral neuropathy is the most prominent microvascular complication of diabetes mellitus and the leading cause of ulceration, amputation, and extended hospitalization. Evidence regarding the magnitude and factors associated with diabetic peripheral neuropathy is not well documented in Ethiopia, particularly in the study area. A facility-based cross-sectional study was conducted among 293 adult type 2 diabetic patients who were on treatment and follow-up from May to June 31, 2023. To select participants in the study, a systematic random sampling method was utilized. Data were collected using semi-structured questionnaires and medical record reviews. The Michigan Neuropathy Screening Instrument (MNSI) was employed to assess diabetic peripheral neuropathy. To model the association between diabetic peripheral neuropathy and independent variables, binary logistic regression model was used. An adjusted odds ratio with a 95% confidence interval was used to estimate the association and statistical significance was proclaimed at a p-value < 0.05. The magnitude of diabetic peripheral neuropathy was 14.3% (95% CI 10.4-18.0). It was 13.4% (95% CI 8.4-19.1) among males and 15.4% (95% CI 10.1-22.2) among females. Age above 60 years (AOR = 5.06, 95% CI 1.60-15.96), being rural resident (AOR = 2.41; 95% CI 1.15-5.06), duration of diabetes above 5 years (AOR = 2.48, 95% CI 1.16-5.27) and having comorbid hypertension (AOR = 2.56, 95% CI 1.24-5.28) were independently associated with diabetic peripheral neuropathy. One in seven adult type 2 diabetes patients in the study area had diabetic peripheral neuropathy. Factors such as age, place of residence, duration of diabetes, and comorbid hypertension showed positive associations with diabetic peripheral neuropathy. Thus, it is imperative to give special consideration to diabetic patients who are elderly, living in rural areas, experiencing a prolonged duration of diabetes, or dealing with comorbid hypertension.

PMID:38361024 | DOI:10.1038/s41598-024-53951-y

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Generative adversarial reduced order modelling

Sci Rep. 2024 Feb 15;14(1):3826. doi: 10.1038/s41598-024-54067-z.

ABSTRACT

In this work, we present GAROM, a new approach for reduced order modeling (ROM) based on generative adversarial networks (GANs). GANs attempt to learn to generate data with the same statistics of the underlying distribution of a dataset, using two neural networks, namely discriminator and generator. While widely applied in many areas of deep learning, little research is done on their application for ROM, i.e. approximating a high-fidelity model with a simpler one. In this work, we combine the GAN and ROM framework, introducing a data-driven generative adversarial model able to learn solutions to parametric differential equations. In the presented methodology, the discriminator is modeled as an autoencoder, extracting relevant features of the input, and a conditioning mechanism is applied to the generator and discriminator networks specifying the differential equation parameters. We show how to apply our methodology for inference, provide experimental evidence of the model generalization, and perform a convergence study of the method.

PMID:38361023 | DOI:10.1038/s41598-024-54067-z