Category: Statistics

J Assoc Physicians India. 2022 Oct;70(10):11-12. doi: 10.5005/japi-11001-0109.

ABSTRACT

BACKGROUND: HIV infection is a global pandemic. The adult HIV prevalence in India is 0.22%. Successful therapy is transforming HIV into a chronic medical condition, and there are many metabolic complications. This study aimed to evaluate the metabolic abnormalities in people living with HIV (PLHIV) who were on antiretroviral therapy (ART) for at least 2 years and compare it with ART-naïve patients as well as the effect of protease inhibitor-based (PI-based) and non-protease inhibitor-based (non-PI-based) ART was assessed.

METHODOLOGY: Adult HIV-positive patients both ART-naïve and on ART for more than 2 years were included. Detailed history and clinical examination, including blood pressure and anthropometric measurements were done. This was followed by investigations like lipid profile including total cholesterol, triglyceride, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), fasting plasma glucose, and hemoglobin A1c (HbA1C) estimation. Standard statistical tools were utilized to assess derangements and association to therapy.

RESULTS: The study was conducted for 1.5 years in a tertiary care hospital. A total of 70% of the study population was male with mean age of participants being 43.2 years, 40% were ART-naïve, 37% received non-PI-based ART, and 23% PI-based ART. The mean total cholesterol level and mean triglyceride value were significantly higher in the PI-based ART group than in the therapy-naïve group. The ART-naïve group was seen to have more subjects with abnormally low HDL-C values. The PI-based ART study subjects were found to have a greater number of cases of glucose intolerance in relation to the rest of the two groups significantly (p-value <0.001). The LDL-C systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), and waist circumference had no association with the different ART regimens or with the HIV infection itself. CD4 T cell count at diagnosis in the three study groups was compared with all the variables of metabolic syndrome and no association was found.

CONCLUSION: Total cholesterol, triglycerides, and glucose levels are the main parameters found to be affected in PLHIV on therapy.

PMID:37355860 | DOI:10.5005/japi-11001-0109

JPEN J Parenter Enteral Nutr. 2023 Jun 25. doi: 10.1002/jpen.2540. Online ahead of print.

ABSTRACT

OBJECTIVES: The objective of the study was to compare body composition of children with intestinal failure measured using bioelectrical impedance analysis (BIA) and skinfolds to dual energy x-ray absorptiometry (DXA). DXA is the reference method for body composition assessment in clinical settings.

METHODS: Children 1-18 years with intestinal failure, having a DXA as part of routine clinical monitoring were eligible. BIA measured total body water on the same day as DXA. Skinfold measurements were taken at four sites: triceps, biceps, subscapular, and suprailiac. Percent fat- and fat-free mass (FFM) were derived from resistance and reactance measured by BIA using age-specific equations. Percent fat-mass (FM) was calculated from skinfold measures using age-specific equations. Data on subject characteristics, intestinal failure related factors and feeding method were collected. Paired T-test examined differences in %FM and %FFM and Bland Altman analysis determined agreement between BIA, skinfolds and DXA. Marginal linear model assessed the effect of age, sex and feeding method on the difference in body composition obtained between DXA and BIA, and DXA and skinfolds.

RESULTS: Sixty-eight children with intestinal failure, mean age 8.9±4.2 years, were studied. There was no difference between %FFM and %FM obtained by DXA and BIA (p=0.26), with a mean bias (95% CI) of -0.69(-1.9, 0.5)% for %FFM. Sex and age were individually and jointly associated with the bias observed between DXA and BIA (p<0.05). Skinfold and DXA measurements were significantly different (p<0.05).

CONCLUSIONS: BIA is an acceptable clinical tool for assessing body composition in pediatric intestinal failure. This article is protected by copyright. All rights reserved.

PMID:37355855 | DOI:10.1002/jpen.2540

J Assoc Physicians India. 2023 Jun;71(6):11-12. doi: 10.5005/japi-11001-0261.

ABSTRACT

AIMS: Early identification of at-risk individuals for diabetic nephropathy would help in preventing or delaying end-stage renal failure. We measured the levels of circulating soluble tumor necrosis factor receptor 1 (sTNFR1) in various stages of proteinuria (MAC) to determine the association of this marker with diabetic nephropathy.

MATERIALS AND METHODS: The study was performed on 160 subjects, and a case-control methodology was employed. Type 2 diabetic subjects were recruited based on albuminuria and were grouped as (1) normoalbuminuria (NA); (2) microalbuminuria (MIC); (3) MAC; (4) normal glucose tolerance (NGT) subjects who served as healthy controls. sTNFR1 levels were measured by quantitative enzyme-linked immunosorbent assay (ELISA).

RESULTS: Soluble tumor necrosis factor receptor 1 (sTNFR1) levels were highest in the MAC group, followed by the microMAC group. The sTNFR1 levels were not statistically different between the NGT and NA groups. On regression models, sTNFR1 was associated with MIC [odds ratio (OR)- 6.491, 95% confidence interval (CI)-1.868-22.55] and MAC (OR per standard deviation-15.28; 95% CI-3.76-62.15; p &lt; 0.001) even after controlling for all the possible confounding factors. Receiver operator curve (ROC) analysis revealed sTNFR1 cut-point of 1832 pg/mL had a C-statistic of 0.685 to discriminate MI from NA with 52% sensitivity. Whereas the sTNFR1 cut-point of 2050 pg/mL with a C-statistic of 0.8177 had 77% sensitivity for identifying MAC.

CONCLUSION: Soluble tumor necrosis factor receptor 1 (sTNFR1) is significantly associated with MIC and MAC group in type 2 diabetes, and this suggests a potential early diagnostic biomarker role of sTNFR1 for MAC among Asian Indians.

PMID:37355839 | DOI:10.5005/japi-11001-0261

J Assoc Physicians India. 2023 May;71(5):11-12. doi: 10.5005/japi-11001-0238.

ABSTRACT

INTRODUCTION: Asthma and chronic obstructive pulmonary disease (COPD) are characterized by chronic airway inflammation. Lack of knowledge about the correct inhalation techniques leads to poor control of both diseases. This study aimed to study the effectiveness of inhalation technique training in patients with COPD and asthma.

MATERIALS AND METHODS: A total of 132 patients fulfilling the inclusion criteria were trained with the correct technique of inhalation on day 0 and at the end of 1 and 6 months. Evaluation of technique training was done on these three occasions posttraining. The mean score of devices was obtained, and the mean inhalation technique score of various devices was compared.

RESULTS: Out of 132 patients, 65.1% (86/132) patients were using a dry powdered inhaler (DPIs), 26.5% (35/132) patients used metered dose inhalers (MDIs), and 8.4% (11/132) patients used MDI with spacer. The mean scores of patients using MDI at baseline were 5.68 ± 0.83, and after 1 month, 6.68 ± 0.58 (p &lt; 0.000). The inhalation technique mean score of MDI improved after 6 months, 7.02 ± 0.56 as compared to baseline (p &lt; 0.008) mean score of the patients using DPIs improved after 1 month, 5.53 ± 0.58 as compared to baseline 4.37 ± 5.53 (p &lt; 0.000). There was no statistical improvement in the device mean score of DPIs after 6 months, 5.62 ± 0.55 when compared with 1 month, 5.53 ± 0.58 (p &lt; 0.117). Patients who used pressurized metered-dose inhalers (pMDI) with spacers improved their inhalation score after 1 month by 6.90 ± 0.94 as compared to the baseline score of 6.90 ± 0.94 (p &lt; 0.001). The mean score decreased marginally after 6 months, 7.818 ± 0.60, as compared to the score at the end of 1 month of 8.27 ± 0.64 (p &lt; 0.053).

DISCUSSION: Patients showed improvement in the technique of inhalation after educational training, reinstructions, and a standard checklist.

PMID:37355820 | DOI:10.5005/japi-11001-0238

Sci Rep. 2023 Jun 24;13(1):10266. doi: 10.1038/s41598-023-37172-3.

ABSTRACT

Data plots are widely used in science, journalism and politics, since they efficiently allow to depict a large amount of information. Graphicacy, the ability to understand graphs, has thus become a fundamental cultural skill comparable to literacy or numeracy. Here, we introduce a measure of intuitive graphicacy that assesses the perceptual ability to detect a trend in noisy scatterplots (“does this graph go up or down?”). In 3943 educated participants, responses vary as a sigmoid function of the t-value that a statistician would compute to detect a significant trend. We find a minimum level of core intuitive graphicacy even in unschooled participants living in remote Namibian villages (N = 87) and 6-year-old 1st-graders who never read a graph (N = 27). The sigmoid slope that we propose as a proxy of intuitive graphicacy increases with education and tightly correlates with statistical and mathematical knowledge, showing that experience contributes to refining graphical intuitions. Our tool, publicly available online, allows to quickly evaluate and formally quantify a perceptual building block of graphicacy.

PMID:37355745 | DOI:10.1038/s41598-023-37172-3

Sci Rep. 2023 Jun 24;13(1):10257. doi: 10.1038/s41598-023-37333-4.

ABSTRACT

Research on mortality outcomes and non-cancer-related causes of death in patients with cutaneous melanoma (CM) remains limited. This study aimed to identify the prevalence of non-cancer-related deaths following CM diagnosis. The data of 224,624 patients diagnosed with malignant CM in the United States between 2000 and 2019 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. We stratified our cohort based on their melanoma stage at diagnosis and further calculated standardized mortality ratios (SMRs) for each cause of death, comparing their relative risk to that of the general US population. The total number of fatalities among melanoma patients was 60,110, representing 26.8% of the total cases. The percentage of deaths is directly proportional to the disease stage, reaching 80% in distant melanoma. The highest fatalities among the localized melanoma group (25,332; 60.5%) occurred from non-cancer causes, followed by melanoma-attributable deaths (10,817; 25.8%). Conversely, melanoma is the leading cause of death in regional and distant melanoma cohorts. Cardiovascular and cerebrovascular diseases were the most prevalent non-cancer causes of death among the three disease-stage cohorts. Compared to the general population, we did not observe an increased risk of death due to non-cancer causes in the localized CM cohort, while patients diagnosed with regional and distant CMs had a statistically significant higher risk of death from all the reported major causes of death.

PMID:37355743 | DOI:10.1038/s41598-023-37333-4

ISME Commun. 2023 Jun 24;3(1):63. doi: 10.1038/s43705-023-00268-y.

ABSTRACT

Biological nitrogen fixation, the conversion of N₂ gas into a bioavailable form, is vital to sustaining marine primary production. Studies have shifted beyond traditionally studied tropical diazotrophs. Candidatus Atelocyanobacterium thalassa (or UCYN-A) has emerged as a focal point due to its streamlined metabolism, intimate partnership with a haptophyte host, and broad distribution. Here, we explore the environmental parameters that govern UCYN-A’s presence at the San Pedro Ocean Time-series (SPOT), its host specificity, and statistically significant interactions with non-host eukaryotes from 2008-2018. 16S and 18S rRNA gene sequences were amplified by “universal primers” from monthly samples and resolved into Amplicon Sequence Variants, allowing us to observe multiple UCYN-A symbioses. UCYN-A1 relative abundances increased following the 2015-2016 El Niño event. This “open ocean ecotype” was present when coastal upwelling declined, and Ekman transport brought tropical waters into the region. Network analyses reveal all strains of UCYN-A co-occur with dinoflagellates including Lepidodinium, a potential predator, and parasitic Syndiniales. UCYN-A2 appeared to pair with multiple hosts and was not tightly coupled to its predominant host, while UCYN-A1 maintained a strong host-symbiont relationship. These biological relationships are particularly important to study in the context of climate change, which will alter UCYN-A distribution at regional and global scales.

PMID:37355737 | DOI:10.1038/s43705-023-00268-y

Sci Rep. 2023 Jun 24;13(1):10274. doi: 10.1038/s41598-023-37152-7.

ABSTRACT

Curcumin is a phytochemical isolated from the dried rhizome of Curcuma longa L. family Zingiberaceae which possesses versatile biological activities and has hydrophobic properties. The current study was conducted to fabricate, and optimize curcumin loaded chitosan and Sodium tripolyphosphate (STPP) nanoparticles (NPs) to improve the bioavailability of curcumin. NPs were fabricated employing the Ionic gelation method. Four formulations were developed based on the selected variables like STPP and chitosan concentration, rotations per minute (rpm), temperature, and pH of chitosan solution. NPs were characterized for morphology, drug-polymer compatibility, yield, particle size, encapsulation efficiency, release behavior, anti-inflammatory and anti-arthritic activity compared to curcumin and standard drug. Fourier transform infrared spectroscopy (FTIR) shows nanoparticle compatibility. The maximum yield was 60%. Entrapment efficiency ranged from 45 to 65%. Curcumin NPs and standard drug 600 µg/ml shows 59% and 70% anti-inflammatory activity by HRB membrane stabilization method respectively which are greater than curcumin alone whereas anti-arthritic activity by protein denaturation method which is also comparable to standard drug and greater than curcumin was 66 and 70% respectively. Statistical analysis shows the mean significant difference at p ≤ 0.05. The study concluded that curcumin-loaded chitosan and STPP NPs formulated successfully by the Ionic gelation method, which increased curcumin absorption leading to a reduced dosing rate and improved patient compliance.

PMID:37355723 | DOI:10.1038/s41598-023-37152-7

Sci Rep. 2023 Jun 24;13(1):10277. doi: 10.1038/s41598-023-37518-x.

ABSTRACT

Multiphoton absorbing upconversion nanoparticles are emerging as bioimaging materials but are limited by the low quantum yield of their visible fluorescence. This article contains colloids of graphene quantum dots (GQDs), Neodymium, and Cobalt doped Graphene Quantum dots (Co-GQDs and Nd-GQDs) surrounded by carboxylic acids are synthesized which especially are suitable for bio applications; in this way, carboxylic acid groups exchanged by Amoxicillin as an antibiotic with bactericidal activity. The XRD diffraction method, TEM microscope, UV-Vis, and photoluminescence spectroscopies characterize the synthesized materials. The synthesized Quantum dots (QDs) exhibit upconversion properties and their emission is centered at 480 nm, but a red shift was observed with the increase of the excitation wavelength. In the emission spectra of synthesized QDs that can be related to the defect levels introduced by passivation of the QDs in the structure, the results show that with the interaction of the surface QDs with more carboxylic groups, the redshift is not observed. As the results indicate an increase in the intensity of upconversion emission is recorded for Co-GQDs and Nd-GQDs. The absolute quantum efficiency (QY) for Co-GQDs and Nd-GQDs were determined to be 41% and 100% more than GQDs respectively. DFT calculations indicate a strong bond between graphene and cobalt and Neodymium atoms. In doped materials, there are trap levels between the band gap of the GQDs which are responsible for increasing the intensity of the upconversion phenomenon.

PMID:37355717 | DOI:10.1038/s41598-023-37518-x

Arch Public Health. 2023 Jun 25;81(1):116. doi: 10.1186/s13690-023-01119-x.

ABSTRACT

OBJECTIVES: Within the framework of the burden of disease (BoD) approach, disease and injury burden estimates attributable to risk factors are a useful guide for policy formulation and priority setting in disease prevention. Considering the important differences in methods, and their impact on burden estimates, we conducted a scoping literature review to: (1) map the BoD assessments including risk factors performed across Europe; and (2) identify the methodological choices in comparative risk assessment (CRA) and risk assessment methods.

METHODS: We searched multiple literature databases, including grey literature websites and targeted public health agencies websites.

RESULTS: A total of 113 studies were included in the synthesis and further divided into independent BoD assessments (54 studies) and studies linked to the Global Burden of Disease (59 papers). Our results showed that the methods used to perform CRA varied substantially across independent European BoD studies. While there were some methodological choices that were more common than others, we did not observe patterns in terms of country, year or risk factor. Each methodological choice can affect the comparability of estimates between and within countries and/or risk factors, since they might significantly influence the quantification of the attributable burden. From our analysis we observed that the use of CRA was less common for some types of risk factors and outcomes. These included environmental and occupational risk factors, which are more likely to use bottom-up approaches for health outcomes where disease envelopes may not be available.

CONCLUSIONS: Our review also highlighted misreporting, the lack of uncertainty analysis and the under-investigation of causal relationships in BoD studies. Development and use of guidelines for performing and reporting BoD studies will help understand differences, avoid misinterpretations thus improving comparability among estimates.

REGISTRATION: The study protocol has been registered on PROSPERO, CRD42020177477 (available at: https://www.crd.york.ac.uk/PROSPERO/ ).

PMID:37355706 | DOI:10.1186/s13690-023-01119-x