Category: Statistics

J Viral Hepat. 2022 Feb 13. doi: 10.1111/jvh.13656. Online ahead of print.

ABSTRACT

Renal safety is a critical issue in chronic hepatitis B (CHB) patients receiving long-term entecavir (ETV) or tenofovir disofuroxil fumarate (TDF) therapy. We investigated their effects on estimated glomerular filtration rate (eGFR). Treatment-naïve CHB patients receiving ETV or TDF for ≥1 year were recruited. The eGFR was assessed using the Chronic Kidney Disease Epidemiology Collaboration equation. We calculated average annual percent change (AAPC) in eGFR using Joinpoint regression. At the beginning of the observation, the ETV group had more unfavorable conditions than the TDF group: lower eGFR and higher FIB-4 and APRI than the TDF group (all P<0.001). After 6 years of antiviral therapy, the mean eGFR in the ETV group (n=1,793) was maintained (96.0 at first year to 95.6 mL/min/1.73 m² at sixth year; AAPC -0.09%; P=0.322), whereas that in the TDF group (n=1,240) significantly decreased annually (101.9 at first year to 96.9 mL/min/1.73 m² at sixth year; AAPC -0.88%; P<0.001). Notably, in the TDF group, even patients without diabetes (AAPC -0.80%; P=0.001) or hypertension (AAPC -0.87%; P=0.001) experienced significant decrease in eGFR. Expectably, accompanying diabetes (AAPC -1.59%; p=0.011) or hypertension (AAPC -1.00%; p=0.002) tended to accelerate eGFR decrease. TDF treatment (odds ratio 1.66, P<0.001), along with eGFR<60 mL/min/1.73 m² , serum albumin<3.5 mg/dL, and hypertension, were independently associated with ongoing renal dysfunction, defined as a negative slope of the mean eGFR change. In conclusion, compared to ETV, long-term TDF treatment induced slow, but progressive renal dysfunction. Although the annual eGFR change by TDF was small, careful monitoring is necessary, especially in patients requiring life-long therapy.

PMID:35152517 | DOI:10.1111/jvh.13656

J Occup Health. 2022 Jan;64(1):e12318. doi: 10.1002/1348-9585.12318.

ABSTRACT

OBJECTIVE: Exposure to ultraviolet (UV) radiation from sunlight induces the production of essential vitamin D, whereas overexposure to sunlight leads to skin cancer. Sunlight exposure has been measured using questionnaires, dosimeters, and vitamin D levels. Several studies have measured vitamin D in the working population; however, these studies were limited to certain occupations such as farmers and construction workers. In the present study, we evaluated sunlight exposure using blood vitamin D as an exposure surrogate across industries and occupations.

METHODS: The Korea National Health and Nutrition Examination Survey (KNHANES) is a nationwide study representing the Korean population. We analyzed data from KNHANES between 2008 and 2009. We examined the association between vitamin D levels and pertinent personal, seasonal, residential, and occupational factors. Furthermore, we developed a multiple regression model with factors other than occupational factors (industry and occupation) and obtained residual values. We computed the third quartile (Q3) of the residuals and then calculated the fractions exceeding the Q3 level for each combination of industry and occupation.

RESULTS: Age, sex, body mass index, year, season, latitude, living area, living in an apartment, industry, and occupation were significantly associated with vitamin D levels. Based on the exceeding fraction, the armed forces showed the highest exceeding fraction level of 0.71.

CONCLUSIONS: Our results present the high exposure groups to sunlight across industries and occupations. Our results may provide a source for prioritizing occupational groups with a high risk of adverse health effects from sunlight exposure.

PMID:35152501 | DOI:10.1002/1348-9585.12318

J Card Surg. 2022 Feb 13. doi: 10.1111/jocs.16306. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the impact of left ventricle outflow tract calcification (LVOT) on the outcomes of transcatheter aortic valve implantation (TAVI).

METHODS: Meta-analysis including studies published by October 2021. Primary endpoints were operative and 1-year mortality. The secondary endpoints were stroke, myocardial infarction, paravalvular leakage (PVL), new permanent pacemaker implantation (PPI), aortic annulus/root rupture.

RESULTS: Nine studies met our eligibility criteria, including a total of 4459 patients (1330 patients with significant LVOT calcification and 3129 patients without significant LVOT calcification). Pooled risk of operative death was higher in the group with significant LVOT calcification (odds ratio [OR]: 2.28; 95% confidence interval [CI]: 1.33-3.91; p < .001). Worse 1-year survival was observed in the group with LVOT calcification (hazard ratio 1.53, 95% CI: 1.26-1.87, p < .001). Patients with significant LVOT calcification had higher risk of stroke (OR: 1.83; 95% CI: 1.08-3.09; p = .032), myocardial infarction (OR: 1.74; 95% CI: 1.08-2.80; p = .034), PVL (OR: 1.88; 95% CI: 1.09-3.22; p = .028) and aortic annulus/root rupture (OR: 7.48; 95% CI: 3.58-15.65; p = .002). We did not observe a statistically significant difference in the pooled results for new PPI between the groups (OR: 1.19; 95% CI: 0.79-1.80; p = .337).

CONCLUSION: The presence of significant LVOT calcification increases the risk of periprocedural and 1-year mortality, stroke, myocardial infarction, PVL and aortic annulus/root rupture after TAVI. Self-expandable valves may be a preferrable option in this scenario. Structural heart surgeons and interventional cardiologists should consider this factor when referring patients for TAVI and technical aspects (such as the type of transcatheter heart valve to be deployed or the use of pre-/post-dilatation) should be factored in.

PMID:35152472 | DOI:10.1111/jocs.16306

Nurs Forum. 2022 Feb 13. doi: 10.1111/nuf.12705. Online ahead of print.

ABSTRACT

BACKGROUND: Nurses play a critical role in providing care to patients, in particular, they work in the frontlines in caring for patients with complicated COVID-19 requiring hospitalization. Evaluation of the caregiving roles and attitudes of nurses is critical in the current crisis. Therefore, this study aimed to determine the caregiving roles and attitudes of nurses during the COVID-19 pandemic.

METHODS: A quantitative descriptive study was performed with 130 nurses in Turkey. The attitude scale for the caregiving roles of nurses (ASCRNs) was used to collect data. We conducted an online survey between May and November 2020.

RESULTS: The mean total score of the participants on the ASCRN was 62.20 ± 18.42. All nurses stated that they were affected by the COVID-19 pandemic. The ASCRN scores of nurses who received training about the COVID-19 pandemic and who thought that the personal protective equipment they used was sufficient had statistically higher scores on the ASCRN (p < .05).

CONCLUSION: The results of this study suggested that the COVID-19 pandemic had a negative effect on the caregiving roles and attitudes of the nurses.

PMID:35152449 | DOI:10.1111/nuf.12705

Biom J. 2022 Feb;64(2):198-224. doi: 10.1002/bimj.202000202. Epub 2021 Jun 4.

ABSTRACT

Targeted therapies tend to have biomarker defined subgroups that derive differential efficacy from treatments. This article corrects three prevailing oversights in stratified analyses comparing treatments in randomized controlled trials (RCTs) with binary and time-to-event outcomes: 1.Using efficacy measures such as odds ratio (OR) and hazard ratio (HR) can make a prognostic biomarker appear predictive, targeting wrong patients, because the inference is affected by a confounding/covert factor even with ignorable treatment assignment in an RCT. As shown analytically and with real immunotherapy patient level data, OR and HR cannot meet the causal Estimand requirement of ICH E9R1. 2.Mixing efficacy in subgroups by prevalence, the prevailing practice, can give misleading results also, for any efficacy measured as a ratio. However, mixing relative response (RR) and ratio of median (RoM) survival times by the prognostic effect, the confounding/covert factor hiding in plain sight, will give causal inference in an RCT. 3.Effects in subgroups should not be mixed on the logarithmic scale, because it creates an artificial Estimand for the whole population which changes depending on how the population is divided into subgroups. Current computer package implementations contain all these oversights. Probabilities, including survival curve probabilities, naturally average within each treatment arm by prevalence. The subgroup mixable estimation (SME) principle fixes the oversights by first averaging probabilities (not their logarithms) within each treatment arm, then computing simultaneous confidence intervals for ratio efficacy in subgroups and their mixtures based on rigorous mathematical derivation, to finally provide causal inference in the form of apps.

PMID:35152457 | DOI:10.1002/bimj.202000202

Perspect Psychiatr Care. 2022 Feb 13. doi: 10.1111/ppc.13050. Online ahead of print.

ABSTRACT

PURPOSE: Anorexia nervosa (AN) may be treated with intravenous hyperalimentation (IVH) that may be associated with catheter-related bloodstream infection (CRBSI).

DESIGN AND METHODS: Retrospective chart review was conducted to compare those who developed CRBSI were compared with those who did not.

FINDINGS: Of 34 patients, 17 episodes of AN treated with IVH were identified, of which five resulted in CRBSI. The average body mass index at admission was low at 12.2. Patients who needed physical restraint during IVH had a higher (albeit statistically nonsignificant) risk. Also, those with purging had numerically lower risk.

PRACTICE IMPLICATIONS: CRBSI complicated IVH in 29.4% instances of severe life-threatening AN in our sample. Whether physical restraints and no purging constitute a risk factor of CRBSI needs to be further investigated.

PMID:35152427 | DOI:10.1111/ppc.13050

Perspect Psychiatr Care. 2022 Feb 13. doi: 10.1111/ppc.13056. Online ahead of print.

ABSTRACT

PURPOSE: This study investigates the relationships between social media addiction and social and emotional loneliness in university students.

METHODS: This is a descriptive, correlational study. Data were collected from 555 university students. The study data were then collected through an online survey. The data were analyzed using the descriptive statistics, Mann-Whitney U test, the Kruskal Wallis analysis, and Spearman correlation.

RESULTS: Higher and statistically significant levels of loneliness were found in males, single students, students displaying poor academic performance, and learners who perceived their economic situation as worse than the other groups (p ≤ 0.005). A positive and significant relationship association was noted between the aggregate social media scores of students and their total loneliness scores (r = 0.196 p = 0.000) (p < 0.05).

PRACTICE IMPLICATIONS: Social skills training should be provided to young social media users. Young people should be offered social support resources and ways to reduce loneliness, such as listening to music, exercising, and doing yoga.

PMID:35152424 | DOI:10.1111/ppc.13056

Methods Mol Biol. 2022;2462:201-219. doi: 10.1007/978-1-0716-2156-1_16.

ABSTRACT

Drought stress is a serious agronomic problem resulting in significant yield losses globally. Breeding cultivars with drought tolerance is an important strategy that can be used to address this problem. Drought tolerance, however, is a complex multigenic trait, making advancements with conventional breeding approaches very challenging. This emphasizes the importance of dissecting the genetics of this trait and the identification and cloning of genes responsible for drought tolerance. With the rapid development of sequencing technologies and analytic methodologies, genome-wide association study (GWAS) has become an important tool for detecting natural variations underlying complex traits in crops. Identified loci can serve as targets for genomic selection or precise editing that enables the molecular design of new cultivars. This chapter describes the pipeline of statistical methods used in GWAS analysis, and covers field design, quality control, population structure control, association tests, and visualization of data. GWAS methodology used to dissect the genetic basis of drought tolerance is presented, and perspectives for optimizing the design and analysis of GWAS are discussed. The provided information serves as a valuable resource for researchers interested in GWAS technology.

PMID:35152391 | DOI:10.1007/978-1-0716-2156-1_16

Acta Psychiatr Scand. 2022 Feb 12. doi: 10.1111/acps.13408. Online ahead of print.

ABSTRACT

OBJECTIVE: There is limited evidence that adding an antidepressant to electroconvulsive therapy (ECT), compared with ECT monotherapy, improves outcomes. We aimed to determine whether the addition of nortriptyline to ECT enhances its efficacy and prevents post-ECT relapse.

METHODS: We conducted a randomized, double-blind, placebo-controlled trial (RCT). Patients with major depressive disorder and an indication for ECT received either nortriptyline or placebo during a bilateral ECT course. Outcome measures were mean decrease in Hamilton Rating Scale for Depression (HRSD) score, response, remission, and time to response and remission. Patients who attained remission participated in a one-year follow-up study with open-label nortriptyline. Outcome measures were relapse and time to relapse.

RESULTS: We included 47 patients in the RCT. In the nortriptyline group, 83% showed response, 74% attained remission, and the mean decrease in HRSD score was 21.6 points. In the placebo group these figures were, respectively, 81% (p=0.945), 73% (p=0.928) and 20.7 points (p=0.748). Thirty-one patients participated in the follow-up study. In patients who had received nortriptyline during the RCT, 47% relapsed at a mean of 34.2 weeks. Patients who had received placebo showed similar treatment results. In both study phases no statistically significant differences between the nortriptyline and the placebo group were found.

CONCLUSION: In our sample of severely depressed patients who were often medication resistant and suffering from psychotic depression, the addition of nortriptyline to ECT did not enhance its efficacy or prevent post-ECT relapse. Encouragingly, even in these patients ECT was highly effective and relapse rates were relatively low.

PMID:35152416 | DOI:10.1111/acps.13408

Curr Top Behav Neurosci. 2022 Feb 14. doi: 10.1007/7854_2021_293. Online ahead of print.

ABSTRACT

Anhedonia, or the decreased ability to experience pleasure, is a cardinal symptom of major depression that commonly occurs within other forms of psychopathology. Supportive of long-held theory that anhedonia represents a genetically influenced vulnerability marker for depression, evidence from twin studies suggests that it is moderately-largely heritable. However, the genomic sources of this heritability are just beginning to be understood. In this review, we survey what is known about the genomic architecture underlying anhedonia and related constructs. We briefly review twin and initial candidate gene studies before focusing on genome-wide association study (GWAS) and polygenic efforts. As large samples are needed to reliably detect the small effects that typically characterize common genetic variants, the study of anhedonia and related phenotypes conflicts with current genomic research requirements and frameworks that prioritize sample size over precise phenotyping. This has resulted in few and underpowered studies of anhedonia-related constructs that have largely failed to reliably identify individual variants. Nonetheless, the polygenic architecture of anhedonia-related constructs identified in these studies has genetic overlap with depression and schizophrenia as well as related brain structure (e.g., striatal volume), providing important clues to etiology that may usefully guide refinement in nosology. As we await the accumulation of larger samples for more well-powered GWAS of reward-related constructs, novel analytic techniques that leverage GWAS summary statistics (e.g., genomic structural equation modeling) may currently be used to help characterize how the genomic architecture of anhedonia is shared and distinct from that underlying other constructs (e.g., depression, neuroticism, anxiety).

PMID:35152374 | DOI:10.1007/7854_2021_293