Nevin Manimala

Behav Res Methods. 2023 Nov 7. doi: 10.3758/s13428-023-02256-5. Online ahead of print.

ABSTRACT

Recently, a study compared the effect size and statistical power of covariance-based structural equation modeling (CB-SEM) and path analysis using various types of composite scores (Deng, L., & Yuan, K.-H., Behavior Research Methods, 55, 1460-1479, 2023). This comparison uses nine empirical datasets to estimate eleven models. Based on the meta-comparison, that study concludes that path analysis via weighted composites yields “path coefficients with less relative errors, as reflected by greater effect size and statistical power” (ibidem, p. 1475). In our paper, we object to this central conclusion. We demonstrate that the justification these authors provided for comparing CB-SEM and path analysis via weighted composites is not well grounded. Similarly, we explain that their employed study design, i.e., a meta-comparison, is very limited in its ability to compare the effect size and power delivered across these methods. Finally, we replicated Deng and Yuan’s (ibidem) meta-comparison and show that CB-SEM using the normal-distribution-based maximum likelihood estimator does not necessarily deliver smaller effect sizes than path analysis via composites if a different scaling method is employed for CB-SEM.

PMID:37936011 | DOI:10.3758/s13428-023-02256-5

Abdom Radiol (NY). 2023 Nov 8. doi: 10.1007/s00261-023-04068-9. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the value of ultrasound-guided percutaneous nephrostomy and nephrostomy tube replacement for treating a solitary kidney with hydronephrosis due to renal tuberculosis.

METHODS: Clinical data of patients with a solitary kidney with hydronephrosis caused by renal tuberculosis who underwent ultrasound-guided percutaneous nephrostomy in our hospital from January 2011 to December 2022 were retrospectively analyzed. The associated success rate and complications were statistically analyzed, pre- and post-catheterization changes in serum creatinine and blood urea nitrogen levels were compared, success rate and complications of nephrostomy tube replacement in patients with long-term catheterization were statistically analyzed, and the impact of long-term catheterization on patient life was investigated.

RESULTS: Overall, 32 patients aged 17-75 years (average age: 44.1 ± 16.9 years) underwent ultrasound-guided percutaneous nephrostomy. Sixty-three punctures were performed; the puncture success rate was 100%. The levels of serum creatinine and blood urea nitrogen of patients decreased after catheterization, and the differences between the pre-catheterization and post-catheterization were significant (P < 0.05). There were 1, 3, and 12 cases of serious, minor, and fistula-related complications, respectively. The mean duration of the indwelling catheter was 56.7 ± 36.2 (range, 13-120) months. The number of nephrostomy tube replacements was 344 times, and the success rate was 100%. All patients could take care of the puncture point by themselves.

CONCLUSION: Ultrasound-guided percutaneous nephrostomy and nephrostomy tube replacement have a high success rate and few complications, which can improve the renal function of patients. It is of great value for treating a solitary kidney with hydronephrosis caused by renal tuberculosis.

PMID:37936009 | DOI:10.1007/s00261-023-04068-9

Int Ophthalmol. 2023 Nov 8. doi: 10.1007/s10792-023-02889-7. Online ahead of print.

ABSTRACT

BACKGROUND: Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly population, and Dry AMD is the most common clinical subtype. However, effective measures for the early diagnosis and treatment of dry AMD have not been proposed. In recent years, NOD-like receptors (NLRs) have received attention in the study of AMD as an important class of pattern recognition receptors. We attempted to elucidate the pathogenesis of NLRs in dry AMD from the perspective of chronic inflammation.

METHODS: This study involved 13 patients with dry AMD, 10 age- and sex-matched normal population without any history of disease and 8 patients with wet AMD as controls. Using RT-qPCR, the mRNA expression levels of NLRs in peripheral blood peripheral blood mononuclear cells (PBMCs) were compared to analyze the statistical differences in the expression contents among the three populations.

RESULTS: The relative RNA expression of nucleotide-binding oligomerization-like receptor protein 12 (NLRP12) with negative regulation of inflammation was significantly lower in dry AMD patients than in normal people and wet AMD patients. And NLRX1, which also has an anti-inflammatory effect, was lower in dry AMD patients than in wet AMD patients. However, NLRP3 with proinflammatory effect was significantly expressed in wet AMD.

CONCLUSION: The significant decrease in NLRP12 in dry AMD may become a breakthrough in the study of dry AMD and systemic chronic inflammatory response. However, NLRP3 may have a more important role in wet AMD.

PMID:37936001 | DOI:10.1007/s10792-023-02889-7

Sports Med Open. 2023 Nov 7;9(1):103. doi: 10.1186/s40798-023-00654-9.

ABSTRACT

BACKGROUND: First evidence indicates that the supplementation of specific collagen peptides (SCP) is associated with a significant improvement in running performance in physically active women; however, it is unclear if the same is true in males. The purpose of the present study was to investigate the effects of a concurrent training program including 60 min of continuous moderate intensity running training and 15 min of dynamic resistance training combined with supplementation of SCP on parameters of running performance in moderately trained males.

METHODS: In a double-blind, placebo-controlled, randomized trial, participants performed a 12 weeks concurrent training and ingested 15 g of SCP [treatment group (TG)] or placebo [control group (CG)] daily. Before and after the intervention, running endurance performance was measured by a 1-h time trial on a running track. Velocity at the lactate threshold (V_LT) and at the individual anaerobic threshold (V_IAT) were assessed on a treadmill ergometer. Body composition was evaluated by bioelectrical impedance analysis.

RESULTS: Thirty-two men (28.4 ± 5.2 years) completed the study and were included in the analysis. After 12 weeks, TG had a statistically significant (p ≤ 0.05) higher increase in running distance (1727 ± 705 m) compared to the CG (1018 ± 976 m) in the time trial. V_LT increased in the TG by 0.680 ± 1.27 km h^-1 and slightly decreased by – 0.135 ± 0.978 km h^-1 in the CG, resulting in statistically significant group differences (p ≤ 0.05). A significantly higher improvement in V_IAT (p ≤ 0.05) was shown in the TG compared with the CG only (1.660 ± 1.022 km h^-1 vs 0.606 ± 0.974 km h^-1; p ≤ 0.01). Fat mass decreased (TG – 1.7 ± 1.6 kg; CG – 1.2 ± 2.0 kg) and fat free mass increased (TG 0.2 ± 1.2 kg; CG 0.5 ± 1.3 kg) in both groups with no significant group differences.

CONCLUSION: In summary, supplementation with 15 g of SCP improved running performance in a 1-h time trial and enhanced indicators of endurance capacity at submaximal exercise intensities such as an increased velocity at the lactate as well as the anaerobic threshold more effectively than CT alone.

TRIAL REGISTRATION: ETK: 123/17; DRKS-ID: DRKS00015529 (Registered 07 November 2018-Retrospectively registered); https://drks.de/search/de/trial/DRKS00015529.

PMID:37935999 | DOI:10.1186/s40798-023-00654-9

Rev Med Inst Mex Seguro Soc. 2023 Oct 2;61(Suppl 3):S503-S509. doi: 10.5281/zenodo.8319834.

ABSTRACT

Data management “behind the scenes” refers to collection, cleaning, imputation, and demarcation; and despite of being indispensable processes, they are usually neglected and thus, generate erroneous information. During the collection are errors: omission of covariates, deviation from the objective, and insufficient quality. The omission of covariates distorts the result attributed to the main manoeuvre. Deviation from the primary objective commonly occurs when the outcome is rare, delayed, or subjective and promotes substitution by non-equivalent surrogate variables. Moreover, insufficient quality occurs due to inadequate instruments, omission of the measurement procedure, or measurements out of context, such as attribution at the wrong time or equivalent. Furthermore, cleaning implies identifying erroneous, extreme, and missing values, which may or may not be imputed, depending on the percentage. The values of the manoeuvre or the outcome are never imputed, nor are patients eliminated due to a lack of values. Finally, the demarcation of each variable seeks to give it a clinical meaning about the outcome, for which a hierarchical sequence of criteria is followed: 1) previous clinical study, 2) expert agreement, 3) clinical judgment of the investigator/investigators, and 4) statistics. Acting without quality controls in data management frequently causes involuntary lies and confuses instead of clarifying.

PMID:37935026 | DOI:10.5281/zenodo.8319834

J Integr Complement Med. 2023 Nov 8. doi: 10.1089/jicm.2023.0102. Online ahead of print.

ABSTRACT

Objective: Whole person health care, like that being implemented in the U.S. Veterans Health Administration (VHA), involves person-centered approaches that address what matters most to patients to achieve well-being beyond the biomedical absence of disease. As whole health (WH) approaches expand, their integration into clinical practice is predicated on health care employees reconceptualizing practice beyond find-it-fix-it medicine and embracing WH as a new philosophy of care. This study examined employee perspectives of WH and their integration of this approach into care. Design: We conducted a survey with responses from 1073 clinical and 800 nonclinical employees at 5 VHA WH Flagship sites about their perceptions and use of a WH approach. We used descriptive statistics to examine employees’ support for WH and conducted thematic analysis to qualitatively explore their perceptions about this approach from free-text comments supplied by 475 respondents. Results: On structured survey items, employees largely agreed that WH was a valuable approach but were relatively less likely to have incorporated it into practice or report support within their organization for WH. Qualitative comments revealed varying conceptualizations of WH. While some respondents understood that WH represented a philosophical shift in care, many characterized WH narrowly as services. These conceptualizations contributed to lower perceived relevance, skepticism, and misgivings that WH diverted needed resources away from existing clinical services. Organizational context including leadership messaging, siloed structures, and limited educational opportunities reinforced these perceptions. Conclusions: Successfully transforming the culture of care requires a shift in mindset among employees and leadership alike. Employees’ depictions didn’t always reflect WH as a person-centered approach designed to engage patients to enhance their health and well-being. Without consistent leadership messaging and accessible training, opportunities to expand understandings of WH are likely to be missed. To promote WH transformation, additional attention is needed for employees to embrace this approach to care.

PMID:37935016 | DOI:10.1089/jicm.2023.0102

Rev Med Inst Mex Seguro Soc. 2023 Oct 2;61(Suppl 3):S497-S502. doi: 10.5281/zenodo.8319791.

ABSTRACT

The use of diagnostic tests to determine the presence or absence of a disease is essential in clinical practice. The results of a diagnostic test may correspond to numerical estimates that require quantitative reference parameters to be transferred to a dichotomous interpretation as normal or abnormal and thus implement actions for the care of a condition or disease. For example, in the diagnosis of anemia it is necessary to define a cut-off point for the hemoglobin variable and create two categories that distinguish the presence or absence of anemia. The method used for this process is the preparation of diagnostic performance curves, better known by their acronym in English as ROC (Receiver Operating Characteristic). The ROC curve is also useful as a prognostic marker, since it allows defining the cut-off point of a quantitative variable that is associated with greater mortality or risk of complications. They have been used in different prognostic markers in COVID-19, such as the neutrophil/lymphocyte ratio and D-dimer, in which cut-off points associated with mortality and/or risk of mechanical ventilation were identified. The ROC curve is used to evaluate the diagnostic performance of a test in isolation, but it can also be used to compare the performance of two or more diagnostic tests and define which one is more accurate. This article describes the basic concepts for the use and interpretation of the ROC curve, the interpretation of an area under the curve (AUC) and the comparison of two or more diagnostic tests.

PMID:37935015 | DOI:10.5281/zenodo.8319791

Radiat Prot Dosimetry. 2023 Nov 2;199(18):2199-2202. doi: 10.1093/rpd/ncad205.

ABSTRACT

Good response was observed in simultaneously using six RAD7 detectors at high radon concentrations, temperatures and relative humidity conditions. RAD7 detectors were tested in laboratory using radon chambers from 13 up to 59.8 kBq m-3, statistical analysis allows to distinct between counting errors and radon variation. RAD7 detectors were exposure to extreme environmental conditions at uranium flat mine. High radon concentration in soil from a confined uranium mineral was 274.3 kBq m-3 at 44°C temperature and 20% relative humidity. Inside uranium mine radon increased from 1.0 up to 88.5 kBq m-3.

PMID:37934994 | DOI:10.1093/rpd/ncad205

Lab Med. 2023 Nov 2;54(6):652-658. doi: 10.1093/labmed/lmad025.

ABSTRACT

OBJECTIVE: The aim of this study was to optimize the currently used direct spectrophotometric serum prolidase enzyme activity (SPEA) assay method and compare its diagnostic accuracy with current precipitation and direct spectrophotometric assay methods, AST-to-ALT ratio, age platelet index, AST-to-platelet ratio index, cirrhosis discriminate score, Doha score, FIB-4, FibroQ, fibrosis index, Goteborg University Cirrhosis Index , King’s score, and Pohl score for distinguishing Ishak F0 from F1-F3 in patients with chronic hepatitis B (CHB) infection.

METHODS: Liver biopsy results from 112 patients were included in this study.

RESULTS: The SPEA values were 529 (292-794) U/L, 671 (486-927) U/L, and 1077 (867-1399) U/L with the precipitation, current, and optimized direct spectrophotometric assay methods, respectively. According to multivariate logistic regression analysis optimized direct spectrophotometric SPEA was the only statistically significant parameter to predict the early stages of liver fibrosis.

CONCLUSIONS: Optimized direct spectrophotometric SPEA assay method could be used to distinguish early stages of liver fibrosis in patients with CHB infection instead of the currently used spectrophotometric SPEA assay methods and other evaluated liver fibrosis indexes.

PMID:37934976 | DOI:10.1093/labmed/lmad025

J Glob Health. 2023 Nov 9;13:04140. doi: 10.7189/jogh.13.04140.

ABSTRACT

BACKGROUND: The high costs of novel anticancer drugs have caused concern among healthcare stakeholders. To address the knowledge gap on the proportion of survival benefit with the related economic expenditure, we aimed to assess the correlation between the costs and value of innovative drugs targeted to specific tumours, before and after price negotiation policy implementation.

METHODS: We identified new drugs for lung and breast cancer that entered the National Reimbursement Drug List (NRDL) through price negotiation from 2016 to 2023. Therapeutic value consisted of traditional clinical endpoints, like the percentage improvement of overall survival (ΔOS%) and progression-free survival (ΔPFS%), and the quantified gains of the American Society of Clinical Oncology Value Framework (ASCO-VF) and the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS). We calculated monthly drug costs and used Spearman’s correlation coefficient and Cohen’s kappa statistics for statistical analysis.

RESULTS: Twenty-nine innovative price-negotiated drugs were collected between 2016 and 2023. The median monthly costs were US$3381.31 out of NRDL and US$1095.88 within NRDL, with an ΔOS% of 22.24% (IQR = 6.45-29.48) and a ΔPFS% of 83.82% (IQR = 50.41-104.05). The median ASCO-VF score was 40.98, and 17 drugs scored the meaningful benefit of ESMO-MCBS. We found no association between clinical benefits and their costs before and after NRDL, either overall or for specific cancers. The agreement between the two frameworks was stable.

CONCLUSIONS: The negotiation policy decreased medication costs, but did not generate the expected correlation between the value and costs of anticancer drugs. Comprehensive value assessments need to be performed in the future to explore more in-depth findings and promote the affordability and availability of effective anticancer drugs.

PMID:37934965 | DOI:10.7189/jogh.13.04140