Nevin Manimala

BMC Med Res Methodol. 2023 Jan 5;23(1):3. doi: 10.1186/s12874-022-01759-7.

ABSTRACT

BACKGROUND: In inter-rater agreement studies, the assessment behaviour of raters can be influenced by their experience, training levels, the degree of willingness to take risks, and the availability of clear guidelines for the assessment. When the assessment behaviour of raters differentiates for some levels of an ordinal classification, a grey zone occurs between the corresponding adjacent cells to these levels around the main diagonal of the table. A grey zone introduces a negative bias to the estimate of the agreement level between the raters. In that sense, it is crucial to detect the existence of a grey zone in an agreement table.

METHODS: In this study, a framework composed of a metric and the corresponding threshold is developed to identify grey zones in an agreement table. The symmetry model and Cohen’s kappa are used to define the metric, and the threshold is based on a nonlinear regression model. A numerical study is conducted to assess the accuracy of the developed framework. Real data examples are provided to illustrate the use of the metric and the impact of identifying a grey zone.

RESULTS: The sensitivity and specificity of the proposed framework are shown to be very high under moderate, substantial, and near-perfect agreement levels for [Formula: see text] and [Formula: see text] tables and sample sizes greater than or equal to 100 and 50, respectively. Real data examples demonstrate that when a grey zone is detected in the table, it is possible to report a notably higher level of agreement in the studies.

CONCLUSIONS: The accuracy of the proposed framework is sufficiently high; hence, it provides practitioners with a precise way to detect the grey zones in agreement tables.

PMID:36604617 | DOI:10.1186/s12874-022-01759-7

BMC Infect Dis. 2023 Jan 5;23(1):2. doi: 10.1186/s12879-022-07975-2.

ABSTRACT

BACKGROUND: Chlamydia trachomatis and Mycoplasma infections have been regarded as severe challenges to public health worldwide because their potential risk of leading to serious reproductive complications. C. trachomatis is the most common sexually transmitted bacterial infections and the prevalence has been increasing in recent years. As a newly discovered pathogen, Mycoplasma genitalium has gradually been recognized as important sexually transmitted infection and even been called a “new chlamydia”. There are no official epidemiological data of M. genitalium in China especially in women with lower reproductive tract infection. This work aims to understand the prevalence and risk factors of M. genitalium and C. trachomatis in women with lower reproductive tract infections and to provide reference for the formulation of health policy in China.

METHODS: This study was conducted in the gynecological clinics of 12 hospitals geographically located in different regions in China. Women with purulent cervical secretions or abnormal vaginal microecology were included as the research group, and those with normal vaginal microecology and cervical secretions were included as the control group. A total of 2190 participants were recruited in this project including 1357 of research group and 833 of control group. All participants were required to complete questionnaires, whose vaginal discharge were collected for vaginal microecology test and cervical discharge for detection of M. genitalium and C. trachomatis.

RESULTS: The prevalence of C. trachomatis and M. genitalium were 7.1% (96/1357) and 3.8% (51/1357), respectively in research group. The prevalence of C. trachomatis and M. genitalium varied in different regions. Infection rates of C. trachomatis and M. genitalium were higher in women with abnormal vaginal microecology (C.t P = 0.038, M.g P = 0.043), especially in women with bacterial vaginosis and mixed vaginitis, of which C. trachomatis showed statistical differences (bacterial vaginosis, P = 0.035; mixed vaginitis, P = 0.0001) and M. genitalium was close to statistical differences (bacterial vaginosis, P = 0.057; mixed vaginitis, P = 0.081). Alcoholism and abnormal vaginal microecology were positively correlated with both C. trachomatis and M. genitalium infection. Increasing age, being married and multi-parity were negatively correlated with C. trachomatis infection. There is a positive correlation between multiple sexual partners, diversed styles of sex and C. trachomatis infection.

CONCLUSIONS: Women with lower genital dysbiosis have an increased risk of C. trachomatis and M. genitalium. The overall prevalence of M. genitalium is lower than that of C. trachomatis, while they have similarities in the characteristics of infection. Although M. genitalium is not routinely screened as C. trachomatis in young women, attention should be paid to M. genitalium infection in young women with abnormal vaginal microecology or having childbearing needs.

PMID:36604611 | DOI:10.1186/s12879-022-07975-2

Mol Psychiatry. 2023 Jan 6. doi: 10.1038/s41380-022-01929-5. Online ahead of print.

ABSTRACT

Genome-wide association studies (GWAS) of suicidal thoughts and behaviors support the existence of genetic contributions. Continuous measures of psychiatric disorder symptom severity can sometimes model polygenic risk better than binarized definitions. We compared two severity measures of suicidal thoughts and behaviors at the molecular and functional levels using genome-wide data. We used summary association data from GWAS of four traits analyzed in 122,935 individuals of European ancestry: thought life was not worth living (TLNWL), thoughts of self-harm, actual self-harm, and attempted suicide. A new trait for suicidal thoughts and behaviors was constructed first, phenotypically, by aggregating the previous four traits (termed “suicidality”) and second, genetically, by using genomic structural equation modeling (gSEM; termed S-factor). Suicidality and S-factor were compared using SNP-heritability (h²) estimates, genetic correlation (r_g), partitioned h², effect size distribution, transcriptomic correlations (ρ_GE) in the brain, and cross-population polygenic scoring (PGS). The S-factor had good model fit (χ² = 0.21, AIC = 16.21, CFI = 1.00, SRMR = 0.024). Suicidality (h² = 7.6%) had higher h² than the S-factor (h² = 2.54, P_diff = 4.78 × 10^-13). Although the S-factor had a larger number of non-null susceptibility loci (π_c = 0.010), these loci had small effect sizes compared to those influencing suicidality (π_c = 0.005, P_diff = 0.045). The h² of both traits was enriched for conserved biological pathways. The r_g and ρ_GE support highly overlapping genetic and transcriptomic features between suicidality and the S-factor. PGS using European-ancestry SNP effect sizes strongly associated with TLNWL in Admixed Americans: Nagelkerke’s R² = 8.56%, P = 0.009 (PGS_suicidality) and Nagelkerke’s R² = 7.48%, P = 0.045 (PGS_S-factor). An aggregate suicidality phenotype was statistically more heritable than the S-factor across all analyses and may be more informative for future genetic study designs interested in common genetic factors among different suicide related phenotypes.

PMID:36604601 | DOI:10.1038/s41380-022-01929-5

Sci Rep. 2023 Jan 5;13(1):187. doi: 10.1038/s41598-023-27571-x.

ABSTRACT

Binge drinking is a deadly pattern of excessive alcohol use that is associated with multiple diseases in the United States. To date, little is known about the associations between the early onset of substance use and other factors with the severity of adult binge drinking. The 2018 National Survey on Drug Use and Health data was used to identify binge drinking (binary and in number of days in the past month). Age at onset was categorized into four groups as 1-12, 13-14, 15-17, or beyond 18. Weighted multivariate logistic regression and Poisson regression analyses were performed to examine the associations between early onset of alcohol, smokeless tobacco, and marijuana use with binge drinking. The severity of binge drinking was statistically significantly associated with substance use (4.15 days in a month), early onset of alcohol, smokeless tobacco, and marijuana use (2.15-4.93 days, all p-values < 0.0001), after accounting for the covariates. Past year substance use disorder is strongly associated with binge drinking. The severity of adult binge drinking is significantly associated with early onset of substance use including alcohol, smokeless tobacco, and marijuana. Continued efforts are warranted to improve substance use prevention and treatment tailored for adolescents and youths to prevent development of adult binge drinking.

PMID:36604596 | DOI:10.1038/s41598-023-27571-x

J Neural Eng. 2023 Jan 5. doi: 10.1088/1741-2552/acb088. Online ahead of print.

ABSTRACT

OBJECTIVE: Brain connectivity network is a vital tool to reveal the interaction between different brain regions. Currently, most functional connectivety methods can only capture pairs of information to construct brain networks which ignored the high-order correlations between brain regions.

APPROACH: Therefore, this study proposed a weighted connectivity hyper-network based on resting-state EEG data, and then applied to depression identification and analysis. The hyper-network model was builed based on least absolute shrinkage and selection operator (LASSO) sparse regression method to effectively represent the higher-order relationships of brain regions. On this basis, by integrating the correlation-based weighted hyper-edge information, the weighted hyper-network is constructed, and the topological features of the network are extracted for classification.

MAIN RESULTS: The experimental results obtained an optimal accuracy compared to the traditional coupling methods. The statistical results on network metrics proved that there were significant differences between depressive patients (DP) and normal controls (NC). In addition, some brain regions and electrodes were found and discussed to highly correlate with depression by analyzing of the critical nodes and hyper-edges.

SIGNIFICANCE: These may help discover disease-related biomarkers important for depression diagnosis.

PMID:36603214 | DOI:10.1088/1741-2552/acb088

Psychol Methods. 2023 Jan 5. doi: 10.1037/met0000541. Online ahead of print.

ABSTRACT

Text is a burgeoning data source for psychological researchers, but little methodological research has focused on adapting popular modeling approaches for text to the context of psychological research. One popular measurement model for text, topic modeling, uses a latent mixture model to represent topics underlying a body of documents. Recently, psychologists have studied relationships between these topics and other psychological measures by using estimates of the topics as regression predictors along with other manifest variables. While similar two-stage approaches involving estimated latent variables are known to yield biased estimates and incorrect standard errors, two-stage topic modeling approaches have received limited statistical study and, as we show, are subject to the same problems. To address these problems, we proposed a novel statistical model-supervised latent Dirichlet allocation with covariates (SLDAX)-that jointly incorporates a latent variable measurement model of text and a structural regression model to allow the latent topics and other manifest variables to serve as predictors of an outcome. Using a simulation study with data characteristics consistent with psychological text data, we found that SLDAX estimates were generally more accurate and more efficient. To illustrate the application of SLDAX and a two-stage approach, we provide an empirical clinical application to compare the application of both the two-stage and SLDAX approaches. Finally, we implemented the SLDAX model in an open-source R package to facilitate its use and further study. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:36603124 | DOI:10.1037/met0000541

Breastfeed Med. 2023 Jan 5. doi: 10.1089/bfm.2022.0179. Online ahead of print.

ABSTRACT

Objective: The aim of this study was to investigate the effects of aroma of Citrus aurantium and Lavender essence on sexual satisfaction in breastfeeding women. Materials and Methods: This was a double-blind randomized controlled trial that was conducted on 180 breastfeeding women from January to May 2019. The participants were allocated to three groups of Citrus aurantium (n = 60), Lavender (n = 60), and control (n = 60) groups. Two groups of intervention used 2 drops of essential oil, twice a day, for 40 days as inhalation. The control group received almond oil in the same. The sexual satisfaction was evaluated using the Linda Berg’s Sexual Satisfaction Questionnaire before the intervention and 40 days after the intervention started. The data were analyzed using the SPSS statistical software, version 21, and p < 0.05 was considered statistically significant. Results: After the 40 days of intervention, the mean score of sexual satisfaction was significantly higher in the Citrus aurantium and Lavender groups compared with the control group (59.3 ± 11.7, 59.3 ± 11.6 vs. 52.02 ± 11.5, p < 0.001). There was no significant difference between Lavender and Citrus aurantium groups. Conclusions: The results of this study showed that the aroma of Citrus aurantium and Lavender essence could significantly improve the sexual satisfaction of breastfeeding women. Therefore, it is recommended that health care providers should inform the breastfeeding women and advise them to use these interventions for increase of the sexual satisfaction. Trial Registration Number: IRCT20160427027633N3.

PMID:36603110 | DOI:10.1089/bfm.2022.0179

J Cogn Neurosci. 2022 Dec 28:1-13. doi: 10.1162/jocn_a_01954. Online ahead of print.

ABSTRACT

BACKGROUND: The SMA is fundamental in planning voluntary movements and execution of some cognitive control operations. Specifically, the SMA has been associated to play a dominant role in controlling goal-directed actions as well as those that are highly predicted (i.e., automatic). Yet, the essential contribution of SMA in goal-directed or automatic control of behavior is scarce. Our objective was to test the possible direct role of SMA in automatic and voluntary response inhibition.

METHODS: We separately applied two noninvasive brain stimulation (NIBS) inhibitory techniques over SMA: either continuous theta-burst stimulation using repetitive transcranial magnetic stimulation or transcranial static magnetic field stimulation. Each NIBS technique was performed in a randomized, crossover, sham-controlled design. Before applying NIBS, participants practiced a go/no-go learning task where associations between stimulus and stopping behaviors were created (initiation and inhibition). After applying each NIBS, participants performed a go/no-go task with reversed associations (automatic control) and the stop signal task (voluntary control).

RESULTS: Learning associations between stimuli and response initiation/inhibition was achieved by participants and therefore automatized during training. However, no significant differences between real and sham NIBS were found in either automatic (go/no-go learning task) or voluntary inhibition (stop signal task), with Bayesian statistics providing moderate evidence of absence.

CONCLUSIONS: Our results are compatible with a nondirect involvement of SMA in automatic control of behavior. Further studies are needed to prove a noncausal link between prior neuroimaging findings relative to SMA controlling functions and the observed behavior.

PMID:36603037 | DOI:10.1162/jocn_a_01954

PLoS One. 2023 Jan 5;18(1):e0279894. doi: 10.1371/journal.pone.0279894. eCollection 2023.

ABSTRACT

The COVID-19 pandemic has highlighted a need for better understanding of countries’ vulnerability and resilience to not only pandemics but also disasters, climate change, and other systemic shocks. A comprehensive characterization of vulnerability can inform efforts to improve infrastructure and guide disaster response in the future. In this paper, we propose a data-driven framework for studying countries’ vulnerability and resilience to incident disasters across multiple dimensions of society. To illustrate this methodology, we leverage the rich data landscape surrounding the COVID-19 pandemic to characterize observed resilience for several countries (USA, Brazil, India, Sweden, New Zealand, and Israel) as measured by pandemic impacts across a variety of social, economic, and political domains. We also assess how observed responses and outcomes (i.e., resilience) of the COVID-19 pandemic are associated with pre-pandemic characteristics or vulnerabilities, including (1) prior risk for adverse pandemic outcomes due to population density and age and (2) the systems in place prior to the pandemic that may impact the ability to respond to the crisis, including health infrastructure and economic capacity. Our work demonstrates the importance of viewing vulnerability and resilience in a multi-dimensional way, where a country’s resources and outcomes related to vulnerability and resilience can differ dramatically across economic, political, and social domains. This work also highlights key gaps in our current understanding about vulnerability and resilience and a need for data-driven, context-specific assessments of disaster vulnerability in the future.

PMID:36603015 | DOI:10.1371/journal.pone.0279894

PLoS One. 2023 Jan 5;18(1):e0279920. doi: 10.1371/journal.pone.0279920. eCollection 2023.

ABSTRACT

PURPOSE: Our recent publication used optical coherence tomography (OCT) to follow thinning of the retinal ganglion cell layer (GCL) in central retinal artery occlusion (CRAO). Thinning of the inner layers also occurs in patients with branch retinal artery occlusion (BRAO). The mechanism for such thinning may be partially due to proteolysis by a calcium-activated protease called calpain. Calpain inhibitor SNJ-1945 ameliorated the proteolysis in a past series of model experiments. The purposes of the present retrospective study were to: 1) use segmentation analysis of OCT images to follow the loss of retinal layers in BRAO compared to CRAO patients, and 2) predict the number of patients and days of observation needed for a clinical trial of a calpain inhibitor against BRAO.

METHODS: A retrospective, case control study was conducted by computer-aided search in a medical records database for BRAO (ICD10 Code H34.239) with at least one OCT procedure (CPT: 92134). Non-proliferative, co-morbid eye diseases were allowed in the patient data base, and manual correction of auto-segmentation errors was performed. GCL thickness changes were followed over time and Cohen-d/sample size statistics were used to predict minimal patients needed for drug trials.

RESULTS: The thickness of the GCL layer in BRAO decreased rapidly with time as in CRAO, but in more limited quadrants. The data, as fit to a single-phase decay curve, showed that GCL thickness could be used to provide sample size statistics in a clinical trial to test a calpain inhibitor. For example, a 60-day trial with a 60% effective inhibitor would need a minimum of 29 patients.

CONCLUSIONS: Using thickness changes in the GCL layer to monitor the efficacy of potential inhibitors against BRAO and CRAO is practical in human trials requiring a reasonable number of patients and relatively short trial period.

TRANSLATIONAL RELEVANCE: Measurement of GCL thickness would be a useful indicator of amelioration of BRAO and CRAO progression in a clinical trial of a putative inhibitor.

PMID:36603006 | DOI:10.1371/journal.pone.0279920