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Nevin Manimala Statistics

Rapid identification of methicillin-resistant Staphylococcus aureus by MALDI-TOF MS: A Meta-Analysis

Biotechnol Appl Biochem. 2022 Dec 27. doi: 10.1002/bab.2433. Online ahead of print.

ABSTRACT

Invasive infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are associated with high mortality and morbidity. The sooner the pathogen is determined, the better it is beneficial to patient. However, routine laboratory inspections are time-consuming and laborious. A thorough research was conducted in PubMed, Web of Science (until June 2021) to identify studies evaluating the accuracy of MRSA identification by MALDI-TOF-MS. STATA 15.0 software was used to analyze the pooled results of sensitivity, specificity and 95% confidence intervals (CI). The summary receiver operating characteristic curves (SROC) and area under the curve (AUC) were utilized to show the overall performance of MALDI-TOF-MS. Fifteen studies involving 2,471 isolates were included in this study after the final selection in this meta-analysis. Using the random effects model forest plot to summarize the overall statistics, the sensitivity of MALDI-TOF MS for identifying MRSA was 92% (95% CI, 81%-97%), and the specificity was 97% (95% CI, 89%-99%). In the SROC curve, the AUC reached 0.99 (95% CI, 97%-99%). Deeks’ test showed no significant publication bias in this meta-analysis. Compared with clinical reference methods, MALDI-TOF MS identification of MRSA shows a higher degree of sensitivity and specificity. This article is protected by copyright. All rights reserved.

PMID:36575908 | DOI:10.1002/bab.2433

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Development and psychometric evaluation of the Emotional Intelligence Test (EMI-T) for social care and healthcare student selection

J Adv Nurs. 2022 Dec 27. doi: 10.1111/jan.15557. Online ahead of print.

ABSTRACT

AIM: To develop an emotional intelligence (EI) test and evaluate its psychometrics for social and healthcare student selection.

DESIGN: A cross-sectional methodological design.

METHODS: The test was developed based on a systematic review and focus group interviews. Content validity was evaluated with expert panels, and preliminary psychometrics with two pilot studies. Descriptive statistics, correlations and item response theory were used.

DATA SOURCES: Search was conducted in six databases 2018. Focus group interviews were conducted with educators and professionals in 2019. Expert panels with doctoral students, researchers and educators were conducted in 2020. Pilot tests with students were conducted 2020-2021. The developed test was administered to 4808 applicants 2021.

RESULTS: The test included four subscales. Correlations support the test’s theoretical structure. The items were mainly easy.

CONCLUSION: The test assesses EI objectively and comprehensively. The item-level distractor analysis can be used for further test development.

IMPACTS: Social care and healthcare students engage in clinical practice early in their studies, and these environments can be emotionally challenging. Assessing EI in student selection with adequate test can help the institutions of higher education to select the students with required abilities to succeed in the studies. The assessment of EI during student selection also provides information higher education institutions could use to develop and provide support interventions. The results may also encourage practice placements to include EI elements as learning objective. The results of this study and especially the use of IRT and detailed distractor analysis to evaluate the psychometric properties of EMI-T can benefit researchers and educators that develop or evaluate objective assessment tools with multiple choice questions.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Emotional intelligence is important for students to enable professional interaction.

PMID:36575904 | DOI:10.1111/jan.15557

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Skin manifestations following anti-COVID-19 vaccination: A multicentricstudy from Turkey

J Cosmet Dermatol. 2022 Dec 27. doi: 10.1111/jocd.15570. Online ahead of print.

ABSTRACT

PURPOSE: After the emergence of the pandemic caused by the COVID-19 virus, vaccination with various vaccines has started to be implemented across the world. To identify dermatological reactions developing after the COVID-19 vaccines administered in Turkey and determine their clinical features and risk factors that may play a role in their development.

MATERIALS AND METHODS: The study included patients aged ≥18 years, who presented to 13 different dermatology clinics in Turkey between July 2021 and September 2021 after developing dermatological reactions following the administration of the COVID-19 vaccine. After providing written consent, the patients were asked to complete a standard survey including questions related to age, gender, occupation, comorbidities, the regular medication used, the onset of cutaneous reactions after vaccination, and localization of reactions. Dermatological reactions were categorized according to whether they developed after the first or second dose of the vaccine or whether they occurred after the inactivated or messenger RNA (mRNA) vaccine. The relationship between dermatological reactions and some variables such as gender and comorbidities was also evaluated.

RESULTS: A total of 269 patients [116 women (43.1%), 153 men (56.9%)] were included in the study. It was observed that the dermatological diseases and reactions that most frequently developed after vaccination were urticaria (25.7%), herpes zoster (24.9%), maculopapular eruption (12.3%), and pityriasis rosea (4.5%). The rate of dermatological reactions was 60.6% after the administration of the mRNA vaccine and 39.4% after that of the inactivated vaccine. There was a statistically significantly higher number of reactions among the patients that received the mRNA vaccine (p = 0.001).

CONCLUSION: The most common reactions in our sample were urticaria, herpes zoster, and maculopapular eruption. Physicians should know the dermatological side effects of COVID-19 vaccines and their clinical features.

PMID:36575896 | DOI:10.1111/jocd.15570

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Comparative evaluation of the efficacy of topical tacrolimus 0.03% and topical calcipotriol 0.005% mixed with betamethasone dipropionate versus topical clobetasol 0.05% in treatment of alopecia areata: A clinical and trichoscopic study

J Cosmet Dermatol. 2022 Dec 27. doi: 10.1111/jocd.15558. Online ahead of print.

ABSTRACT

BACKGROUND: Alopecia areata (AA) is a common non-scarring hair loss disorder that affects children and adults with a great psychological burden because of its recurrent and sometimes treatment-refractory nature.

OBJECTIVE: To compare the efficacy of topical calcineurin inhibitor, topical potent steroid combined with vitamin D analogue versus topical superpotent steroid in treatment of localized AA.

PATIENTS AND METHODS: Sixty subjects with chronic (>1 year) localized (SALT score < 25%) AA, confirmed clinically and dermoscopically, were randomized into three groups. Group I used topical 0.03% tacrolimus (Tarolimus®), group II used topical potent steroid combined with vitamin D analogue (Daivobet®). and group III used topical superpotent steroid (Dermovate®). All patients continued a daily therapy for three successive months and were followed up for three other months. Assessment was done using PULL test, SALT score, and dermoscopic comparison before and after therapy.

RESULTS: Group II showed comparable statistical results to group III with lower values in a non-statistically significant way. Group I achieved the least improvement among all groups.

CONCLUSION: Combined vitamin D analogues with potent steroid appears to be a more convenient treatment for localized AA than superpotent steroids because of less side effects and comparable efficacy. Tacrolimus needs further research or formula customization to be used as a topical therapy for AA.

PMID:36575890 | DOI:10.1111/jocd.15558

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A comparative study of pain perception during the microfocused ultrasound procedure between topical anesthesia and combined topical anesthesia with forced air cooling

J Cosmet Dermatol. 2022 Dec 27. doi: 10.1111/jocd.15568. Online ahead of print.

ABSTRACT

BACKGROUND: The experience of pain during microfocused ultrasound with visualization (MFU-V) treatment is common and crucial for dictating patient satisfaction and retention.

OBJECTIVE: To compare the pain perception during the MFU-V procedure between two pain reduction methods (topical anesthesia alone versus combined topical anesthesia with forced air cooling).

MATERIALS AND METHODS: This was a prospective, single-blinded, randomized controlled trial. A square area on the inner side of both arms of healthy volunteers was marked as an experimental site and randomly assigned to receive each pain reduction method: topical anesthesia or combined topical anesthesia with forced air cooling. Thereafter, MFU-V was performed with a 4.5 MHz, 4.5 mm transducer (10 lines, 0.9 J) followed by a 7 MHz, 3.0 mm transducer (10 lines, 0.3 J). The visual analog scale (VAS) for pain was measured immediately after 4.5 mm transducer (T1a), immediately after 3.0 mm transducer (T1b), and after the entire procedure (T2).

RESULTS: Twenty-one participants with a mean (SD) age of 34.67 (±6.18) years were enrolled. The mean (±SD) pain score of combined topical anesthesia with forced air cooling-treated area was 5.40 (±1.64), 4.80 (±1.63), and 5.40 (±1.56) at T1a, T1b, and T2, respectively. The mean pain score for topical anesthesia-treated areas was 5.89 (±1.45), 5.00 (±1.72), and 5.76 (±1.67) at T1a, T1b, and T2, respectively. There were no statistically significant differences in the pain perception between the two methods.

CONCLUSION: The addition of forced air cooling is not beneficial for pain reduction during the MFU-V procedure because its temperature reduction effect cannot be delivered to the deep parts of the skin, which is the target site of MFU-V.

PMID:36575874 | DOI:10.1111/jocd.15568

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Uroflowmetry is a viable surrogate for urethroscopy in evaluation of anatomical success following urethroplasty

Int J Urol. 2022 Dec 27. doi: 10.1111/iju.15137. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to investigate the utility of uroflowmetry in predicting anatomical success following urethroplasty based on real-world clinical data.

METHODS: Data from 100 male patients who underwent urethroplasty for urethral strictures at our institute were analyzed. Postoperative anatomical success was determined as the passage of a 16.2 Fr flexible endoscope after approximately 4 months following the procedure. Sensitivity and specificity of the maximal flow rate (Qmax ), average flow rate (Qave ), and Qmax – Qave for anatomical success were determined, along with receiver operating characteristic analysis. The optimal cutoff was set using Youden’s index.

RESULTS: Anatomical success was observed in 67%. Voided volumes in the success and failure groups were equivalent: 252 ± 121 versus 242 ± 91 ml, respectively. In 18 cases, voided volumes were <150 ml. Parameters of uroflowmetry were all significantly higher in the anatomical success group when compared to those in the failure group: the mean value of Qmax was 26.1 versus 15.0 ml/s; Qave , 14.2 versus 9.1 ml/s; and Qmax – Qave , 11.9 versus 5.9 ml/s, respectively (p < 0.0001 for each parameter). The area under the curve was 0.8082 for Qmax , 0.7727 for Qave , and 0.8186 for Qmax – Qave . Optimal cutoff values for Qmax and Qmax – Qave were 20 and 6 ml/s, which predicted anatomical success with 86% and 87% positive predictive value, respectively.

CONCLUSION: This analysis presents statistically valid cutoffs by which uroflowmetry can be used as a viable surrogate of anatomical success following urethroplasty in clinical practice.

PMID:36575864 | DOI:10.1111/iju.15137

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Brain structure and allelic associations in Alzheimer’s disease

CNS Neurosci Ther. 2022 Dec 27. doi: 10.1111/cns.14073. Online ahead of print.

ABSTRACT

BACKGROUND: Alzheimer’s disease (AD), the most prevalent form of dementia, affects 6.5 million Americans and over 50 million people globally. Clinical, genetic, and phenotypic studies of dementia provide some insights of the observed progressive neurodegenerative processes, however, the mechanisms underlying AD onset remain enigmatic.

AIMS: This paper examines late-onset dementia-related cognitive impairment utilizing neuroimaging-genetics biomarker associations.

MATERIALS AND METHODS: The participants, ages 65-85, included 266 healthy controls (HC), 572 volunteers with mild cognitive impairment (MCI), and 188 Alzheimer’s disease (AD) patients. Genotype dosage data for AD-associated single nucleotide polymorphisms (SNPs) were extracted from the imputed ADNI genetics archive using sample-major additive coding. Such 29 SNPs were selected, representing a subset of independent SNPs reported to be highly associated with AD in a recent AD meta-GWAS study by Jansen and colleagues.

RESULTS: We identified the significant correlations between the 29 genomic markers (GMs) and the 200 neuroimaging markers (NIMs). The odds ratios and relative risks for AD and MCI (relative to HC) were predicted using multinomial linear models.

DISCUSSION: In the HC and MCI cohorts, mainly cortical thickness measures were associated with GMs, whereas the AD cohort exhibited different GM-NIM relations. Network patterns within the HC and AD groups were distinct in cortical thickness, volume, and proportion of White to Gray Matter (pct), but not in the MCI cohort. Multinomial linear models of clinical diagnosis showed precisely the specific NIMs and GMs that were most impactful in discriminating between AD and HC, and between MCI and HC.

CONCLUSION: This study suggests that advanced analytics provide mechanisms for exploring the interrelations between morphometric indicators and GMs. The findings may facilitate further clinical investigations of phenotypic associations that support deep systematic understanding of AD pathogenesis.

PMID:36575854 | DOI:10.1111/cns.14073

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Proximate Composition, Physicochemical and Microbiological Characterization of Edible Seaweeds Available in the Portuguese Market

Front Biosci (Elite Ed). 2022 Sep 28;14(4):26. doi: 10.31083/j.fbe1404026.

ABSTRACT

BACKGROUND: The aim of this work was the study of the proximate composition and profile of fatty acids, minerals, and some microbiological aspects of four edible seaweed species (Chondrus crispus, Palmaria palmata, Porphyra sp., and Ulva sp.) available in the Portuguese market for food consumption, and produced in a national Integrated Multi-Trophic System (IMTA).

METHODS: Moisture, ash, and total lipids were determined gravimetrically. Crude protein was analysed by Duma’s combustion procedures. The total carbohydrate content was assayed by the phenol/sulphuric acid method. The assessment of the fatty acids methyl esters (FAMEs) was determined through GC-MS. Characterization of elemental analysis was performed by ICP-AES. Different standard microbiological methods were applied for microorganisms. Statistics were performed using the non-parametric Mann-Whitney U test to assess significant differences between samples.

RESULTS: Lipid contents (n = 3) were very low (1.6-2.3%), particularly in Palmaria palmata, and Chondrus crispus (1.6-1.7%). The protein content (n = 4) varied from 14.4% in P. palmata to 23.7% in Porphyra sp. Carbohydrates (n = 3) were the major constituent of most seaweeds (31-34%), except in Porphyra sp., with higher content in proteins than carbohydrates. Regarding the fatty acid content (n = 4), in general, saturated fatty acids (SFAs) were the most abundant followed by polyunsaturated fatty acids (PUFAs) and monounsaturated fatty acids (MUFAs). Among macro and trace elements (n = 3), Chondrus crispus shows the highest average content in Zn (71.1 mg ⋅ kg – 1 D.W.), Palmaria palmata the highest average content in K (124.8 g ⋅ kg – 1 D.W.), Porphyra sp. the highest average content in P (2.1 g ⋅ kg – 1 D.W.), and Ulva sp. the highest average content of Ca (5.5 g ⋅ kg – 1 D.W.), Mg (55.8 g ⋅ kg – 1 D.W.), and Fe (336.3 mg ⋅ kg – 1 D.W.). In general, Na and K were the most abundant elements among analysed seaweed. Additionally, the microbiological results (n = 4) comply with the Portuguese guidelines (subgroup 2D) on the application of general principles of food hygiene in ready-to-eat foods.

CONCLUSIONS: Overall, the results highlight the potential of using these seaweeds as an alternative and sustainable source of elements and bioactive compounds to produce enriched food products with a beneficial potential for human nutrition.

PMID:36575846 | DOI:10.31083/j.fbe1404026

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A Bayesian model for identifying cancer subtypes from paired methylation profiles

Brief Bioinform. 2022 Dec 28:bbac568. doi: 10.1093/bib/bbac568. Online ahead of print.

ABSTRACT

Aberrant DNA methylation is the most common molecular lesion that is crucial for the occurrence and development of cancer, but has thus far been underappreciated as a clinical tool for cancer classification, diagnosis or as a guide for therapeutic decisions. Partly, this has been due to a lack of proven algorithms that can use methylation data to stratify patients into clinically relevant risk groups and subtypes that are of prognostic importance. Here, we proposed a novel Bayesian model to capture the methylation signatures of different subtypes from paired normal and tumor methylation array data. Application of our model to synthetic and empirical data showed high clustering accuracy, and was able to identify the possible epigenetic cause of a cancer subtype.

PMID:36575828 | DOI:10.1093/bib/bbac568

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De Ritis ratio and long-term major cardiovascular adverse events in patients undergoing elective percutaneous coronary intervention

Eur J Clin Invest. 2022 Dec 27:e13942. doi: 10.1111/eci.13942. Online ahead of print.

ABSTRACT

BACKGROUND: The association of aspartate aminotransferase to alanine aminotransferase ratio (De Ritis ratio) with clinical outcome in patients with chronic coronary syndromes (CCS) remains unclear. This study aims to assess the association of De Ritis ratio with adverse cardiovascular events in patients with CCS.

MATERIALS AND METHODS: The study included 5020 patients with CCS undergoing percutaneous coronary intervention. Patients were categorized in groups according to tertiles of the De Ritis ratio: tertile 1 (De Ritis ratio: <0.75; n=1688 patients), tertile 2 (De Ritis ratio: 0.75-1.08; n=1666 patients) and tertile 3 (De Ritis ratio: >1.08; n=1666 patients). The primary endpoint was 3-year mortality.

RESULTS: At 3 years, there were 384 deaths, 176 myocardial infarctions and 61 strokes. In groups with De Ritis in the 1st, 2nd and 3rd tertiles deaths occurred in 5.0%, 7.5% and 14.5% of the patients, respectively (adjusted hazard ratio =1.09, 95% confidence interval 1.06 to 1.12], P<0.001); myocardial infarctions occurred in 2.6%, 3.5% and 5.1% of the patients, respectively (P<0.001); strokes occurred in 1.0%, 1.2% and 1.9% of the patients, respectively (P=0.030); bleeding at 30 days (n=112) occurred in 1.4%, 1.6% and 3.7% of the patients, respectively (P<0.001). The C-statistic of the Cox proportional hazards model for all-cause mortality with baseline data without the De Ritis ratio was 0.815 [0.794-0.836] and 0.818 [0.797-0.838] after inclusion of the De Ritis ratio (delta C-statistic =0.003; P=0.005).

CONCLUSIONS: In patients with CCS undergoing percutaneous coronary intervention an elevated De Ritis ratio was associated with long-term major cardiovascular adverse events.

PMID:36575818 | DOI:10.1111/eci.13942