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Nevin Manimala Statistics

Letter to the editor: What is the value of statistical testing of observational data?

Vet Surg. 2022 Nov 4. doi: 10.1111/vsu.13904. Online ahead of print.

NO ABSTRACT

PMID:36333870 | DOI:10.1111/vsu.13904

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Nevin Manimala Statistics

Sickness Symptoms in Kidney Transplant Recipients: A Scoping Review

West J Nurs Res. 2022 Nov 4:1939459221128125. doi: 10.1177/01939459221128125. Online ahead of print.

ABSTRACT

Sickness symptoms (depressive symptoms, anxiety, and fatigue) are common among people with chronic illness, often presenting as a symptom cluster. Sickness symptoms persist in many patients with chronic kidney disease, even after kidney transplantation (KT); however, little is known about sickness symptom-induced burden in KT recipients. This scoping review synthesizes available evidence for sickness symptoms in KT recipients, including findings on symptom prevalence, predictors, outcomes, interrelationships, and clustering. Among 38 reviewed studies, none identified sickness symptoms as a cluster, but we observed interrelationships among the symptoms examined. Fatigue was the most prevalent sickness symptom, followed by anxiety and depressive symptoms. Predictors of these symptoms included demographic, clinical, and psychosocial factors, and health-related quality of life was the most researched outcome. Future research should use common data elements to phenotype sickness symptoms, include biological markers, and employ sophisticated statistical methods to identify potential clustering of sickness symptoms in KT recipients.

PMID:36333867 | DOI:10.1177/01939459221128125

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Nevin Manimala Statistics

Neurodevelopment in school aged children after intrauterine exposure to antipsychotics

Acta Psychiatr Scand. 2022 Nov 4. doi: 10.1111/acps.13517. Online ahead of print.

ABSTRACT

OBJECTIVE: Antipsychotics are increasingly prescribed in pregnancy, yet little is known about potential long-term developmental effects on children. In this study we investigated the effect of prenatal antipsychotic exposure on neurodevelopmental functioning in school-aged children.

METHODS: We performed a cross-sectional neurodevelopmental assessment of 91 children aged 6-14 years whose mothers had severe mental illness (SMI) and were either exposed or unexposed to antipsychotic medication during pregnancy. Neurodevelopmental outcomes were assessed using validated neurodevelopmental assessment instruments to examine the child’s IQ and global cognitive functioning, and the presence of any psychiatric disorders and/or learning problems in the child was assessed by parental report.

RESULTS: No statistically significant associations were found between antipsychotic exposure during pregnancy and either adverse neurodevelopmental outcomes (IQ, neuropsychological function), likelihood of psychiatric diagnosis, or learning problems based on parental report. Analyses were likely limited in power to detect subtler differences in neurodevelopmental functioning due to small sample size and heterogeneity of the sample.

CONCLUSIONS: In this exploratory cohort study, intrauterine exposure to antipsychotics was not associated with any adverse effect on IQ or neurodevelopmental functioning in a cohort of school aged children (6-14 years). This article is protected by copyright. All rights reserved.

PMID:36333825 | DOI:10.1111/acps.13517

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Nevin Manimala Statistics

Plasma proteomic signature of decline in gait speed and grip strength

Aging Cell. 2022 Nov 4:e13736. doi: 10.1111/acel.13736. Online ahead of print.

ABSTRACT

The biological mechanisms underlying decline in physical function with age remain unclear. We examined the plasma proteomic profile associated with longitudinal changes in physical function measured by gait speed and grip strength in community-dwelling adults. We applied an aptamer-based platform to assay 1154 plasma proteins on 2854 participants (60% women, aged 76 years) in the Cardiovascular Health Study (CHS) in 1992-1993 and 1130 participants (55% women, aged 54 years) in the Framingham Offspring Study (FOS) in 1991-1995. Gait speed and grip strength were measured annually for 7 years in CHS and at cycles 7 (1998-2001) and 8 (2005-2008) in FOS. The associations of individual protein levels (log-transformed and standardized) with longitudinal changes in gait speed and grip strength in two populations were examined separately by linear mixed-effects models. Meta-analyses were implemented using random-effects models and corrected for multiple testing. We found that plasma levels of 14 and 18 proteins were associated with changes in gait speed and grip strength, respectively (corrected p < 0.05). The proteins most strongly associated with gait speed decline were GDF-15 (Meta-analytic p = 1.58 × 10-15 ), pleiotrophin (1.23 × 10-9 ), and TIMP-1 (5.97 × 10-8 ). For grip strength decline, the strongest associations were for carbonic anhydrase III (1.09 × 10-7 ), CDON (2.38 × 10-7 ), and SMOC1 (7.47 × 10-7 ). Several statistically significant proteins are involved in the inflammatory responses or antagonism of activin by follistatin pathway. These novel proteomic biomarkers and pathways should be further explored as future mechanisms and targets for age-related functional decline.

PMID:36333824 | DOI:10.1111/acel.13736

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Nevin Manimala Statistics

Prevalence and influence factors of occupational exposure to blood and body fluids in registered Chinese nurses: a national cross-sectional study

BMC Nurs. 2022 Nov 4;21(1):298. doi: 10.1186/s12912-022-01090-y.

ABSTRACT

BACKGROUND: Occupational exposure to blood and body fluids poses a threat to medical providers and to nurses especially. This harm is not only physical, but psychology as well and can ultimately impact patient safety. This study aims to understand the prevalence of occupational exposure to blood and body fluids among Chinese registered nurses and explores the factors that influence this exposure.

METHODS: A cross-sectional online survey was conducted for 31 province-level divisions in China, using a self-created questionnaire entitled Status Survey on Occupational Exposure in Nurses. Descriptive statistics were used to describe both the demographic characteristics of the respondents and the characteristics of occupational exposure. Categorical variables were presented as frequencies and percentage, and the relationship between possible influential factors and the occurrence of occupational exposure was determined using binary logistic regression.

RESULTS: Out of a total of 20,791 nurses analyzed, over half (52.1%) of them had experienced occupational exposure to blood or body fluids, but over 1/3 (34.6%) of them did not ever report their exposures to a supervisor/official. The top three causes of under-reporting were: the source patient failed to test positive for infectious pathogens (43.6%), perception of a burdensome reporting process (24.6%), and indifferent attitude towards being infected (16.9%). Nurses who worked over 8 hours per day had higher risks of exposure (OR 1.199, 95% CI 1.130 to 1.272, P < 0.001, respectively). The occupational exposure risk from providing 1-2 types of PPE is 1.947 times that of providing 9-10 types of PPE (OR 1.947, 95% CI 1.740 to 2.178, P < 0.001). Likewise, the occupational exposure risk of providing 1-2 types of safety-engineered injection devices is 1.275 times of that of providing 5-6 types (OR 1.275, 95% CI 1.179 to 1.379, P < 0.001).

CONCLUSIONS: Occupational exposure to blood and body fluids in registered nurses is common, but the rate of under-reporting such exposure is high. Implementing engineered “sharp” injury prevention devices, following exposure prevention procedures, giving sufficient education and training to healthcare personnel on exposure prevention and control, and developing exposure reporting policies are all steps that can both reduce exposure and increase its reporting.

PMID:36333812 | DOI:10.1186/s12912-022-01090-y

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Nevin Manimala Statistics

Pediatric tuberculosis outcomes and factors associated with unfavorable treatment outcomes in Botswana, 2008-2019: a retrospective analysis

BMC Public Health. 2022 Nov 4;22(1):2020. doi: 10.1186/s12889-022-14477-y.

ABSTRACT

INTRODUCTION: Globally, the amount of research on the outcomes of pediatric tuberculosis (TB) is disproportionately less than that of adult TB. The diagnosis of paediatric TB is also problematic in developing countries. The aim of this study was to describe the outcomes of pediatric TB in Botswana and to identify the factors associated with unfavorable outcomes.

METHODS: This was a retrospective analysis of pediatric TB outcomes in Botswana, over a 12-year period from January 2008 to December 2019. Treatment success (treatment completion or cured) was considered a favorable outcome, while death, loss to follow-up and treatment failure were considered unfavorable outcomes. Program data from drug-sensitive TB (DS-TB) cases under the age of 15 years were included. Sampling was exhaustive. Binary logistic regression was used to determine the factors associated with unfavorable outcomes during TB treatment. A p value of < 0.05 was considered a statistically significant association between the predictor variables and unfavorable outcomes.

RESULTS: The data of 6,004 paediatric TB cases were extracted from the Botswana National TB Program (BNTP) electronic registry and analyzed. Of these data, 2,948 (49.4%) were of female patients. Of the extracted data, 1,366 (22.8%) were of HIV positive patients and 2,966 (49.4%) were of HIV negative patients. The rest of the data were of patients with unknown HIV status. Pulmonary TB accounted for 4,701 (78.3%) of the cases. Overall, 5,591 (93.1%) of the paediatric TB patient data showed treatment success, 179 (3.0%) were lost to follow-up, 203 (3.4%) records were of patients who died, and 31 (0.5%) were of patients who experienced treatment failure. The factors associated with unfavorable outcomes were positive HIV status (AOR 2.71, 95% CI: 2.09-3.52), unknown HIV status (AOR 2.07, 95% CI: 1.60-2.69) and retreatment category (AOR 1.92, 95% CI: 1.30-2.85). Compared with the 0-4 years age category, the 5-9 years (AOR 0.62, 95% CI: 0.47-0.82) and 10-14 years (AOR 0.76, 95% CI: 0.60-0.98) age categories were less likely to experience the unfavorable outcomes.

CONCLUSION: This study shows a high treatment success rate among paediatric TB cases in Botswana. The government under the National TB Program should maintain and consolidate the gains from this program. Public health interventions should particularly target children with a positive or unknown HIV status, those under 5 years, and those who have been previously treated for TB.

PMID:36333805 | DOI:10.1186/s12889-022-14477-y

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Nevin Manimala Statistics

Occupational risk variation of nasopharyngeal cancer in the Nordic countries

BMC Cancer. 2022 Nov 4;22(1):1130. doi: 10.1186/s12885-022-10209-y.

ABSTRACT

BACKGROUND: The aim of this study was to estimate occupational risk variation in the incidence of nasopharyngeal cancer (NPC) in a large population-based cohort of the Nordic Occupational Cancer (NOCCA) study.

METHODS: This study is based on a cohort of almost 15 million persons from Denmark, Finland, Iceland, Norway and Sweden, with 2898 nasopharyngeal cancer cases diagnosed in 1961-2005. The data on occupations were gathered from population censuses and cancer data from the national cancer registries. Standardized incidence ratios (SIR) with 95% confidence intervals (CI) were estimated using the national NPC incidence rates as the reference.

RESULTS: There were 1980 male and 918 female NPC patients. The highest SIRs of NPC were observed among male waiters (SIR 3.69, 95% CI 1.91-6.45) and cooks and stewards (SIR 2.24, 95% CI 1.16-3.91). Among women, launderers had the highest SIR of NPC (2.04, 95% CI 1.02-3.65). Significantly decreased SIRs were found among male farmers (SIR 0.79, 95% CI 0.68-0.92) and male textile workers (SIR 0.49, 95% CI 0.22-0.93).

CONCLUSIONS: This study suggests that NPC may be associated with several work-related exposure agents such as smoking, kitchen air pollution and solvents. In future, occupational exposure-risk relations should be studied to understand more about causality and to assess effective prevention strategies.

PMID:36333796 | DOI:10.1186/s12885-022-10209-y

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Nevin Manimala Statistics

Pneumocystis jirovecii colonization in bronchoalveolar lavage among naïve non-small cell lung cancer from tertiary respiratory hospital in Jakarta, Indonesia

J Infect Dev Ctries. 2022 Oct 31;16(10):1643-1647. doi: 10.3855/jidc.15840.

ABSTRACT

INTRODUCTION: Pneumocystis jirovecii pneumonia (PJP) is a lung mycosis commonly found in immunocompromised patients (e.g., HIV patients); however, its role in solid cancer remains unclear. This study aims to identify Pneumocystis jirovecii colonization among naïve non-small-cell lung cancer (NSCLC) through bronchoalveolar lavage (BAL) and explore its correlation with clinical parameters.

METHODOLOGY: This cross-sectional study recruited newly diagnosed naïve NSCLC patients who had not been given systemic treatments. We tested BAL from patients for P. jirovecii colonization with nested PCR targeting the mtLSU rRNA gene. Demographic and clinical characteristics were obtained from medical records, and the correlation between P. jirovecii colonization and clinicopathological data were analyzed. Kaplan-Meier analyses were done to evaluate survival.

RESULTS: Among 56 newly diagnosed, naïve NSCLC patients enrolled, the prevalence of P. jirovecii colonization was 17.9% (10 subjects). There was no statistically significant difference in demographic and clinical characteristics between the P. jirovecii colonization group versus no colonization (p value > 0.05). The overall survival duration for both groups demonstrated no significant difference.

CONCLUSIONS: This study demonstrated a relatively high prevalence of P. jirovecii colonization among BAL samples of naïve Indonesian NSCLC patients. Further study is needed to delineate its implications for the potential transmission source, lung cancer pathogenesis, and prognosis.

PMID:36332219 | DOI:10.3855/jidc.15840

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Polymerase chain reaction of human cytomegalovirus from liver and urine compared with serological test in cholestasis infants

J Infect Dev Ctries. 2022 Oct 31;16(10):1630-1636. doi: 10.3855/jidc.16851.

ABSTRACT

INTRODUCTION: The most common infection in cholestatic infants is caused by human cytomegalovirus (HCMV). The aims were to detect the presentation of HCMV in cholestatic infants and to evaluate the concordance, sensitivity, and specificity between serology and polymerase chain reaction (PCR) of HCMV from liver biopsy and urine specimens.

METHODOLOGY: A descriptive observational study with a cross-sectional approach was conducted on 35 cholestatic infants with ethical approval. Specimens were liver biopsy, urine, and anti-HCMV serology. Liver and urine specimens were performed to nested PCR, followed by statistical analysis.

RESULTS: PCR from the liver biopsy and urine specimen were positive in 74.3% and 85.7%, respectively. There was no concordance between IgM with the liver PCR, but there was a concordance between IgM with the urine PCR and between IgG with the liver and urine PCR. The sensitivity and specificity of IgM with the liver PCR were 46 % and 56%, respectively, with a diagnostic accuracy of 49%. While IgG sensitivity was 96% with a diagnostic accuracy of 80%. IgG sensitivity and IgM specificity compared with the urine PCR were 93% and 100%, respectively, with a diagnostic accuracy of more than 60%.

CONCLUSIONS: It demonstrates a high prevalence of HCMV DNA in urine and liver biopsy from cholestatic infants. HCMV PCR assay is more sensitive and specific than the anti-HCMV IgM, but IgG has high sensitivity and accuracy diagnostic. Therefore, serological examination is an option for diagnosing HCMV infection in cholestatic infants in developing countries with no PCR facilities.

PMID:36332217 | DOI:10.3855/jidc.16851

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Nevin Manimala Statistics

Parents’ knowledge, attitude and practice towards seasonal influenza vaccination in Riyadh region, Saudi Arabia

J Infect Dev Ctries. 2022 Oct 31;16(10):1623-1629. doi: 10.3855/jidc.15151.

ABSTRACT

INTRODUCTION: Parents’ knowledge and attitudes regarding influenza vaccine significantly determine whether or not their children will receive the vaccine. The objective of the present study was to evaluate the knowledge, attitude and practice among Saudi parents towards vaccinating their children against influenza.

METHODOLOGY: A descriptive cross-sectional study was conducted in multiple regions of Riyadh. We used a convenience sampling technique to enroll study subjects. Individuals who were Saudi nationals, with at least one child between 6 months and 14 years of age were included.

RESULTS: Over half of the Saudi parents (53.8%) scored well on influenza and vaccine knowledge, while most of them (92.0%) showed positive attitude towards vaccination. Most of the children (87.9%) were immunized with national vaccination program and 63.6% of the parents were aware of the availability of seasonal influenza vaccines in primary healthcare centres (PHCs) and hospitals. However, only 28% of the parents and 18% of their children received the seasonal influenza vaccine between 2019 and 2020. High education level, high monthly household income and being part of a medical profession were statistically significant (p < 0.05) determinants of good knowledge. Similarly, male gender, younger parent, low monthly income, working in a medical profession and parents with one child aged between 6 months and 14 years were significant predictors (p < 0.05) of positive attitude.

CONCLUSIONS: Compliance of Saudi parents towards influenza vaccination is fairly poor despite positive attitude. Stringent efforts are needed to encourage the parents to actively ensure annual influenza immunization of their children.

PMID:36332216 | DOI:10.3855/jidc.15151