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Nevin Manimala Statistics

The mediation effect of liver and anthropometric indices on the relationship between incidence of diabetes and physical activity: results of 5-year follow up azar cohort study

BMC Public Health. 2024 Nov 18;24(1):3190. doi: 10.1186/s12889-024-20587-6.

ABSTRACT

BACKGROUND: It has been documented that regular physical activity is considered one of the most effective strategies for preventing diabetes; however, it is not the sole contributing factor. Therefore, we decided to evaluate the meditation effect of liver function and anthropometric indices on the relationship between incidence of diabetes and physical activity (PA) in the Azar cohort population.

MATERIALS AND METHODS: Subjects who were diabetic in the baseline phase from 15,006 participants in study of azar cohort population were excluded and to follow up, a total of 13,253 people was included in the analysis. Demographic characteristics, physical activity, 10 anthropometric indices (AI) and seven liver indices (LI) were measured. Evaluated and displayed using Pearson correlation heatmap and canonical correlation of liver and anthropometric indices. The Generalized Structural Equation Modeling (GSEM) with the Maximum Likelihood method employed to estimate the model.

RESULTS: During the follow-up years, a total of 685 participants developed diabetes. The measurements of the AI were significantly higher in subjects with diabetes (P < .001). Patients with diabetes were older, had a higher proportion of women, and had lower values of PA (P < .05). Body Roundness Index (BRI) and Waist height ratio (WHtR) exhibited the largest AUCs for predicting diabetes onset risk (both AUC = 0.6989) among these anthropometric measures. The increase in AI (RR [95%CI] = 1.25 [1.22,1.29], P < .001) and liver enzyme (LE) (RR [95%CI] = 1.14 [1.08.1.19], P < .001) increase the risk of diabetes by 25% and 14%, respectively. Despite the mediation effects of AI and Liver Enzymes for an increase of one MET of PA, the risk of developing diabetes decreases by 5% (RR [95% CI] = .95 [.92,.99], P = .013). Around VAF = 53% of the association between PA and diabetes onset (Total effect: RR [95% CI] = .90 [.87,.94], P < .001) was mediated by AI and LE.

CONCLUSIONS: A low level of PA was found to be significantly correlated with high levels of AI and LI, all of which are associated with an increased risk of developing diabetes. These analyses provide evidence that when the relationship between PA and diabetes is mediated by AI and LI this association becomes stronger, with AI playing a more significant role than LI.

PMID:39558270 | DOI:10.1186/s12889-024-20587-6

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Nevin Manimala Statistics

qGO: a novel method for quantifying the diversity of mitochondrial genome organization

BMC Genomics. 2024 Nov 18;25(1):1097. doi: 10.1186/s12864-024-11006-6.

ABSTRACT

Quantifying the features of mitochondrial genome structural variation is crucial for understanding its contribution to complexity. Accurate quantification and interpretation of organizational diversity can help uncover biological evolutionary laws and patterns. The current qMGR approach accumulates the changes in two adjacent genes to calculate the rearrangement frequency RF of each single gene and the rearrangement score RS for specific taxa in the mitogenomes of a given taxonomic group. However, it may introduce bias, as it assigns scores to adjacent genes rather than to rearranged genes. To overcome this limitation, we propose a novel statistical method called qGO to quantify the diversity of gene organization. The qGO method, which is based on the homology of gene order, provides a more accurate representation of genome organizational diversity by partitioning gene strings and individually assigning weights to genes spanning different regions. Additionally, a comprehensive approach is employed for distance computation, generating an extensive matrix of rearrangement distances. Through experiments on more than 5500 vertebrate mitochondrial genomes, we demonstrated that the qGO method outperforms existing methods in terms of accuracy and interpretability. This method improves the comparability of genomes and allows a more accurate comparison of the diversity of mitochondrial genome organization across taxa. These findings have significant implications for unraveling genome evolution, exploring genome function, and investigating the process of molecular evolution.

PMID:39558268 | DOI:10.1186/s12864-024-11006-6

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Nevin Manimala Statistics

Evaluation of histopathological findings in very old people (≥ 80 years old) in Turkish population

BMC Geriatr. 2024 Nov 18;24(1):960. doi: 10.1186/s12877-024-05500-5.

ABSTRACT

BACKGROUND: The lesions observed in very old populations exhibit a wide spectrum of characteristics. Histopathological evaluation may be necessary for accurate diagnosis in this demographic. There is limited amount of data on the histopathological evaluation of lesions in very old patients. Therefore, the aim of this study was to assess the histopathological features in this population.

METHODS: A total of 5376 pathological samples from very old patients (≥ 80 years old) were analyzed. Clinical and pathological data were retrospectively reviewed. Histopathological diagnoses were categorized into three groups: malignant (invasive) lesions (MLs), benign/inflammatory lesions (BLs), and dysplastic-dysmorphic/non-invasive malignant lesions (DLs). Statistical analyses were conducted on the histopathological data. Pearson’s chi-square test and the Fisher exact test were used to analyze the data, and statistical significance was considered at a p-value of < 0.05.

RESULTS: The mean age of the patients was 83.6 ± 3.4 years (range: 80-107), with 53% being female. The upper gastrointestinal (GI) tract was the most common site among all materials (28%, n = 1524). Benign/inflammatory lesions (BLs) accounted for the highest proportion of cases (62%, n = 3322) compared to MLs and DLs. BLs were significantly more prevalent in female patients (p < 0.001). MLs were notably more common in biopsies from breast locations (p < 0.001). No patients were diagnosed with DLs in the cytological materials.

CONCLUSIONS: Despite the broad spectrum of lesions observed in very old patients, the majority tend to be benign. While the Coronavirus disease 2019 (COVID-19) pandemic has altered healthcare dynamics, the increased frequency of benign lesions among the very old population, as a result of more frequent healthcare facility visits, is noteworthy. However, dysplastic and malignant lesions remain significant in this population and can profoundly impact patients’ quality of life. This study contributes to our understanding of histopathological diagnoses in the very old population, shedding light on the current approach to managing their pathological specimens.

PMID:39558257 | DOI:10.1186/s12877-024-05500-5

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Nevin Manimala Statistics

Survival outcomes of population-wide colonoscopy screening: reanalysis of the NordICC data

BMC Gastroenterol. 2024 Nov 18;24(1):414. doi: 10.1186/s12876-024-03506-2.

ABSTRACT

BACKGROUND: Colonoscopy as a common screening practice to prevent colorectal cancer lacks strong evidence. NordICC, the first randomized trial of colonoscopy screening, reported no clear clinical benefit for colonoscopy in the intention-to-screen population with suggested benefit in the risk of colorectal incidence and cancer-specific mortality in the per-protocol analyses. However, although the study was designed to perform survival analysis, no survival outcomes were reported since the underlying assumption for hazard ratio was not valid. We aimed to assess whether colonoscopy screening is associated with improved survival outcomes compared with usual care.

METHODS: We reconstructed patient-level data from the Kaplan-Meier estimator of the primary endpoints reported in NordICC for the intention-to-screen and adjusted per-protocol populations. The restricted-mean survival time difference (RMST-D) and restricted-mean time loss ratio (RMTL-R), which are robust alternatives to the hazard ratio without specific model assumptions, were calculated for colorectal cancer incidence and death.

RESULTS: In this study, no significant difference in colorectal cancer incidence over 10 years was found in the intention-to-screen population (RMST-D: -0.68 days, 95% CI -3.9-2.6; RMTL-R: 1.04, 95% CI 0.88-1.22) or in the per-protocol analysis population (RMST-D: -2.9 days, 95% CI -6.5-0.67; RMTL-R: 1.15, 95% CI 0.97-1.35). In the intention-to-screen population, inviting individuals to colonoscopy did not improve colorectal-cancer death (RMST-D: -0.29 days, 95% CI -1.6-1.0; RMTL-R: 1.07, 95% CI 0.78-1.48). Over 10 years, in the per-protocol analysis, individuals who underwent colonoscopy survived an average of 1.1 more days free of colorectal cancer, but this difference was not statistically significant (RMST-D: 95% CI -0.13-2.3; RMTL-R: 0.72, 95% CI 0.49-1.07).

CONCLUSIONS: In this reanalysis of the NordICC data, no evidence of improvement in survival outcomes for participants invited to undergo colonoscopy compared to usual care was identified, even when assuming that all invited participants did undergo colonoscopy. Thus, our results do not support the use of colonoscopy as a population-wide screening test as a mean to decrease colorectal cancer incidence or death.

REGISTRY: Not applicable.

PMID:39558249 | DOI:10.1186/s12876-024-03506-2

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Nevin Manimala Statistics

Greater risk-taking by non-native than native shrimp: an advantage in a human-disturbed environment?

BMC Ecol Evol. 2024 Nov 19;24(1):143. doi: 10.1186/s12862-024-02330-2.

ABSTRACT

BACKGROUND: The invasion of non-native species into ecosystems is a growing human-induced problem. To control their spread and population growth, knowledge is needed on the factors that facilitate or impede their invasions. In animals, traits often associated with invasion success are high activity, boldness, and aggression. However, these traits also make individuals susceptible to predation, which could curb population growth. We investigated if a recent invader into the Baltic Sea, the shrimp Palaemon elegans, differs in risk-taking from a native shrimp, P. adspersus. We recorded activity, habitat choice, and response to perceived predation threat of both species.

RESULTS: We found the invading shrimp to take greater risks than the native one; while the native shrimp adjusted its behaviour to habitat structure and exposure to a perceived predator, the non-native shrimp did not, and it resumed normal activity sooner after a perceived predation threat. Despite the greater risk taking by the non-native shrimp, its population has grown rapidly during the last two decades in the investigated area and is now larger than that of the native shrimp.

CONCLUSIONS: We discuss plausible explanations for the population growth of the invader, including the recent decline in predatory fishes that could have reduced the cost of risk-taking, and anthropogenic eutrophication that has increased food abundance could have allowed the population growth. These results stress the need to assess the optimality of the behaviours of both native and non-native species when investigating the factors that influence invasion success in human-disturbed environments.

PMID:39558248 | DOI:10.1186/s12862-024-02330-2

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Nevin Manimala Statistics

Prediction of esophageal fistula in radiotherapy/chemoradiotherapy for patients with advanced esophageal cancer by a clinical-deep learning radiomics model : Prediction of esophageal fistula in radiotherapy/chemoradiotherapy patients

BMC Med Imaging. 2024 Nov 18;24(1):313. doi: 10.1186/s12880-024-01473-4.

ABSTRACT

BACKGROUND: Esophageal fistula (EF), a rare and potentially fatal complication, can be better managed with predictive models for personalized treatment plans in esophageal cancers. We aim to develop a clinical-deep learning radiomics model for effectively predicting the occurrence of EF.

METHODS: The study involved esophageal cancer patients undergoing radiotherapy or chemoradiotherapy. Arterial phase enhanced CT images were used to extract handcrafted and deep learning radiomic features. Along with clinical information, a 3-step feature selection method (statistical tests, Least Absolute Shrinkage and Selection Operator, and Recursive Feature Elimination) was used to identify five feature sets in training cohort for constructing random forest EF prediction models. Model performance was compared and validated in both retrospective and prospective test cohorts.

RESULTS: One hundred seventy five patients (122 in training and 53 in test cohort)were retrospectively collected from April 2018 to June 2022. An additional 27 patients were enrolled as a prospective test cohort from June 2022 to December 2023. Post-selection in the training cohort, five feature sets were used for model construction: clinical, handcrafted radiomic, deep learning radiomic, clinical-handcrafted radiomic, and clinical-deep learning radiomic. The clinical-deep learning radiomic model excelled with AUC of 0.89 (95% Confidence Interval: 0.83-0.95) in the training cohort, 0.81 (0.65-0.94) in the test cohort, and 0.85 (0.71-0.97) in the prospective test cohort. Brier-score and calibration curve analyses validated its predictive ability.

CONCLUSIONS: The clinical-deep learning radiomic model can effectively predict EF in patients with advanced esophageal cancer undergoing radiotherapy or chemoradiotherapy.

PMID:39558242 | DOI:10.1186/s12880-024-01473-4

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Nevin Manimala Statistics

Impact of multicomponent exercise and nutritional supplement interventions for improving physical frailty in community-dwelling older adults: a systematic review and meta-analysis

BMC Geriatr. 2024 Nov 18;24(1):958. doi: 10.1186/s12877-024-05551-8.

ABSTRACT

OBJECTIVE: To investigate the efficacy of both multicomponent exercise and nutritional interventions on frailty by conducting a systematic review and meta-analysis to examine changes in frailty incidence.

DESIGN: A systematic review and meta-analysis.

ELIGIBLE CRITERIA: The included studies were limited to original controlled trials focused on frailty interventions in older adults aged 65 years and over. The studies involved only participants with specific diseases, and those recovering from surgery or being hospitalized were excluded.

INFORMATION SOURCES: A systematic search was performed on three databases: PUBMED, EMBASE, and Cumulative Index to Nursing and Allied Health, with the latest search in October 2024. Three authors independently extracted the data using a standardized data collection form. Relative risks were used as a summary measure. Pooled-effect estimates of each outcome were calculated by the random-effects meta-analysis.

RESULTS: After searching three databases, 5327 records were identified. After removing duplicates and screening the titles and abstracts, 19 multicomponent exercise studies and 7 nutritional intervention studies were eligible. In a pooled analysis of 18 multicomponent exercise RCTs, including a total of 3457 older adults, the multicomponent exercises showed a clinically significant reduction in frailty risk by relative change 55% times (95% CI 45% to 67%, p value < 0.001). The subgroup analysis of combinations of macronutrients and micronutrients also demonstrated statistically significant decrease in frailty risk by relative change 28% times (95% CI 11% to 72%, p value = 0.008).

CONCLUSION: Multicomponent exercises can effectively improve physical frailty, regardless of the duration and types of the activities, whereas the efficacy of nutritional supplements remains unclear. Personalized multicomponent approaches that incorporate both exercises and nutritional supplements have promised to enhance effectiveness in reducing frailty, thus warranting further investigation.

TRIAL REGISTRATION: The study was registered on 12 September 2022, under PROSPERO registration number CRD42022357357.

PMID:39558234 | DOI:10.1186/s12877-024-05551-8

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Nevin Manimala Statistics

Dental plaque as an extra-gastric reservoir of Helicobacter pylori: A systematic review and meta-analysis

Arch Oral Biol. 2024 Nov 10;170:106126. doi: 10.1016/j.archoralbio.2024.106126. Online ahead of print.

ABSTRACT

OBJECTIVE: This systematic review and meta-analysis (SRMA) aimed to determine whether the presence of H. pylori in dental plaque is associated with gastric H. pylori infection.

DESIGN: Search for the relevant literature was done in various databases: PubMed, Embase, Web of Science and Cochrane till September 21, 2023. The studies were screened for outcome of interest i.e. gastric H. pylori infection and exposure of interest i.e. H. pylori positivity in dental plaque. The pooled results of the study outcomes were evaluated using Odds Ratio (OR), accompanied by a 95 % confidence interval (CI). To evaluate the heterogeneity among studies, I2 statistics were utilized, with an I2 exceeding 50 % indicating a significant to high variation. In cases where I2 was greater than 50 %, a random-effects model (specifically, the Der Simonian and Laird method) was employed.

RESULTS: Data from 27 observational studies and 2408 participants were included. The pooled OR of the H. pylori positivity in dental plaque among the patients with H. pylori positivity in stomach was 3.80 (95 % CI 2.24; 6.43), with high heterogeneity (I2= 69 %, p<0.01). Sensitivity analysis after removing the outliers reduced the heterogeneity significantly (I2=22 %, p=0.16). Meta-regression revealed that the strength of association did not vary according to the year of study or the sample size included in the studies. Overall certainty of the evidence was low.

CONCLUSIONS: The present meta-analysis showed that the presence of gastric H. pylori infection was higher among patients with H. pylori in dental plaque compared to patients without H. pylori in dental plaque. Presence of H. pylori infection in dental plaque can have implications in the management of H. pylori infection as dental plaque can serve as a reservoir from which the microorganism can recolonize the gastric mucosa.

PMID:39556904 | DOI:10.1016/j.archoralbio.2024.106126

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Nevin Manimala Statistics

The Effect of Detethering Surgery on the Bladder Function and Psychology of Children with Primary Tethered Cord Syndrome

Int Braz J Urol. 2025 Jan-Feb;51(1):e20240311. doi: 10.1590/S1677-5538.IBJU.2024.0311.

ABSTRACT

PURPOSE: Currently, detethering surgery (DS) is the modality most extensively utilized to treat primary Tethered cord syndrome (TCS). Disappointingly, some children without bladder impairment showed a deterioration of bladder function after surgery, which critically influences the health-related quality of life. It was hypothesized that the DS might have a significant effect on bladder function and psychology. Therefore, the purpose of this study was to investigate the effect of DS on bladder function and quality of life in children with primary TCS.

MATERIALS AND METHODS: A retrospective study of 83 patients aged 6 to 10 years who were diagnosed with TCS and underwent DS between 2022 and 2023. The urodynamic parameters and score, psychological-behavioral profile, and lower urinary tract symptoms were compared before and after DS. Additionally, the patients were divided into the normal group and the abnormal group according to the preoperative urodynamics parameters.

RESULTS: A total of 66 children fulfilled the criteria, with a mean age at surgery of 89.5 ± 13.7 months. There were statistically significant differences in bladder detrusor sphincter synergy and urodynamic score and no statistically significant difference in the remaining urodynamic parameters and psychological-behavioral items before and after DS. The proportion of bladder dysfunction that improved or did not worsen after surgery was higher in the Abnormal group than in the Normal group. Nevertheless, the detection rate of each psychological behavior abnormality in children with TCS was higher compared with that of normal children, both preoperatively and postoperatively.

CONCLUSIONS: DS could not considerably ameliorate pre-existing bladder dysfunction and patients exhibiting non-progressive bladder dysfunction could be treated conservatively with close observation. TCS plagues patients all the time even if detethering. Psychological counseling for children with TCS should be strengthened after DS.

PMID:39556851 | DOI:10.1590/S1677-5538.IBJU.2024.0311

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Nevin Manimala Statistics

Knowledge, Attitudes, and Behaviors Toward Salt Consumption and Its Association With 24-Hour Urinary Sodium and Potassium Excretion in Adults Living in Mexico City: Cross-Sectional Study

Interact J Med Res. 2024 Nov 18;13:e57265. doi: 10.2196/57265.

ABSTRACT

BACKGROUND: The World Health Organization recommends a daily sodium intake of less than 2000 mg for adults; however, the Mexican population, like many others globally, consumes more sodium than this recommended amount. Excessive sodium intake is often accompanied by inadequate potassium intake. The association between knowledge, attitudes, and behaviors (KAB) and actual sodium intake has yielded mixed results across various populations. In Mexico, however, salt/sodium-related KAB and its relationship with sodium and potassium intake have not been evaluated.

OBJECTIVE: This study primarily aims to describe salt/sodium-related KAB in a Mexican population and, secondarily, to explore the association between KAB and 24-hour urinary sodium and potassium excretion.

METHODS: We conducted a cross-sectional study in an adult population from Mexico City and the surrounding metropolitan area. Self-reported KAB related to salt/sodium intake was assessed using a survey developed by the Pan American Health Organization. Anthropometric measurements were taken, and 24-hour urinary sodium and potassium excretion levels were determined. Descriptive statistics were stratified by sex and presented as means (SD) or median (25th-75th percentiles) for continuous variables, and as absolute and relative frequencies for categorical variables. The associations between KAB and sodium and potassium excretion were assessed using analysis of covariance, adjusting for age, sex, BMI, and daily energy intake as covariates, with the Šidák correction applied for multiple comparisons.

RESULTS: Overall, 232 participants were recruited (women, n=184, 79.3%). The mean urinary sodium and potassium excretion were estimated to be 2582.5 and 1493.5 mg/day, respectively. A higher proportion of men did not know the amount of sodium they consumed compared with women (12/48, 25%, vs 15/184, 8.2%, P=.01). More women reported knowing that there is a recommended amount for daily sodium intake than men (46/184, 25%, vs 10/48, 20.8%, P=.02). Additionally, more than half of men (30/48, 62.5%) reported never or rarely reading food labels, compared with women (96/184, 52.1%, P=.04). Better salt/sodium-related KAB was associated with higher adjusted mean sodium and potassium excretion. For example, mean sodium excretion was 3011.5 (95% CI 2640.1-3382.9) mg/day among participants who reported knowing the difference between salt and sodium, compared with 2592.8 (95% CI 2417.2-2768.3) mg/day in those who reported not knowing this difference (P=.049). Similarly, potassium excretion was 1864.9 (95% CI 1669.6-2060.3) mg/day for those who knew the difference, compared with 1512.5 (95% CI 1420.1-1604.8) mg/day for those who did not (P=.002). Additionally, higher urinary sodium excretion was observed among participants who reported consuming too much sodium (3216.0 mg/day, 95% CI 2867.1-3565.0 mg/day) compared with those who claimed to eat just the right amount (2584.3 mg/day, 95% CI 2384.9-2783.7 mg/day, P=.01).

CONCLUSIONS: Salt/sodium-related KAB was poor in this study sample. Moreover, KAB had a greater impact on potassium excretion than on sodium excretion, highlighting the need for more strategies to improve KAB related to salt/sodium intake. Additionally, it is important to consider other strategies aimed at modifying the sodium content of foods.

PMID:39556832 | DOI:10.2196/57265