Tag: nevin manimala

Sci Prog. 2022 Apr-Jun;105(2):368504221105173. doi: 10.1177/00368504221105173.

ABSTRACT

BACKGROUND: Direct-acting antiviral (DAA) regimens and telemedicine services are both options for treating hepatitis C virus (HCV) within the prison setting. We aimed to compare factors associated with HCV treatment success over the past decade in Israeli prisons, specifically the influence of DAAs and telemedicine.

METHODS: We retrospectively reviewed the medical records of inmates with HCV infection in Israeli prisons from 2010 through 2020. Demographic, clinical, and laboratory data were recorded, including treatment regimens and success rates.

RESULTS: A total of 273 inmates were treated; mean age 45 ± 9.36 years; 98.2% males; 63.9% with a history of drug abuse. Advanced fibrosis was documented in 42.9%. The most common genotypes were 1 (46%) followed by 3 (40.7%). Interferon-based regimens were given to 68 inmates between 2010 and 2017. DAA agents were introduced in 2016, with pan-genotype regimens being exclusively used since 2019. Telemedicine services were used in 140 patients (51.3%), starting in February 2019. The sustained viral response (SVR) rate with interferon-based therapy was 78.8% and 98.8% with DAA treatment, giving an overall SVR of 93.2%. This difference between regimens proved to be the only statistically significant predictor of treatment success. The number of prisoners being treated with DAAs increased exponentially after telemedicine was introduced. Comparable SVR rates were achieved with either in-person or telemedicine consultation.

CONCLUSION: Screening of this high-risk population and using telemedicine for treatment may be an effective strategy for the elimination of HCV from the prison population.

PMID:35722762 | DOI:10.1177/00368504221105173

J Biopharm Stat. 2022 Jun 19:1-27. doi: 10.1080/10543406.2022.2065507. Online ahead of print.

ABSTRACT

Conducting causal inference in settings with more than one treatment level can be challenging. Classical methods, such as propensity score matching (PSM), are restricted to only a binary treatment. To extend propensity score methods beyond a binary treatment, generalized propensity score methods have been proposed, with generalized propensity score matching (GPSM) standing as the multi-level treatment analog to PSM. One drawback of GPSM is it is only capable of emulating a completely randomized trial (CRT) design and not the more efficient blocked randomized trial design. Motivated by the desire to emulate the more efficient design, we expand on GPSM estimating literature and develop a new estimator incorporating relevant stratifying variables into the GPSM framework. We examine the variance estimation methods available for GPSM and demonstrate how to extend the estimator to one where stratifying variables are included. While it would be straightforward to include relevant stratifying variables as covariates in the propensity score estimation, our method provides for researchers to conduct retrospective analyses more consistently with the prospective experiment they would have designed if permitted. Namely, our method permits researchers to approximate a stratified randomized trial as opposed to the CRT otherwise obtainable by GPSM. We apply our proposed method to an analysis of how the number of children in a household affects systolic blood pressure in adults. We conduct a simulation study assessing how the relationship between response, treatment, and strata affect the performance of our method and compare the results to non-stratified GPSM.

PMID:35722726 | DOI:10.1080/10543406.2022.2065507

J Orthop Sports Phys Ther. 2022 Jun 19:1-25. doi: 10.2519/jospt.2022.11200. Online ahead of print.

ABSTRACT

OBJECTIVE: 1) Describe overall illness, and COVID-19-specific illness in high school athletes in the 2019-2020 and 2020-2021 academic school years; and 2) describe and assess the risk of musculoskeletal injury following general infection, and after COVID-19.

DESIGN: Ecological study.

METHODS: High schools (6 states; 176 high schools) were matched between the 2019-2020 and 2020-2021 academic school years, based on 2020-2021 high school sport participation. Illness and injury data were collected from the high school athletic trainers. Illness was stratified by overall illness, general infection, and COVID-19. Injuries following moderate or severe infections or COVID-19 were recorded. Illness and injury incidence rate per 100 athletes per year with 95% confidence intervals (95% CI) were calculated. Negative binomial models comparing injury following general infections and COVID-19 infections were calculated.

RESULTS: 98,487 and 72,521 athletes participated in the 2019-2020 and 2020-2021 years. Illness incidence rate was less in the 2019-2020 [0.30 (95% CI: 0.27-0.34)] than 2020-2021 [1.1 (1.0-1.2)] year, resulting in a difference of 0.8 (95% CI: 0.7, 0.9). COVID-19 incidence rate was 0.52 (0.47-0.58) in the 2020-2021 year. Injury following general infection incidence rate was 27.9 injuries (21.4-34.5) per 100 athletes in 2019-2020, and 22.5 injuries (19.3-25.7) per 100 athletes in 2020-2021. There was no difference in injury risk following general infection and COVID-19 [Rate Ratio: 1.2 (95% CI: 0.7-2.4)].

CONCLUSIONS: The incidence rate for all illnesses in high school athletes was slightly (0.8) greater in the 2020-2021 academic compared to the 2019-2020 year. Most of the incidence increase was due to infections and COVID-19. Subsequent injury incidence following moderate and severe infections were similar between years and between general infections and COVID-19.

PMID:35722758 | DOI:10.2519/jospt.2022.11200

Med Phys. 2022 Jun 20. doi: 10.1002/mp.15779. Online ahead of print.

ABSTRACT

PURPOSE: We aim at developing a model-based algorithm that compensates for the effect of both pulse pileup (PP) and charge sharing (CS), and evaluate the performance using computer simulations.

METHODS: The proposed PCP algorithm for PP and CS compensation cascaded models for CS and PP we previously developed, maximizes Poisson log-likelihood, and uses an efficient 3-step exhaustive search. For comparison, we also developed LCP algorithm that combines models for a loss of counts (LC) and CS. Two types of computer simulation, slab-based and CT-based, were performed to assess the performance of both PCP and LCP with 200 mA and 800 mA, (300 μm)² x 1.6 mm cadmium telluride detector, and a deadtime of 23 ns. A slab-based assessment used a pair of adipose and iodine with different thicknesses, attenuated x-rays, assessed the bias and noise of the outputs from one detector pixel; a CT-based assessment simulated a chest/cardiac scan and a head-and-neck scan using 3-D phantom and noisy cone-beam projections.

RESULTS: With the slab simulation, the PCP had little or no biases when the expected counts was sufficiently large, even though a probability of count loss (PCL) due to deadtime loss or pulse pileup was as high as 0.8. In contrast, the LCP had significant biases (>±2 cm of adipose) when the PCL was higher than 0.15. Biases were present with both PCP and LCP when the expected counts were less than 10-120 per datum, which was attributed to the fact that the maximum-likelihood did not approach the asymptote. The noise of PCP was within 8% from Cramér-Rao lower bounds for most cases, when no significant bias was present. The two CT studies essentially agreed with the slab simulation study. PCP had little or no biases in the estimated basis line integrals, reconstructed basis density maps, and synthesized monoenergetic CT images. But the LCP had significant biases in basis line integrals when x-ray beams passed through lungs and near the body and neck contours, where the PCL were above 0.15. As a consequence, basis density maps and monoenergetic CT images obtained by LCP had biases throughout the imaged space.

CONCLUSION: We have developed the PCP algorithm that uses the PP-CS model. When the expected counts were more than 10-120 per datum, the PCP algorithm was statistically efficient and successfully compensates for the effect of the spectral distortion due to both PP and CS providing little or no biases in basis line integrals, basis density maps, and monoenergetic CT images regardless of count-rates. In contrast, the LCP algorithm, which models a loss of count due to pileup, produces severe biases when incident count-rates are high and the PCL is 0.15 or higher. This article is protected by copyright. All rights reserved.

PMID:35722721 | DOI:10.1002/mp.15779

Interv Neuroradiol. 2022 Jun 19:15910199221108308. doi: 10.1177/15910199221108308. Online ahead of print.

ABSTRACT

BACKGROUND: To identify an association between morphological parameters and the rupture risk of anterior communicating artery (ACoA) aneurysms using propensity score matching (PSM).

METHODS: Data for 109 patients with ACoA aneurysms treated from January 2018 to October 2021 were reviewed; 94 patients were enrolled. The geometrical parameters of the ACoA aneurysms were measured and calculated using three-dimensional reconstructed digital subtraction angiography images. The aneurysms’ morphological parameters were analyzed using a propensity score for six factors (age, sex, excess alcohol intake, smoking, hypertension, diabetes mellitus). Univariate logistic regression was used to analyze the relationship between the aneurysms’ morphological parameters and rupture risk.

RESULTS: Twenty-five patients each with or without ruptured aneurysms were selected. After matching, no statistically significant differences were seen between the groups in their baseline characteristics. Aneurysm neck size (p = 0.038) was higher in the unruptured group than that in the ruptured group, and the dome-to-neck ratio (D/N; p = 0.009) and aspect ratio (AR; p = 0.003) were higher in the ruptured group than those in the unruptured group. Univariable logistic regression analysis demonstrated that ACoA aneurysm rupture was associated with AR (odds ratio: 8.047; 95% confidence interval: 1.569-41.213; p = 0.012) and D/N (odds ratio: 4.253; 95% confidence interval: 1.228-14.731; p = 0.022). The areas under the receiver operating characteristic curves for AR and D/N were 0.746 and 0.715, respectively.

CONCLUSIONS: After PSM, ACoA aneurysms with higher AR and D/N, and smaller neck size were more likely to rupture. AR may be a much more important predictor of aneurysm rupture than other predictors.

PMID:35722707 | DOI:10.1177/15910199221108308

J Nutr Health Aging. 2022;26(6):621-627. doi: 10.1007/s12603-022-1811-y.

ABSTRACT

OBJECTIVES: Extending healthy life expectancy (HALE), defined as the average number of years that a person can expect to live in “full health” by taking into account years lived in less than full health due to disease and/or injury, is a common topic worldwide. This study aims to clarify the relationships between the Mediterranean diet score (MDS) and life expectancy (LE) and HALE globally using publicly available international data.

SETTING: Analyses were conducted on 130 countries with populations of 1 million or more for which all data were available. Individual countries were scored from 0 to 9 to indicate adherence to the Mediterranean diet according to the MDS scoring method. The supply of vegetables, legumes, fruits and nuts, cereals, fish, and olive oil per 1,000 kcal per country was calculated based on the Food and Agriculture Organization Corporate Statistical Database, with a score of 1 for above the median and 0 for below. The same method was used to calculate scores of presumed detrimental components (meat and dairy), with consumption below the median given a value of 1, and consumption above the median given a value of 0. For ethanol, a score of 1 was given for 10g to 50 g of consumption. We investigated the cross-sectional associations between the MDS and LE and HALE at birth in 2009, and the longitudinal associations between the MDS in 2009 and LE and HALE between 2009 and 2019, controlling for covariates at baseline using linear mixed models.

RESULTS: In the cross-sectional analysis, the MDS was significantly positively associated with LE (β=0.906 [95% confidence interval, 0.065-1.747], p=0.037) and HALE (β=0.875 [0.207-1.544], p=0.011) after controlling for all covariates. The longitudinal analysis also revealed significantly positive associations between the MDS and LE (0.621 [0.063-1.178], p=0.030) and HALE (0.694 [0.227-1.161], p=0.004) after controlling for all covariates.

CONCLUSION: The present study, based on an analysis using 10 years of international data, showed that countries with a higher MDS showed a positive association with HALE.

PMID:35718872 | DOI:10.1007/s12603-022-1811-y

J Nutr Health Aging. 2022;26(6):545-551. doi: 10.1007/s12603-022-1793-9.

ABSTRACT

BACKGROUND: Frailty may in most cases result from two main causes: the aging process (age-related frailty) and diseases (evolving chronic conditions or acute medical illnesses – disease-related frailty). The biological determinants characterizing these two main causes of frailty may be different.

OBJECTIVES: The aim of this study is to compare the biological and neuroimaging profile of people without frailty, those with age-related frailty, and subjects with disease-related frailty in community-dwelling older adults.

MATERIAL AND METHODS: We performed a secondary, cross-sectional analysis from the Multidomain Alzheimer Preventive Trial (MAPT). We included 1199 subjects without frailty throughout the 5-year follow-up, 82 subjects with incident age-related frailty, and 53 with incident disease-related frailty. Available blood biomarkers involved nutritional (eg, vitamin D, omega-3 fatty acids), inflammatory-related (IL-6, TNFR1, GDF15), neurodegenerative (eg, beta-amyloid, neurofilament light chain) and neuroimaging markers (MRI, Amyloid-PET).

RESULTS: Although not statistically significant, the results of the unadjusted model showed increasing gradients for inflammatory markers (GDF15, TNFR1) and decreasing gradients for nutritional and neuroimaging markers (omega 3 index, hippocampal volume) from age-related frailty participants to individuals with disease-related frailty. Considering the linear models we observed higher GDF15 values in disease-related frailty group compared to age-related frailty individuals [β = 242.8 (49.5, 436.2)]. We did not find any significant difference between subjects without frailty and those with age-related frailty. Subjects with disease-related frailty compared to subjects without frailty had lower values of DHA [β = -2.42 (-4.76, -0.08)], Omega 3 Index [β = -0.50 (-0.95, -0.06)] and hippocampal volume [β = -0.22 (-0.42,-0.02)]. They also had higher values of GDF15 [β = 246.1 (88.9, 403.4)] and TNFR1 [β = 157.5 (7.8, 307.2)].

CONCLUSION: Age-related frailty and disease-related frailty may represent different degrees of frailty severity on a biological level. Further research is needed to identify biomarkers potentially able to distinguish these classifications of frailty.

PMID:35718861 | DOI:10.1007/s12603-022-1793-9

J Nutr Health Aging. 2022;26(6):576-580. doi: 10.1007/s12603-022-1798-4.

ABSTRACT

OBJECTIVES: We aimed to assess the comparative accuracy of using SARC-F, as well as the SARC-F in tandem with calf circumference (SARC-CalF) and Ishii test, to screen severe sarcopenia in older adults residing in nursing homes.

METHOD: In this cross-sectional study, the AWGS2019 criteria were used as diagnostic standards. We adopted an “exclusion” screening test, focusing on sensitivity and the negative predictive value (NPV) combined with AUC, to assess the accuracy of the screening tools.

RESULTS: We studied 199 people aged 60 and older, of whom 67 (33.7%) had severe sarcopenia, including 40 males (41.2%) and 27 females (26.5%). Among all participants, the sensitivities and NPV of SARC-F, SARC-CalF, and Ishii test were 85.1%/0.88, 68.7%/0.82, and 89.6%/0.94, respectively. For males, the SARC-F, SARC-CalF, and Ishii test sensitivities and NPV were 77.5%/0.78, 47.5%/0.7, and 85%/0.88, respectively. Among females, the SARC-F, SARC-CalF, and Ishii test sensitivities and NPV were 74.1%/0.9, 81.5%/0.92, 96.3%/0.99, respectively. There were no statistical differences between the AUCs of SARC-F or SARC-CalF for all participants or for the male or female groups; however, in terms of the AUC, the Ishii test was superior compared with the other two screening methods.

CONCLUSION: The Ishii test is more suitable for screening severe sarcopenia in older adults in nursing homes compared to SARC-F and SARC-CalF, and 130 points are recommended as the cut-off value of the Ishii test for screening severe sarcopenia.

PMID:35718866 | DOI:10.1007/s12603-022-1798-4

J Neurovirol. 2022 Jun 19. doi: 10.1007/s13365-022-01078-z. Online ahead of print.

ABSTRACT

Based on the available literature, women living with HIV (WLWH) seem to show greater cognitive and emotional disadvantages than men living with HIV (MLWH). Our aim was to compare the cognitive performance of MLWH and WLWH in an Italian cohort of People Living With HIV (PLWH) and to analyse factors potentially contributing to sex differences in cognitive function. We ran a retrospective, cross-sectional analysis of a monocentric dataset of PLWH who were administered a standardized neuropsychological test battery (SNB) during routine clinical care. We enrolled 161 Italian PLWH who are on combined antiretroviral therapy (cART): 114 (70.8%) MLWH and 47 (29.2%) WLWH.Global cognitive performance (composite z score) (GCP) was significantly higher in MLWH than WLWH [mean 0.19 (SD 0.85) vs – 0.13 (SD 0.96); p = 0.039]. Moreover, WLWH obtained significantly higher scores on the Zung Depression Scale than MLWH [mean 41.8 (SD 10.9) vs 36.7 (SD 9.2); p = 0.003]. However, there was no statistically significant direct effect between male sex and better GCP (p = 0.692) in the context of a mediation model. On the contrary, the associations between male sex and better GCP were mediated by higher level of education (a*b = + 0.15, Bootstrap CI95 = 0.05 and 0.27) and a lower Zung depression score (a*b = + 0.10, Bootstrap CI95 = 0.02 and 0.21).In conclusion, the global cognitive performance of WLWH is lower than that of MLWH. However, other demographic and clinical factors besides sex might help explain differences in their neurocognitive functions and make it possible for us to monitor them and identify those patients most in need.

PMID:35718852 | DOI:10.1007/s13365-022-01078-z

J Hum Genet. 2022 Jun 20. doi: 10.1038/s10038-022-01051-y. Online ahead of print.

ABSTRACT

Although several genes involved in the development of Tetralogy of Fallot have been identified, no genetic diagnosis is available for the majority of patients. Low statistical power may have prevented the identification of further causative genes in gene-by-gene survey analyses. Thus, bigger samples and/or novel analytic approaches may be necessary. We studied if a joint analysis of groups of functionally related genes might be a useful alternative approach. Our reanalysis of whole-exome sequencing data identified 12 groups of genes that exceedingly contribute to the burden of Tetralogy of Fallot. Further analysis of those groups showed that genes with high-impact variants tend to interact with each other. Thus, our results strongly suggest that additional candidate genes may be found by studying the protein interaction network of known causative genes. Moreover, our results show that the joint analysis of functionally related genes can be a useful complementary approach to classical single-gene analyses.

PMID:35718831 | DOI:10.1038/s10038-022-01051-y