Tag: nevin manimala

J Vitreoretin Dis. 2022 Jun 9;6(6):437-442. doi: 10.1177/24741264221094683. eCollection 2022 Nov-Dec.

ABSTRACT

PURPOSE: This work aims to assess the quality, accountability, readability, accessibility, and presence of Spanish translation in online material through a Google search of “macular degeneration”.

METHODS: In this retrospective cross-sectional analysis of website results from a Google search of “macular degeneration”, the quality and accountability for each website were assessed using the DISCERN criteria and the Health on the Net Foundation Code of Conduct (HONcode) principles. All 31 sites were independently graded by 2 ophthalmologists. Readability was evaluated using an online tool. The presence of accessibility features on the website and Spanish translation was recorded. The primary outcome measure was the DISCERN and HONcode quality and accountability scores of each website. Secondary outcome measures included the readability, accessibility, and presence of Spanish translation.

RESULTS: The mean ± SD of each criterion across all 15 DISCERN questions was 2.761 ± 0.666 (out of 5). The mean HONcode score for all websites was 7.355 ± 3.123. The mean consensus reading grade level was 10.258 ± 2.49. There were no statistically significant differences in any score between the top 5 websites and the bottom 26 websites evaluated. Accessibility was available on 10 of 31 websites. Spanish translation was available on 10 of 31 websites.

CONCLUSIONS: The top 5 websites that appeared on a Google search did not have better quality or readability of online content. Improving quality, accountability, and readability can help improve patients’ health literacy regarding macular degeneration.

PMID:37009540 | PMC:PMC9954772 | DOI:10.1177/24741264221094683

Information (Basel). 2022 Nov;13(11):547. doi: 10.3390/info13110547. Epub 2022 Nov 19.

ABSTRACT

Many systems for exploratory and visual data analytics require platform-dependent software installation, coding skills, and analytical expertise. The rapid advances in data-acquisition, web-based information, and communication and computation technologies promoted the explosive growth of online services and tools implementing novel solutions for interactive data exploration and visualization. However, web-based solutions for visual analytics remain scattered and relatively problem-specific. This leads to per-case re-implementations of common components, system architectures, and user interfaces, rather than focusing on innovation and building sophisticated applications for visual analytics. In this paper, we present the Statistics Online Computational Resource Analytical Toolbox (SOCRAT), a dynamic, flexible, and extensible web-based visual analytics framework. The SOCRAT platform is designed and implemented using multi-level modularity and declarative specifications. This enables easy integration of a number of components for data management, analysis, and visualization. SOCRAT benefits from the diverse landscape of existing in-browser solutions by combining them with flexible template modules into a unique, powerful, and feature-rich visual analytics toolbox. The platform integrates a number of independently developed tools for data import, display, storage, interactive visualization, statistical analysis, and machine learning. Various use cases demonstrate the unique features of SOCRAT for visual and statistical analysis of heterogeneous types of data.

PMID:37009525 | PMC:PMC10062429 | DOI:10.3390/info13110547

Res Methods Med Health Sci. 2023 Jan;4(1):34-48. doi: 10.1177/26320843221141056. Epub 2022 Dec 13.

ABSTRACT

Studies that investigate the performance of prognostic and predictive biomarkers are commonplace in medicine. Evaluating the performance of biomarkers is challenging in traumatic brain injury (TBI) and other conditions when both the time factor (i.e. time from injury to biomarker measurement) and different levels or doses of treatments are in play. Such factors need to be accounted for when assessing the biomarker’s performance in relation to a clinical outcome. The Hyperbaric Oxygen in Brain Injury Treatment (HOBIT) trial, a phase II randomized control clinical trial seeks to determine the dose of hyperbaric oxygen therapy (HBOT) for treating severe TBI that has the highest likelihood of demonstrating efficacy in a phase III trial. Hyperbaric Oxygen in Brain Injury Treatment will study up to 200 participants with severe TBI. This paper discusses the statistical approaches to assess the prognostic and predictive performance of the biomarkers studied in this trial, where prognosis refers to the association between a biomarker and the clinical outcome while the predictiveness refers to the ability of the biomarker to identify patient subgroups that benefit from therapy. Analyses based on initial biomarker levels accounting for different levels of HBOT and other baseline clinical characteristics, and analyses of longitudinal changes in biomarker levels are discussed from a statistical point of view. Methods for combining biomarkers that are of complementary nature are also considered and the relevant algorithms are illustrated in detail along with an extensive simulation study that assesses the performance of the statistical methods. Even though the discussed approaches are motivated by the HOBIT trial, their applications are broader. They can be applied in studies assessing the predictiveness and prognostic ability of biomarkers in relation to a well-defined therapeutic intervention and clinical outcome.

PMID:37009524 | PMC:PMC10061824 | DOI:10.1177/26320843221141056

Orthop J Sports Med. 2023 Mar 28;11(3):23259671221147896. doi: 10.1177/23259671221147896. eCollection 2023 Mar.

ABSTRACT

BACKGROUND: Recurrent tears of the rotator cuff pose a substantial problem despite advances in repair technique. Biologic augmentation via marrow stimulation or vented anchors may strengthen the suture-tendon junction and improve healing rates of native tissue, thereby enhancing outcomes of primary surgical repair.

PURPOSE: To provide a focused systematic review and meta-analysis of local, intraoperative marrow-derived augmentation techniques in clinical primary rotator cuff repair.

STUDY DESIGN: Systematic review; Level of evidence, 4.

METHODS: A systematic review of PubMed, Embase, and Cochrane was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 2131 studies from 2010 to 2022, focused on either marrow stimulation or vented anchors, were isolated and classified as either preclinical or clinical. Meta-analysis was performed for comparative marrow stimulation and vented anchor studies. Heterogeneity was tested through calculation of I ².

RESULTS: A total of 13 clinical studies were included in the review. All 9 comparative studies included in the meta-analysis demonstrated high methodologic quality or a low risk of bias. The pooled retear rate across all 9 clinical studies for patients undergoing marrow stimulation was 11%. For the 5 studies in the meta-analysis, the pooled retear rates were 15% for marrow stimulation and 30% for controls. Meta-analysis demonstrated a significant difference in the overall retear rate that favored marrow stimulation (odds ratio [OR], 0.41; 95% CI, 0.25-0.66; P = .0003; I ² = 0%). Similarly, meta-analysis of the Constant score at final follow-up demonstrated a statistically significant difference between the 2 groups that favored a higher Constant score in the marrow stimulation group (mean difference, 2.84; 95% CI, 1.02-4.66; P = .002; I ² = 29%). Vented anchors demonstrated improved ossification and bone density at the anchor site, but no difference in outcomes or retear. Pooled retear rates were 22.5% for vented anchors and 27.8% for controls.

CONCLUSION: Current evidence demonstrates that marrow-stimulation techniques may have a positive impact on healing and retear rate, while vented anchors have a muted impact relative to nonvented anchors. Although available evidence is limited and more research is needed, findings to date suggest that marrow stimulation techniques may be an inexpensive, straightforward technique to consider in qualifying patients to prevent rotator cuff retears.

PMID:37009491 | PMC:PMC10061649 | DOI:10.1177/23259671221147896

Front Aging Neurosci. 2023 Mar 15;15:1117250. doi: 10.3389/fnagi.2023.1117250. eCollection 2023.

ABSTRACT

BACKGROUND AND OBJECTIVES: Alzheimer’s disease (AD) has an insidious onset, the early stages are easily overlooked, and there are no reliable, rapid, and inexpensive ancillary detection methods. This study analyzes the differences in handwriting kinematic characteristics between AD patients and normal elderly people to model handwriting characteristics. The aim is to investigate whether handwriting analysis has a promising future in AD auxiliary screening or even auxiliary diagnosis and to provide a basis for developing a handwriting-based diagnostic tool.

MATERIALS AND METHODS: Thirty-four AD patients (15 males, 77.15 ± 1.796 years) and 45 healthy controls (20 males, 74.78 ± 2.193 years) were recruited. Participants performed four writing tasks with digital dot-matrix pens which simultaneously captured their handwriting as they wrote. The writing tasks consisted of two graphics tasks and two textual tasks. The two graphics tasks are connecting fixed dots (task 1) and copying intersecting pentagons (task 2), and the two textual tasks are dictating three words (task 3) and copying a sentence (task 4). The data were analyzed by using Student’s t-test and Mann-Whitney U test to obtain statistically significant handwriting characteristics. Moreover, seven classification algorithms, such as eXtreme Gradient Boosting (XGB) and Logistic Regression (LR) were used to build classification models. Finally, the Receiver Operating Characteristic (ROC) curve, accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Area Under Curve (AUC) were used to assess whether writing scores and kinematics parameters are diagnostic.

RESULTS: Kinematic analysis showed statistically significant differences between the AD and controlled groups for most parameters (p < 0.05, p < 0.01). The results found that patients with AD showed slower writing speed, tremendous writing pressure, and poorer writing stability. We built statistically significant features into a classification model, among which the model built by XGB was the most effective with a maximum accuracy of 96.55%. The handwriting characteristics also achieved good diagnostic value in the ROC analysis. Task 2 had a better classification effect than task 1. ROC curve analysis showed that the best threshold value was 0.084, accuracy = 96.30%, sensitivity = 100%, specificity = 93.41%, PPV = 92.21%, NPV = 100%, and AUC = 0.991. Task 4 had a better classification effect than task 3. ROC curve analysis showed that the best threshold value was 0.597, accuracy = 96.55%, sensitivity = 94.20%, specificity = 98.37%, PPV = 97.81%, NPV = 95.63%, and AUC = 0.994.

CONCLUSION: This study’s results prove that handwriting characteristic analysis is promising in auxiliary AD screening or AD diagnosis.

PMID:37009455 | PMC:PMC10050722 | DOI:10.3389/fnagi.2023.1117250

Liver Int. 2023 Apr 2. doi: 10.1111/liv.15566. Online ahead of print.

ABSTRACT

BACKGROUND & AIMS: Antihypertensive drugs were recently reported to have an oncogenic role in common cancer, however, whether these drugs would affect the risk of hepatocellular carcinoma (HCC) remains unclear.

METHODS: A drug-target Mendelian randomization method was adopted to examine the long-term effect of 12 antihypertensive drugs classes on the risk of HCC in Europeans and East Asians. To proxy antihypertensive drugs, we leveraged genetic variants located near or within drug target genes that were associated with systolic blood pressure (SBP). Genetically proxied drugs associated with reduced risk of coronary artery disease were included in primary analysis. Genetic summary statistics of SBP and HCC were derived from publicly available large-scale genome-wide association studies in Europeans and East Asians, respectively. Expression quantitative trait loci (eQTLs) of drugs target genes were used to proxy drugs in a sensitivity analysis.

RESULTS: Genetically proxied thiazides and related diuretics were associated with decreased risk of HCC in both Europeans (OR [95% CI]:0.79 [0.73,0.86] per 1mmHg reduction in SBP; P<0.001) and East Asians (0.60 [0.45,0.82]; P=0.001). Genetically proxied beta-adrenoceptor blockers (BBs) were strongly associated with increased risk of HCC in Europeans (1.46 [1.12,1.91]; P=0.004). These findings were replicated in deCODE genetics study and remained consistent when using eQTLs to proxy antihypertensive drugs.

CONCLUSIONS: Our findings suggested that thiazides diuretics may lower the risk of HCC in both Europeans and East Asians, while BBs may increase the risk of HCC specifically in Europeans. Further studies are warranted to explore the potential of repurposing or retargeting antihypertensive drugs for HCC prevention.

PMID:37005366 | DOI:10.1111/liv.15566

Vet Radiol Ultrasound. 2023 Apr 2. doi: 10.1111/vru.13232. Online ahead of print.

ABSTRACT

Learning by comparison is a frequently employed education strategy used across many disciplines and levels. Interpreting radiographs requires both skills of perception and pattern recognition, which makes comparison techniques particularly useful in this field. In this randomized, prospective, parallel-group study, students enrolled in second and third-year radiology veterinary courses were given a case-based thoracic radiographic interpretation assignment. A cohort of the participants was given cases with side-by-side comparison normal images while the other cohort only had access to the cases. Twelve cases in total were presented to the students, with 10 cases depicting examples of common thoracic pathologies, while 2 cases were examples of normal. Radiographs of both feline and canine species were represented. Correctness of response to multiple choice questions was tracked, as was year and group (group 1: non compare, Control; group 2: compare, Intervention). Students assigned to group 1 had a lower percentage of correct answers than students assigned to group 2 (45% Control vs. 52% Intervention; P = 0.01). This indicates that side-by-side comparison to a normal example is helpful in identifying disease. No statistical significance was noted for the correctness of responses according to the year of training (P = 0.90). The overall poor performance on the assignment, regardless of group or year, shows that students in the early years of undergraduate veterinary radiology training struggle with the interpretation of common pathologies, likely a result of a lack of exposure to a multitude of cases and normal variants.

PMID:37005363 | DOI:10.1111/vru.13232

Prehosp Disaster Med. 2023 Apr 3:1-6. doi: 10.1017/S1049023X23000407. Online ahead of print.

ABSTRACT

INTRODUCTION: Disaster Medicine (DM) is defined by Koenig and Shultz as the “disciplines and organizations involved with governmental public health, public and private medical delivery including Emergency Medical Services (EMS), and governmental emergency management.” The Accreditation Council for Graduate Medical Education (ACGME) sets curriculum requirements and standards for Emergency Medicine (EM) residencies and EMS fellowships, which include a limited portion of the DM curriculum topics recommended by the Society of Academic Emergency Medicine (SAEM). The ACGME does not currently approve DM fellowships, as DM is not recognized as a subspecialty by the American Board of Medical Specialties (ABMS). This lack of nationally standardized guidelines for DM training leads to variability in disaster-related knowledge and skills, even among physicians trained by ACGME-accredited programs.

STUDY OBJECTIVE: The objective of this study is to analyze the DM components covered in EM residency and EMS fellowship in the United States and compare those to SAEM DM fellowship curriculum guidelines.

METHODS: The DM curriculum components of EM residencies and EMS fellowships were evaluated, using the SAEM DM curriculum as a control. Overlapping topics, as well as gaps between the programs, were analyzed using descriptive statistics.

RESULTS: Of the DM curriculum components developed by SAEM, EMS fellowship covered 15 of 19 (79%) major curriculum components and 38 of 99 (38%) subtopics, while EM residency covered seven of 19 major curriculum components (37%) and 16 of 99 (16%) subtopics. Together, EM residency and EMS fellowship cover 16 of 19 (84%) major curriculum components and 40 of 99 (40%) subtopics.

CONCLUSION: While EMS fellowship covers a large portion of the DM major curriculum components recommended by SAEM, there are several important DM subtopics that are not covered either in EM residency or EMS fellowship. Furthermore, there is no standardization for the depth and manner that DM topics are addressed in either curriculum. Time constraints in EM residency and EMS fellowship may also prevent extensive review of important DM topics. Disaster Medicine covers a distinct body of knowledge, represented in the curriculum subtopics, that are not covered in either EM residency or EMS fellowship. The development of an ACGME-accredited DM fellowship and recognition of DM as a distinct subspecialty could allow for more effective DM graduate medical education.

PMID:37005359 | DOI:10.1017/S1049023X23000407

Worldviews Evid Based Nurs. 2023 Apr 2. doi: 10.1111/wvn.12644. Online ahead of print.

ABSTRACT

BACKGROUND: The inconsistencies between randomized clinical trials (RCTs) registrations and peer-reviewed publications may distort trial results and threaten the validity of evidence-based medicine. Previous studies have found many inconsistencies between RCTs registrations and peer-reviewed publications, and outcome reporting bias is prevalent.

AIMS: The aims of this review were to assess whether the primary outcomes and other data reported in publications and registered records in RCTs of nursing journals were consistent and whether discrepancies in the reporting of primary outcomes favored statistically significant results. Moreover, we reviewed the proportion of RCTs for prospective registration.

METHODS: We systematically searched PubMed for RCTs published in the top 10 nursing journals between March 5, 2020, and March 5, 2022. Registration numbers were extracted from the publications, and registered records were identified from the registration platforms. The publications and registered records were compared to identify consistency. Inconsistencies were subdivided into discrepancies and omissions.

RESULTS: A total of 70 RCTs published in seven journals were included. The inconsistencies involved sample size estimation (71.4%), random sequence generation (75.7%), allocation concealment (97.1%), blinding (82.9%), primary outcomes (60.0%) and secondary outcomes (84.3%). Among the inconsistencies in the primary outcomes, 21.4% were due to discrepancies and 38.6% resulted from omissions. Fifty-three percent (8/15) presented discrepancies in the primary outcomes that favored statistically significant results. Additionally, although only 40.0% of the studies were prospective registrations, the number of prospectively registered trials has trended upward over time.

LINKING EVIDENCE TO ACTION: While not including all RCTs in the nursing field, our sample reflected a general trend: inconsistencies between publications and trial registrations were prevalent in the included nursing journals. Our research helps to provide a way to improve the transparency of research reports. Ensuring that clinical practice has access to transparent and reliable research results are essential to achieve the best possible evidence-based medicine.

PMID:37005350 | DOI:10.1111/wvn.12644

Br J Clin Pharmacol. 2023 Apr 2. doi: 10.1111/bcp.15731. Online ahead of print.

ABSTRACT

INTRODUCTION: The combination of daptomycin and ceftaroline used as salvage therapy is associated with higher survival and decreased clinical failure in complicated methicillin-resistant Staphylococcus aureus (MRSA) infections that are resistant to standard MRSA treatment.

OBJECTIVES: This study aimed to evaluate dosing regimens for co-administration of daptomycin and ceftaroline in special populations including pediatrics, renally impaired (RI), obese and geriatrics that generate sufficient coverage against daptomycin-resistant MRSA.

METHODS: PBPK models were developed from pharmacokinetic studies of healthy adults, geriatrics, pediatrics, obese, and RI patients. The predicted profiles were used to evaluate joint probability of target attainment (PTA), as well as tissue-to-plasma ratios.

RESULTS: The adult dosing regimens of 6 mg/kg q24h or q48h daptomycin and 300-600 mg q12h ceftaroline fosamil by RI categories achieved ≥90% joint PTA when the minimum inhibitory concentrations (MICs) in the combination are at or below 1 and 4 μg/mL against MRSA. In pediatrics, wherein there is no recommended daptomycin dosing regimen for S. aureus bacteremia, ≥90% joint PTA is achieved when the MICs in the combination are up to 0.5 and 2 μg/mL for standard pediatric dosing regimens of 7 mg/kg q24h daptomycin and 12 mg/kg q8h ceftaroline fosamil. Model predicted tissue-to-plasma ratios of 0.3 and 0.7 in the skin and lung, respectively, for ceftaroline and 0.8 in the skin for daptomycin.

CONCLUSION: Our work illustrates how PBPK modeling can inform appropriate dosing of adult and pediatric patients and thereby enable prediction of target attainment in the patients during multi-therapies.

PMID:37005335 | DOI:10.1111/bcp.15731