Researchers have created and preliminarily tested what they believe may be one of the first models for predicting who has the highest probability of being resistant to COVID-19 in spite of exposure to SARS-CoV-2, the virus that causes it.
Tag: nevin manimala
Eur J Health Econ. 2023 Feb 23. doi: 10.1007/s10198-023-01569-8. Online ahead of print.
ABSTRACT
BACKGROUND: We investigate whether and how general population health state values were influenced by the initial stages of the COVID-19 pandemic. Changes could have important implications, as general population values are used in health resource allocation.
DATA: In Spring 2020, participants in a UK general population survey rated 2 EQ-5D-5L states, 11111 and 55555, as well as dead, using a visual analogue scale (VAS) from 100 = best imaginable health to 0 = worst imaginable health. Participants answered questions about their pandemic experiences, including COVID-19’s effect on their health and quality of life, and their subjective risk/worry about infection.
ANALYSIS: VAS ratings for 55555 were transformed to the full health = 1, dead = 0 scale. Tobit models were used to analyse VAS responses, as well as multinomial propensity score matching (MNPS) to create samples balanced according to participant characteristics.
RESULTS: Of 3021 respondents, 2599 were used for analysis. There were statistically significant, but complex associations between experiences of COVID-19 and VAS ratings. For example, in the MNPS analysis, greater subjective risk of infection implied higher VAS ratings for dead, yet worry about infection implied lower ratings. In the Tobit analysis, people whose health was affected by COVID-19 rated 55555 higher, whether the effect on health was positive or negative.
CONCLUSION: The results complement previous findings that the onset of the COVID-19 pandemic may have impacted EQ-5D-5L health state valuation, and different aspects of the pandemic had different effects.
PMID:36814039 | DOI:10.1007/s10198-023-01569-8
Int J Clin Oncol. 2023 Feb 22. doi: 10.1007/s10147-023-02314-0. Online ahead of print.
ABSTRACT
BACKGROUND: Although brachytherapy is a standard treatment option for patients with high-risk prostate cancer, only a few studies have compared low-dose-rate brachytherapy (LDR-BT) and high-dose-rate brachytherapy (HDR-BT). We applied propensity score-based inverse probability treatment weighting (IPTW) to compare oncological outcomes for LDR-BT and HDR-BT.
METHODS: We retrospectively assessed prognosis in 392 patients with high-risk localized prostate cancer who had undergone brachytherapy plus external beam radiation. IPTW was applied to adjust the Kaplan-Meier survival analyses and Cox proportional hazards regression analyses, with the goal of minimizing bias from patient background.
RESULTS: The IPTW-adjusted Kaplan-Meier survival analyses showed no statistically significant differences for time to biochemical recurrence, clinical progression, castration-resistant prostate cancer, or death from any cause. The IPTW-adjusted Cox regression analyses also showed that the modality of brachytherapy was not an independent factor in these oncological outcomes. Notably, the two groups differed regarding complications; LDR-BT was associated with a higher rate of acute grade ≥ 2 GU toxicity, and late grade 3 toxicity was noted only in HDR-BT.
CONCLUSION: Our analysis of long-term outcomes in patients with high-risk localized prostate cancer shows no significant differences in oncological outcomes between LDR-BT and HDR-BT, but some differences in toxicity, and offers patients and clinicians useful information in deciding management strategies for high-risk localized prostate cancer.
PMID:36814038 | DOI:10.1007/s10147-023-02314-0
Eur Radiol. 2023 Feb 23. doi: 10.1007/s00330-023-09447-w. Online ahead of print.
ABSTRACT
OBJECTIVES: This study was carried out to investigate a new device for axial loading MRI (alMRI) in the diagnosis of lumbar spinal stenosis (LSS).
METHODS: A total of 87 patients with suspected LSS sequentially underwent conventional MRI and alMRI using a new device with pneumatic shoulder-hip compression mode. Four quantitative parameters of dural sac cross-sectional area (DSCA), sagittal vertebral canal diameter (SVCD), disc height (DH), and ligamentum flavum thickness (LFT) at L3-4, L4-5, and L5-S1 in both examinations were measured and compared. Eight qualitative indicators were compared as valuable diagnostic information. Image quality, examinee comfort, test-retest repeatability, and observer reliability were also assessed.
RESULTS: Using the new device, all 87 patients successfully completed alMRI with no statistically significant differences in image quality and examinee comfort from conventional MRI. Statistically significant changes were observed in DSCA, SVCD, DH, and LFT after loading (p < 0.01). SVCD, DH, LFT, and DSCA changes were all positively correlated (r = 0.80, 0.72, 0.37, p < 0.01). Eight qualitative indicators increased from 501 to 669 after axial loading, for a total increase of 168 (33.5%). Nineteen patients (21.8%, 19/87) developed absolute stenosis after axial loading and 10 of them (11.5%, 10/87) also had a significant reduction in DSCA (> 15 mm2). The test-retest repeatability and observer reliability were good to excellent.
CONCLUSION: The new device is stable for performing alMRI and can exacerbate the severity of spinal stenosis, providing more valuable information for diagnosing LSS and reducing missed diagnoses.
KEY POINTS: • The new axial loading MRI (alMRI) device could detect a higher frequency of patients with lumbar spinal stenosis (LSS). • The new device with pneumatic shoulder-hip compression mode was used to investigate its applicability in alMRI and diagnostic value for LSS. • The new device is stable for performing alMRI and can provide more valuable information for diagnosing LSS.
PMID:36814030 | DOI:10.1007/s00330-023-09447-w
Arch Gynecol Obstet. 2023 Feb 23. doi: 10.1007/s00404-023-06954-5. Online ahead of print.
ABSTRACT
PURPOSE: Despite the beneficial effects of levothyroxine (LT4) therapy on pregnancy outcomes of women with subclinical hypothyroidism (SCH), its impact on the developmental status of offspring remains unclear. We aimed to assess the effects of LT4 therapy on the neurodevelopment of infants of SCH women in the first 3 years of life.
METHODS: A follow-up study was conducted on children born to SCH pregnant women who had participated in a single-blind randomized clinical trial (Tehran Thyroid and Pregnancy Study). In this follow-up study, 357 children of SCH mothers were randomly assigned to SCH + LT4 (treated with LT4 after the first prenatal visit and throughout pregnancy) and SCH-LT4 groups. Children born of euthyroid TPOAb-women served as the control group (n = 737). The neurodevelopment status of children was assessed in five domains (communication, gross motor, fine motor, problem-solving, and social-personal domains) using the Ages and Stages Questionnaires (ASQ) at the age of 3 years.
RESULTS: Pairwise comparisons of ASQ domains between euthyroid, SCH + LT4, and SCH-LT4 groups show no statistically significant difference between groups in the total score [median 25-75 total score: 265 (240-280); 270 (245-285); and 265 (245-285); P-value = 0.2, respectively]. The reanalyzing data using the TSH cutoff value of 4.0 mIU/L indicated no significant difference between groups in the score of ASQ in each domain or total score with TSH levels < 4.0 mIU/L, however, a statistically significant difference in the median score of the gross motor was observed between those SCH + LT4 with baseline TSH values ≥ 4.0 mIU/L and SCH-LT4 [60 (55-60) vs. 57.5 (50-60); P = 0.01].
CONCLUSIONS: Our study does not support the beneficiary effect of LT4 therapy for SCH pregnant women in terms of the neurological development of their offspring in the first three years of life.
PMID:36814028 | DOI:10.1007/s00404-023-06954-5
Behav Res Methods. 2023 Feb 22. doi: 10.3758/s13428-023-02079-4. Online ahead of print.
ABSTRACT
Mediation analysis in repeated measures studies can shed light on the mechanisms through which experimental manipulations change the outcome variable. However, the literature on interval estimation for the indirect effect in the 1-1-1 single mediator model is sparse. Most simulation studies to date evaluating mediation analysis in multilevel data considered scenarios that do not match the expected numbers of level 1 and level 2 units typically encountered in experimental studies, and no study to date has compared resampling and Bayesian methods for constructing intervals for the indirect effect in this context. We conducted a simulation study to compare statistical properties of interval estimates of the indirect effect obtained using four bootstrap and two Bayesian methods in the 1-1-1 mediation model with and without random effects. Bayesian credibility intervals had coverage closest to the nominal value and no instances of excessive Type I error rates, but lower power than resampling methods. Findings indicated that the pattern of performance for resampling methods often depended on the presence of random effects. We provide suggestions for selecting an interval estimator for the indirect effect depending on the most important statistical property for a given study, as well as code in R for implementing all methods evaluated in the simulation study. Findings and code from this project will hopefully support the use of mediation analysis in experimental research with repeated measures.
PMID:36814007 | DOI:10.3758/s13428-023-02079-4
Matern Child Nutr. 2023 Feb 22:e13493. doi: 10.1111/mcn.13493. Online ahead of print.
ABSTRACT
The southeastern region of Kenya is prone to aflatoxin outbreaks, yet maternal and infant aflatoxin intake levels remain unclear. We determined dietary aflatoxin exposure of 170 lactating mothers breastfeeding children aged 6 months and below in a descriptive cross-sectional study involving aflatoxin analysis of maize-based cooked food samples (n = 48). Their socioeconomic characteristics, food consumption patterns and postharvest handling of maize were determined. Aflatoxins were determined using high-performance liquid chromatography and enzyme-linked immunosorbent assay. Statistical analysis was conducted using Statistical Package Software for Social Sciences (SPSS version 27) and Palisade’s @Risk software. About 46% of the mothers were from low-income households, and 48.2% had not attained the basic level of education. A generally low dietary diversity was reported among 54.1% of lactating mothers. Food consumption pattern was skewed towards starchy staples. Approximately 50% never treated their maize, and at least 20% stored their maize in containers that promote aflatoxin contamination. Aflatoxin was detected in 85.4% of food samples. The mean of total aflatoxin was 97.8 μg/kg (standard deviation [SD], 57.7), while aflatoxin B1 was 9.0 μg/kg (SD, 7.7). The mean dietary intake of total aflatoxin and aflatoxin B1 was 7.6 μg/kg/b.w.t/day (SD, 7.5) and 0.6 (SD, 0.6), respectively. Dietary aflatoxin exposure of lactating mothers was high (margin of exposure < 10,000). Sociodemographic characteristics, food consumption patterns and postharvest handling of maize variably influenced dietary aflatoxin exposure of the mothers. The high prevalence and presence of aflatoxin in foods of lactating mothers are a public health concern and calls for the need to devise easy-to-use household food safety and monitoring measures in the study area.
PMID:36814005 | DOI:10.1111/mcn.13493
Biomech Model Mechanobiol. 2023 Feb 23. doi: 10.1007/s10237-022-01682-2. Online ahead of print.
ABSTRACT
Cells mechanically interact with their environment to sense, for example, topography, elasticity and mechanical cues from other cells. Mechano-sensing has profound effects on cellular behaviour, including motility. The current study aims to develop a mathematical model of cellular mechano-sensing on planar elastic substrates and demonstrate the model’s predictive capabilities for the motility of individual cells in a colony. In the model, a cell is assumed to transmit an adhesion force, derived from a dynamic focal adhesion integrin density, that locally deforms a substrate, and to sense substrate deformation originating from neighbouring cells. The substrate deformation from multiple cells is expressed as total strain energy density with a spatially varying gradient. The magnitude and direction of the gradient at the cell location define the cell motion. Cell-substrate friction, partial motion randomness, and cell death and division are included. The substrate deformation by a single cell and the motility of two cells are presented for several substrate elasticities and thicknesses. The collective motility of 25 cells on a uniform substrate mimicking the closure of a circular wound of 200 µm is predicted for deterministic and random motion. Cell motility on substrates with varying elasticity and thickness is explored for four cells and 15 cells, the latter again mimicking wound closure. Wound closure by 45 cells is used to demonstrate the simulation of cell death and division during migration. The mathematical model can adequately simulate the mechanically induced collective cell motility on planar elastic substrates. The model is suitable for extension to other cell and substrates shapes and the inclusion of chemotactic cues, offering the potential to complement in vitro and in vivo studies.
PMID:36814004 | DOI:10.1007/s10237-022-01682-2
J Gastrointest Cancer. 2023 Feb 23. doi: 10.1007/s12029-023-00919-2. Online ahead of print.
ABSTRACT
BACKGROUND: Obstructive sleep apnea (OSA), characterised by recurrent episodes of upper airway collapse, intermittent hypoxia (IH) and sleep fragmentation (SF), has been associated with carcinogenesis in pre-clinical models. The relationship between OSA and colorectal cancer (CRC) in clinical studies is controversial.
AIM: The objective of this meta-analysis was to assess the association between OSA and CRC.
METHODS: Two independent investigators searched studies indexed in CINAHL, MEDLINE, EMBASE, the Cochrane Database and clinicaltrials.gov that were randomised controlled trials (RCT) or observational studies evaluating the relationship between OSA and CRC. Studies were included if they had available odds ratios (OR) and relative risks (RR) or if hazard ratios (HR) with 95% confidence intervals (CI) were available and a reference group composed of participants who did not have OSA. OR and 95% CI were calculated using a random-effect, generic inverse variance method.
RESULTS: We included four observational studies out of 85 records, comprising a combined cohort of 5,651,662 identified patients in the data analysis. Three studies used polysomnography to identify OSA. The pooled OR of CRC in patients with OSA was 1.49 (95% CI, 0.75 to 2.97). The statistical heterogeneity was high with I2 of 95%.
CONCLUSIONS: Our study is unable to conclusively point towards OSA being a risk factor in the development of CRC, despite the plausible biological mechanisms for this. Further well-designed prospective RCT assessing the risk of CRC in patients with OSA and the impact of OSA treatments on the incidence and prognosis of CRC are needed.
PMID:36813984 | DOI:10.1007/s12029-023-00919-2
Neurol Sci. 2023 Feb 23. doi: 10.1007/s10072-023-06632-z. Online ahead of print.
ABSTRACT
OBJECT: Recent evidence has suggested that systemic inflammatory and immune index (SIRI) and systematic inflammation index (SII) could predict prognosis in stroke patients. This study aimed to determine the effects of SIRI and SII on predicting in-hospital infections and unfavorable outcomes in patients with acute intracerebral hemorrhage (ICH).
METHODS: We used the data from a prospective and registry-based study recruiting ICH patients between January 2014 and September 2016 in a single comprehensive stroke center. All patients were stratified by quartiles of SIRI or SII. Logistic regression analysis was used to estimate the associations with follow-up prognosis. The receiver operating characteristics (ROC) curves were performed to examine the predictive utility of these indexes for infections and prognosis.
RESULTS: Six hundred and forty spontaneous ICH patients were enrolled in this study. Compared with the lowest quartile (Q1), SIRI or SII values both showed positive correlations with increased risks for poor 1-month outcomes (adjusted ORs in Q4 was 2.162 [95% CI: 1.240-3.772] for SIRI, 1.797 [95% CI: 1.052-3.070] for SII). Additionally, a higher level of SIRI, but not SII, was independently associated with a higher risk of infections and an unfavorable 3-month prognosis. The C-statistic for the combined SIRI and ICH score was higher than SIRI or ICH score alone for predicting in-hospital infections and poor outcomes.
CONCLUSION: Elevated SIRI values were associated with in-hospital infections and poor functional outcomes. It may provide a new biomarker for ICH prognosis prediction, especially in the acute stage.
PMID:36813976 | DOI:10.1007/s10072-023-06632-z