Tag: nevin manimala

PLOS Digit Health. 2023 May 15;2(5):e0000140. doi: 10.1371/journal.pdig.0000140. eCollection 2023 May.

ABSTRACT

The transfer of new insights from basic or clinical research into clinical routine is usually a lengthy and time-consuming process. Conversely, there are still many barriers to directly provide and use routine data in the context of basic and clinical research. In particular, no coherent software solution is available that allows a convenient and immediate bidirectional transfer of data between concrete treatment contexts and research settings. Here, we present a generic framework that integrates health data (e.g., clinical, molecular) and computational analytics (e.g., model predictions, statistical evaluations, visualizations) into a clinical software solution which simultaneously supports both patient-specific healthcare decisions and research efforts, while also adhering to the requirements for data protection and data quality. Specifically, our work is based on a recently established generic data management concept, for which we designed and implemented a web-based software framework that integrates data analysis, visualization as well as computer simulation and model prediction with audit trail functionality and a regulation-compliant pseudonymization service. Within the front-end application, we established two tailored views: a clinical (i.e., treatment context) perspective focusing on patient-specific data visualization, analysis and outcome prediction and a research perspective focusing on the exploration of pseudonymized data. We illustrate the application of our generic framework by two use-cases from the field of haematology/oncology. Our implementation demonstrates the feasibility of an integrated generation and backward propagation of data analysis results and model predictions at an individual patient level into clinical decision-making processes while enabling seamless integration into a clinical information system or an electronic health record.

PMID:37186586 | DOI:10.1371/journal.pdig.0000140

PLoS One. 2023 May 15;18(5):e0285826. doi: 10.1371/journal.pone.0285826. eCollection 2023.

ABSTRACT

Limited information exists on mercury concentrations and environmental drivers of mercury bioaccumulation in high latitude terrestrial carnivores. Spatial patterns of mercury concentrations in wolverine (Gulo gulo, n = 419) were assessed across a 1,600,000 km2 study area in relation to landscape, climate, diet and biological factors in Arctic and boreal biomes of western Canada. Hydrogen stable isotope ratios were measured in wolverine hair from a subset of 80 animals to assess the spatial scale for characterizing environmental conditions of their habitat. Habitat characteristics were determined using GIS methods and raster datasets at two scales, the collection location point and a 150 km radius buffer, which was selected based on results of a correlation analysis between hydrogen stable isotopes in precipitation and wolverine hair. Total mercury concentrations in wolverine muscle ranged >2 orders of magnitude from 0.01 to 5.72 μg/g dry weight and varied geographically, with the highest concentrations in the Northwest Territories followed by Nunavut and Yukon. Regression models at both spatial scales indicated diet (based on nitrogen stable isotope ratios) was the strongest explanatory variable of mercury concentrations in wolverine, with smaller though statistically significant contributions from landscape variables (soil organic carbon, percent cover of wet area, percent cover of perennial snow-ice) and distance to the Arctic Ocean coast. The carbon and nitrogen stable isotope ratios of wolverine muscle suggested greater mercury bioaccumulation could be associated with feeding on marine biota in coastal habitats. Landscape variables identified in the modelling may reflect habitat conditions which support enhanced methylmercury transfer to terrestrial biota. Spatially-explicit estimates of wet atmospheric deposition were positively correlated with wolverine mercury concentrations but this variable was not selected in the final regression models. These landscape patterns provide a basis for further research on underlying processes enhancing methylmercury uptake in high latitude terrestrial food webs.

PMID:37186585 | DOI:10.1371/journal.pone.0285826

PLOS Glob Public Health. 2023 May 15;3(5):e0001009. doi: 10.1371/journal.pgph.0001009. eCollection 2023.

ABSTRACT

BACKGROUND: Low birthweight (birthweight <2500 grams, g) and underweight (weight-for-age Z-score, WAZ, < -2) infants have higher risk of poor outcomes compared to their well-nourished peers. We evaluated the role of azithromycin for reducing mortality and improving growth outcomes in low birthweight and/or underweight infants.

METHODS: Infants aged 8-27 days of age weighing ≥2500 g at enrollment in Burkina Faso were randomized 1:1 to a single, oral dose of azithromycin (20 mg/kg) or matching placebo. We evaluated mortality and anthropometric outcomes in four subgroups: 1) both low birthweight and underweight at enrollment; 2) low birthweight-only; 3) underweight-only; 4) neither low birthweight nor underweight.

FINDINGS: Of 21,832 enrolled infants, 21,320 (98%) had birthweight measurements and included in this analysis. Of these, 747 (3%) were both low birthweight and underweight, 972 (5%) were low birthweight-only, 825 (4%) were underweight-only, and 18,776 (88%) were neither low birthweight nor underweight. Infants who were both low birthweight and underweight receiving azithromycin had lower odds of underweight at 6 months compared to placebo (OR 0.65, 95% CI 0.44 to 0.95), but the treatment group by subgroup interaction was not statistically significant (P = 0.06). We did not find evidence of a difference between groups for other outcomes in any subgroup.

INTERPRETATION: Azithromycin may have some growth-promoting benefits for the highest risk infants, but we were unable to demonstrate a difference in most outcomes in low birthweight and underweight infants. As a secondary analysis of a trial, this study was underpowered for rare outcomes such as mortality.

TRIAL REGISTRATION: ClinicalTrials.gov NCT03682653.

PMID:37186577 | DOI:10.1371/journal.pgph.0001009

Neuron Behav Data Anal Theory. 2022;1. doi: 10.51628/001c.38960. Epub 2022 Oct 20.

ABSTRACT

While brain rhythms appear fundamental to brain function, why brain rhythms consistently organize into the small set of discrete frequency bands observed remains unknown. Here we propose that rhythms separated by factors of the golden ratio $(\varphi =(1+\sqrt{5})/2))$ optimally support segregation and cross-frequency integration of information transmission in the brain. Organized by the golden ratio, pairs of transient rhythms support multiplexing by reducing interference between separate communication channels, and triplets of transient rhythms support integration of signals to establish a hierarchy of cross-frequency interactions. We illustrate this framework in simulation and apply this framework to propose four hypotheses.

PMID:37186520 | PMC:PMC10181851 | DOI:10.51628/001c.38960

J Pers Soc Psychol. 2023 Jun;124(6):1277-1298. doi: 10.1037/pspp0000463.

ABSTRACT

Age and gender differences in narcissism have been studied often. However, considering the rich history of narcissism research accompanied by its diverging conceptualizations, little is known about age and gender differences across various narcissism measures. The present study investigated age and gender differences and their interactions across eight widely used narcissism instruments (i.e., Narcissistic Personality Inventory, Hypersensitive Narcissism Scale, Dirty Dozen, Psychological Entitlement Scale, Narcissistic Personality Disorder Symptoms from the Diagnostic and Statistical Manual of Mental Disorders, Version IV, Narcissistic Admiration and Rivalry Questionnaire-Short Form, Single-Item Narcissism Scale, and brief version of the Pathological Narcissism Inventory). The findings of Study 1 (N = 5,736) revealed heterogeneity in how strongly the measures are correlated. Some instruments loaded clearly on one of the three factors proposed by previous research (i.e., Neuroticism, Extraversion, Antagonism), while others cross-loaded across factors and in distinct ways. Cross-sectional analyses using each measure and meta-analytic results across all measures (Study 2) with a total sample of 270,029 participants suggest consistent linear age effects (random effects meta-analytic effect of r = -.104), with narcissism being highest in young adulthood. Consistent gender differences also emerged (random effects meta-analytic effect was -.079), such that men scored higher in narcissism than women. Quadratic age effects and Age × Gender effects were generally very small and inconsistent. We conclude that despite the various conceptualizations of narcissism, age and gender differences are generalizable across the eight measures used in the present study. However, their size varied based on the instrument used. We discuss the sources of this heterogeneity and the potential mechanisms for age and gender differences. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37184962 | DOI:10.1037/pspp0000463

Sch Psychol. 2023 May;38(3):173-181. doi: 10.1037/spq0000517.

ABSTRACT

Recent advances in automated writing evaluation have enabled educators to use automated writing quality scores to improve assessment feasibility. However, there has been limited investigation of bias for automated writing quality scores with students from diverse racial or ethnic backgrounds. The use of biased scores could contribute to implementing unfair practices with negative consequences on student learning. The goal of this study was to investigate score bias of writeAlizer, a free and open-source automated writing evaluation program. For 421 students in Grades 4 and 7 who completed a state writing exam that included composition and multiple choice revising and editing questions, writeAlizer was used to generate automated writing quality scores for the composition section. Then, we used multiple regression models to investigate whether writeAlizer scores demonstrated differential predictions of the composition and overall scores on the state-mandated writing exam for students from different racial or ethnic groups. No evidence of bias for automated scores was observed. However, after controlling for automated scores in Grade 4, we found statistically significant group differences in regression models predicting overall state test scores 3 years later but not the essay composition scores. We hypothesize that the multiple choice revising and editing sections, rather than the scoring approach used for the essay portion, introduced construct-irrelevant variance and might lead to differential performance among groups. Implications for assessment development and score use are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37184959 | DOI:10.1037/spq0000517

J Natl Cancer Inst. 2023 May 15:djad078. doi: 10.1093/jnci/djad078. Online ahead of print.

ABSTRACT

BACKGROUND: NSABP B-42 evaluated extended letrozole therapy (ELT) in postmenopausal breast cancer patients who were disease-free after 5 years of aromatase inhibitor-based (AI) therapy. Seven-year results demonstrated a non-statistically significant trend in disease-free survival (DFS) in favor of ELT. We present 10-year outcome results.

METHODS: In this double-blind, phase 3 trial, patients with stage I-IIIA hormone receptor-positive breast cancer, disease-free after 5 years of an AI or tamoxifen followed by an AI, were randomized to 5 years of letrozole or placebo. Primary endpoint was DFS, defined as time from randomization to breast cancer recurrence, second primary malignancy, or death. All statistical tests are two-sided.

RESULTS: Between 09/06 and 01/10, 3,966 patients were randomized (letrozole: 1,983; placebo: 1,983). Median follow-up time for 3,923 patients included in efficacy analyses was 10.3 years. There was statistically significant improvement in DFS in favor of letrozole compared to placebo (Hazard Ratio [HR]=0.85; 95%CI 0.74-0.96, p-value = 0.01, 10-year DFS: placebo = 72.6%, letrozole = 75.9%, absolute difference 3.3%). There was no difference in the effect of letrozole on overall survival (OS) (HR = 0.97, 95%CI 0.82-1.15, p-value = 0.74). Letrozole significantly reduced breast cancer-free interval (BCFI) events (HR = 0.75, 95%CI 0.62-0.91, p-value = 0.003, absolute difference in cumulative incidence: 2.7%) and distant recurrences (DR) (HR = 0.72, 95%CI 0.55-0.92, p-value = 0.01, absolute difference: 1.8%). The rates of osteoporotic fractures and arterial thrombotic events did not differ between treatment groups.

CONCLUSIONS: The beneficial effect of ELT on DFS persisted at 10 years. Letrozole also significantly improved BCFI and DR without improving OS. Careful assessment of potential risks and benefits is necessary for selecting appropriate candidates for ELT.

CLINICAL TRIALS REGISTRATION: NCT00382070.

PMID:37184928 | DOI:10.1093/jnci/djad078

Ther Hypothermia Temp Manag. 2023 May 15. doi: 10.1089/ther.2022.0066. Online ahead of print.

ABSTRACT

The aim of this study was to describe whether whole-body hypothermia induced different respiratory changes in both invasively and noninvasively ventilated newborns and spontaneously breathing asphyxiated newborns during the course and after therapeutic hypothermia (TH). Data of 44 asphyxiated newborns undergoing TH at five different neonatal intensive care units in southern Italy were collected retrospectively between January 2018 and January 2021. For each type of ventilation, patient data on pH, partial pressure of Carbon Dioxide (pCO₂), base excess, lactate, and heart rate were recorded before cooling was started and at 24, 48, 72, and 96 hours from its initiation. Patients were later subgrouped into spontaneously breathing, noninvasively ventilated, and mechanically ventilated groups. The average trend of each parameter was reported, and a nonparametric statistical analysis of differences among groups before initiation and at 96 hours was performed using the Kruskal-Wallis test. Our results confirmed previous findings (supported by a small amount of literature) that no increase in requests for respiratory support is recorded in asphyxiated newborns undergoing TH during and after the rewarming phase. Furthermore, no statistically significant differences in the analyzed parameters were found among spontaneously breathing, noninvasively ventilated, and mechanically ventilated newborns, suggesting that changes in parameters might be attributable to TH itself rather than to an improvement in the respiratory condition over time; otherwise, a difference between spontaneously breathing patients, by definition “stable” from a respiratory point of view, and those requiring any type of respiratory support would have been expected.

PMID:37184915 | DOI:10.1089/ther.2022.0066

J Med Internet Res. 2023 May 15;25:e39854. doi: 10.2196/39854.

ABSTRACT

BACKGROUND: Preterm birth is a global health concern. Its adverse consequences may persist throughout the life course, exerting a potentially heavy burden on families, health systems, and societies. In high-income countries, the first children who benefited from improved care are now adults entering middle age. However, there is a clear gap in the knowledge regarding the long-term outcomes of individuals born preterm.

OBJECTIVE: This study aimed to assess the feasibility of recruiting and following up an e-cohort of adults born preterm worldwide and provide estimations of participation, characteristics of participants, the acceptability of questions, and the quality of data collected.

METHODS: We implemented a prospective, open, observational, and international e-cohort pilot study (Health of Adult People Born Preterm-an e-Cohort Pilot Study [HAPP-e]). Inclusion criteria were being an adult (aged ≥18 years), born preterm (<37 weeks of gestation), having internet access and an email address, and understanding at least 1 of the available languages. A large, multifaceted, and multilingual communication strategy was established. Between December 2019 and June 2021, inclusion and repeated data collection were performed using a secured web platform. We provided descriptive statistics regarding participation in the e-cohort, namely, the number of persons who registered on the platform, signed the consent form, initiated and completed the baseline questionnaire, and initiated and completed the follow-up questionnaire. We also described the main characteristics of the HAPP-e participants and provided an assessment of the quality of the data and the acceptability of sensitive questions.

RESULTS: As of December 31, 2020, a total of 1004 persons had registered on the platform, leading to 527 accounts with a confirmed email and 333 signed consent forms. A total of 333 participants initiated the baseline questionnaire. All participants were invited to follow-up, and 35.7% (119/333) consented to participate, of whom 97.5% (116/119) initiated the follow-up questionnaire. Completion rates were very high both at baseline (296/333, 88.9%) and at follow-up (112/116, 96.6%). This sample of adults born preterm in 34 countries covered a wide range of sociodemographic and health characteristics. The gestational age at birth ranged from 23+6 to 36+6 weeks (median 32, IQR 29-35 weeks). Only 2.1% (7/333) of the participants had previously participated in a cohort of individuals born preterm. Women (252/333, 75.7%) and highly educated participants (235/327, 71.9%) were also overrepresented. Good quality data were collected thanks to validation controls implemented on the web platform. The acceptability of potentially sensitive questions was excellent, as very few participants chose the “I prefer not to say” option when available.

CONCLUSIONS: Although we identified room for improvement in specific procedures, this pilot study confirmed the great potential for recruiting a large and diverse sample of adults born preterm worldwide, thereby advancing research on adults born preterm.

PMID:37184902 | DOI:10.2196/39854

Omega (Westport). 2023 May 15:302228231174573. doi: 10.1177/00302228231174573. Online ahead of print.

ABSTRACT

Background: Providing care for dying patients is a stress-inducing, complicated, as well as essential responsibility for health care providers. Furthermore, end-of-life care is associated with intense personal emotions such as grief, anxiety, depression, frustration, and guilt. Moreover, caring for terminally ill patients is a challenging task that confronts physicians and nurses with the psychological concerns of dealing with death, which is accompanied by a high level of physical and psychological discomfort.Objective: This study was aimed to measure the level of death anxiety among oncology nurses and physicians and to determine the associated factors that influence their level of death anxiety.Method: A cross-sectional descriptive design was used to guide this study, a non-probability convenience sampling method was used to recruit 200 oncology nurses and physicians from one specialized cancer center in Jordan. Data were collected using an electronic self-reported questionnaire include demographic data sheet and Collett-Lester fear of death scale, as well as all participants were invited via email for voluntary participation in this study.Result: The results revealed that the oncology nurses and physicians exhibited a moderate levels of death anxiety (CLDFODS = 91.07), furthermore, the result showed that female nurses and physicians exhibited a higher level of anxiety than male. Further, there were statistically significant differences in nurses’ and physicians’ level of death anxiety according to years of experience, receiving previous education on death and dying, and religious beliefs. On the other hand, there is no statistically significant differences in nurses’ and physicians’ level of death anxiety based on present or previous experience with loss of someone close to them.Conclusion: Jordanian oncology Nurses and physicians exhibited a moderate levels of death anxiety and fear of death, therefore, they have to address the inevitability of mortality since they are caring for dying patients frequently. They have to understand and acknowledge their thoughts regarding death and dying, as well as their death anxiety level before interacting with dying patients.

PMID:37184866 | DOI:10.1177/00302228231174573