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Nevin Manimala Statistics

Effects of a parental support intervention for parents in prison on child-parent relationship and criminal attitude-The For Our Children’s Sake pragmatic controlled study

PLoS One. 2023 Mar 23;18(3):e0283177. doi: 10.1371/journal.pone.0283177. eCollection 2023.

ABSTRACT

BACKGROUND: Children of incarcerated parents run a high risk for poor health and marginalisation across development where positive parenting comprises an essential protective factor. The For Our Children’s Sake (FOCS) intervention is delivered with incarcerated parents in Sweden to support parenting and healthy child development. This study aimed to explore the effects of the FOCS intervention on relationship quality between parent and child, parent criminal attitude and interest in treatment, while investigating intervention fidelity.

METHODS: The non-randomised non-blinded pragmatic controlled study was carried out during 2019-2020 in 15 prisons with 91 parents throughout Sweden. Group allocation was based on the set operation planning at each prison. Prisons delivering FOCS during the study period were recruited to the intervention group, whereas prisons delivering FOCS later were recruited to the control group. Outcomes were measured through parent-report at baseline September-December 2019 (T0), after intervention (T1) in January-April 2020, and at three-months follow-up in April-July in 2020 (T2). The primary outcome was relationship quality between incarcerated parent and child and secondary outcomes were criminal attitude, interest in other treatment programmes, and child-parent contact. Fidelity to intervention delivery was monitored through objectively rated audio recorded sessions by researchers, and by group-leader-reported logs. Group differences on outcome over time and at each time point were explored using mixed-model regression with repeated measures with an intention-to-treat approach and per protocol.

RESULTS: The intention-to-treat analysis showed favourable intervention effects over time for relationship quality, explained by a higher intervention group score at T2. An intervention effect was found for parental interest in other prison-delivered treatments at T2. The analysis per protocol found similar but stronger effects on the relationship quality and an additional intervention effect over time for criminal attitude, also explained by a significant group difference at T2. The effect on treatment interest did not reach statistical significance in the analysis per protocol. Group leaders reported that all sessions had been performed and the objective ratings of fidelity rendered overall acceptable delivery of the intervention.

CONCLUSIONS: The FOCS intervention had beneficial effects on relationship quality, and outcomes related to criminality which suggests that a parenting intervention for incarcerated parents has the potential to influence both parenting outcomes and outcomes related to a criminal lifestyle. Future studies should investigate intervention effectiveness on long-term outcomes related to both child health and parental recidivism. Further development of intervention components is suggested with the hypothesis to increase intervention effectiveness.

TRIAL REGISTRATION: ClinicalTrials.gov: No. NCT04101799, prospectively registered on September 24, 2019, Identifier: https://clinicaltrials.gov/ct2/show/NCT04101799, The authors confirm that all ongoing and related trials for this intervention are registered.

PMID:36952468 | DOI:10.1371/journal.pone.0283177

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Nevin Manimala Statistics

Reading fluency and statistical learning across modalities and domains: Online and offline measures

PLoS One. 2023 Mar 23;18(3):e0281788. doi: 10.1371/journal.pone.0281788. eCollection 2023.

ABSTRACT

The vulnerability of statistical learning has been demonstrated in reading difficulties in both the visual and acoustic modalities. We examined segmentation abilities of Hungarian speaking adolescents with different levels of reading fluency in the acoustic verbal and visual nonverbal domains. We applied online target detection tasks, where the extent of learning is reflected in differences between reaction times to predictable versus unpredictable targets. Explicit judgments of well-formedness were also elicited in an offline two-alternative forced choice (2AFC) task. Learning was evident in both the acoustic verbal and visual nonverbal tasks, both in online and offline measures, but learning effects were larger both in online and offline tasks in the verbal acoustic condition. We haven’t found evidence for a significant relationship between statistical learning and reading fluency in adolescents in either modality. Together with earlier findings, these results suggest that the relationship between reading and statistical learning is dependent on the domain, modality and nature of the statistical learning task, on the reading task, on the age of participants, and on the specific language. The online target detection task is a promising tool which can be adapted to a wider set of tasks to further explore the contribution of statistical learning to reading acquisition in participants from different populations.

PMID:36952465 | DOI:10.1371/journal.pone.0281788

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Nevin Manimala Statistics

More emergency patients presenting with chest pain

PLoS One. 2023 Mar 23;18(3):e0283454. doi: 10.1371/journal.pone.0283454. eCollection 2023.

ABSTRACT

INTRODUCTION: Throughout recent years the demand for prehospital emergency care has increased significantly. Non-traumatic chest pain is one of the most frequent complaints. Our aim was to investigate the trend in frequency of the most urgent ambulance patients with chest pain, subsequent acute myocardial infarction (AMI) diagnoses, and 48-hour and 30-day mortality of both groups.

METHODS: Population-based historic cohort study in the North Denmark Region during 2012-2018 including chest pain patients transported to hospital by highest urgency level ambulance following a 1-1-2 emergency call. Primary diagnoses (ICD-10) were retrieved from the regional Patient Administrative System, and descriptive statistics (distribution, frequency) performed. We evaluated time trends using linear regression, and mortality (48 hours and 30 days) was assessed by the Kaplan Meier estimator.

RESULTS: We included 18,971 chest pain patients, 33.9% (n = 6,430) were diagnosed with”Diseases of the circulatory system” followed by the non-specific R- (n = 5,288, 27.8%) and Z-diagnoses (n = 3,634; 19.2%). AMI was diagnosed in 1,967 patients (10.4%), most were non-ST-elevation AMI (39.7%). Frequency of chest pain patients and AMI increased 255 and 22 patients per year respectively, whereas the AMI proportion remained statistically stable, with a tendency towards a decrease in the last years. Mortality at 48 hours and day 30 in chest pain patients was 0.7% (95% CI 0.5% to 0.8%) and 2.4% (95% CI 2.1% to 2.6%).

CONCLUSIONS: The frequency of chest pain patients brought to hospital during 2012-2018 increased. One-tenth were diagnosed with AMI, and the proportion of AMI patients was stable. Almost 1 in of 4 high urgency level ambulances was sent to chest pain patients. Only 1 of 10 patients with chest pain had AMI, and overall mortality was low. Thus, monitoring the number of chest pain patients and AMI diagnoses should be considered to evaluate ambulance utilisation and triage.

PMID:36952460 | DOI:10.1371/journal.pone.0283454

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Nevin Manimala Statistics

Glycemic control and diabetes complications among adult type 2 diabetic patients at public hospitals in Hadiya zone, Southern Ethiopia

PLoS One. 2023 Mar 23;18(3):e0282962. doi: 10.1371/journal.pone.0282962. eCollection 2023.

ABSTRACT

BACKGROUND: Diabetes is one of the biggest worldwide health emergencies of the 21st century. A major goal in the management of diabetes is to prevent diabetic complications that occur as a result of poor glycemic control. Identification of factors contributing to poor glycemic control is key to institute suitable interventions for glycemic control and prevention of chronic complications.

METHODS: A hospital-based cross-sectional study was conducted among 305 adult type 2 diabetic patients at public hospitals in Hadiya zone from March 1-30, 2019. The study participants were selected by systematic sampling technique. Data were collected using a pretested structured questionnaire and patient chart review; anthropometric and blood pressure measurements were taken. Multivariable logistic regression analysis was used to identify factors associated with poor glycemic control. Adjusted odds ratios (AOR) with respective 95% Confidence Interval (CI) and p < 0.05 were used to set statistically significant variables.

RESULTS: Out of 305 diabetic patients, 222 (72.8%) were found to have poor glycemic control. Longer duration of diabetes (5-10 years) [AOR = 2.24, 95% CI: 1.17-4.27], lack of regular follow-up [AOR = 2.89, 95% CI: 1.08-7.71], low treatment adherence [AOR = 4.12, 95% CI: 1.20-8.70], use of other alternative treatments [AOR = 3.58, 95% CI: 1.24-10.36], unsatisfactory patient physician relationship [AOR = 2.27, 95% CI: 1.27-4.04], and insufficient physical activity [AOR = 4.14, 95% CI: 2.07-8.28] were found to be independent predictors of poor glycemic control. Diabetes Mellitus (DM) complications were slightly higher among participants with poor glycemic control (39.2%), duration of DM 10 and above years (41.9%), low medication adherence (48.5%), taking oral anti-diabetics (54.3%), and DM patients having unsatisfactory patient provider relationship (72.4%).

CONCLUSION: A significant proportion of diabetic patients had poor glycemic control and DM complications. Therefore, appropriate interventions are required to maintain optimal glycemic control and prevent the development of life-threatening complications among DM patients.

PMID:36952453 | DOI:10.1371/journal.pone.0282962

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Nevin Manimala Statistics

Completeness of Reporting in Diet- and Nutrition-Related Randomized Controlled Trials and Systematic Reviews With Meta-Analysis: Protocol for 2 Independent Meta-Research Studies

JMIR Res Protoc. 2023 Mar 23;12:e43537. doi: 10.2196/43537.

ABSTRACT

BACKGROUND: Journal articles describing randomized controlled trials (RCTs) and systematic reviews with meta-analysis of RCTs are not optimally reported and often miss crucial details. This poor reporting makes assessing these studies’ risk of bias or reproducing their results difficult. However, the reporting quality of diet- and nutrition-related RCTs and meta-analyses has not been explored.

OBJECTIVE: We aimed to assess the reporting completeness and identify the main reporting limitations of diet- and nutrition-related RCTs and meta-analyses of RCTs, estimate the frequency of reproducible research practices among these RCTs, and estimate the frequency of distorted presentation or spin among these meta-analyses.

METHODS: Two independent meta-research studies will be conducted using articles published in PubMed-indexed journals. The first will include a sample of diet- and nutrition-related RCTs; the second will include a sample of systematic reviews with meta-analysis of diet- and nutrition-related RCTs. A validated search strategy will be used to identify RCTs of nutritional interventions and an adapted strategy to identify meta-analyses in PubMed. We will search for RCTs and meta-analyses indexed in 1 calendar year and randomly select 100 RCTs (June 2021 to June 2022) and 100 meta-analyses (July 2021 to July 2022). Two reviewers will independently screen the titles and abstracts of records yielded by the searches, then read the full texts to confirm their eligibility. The general features of these published RCTs and meta-analyses will be extracted into a research electronic data capture database (REDCap; Vanderbilt University). The completeness of reporting of each RCT will be assessed using the items in the CONSORT (Consolidated Standards of Reporting Trials), its extensions, and the TIDieR (Template for Intervention Description and Replication) statements. Information about practices that promote research transparency and reproducibility, such as the publication of protocols and statistical analysis plans will be collected. There will be an assessment of the completeness of reporting of each meta-analysis using the items in the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) statement and collection of information about spin in the abstracts and full-texts. The results will be presented as descriptive statistics in diagrams or tables. These 2 meta-research studies are registered in the Open Science Framework.

RESULTS: The literature search for the first meta-research retrieved 20,030 records and 2182 were potentially eligible. The literature search for the second meta-research retrieved 10,918 records and 850 were potentially eligible. Among them, random samples of 100 RCTs and 100 meta-analyses were selected for data extraction. Data extraction is currently in progress, and completion is expected by the beginning of 2023.

CONCLUSIONS: Our meta-research studies will summarize the main limitation on reporting completeness of nutrition- or diet-related RCTs and meta-analyses and provide comprehensive information regarding the particularities in the reporting of intervention studies in the nutrition field.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/43537.

PMID:36951931 | DOI:10.2196/43537

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Nevin Manimala Statistics

Simple, accurate, adjustable-parameter-free prediction of NMR shifts for molecules in solution

Phys Chem Chem Phys. 2023 Mar 23. doi: 10.1039/d3cp00721a. Online ahead of print.

ABSTRACT

Accurate prediction of NMR shifts is invaluable for interpreting and assigning NMR spectra, especially for complex applications such as determining the identity of unknown substances or resolving stereochemical assignments. Statistical linear regression models have proven effective for accurately correlating density functional theory predictions of chemical shieldings with experimentally-measured shifts, but lack transferability – they must be reparameterised using a reasonably extensive training set at each level of theory and for each choice of NMR solvent. We have previously introduced a novel two-point “shift-and-scale” correction procedure for gas phase shieldings that overcomes these limitations without significant loss of accuracy. In this work, we demonstrate that this approach is equally applicable for predicting solution-phase shifts from computed gas phase shieldings, using acetaldehyde as an experimentally and computationally convenient reference system. We also present all of the required experimental reference data to enable this approach to be used for any target analyte in a range of commonly used NMR solvents (chloroform, dichloromethane, acetonitrile, methanol, acetone, DMSO, D2O, benzene, pyridine).

PMID:36951928 | DOI:10.1039/d3cp00721a

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Nevin Manimala Statistics

Smartphone-Tracked Digital Markers of Momentary Subjective Stress in College Students: Idiographic Machine Learning Analysis

JMIR Mhealth Uhealth. 2023 Mar 23;11:e37469. doi: 10.2196/37469.

ABSTRACT

BACKGROUND: Stress is an important predictor of mental health problems such as burnout and depression. Acute stress is considered adaptive, whereas chronic stress is viewed as detrimental to well-being. To aid in the early detection of chronic stress, machine learning models are increasingly trained to learn the quantitative relation from digital footprints to self-reported stress. Prior studies have investigated general principles in population-wide studies, but the extent to which the findings apply to individuals is understudied.

OBJECTIVE: We aimed to explore to what extent machine learning models can leverage features of smartphone app use log data to recognize momentary subjective stress in individuals, which of these features are most important for predicting stress and represent potential digital markers of stress, the nature of the relations between these digital markers and stress, and the degree to which these relations differ across people.

METHODS: Student participants (N=224) self-reported momentary subjective stress 5 times per day up to 60 days in total (44,381 observations); in parallel, dedicated smartphone software continuously logged their smartphone app use. We extracted features from the log data (eg, time spent on app categories such as messenger apps and proxies for sleep duration and onset) and trained machine learning models to predict momentary subjective stress from these features using 2 approaches: modeling general relations at the group level (nomothetic approach) and modeling relations for each person separately (idiographic approach). To identify potential digital markers of momentary subjective stress, we applied explainable artificial intelligence methodology (ie, Shapley additive explanations). We evaluated model accuracy on a person-to-person basis in out-of-sample observations.

RESULTS: We identified prolonged use of messenger and social network site apps and proxies for sleep duration and onset as the most important features across modeling approaches (nomothetic vs idiographic). The relations of these digital markers with momentary subjective stress differed from person to person, as did model accuracy. Sleep proxies, messenger, and social network use were heterogeneously related to stress (ie, negative in some and positive or zero in others). Model predictions correlated positively and statistically significantly with self-reported stress in most individuals (median person-specific correlation=0.15-0.19 for nomothetic models and median person-specific correlation=0.00-0.09 for idiographic models).

CONCLUSIONS: Our findings indicate that smartphone log data can be used for identifying digital markers of stress and also show that the relation between specific digital markers and stress differs from person to person. These findings warrant follow-up studies in other populations (eg, professionals and clinical populations) and pave the way for similar research using physiological measures of stress.

PMID:36951924 | DOI:10.2196/37469

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Nevin Manimala Statistics

Identifying Unique Symptom Groups Following Mild Traumatic Brain Injury Using the Neurobehavioral Symptom Inventory and PTSD Checklist-5 in Military Personnel: A Bifactor Analysis

J Head Trauma Rehabil. 2023 Mar 23. doi: 10.1097/HTR.0000000000000854. Online ahead of print.

ABSTRACT

OBJECTIVE: To identify both shared and unique groups of posttraumatic stress and postconcussive symptoms using bifactor analysis.

SETTING: Two large military outpatient traumatic brain injury (TBI) rehabilitation clinics in the Southwestern United States.

PARTICIPANTS: A sample of 1476 Active Duty Service Members seeking treatment for a mild TBI sustained more than 30 days previously, without history of moderate or severe TBI, who completed measures of postconcussive and posttraumatic stress symptoms assessed at clinic intake.

DESIGN: Observational, correlational study with data taken from an institutional review board-approved clinical registry study.

MAIN MEASURES: Neurobehavioral Symptom Inventory (NSI) and Posttraumatic Stress Disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-V) (PCL-5). Concurrent measures were Patient Health Questionnaire (PHQ-8), Pittsburgh Sleep Quality Index (PSQI), and Headache Impact Test (HIT-6).

RESULTS: Results identified a bifactor model demonstrating unique posttraumatic stress, depressive, cognitive, and neurological/somatic symptom groups that were still evident after accounting for a universal factor representing general distress. These symptom groups were differentially related to concurrently measured clinical outcomes.

CONCLUSION: Use of a bifactor structure may help derive clinically useful signals from self-reported symptoms among Active Duty Service Members seeking outpatient treatment for mild TBI.

PMID:36951920 | DOI:10.1097/HTR.0000000000000854

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Nevin Manimala Statistics

Establishing breakpoints for amoxicillin/clavulanate and ampicillin/sulbactam for rapid antimicrobial susceptibility testing directly from positive blood culture bottles

J Med Microbiol. 2023 Mar;72(3). doi: 10.1099/jmm.0.001672.

ABSTRACT

Introduction. In 2018, EUCAST released guidelines on rapid antimicrobial susceptibility testing (RAST) directly from positive blood culture bottles for selected bacterial species and antimicrobial agents, but not for the commonly used agents amoxicillin/clavulanate (AMC) and ampicillin/sulbactam (SAM).Hypothesis/Gap statement. This work addresses the Enterobacterales RAST capability gap for betalactam/betalactamase inhibitor combinations.Aim. We aimed to determine RAST breakpoints for AMC and SAM for Escherichia coli and Klebsiella pneumoniae after 4 and 6 h of incubation directly from positive blood cultures.Methodology. Blood culture bottles were spiked with clinical isolates of E. coli (n=89) and K. pneumoniae (n=81). RAST was performed according to EUCAST guidelines and zones were read after 4 and 6 h. Breakpoints were defined to avoid very major errors.Results. The proportion of readable zone diameters after 4 h of incubation were 90.8 % in E. coli and 85.8 % in K. pneumoniae isolates. After 6 h of incubation all zone diameters could be read. The proposed breakpoints for E. coli after 6 h of incubation were ≥16 mm S (susceptible), 14-15 mm ATU (area of technical uncertainty) and <14 mm R (resistant) for AMC; ≥15 mm S, 12-14 mm ATU and <12 mm R for SAM; for K. pneumoniae these were ≥16 mm S, 14-15 mm ATU and <14 mm R for AMC; ≥13 mm S, 12 mm ATU, <12 mm R for SAM. Applying our newly set breakpoints, major errors were infrequent (2.6 %).Conclusion. We propose novel AMC and SAM breakpoints for RAST directly from positive blood cultures for reading after 4 and 6 h of incubation.

PMID:36951904 | DOI:10.1099/jmm.0.001672

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Nevin Manimala Statistics

Advantages of analysing both pairwise SNV-distance and differing SNVs between Mycobacterium tuberculosis isolates for recurrent tuberculosis cause determination

Microb Genom. 2023 Mar;9(3). doi: 10.1099/mgen.0.000956.

ABSTRACT

Endogenous reactivation and exogenous reinfection are two possible causes of recurrent tuberculosis (TB). However, in some cases, precise cause determination can be challenging. In this study, we used whole genome sequencing to determine pairwise SNV distances and detect differing SNVs in initial and subsequent isolates for recurrent TB cases when the first and second episodes were caused by Mycobacterium tuberculosis (Mtb) strains with an identical spoligotype pattern. In total, 104 Mtb isolates from 36 recurrent TB and 16 single TB episode patients were included in the study. Most isolate pairs belonged to the SIT1 (n=21), SIT42 (n=9), SIT53 (n=9), and SIT254 (n=7) spoligotypes, and in 27 cases, resistance to at least one anti-TB drug was found in either isolate. Drug susceptibility was more common in the recurrent TB patient cohort, and longitudinal single TB episode isolates were more prone to be drug-resistant (p=0.03), while the association between patient cohort and spoligotype was not statistically significant (p=0.07). The pairwise SNV-distance between the longitudinal single TB episode isolates was small (0-7 SNVs). Among the recurrent TB isolates, based on the high SNV-distance (38-273 SNVs), six reinfection cases (16.7%) were identified. This distance was small (<10 SNVs) in the remaining 30 isolate pairs. Further analysis of differing SNVs revealed that 22 (61.1%) cases could be classified as possible reactivation. Notably, despite the small distance of 2-7 SNVs, initial isolates of eight patients (22.2%) had several SNVs that were not found in the second isolates; therefore, these cases were classified as reinfection with a closely related Mtb strain. No statistically significant difference in the time interval between specimen collection in the reactivation and reinfection Mtb sample groups (p=0.13) or an association between recurrence cause and drug resistance status (p=0.62) or spoligotype (p=0.79) could be detected. The mycobacterial median mutation rate of longitudinal single TB episodes and possible reactivation isolate pairs (n=37) was 0.12 SNVs/genome/year (IQR 0-0.39), and in 18 cases (48.6%), it was equal to zero. No statistically significant differences in mutation rate were found between recurrent TB and longitudinal single TB episode isolates (p=0.087), drug-susceptible and resistant isolates (p=0.37) or isolates of Beijing and other genotype families (p=0.33). Furthermore, four cases of fluoroquinolone resistance development through the acquired SNVs in the gyrA gene were identified. To conclude, this study highlighted the complexity of recurrent episode cause determination and showed the usefulness of differing SNV identification in both Mtb isolates in such cases. Expected drug susceptibility was the only discriminative factor for recurrent TB episode-causing mycobacterial strains, while no differences between reactivation and reinfection sample groups could be identified.

PMID:36951900 | DOI:10.1099/mgen.0.000956