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Nevin Manimala Statistics

Substantive model compatible multilevel multiple imputation: A joint modeling approach

Stat Med. 2022 Aug 12. doi: 10.1002/sim.9549. Online ahead of print.

ABSTRACT

BACKGROUND: Substantive model compatible multiple imputation (SMC-MI) is a relatively novel imputation method that is particularly useful when the analyst’s model includes interactions, non-linearities, and/or partially observed random slope variables.

METHODS: Here we thoroughly investigate a SMC-MI strategy based on joint modeling of the covariates of the analysis model. We provide code to apply the proposed strategy and we perform an extensive simulation work to test it in various circumstances. We explore the impact on the results of various factors, including whether the missing data are at the individual or cluster level, whether there are non-linearities and whether the imputation model is correctly specified. Finally, we apply the imputation methods to the motivating example data.

RESULTS: SMC-JM appears to be superior to standard JM imputation, particularly in presence of large variation in random slopes, non-linearities, and interactions. Results seem to be robust to slight mis-specification of the imputation model for the covariates. When imputing level 2 data, enough clusters have to be observed in order to obtain unbiased estimates of the level 2 parameters.

CONCLUSIONS: SMC-JM is preferable to standard JM imputation in presence of complexities in the analysis model of interest, such as non-linearities or random slopes.

PMID:35959539 | DOI:10.1002/sim.9549

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Nevin Manimala Statistics

Systematic Literature Review of Text Messaging Interventions to Promote Medication Adherence Among People With Serious Mental Illness

Psychiatr Serv. 2022 Aug 12:appips202100634. doi: 10.1176/appi.ps.202100634. Online ahead of print.

ABSTRACT

OBJECTIVE: Mobile health tools are feasible options to encourage behavior change among patients with serious mental illness. Mobile health tools vary widely, both in platforms used and content delivered. This literature review assessed the use of text messaging interventions to promote medication adherence among patients with serious mental illness.

METHODS: A systematic literature review using PRISMA guidelines examined short message service (SMS) text messaging interventions promoting medication adherence to people with a serious mental illness diagnosis. Databases included PubMed, Cochrane, CINAHL, and PsycINFO. Data extraction included demographic information, participant diagnoses, intervention components, medication class, adherence measures, research design, and study outcomes. Study quality was also assessed.

RESULTS: Of 114 full-text articles screened, 10 articles were selected from nine unique interventions (N=937 people with serious mental illness). Study durations ranged from 30 days to 18 months, with frequency of SMS ranging from twice weekly to 12 times daily. Of the nine unique trials, most reported using an automated server to deliver SMS messages (N=7), two-way SMS capabilities (N=6), customized message content or timing (N=7), and additional components (e.g., provider contact, educational content, and monetary rewards) (N=7). Seven of the 10 articles reported statistically significant improvement in medication adherence and in at least one clinical outcome.

CONCLUSIONS: Evidence to date indicates that text messaging interventions are feasible and appear to improve medication adherence and clinical outcomes among patients with serious mental illness. Future research should assess implementation approaches and how to scale up efforts in nonresearch settings.

PMID:35959534 | DOI:10.1176/appi.ps.202100634

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Nevin Manimala Statistics

Mesophyll conductance response to short-term changes in pCO2 is related to leaf anatomy and biochemistry in diverse C4 grasses

New Phytol. 2022 Aug 12. doi: 10.1111/nph.18427. Online ahead of print.

ABSTRACT

Mesophyll CO2 conductance (gm ) in C3 species responds to short-term (minutes) changes in environment potentially due to changes in leaf anatomical and biochemical properties and measurement artifacts. Compared to C3 species, there is less information about gm responses to short-term changes in environmental conditions like pCO2 across diverse C4 species and the potential determinants of these responses. Using 16 C4 grasses we investigated the response of gm to short-term changes in pCO2 and its relationship with leaf anatomy and biochemistry. In general, gm increased as pCO2 decreased (statistically significant increase in 12 species), with percent increases in gm ranging from +13% to +250%. Greater increase in gm at low pCO2 was observed in species exhibiting relatively thinner mesophyll cell walls along with greater mesophyll surface area exposed to intercellular air spaces, leaf N, photosynthetic capacity and activities of phosphoenolpyruvate carboxylase and Rubisco. Species with greater CO2 response of gm were also able to maintain their leaf water-use efficiencies (TEi ) under low CO2 . Our study advances understanding about CO2 response of gm in diverse C4 species, identifies the key leaf traits related to this response and has implications for improving C4 photosynthetic models and TEi through modification of gm .

PMID:35959528 | DOI:10.1111/nph.18427

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Nevin Manimala Statistics

Relationship of microsatellite instability to mismatch repair deficiency in malignant tumors of dogs

J Vet Intern Med. 2022 Aug 11. doi: 10.1111/jvim.16454. Online ahead of print.

ABSTRACT

BACKGROUND: Microsatellite instability (MSI) is a type of genomic instability caused by mismatch repair deficiency (dMMR) in tumors. Studies on dMMR/MSI are limited, and the relationship between dMMR and MSI is unknown in tumors of dogs.

OBJECTIVES: We aimed to identify the frequency of dMMR/MSI by tumor type and evaluate the relationship between dMMR and MSI in tumors of dogs.

ANIMALS: In total, 101 dogs with 11 types of malignant tumors were included.

METHODS: We extracted DNA from fresh normal and tumor tissues. Twelve microsatellite loci from both normal and tumor DNA were amplified by PCR and detected by capillary electrophoresis. Each microsatellite (MS) was defined as MSI if a difference in product size between the tumor and normal DNA was detected. The dMMR was evaluated by immunohistochemistry with formalin-fixed paraffin-embedded tumor tissues. Next, we confirmed whether dMMR induces MSI by serial passaging of MMR gene knockout cell lines for 3 months.

RESULTS: Microsatellite instability was detected frequently in oral malignant melanoma. The number of MSI-positive markers was higher in cases with dMMR than in those with proficient MMR (P < .0001). Statistical analysis indicated that the occurrence of MSI in FH2305 might have relevance to dMMR. Furthermore, MSI occurred in dMMR cell lines 3 months after passaging.

CONCLUSIONS AND CLINICAL IMPORTANCE: Microsatellite instability and dMMR more frequently were found in oral malignant melanoma than in other tumors, and dMMR has relevance to MSI in both clinical cases and cell lines.

PMID:35959511 | DOI:10.1111/jvim.16454

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Nevin Manimala Statistics

Graph-based homogenisation for modelling cardiac fibrosis

J Comput Phys. 2022 Jun 15;459:None. doi: 10.1016/j.jcp.2022.111126.

ABSTRACT

Fibrosis, the excess of extracellular matrix, can affect, and even block, propagation of action potential in cardiac tissue. This can result in deleterious effects on heart function, but the nature and severity of these effects depend strongly on the localisation of fibrosis and its by-products in cardiac tissue, such as collagen scar formation. Computer simulation is an important means of understanding the complex effects of fibrosis on activation patterns in the heart, but concerns of computational cost place restrictions on the spatial resolution of these simulations. In this work, we present a novel numerical homogenisation technique that uses both Eikonal and graph approaches to allow fine-scale heterogeneities in conductivity to be incorporated into a coarser mesh. Homogenisation achieves this by deriving effective conductivity tensors so that a coarser mesh can then be used for numerical simulation. By taking a graph-based approach, our homogenisation technique functions naturally on irregular grids and does not rely upon any assumptions of periodicity, even implicitly. We present results of action potential propagation through fibrotic tissue in two dimensions that show the graph-based homogenisation technique is an accurate and effective way to capture fine-scale domain information on coarser meshes in the context of sharp-fronted travelling waves of activation. As test problems, we consider excitation propagation in tissue with diffuse fibrosis and through a tunnel-like structure designed to test homogenisation, interaction of an excitation wave with a scar region, and functional re-entry.

PMID:35959500 | PMC:PMC9352598 | DOI:10.1016/j.jcp.2022.111126

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Nevin Manimala Statistics

Expression of salivary immunoglobulins and their association with analgesic neuropeptide opiorphin in anorexia nervosa during adolescence

J Eat Disord. 2022 Aug 11;10(1):118. doi: 10.1186/s40337-022-00637-3.

ABSTRACT

BACKGROUND: Patients who suffer from anorexia nervosa (AN) are characterized by exceedingly lower body weight, micro- and macro-nutrient deficiencies, and hyposalivation as compared to healthy subjects. In addition, AN may predispose to difficulties in oral health maintenance. However, little is known about the relationship between stress-dependent salivary neuro/immunopeptidergic biomarkers such as opiorphin and immunoglobulins (Ig) and AN.The aim of this case-control study was to evaluate salivary opiorphin and immunoglobulins in female children and adolescents diagnosed with AN compared to healthy controls.

METHODS: Adolescent patients with clinically-confirmed severe restrictive subtype AN (Body Mass Index BMI < 15 kg/m2, mean age 15.0 ± 1.8, n = 83) were examined in the first week of hospital admission and compared to healthy matched controls (n = 79). Measurements of salivary opiorphin, IgA, IgG, IgM (ELISA technique), and oral hygiene levels (Plaque Control Record index-PCR) were performed.

RESULTS: In the AN group, a significantly higher concentration of opiorphin was evidenced (3.1 ± 4.1 ng/ml) compared to the control group (1.1 ± 1.2 ng/ml), (p < 0.001), contrary to IgM, which was significantly lower (311.0 ± 185.3 ng/ml) than in the control group (421.2 ± 168.1 ng/ml), (p < 0.001). There were no significant differences in the levels of IgA and IgG, despite a higher concentration of IgA in the AN group vs. controls (p = 0.14). Spearman analysis revealed a correlation between opiorphin and age (p < 0.05), but also with all immunoglobulins IgA, IgG, IgM (p = 0.006, p < 0.001, p < 0.001). Similarly a correlation was found between PCR index and immunoglobulins IgG, IgM (respectively p = 0.028, p < 0.001), and between body mass, BMI, IBW% and IgA, IgM (all p < 0.05).

CONCLUSIONS: In the acute phase of AN, salivary changes in opiorphin and immunoglobulins related to dental plaque suggest an essential role in oral health balance. Changes related to AN may affect the anti-inflammatory and analgesic components of saliva and suggest their use as neurobiological markers in severe malnutrition.

PMID:35953876 | DOI:10.1186/s40337-022-00637-3

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Nevin Manimala Statistics

Correction: Primary aim results of a clustered SMART for developing a school-level, adaptive implementation strategy to support CBT delivery at high schools in Michigan

Implement Sci. 2022 Aug 11;17(1):54. doi: 10.1186/s13012-022-01229-0.

NO ABSTRACT

PMID:35953861 | DOI:10.1186/s13012-022-01229-0

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Nevin Manimala Statistics

Risk of transmission of respiratory viruses during aerosol-generating medical procedures (AGMPs) revisited in the COVID-19 pandemic: a systematic review

Antimicrob Resist Infect Control. 2022 Aug 11;11(1):102. doi: 10.1186/s13756-022-01133-8.

ABSTRACT

BACKGROUND: In many jurisdictions healthcare workers (HCWs) are using respirators for aerosol-generating medical procedures (AGMPs) performed on adult and pediatric populations with all suspect/confirmed viral respiratory infections (VRIs). This systematic review assessed the risk of VRIs to HCWs in the presence of AGMPs, the role respirators versus medical/surgical masks have on reducing that risk, and if the risk to HCWs during AGMPs differed when caring for adult or pediatric patient populations.

MAIN TEXT: We searched MEDLINE, EMBASE, Cochrane Central, Cochrane SR, CINAHL, COVID-19 specific resources, and MedRxiv for English and French articles from database inception to September 9, 2021. Independent reviewers screened abstracts using pre-defined criteria, reviewed full-text articles, selected relevant studies, abstracted data, and conducted quality assessments of all studies using the ROBINS-I risk of bias tool. Disagreements were resolved by consensus. Thirty-eight studies were included; 23 studies on COVID-19, 10 on SARS, and 5 on MERS/ influenza/other respiratory viruses. Two of the 16 studies which assessed associations found that HCWs were 1.7 to 2.5 times more likely to contract COVID-19 after exposure to AGMPs vs. not exposed to AGMPs. Eight studies reported statistically significant associations for nine specific AGMPs and transmission of SARS to HCWS. Intubation was consistently associated with an increased risk of SARS. HCWs were more likely (OR 2.05, 95% CI 1.2-3.4) to contract human coronaviruses when exposed to an AGMP in one study. There were no reported associations between AGMP exposure and transmission of influenza or in a single study on MERS. There was limited evidence supporting the use of a respirator over a medical/surgical mask during an AGMP to reduce the risk of viral transmission. One study described outcomes of HCWs exposed to a pediatric patient during intubation.

CONCLUSION: Exposure to an AGMP may increase the risk of transmission of COVID-19, SARS, and human coronaviruses to HCWs, however the evidence base is heterogenous and prone to confounding, particularly related to COVID-19. There continues to be a significant research gap in the epidemiology of the risk of VRIs among HCWs during AGMPs, particularly for pediatric patients. Further evidence is needed regarding what constitutes an AGMP.

PMID:35953854 | DOI:10.1186/s13756-022-01133-8

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Nevin Manimala Statistics

Spatial distribution of vitamin A rich foods intake and associated factors among children aged 6-23 months in Ethiopia: spatial and multilevel analysis of 2019 Ethiopian mini demographic and health survey

BMC Nutr. 2022 Aug 11;8(1):77. doi: 10.1186/s40795-022-00573-0.

ABSTRACT

BACKGROUND: Inadequate micronutrients in the diet and vitamin A deficiency are worldwide public health problems. In developing regions, many preschool children are undernourished, become blind every year and died before the age of 23 months. This study was aimed to explore the spatial distribution of vitamin A rich foods intake among children aged 6-23 months and identify associated factors in Ethiopia.

METHODS: Ethiopian Mini Demographic and Health Survey 2019 dataset with a total 1407 children aged 6-23 months was used. Data management and processing were done using STATA version 15 software and Microsoft Office Excel. ArcMap version 10.7 software was used for mapping and spatial visualization of the distribution. Spatial scan statistics was performed using SaTScan version 9.5 software for Bernoulli-based model. Multilevel mixed effect logistic regression model was employed to identify associated factors.

RESULTS: Overall, 38.99% (95% CI: 36.46-41.62) of children aged 6- 23 months took vitamin A rich foods. Poor intake of vitamin A rich foods was significantly clustered Dire Dawa city, Somali and Harari regions of Ethiopia. Children aged 6-23 months lived in the primary cluster were 70% (RR = 1.70, P-value < 0.001) more likely to intake vitamin A rich foods than children lived outside the window. In the multilevel mixed effect logistic regression analysis, Primary educational status (AOR:1.42, 95% CI: 1.05, 1.93) and higher educational status (AOR:3.0, 95% CI: 1.59, 5.65) of mother, Dire Dawa (AOR:0.49, 95% CI: 0.22, 1.12) city, Afar (AOR: 0.16, 95% CI: 0.07, 0.36), Amhara (AOR: 0.37, 95% CI: 0.19, 0.71) and Somali (AOR: 0.02, 95% CI: 0.003, 0.08) regions of Ethiopia, children aged 13-23 months (AOR: 1.80, 95% CI: 1.28, 2.36), Mothers’ exposure to media (AOR: 1.41, 95% CI: 1.04, 1.92) were statistically significant factors for vitamin A rich foods intake among children aged 6-23 months.

CONCLUSIONS: Only 4 out of ten children took vitamin A rich foods which is too low compared to the national target and significantly clustered in Ethiopia. Mother’s educational status, Region, Child age and Mother’s media exposure are significant factors vitamin A rich foods intake. Stakeholders should strengthen mothers’ education status, creating awareness for mothers on child feeding and using locally available natural resource to produce vitamin A rich foods.

PMID:35953835 | DOI:10.1186/s40795-022-00573-0

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Nevin Manimala Statistics

Periodontal status of students living with disability in Amhara region, Ethiopia: a cross-sectional study

BMC Oral Health. 2022 Aug 11;22(1):343. doi: 10.1186/s12903-022-02377-x.

ABSTRACT

BACKGROUND: Periodontal disease is the most common oral health problem among individuals living with disabilities. Any physical impairment and/or mental handicap can compromise the capability to perform oral health care. Individuals with poor oral hygiene practice were prone to dental caries, periodontal disease, and upper respiratory tract infections. Despite the high prevalence of disabled people in Ethiopia, data are scarce about their periodontal status. The aim of this study was to determine the prevalence and determinant factors of periodontal disease among students living with disability in the Amhara region.

METHODS: A school-based cross-sectional study was done on eight special needs schools in Amhara regional state from November 30, 2020, to April 10, 2021. A simple random sampling technique using a computer random generator was employed to recruit the study participants. The participants were interviewed for sociodemographic characteristics, oral hygiene practice, type of disability, and medical condition through a pre-tested semi-structured questionnaire. The periodontal status of the participants was evaluated using the community periodontal index (CPI). Data entry was done using the Epi-data and analyzed using SPSS 26. Binary logistic regression analysis was used to identify the predictors of periodontal disease at a 5% level of significance.

RESULTS: A total of 443 study participants were involved with a mean age of 15.84 ± 3.882. Among these, 27.5% (95%CI 23.4-32.0) had a periodontal pocket depth of ≥ 4 mm, and 56.7% had bleeding on probing. The prevalence of periodontal disease was higher in participants with poor oral health status (52.2%), dental caries (34.8%), class-2 malocclusion (46.1%), and low monthly income (30.4%), visually impaired (30%), and mentally disorder (29.9%). Age of above 18 years (AOR = 3.41, 95%CI 1.40, 8.28), low family monthly income (AOR = 2.21; 95%CI 1.22, 4.03), malocclusion (AOR = 1.59, 95%CI 1.01, 2.54), poor oral health status (AOR = 9.41; 95%CI 4.92, 17.98), and dental caries (AOR = 1.85, 95%CI 1.21, 2.82) were independent predictors of periodontal disease.

CONCLUSIONS: A substantial amount of disabled school students in the study area had periodontal disease. The study found that there was a statistically significant association between age, family monthly income, malocclusion, oral health status, and dental caries with periodontal disease. The implementation of school oral health programs has a great benefit for the oral health status of disabled school students.

PMID:35953827 | DOI:10.1186/s12903-022-02377-x