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Nevin Manimala Statistics

Cognitive Behavioral Therapy for Veterans With Comorbid Posttraumatic Headache and Posttraumatic Stress Disorder Symptoms: A Randomized Clinical Trial

JAMA Neurol. 2022 Jun 27. doi: 10.1001/jamaneurol.2022.1567. Online ahead of print.

ABSTRACT

IMPORTANCE: Posttraumatic headache is the most disabling complication of mild traumatic brain injury. Posttraumatic stress disorder (PTSD) symptoms are often comorbid with posttraumatic headache, and there are no established treatments for this comorbidity.

OBJECTIVE: To compare cognitive behavioral therapies (CBTs) for headache and PTSD with treatment per usual (TPU) for posttraumatic headache attributable to mild traumatic brain injury.

DESIGN, SETTING, AND PARTICIPANTS: This was a single-site, 3-parallel group, randomized clinical trial with outcomes at posttreatment, 3-month follow-up, and 6-month follow-up. Participants were enrolled from May 1, 2015, through May 30, 2019; data collection ended on October 10, 2019. Post-9/11 US combat veterans from multiple trauma centers were included in the study. Veterans had comorbid posttraumatic headache and PTSD symptoms. Data were analyzed from January 20, 2020, to February 2, 2022.

INTERVENTIONS: Patients were randomly assigned to 8 sessions of CBT for headache, 12 sessions of cognitive processing therapy for PTSD, or treatment per usual for headache.

MAIN OUTCOMES AND MEASURES: Co-primary outcomes were headache-related disability on the 6-Item Headache Impact Test (HIT-6) and PTSD symptom severity on the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (PCL-5) assessed from treatment completion to 6 months posttreatment.

RESULTS: A total of 193 post-9/11 combat veterans (mean [SD] age, 39.7 [8.4] years; 167 male veterans [87%]) were included in the study and reported severe baseline headache-related disability (mean [SD] HIT-6 score, 65.8 [5.6] points) and severe PTSD symptoms (mean [SD] PCL-5 score, 48.4 [14.2] points). For the HIT-6, compared with usual care, patients receiving CBT for headache reported -3.4 (95% CI, -5.4 to -1.4; P < .01) points lower, and patients receiving cognitive processing therapy reported -1.4 (95% CI, -3.7 to 0.8; P = .21) points lower across aggregated posttreatment measurements. For the PCL-5, compared with usual care, patients receiving CBT for headache reported -6.5 (95% CI, -12.7 to -0.3; P = .04) points lower, and patients receiving cognitive processing therapy reported -8.9 (95% CI, -15.9 to -1.9; P = .01) points lower across aggregated posttreatment measurements. Adverse events were minimal and similar across treatment groups.

CONCLUSIONS AND RELEVANCE: This randomized clinical trial demonstrated that CBT for headache was efficacious for disability associated with posttraumatic headache in veterans and provided clinically significant improvement in PTSD symptom severity. Cognitive processing therapy was efficacious for PTSD symptoms but not for headache disability.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02419131.

PMID:35759281 | DOI:10.1001/jamaneurol.2022.1567

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Nevin Manimala Statistics

Estimating decay curves of neutralizing antibodies to SARS-CoV-2 infection

Math Med Biol. 2022 Jun 27:dqac008. doi: 10.1093/imammb/dqac008. Online ahead of print.

ABSTRACT

Estimating the longevity of an individual’s immune response to the SARS-Cov-2 virus is vital for future planning, particularly of vaccine requirements. Neutralizing antibodies (Nabs) are increasingly being recognized as a correlate of protection and while there are many studies that follow the response of a cohort of people, each study alone is not enough to predict the long-term response. Studies use different assays to measure Nabs, making them hard to combine. We present a modelling method that can combine multiple datasets and can be updated as more detailed data becomes available. Combining data from seven published datasets we predict that the NAb decay has two phases, an initial fast but short-lived decay period followed by a longer term and slower decay period.

PMID:35759280 | DOI:10.1093/imammb/dqac008

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Nevin Manimala Statistics

Geographical Differences and Temporal Improvements in Forced Expiratory Volume in 1 Second of Preterm-Born Children: A Systematic Review and Meta-analysis

JAMA Pediatr. 2022 Jun 27. doi: 10.1001/jamapediatrics.2022.1990. Online ahead of print.

ABSTRACT

IMPORTANCE: Although preterm birth is associated with later deficits in lung function, there is a paucity of information on geographical differences and whether improvements occur over time, especially after surfactant was introduced.

OBJECTIVE: To determine deficits in percentage predicted forced expiratory volume in 1 second (%FEV1) in preterm-born study participants, including those with bronchopulmonary dysplasia (BPD) in infancy, when compared with term-born control groups.

DATA SOURCES: Eight databases searched up to December 2021.

STUDY SELECTION: Studies reporting spirometry for preterm-born participants with or without a term-born control group were identified.

DATA EXTRACTION AND SYNTHESIS: Data were extracted and quality assessed by 1 reviewer and checked by another. Data were pooled using random-effects models and analyzed using Review Manager and the R metafor package.

MAIN OUTCOMES AND MEASURES: Deficits in %FEV1 between preterm-born and term groups. Associations between deficits in %FEV1 and year of birth, age, introduction of surfactant therapy, and geographical region of birth and residence were also assessed.

RESULTS: From 16 856 titles, 685 full articles were screened: 86 with and without term-born control groups were included. Fifty studies with term controls were combined with the 36 studies from our previous systematic review, including 7094 preterm-born and 17 700 term-born participants. Of these studies, 45 included preterm-born children without BPD, 29 reported on BPD28 (supplemental oxygen dependency at 28 days), 26 reported on BPD36 (supplemental oxygen dependency at 36 weeks’ postmenstrual age), and 86 included preterm-born participants. Compared with the term-born group, the group of all preterm-born participants (all preterm) had deficits of %FEV1 of -9.2%; those without BPD had deficits of -5.8%, and those with BPD had deficits of approximately -16% regardless of whether they had BPD28 or BPD36. As year of birth increased, there was a statistically significant narrowing of the difference in mean %FEV1 between the preterm- and term-born groups for the all preterm group and the 3 BPD groups but not for the preterm-born group without BPD. For the all BPD group, when compared with Scandinavia, North America and western Europe had deficits of -5.5% (95% CI, -10.7 to -0.3; P = .04) and -4.1% (95% CI, -8.8 to 0.5; P = .08), respectively.

CONCLUSIONS AND RELEVANCE: Values for the measure %FEV1 were reduced in preterm-born survivors. There were improvements in %FEV1 over recent years, but geographical region had an association with later %FEV1 for the BPD groups.

PMID:35759258 | DOI:10.1001/jamapediatrics.2022.1990

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Nevin Manimala Statistics

Stability of a fear effect predator-prey model with mutual interference or group defense

J Biol Dyn. 2022 Dec;16(1):480-498. doi: 10.1080/17513758.2022.2091800.

ABSTRACT

In this paper, we consider a fear effect predator-prey model with mutual interference or group defense. For the model with mutual interference, we show the interior equilibrium is globally stable, and the mutual interference can stabilize the predator-prey system. For the model with group defense, we discuss the singular dynamics around the origin and the occurrence of Hopf bifurcation, and find that there is a separatrix curve near the origin such that the orbits above which tend to the origin and the orbits below which tend to limit cycle or the interior equilibrium.

PMID:35759246 | DOI:10.1080/17513758.2022.2091800

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Nevin Manimala Statistics

Immunologic features of asymptomatic postvaccination infections with the Delta variant of SARS-CoV-2 in adults

Immun Inflamm Dis. 2022 Jul;10(7):e670. doi: 10.1002/iid3.670.

ABSTRACT

BACKGROUND: Asymptomatic infections may play an important role in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) Delta variant transmissions. However, the immunologic features of asymptomatic postvaccination infections with the Delta variant of SARS-CoV-2 in adults remain to be defined.

METHODS: A retrospective study involving 36 vaccinated adults infected with the SARS-CoV-2 Delta variant was performed. Their demographic and laboratory data were collected and analyzed in The First People’s Hospital of Jingmen from August 4 to 20, 2021.

RESULTS: Of the 36 adults, 6 persons had an asymptomatic infection. The severity of the SARS-CoV-2 infections was highly correlated with the doses of vaccinations (p = 0.019). The symptomatic and asymptomatic infected SARS-CoV-2 adults showed normal levels of leukocytes and lymphocytes. The C-reactive protein (CRP) and interleukin-6 (IL-6) levels were elevated in the symptomatic groups. The period between the last vaccination to the time of infection in the asymptomatic group was longer than that in the mild and moderate groups (73 vs. 61 vs. 50 days; p = 0.047). The percentage of suppressor T-cells in the asymptomatic group was the highest (32.2 ± 4.0% vs. 22.0 ± 7.2% vs. 29.3 ± 8.0%; p = 0.004). The signal-to-cutoff ratio value of total antibody against SARS-CoV-2 in the asymptomatic group was lower than that in the other two groups (383 vs. 703 vs. 1792; p < 0.001) and much lower than that in the moderate group. The multivariate ordinal logistic analysis after adjusting for gender, vaccination date, and vaccination dose indicated that CRP at Days 4-7 and 8-14, IL-6 on Days 4-7, and total antibody were risk factors for coronavirus disease 2019 severity.

CONCLUSIONS: Asymptomatic postvaccination infections with the Delta variant of SARS-CoV-2 in adults tend to infect persons vaccinated twice. The immunophenotype profile for asymptomatic postvaccination infections is less inflammatory and accompanied by relatively lower antibody titers.

PMID:35759224 | DOI:10.1002/iid3.670

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Nevin Manimala Statistics

R Statistics: survey and review of packages for the estimation of Rasch models

Int J Med Educ. 2022 Jun 24;13:171-175. doi: 10.5116/ijme.629d.d88f.

ABSTRACT

R Statistics is a comprehensive and widely-used suite of packages for statistical operations. From 27 R packages indexed with the word “Rasch”, 11 packages capable of Rasch estimation and analysis are identified and critiqued. A commercial Rasch application is included for comparison. Three R data frames are used. A larger and a smaller 0/1 data frame are analyzed with the Dichotomous Rasch Model. A polytomous 0/1/2 data frame is analyzed with the Partial Credit Model. The R packages can all use the same data frame. They are easy to use and mostly fast, though their documentation is generally skimpy. Every package has obvious shortcomings, but the unique features of each package could make them all useful. For general Rasch estimation and fit analysis of dichotomous data, three packages stand out: eRm, TAM and autoRasch. Two packages stand out for polytomous data: TAM and autoRasch.

PMID:35759222 | DOI:10.5116/ijme.629d.d88f

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Nevin Manimala Statistics

Assessment methods for interlaboratory comparisons of the dicentric assay

Int J Radiat Biol. 2022 Jun 27:1-24. doi: 10.1080/09553002.2022.2094021. Online ahead of print.

ABSTRACT

PURPOSE: To test the performance of different algorithms that can be used in interlaboratory comparisons based on dicentric chromosome analysis, and to evaluate the impact of considering a priori values different to calculate individual laboratory performance based on the ionizing radiation dose estimation.

METHODS: Mean and standard deviation estimations in inter-laboratory comparisons are tested on simulated data and data from previously published inter-laboratory comparisons using three robust algorithms, algorithm A, Algorithm B and Q/Hampel, all programmed in R-project language and implemented in a Shiny application. The simulated data were generated assuming three different probabilities to contaminate inter-laboratory comparisons samples with atypical dose values. Comparison between different algorithms was also done using published exercises where blood samples were irradiated at 0 and 0.7 Gy that represent a challenge for the assessment of an inter-laboratory comparison.

RESULTS: The best performance was obtained with the Q/Hampel algorithm for the estimation of the dose mean and with the algorithm B for the estimation of the dose standard deviation under the conditions tested in the simulations. The Q/Hampel algorithm showed the best performance when non-irradiated samples were evaluated and there was a high proportion of identical values. The presence identical values causes the Algorithm B to fail. Real examples illustrating the need to consider standard deviation priors, and the need to use algorithms resistant to a high proportion of identical values are presented.

CONCLUSIONS: Q/Hampel algorithm is a serious candidate to estimate the dose mean in the inter-laboratory comparisons, and to estimate both parameters when the proportion of identical values equals or higher than the half of the results. When the proportion of identical values is less than the half of the results, the Algorithm B should be considered as a candidate to estimate the standard deviation in the inter-laboratory comparisons with small number of laboratories. We remark that special attention is needed to establish prior definitions of standard deviation in the assessment of inter-laboratory dicentric assay comparisons.

PMID:35759221 | DOI:10.1080/09553002.2022.2094021

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Nevin Manimala Statistics

Short-term side effects of COVID-19 vaccines: A cross-sectional study in Jordan

Hum Vaccin Immunother. 2022 Jun 27:2082792. doi: 10.1080/21645515.2022.2082792. Online ahead of print.

ABSTRACT

The rapid manufacturing of vaccines has increased hesitancy toward receiving the COVID-19 vaccines. Clarifying what to expect after vaccination and revealing the possible side effects will lower hesitancy toward receiving the COVID-19 vaccine and increase public awareness. This descriptive cross-sectional survey-based study was conducted in Jordan (August 2021) to collect data on the short-term side effects following the COVID-19 vaccines. An extensive literature review was conducted by the research team to assist in developing the first draft of the survey. The survey was tested for face and content validity and piloted test to improve readability and clarity. The survey was organized into two sections (demographics and perceived COVID-19 vaccines’ side effects). Data were analyzed using the Statistical Package for Social Science (SPSS). A total of 1,044 participants were enrolled in the study. The most received vaccine among the participants was Pfizer-BioNTech (51.1%). The most frequently reported side effects were sore arm at the injection site (84.65%), fatigue (84.48%), discomfort (65.43%), muscles/joint pain (61.38%), drowsiness (58.73%), and headache (58.38%). More side effects were significantly associated with being older (p = 0.046), having an allergy (p = 0.024) or rheumatoid arthritis (p = 0.023), and participants who take NSAIDs regularly (p = 0.029). Short-term side effects of COVID-19 vaccines seem to be mostly local or transient in nature. Older age and certain comorbidities may increase susceptibility to side effects.

PMID:35759219 | DOI:10.1080/21645515.2022.2082792

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Nevin Manimala Statistics

Morphological, histological, and chemical analysis of first permanent molars with molar incisor malformation

Eur Arch Paediatr Dent. 2022 Jun 27. doi: 10.1007/s40368-022-00723-9. Online ahead of print.

ABSTRACT

PURPOSE: Molar incisor malformation (MIM) is a dental anomaly rendering first permanent molar pulps inflamed/necrotic at a young age. It often affects permanent incisors, primary second molars and less frequently other teeth. The purpose of this study was to investigate the anatomy and histology of MIM in seeking insight into its pathogenesis.

METHODS: Five MIM first permanent molars were examined with micro-computed tomography (micro-CT) for 3D morphology, with scanning electron microscopy for microanatomy, with energy-dispersive X-ray spectrometer (EDS) for chemical composition and for histology with optical microscopy. Composition differences were statistically determined using one-way ANOVA.

RESULTS: Micro-CT confirmed dentin abnormalities in the middle and cervical third of the crown in the form of the radiodense ‘cervical mineralized diaphragm’ (CMD). This was peripherally intertwined with enamel fjords and projections severely disrupting the integrity of pulp chamber and its continuity with root canals. EDS showed increased Ca in CMD compared to dentin. The histological examination revealed anomalous osteodentin-like hard tissue with denticles in the CMD.

CONCLUSION: An interconnection of anomalous cervical enamel with crown CMD dentin preceded to the severe pulp chamber and root dysplasias in MIM molar teeth.

PMID:35759186 | DOI:10.1007/s40368-022-00723-9

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Nevin Manimala Statistics

A meta-analysis on the association between obstructive sleep apnea and periodontitis

Sleep Breath. 2022 Jun 27. doi: 10.1007/s11325-022-02668-1. Online ahead of print.

ABSTRACT

PURPOSE: The present meta-analysis aimed to evaluate quantitively the recent scientific evidence regarding the association between obstructive sleep apnea (OSA) and periodontitis.

METHODS: Databases searched were PubMed, EMBASE, Scopus, and Web of Science. Publications were included according to the inclusion criteria. The following outcomes were evaluated: the prevalence of periodontitis, probing depth (PD), clinical attachment loss (CAL), the percentage of sites with bleeding on probing (BOP), plaque index (PI), and gingival index (GI). The statistical analysis was processed using the software STATA.

RESULTS: Thirteen eligible studies comprising a total of 31,800 patients were included. The meta-analysis showed an increased prevalence of periodontitis in OSA populations compared to controls. Both PD and CAL were increased in OSA populations compared with controls. (Prevalence of periodontitis: OR 2.348; 95%CI 2.221-2.482; PD: SMD = 0.681, 95% CI: 0.062-1.301, Z = 2.61, P = 0.031; CAL: SMD = 0.694, 95% CI: 0.167-1.22, Z = 2.58, P = 0.01). The study also found significantly increased BOP in patients with OSA after heterogeneity was clarified. (SMD = 0.357, 95% CI: 0.079-0.635, Z = 2.52, P = 0.012).

CONCLUSIONS: The findings suggest that OSA was associated with an increased prevalence of periodontitis.

PMID:35759182 | DOI:10.1007/s11325-022-02668-1