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Nevin Manimala Statistics

Impact of adherence to CKD-MBD guidelines on mortality among Japanese dialysis patients: an ecological study

J Bone Miner Metab. 2022 Jun 27. doi: 10.1007/s00774-022-01351-5. Online ahead of print.

ABSTRACT

INTRODUCTION: This study evaluated the association between prefecture-level achievement of chronic kidney disease-mineral and bone disorder (CKD-MBD) parameter targets and mortality in Japanese dialysis patients.

MATERIALS AND METHODS: We conducted an ecological study of all prefectures in Japan using data from the Japanese Society of Dialysis Therapy and National Vital Statistics between 2016 and 2017. We calculated adherence rates to recommend target ranges for CKD-MBD parameters, including phosphate, corrected calcium, and parathyroid hormone (PTH), and explored associations of these rates with prefecture-specific standardized mortality rates (SMRs) among the general population and among prevalent dialysis patients using bivariate association analysis and structural equation modeling.

RESULTS: Prefecture-level adherence to the target phosphate range was significantly and negatively associated with prefecture-specific SMRs in men (standardized estimate (β) = – 0.61, p < 0.001) and women (β = – 0.41, p < 0.001). However, prefecture-level adherence to the target corrected calcium range was significantly and negatively associated with prefecture-specific SMRs only in men (β = – 0.28, p = 0.01). Meanwhile, prefecture-level adherence to the target PTH range was significantly and positively associated with prefecture-specific SMRs in men (β = 0.23, p = 0.04). Prefecture-level SMRs of females in the general population had a significant impact on prefecture-level SMRs of female dialysis patients (β = 0.27, p = 0.03). The models explained 52% of variance in SMR for men and 33% for women.

CONCLUSION: A higher prefecture-level achievement rate of the target phosphate range recommended by the Japanese CKD-MBD guidelines was associated with a lower prefecture-specific SMR in the Japanese dialysis population.

PMID:35759144 | DOI:10.1007/s00774-022-01351-5

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Nevin Manimala Statistics

Oral iron supplementation in patients with heart failure: a systematic review and meta-analysis

ESC Heart Fail. 2022 Jun 27. doi: 10.1002/ehf2.14020. Online ahead of print.

ABSTRACT

AIMS: This review aimed to assess whether oral iron supplementation in a chronic heart failure (HF) population with iron deficiency (ID) or mild anaemia is safe and effective according to evidence-based medicine.

METHODS: We retrieved 1803 records from the PubMed, Embase, and the Cochrane Library databases from 1 January 1991 to 15 September 2021. The clinical outcome of oral iron supplementation for ID anaemia in patients with HF was the primary endpoint. The primary safety measures included adverse events and all-cause mortality, and efficacy measures included transferrin saturation (Tsat), ferritin levels, and the 6-min walk test (6MWT). The rate ratio (RR) was used to pool the efficacy measures.

RESULTS: Five randomized controlled trials that compared oral iron treatment for patients with the placebo group and included a combined total of 590 participants were analysed. No significant difference was found in all-cause death between oral iron treatment and placebo groups (RR = 0.77; 95% confidence intervals (CI), 0.46-1.29, Z = 0.98; P = 0.33). However, adverse events were not significantly higher in the iron treatment group (RR = 0.83; 95% CI, 0.60-1.16, Z = 1.07; P = 0.28). In addition, ferritin levels and Tsat were slightly increased after iron complex administration in patients with HF but were not statistically significant (ferritin: mean difference [MD] = 2.70, 95% CI, -2.41 to 7.81, Z = 1.04; P = 0.30; Tsat: MD = 27.42, 95% CI, -4.93 to 59.78, Z = 1.66; P = 0.10). No significant difference was found in exercise capacity, as indicated by the 6MWT results (MD = 59.60, 95% CI, -17.89 to 137.08, Z = 1.51; P = 0.13). We also analysed two non-randomized controlled trials with follow-up results showing that oral iron supplementation increased serum iron levels (MD = 28.87, 95% CI, 1.62-56.12, Z = 2.08; P = 0.04).

CONCLUSIONS: Based on the current findings, oral iron supplementation can increase serum iron levels in patients with HF and ID or mild anaemia but does not improve Tsat and 6MWT. In addition, oral iron supplementation is relatively safe.

PMID:35758130 | DOI:10.1002/ehf2.14020

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Nevin Manimala Statistics

Quantification of behavioral data with effect sizes and statistical significance tests

J Appl Behav Anal. 2022 Jun 27. doi: 10.1002/jaba.938. Online ahead of print.

ABSTRACT

This article describes the use of statistical significance tests and distance-based effect sizes with behavioral data from single case experimental designs (SCEDs). Such data often are interpreted only with visual analysis. However, a growing movement in the field is to quantify results to improve decision-making and communication across studies and sciences. The goal of the present study was to assess the agreement between visual analysis and various statistical tests. We recruited visual analysts to judge 160 pairwise data sets from published articles and compared these analyses to significance tests and effect sizes. One-tailed significance testing of Tau z and the percentage of pairwise differences in the predicted direction (PWD) generally agreed with each other, and complemented the effect sizes of Ratio of Distances (RD) and g. Visual analysis was somewhat unreliable and should be combined with statistical complements to maximize decision accuracy.

PMID:35758067 | DOI:10.1002/jaba.938

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Nevin Manimala Statistics

Automated bone healing evaluation: New approach to histomorphometric analysis

Microsc Res Tech. 2022 Jun 27. doi: 10.1002/jemt.24188. Online ahead of print.

ABSTRACT

This study aimed to assess different approaches for bone healing evaluation on histological images and to introduce a new automatic evaluation method based on segmentation with distinct thresholds. We evaluated the hyperbaric oxygen therapy (HBO) effects on bone repair in type 1 diabetes mellitus rats. Twelve animals were divided into four groups (n = 3): non-diabetic, non-diabetic + HBO, diabetic, and diabetic + HBO. Diabetes was induced by intravenous administration of streptozotocin (50 mg/kg). Bone defects were created in femurs and HBO was immediately started at one session/day. After 7 days, the animals were euthanized, femurs were removed, demineralized, and embedded in paraffin. Histological sections were stained with hematoxylin and eosin (HE) and Mallory’s trichrome (MT), and evaluated using three approaches: (1) conventional histomorphometric analysis (HE images) using a 144-point grid to quantify the bone matrix; (2) a semi-automatic method based on bone matrix segmentation to assess the bone matrix percentage (MT images); and (3) automatic approach, with the creation of a plug-in for ImageJ software. The time required to perform the analysis in each method was measured and subjected to Bland-Altman statistical analysis. All three methods were satisfactory for measuring bone formation and were not statistically different. The automatic approach reduced the working time compared to visual grid and semi-automated method (p < .01). Although histological evaluation of bone healing was performed successfully using all three methods, the novel automatic approach significantly shortened the time required for analysis and had high accuracy.

PMID:35758056 | DOI:10.1002/jemt.24188

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Nevin Manimala Statistics

Epigenetic rewiring of pathways related to odour perception in immune cells exposed to SARS-CoV-2 in vivo and in vitro

Epigenetics. 2022 Jun 26:1-17. doi: 10.1080/15592294.2022.2089471. Online ahead of print.

ABSTRACT

A majority of SARS-CoV-2 recoverees develop only mild-to-moderate symptoms, while some remain completely asymptomatic. Although viruses, including SARS-CoV-2, may evade host immune responses by epigenetic mechanisms including DNA methylation, little is known about whether these modifications are important in defence against and healthy recovery from COVID-19 in the host. To this end, epigenome-wide DNA methylation patterns from COVID-19 convalescents were compared to uninfected controls from before and after the pandemic. Peripheral blood mononuclear cell (PBMC) DNA was extracted from uninfected controls, COVID-19 convalescents, and symptom-free individuals with SARS-CoV-2-specific T cell-responses, as well as from PBMCs stimulated in vitro with SARS-CoV-2. Subsequently, the Illumina MethylationEPIC 850K array was performed, and statistical/bioinformatic analyses comprised differential DNA methylation, pathway over-representation, and module identification analyses. Differential DNA methylation patterns distinguished COVID-19 convalescents from uninfected controls, with similar results in an experimental SARS-CoV-2 infection model. A SARS-CoV-2-induced module was identified in vivo, comprising 66 genes of which six (TP53, INS, HSPA4, SP1, ESR1, and FAS) were present in corresponding in vitro analyses. Over-representation analyses revealed involvement in Wnt, muscarinic acetylcholine receptor signalling, and gonadotropin-releasing hormone receptor pathways. Furthermore, numerous differentially methylated and network genes from both settings interacted with the SARS-CoV-2 interactome. Altered DNA methylation patterns of COVID-19 convalescents suggest recovery from mild-to-moderate SARS-CoV-2 infection leaves longstanding epigenetic traces. Both in vitro and in vivo exposure caused epigenetic modulation of pathways thataffect odour perception. Future studies should determine whether this reflects host-induced protective antiviral defense or targeted viral hijacking to evade host defence.

PMID:35758003 | DOI:10.1080/15592294.2022.2089471

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Nevin Manimala Statistics

Social robots in the instruction of social skills in autism: a comprehensive descriptive analysis of single-case experimental designs

Disabil Rehabil Assist Technol. 2022 Jun 26:1-20. doi: 10.1080/17483107.2022.2087772. Online ahead of print.

ABSTRACT

PURPOSE: The rapid technological advances, the traits of individuals with ASD and their interest in technology are promising for the instruction of social skills to individuals with autism spectrum disorder (ASD) using various technological interventions. Robotic interventions are among these. However, although robotics is frequently used with individuals with ASD, there is a limited number of reviews on social skills instruction and methods. The present study aimed to conduct a comprehensive descriptive analysis on single-case experimental designs where social skills were instructed to individuals with ASD and social robots were included as independent variables.

MATERIALS AND METHODS: Thirteen single-case experimental designs published in peer-reviewed journals in which social skills were taught to individuals with ASD using social robots were reviewed with a comprehensive descriptive analysis based on five categories: (a) key characteristics, (b) methodological characteristics, (c) findings, (d) data analysis, and (e) key parameters in single-case experimental designs.

RESULTS: Social robots are generally effective in the instruction of social skills. Several social skills (e.g., making eye contact, social interaction, simple greetings) were instructed in the studies. Humanoid robots and NAO were used generally. The study data were predominantly analyzed statistically. There were several problems in research based on the basic parameters in single-case experimental designs.

CONCLUSIONS: The researches in this study differ in several respects (e.g., results, data analysis, and dependent variable). Thus, there is still a need for several robotics studies in the instruction of social skills. IMPLICATIONS FOR REHABILITATIONThis study will be a guide for teachers who currently use robots in their classrooms but do not know which skills to use in teaching and how to use them functionally, as it shows applied research with robots.The findings of this research will show implementers working with children with ASD that technological tools can be used in rehabilitation environments, and that teachers can take a place in their robots in interventions for children with ASD, giving them a different perspective.It will be seen that the education of children with ASD is not only 1:1 and with humans, but robots can also provide education. In this way, the power of technology in teaching will become clearer. Especially in rehabilitation.Finally, this research will offer new options in teaching especially for teachers who aim at teaching social skills and will give them the opportunity to comprehensively examine the processes of different studies on these subjects.

PMID:35758001 | DOI:10.1080/17483107.2022.2087772

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Nevin Manimala Statistics

Win statistics (win ratio, win odds, and net benefit) can complement one another to show the strength of the treatment effect on time-to-event outcomes

Pharm Stat. 2022 Jun 27. doi: 10.1002/pst.2251. Online ahead of print.

ABSTRACT

Conventional analyses of a composite of multiple time-to-event outcomes use the time to the first event. However, the first event may not be the most important outcome. To address this limitation, generalized pairwise comparisons and win statistics (win ratio, win odds, and net benefit) have become popular and have been applied to clinical trial practice. However, win ratio, win odds, and net benefit have typically been used separately. In this article, we examine the use of these three win statistics jointly for time-to-event outcomes. First, we explain the relation of point estimates and variances among the three win statistics, and the relation between the net benefit and the Mann-Whitney U statistic. Then we explain that the three win statistics are based on the same win proportions, and they test the same null hypothesis of equal win probabilities in two groups. We show theoretically that the Z-values of the corresponding statistical tests are approximately equal; therefore, the three win statistics provide very similar p-values and statistical powers. Finally, using simulation studies and data from a clinical trial, we demonstrate that, when there is no (or little) censoring, the three win statistics can complement one another to show the strength of the treatment effect. However, when the amount of censoring is not small, and without adjustment for censoring, the win odds and the net benefit may have an advantage for interpreting the treatment effect; with adjustment (e.g., IPCW adjustment) for censoring, the three win statistics can complement one another to show the strength of the treatment effect. For calculations we use the R package WINS, available on the CRAN (Comprehensive R Archive Network).

PMID:35757986 | DOI:10.1002/pst.2251

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Gender in mental health: Comparing the rate and social factors of depression, anxiety, and stress among young heterosexual and sexual minority women in the Philippines

J Lesbian Stud. 2022 Jun 25:1-15. doi: 10.1080/10894160.2022.2091731. Online ahead of print.

ABSTRACT

Young sexual minority Filipinos have been found to have a higher level of mental health problems compared to peers. It was also reported that Filipino sexual minority women had twice the odds of ill mental health such as depression compared to sexual minority men. Thus, this study compared the rates and social factors of depression, anxiety, and stress among young adult Filipino heterosexual and sexual minority women. Particularly, this quantitative study utilized a cross-sectional survey design. The Depression, Anxiety, and Stress Scale 21 (DASS-21), Daily Discrimination Subscale of the Perceived Discrimination Scale, and sociodemographic questionnaire were completed by 622 heterosexual and 177 sexual minority women. Afterward, descriptive statistics, chi-square, and logistic regression were done. Depression, anxiety, and stress rates were higher among sexual minority women compared to their peers. The possible risk factor for these mental health issues among heterosexual women was discrimination, while a possible protective factor was living with peers (p <.05). Among sexual minority women, it was found that discrimination is a risk factor, albeit with higher effects compared to their heterosexual counterparts. These may be explained by the reported high level of negative attitudes and discrimination that sexual minorities in the Philippines face daily in their social environment. Thus, anti-discrimination policies, gender-responsive healthcare for sexual minorities, and gender mainstreaming must be instituted and strengthened.

PMID:35757983 | DOI:10.1080/10894160.2022.2091731

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Nevin Manimala Statistics

Family Educational Attainment and Racial Disparities in Low Birth Weight

Pediatrics. 2022 Jun 27:e2021052369. doi: 10.1542/peds.2021-052369. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the effect of grandmother and mother educational attainment on low birth weight (LBW) in children and grandchildren.

METHODS: The National Longitudinal Study of Adolescent to Adult Health is a multigenerational study that collected survey data from 1994 to 2018. Using this database, we constructed a cohort of 2867 non-Hispanic Black (NHB) and non-Hispanic White (NHW) grandmother-mother-grandchild triads to evaluate how education affects the likelihood of having LBW children and grandchildren, while adjusting for socioeconomic and maternal health factors using multivariable logistic regression.

RESULTS: Similar to previous studies, NHB women were more likely to have LBW descendants compared with NHW women in unadjusted and adjusted analyses. The prevalence of LBW descendants was lower in women with college education, regardless of race. Irrespective of race, mother and grandmother college education was associated with decreased odds of LBW children and grandchildren after adjusting for individual variables. When mother and grandmother education were examined together, and after adjusting for all individual, community, and health variables together, mother college education remained associated with lower odds of LBW (adjusted odds ratio, 0.58; 95% confidence interval, 0.44-0.77). There were no statistically significant differences in these effects between NHW and NHB populations.

CONCLUSIONS: Educational attainment in mothers is associated with decreased odds of LBW descendants after adjusting for multiple individual, community, and health covariates, regardless of race. Targeting improvements in education may ameliorate adverse pregnancy outcomes that disproportionately affect minority communities and cause significant lifelong consequences.

PMID:35757969 | DOI:10.1542/peds.2021-052369

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Nevin Manimala Statistics

Surgery for Anomalous Aortic Origin of a Coronary Artery (AAOCA) in Children and Adolescents: A Meta-Analysis

World J Pediatr Congenit Heart Surg. 2022 Jul;13(4):485-494. doi: 10.1177/21501351221095424.

ABSTRACT

We conducted a systematic review and meta-analysis of the literature to assess the outcomes of surgery for the anomalous aortic origin of a coronary artery in children and young adults (<30 years). Thirteen publications were selected, including a total of 384 patients. Unroofing of the intramural segment was adopted in 92% (95% CI: 81%-98%) of cases, with pooled early and late mortality of 0% (95% CI: 0%-0.3%) and 0.1% (95% CI: 0%-1%), respectively. Reoperation for aortic regurgitation was anecdotal. Surgical management of anomalous aortic origin of coronary arteries can be achieved with excellent results in pediatric patients, but concerns remain about the durability of surgery.

PMID:35757950 | DOI:10.1177/21501351221095424