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Nevin Manimala Statistics

COVID-19 pandemic influence on epilepsy course in pediatric patients

Epilepsy Behav. 2022 Jan 24;129:108581. doi: 10.1016/j.yebeh.2022.108581. Online ahead of print.

ABSTRACT

INTRODUCTION: In 2020, Coronavirus Disease 2019 (COVID-19) was declared as a global pandemic. Self-reported stress, anxiety, and insomnia, which are believed to be common triggers for epilepsy, are more likely to occur. We aimed to establish the influence of COVID-19 pandemic itself on changes in the daily life routine related to pandemic on epilepsy course in pediatric patients. The unique form of clinical care which is telemedicine was also taken into consideration. We wanted to evaluate patients’ satisfaction with telemedicine and if changing stationary visits into telemedicine influenced epilepsy course in our patients.

METHODS: Patients, who attended developmental neurology outpatient clinic in the period March-December 2020 were collected. As patients were minors, legal guardians were asked to fill out the questionnaire. Patients were divided according to the outcome into three groups: those with a worsened, stable, or improved course of epilepsy during the pandemic. Appropriate statistical tests for two-group and multi-group comparisons have been implemented. Post hoc p values were also calculated.

RESULTS: Four hundred and two questionnaires were collected. Most of the patients had a stable course of epilepsy during the pandemic; in 13% of participants an improvement has been observed, worsening of the disease was seen in 16% of patients. Age, sex, type of epilepsy, number of seizure incidents before pandemic, and duration of the disease had no statistically significant connection with changes in the course of the disease. Behavioral changes and altered sleep patterns were found to be more common in the worsened group. Fifty-eight percent of patients were satisfied with telemedicine. Poorer satisfaction was connected with less frequent visits, cancellation of scheduled appointments, and lack of help in case of need in an emergency situation.

CONCLUSION: Epilepsy course in pediatric patients seems to be stable during COVID-19 pandemic. Sleep disturbances and changes in a child’s behavior may be related to increase in seizure frequency. Telemedicine is an effective tool for supervising children with epilepsy. Patients should be informed about possible ways of getting help in urgent cases.

PMID:35203013 | DOI:10.1016/j.yebeh.2022.108581

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Multiway resolution of spectrochromatographic measurements for the quantification of echinuline in marine-derived fungi Aspergillus chevalieri using parallel factor analysis

J Chromatogr B Analyt Technol Biomed Life Sci. 2022 Feb 18;1193:123181. doi: 10.1016/j.jchromb.2022.123181. Online ahead of print.

ABSTRACT

A multiway resolution of incomplete chromatographic separation was presented for spectrochromatographic quantification of echinuline in marine-derived fungi Aspergillus chevalieri. Two-dimensional spectrochromatographic maps of calibration, validation and real samples were recorded as a function of time and wavelength using UPLC-PDA instrument under non-optimized chromatographic conditions, which gave rise to co-elution of echinuline and the constituents of sample matrix. A three-way array was obtained by concatenating the data matrices of the spectrochromatographic maps. Then, parallel factor analysis was applied to the multiway array to extract the individual contribution of echinuline in three modes (time, wavelength and sample). While time and wavelength profiles were used for the characterization of echinuline, the sample profile was used for its quantitative determination of the analyte in validation set and in real samples. Validity of the analytical method was evaluated by analyzing the validation set, which consist of test samples, standard addition samples, intra-day and inter-day samples. The proposed multiway analysis method was then applied to marine-derived fungi extracts and echinuline content was found to be 31.9 µg/g based on the average of ten assay results. The assay results provided by PARAFAC model were statistically compared with those obtained by a newly developed classical UPLC method, which ensured the complete separation of echinuline in a run time of nine minutes. The assay results were found to be comparable due to the fact that there was no significant difference between the analysis results (F = 1.63, Fcrit = 3.17; t = 0.69, tcrit = 2.11) at the significance level of 95%). Consequently, the PARAFAC method permitted the accurate determination of echinuline in fungal extracts despite the partial chromatographic separation with a run time of only three minutes.

PMID:35203040 | DOI:10.1016/j.jchromb.2022.123181

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Time to active sitting position: One-year findings from a temporary COVID-19 intensive care unit

Respir Med. 2022 Feb 15;194:106773. doi: 10.1016/j.rmed.2022.106773. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the association between time to active sitting position and clinical features in people with COVID-19 admitted to intensive care unit (ICU) and referred to physiotherapists.

METHOD: Prospective study conducted in the largest temporary ICU in Lombardy (Italy) between April 2020 and June 2021. All individuals with COVID-19 who received physiotherapy were included. Multivariable Cox proportional hazard model was fitted to explore the statistical association between active sitting position and characteristics of patients referred to physiotherapists, also accounting for the different multidisciplinary teams responsible for patients.

RESULTS: 284 individuals over 478 (59.4%) had access to physiotherapy, which was performed for a median of 8 days, without difference between multidisciplinary teams (P = 0.446). The active sitting position was reached after a median of 18 (IQR: 10.0-32.0) days. Sex was the only characteristic associated with the time to active sitting position, with males showing a reduced hazard by a factor of 0.65 (95% CI: 0.48-0.87; P = 0.0042) compared to females. At ICU discharge, nearly 50% individuals increased Manchester Mobility Score by 3 points. During physiotherapy no major adverse event was recorded.

CONCLUSION: Individuals with COVID-19 take long time to reach active sitting position in ICU, with males requiring longer rehabilitation than females.

PMID:35203010 | DOI:10.1016/j.rmed.2022.106773

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Nevin Manimala Statistics

Exploring nursing students’ learning experiences and attitudes toward older persons in a gerontological nursing course using self-regulated online enquiry-based learning during the COVID-19 pandemic: A mixed-methods study

Nurse Educ Today. 2022 Feb 18;111:105301. doi: 10.1016/j.nedt.2022.105301. Online ahead of print.

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, universities adopted online teaching as the primary teaching and learning method. Most of the online teaching, however, has been limited to the broadcasting of asynchronous lectures and sharing of teaching materials.

OBJECTIVES: To explore undergraduate nursing students’ self-regulated learning experiences, satisfaction, and attitudes toward older persons in a gerontological nursing course using online self-regulated enquiry-based learning (EBL) during the COVID-19 pandemic.

DESIGN: A mixed-methods design was adopted.

SETTING: A university in Hong Kong providing pre-registration nursing programmes.

PARTICIPANTS: 155 students studying in the fourth year in a five-year Bachelor of Nursing programme participated in the quantitative study in which 18 joined the focus groups (4 groups with group size of 4-5).

METHODS: Five video-based scenarios along with two interactive online workshops, a mind-map development exercise, gamified assessments, reading materials, group discussions, and presentations were adopted in a gerontological nursing course offered in 2019-2020 to enhance the students’ learning, driven by a process of enquiry. Attitudes toward older people were measured at baseline and one week after the course (post-test). Information on self-regulated learning experiences, satisfaction, and confidence were collected at post-test only. Paired t-tests and descriptive statistics were used to analyse the data. Focus groups were conducted through semi-structured interviews and transcribed verbatim for inductive content analysis.

RESULTS: A significant improvement was demonstrated in the students’ attitude toward older people. The students appreciated the opportunities provided by the online EBL to apply key concepts of gerontology in the teaching and learning activities and to enhance their critical thinking skills. Three major themes were revealed from the focus group: Perception of the teaching pedagogy, Improvement of cognitive skills, and Positive and negative aspects of the learning experience.

CONCLUSIONS: The online self-regulated EBL improved the students’ online learning experience in a gerontological nursing course during the pandemic and improved their attitudes toward older people.

PMID:35202963 | DOI:10.1016/j.nedt.2022.105301

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Tannin as a modulator of rumen microbial profile, apparent digestibility and ingestive behavior of lactating goats: A preliminary metagenomic view of goats adaptability to tannin

Res Vet Sci. 2022 Feb 7;145:159-168. doi: 10.1016/j.rvsc.2022.02.002. Online ahead of print.

ABSTRACT

The aim with this study was to use interdisciplinary techniques and visions in order to identify the modulating effect of tannins on adaptive factors in lactating goats with different genetic patterns, through the assessment of digestibility and nutrient intake, ingestive behavior and rumen metagenome. We used in this study 8 of the Repartida ecotype and 6 of the Canindé breed goats, on average five years old, distributed in a completely randomized design, in a 2 × 2 factorial design, with two genetic groups and two diets. The applied diets were: basal diet and inclusion of 5% commercial tannin extract in basal diet. Intake and apparent digestibility of nutrients were evaluated, based on the quantification of the offered feed and refusals, and bromatological evaluation of samples of the offered feed, refusals and feces. Behavioral data were collected in 24-h continuous visual observations. The ruminal fluid was collected and DNA extraction, sequencing, and evaluation of relative abundance of the rumen microbiome were performed. The data obtained were analyzed statistically, through analysis of variance with 5% significance and, when necessary, a comparison of means test was applied. In this preliminary findings was observed that the genetic group factor caused changes in the number of chews and the relative abundance of microorganisms (P = 0.0290 and P = 0.0051). The diet factor influenced digestibility, which better values were observed for the tannin diet (P = 0.0049), in addition, it promoted changes in the rumen microbiota, with a beneficial modulatory characteristic. The inclusion of 5% tannin extract from Acacia mearnsii modulates the rumen microbiome, improving the apparent digestibility of nutrients without affecting the feed intake of goats from the Repartida and Canindé genetic groups.

PMID:35202972 | DOI:10.1016/j.rvsc.2022.02.002

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Multiday load carriage decreases ability to mitigate ground reaction force through reduction of ankle torque production

Appl Ergon. 2022 Feb 21;101:103717. doi: 10.1016/j.apergo.2022.103717. Online ahead of print.

ABSTRACT

The aim of this study was to examine the impact of backpack load carriage on lower limb strength and loading rate change in a cohort that match military recruit profiles. Twenty-six participants walked on a treadmill either carrying a military load carriage system (32 kg) or unloaded for 2 h on two consecutive days. Participants ground reaction forces and strength measures were assessed using a force platform and dynamometry, respectively. Testing included assessments before and after treadmill walking on days one and two, and 24 h following day 2. When assessed by mixed methods ANOVA (alpha: 0.05) statistically significant interaction effects were observed for loading peak (p = 0.031), loading rate (p = 0.035) and plantarflexor torque dynamometry variables at 60°s-1 (p = 0.011) and 120°s-1 (p = 0.024). Repeated measures correlation highlighted associations between plantarflexor torque at 60°s-1 and loading rate (r = -0.901, p < 0.001). Load carriage reduced lower limb torque which did not recover between days. Plantarflexor torque reductions were associated with increases in loading rate. Practitioners should consider that load bearers are more likely to experience lower limb injury during multi-day load carriage. Future work should develop protocols to reduce plantarflexor torque loss in order to reduce ground reaction force change.

PMID:35202961 | DOI:10.1016/j.apergo.2022.103717

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Diagnostic delay in focal epilepsy: Association with brain pathology and age

Seizure. 2022 Feb 11;96:121-127. doi: 10.1016/j.seizure.2022.02.004. Online ahead of print.

ABSTRACT

PURPOSE: Between 16-77% of patients with newly diagnosed epilepsy report seizures before diagnosis but little is known about the risk factors for diagnostic delay. Here, we examined the association between prior seizures and neuroimaging findings in newly diagnosed focal epilepsy.

METHODS: Adults diagnosed with focal epilepsy at First Seizure Clinics (FSC) at the Royal Melbourne Hospital or Austin Health, Melbourne, Australia, between 2000 and 2010 were included. Medical records were audited for seizure history accrued from the detailed FSC interview. Potentially epileptogenic brain abnormality type, location and extent was determined from neuroimaging. Statistical analysis comprised multivariate logistic regression.

RESULTS: Of 735 patients, 44% reported seizure/s before the index seizure. Among the 260 individuals with a potentially epileptogenic brain imaging abnormality, 34% reported prior seizures. Of 475 individuals with no abnormality, 50% reported prior seizures (p < 0.001). Patients with post-stroke changes had lower odds of prior seizures (n = 24/95, OR 0.5, p = 0.005) compared to patients without abnormalities, as did patients with high-grade tumors (n = 1/10, OR 0.1, p = 0.04). Abnormality location or extent was not associated with seizures. Prior seizures were inversely associated with age, patients aged >50 years had lower odds compared to those 18-30 years (OR 0.5, p = 0.01).

CONCLUSIONS: A history of prior seizures is less common in patients with newly diagnosed focal epilepsy associated with antecedent stroke or high-grade tumor than in those without a lesion, and is also less common in older individuals. These findings may be related to age, biological mechanisms or aspects of diagnosis and assessment of these events.

PMID:35202928 | DOI:10.1016/j.seizure.2022.02.004

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On the interpretability of machine learning methods in crash frequency modeling and crash modification factor development

Accid Anal Prev. 2022 Feb 21;168:106617. doi: 10.1016/j.aap.2022.106617. Online ahead of print.

ABSTRACT

Machine learning (ML) model interpretability has attracted much attention recently given the promising performance of ML methods in crash frequency studies. Extracting accurate relationship between risk factors and crash frequency is important for understanding the causal effects of risk factors and developing safety countermeasures. However, there is no study that comprehensively summarizes ML model interpretation methods and provides guidance for safety researchers and practitioners. This research aims to fill this gap. Model-based and post-hoc ML interpretation methods are critically evaluated and compared to study their suitability in crash frequency modeling. These methods include classification and regression tree (CART), multivariate adaptive regression splines (MARS), Local Interpretable Model-agnostic Explanations (LIME), Local Sensitivity Analysis (LSA), Partial Dependence Plots (PDP), Global Sensitivity Analysis (GSA), and SHapley Additive exPlanations (SHAP). Model-based interpretation methods cannot reveal the detailed interaction relationships among risk factors. LIME can only be used to analyze the effects of a risk factor at the prediction level. LSA and PDP assume that different risk factors are independently distributed. Both GSA and SHAP can account for the potential correlation among risk factors. However, only SHAP can visualize the detailed relationships between crash outcomes and risk factors. This study also demonstrates the potential and benefits of using ML and SHAP to derive Crash Modification Factors (CMF). Finally, it is emphasized that statistical and ML models may not directly differentiate causation from correlation. Understanding the differences between them is critical for developing reliable safety countermeasures.

PMID:35202941 | DOI:10.1016/j.aap.2022.106617

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Nevin Manimala Statistics

Mahalanobis distance correlation: A novel approach for quantitating changes in multidimensional NMR spectra in biological applications

J Magn Reson. 2022 Feb 17;337:107165. doi: 10.1016/j.jmr.2022.107165. Online ahead of print.

ABSTRACT

We present here a novel protocol for quantitating changes in the NMR spectra, which is based on Mahalanobis statistics. In a two dimensional NMR spectrum, the various peaks are taken to represent a distribution, and the two chemical shifts along the orthogonal axes and the peak intensities constitute three observables. All these observables vary in a correlated manner. Taking account of these, the Mahalanobis distance (MD) reflects the distance of any chosen peak from the centre of the distribution. For quantitating changes in a particular spectrum (say A) with N peaks (altered protein NMR spectrum) with respect to a reference spectrum (say B) with M peaks (original protein NMR spectrum), a composite spectrum with N + M peaks is generated. A one-to-one correspondence between N MD values considering all the N peaks in A and the same N peaks in the composite spectrum (A + B) is calculated. The MD distance of corresponding peaks in two different distributions can be correlated to assess the changes in the spectra during the course of a biological phenomenon, or as a result of biomolecular interactions. We have demonstrated these ideas, first, using the 1H-15N HSQC spectrum of Ubiquitin, and then application of these has been demonstrated for monitoring progression of fibrillation of the protein α-Synuclein, in absence and presence of safranal, a known inhibitor of fibrillation of the protein. The method is in general applicable to multidimensional NMR spectra, does not require extensive data collection, and allows quantitative assessment of spectral changes via a single parameter. We believe that the method will have wide ranging applications to monitor many biological phenomena, and will also be useful in an industrial environment for mass comparison of molecules in a rapid manner.

PMID:35202919 | DOI:10.1016/j.jmr.2022.107165

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Racial disparity in sleep apnea-related mortality in the United States

Sleep Med. 2022 Feb 7;90:204-213. doi: 10.1016/j.sleep.2021.11.014. Online ahead of print.

ABSTRACT

BACKGROUND: Sleep apnea is one of the most common sleep disorders in the United States (US). Although the prevalence, risk factors, and clinical presentations of sleep apnea vary by racial groups, the racial disparity in sleep apnea-related mortality remains unclear.

METHODS: Sleep apnea-related mortality for 1999-2019 was obtained from the National Center for Health Statistics provided by the Centers for Disease Control and Prevention. We examined the mortality trends for sleep apnea using Joinpoint regression analysis and compared the associated outcomes and multiple causes of death between Blacks and Whites.

RESULTS: For 1999-2019, sleep apnea was documented as the underlying cause of death in 17,053 decedents, with 2593 Blacks and 14,127 Whites. The overall age-adjusted mortality rates in all population, Blacks, and Whites were 2.5, 3.5, and 2.4 per 1,000,000 population, respectively (P < 0.001). Both Blacks and Whites had the highest mortality rates in the Midwest and the lowest in the Northeast. Despite the flattened mortality trend in the last decade overall, Black males had a continuous mortality increase over the study period (Annual Percentage Change 2.7%, 95% CI: 1.2-4.2). For both genders of sleep apnea decedents, Blacks were more likely to have multiple cause of death of Cardiac Arrest, Hypertension, Obesity, and Chronic Renal Failure, but Arrhythmia was more common in Whites (P < 0.05).

CONCLUSIONS: There is a significant racial disparity in sleep apnea-related mortality in the US. The uptrend in mortality in Black males and associated outcomes related to cardiovascular disease should raise concerns specifically in Blacks with sleep apnea.

PMID:35202926 | DOI:10.1016/j.sleep.2021.11.014