Categories
Nevin Manimala Statistics

Frailty in the elderly: screening possibilities in Primary Health Care

Rev Bras Enferm. 2021 Oct 1;75(2):e20200973. doi: 10.1590/0034-7167-2020-0973. eCollection 2021.

ABSTRACT

OBJECTIVES: to evaluate two instruments for screening frailty in the elderly in Primary Health Care.

METHODS: this is an observational, cross-sectional study, with a quantitative approach, with 396 elderly people. SPSS software helped to perform the statistical analyses. The study used the kappa coefficient and Spearman’s correlation.

RESULTS: the kappa coefficient between the Clinical-Functional Vulnerability Index 20 and the Edmonton Frailty Scale was 0.496, considered moderate. There was a positive and significant correlation (r = 0.77; p < 0.001) between the frailty conditions and the total score of the two instruments.

CONCLUSIONS: when this article assessed fragility through the kappa coefficient, both instruments presented positive correlation and agreement. However, the identification of frailty was higher when it used the Edmonton Frailty Scale.

PMID:34614095 | DOI:10.1590/0034-7167-2020-0973

Categories
Nevin Manimala Statistics

Panorama de tres países latinoamericanos en problemas de voz relacionados con condiciones de trabajo

Codas. 2021 Sep 29;33(5):e20200304. doi: 10.1590/2317-1782/20202020304. eCollection 2021.

ABSTRACT

PURPOSE: To identify the normative framework on work-related voice disorders in three Latin American countries: Brazil, Chile and Colombia.

METHODS: Documentary research focused on regulations and statistics occupational voice in the three included countries.

RESULTS: In the three countries included there are normatives that regulate the relationship between work and vocal health.

CONCLUSION: Although previous research has reported the negative effect of adverse working conditions on vocal functioning, it is common for workers with vocal problems to continue working in these environments, which reduces their quality of life and increases associated costs. This study shows that there are limitations in the implementation of the regulations. Weaknesses detected in this study could benefit from multicenter investigations that strengthen speech therapy actions in prevention, promotion, diagnosis and rehabilitation.

PMID:34614110 | DOI:10.1590/2317-1782/20202020304

Categories
Nevin Manimala Statistics

Bicycle injuries presenting to the emergency department during COVID-19 lockdown

J Paediatr Child Health. 2021 Oct 6. doi: 10.1111/jpc.15775. Online ahead of print.

ABSTRACT

AIM: Since the start of the COVID-19 pandemic, there have been many changes in the presenting complaints in paediatric emergency departments (EDs). We sought to characterise the impact of the COVID-19 pandemic on bicycle-related injuries in children presenting to a tertiary care paediatric ED.

METHODS: We conducted a descriptive, cross-sectional study of ED visits to a large urban tertiary children’s hospital, comparing March to October 2020 (the study period) to the same date range 2 years prior (i.e. March to October 2018-2019). We included children 0-17.99 years presenting for a bicycle-related injury. We compared absolute visit counts of bike injuries per month, demographics, triage acuity, injury type and disposition.

RESULTS: A total of 1215 bike-related visits were analysed. There were 234 presentations in 2018 (March to October), 305 in 2019, and 676 in 2020. Overall, the mean age was 9.5 years (standard deviation 5.5-13.5), there were 67% males, median Canadian Emergency Department Triage and Acuity Scale score was 3 (interquartile range 3-4) and the most common injuries were fractures (n = 471, 38.8%). There were significantly more bike injuries presenting to the ED per month in the COVID group, 33.7(17.9) versus 84.5(61.4) (two-tailed P value = 0.041). There was no statistical difference in ‘severe injuries’ pre- versus post-COVID (odds ratio 0.815 (95% confidence interval 0.611-1.088), P = 0.165).

CONCLUSION: There was a significant increase in bicycle-related injuries presenting to our ED during the pandemic, compared to previous years. Evaluating these trends will allow for the exploration of harm reduction strategies for preventing future bicycle-related injuries.

PMID:34612571 | DOI:10.1111/jpc.15775

Categories
Nevin Manimala Statistics

Genetic Stratification of Age-Dependent Parkinson’s Disease Risk by Polygenic Hazard Score

Mov Disord. 2021 Oct 6. doi: 10.1002/mds.28808. Online ahead of print.

ABSTRACT

BACKGROUND: Parkinson’s disease (PD) is a highly age-related disorder, where common genetic risk variants affect both disease risk and age at onset. A statistical approach that integrates these effects across all common variants may be clinically useful for individual risk stratification. A polygenic hazard score methodology, leveraging a time-to-event framework, has recently been successfully applied in other age-related disorders.

OBJECTIVES: We aimed to develop and validate a polygenic hazard score model in sporadic PD.

METHODS: Using a Cox regression framework, we modeled the polygenic hazard score in a training data set of 11,693 PD patients and 9841 controls. The score was then validated in an independent test data set of 5112 PD patients and 5372 controls and a small single-study sample of 360 patients and 160 controls.

RESULTS: A polygenic hazard score predicts the onset of PD with a hazard ratio of 3.78 (95% confidence interval 3.49-4.10) when comparing the highest to the lowest risk decile. Combined with epidemiological data on incidence rate, we apply the score to estimate genetically stratified instantaneous PD risk across age groups.

CONCLUSIONS: We demonstrate the feasibility of a polygenic hazard approach in PD, integrating the genetic effects on disease risk and age at onset in a single model. In combination with other predictive biomarkers, the approach may hold promise for risk stratification in future clinical trials of disease-modifying therapies, which aim at postponing the onset of PD. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

PMID:34612543 | DOI:10.1002/mds.28808

Categories
Nevin Manimala Statistics

The Enhancing NeuroImaging Genetics through Meta-Analysis Consortium: 10 Years of Global Collaborations in Human Brain Mapping

Hum Brain Mapp. 2021 Oct 6. doi: 10.1002/hbm.25672. Online ahead of print.

ABSTRACT

This Special Issue of Human Brain Mapping is dedicated to a 10-year anniversary of the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Consortium. It reports updates from a broad range of international neuroimaging projects that pool data from around the world to answer fundamental questions in neuroscience. Since ENIGMA was formed in December 2009, the initiative grew into a worldwide effort with over 2,000 participating scientists from 45 countries, and over 50 working groups leading large-scale studies of human brain disorders. Over the last decade, many lessons were learned on how best to pool brain data from diverse sources. Working groups were created to develop methods to analyze worldwide data from anatomical and diffusion magnetic resonance imaging (MRI), resting state and task-based functional MRI, electroencephalography (EEG), magnetoencephalography (MEG), and magnetic resonance spectroscopy (MRS). The quest to understand genetic effects on human brain development and disease also led to analyses of brain scans on an unprecedented scale. Genetic roadmaps of the human cortex were created by researchers worldwide who collaborated to perform statistically well-powered analyses of common and rare genetic variants on brain measures and rates of brain development and aging. Here, we summarize the 31 papers in this Special Issue, covering: (a) technical approaches to harmonize analysis of different types of brain imaging data, (b) reviews of the last decade of work by several of ENIGMA’s clinical and technical working groups, and (c) new empirical papers reporting large-scale international brain mapping analyses in patients with substance use disorders, schizophrenia, bipolar disorders, major depression, posttraumatic stress disorder, obsessive compulsive disorder, epilepsy, and stroke.

PMID:34612558 | DOI:10.1002/hbm.25672

Categories
Nevin Manimala Statistics

Patient selection in the Comprehensive Care for Joint Replacement model

Health Serv Res. 2021 Oct 6. doi: 10.1111/1475-6773.13880. Online ahead of print.

ABSTRACT

OBJECTIVE: To understand whether the Comprehensive Care for Joint Replacement (CJR) program induces participating hospitals to (1) preferentially select lower risk patients, (2) reduce 90-day episode-of-care costs, (3) improve quality of care, and (4) achieve greater cost reduction during its second year, when downside financial risk was applied.

DATA SOURCES: We identified beneficiaries of age 65 years or older undergoing hip or knee joint replacement in the 100% sample of Medicare fee-for-service inpatient (Part A) claims from January 1, 2013 to August 31, 2017. Cases were linked to subsequent outpatient, Part B, home health agency, and skilled nursing facility claims, as well as publicly available participation status for CJR.

STUDY DESIGN: We estimated the effect of CJR for hospitals in the 67 metropolitan statistical areas (MSA) selected to participate in CJR (785 hospitals), compared to those in 104 non-CJR MSAs (962 hospitals; maintaining fee-for-service). A difference-in-differences approach was used to detect patient selection, as well as to compare 90-day episode-of-care costs and quality of care between CJR and non-CJR hospitals over the first two performance years.

DATA COLLECTION: We excluded 172 hospitals from our analysis due to their preexisting BPCI participation. We focused on elective admissions in the main analysis.

PRINCIPAL FINDINGS: While reductions in 90-day episode-of-care costs were greater among CJR hospitals (-$902, 95% CI: -$1305, -$499), largely driven by a 16.8% (p < 0.01) decline in 90-day spending in skilled nursing facilities, CJR hospitals significantly reduced the 90-day readmission rate (-3.9%; p < 0.05) and preferentially avoided patients aged 85 years or older (-5.9%; p < 0.01) and Black (-7.0%; p < 0.01). Cost reduction was greater in 2017 than in 2016, corresponding to the start of downside risk.

CONCLUSIONS: Participation in CJR was associated with a modest cost reduction and a reduction in 90-day readmission rates; however, we also observed evidence of preferential avoidance of older patients perceived as being higher risk among CJR hospitals.

PMID:34612519 | DOI:10.1111/1475-6773.13880

Categories
Nevin Manimala Statistics

Kinetics of photon upconversion by triplet-triplet annihilation: a comprehensive tutorial

Phys Chem Chem Phys. 2021 Sep 14;23(34):18268-18282. doi: 10.1039/d1cp02654b. Epub 2021 Aug 24.

ABSTRACT

This perspective article provides a comprehensive but organized tutorial introduction of the kinetics related to photon upconversion (UC) by triplet-triplet annihilation (TTA) (TTA-UC). The field of TTA-UC is multi-disciplinary and rapidly growing with the involvement of researchers from diverse backgrounds. TTA-UC consists of a series of tangled photophysical processes, so a solid understanding of the kinetic features and consequences is important to develop and evaluate materials for TTA-UC. This tutorial starts with an introduction of the standard model of TTA-UC along with the assumptions used in the model. The essential concept of the spin statistics for TTA and how this concept is related to the singlet branching ratio, which directly affects the efficiency of UC, are then explained through step-by-step analyses. Using these foundations, solutions for the steady-state behaviors are derived, featuring the universal curve that describes the excitation intensity dependence of the UC quantum yield for any sample type. Various useful functions for analyzing experimental data are also introduced and summarized. The transient behaviors of TTA-UC are then discussed along with their equations, and the usefulness for analyzing transient experimental data is explained using examples. In this article, self-consistent derivations and relevant references are provided for an easy understanding of the advanced discussion and analyses.

PMID:34612372 | DOI:10.1039/d1cp02654b

Categories
Nevin Manimala Statistics

Directed gas-phase preparation of the elusive phosphinosilylidyne (SiPH2, X2A”) and cis/trans phosphinidenesilyl (HSiPH; X2A’) radicals under single-collision conditions

Phys Chem Chem Phys. 2021 Sep 14;23(34):18506-18516. doi: 10.1039/d1cp02812j. Epub 2021 Aug 19.

ABSTRACT

The reaction of the D1-silylidyne radical (SiD; X2Π) with phosphine (PH3; X1A1) was conducted in a crossed molecular beams machine under single collision conditions. Merging of the experimental results with ab initio electronic structure and statistical Rice-Ramsperger-Kassel-Marcus (RRKM) calculations indicates that the reaction is initiated by the barrierless formation of a van der Waals complex (i0) as well as intermediate (i1) formed via the barrierless addition of the SiD radical with its silicon atom to the non-bonding electron pair of phosphorus of the phosphine. Hydrogen shifts from the phosphorous atom to the adjacent silicon atom yield intermediates i2a, i2b, i3; unimolecular decomposition of these intermediates leads eventually to the formation of trans/cis-phosphinidenesilyl (HSiPH, p2/p4) and phosphinosilylidyne (SiPH2, p3) via hydrogen deuteride (HD) loss (experiment: 80 ± 11%, RRKM: 68.7%) and d-trans/cis-phosphinidenesilyl (DSiPH, p2’/p4′) plus molecular hydrogen (H2) (experiment: 20 ± 7%, RRKM: 31.3%) through indirect scattering dynamics via tight exit transition states. Overall, the study reveals branching ratios of p2/p4/p2’/p4′ (trans/cis HSiPH/DSiPH) to p3 (SiPH2) of close to 4 : 1. The present study sheds light on the complex reaction dynamics of the silicon and phosphorous systems involving multiple atomic hydrogen migrations and tight exit transition states, thus opening up a versatile path to access the previously elusive phosphinidenesilyl and phosphinosilylidyne doublet radicals, which represent potential targets of future astronomical searches toward cold molecular clouds (TMC-1), star forming regions (Sgr(B2)), and circumstellar envelopes of carbon rich stars (IRC + 10216).

PMID:34612389 | DOI:10.1039/d1cp02812j

Categories
Nevin Manimala Statistics

Enhanced hyaluronic acid production in Streptococcus zooepidemicus by an optimized culture medium containing hyaluronidase inhibitor

Prep Biochem Biotechnol. 2021 Oct 6:1-11. doi: 10.1080/10826068.2021.1955710. Online ahead of print.

ABSTRACT

This study describes the hyaluronic acid (HA) production by S. zooepidemicus ATCC 43079, and the effect of the hyaluronidase enzyme on HA levels. The hyaluronidase production, glucose consumption, and lactate formation were recorded during fermentation. The HA production, and productivity at different amounts of glucose, yeast extract and pH were evaluated by response surface statistical approach in presence of 6-O-palmytoil-l-ascorbic acid as a chemical inhibitor for biocatalyst hyaluronidase. Under optimum conditions, HA production was increased two-fold from 190 ± 17 mg L-1 in basal medium to 384.6 ± 7.5 mg L-1 in the optimized medium containing enzyme inhibitor. Furthermore, the results indicated that the chemical inhibitor could suppress the biocatalyst activity and prevent the HA loss at the end of the exponential phase of S. zooepidemicus ATCC 43079.

PMID:34612172 | DOI:10.1080/10826068.2021.1955710

Categories
Nevin Manimala Statistics

Properties of the Cognitive Function Battery for the MIND Diet Intervention to Prevent Alzheimer’s Disease

J Int Neuropsychol Soc. 2021 Oct 6:1-8. doi: 10.1017/S1355617721001089. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the properties of the cognitive battery used in the MIND Diet Intervention to Prevent Alzheimer’s Disease. The MIND Diet Intervention is a randomized control trial to determine the relative effectiveness of the MIND diet in slowing cognitive decline and reducing brain atrophy in older adults at risk for Alzheimer’s dementia.

METHODS: The MIND cognitive function battery was administered at baseline to 604 participants of an average age of 70 years, who agreed to participate in the diet intervention study, and was designed to measure change over time. The battery included 12 cognitive tests, measuring the 4 cognitive domains of executive function, perceptual speed, episodic memory, and semantic memory. We conducted a principal component analysis to examine the consistency between our theoretical domains and the statistical performance of participants in each domain. To further establish the validity of each domain, we regressed the domain scores against a late-life cognitive activity score, controlling for age, race, sex, and years of education.

RESULTS: Four factors emerged in the principal component analyses that were similar to the theoretical domains. In regression equations, we found the expected associations with age, education, and late-life cognitive activity with each of the four cognitive domains.

CONCLUSIONS: These results indicate that the MIND cognitive battery is a comprehensive and valid battery of four separate domains of cognitive function that can be used in diet intervention trials for older adults.

PMID:34612190 | DOI:10.1017/S1355617721001089