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Nevin Manimala Statistics

A novel statistical framework for meta-analysis of total mediation effect with high-dimensional omics mediators in large-scale genomic consortia

PLoS Genet. 2024 Nov 19;20(11):e1011483. doi: 10.1371/journal.pgen.1011483. Online ahead of print.

ABSTRACT

Meta-analysis is used to aggregate the effects of interest across multiple studies, while its methodology is largely underexplored in mediation analysis, particularly in estimating the total mediation effect of high-dimensional omics mediators. Large-scale genomic consortia, such as the Trans-Omics for Precision Medicine (TOPMed) program, comprise multiple cohorts with diverse technologies to elucidate the genetic architecture and biological mechanisms underlying complex human traits and diseases. Leveraging the recent established asymptotic standard error of the R-squared (R2)-based mediation effect estimation for high-dimensional omics mediators, we have developed a novel meta-analysis framework requiring only summary statistics and allowing inter-study heterogeneity. Whereas the proposed meta-analysis can uniquely evaluate and account for potential effect heterogeneity across studies due to, for example, varying genomic profiling platforms, our extensive simulations showed that the developed method was more computationally efficient and yielded satisfactory operating characteristics comparable to analysis of the pooled individual-level data when there was no inter-study heterogeneity. We applied the developed method to 5 TOPMed studies with over 5800 participants to estimate the mediation effects of gene expression on age-related variation in systolic blood pressure and sex-related variation in high-density lipoprotein (HDL) cholesterol. The proposed method is available in R package MetaR2M on GitHub.

PMID:39561194 | DOI:10.1371/journal.pgen.1011483

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Nevin Manimala Statistics

Test Validity of a Single-Item Food Insecurity Screening Assessment Among College Students

Am J Health Promot. 2024 Nov 19:8901171241302001. doi: 10.1177/08901171241302001. Online ahead of print.

ABSTRACT

PURPOSE: Given the high prevalence of food insecurity among college students, there is an interest in identifying whether the use of a single item can adequately screen for food insecurity. The current study aimed to determine the validity of a single-item food insecurity screening question among college students.

DESIGN: Cross-sectional study exploring food insecurity among racial and ethnic undergraduate college students.

SETTING: Large urban U.S. research university.

SAMPLE: Undergraduate students (n = 667) 18 years or older.

MEASURES: Food Insecurity screening was assessed via a single-item from the USDA Household Food Security Short Form (USDA FSSM-SF). Food security was assessed via the USDA FSSM-SF, a validated six-item scale that assesses food insecurity and hunger.

ANALYSIS: Logistic regression assessed the validity of the single-item food insecurity question tested against the USDA FSSM-SF.

RESULTS: The full model was statistically significant, χ2(1) = 161.44, P < .001 explaining 54.5% of the variance in food insecurity status correctly classifying 95.7% of cases. Sensitivity of the model was found to be 97.6%; specificity was found to be 69.6%. Positive predictive value was calculated to be 97.74%; negative predictive value was computed to be 68.09%.

CONCLUSION: Results support for the test validity of a single-item screening question that can be used to detect food insecurity among college students and inform secondary prevention programs aimed at food insecurity.

PMID:39561187 | DOI:10.1177/08901171241302001

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Nevin Manimala Statistics

Protective factors, risk factors, and intervention strategies in the prevention and reduction of crime among adolescents and young adults aged 12-24 years: A scoping review protocol

PLoS One. 2024 Nov 19;19(11):e0312684. doi: 10.1371/journal.pone.0312684. eCollection 2024.

ABSTRACT

BACKGROUND: Evidence indicates that criminal behaviour in youth is linked with a range of negative physical, mental, and social health consequences. Despite a global decrease over the last 30 years, youth crime remains prevalent. Identifying and mapping the most robust risk and protective factors, and intervention strategies for youth crime could offer important keys for predicting future offense outcomes and assist in developing effective preventive and early intervention strategies. Current reviews in the area do not include literature discussing at risk populations such as First Nations groups from countries such as Australia, Canada and New Zealand. This is a critical gap given the disproportionally high rates of incarceration and youth detention among First Nations people globally, particularly in countries with a colonial past. The aim of this scoping review is to identify and map the key risk and protective factors, along with intervention strategies, that are essential for recognizing adolescents and young adults at risk of crime.

METHODS: This scoping review protocol has been developed in line with the Arksey and O’Malley framework and the Joanna Briggs Institute (JBI) Reviewers’ Manual. The review protocol was preregistered with Open Science Framework (https://osf.io/kg4q3). ProQuest, PubMed, Web of Science, Scopus, and PsycInfo were used to retrieve relevant articles. Grey literature was searched using Google searches and ProQuest dissertations databases. Original research articles examining protective factors, risk factors, and intervention strategies for prevention and reduction of crime in 12-24-year-olds were included. Two independent reviewers conducted eligibility decisions and data extraction. Findings has been reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.

CONCLUSION: Anticipated findings suggest that current research has extensively examined factors across all levels of the socioecological model, from individual to community levels, revealing a predominant focus on individual-level predictors such as substance use, prior criminal history, and moral development. The review is expected to identify effective interventions that address critical factors within each domain, including Multisystemic Therapy (MST) and Multidimensional Treatment Foster Care (MTFC), which have shown promise in reducing youth crime. Additionally, it will likely highlight significant trends in risk and protective factors, such as the dual role of academic achievement-both as a risk and protective factor-and the impact of family-based interventions. The review will also address gaps in research, particularly regarding Indigenous youth, underscoring the need for targeted studies to better understand their unique challenges. These findings will guide future research and inform the development of comprehensive prevention and early intervention programs tailored to diverse youth populations.

PMID:39561166 | DOI:10.1371/journal.pone.0312684

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Nevin Manimala Statistics

The “Genetic Test Request”: A genomic stewardship intervention for inpatient exome and genome orders at a tertiary pediatric hospital

Genet Med. 2024 Nov 15:101330. doi: 10.1016/j.gim.2024.101330. Online ahead of print.

ABSTRACT

PURPOSE: Exome and genome sequencing (ES, GS) are useful tests to diagnose rare disease in pediatric patients in critical care settings. Genomic test stewardship can increase appropriate use of these tests leading to improved diagnostics and cost savings.

METHODS: Mandatory review of ES and GS orders for admitted patients was implemented in March 2023. Outcomes of the reviews, cost analysis, and subsequent test results through February 2024 were analyzed with descriptive statistics.

RESULTS: There were 444 Genetic Test Request (GTR) orders placed for 412 unique patients. Of these, 81 (18.2%) were redirected and 57 (12.8%) required modification after approval leading to an overall cost savings of $345,821.00 USD or $778 USD per order. The combined diagnostic rate was 28.2% in this patient population.

CONCLUSION: Stewardship of ES/GS orders for pediatric inpatients is an effective tool to improve appropriate usage of these genomic tests. Additional collaboration with stakeholders and expansion of genomic stewardship initiatives may shorten the diagnostic odyssey for critically ill pediatric patients and result in cost savings.

PMID:39559977 | DOI:10.1016/j.gim.2024.101330

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Nevin Manimala Statistics

Prevalence of pediculosis among primary school children in Tunisia

East Mediterr Health J. 2024 Sep 1;30(8):561-569. doi: 10.26719/2024.30.8.561.

ABSTRACT

BACKGROUND: Pediculus humanus capitis (head lice) infestation is a global health concern, yet no study has examined its occurrence among primary school children in Tunisia.

AIM: To assess the prevalence of Pediculus capitis and its epidemiological characteristics among primary school children living in rural and urban areas of Monastir, Tunisia.

METHODS: We used 2-step stratified cluster sampling to randomly select 2396 children from 14 primary schools in Monastir during the 2022/2023 academic year. Head lice infestation was assessed through visual inspection of the hair, and data on the socio-demographic characteristics, lifestyle and pediculosis history of the children were collected. We used SPSS version 20 to analyse the data and used descriptive statistics to rate the frequencies. Multivariate logistic regression was used to examine the association between pediculosis and the predictor variables.

RESULTS: Overall infestation rate was 17.5% (95% CI 16.0-19.1%); infestation was 5 times higher among girls (29.1%) than boys (6.3%). Schoolchildren living in crowded family households, those in the third and fourth grades and whose parents had low education level were more exposed to infestation. Combing frequency, comb sharing and history of previous infestation had significant impact (P < 0.05) on the prevalence of pediculosis. Multivariate logistic regression showed gender and treatment outcome as the main potentiating factors.

CONCLUSION: These findings highlight the need for pediculosis prevention and integrated health promotion programmes among primary school children and their parents, teachers and nurses in Monastir and other parts of Tunisia.

PMID:39559973 | DOI:10.26719/2024.30.8.561

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Nevin Manimala Statistics

Decreasing Endomyocardial Biopsy Frequency in Pediatric Heart Transplantation Using A Rejection Risk Prediction Score-A Single Center Study

Pediatr Transplant. 2024 Dec;28(8):e14894. doi: 10.1111/petr.14894.

ABSTRACT

BACKGROUND: Rejection remains an important cause of morbidity and mortality after pediatric heart transplantation (HT). Endomyocardial biopsy (EMB) is the gold standard for rejection diagnosis, but it comes with procedural risk. The frequency of EMB varies significantly across centers. Since April 2018, our center’s surveillance EMB schedule is based on a rejection risk prediction score employing age, pre-HT diagnosis, and panel reactive antibodies (PRA). We aimed to evaluate outcomes in the 1st year post-HT before and after risk score implementation.

METHODS: Patients who underwent HT at our center at ≤ 18 years of age from January 2015 to December 2020 were reviewed. The primary endpoint was rejection-free survival at 1 year-post- HT. Clinical characteristics were compared for patients transplanted in Era 1 (January 2015-April 2018) and Era 2 (April 2018-December 2020). Cumulative 1-year survival free from rejection and from rejection with hemodynamic compromise (RHC) was compared between eras using Kaplan-Meier survival analysis.

RESULTS: 115 patients underwent HT during our study period (52 in Era 1 and 63 in Era 2). There was an increase in VAD utilization between eras (19% in Era 1 vs. 40% in Era 2, p = 0.025), but otherwise no significant difference in demographic or clinical variables between the two eras. No statistically significant difference in freedom from rejection or freedom from RHC was identified between the two eras. There was a 60% reduction in the median number of EMB per patient in the first year post-HT after employing the score (5 in Era 1 vs. 2 in Era 2, p < 0.001).

CONCLUSIONS: After employing a rejection risk prediction score, our center decreased the frequency of EMB without worsening early post-HT outcomes, thus establishing the clinical applicability of this tool.

PMID:39559942 | DOI:10.1111/petr.14894

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Nevin Manimala Statistics

Zygomatic implants in the rehabilitation of severe maxillary atrophy: A retrospective study of 274 zygomatic implants with a mean follow-up period of 7.5 years

Int J Oral Implantol (Berl). 2024 Nov 19;17(4):401-408.

ABSTRACT

PURPOSE: Zygomatic implants are considered one of the last options for the rehabilitation of severe maxillary atrophy when standard implants cannot be placed. They offer several advantages but can also present complications. This study aimed to investigate the long-term clinical and radiographic outcomes of zygomatic implant placement.

MATERIALS AND METHODS: A retrospective chart review was conducted, and the inclusion criteria consisted of patients previously treated with zygomatic implants who had Class V or VI maxillary bone atrophy according to Cawood and Howell, and with a minimum follow-up period of 2 years after prosthetic loading. Outcome measures included implant and prosthesis survival rate, biological and biomechanical complications, and Lund-Mackay staging score before and after implant placement.

RESULTS: The study included 78 patients who received a total of 274 zygomatic implants. The mean follow-up period was 90.4 ± 26.0 months. Seventeen implant failures occurred, resulting in a survival rate of 93.8%, with a statistically significant negative correlation with smoking habits (P = 0.049), anchorage to the two zygomatic bone cortices (bicorticality) (P 0.001) and soft tissue complications (P 0.001). The prosthetic success rate was 92.3%. A statistically significant increase in maxillary sinus radiopacity was recorded when comparing the situation before and after surgery (P 0.001), and the intrasinus pathway had a statistically significant influence on that increase (P = 0.003).

CONCLUSIONS: Zygomatic implants utilised for rehabilitating patients with severe maxillary atrophy have shown favourable outcomes. Nonetheless, owing to potential complications, strict case selection is necessary, combined with regular recall visits and proper oral hygiene maintenance. Furthermore, this type of surgery necessitates specialised training and expertise on the part of the practitioner.

PMID:39559940

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Nevin Manimala Statistics

No Association Found: Adverse Childhood Experiences and Cognitive Impairment in Older Australian Adults

J Prev Alzheimers Dis. 2024;11(6):1818-1825. doi: 10.14283/jpad.2024.133.

ABSTRACT

OBJECTIVE: This study aimed to investigate the relationship between childhood adversity and cognitive impairment in older adults.

METHODS: We analysed data from 1568 participants aged 72-79 (M = 75.1, SD = 1.5, % male = 52.6%) from Wave 4 of the Personality and Total Health (PATH) Through Life Project. The outcome variable was the presence of mild cognitive impairment (MCI) or dementia, determined through a clinically validated algorithmic diagnostic criteria. Childhood adversity was assessed using a 17-item scale covering various domestic adversities such as poverty, neglect, physical abuse, and verbal abuse. Adversity was operationalised using cumulative analysis, dichotomisation (<3 adversities; 3+ adversities), and latent class analysis. Multiple logistic regressions were employed to estimate the association between childhood adversity and cognitive impairment, while controlling for covariates including education, gender, ethnicity, and APOE ε4 status.

RESULTS: Our analyses revealed no significant association between childhood adversity and the presence of MCI or dementia across all tested models. Sensitivity analyses, exploring alternative scenarios, consistently failed to yield statistically significant findings.

CONCLUSION: In contrast to prevailing research findings, this study does not support a link between childhood domestic adversity and late-life cognitive outcomes. These results underscore the mixed results on adversity and cognition, highlighting the need for further research. Future investigations should consider the roles of potential mediating and protective factors within this complex relationship.

PMID:39559893 | DOI:10.14283/jpad.2024.133

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Nevin Manimala Statistics

Acoustic Speech Analysis in Alzheimer’s Disease: A Systematic Review and Meta-Analysis

J Prev Alzheimers Dis. 2024;11(6):1789-1797. doi: 10.14283/jpad.2024.132.

ABSTRACT

BACKGROUND: The potential of biomarkers in the detection of Alzheimer’s disease (AD) is prominent. Acoustics may be useful in this context but the evaluation and weighting for specific acoustic parameters on continuous speech is missing. This meta-analysis aimed to explore the significance of acoustic parameters from acoustic speech analysis on continuous speech, as a diagnostic tool for clinical AD.

METHODS: Applying PRISMA protocol, a comprehensive search was done in MEDLINE, Scopus, Web of Science, and CENTRAL, from 1960 to January 2024. Cross-sectional studies comparing the acoustic speech analysis between AD patients and healthy controls (HC), were taken into account. The bias risk of the included studies were examined via JBI checklist. Using Review Manager v.5.4.1, the mean differences of acoustic speech parameters among AD and HC were weighted, and the pooled analysis and the heterogeneity statistics were conducted.

RESULTS: In total, 1112 records (without duplicates) were obtained, and 11 papers with 7 acoustic parameters were included for this study, and 8 from 11 studies were identified with a low level of bias. Five from 7 acoustic parameters revealed significant differences among the two groups (p-values ≤ 0.01), in which for all rate-related and interruption-related acoustic parameters were the most prominent and less in temporal-related acoustic parameters.

CONCLUSIONS: Although a small number of acoustic parameters on continuous speech could be evaluated in the detection of clinical AD, the greatest potential of acoustic biomarkers for AD appeared to exist in two of three categories. Further contributions of high-quality studies are needed to support evidence for acoustics as biomarkers for AD.

PMID:39559890 | DOI:10.14283/jpad.2024.132

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Nevin Manimala Statistics

Correlates of Subjective Cognitive Decline in Black American Men

J Prev Alzheimers Dis. 2024;11(6):1734-1740. doi: 10.14283/jpad.2024.162.

ABSTRACT

BACKGROUND: Past research suggests that subjective cognitive decline serves as an early and potentially important indicator that individuals may be at risk for future cognitive decline or neurodegenerative conditions. However, there is a dearth of studies on factors influencing the experience of subjective cognitive decline in Black Americans, especially in Black American men.

OBJECTIVE: The current study explored correlates of subjective cognitive decline in Black American men.

PARTICIPANTS: A total of 117 Black American men, with a mean age of 38.5 (SD = 7.14) years, participated in the study.

MEASUREMENT: Participants completed a survey that assessed their demographic characteristics, self-rated health, neighborhood problems, length of residency in neighborhood, bodily symptoms, sleep comorbidities, sleep difficulties, and subjective cognitive decline. Linear regression analyses was performed and standardized beta coefficients were reported to describe the estimated independent effect of the predictor variables.

RESULTS: We found that socioecomic status (β = -.222, p=.003), bodily symptoms (β = .246, p=.005), length of residency in neighborhood (β = .157, p=.029), and sleep difficulties (β = .305, p<.001) were significant correlates of subjective cognitive decline among Black American men.

CONCLUSION: These findings underscore the intricate roles of socioeconomic status, bodily symptoms, neighborhood factors, and sleep health in shaping subjective cognitive experiences in this population. Research on subjective cognitive decline can contribute to the early identification of individuals at risk for cognitive decline, allowing for timely interventions, lifestyle modifications, and potential preventive measures.

PMID:39559884 | DOI:10.14283/jpad.2024.162