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Nevin Manimala Statistics

Healthcare Costs and Early Complications in Liver-Transplanted Patients With Portal Vein Thrombosis: Experience From a Colombian Reference Center

Value Health Reg Issues. 2025 Jan 15;46:101070. doi: 10.1016/j.vhri.2024.101070. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to analyze the direct healthcare costs and early complications associated with pretransplant portal vein thrombosis (PVT) in cirrhotic patients undergoing their first orthotopic liver transplant (LT) at a hospital in Colombia from 2013 to 2021.

METHODS: A registry-based retrospective follow-up study was conducted on cirrhotic patients aged 14 years or older who underwent their first LT at the San Vicente Fundación Rionegro Hospital between January 2013 and April 2021. The primary outcomes were early (30-day) vascular and biliary complications and direct healthcare costs. The generalized linear model was used to estimate observed and adjusted mean differences in costs and risk ratios for complications based on pretransplant PVT. Costs were expressed in 2020 international dollars.

RESULTS: The medical records of 161 patients were analyzed, with 15.5% having pretransplant PVT. Patients with pretransplant PVT exhibited a statistically significant higher risk of early vascular complications (adjusted risk ratio 2.17; 95% CI 1.04-4.51; P = .039). However, there was no statistically significant difference in the risk of early biliary complications (P = .225). Patients with grade I PVT did not show a significant difference in costs compared with patients without PVT (P = .661). For patients with grade II-IV PVT, the adjusted mean difference in the healthcare cost was 33 175 international dollars (95% CI 730-65 620).

CONCLUSIONS: Patients with pretransplant grade II-IV PVT have a higher risk of early vascular complications and require more medical resources, leading to increased costs associated with LT.

PMID:39818171 | DOI:10.1016/j.vhri.2024.101070

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Nevin Manimala Statistics

Relative abundance of atropisomer pairs in metolachlor metabolites, MESA and MOXA, vary with slope and hydric soils in subwatersheds of the Choptank River watershed, Maryland

Sci Total Environ. 2025 Jan 15;963:178399. doi: 10.1016/j.scitotenv.2025.178399. Online ahead of print.

ABSTRACT

Metolachlor is the most heavily used member of acetanilide herbicides, which are noted for forming highly soluble metabolites in root zone soils soon after field application. The two primary metabolites of metolachlor, metolachlor ethane sulfonic acid (MESA) and metolachlor oxanilic acid (MOXA), retain the same chiral chemistry as their source and are important tracers of nitrate loading from agricultural cropland. New analytical methods for separating the isomers of MESA and MOXA, enable studies assessing changes in the abundance of atropisomer pairs of the carbon chiral enantiomers in environmental samples. These changes were documented starting with the atropisomers in the parent metolachlor structure, leading to soil-degraded metabolites, and then in samples collected over 3 years from 15 subwatersheds in the Upper Choptank River Watershed. The influence of drainage differences, %hydric soil and slope, across the watershed strongly correlate with shifts in atropisomer abundance ratios, especially for those enantiomers of MOXA and MESA with axial aS rotations. The hypothesis is that differentiating atropisomer chiral shifts occur as the compounds exit to receiving waters. These findings offer a novel tool to study the transport of these important tracers of cropland-influenced groundwater.

PMID:39818152 | DOI:10.1016/j.scitotenv.2025.178399

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Nevin Manimala Statistics

Effects of warning information at medication initiation on deprescribing intentions in older adults: A hypothetical vignette

Patient Educ Couns. 2025 Jan 10;133:108654. doi: 10.1016/j.pec.2025.108654. Online ahead of print.

ABSTRACT

OBJECTIVES: To explore to what degree providing patients warning information about the long-term risks of a medication would affect their subsequent desire to discontinue it.

METHODS: We conducted a vignette-based online experiment in which participants aged ≥ 65 years from the United States were asked to imagine starting and subsequently stopping omeprazole. Participants were randomized to one of four vignettes about starting omeprazole (potential long-term harms or no harm information; OTC vs. prescription). Participants reported interest in stopping omeprazole on a 6-point Likert scale. We calculated descriptive statistics and used logistic regression to compare participants with high (scores 4-6) versus low agreement (scores 1-3) with stopping.

RESULTS: Participants (n = 1245) had a median age of 70 years. After adjusting for demographic characteristics, older adults who received warning information when starting the medication were more likely to agree to stop omeprazole (OR 1.21, 95 % C.I. 1.02, 1.43). Willingness to stop omeprazole was higher among women (vs. men), among respondents with higher literacy, and among those who had never or previously used PPIs (vs current use).

CONCLUSION: Warning information about potential long-term risks when initiating a medication may increase the likelihood of subsequently stopping a medication when recommended by a PCP.

PMID:39818128 | DOI:10.1016/j.pec.2025.108654

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Nevin Manimala Statistics

Efficacy and safety of olive leaf extract (Olea europaea L.) for glycaemic control in adults with type 2 diabetes mellitus (ESOLED): A pilot randomised controlled trial

Complement Ther Clin Pract. 2025 Jan 13;59:101949. doi: 10.1016/j.ctcp.2025.101949. Online ahead of print.

ABSTRACT

BACKGROUND: Maintaining optimum glycaemic control is essential to reducing comorbidity and mortality in diabetes. However, research indicates that <50 % of patients achieve their target HbA1c ranges. Laboratory studies suggest that olive leaf extract (OLE) may improve glycaemic control, however clinical studies in persons with diabetes are lacking.

METHODS: ESOLED is a pilot, randomised, placebo-controlled trial. Adults with a diagnosis of type 2 diabetes of ≥12 months duration, and not receiving insulin therapy, were eligible to participate. Participants were randomised to receive OLE or placebo capsules for 24 weeks. The primary outcome was change in HbA1c. Secondary outcomes included changes in the homeostasis model assessment of insulin resistance, diabetes-related stress, health-related quality of life, and safety.

RESULTS: Thirty-one participants were randomly assigned to the OLE (n = 16) and placebo (n = 15) groups. Analyses found no statistically significant time-group interactions for HbA1c, diabetes-related distress or health-related quality of life. Although participants receiving OLE demonstrated greater improvements in insulin sensitivity than those on placebo, there was no significant difference between groups over time. OLE and placebo were found to be well-tolerated, with no severe or serious adverse events reported in either group.

CONCLUSION: The ESOLED trial has provided preliminary evidence on the tolerability of OLE in adults with type 2 diabetes, but was inconclusive in determining whether OLE is effective at improving glycaemic control, insulin sensitivity, diabetes-related distress and quality of life. Larger trials and further exploration of the bioavailability of OLE are needed to fully assess the therapeutic potential of OLE in diabetes.

TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ACTRN12622000616774).

PMID:39818111 | DOI:10.1016/j.ctcp.2025.101949

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Nevin Manimala Statistics

Trauma exposure as a risk factor of major depressive disorder: A matched case-control study

J Psychiatr Res. 2025 Jan 10;182:204-211. doi: 10.1016/j.jpsychires.2025.01.028. Online ahead of print.

ABSTRACT

The association between childhood trauma (CT), stressful life events (SLE) and the onset and severity of major depressive disorder (MDD) has not been extensively studied. This study aimed to investigate the separate and combined association of CT and SLE with the onset and severity of MDD. A total of 503 patients with MDD and 503 controls were included. The diagnosis of MDD was assessed using the Mini-International Neuropsychiatric Interview (M.I.N.I.) by trained psychiatrists. Trauma exposure was assessed using the short form of Childhood Trauma Questionnaire (CTQ-SF) and stressful life events screening questionnaire (SLESQ). A series of conditional logistic regression models and multiple linear regression models were performed. The majority of patients with MDD (84.9%) and controls (61.6%) have reported trauma exposure. After adjusting for covariates, exposure to CT or SLE was independently associated with an elevated risk of the onset and severity of MDD. Moreover, a significant additive interaction between CT and SLE on the onset of MDD was observed (relative excess risk due to interactions [RERI] = 6.93, 95% confidence interval [CI] = 0.19-13.66). MDD patients were more likely to experience both CT and SLE compared with controls (odds ratio [OR] = 10.37, 95% CI = 4.99-21.56). MDD patients with both CT and SLE experience were more like to have more severe depressive symptoms (β = 2.16, 95% CI = 1.02-3.30). These findings underscore the importance of targeted prevention measures addressing the occurrence of CT and SLE to mitigate the risk of MDD development and the severity of depressive symptoms.

PMID:39818108 | DOI:10.1016/j.jpsychires.2025.01.028

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Nevin Manimala Statistics

Effectiveness of the handgrip test for assessing readiness in national level basketball players: a cohort study

J Sports Med Phys Fitness. 2025 Jan 16. doi: 10.23736/S0022-4707.24.16490-0. Online ahead of print.

ABSTRACT

BACKGROUND: Assessing player readiness is crucial in elite basketball. This study aims to provide a practical method for monitoring player readiness through the handgrip test and identify associations with wellness scales.

METHODS: Fifteen players (age: 25.3±3.3 years; weight: 92.2±11.8 kg; height: 1.94±0.09 m; BMI: 24.3±1.8 kg/m2; experience: 6.5±3.4 years) from an elite basketball team participated in this cohort study, which was conducted over 9 weeks of training and official competitions. All players were medically cleared and injury-free for three months prior. Daily psychometric questionnaires assessed different aspects of wellness using analog scales, combined with a handgrip test. Training cycles were developed according to the Game-Day method.

RESULTS: All parameters investigated, except the handgrip test, (means ranging from 53.43±8.06 kg to 54.03±7.79 kg) showed significant variations in the weekly training cycle (P<0.05). The linear regression results indicate that while the overall model is statistically significant (P=0.039), the predictive power of the individual independent variables is not strong, with the model able to explain approximately 4.13% of the variability in the dependent variable “Handgrip.” The calculation of the minimal detectable change (MDC) confirmed that for this variable, on average, significant changes (approximately 6.77 kg) are generally required to be noteworthy.

CONCLUSIONS: This study demonstrates that the handgrip test is not an effective tool for objectively assessing player readiness in elite basketball. Regular monitoring using this method cannot help in making informed decisions about training and competition readiness. Conversely, psychometric have shown stronger sensitivity in determining player status during the weekly training cycle.

PMID:39817900 | DOI:10.23736/S0022-4707.24.16490-0

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Nevin Manimala Statistics

Psychosocial factors and running-related injuries: unraveling the connection, based on a one-year prospective study

J Sports Med Phys Fitness. 2025 Jan 16. doi: 10.23736/S0022-4707.24.16398-0. Online ahead of print.

ABSTRACT

BACKGROUND: Although runners are healthier than most of the population, they can incur a risk of injury. Literature shows a strong evidence of risk factors for running-related injuries (RRIs) based on characteristics of running. This study aimed to assess differences in psychosocial factors between injured and uninjured recreational runners.

METHODS: The study was designed as a 1-year prospective study with 108 participants (age 36.3±8.4y). The primary outcome was the incidence of RRIs at 1-year follow-up. The primary exposure variables were running-related characteristics and psychosocial factors assessed upon entry into the study. The differences between injured and uninjured runners were assessed using Mann-Whitney U Test, independent samples t-test and the effect size was assessed by Cohen’s d.

RESULTS: No statistically significant differences were observed between injured and uninjured runners in relation to the psychosocial factors examined.

CONCLUSIONS: However, it is noteworthy that we identified medium-sized effects for the amount of sleep (d=0.46) and restless sleep (d=0.43), providing a basis for future research with larger sample sizes and more refined measures of sleep patterns to elucidate the potential role of sleep in RRIs.

PMID:39817899 | DOI:10.23736/S0022-4707.24.16398-0

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Nevin Manimala Statistics

Emotional Intelligence and Job Satisfaction Among Nephrology Nurses Working in Acute and Chronic Hemodialysis Settings

Nephrol Nurs J. 2024 Nov-Dec;51(6):525-530.

ABSTRACT

Nephrology nurses working in hemodialysis units face unique challenges managing multiple patients – an experience often contributing to higher levels of burnout and stress, and potentially lower job satisfaction and retention rates, exacerbating the existing nursing shortage in dialysis settings. Targeted strategies are essential to improve job satisfaction. In this study, we explored the relationship between emotional intelligence and job satisfaction among nephrology nurses working in acute and chronic hemodialysis settings. A quantitative, non-experimental, descriptive, correlational design was used. There was a statistically significant positive correlation between emotional intelligence and job satisfaction, suggesting that heightened levels of emotional intelligence are associated with increased job satisfaction among nurses. Recommendations for enhancing emotional intelligence are discussed.

PMID:39817889

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Nevin Manimala Statistics

Fetal Mortality in the United States: Final 2021-2022 and 2022-Provisional 2023

NCHS Data Brief. 2024 Oct;(36).

ABSTRACT

OBJECTIVES: This report describes changes in total, early, and late fetal mortality between 2022 and 2023 (provisional), as well as fetal mortality by maternal race and Hispanic origin and state of residence. Comparisons are made with findings from 2021 to 2022.

METHODS: Data are based on reports of fetal death filed in the 50 states and the District of Columbia and collected via the National Vital Statistics System. In this report, only fetal deaths reported at 20 weeks of gestation or more are included. Data for 2021 and 2022 are final and data for 2023 are provisional.

RESULTS: In 2023, the overall fetal mortality rate was 5.52 fetal deaths per 1,000 live births and fetal deaths, which was not significantly different from the 2022 rate (5.48). From 2022 to 2023, the early fetal mortality rate (20-27 weeks of gestation) significantly increased by 4% to 2.89 per 1,000, while the late fetal mortality rate (28 weeks of gestation or more) was essentially unchanged at 2.64. Among the race and Hispanic-origin groups, the fetal mortality rate increased for Asian non-Hispanic women and was not significantly different for other groups. Fetal mortality rates increased in 4 states, declined in 1 state, and were not significantly different for 45 states and the District of Columbia from 2022 to 2023. In comparison, from 2021 to 2022, the fetal mortality rate declined for total, early, and late fetal deaths, as well as for White non-Hispanic women and in five states.

PMID:39817856

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Nevin Manimala Statistics

Change surface regression for nonlinear subgroup identification with application to warfarin pharmacogenomics data

Biometrics. 2025 Jan 7;81(1):ujae169. doi: 10.1093/biomtc/ujae169.

ABSTRACT

Pharmacogenomics stands as a pivotal driver toward personalized medicine, aiming to optimize drug efficacy while minimizing adverse effects by uncovering the impact of genetic variations on inter-individual outcome variability. Despite its promise, the intricate landscape of drug metabolism introduces complexity, where the correlation between drug response and genes can be shaped by numerous nongenetic factors, often exhibiting heterogeneity across diverse subpopulations. This challenge is particularly pronounced in datasets such as the International Warfarin Pharmacogenetic Consortium (IWPC), which encompasses diverse patient information from multiple nations. To capture the between-patient heterogeneity in dosing requirement, we formulate a novel change surface model as a model-based approach for multiple subgroup identification in complex datasets. A key feature of our approach is its ability to accommodate nonlinear subgroup divisions, providing a clearer understanding of dynamic drug-gene associations. Furthermore, our model effectively handles high-dimensional data through a doubly penalized approach, ensuring both interpretability and adaptability. We propose an iterative 2-stage method that combines a change point detection technique in the first stage with a smoothed local adaptive majorize-minimization algorithm for surface regression in the second stage. Performance of the proposed methods is evaluated through extensive numerical studies. Application of our method to the IWPC dataset leads to significant new findings, where 3 subgroups subject to different pharmacogenomic relationships are identified, contributing valuable insights into the complex dynamics of drug-gene associations in patients.

PMID:39817854 | DOI:10.1093/biomtc/ujae169