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Nevin Manimala Statistics

Efficacy and Safety of Cardiac Myosin Inhibitors in Hypertrophic Cardiomyopathy: A Meta-Analysis of Randomized Controlled Trials

Cardiol Rev. 2024 Oct 14. doi: 10.1097/CRD.0000000000000803. Online ahead of print.

ABSTRACT

Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disorder characterized by structural and functional abnormalities. Current management strategies, such as medications and septal reduction therapies, have significant limitations and risks. Recently, cardiac myosin inhibitors (CMIs) like mavacamten and aficamten have shown promise as noninvasive treatment options. This meta-analysis aims to evaluate the efficacy and safety of CMIs in HCM patients. PubMed/MEDLINE, Embase, the Cochrane Library, Ovid, and ClinicalTrials.gov were searched for randomized controlled trials (RCTs) that compared CMIs to control treatments in HCM patients from inception till June 15, 2024. A random-effects model was used to pool odds ratios (ORs) for dichotomous outcomes and mean differences (MDs) for continuous outcomes along with the corresponding 95% confidence intervals (CIs). Heterogeneity was assessed using the χ2 test and Higgins I2 statistic, and sensitivity and subgroup analyses were performed. Six RCTs involving 826 patients were included. CMI therapy significantly reduced resting left ventricular outflow tract (LVOT) gradient (MD, -37.64; 95% CI, -46.71 to -28.56), Valsalva LVOT gradient (MD, -46.04; 95% CI, -57.60 to -34.48), post-exercise LVOT peak gradient (MD, -48.64; 95% CI, -68.20 to -28.88), N-terminal pro-b-type natriuretic peptide levels (MD, -1.05; 95% CI, -1.64 to -0.47), and cardiac troponin I levels (MD, -7.96; 95% CI, -12.84 to -3.07). Improvements were observed in peak oxygen consumption (MD, 1.20; 95% CI, 0.23-2.17) and patient-reported outcomes (Kansas City Cardiomyopathy Questionnaire Clinical Summary Score: MD, 6.44; 95% CI, 3.50-9.37), with more patients achieving New York Heart Association class improvement >1 (OR, 4.05; 95% CI, 2.61-6.30). Treatment-emergent adverse events were higher with CMI therapy (OR, 1.45; 95% CI, 1.02-2.05), but serious adverse events and other safety outcomes were comparable in both groups. CMIs, including mavacamten and aficamten, significantly improve clinical outcomes in HCM patients with a manageable safety profile. These results indicate that CMIs offer a promising noninvasive alternative to septal reduction therapies.

PMID:39729579 | DOI:10.1097/CRD.0000000000000803

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Nevin Manimala Statistics

Patient-Reported Experience Measures for In- and Outpatients in Mental Health and Substance Use Services: Psychometric Properties and Results From a Nationwide Survey in Finland

Int J Methods Psychiatr Res. 2025 Mar;34(1):e70010. doi: 10.1002/mpr.70010.

ABSTRACT

OBJECTIVES: We implemented the first national patient experience survey, with novel patient-reported experience measures (PREMs), in out- and inpatient mental health and substance use services in Finland.

METHODS: The Outpatient Experience Scale (OPES) and the Inpatient Experience Scale (IPES) were co-designed with experts by experience and professionals. The survey was carried out in 2021 in 435 treatment facilities. We applied bi-factor analysis of ordinal indicators to prespecified and exploratory models.

RESULTS: We received 8794 outpatient and 1112 inpatient responses. Both the OPES and the IPES were essentially unidimensional, with high internal consistency (omega 0.98 in both) and strong factor loadings. The Net Promoter Score item was a fairly poor indicator of overall satisfaction. The most positive experiences were related to respect and acceptance, while statements related to receiving information and inclusion of significant others in the treatment process received more critical feedback. The best experience was in integrated mental health and substance use services. Involuntarily admitted patients had the most negative patient experiences.

CONCLUSIONS: The new PREMs proved to work well in measuring patient experience. Service users generally reported positive experiences. The primary service development need is sharing information with patients.

PMID:39729570 | DOI:10.1002/mpr.70010

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Nevin Manimala Statistics

Burnout among Nurses, Midwives, and Physicians in Maternity Care Exposed to Traumatic Childbirth Events

MCN Am J Matern Child Nurs. 2024 Nov-Dec 01;49(6):332-340. doi: 10.1097/NMC.0000000000001046. Epub 2024 Oct 15.

ABSTRACT

PURPOSE: To describe the relationship between experiencing traumatic childbirth events and burnout.

STUDY DESIGNS AND METHODS: This descriptive cross-sectional study used an anonymous online survey to assess traumatic childbirth event exposure and the three independent constructs of burnout: emotional exhaustion, depersonalization, and personal accomplishment. Participants were a convenience sample of registered nurses, obstetric residents, family medicine residents, and attending obstetricians across five hospitals from December 2020 through June 2021. The traumatic childbirth event questionnaire measured the frequency of traumatic childbirth event exposure, perception of severity, and perceived influence on the participant’s professional practice and personal life.

RESULTS: Data were analyzed from 150 participants. Registered nurses represented the largest percentage of participants (66%). Components of burnout varied according to race and occupation. Asian/Pacific Islanders had significantly higher mean depersonalization scores at 10.1 (SD = 6.0). Resident physicians had the highest emotional exhaustion scores (M = 34.6, SD = 8.8). Traumatic childbirth events perceived influence on practice correlates with personal accomplishments. Yet, no relationship was observed between traumatic childbirth events, emotional exhaustion, and depersonalization. Linear mixed analysis revealed that hospitals account for 7.5% of the variance in emotional exhaustion scores, 11.1% in depersonalization scores, and 1.3% in personal accomplishments scores.

CLINICAL IMPLICATIONS: Maternity clinicians experience burnout at similar rates to those in other specialties. Although traumatic childbirth events are infrequent and not strongly correlated with emotional exhaustion and depersonalization, hospitals should implement effective strategies to support clinicians after such events. Educational interventions can enhance knowledge and resilience, whereas specialized training effectively alleviates burnout. Development of evidence-based strategies that prioritize the wellbeing of clinicians and patients is crucial.

PMID:39729560 | DOI:10.1097/NMC.0000000000001046

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Nevin Manimala Statistics

A Software Tool for Rapid and Automated Preprocessing of Large-Scale Serum Metabolomic Data by Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry

Anal Chem. 2024 Dec 27. doi: 10.1021/acs.analchem.4c03513. Online ahead of print.

ABSTRACT

Mass spectrometry (MS)-based metabolomics often rely on separation techniques when analyzing complex biological specimens to improve method resolution, metabolome coverage, quantitative performance, and/or unknown identification. However, low sample throughput and complicated data preprocessing procedures remain major barriers to affordable metabolomic studies that are scalable to large populations. Herein, we introduce PeakMeister as a new software tool in the R statistical environment to enable standardized processing of serum metabolomic data acquired by multisegment injection-capillary electrophoresis-mass spectrometry (MSI-CE-MS), a high-throughput separation platform (<4 min/sample) which takes advantage of a serial injection format of 13 samples within a single analytical run. We performed a rigorous validation of PeakMeister by analyzing 47 cationic metabolites consistently measured in 5,000 serum and 420 quality control samples from the Brazilian National Survey on Child Nutrition (ENANI-2019) comprising a total of 224,983 metabolite peaks acquired in 40 days across three batches over an eight-month period. A migration time index using a panel of 11 internal standards was introduced to correct for large variations in migration times, which allowed for reliable peak annotation, peak integration, and sample position assignment for serum metabolites having two flanking internal standards or a single comigrating stable-isotope internal standard. PeakMeister accelerated data preprocessing times by 30-fold compared to manual processing of MSI-CE-MS data by an experienced analyst using vendor software, while also achieving excellent peak annotation fidelity (median accuracy >99.9%), acceptable intermediate precision (median CV = 16.0%), consistent metabolite peak integration (mean bias = -2.1%), and good mutual agreement when quantifying 16 plasma metabolites from NIST SRM-1950 (mean bias = -1.3%). Reference ranges are also reported for 40 serum metabolites in a national nutritional survey of Brazilian children under 5 years of age from the ENANI-2019 study. MSI-CE-MS in conjunction with PeakMeister allows for rapid and automated processing of large-scale metabolomic studies that tolerate nonlinear migration time shifts without complicated dynamic time warping or effective mobility scale transformations.

PMID:39729551 | DOI:10.1021/acs.analchem.4c03513

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Nevin Manimala Statistics

Assessing the Reliability of YouTube Content for Plastic Surgery Patient Information in Africa With the Modified DISCERN and JAMA Scores

Ann Plast Surg. 2024 Dec 18. doi: 10.1097/SAP.0000000000004186. Online ahead of print.

ABSTRACT

INTRODUCTION: YouTube has become a popular source of health information, including plastic surgery. Given the platform’s wide reach and potential influence on patient decisions, this study aimed to assess the quality of information available on YouTube for African audiences seeking plastic surgery procedures.

METHODS: This cross-sectional study extracted data from YouTube videos on plastic surgery relevant to Africa. A search strategy identified videos in English using keywords. The first 50 results for each term were included, with duplicates removed. Next, the metadata of videos published from inception to June 9, 2024, were extracted. Two reviewers independently assessed videos using standardized tools to evaluate reliability (modified DISCERN and JAMA criteria) and engagement (likes-to-views ratio [LVR] and comments-to-views ratio [CVR]). The Mann-Whitney U test was used for unadjusted bivariable comparisons. Then ordinal logistic and beta regression analyses were used to evaluate the primary (modified DISCERN and JAMA scores) and secondary (LVR and CVR) outcomes, with a statistical significance level set at 0.05.

RESULTS: Eight hundred ninety-seven plastic surgery videos were analyzed, and 3.9% were published by African entities. Large subscriber count (coefficient = -6.9e-8, 95% confidence interval [CI] [-1.13e-7, -2.9e-8], P = 0.001), African-authored (coefficient = -0.85, 95% CI [-1.44, -0.25], P = 0.005), and advertising (coefficient = -1.01, 95% CI [-1.63, -0.57], P < 0.001) videos had lower modified DISCERN scores. Advertising videos equally had lower JAMA scores (coefficient = -1.29, 95% CI [-1.83, -0.74], P < 0.001). Academic videos had lower LVR (coefficient = -0.48, 95% CI [-0.66, -0.30], P < 0.001), whereas independent videos had higher LVR (coefficient = 0.40, 95% CI [0.26, 0.54], P < 0.001). Academic videos had lower CVR (coefficient = -0.40, 95% CI [-0.67, -0.13], P = 0.003), whereas videos with other purposes had higher CVR (coefficient = 0.37, 95% CI [0.10, 0.64], P = 0.007).

CONCLUSIONS: This study underscores a potential disparity in the quality of online plastic surgery information based on video sources and purposes.

PMID:39729548 | DOI:10.1097/SAP.0000000000004186

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Nevin Manimala Statistics

Smear layer removal comparing conventional irrigation, passive ultrasonic irrigation, EndoActivator System, and a new sonic device (Perfect Clean System) by scanning electron microscopy: An ex vivo study

PLoS One. 2024 Dec 27;19(12):e0314940. doi: 10.1371/journal.pone.0314940. eCollection 2024.

ABSTRACT

AIM: This study evaluated the smear layer removal provided by conventional, sonic, and ultrasonic irrigation techniques.

METHODOLOGY: Forty extracted human mandibular first premolars were selected and instrumented using the ProTaper Next System files and 2.5% sodium hypochlorite. Afterward, they were divided into 4 groups (n. 10) according to the irrigation technique used to perform the final irrigation with a chelating solution (17% EDTA): conventional irrigation (CI), passive ultrasonic irrigation (PUI), EndoActivator System (EAS), and Perfect Clean System (PCS). The smear layer removal was determined through a score after evaluating scanning electron microscope images (1.000x) obtained at 1, 5, 8, and 12mm from the working length (WL). Statistical analyses were carried out by the Kruskal-Wallis and Dunn’s tests with a significance level of 5% (P < 0.05).

RESULTS: All irrigation techniques were unable to promote an effective smear layer removal at 1mm from the WL in comparison with the other locations (P < .05). At 5, 8, and 12mm from the WL, no statistically significant differences were observed among CI, PUI, EAS, and PCS (P > 0.05). At 12mm from the WL, statistically significant differences were only identified after comparing PCS and CI (P < .05).

CONCLUSION: The smear layer removal was only efficient at 5, 8, and 12 from the WL with no significant statistical differences among CI, PUI, EAS, and PCS (P > 0.05).

PMID:39729517 | DOI:10.1371/journal.pone.0314940

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Nevin Manimala Statistics

Improving patient satisfaction based on service quality in clinical trials: A cross-sectional study

PLoS One. 2024 Dec 27;19(12):e0313340. doi: 10.1371/journal.pone.0313340. eCollection 2024.

ABSTRACT

BACKGROUND: Participants’ satisfaction is an important factor in securing competitiveness in clinical trials. In many industries, such as healthcare, customer service quality has been analyzed to increase customer satisfaction. However, no study so far has attempted to measure participants’ perceptions of service quality in the clinical trial area and identify its effect on participant satisfaction.

OBJECTIVE: This study examined the experiences and perceptions of clinical trial participants in terms of service quality and identified the factors that impact participant satisfaction in clinical trials.

METHODS: This study used a cross-sectional descriptive and explanatory research design. Data were collected from March 29 to May 26, 2023, via a survey. The survey was conducted with 206 adults participating in clinical trials at two hospitals in Korea. The collected data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson’s correlation, and multiple linear regression analysis.

RESULTS: Participants’ perceptions of the service quality and their satisfaction in clinical trials were generally positive. The variables that significantly predicted participant satisfaction in clinical trials included quality of interaction with researchers, physical environment, performance results in clinical trials, changes in health status after participating in the trial, and consideration of discontinuing the trial.

CONCLUSIONS: Participants’ perception of the service quality significantly affected their satisfaction in clinical trials. Thus, all components of service quality should be considered in the overall clinical trial process to increase participants’ satisfaction.

PMID:39729511 | DOI:10.1371/journal.pone.0313340

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Nevin Manimala Statistics

The prevalence and associated factors of the minimum acceptable diet among children aged 6-23 months in Ethiopia: A community-based cross-sectional study

PLoS One. 2024 Dec 27;19(12):e0315121. doi: 10.1371/journal.pone.0315121. eCollection 2024.

ABSTRACT

BACKGROUND: A minimum acceptable diet for children aged 6-23 months is limited globally, with Ethiopia’s proportion reducing to one in nine. This study was aimed to assess the prevalence of the minimum acceptable diet and associated factors among children aged 6-23 months in Dera town, Oromia, Ethiopia.

METHODS: A community-based cross-sectional study was conducted. Systematic random sampling techniques were used to select the study subjects. The data was coded, entered into Epi-Info version 7, and then exported to SPSS version 24 for analysis. The variance inflation factor and tolerance test are used to check multicollinearity. Descriptive statistics of frequency (%) were used. Hosmer and Lemeshow’s goodness-of-fit test at a P-value > 0.05 is considered the model fit. Bivariate and multivariate logistic regression analyses were computed with a 95% confidence interval, and a P-value < 0.05 was, considered statistically significant.

RESULTS: A total of 430 study subjects were included in this study. The prevalence of a minimum acceptable diet was 36.5% (95% confidence interval (CI): 32, 41%). In the adjusted model, mothers attaining a primary school (adjusted odds ratio (AOR) = 2.7, 95%CI: 1.3, 4.8), college and above education (AOR = 4.3, 95%CI: 1.4, 13), child age between 12-17 months (AOR = 6.2, 95%CI: 2.80, 13.50) and 18-23 months (AOR = 4.61, 95%CI: 2.04, 10.40), ANC visit four or more (AOR = 2.0, 95%CI: 1.2, 3.4), and not feeding breast (AOR = 0.15, 95% CI: 0.07, 0.31) were significantly associated with meeting the minimum acceptable diet.

CONCLUSION: This study showed that the practice of a minimum acceptable diet was low, according to the World Food Program target. Mothers’ educational status, antenatal care visits, age of the child, and breastfeeding were the predictors of the minimum acceptable diet.

PMID:39729498 | DOI:10.1371/journal.pone.0315121

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Nevin Manimala Statistics

Use of interactional metadiscourse and identity construction in responses to negative online reviews of Chinese and British hotels

PLoS One. 2024 Dec 27;19(12):e0316071. doi: 10.1371/journal.pone.0316071. eCollection 2024.

ABSTRACT

In the business context, effectively responding to negative reviews is critical for a hotel to maintain reputation and customer relations. To explore the linguistic devices employed in addressing guest complaints, a corpus-based study is conducted on the use of interactional metadiscourse and identity construction in responses to negative online reviews of Chinese and British Hotels. Drawing upon the statistical results of the usage of interactional metadiscourse and the analysis of discourse examples, this study delves into the frequency and similarities/differences in the employment of five subcategories of interactional metadiscourse across the respective corpora of 100 responses to negative reviews from hotels in Beijing and hotels in London. Furthermore, the study examines the characteristics and similarities/ differences of the identity construction of manager, communicator, doer and advisor with the use of interactional metadiscourse. The findings reveal that there are significant differences between the two sides in the use of self-mentions, boosters, hedges and positive attitude markers, while there is little difference in the use of engagement markers and negative attitude markers. The most constructed identity by both sides is the communicator, and the least is the adviser, with little difference. The identity of manager is significantly more prevalent in responses from hotels in Beijing, whereas hotel responders in London exhibit a notably greater tendency to construct the identity of doer. The similarities and variances of interactional metadiscourse use and identity construction indicate the two sides’ distinctive priorities in interactions with guests and different cultural values, which provide valuable insights for hotels on the effective use of metadiscourse to construct multiple identities, revealing that the strategically crafted responses play a pivotal role in shaping favorable images, fostering harmonious relationships with customers and promoting sustainable development of the hotels.

PMID:39729493 | DOI:10.1371/journal.pone.0316071

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Nevin Manimala Statistics

Association between exposure to urinary metal and all-cause and cardiovascular mortality in US adults

PLoS One. 2024 Dec 27;19(12):e0316045. doi: 10.1371/journal.pone.0316045. eCollection 2024.

ABSTRACT

BACKGROUND: Further evidence is required regarding the influence of metal mixture exposure on mortality. Therefore, we employed diverse statistical models to evaluate the associations between eight urinary metals and the risks of all-cause and cardiovascular mortality.

METHODS: We measured the levels of 8 metals in the urine of adults who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Based on follow-up data, we determined whether they died and the reasons for their deaths. We estimated the association between urine metal exposure and all-cause mortality using Cox regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) models. Additionally, we used a competing risk model to estimate the relationship between metal exposure and cardiovascular mortality.

RESULTS: Among the 14,305 individuals included in our final analysis, there were 2,066 deaths, with 1,429 being cardiovascular-related. Cox regression analysis showed that cobalt (Co) (HR: 1.21; 95% CI: 1.13, 1.30) and antimony (Sb) (HR: 1.26; 95% CI: 1.12, 1.40) were positively associated with all-cause mortality (all P for trend <0.001). In the competing risk model, Co (HR: 1.29; 95% CI: 1.12, 1.48), lead (Pb) (HR: 1.18; 95% CI: 1.03, 1.37), and Sb (HR: 1.44; 95% CI: 1.18, 1.75) were significantly associated with an increased risk of cardiovascular mortality (all P for trend <0.001). Sb, Pb, cadmium (Cd), and molybdenum (Mo) had the highest weight rankings in the final WQS model. All metals showed a complex non-linear relationship with all-cause mortality, with high posterior inclusion probabilities (PIPs) in the final BKMR models.

CONCLUSIONS: Combining all models, it is possible that Sb may have a more stable impact on all-cause and cardiovascular mortality. Meaningful metal effects in individual statistical models still require careful attention.

PMID:39729492 | DOI:10.1371/journal.pone.0316045