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Nevin Manimala Statistics

Alexithymia as a risk factor for poor emotional outcomes in adults with acquired brain injury

Neuropsychol Rehabil. 2023 Dec;33(10):1650-1671. doi: 10.1080/09602011.2022.2140680. Epub 2022 Nov 3.

ABSTRACT

Emotional disorders are pervasive in the acquired brain injury (ABI) population, adversely affecting quality of life and rehabilitation. This study aimed to explore the unique associative effects of alexithymia as measured by the Perth Alexithymia Questionnaire (PAQ; i.e., difficulty identifying positive/negative feelings, difficulty describing positive/negative feelings, and externally orientated thinking), on emotional outcomes as measured by the Depression Anxiety Stress Scale-21 (DASS-21) and Mayo-Portland Adaptability Inventory (MPAI-4) Adjustment index, in 83 adults with ABI. The addition of alexithymia to hierarchical multiple regression models (controlling for demographic, injury-related, and functional outcome variables) yielded statistically significant changes in R2 for all emotional outcome measures (i.e., Depression, Anxiety, Stress, and Adjustment). Difficulty identifying negative feelings was found to be a significant unique predictor of Depression (β = .43 p = <.001), Anxiety (β = .40, p <.001), Stress (β = .49, p <.001), and Adjustment (β = .26, p = .001). Externally oriented thinking was found to be a significant unique predictor of Adjustment (β = -.15, p = .033). These findings strengthen the argument that alexithymia, especially difficulties identifying negative feelings, may be an important risk factor for psychological distress in ABI and should be considered during early rehabilitation.

PMID:37988367 | DOI:10.1080/09602011.2022.2140680

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Extending the R number by applying hyperparameters of Log Gaussian Cox process models in an epidemiological context to provide insights into COVID-19 positivity in the City of Edinburgh and in students residing at Edinburgh University

PLoS One. 2023 Nov 21;18(11):e0291348. doi: 10.1371/journal.pone.0291348. eCollection 2023.

ABSTRACT

The impact of the COVID-19 pandemic on University students has been a topic of fiery debate and of public health research. This study demonstrates the use of a combination of spatiotemporal epidemiological models to describe the trends in COVID-19 positive cases on spatial, temporal and spatiotemporal scales. In addition, this study proposes new epidemiological metrics to describe the connectivity between observed positivity; an analogous metric to the R number in conventional epidemiology. The proposed indices, Rspatial, Rspatiotemporal and Rscaling will aim to improve the characterisation of the spread of infectious disease beyond that of the COVID-19 framework and as a result inform relevant public health policy. Apart from demonstrating the application of the novel epidemiological indices, the key findings in this study are: firstly, there were some Intermediate Zones in Edinburgh with noticeably high levels of COVID-19 positivity, and that the first outbreak during the study period was observed in Dalry and Fountainbridge. Secondly, the estimation of the distance over which the COVID-19 counts at the halls of residence are spatially correlated (or related to each other) was found to be 0.19km (0.13km to 0.27km) and is denoted by the index, Rspatial. This estimate is useful for public health policy in this setting, especially with contact tracing. Thirdly, the study indicates that the association between the surrounding community level of COVID-19 positivity (Intermediate Zones in Edinburgh) and that of the University of Edinburgh’s halls of residence was not statistically significant. Fourthly, this study reveals that relatively high levels of COVID-19 positivity were observed for halls for which higher COVID-19 fines were issued (Spearman’s correlation coefficient = 0.34), and separately, for halls which were non-ensuite relatively to those which were not (Spearman’s correlation coefficient = 0.16). Finally, Intermediate Zones with the highest positivity were associated with student residences that experienced relatively high COVID-19 positivity (Spearman’s correlation coefficient = 0.27).

PMID:37988358 | DOI:10.1371/journal.pone.0291348

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The Impact of WhatsApp as a Health Education Tool in Albinism: Interventional Study

JMIR Dermatol. 2023 Nov 21;6:e49950. doi: 10.2196/49950.

ABSTRACT

BACKGROUND: Oculocutaneous albinism is a congenital disorder that causes hypopigmentation of the skin, hair, and eyes due to a lack of melanin. People with albinism are at increased risk of developing skin complications, such as solar keratosis and skin cancers, leading to higher morbidity. As education is crucial in managing albinism, leveraging information technology, such as WhatsApp, can provide an effective intervention for digital health education.

OBJECTIVE: This study aims to assess the impact of WhatsApp as a tool for providing health education among people with albinism.

METHODS: The design of the study was interventional. The intervention consisted of weekly health education sessions conducted in a WhatsApp group for the duration of 4 weeks. The topics discussed were knowledge of albinism, sun protection practices, the use of sunscreen, and myths about albinism. They were all covered in 4 WhatsApp sessions held in 4 separate days. A web-based questionnaire was filled out before and after the intervention by the participants. Mann-Whitney U test was used to compare the pre- and postknowledge scores. Spearman correlation was used to correlate data.

RESULTS: The mean age of the study participants was 28.28 (SD 11.57) years. The number of participants was 140 in the preintervention period and 66 in the postintervention period. A statistically significant increase in overall knowledge (P=.01), knowledge of sunscreen (P=.01), and knowledge of sun protection (P<.01) was observed following the intervention. Before the intervention, a positive correlation was observed between age (r=0.17; P=.03) and education level (r=0.19; P=.02) with participants’ overall knowledge. However, after the intervention, there was no significant correlation between knowledge and age or education level. A percentage increase of 5.23% was observed in the overall knowledge scores following the intervention.

CONCLUSIONS: WhatsApp is an effective tool for educating people with albinism and can act as an alternative to the conventional methods of health education. It shows promising outcomes irrespective of the health literacy level of people with albinism. This educational intervention can positively impact behavior change and translate to consistent sun protection practices. The limitations of this study include the possibility of social desirability bias and data security.

PMID:37988154 | DOI:10.2196/49950

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Ensemble-GNN: federated ensemble learning with graph neural networks for disease module discovery and classification

Bioinformatics. 2023 Nov 21:btad703. doi: 10.1093/bioinformatics/btad703. Online ahead of print.

ABSTRACT

SUMMARY: Federated learning enables collaboration in medicine, where data is scattered across multiple centers without the need to aggregate the data in a central cloud. While, in general, machine learning models can be applied to a wide range of data types, graph neural networks (GNNs) are particularly developed for graphs, which are very common in the biomedical domain. For instance, a patient can be represented by a protein-protein interaction (PPI) network where the nodes contain the patient-specific omics features. Here, we present our Ensemble-GNN software package, which can be used to deploy federated, ensemble-based GNNs in Python. Ensemble-GNN allows to quickly build predictive models utilizing PPI networks consisting of various node features such as gene expression and/or DNA methylation. We exemplary show the results from a public dataset of 981 patients and 8469 genes from the Cancer Genome Atlas (TCGA).

AVAILABILITY: The source code is available at https://github.com/pievos101/Ensemble-GNN, and the data at Zenodo (DOI: 10.5281/zenodo.8305122).

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:37988152 | DOI:10.1093/bioinformatics/btad703

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Exploring Variations in Sleep Perception: Comparative Study of Chatbot Sleep Logs and Fitbit Sleep Data

JMIR Mhealth Uhealth. 2023 Nov 21;11:e49144. doi: 10.2196/49144.

ABSTRACT

BACKGROUND: Patient-generated health data are important in the management of several diseases. Although there are limitations, information can be obtained using a wearable device and time-related information such as exercise time or sleep time can also be obtained. Fitbits can be used to acquire sleep onset, sleep offset, total sleep time (TST), and wakefulness after sleep onset (WASO) data, although there are limitations regarding the depth of sleep and satisfaction; therefore, the patient’s subjective response is still important information that cannot be replaced by wearable devices.

OBJECTIVE: To effectively use patient-generated health data related to time such as sleep, it is first necessary to understand the characteristics of the time response recorded by the user. Therefore, the aim of this study was to analyze the characteristics of individuals’ time perception in comparison with wearable data.

METHODS: Sleep data were acquired for 2 weeks using a Fitbit. Participants’ sleep records were collected daily through chatbot conversations while wearing the Fitbit, and the two sets of data were statistically compared.

RESULTS: In total, 736 people aged 30-59 years were recruited for this study, and the sleep data of 543 people who wore a Fitbit and responded to the chatbot for more than 7 days on the same day were analyzed. Research participants tended to respond to sleep-related times on the hour or in 30-minute increments, and each participant responded within the range of 60-90 minutes from the value measured by the Fitbit. On average for all participants, the chat responses and the Fitbit data were similar within a difference of approximately 15 minutes. Regarding sleep onset, the participant response was 8 minutes and 39 seconds (SD 58 minutes) later than that of the Fitbit data, whereas with respect to sleep offset, the response was 5 minutes and 38 seconds (SD 57 minutes) earlier. The participants’ actual sleep time (AST) indicated in the chat was similar to that obtained by subtracting the WASO from the TST measured by the Fitbit. The AST was 13 minutes and 39 seconds (SD 87 minutes) longer than the time WASO was subtracted from the Fitbit TST. On days when the participants reported good sleep, they responded 19 (SD 90) minutes longer on the AST than the Fitbit data. However, for each sleep event, the probability that the participant’s AST was within ±30 and ±60 minutes of the Fitbit TST-WASO was 50.7% and 74.3%, respectively.

CONCLUSIONS: The chatbot sleep response and Fitbit measured time were similar on average and the study participants had a slight tendency to perceive a relatively long sleep time if the quality of sleep was self-reported as good. However, on a participant-by-participant basis, it was difficult to predict participants’ sleep duration responses with Fitbit data. Individual variations in sleep time perception significantly affect patient responses related to sleep, revealing the limitations of objective measures obtained through wearable devices.

PMID:37988148 | DOI:10.2196/49144

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Effective early strategy to prevent olfactory and gustatory dysfunction in COVID-19: A randomized controlled trial

QJM. 2023 Nov 21:hcad262. doi: 10.1093/qjmed/hcad262. Online ahead of print.

ABSTRACT

BACKGROUND: Olfactory and gustatory dysfunctions (OGDs) are key symptoms of COVID-19, which may lead to neurological complications, and lack of effective treatment. This may be because post-disease treatments may be too late to protect the olfactory and gustatory functions.

AIM: To evaluate the effectiveness of early use of saline nasal irrigation (SNI), corticosteroid nasal spray, and saline or chlorhexidine gluconate mouthwash for preventing OGDs in COVID-19.

DESIGN: This study was a double-blind randomized controlled trial.

METHODS: The study was conducted from May 5 to June 16, 2022. We recruited patients from three hospitals who were admitted with COVID-19 but without OGDs on the day of admission. Olfactory and gustatory functions were evaluated using the Taste and Smell Survey and the numerical visual analog scale. Participants were randomized to the saline, drug, or control groups. The control group received no intervention, saline group received SNI plus saline nasal spray and mouthwash, and the trial group received SNI plus budesonide nasal spray and chlorhexidine gluconate mouthwash. Participants were assessed again on the day of discharge.

RESULTS: A total of 379 patients completed the trial. The prevalence of OGDs was significantly lower in the saline (11.8%, 95% CI, 6.6-19.0%; P < 0.001) and trial (8.3%, 95% CI, 4.1-14.8%; P < 0.001) groups than in the control group (40.0%, 95% CI, 31.8-48.6%). Additionally, both interventions reduced the severity of OGDs.

CONCLUSIONS: We demonstrated effective strategies for preventing COVID-19-related OGDs, and the findings may guide early management of SARS-CoV-2 infection to reduce the incidence of COVID-19-related complications.

PMID:37988146 | DOI:10.1093/qjmed/hcad262

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The Effect of Interactivity, Tailoring, and Use Intensity on the Effectiveness of an Internet-Based Smoking Cessation Intervention Over a 12-Month Period: Randomized Controlled Trial

J Med Internet Res. 2023 Nov 21;25:e47463. doi: 10.2196/47463.

ABSTRACT

BACKGROUND: eHealth approaches show promising results for smoking cessation (SC). They can improve quit rates, but rigorous research is sparse regarding their effectiveness and the effects of their interactivity, tailoring, and use intensity.

OBJECTIVE: We examined the effectiveness of Techniker Krankenkasse Smoking Cessation Coaching (TK-SCC), an internet-based, tailored, and interactive SC intervention. Our hypotheses were as follows: hypothesis 1, in the intervention group (IG; access to TK-SCC), a clinically relevant number of participants will be abstinent at the 12-month follow-up (T3); hypothesis 2, the number of abstinent participants will be significantly greater in the IG than the control group (CG) at T3; and hypothesis 3, in the IG, more intense use of TK-SCC will be positively associated with abstinence.

METHODS: Individuals who smoke were randomized into the IG (563/1115, 50.49%) or CG (552/1115, 49.51%), which received a noninteractive, nontailored, and information-only web-based intervention. Data were collected before the intervention, at the postintervention time point (T1), at the 4-month follow-up (T2), and at T3. We tested hypothesis 1 through equivalence tests between the IG’s success rate and success rates of comparable effective interventions reported in 2 current meta-analyses. For hypothesis 2, we conducted binary logistic regressions. For hypothesis 3, we assigned the IG participants to 1 of 4 user types and used binary logistic regressions with user types as the independent variable and smoking abstinence as the dependent variable.

RESULTS: In the IG, 11.5% (65/563) and 11.9% (67/563) of participants were smoke free at T1 and T3, respectively. These values were statistically equivalent to the effects in the 2 meta-analyses, which reported 9% (z score=0.64, P=.74) and 10.9% (z score=-0.71, P=.24) success rates, respectively. In the CG, 6.2% (34/552) of the participants were smoke free at T1, which increased up to 8.2% (45/552) at T3. The difference between the IG and CG was statistically significant only at T1 (odds ratio [OR] 2.0, 99% CI 1.1 to 3.6; P=.002), whereas the effect was nonsignificant following α error corrections at T3 (OR 1.6, 99% CI 0.9 to 2.7; P=.02). In the IG, constant users of the program became smoke free significantly more often than rare users of the program (T1: OR 15.0, 99% CI 6.1 to 36.9; P<.001; T3: OR 6.5, 99% CI 2.8 to 15.5; P<.001).

CONCLUSIONS: TK-SCC is effective for SC. However, its superiority compared with a minimal SC intervention could not be confirmed in the long term. Insufficient implementation of the techniques used and cotreatment bias could explain this outcome. Higher use intensity of TK-SCC was positively related to abstinence. Therefore, additional efforts to motivate users to adhere to intervention use as intended could improve the intervention’s effectiveness.

TRIAL REGISTRATION: German Clinical Trials Register DRKS00020249, Universal Trial Number U1111-1245-0273; https://drks.de/search/de/trial/DRKS00020249.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s13063-021-05470-8.

PMID:37988144 | DOI:10.2196/47463

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regioneReloaded: evaluating the association of multiple genomic region sets

Bioinformatics. 2023 Nov 21:btad704. doi: 10.1093/bioinformatics/btad704. Online ahead of print.

ABSTRACT

MOTIVATION: Next-generation sequencing methods continue improving the annotation of genomes in part by determining the distribution of features such as epigenetic marks. Evaluating and interpreting the association between genomic regions and their features has become a common and challenging analysis in genomic and epigenomic studies.

RESULTS: With regioneR we provided an R package allowing to assess the statistical significance of pairwise associations between genomic region sets using permutation tests. We now present the R package regioneReloaded that builds upon regioneR’s statistical foundation and extends the functionality for the simultaneous analysis and visualization of the associations between multiple genomic region sets. Thus, we provide a novel discovery tool for the identification of significant associations that warrant to be tested for functional interdependence.

AVAILABILITY: regioneReloaded is an R package released under an Artistic-2.0 License. The source code and documentation are freely available through Bioconductor: http://www.bioconductor.org/packages/regioneReloaded.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:37988135 | DOI:10.1093/bioinformatics/btad704

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Intersecting risk factors for physical inactivity among Canadian adults

Health Rep. 2023 Nov 15;34(11):12-24. doi: 10.25318/82-003-x202301100002-eng.

ABSTRACT

BACKGROUND: On average, 45% of Canadian adults meet the recommended 150 minutes per week of moderate-to-vigorous physical activity. This singular statistic masks a wide range of adherence levels among different groups within the population. The purpose of this paper is to determine how sex, age, and family arrangement intersect with known risk factors for physical inactivity to identify groups within the Canadian population most at risk of not meeting the physical activity recommendation.

METHODS: Using six combined cycles of the Canadian Health Measures Survey (from 2007 to 2019), this study examines how the percentage of Canadian males and females aged 18 to 79 years meeting the physical activity recommendation differs across sociodemographic, family arrangement, and health factors. Logistic regression was used to examine whether the association between specific factors and adherence to the physical activity recommendation differed by sex. Latent class analysis was used to identify sex-specific combinations of sociodemographic, family arrangement and health-related factors within the Canadian population that are associated with varying levels of adherence to the physical activity recommendation.

RESULTS: More males met the physical activity recommendation compared with females (49% versus 38%). Latent classes with the lowest adherence to the physical activity recommendation (19% among females and 29% among males) primarily included those who were single or married with no children and who had a high probability of having many risk factors for physical inactivity, including being older, having a lower education, having lower income, smoking, having central adiposity, and having poor or fair self-rated general health. Latent classes with the highest adherence to the physical activity recommendation (61% among females and 67% among males) primarily included individuals with no spouse and no children and who had a low probability of having any risk factors for physical inactivity. For females, an additional class (32% of which met the physical activity recommendation) comprised young single mothers who had several risk factors for physical inactivity, including having low income, smoking and having central adiposity.

INTERPRETATION: Understanding how risk factors for physical inactivity intersect with sex, age, and family arrangement may inform strategies aimed at increasing physical activity among those who are most vulnerable.

PMID:37988111 | DOI:10.25318/82-003-x202301100002-eng

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Sex differences in COVID-19 deaths in the early months of the pandemic in Canada: An examination with an immigration lens

Health Rep. 2023 Nov 15;34(11):3-11. doi: 10.25318/82-003-x202301100001-eng.

ABSTRACT

BACKGROUND: At the onset of the COVID-19 pandemic, there was an overrepresentation of males in COVID-19 deaths worldwide, with Canada reporting more female COVID-19 deaths. This paper examines the overrepresentation of female COVID-19 deaths in Canada, with an immigration lens.

DATA AND METHODS: Data were extracted from the COVID-19 Sex-Disaggregated Data Tracker to compare the sex distribution of COVID-19 deaths in Canada with that of other countries. A linkage of deaths to the Longitudinal Immigration Database (IMDB) allows for the comparison of sex-specific COVID-19 death rates by immigrant status for age and geography, as well as by major employment sector among immigrants, using the tax data from the IMDB.

RESULTS: While there were proportionately more female than male COVID-19 deaths in Canada in the early months of the pandemic, this trend was mainly a phenomenon among non-immigrants aged 85 and older. In addition, COVID-19-specific death rates for males were higher than those for females across age groups by immigrant status, except for those aged 85 and older among the non-immigrant population. Among immigrants, the death rate among health care and social assistance workers was higher among males than among females (10.7 vs. 2.9 per 100,000 population). The initially observed overrepresentation of female COVID-19 deaths to male COVID-19 deaths in Canada evened out in the summer of 2021.

INTERPRETATION: The higher proportion of female COVID-19 deaths was likely related to the high concentration of COVID-19 deaths in long-term care facilities, where a lower institutionalization rate for immigrants had been observed. Since the implementation of vaccination targeting long-term care facility residents in Canada, the overrepresentation of female COVID-19 deaths ceased.

PMID:37988110 | DOI:10.25318/82-003-x202301100001-eng