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Nevin Manimala Statistics

Precision and agreement of axial length in paediatric population measured with MYAH and AL-Scan biometers

Clin Exp Optom. 2023 Nov 13:1-6. doi: 10.1080/08164622.2023.2277287. Online ahead of print.

ABSTRACT

CLINICAL RELEVANCE: Measuring axial length is key in the field of myopia development and control. Hence, the precision and agreement of commercially available biometers is of vital interest to understand their variability and interchangeability in the paediatric population.

BACKGROUND: Different biometers are available to measure axial length and monitor myopia progression in clinical practice. The purpose of this study was to assess the precision (repeatability and reproducibility) and agreement of the MYAH and AL-Scan biometers in a paediatric population.

METHODS: Three consecutive measurements were performed using MYAH and AL-Scan biometers in each subject by the same operator to test for repeatability. To test for reproducibility, two measurements were performed for each subject by two different observers with a 5-min interval between measurements. To test the agreement, each subject was measured once with each instrument.

RESULTS: A total of 187 subjects, with a mean age of 8.5 ± 0.3 years and mean spherical equivalent refractive error of +0.22 ± 0.77 D participated in the study. For the repeatability study, the within-subject standard deviation was 0.01 mm, and the repeatability limit was 0.04 mm for both instruments, with no statistically significant differences among repeated measures (p = 0.162 for MYAH and p = 0.774 for AL-Scan). For the reproducibility study, the within-subject standard deviation was 0.01 mm and the repeatability limit was 0.04 mm. There were statistically significant differences for the repeated measures for the AL-Scan (p = 0.002) but not for the MYAH (p = 0.643). Regarding the agreement between both instruments, the 95% limit of agreement ranged from -0.04 to 0.05 mm, and the differences were statistically significant (p = 0.021).

CONCLUSIONS: The repeatability, reproducibility, and agreement of the MYAH and AL-Scan biometers seem optimal for following children with myopia.

PMID:37956406 | DOI:10.1080/08164622.2023.2277287

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Osteosarcoma Explorer: A Data Commons With Clinical, Genomic, Protein, and Tissue Imaging Data for Osteosarcoma Research

JCO Clin Cancer Inform. 2023 Sep;7:e2300104. doi: 10.1200/CCI.23.00104.

ABSTRACT

PURPOSE: Osteosarcoma research advancement requires enhanced data integration across different modalities and sources. Current osteosarcoma research, encompassing clinical, genomic, protein, and tissue imaging data, is hindered by the siloed landscape of data generation and storage.

MATERIALS AND METHODS: Clinical, molecular profiling, and tissue imaging data for 573 patients with pediatric osteosarcoma were collected from four public and institutional sources. A common data model incorporating standardized terminology was created to facilitate the transformation, integration, and load of source data into a relational database. On the basis of this database, a data commons accompanied by a user-friendly web portal was developed, enabling various data exploration and analytics functions.

RESULTS: The Osteosarcoma Explorer (OSE) was released to the public in 2021. Leveraging a comprehensive and harmonized data set on the backend, the OSE offers a wide range of functions, including Cohort Discovery, Patient Dashboard, Image Visualization, and Online Analysis. Since its initial release, the OSE has experienced an increasing utilization by the osteosarcoma research community and provided solid, continuous user support. To our knowledge, the OSE is the largest (N = 573) and most comprehensive research data commons for pediatric osteosarcoma, a rare disease. This project demonstrates an effective framework for data integration and data commons development that can be readily applied to other projects sharing similar goals.

CONCLUSION: The OSE offers an online exploration and analysis platform for integrated clinical, molecular profiling, and tissue imaging data of osteosarcoma. Its underlying data model, database, and web framework support continuous expansion onto new data modalities and sources.

PMID:37956387 | DOI:10.1200/CCI.23.00104

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Comparison of two multiplex PCR tests for common pathogen detection in hospitalized children with acute respiratory infection

J Infect Dev Ctries. 2023 Oct 31;17(10):1474-1479. doi: 10.3855/jidc.17999.

ABSTRACT

INTRODUCTION: Multiplex PCR methods have significantly improved the diagnosis of acute respiratory tract infections (ARTIs) in children. The ResP-CE System coupled with capillary electrophoresis is a highly specialized, automated, and expensive technology for detecting common pathogens in ARTIs. The XYRes-MCA System, a remarkably less expensive multiplex PCR instrument, employs hybridization for the detection of ARTI pathogens. Both methods detect 9 common microorganisms in ARTIs, i.e., RSV, FLUAV, FLUBV, ADV, PIV, HMPV, HBOV, HCOV, and MP. In this study, we aimed to compare the performance of these two methods in the detection of pathogens from sputum specimens collected from children with ARTIs.

METHODOLOGY: Sputum specimens were collected from 237 hospitalized children with ARTIs. Nucleic acid was extracted on an automated workstation. The ResP-CE and XYres-MCA systems were applied to detect pathogens from the samples, and the test result agreement between the two methods was evaluated using Kappa statistics.

RESULTS: The ResP-CE and XYres-MCA identified pathogens, single or in combination, in 151 (63.7%) and 171 (72.1%) of 237 samples, respectively. Approximately 85% of positive samples identified by either method contained a single pathogen. Moderate to almost perfect concordance between the two methods was found in detecting the following 7 pathogens: RSV, FLUAV, FLUBV, PIV, HMPV, HBOV, and MP.

CONCLUSIONS: These two methods are comparable in detecting common pathogens of ARTIs in children. As XYres-MCA analysis is more cost-effective, it could play an important role in diagnosing ARTIs in children in less economically developed regions.

PMID:37956382 | DOI:10.3855/jidc.17999

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Serum vitamin D concentration in children with pneumonia and acute respiratory infections, risk factors for its low level

J Infect Dev Ctries. 2023 Oct 31;17(10):1413-1419. doi: 10.3855/jidc.17749.

ABSTRACT

INTRODUCTION: While there is extensive literature discussing the link between various respiratory infections and risk factors that contribute to low vitamin D levels, there is still no consensus on this relationship. The aim of this study was to test whether low vitamin D levels are associated with pneumonia and acute respiratory infections (ARI) and to identify risk factors for low vitamin D levels in children with these conditions.

METHODOLOGY: The study was conducted at the Muratsan Hospital in Yerevan from February to December 2017. It included 140 randomly selected children aged 1 to 5 years, half of whom had pneumonia and the other half had ARI. Based on serum vitamin D levels, the children were further divided into groups with low (52 patients with pneumonia and 38 patients with ARI) and normal vitamin D levels (18 patients with pneumonia and 32 patients with ARI). Factors such as feeding, age, gender, and mother’s education were included as indicators of risk for low vitamin D.

RESULTS: The difference between the mean values of vitamin D in groups of children with pneumonia and ARI was statistically significant (p < 0.05). Feeding was positively, and age was negatively associated with the level of vitamin D (p < 0.05).

CONCLUSIONS: We found that children with pneumonia had a lower vitamin D level. We also found that poor nutrition and the age of the child (1 to 5 years) were risk factors for low vitamin D levels with respiratory infections.

PMID:37956365 | DOI:10.3855/jidc.17749

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Nevin Manimala Statistics

Investigation and treatment after non-ST segment elevation acute coronary syndrome for patients presenting to rural or urban hospitals in Aotearoa New Zealand: ANZACS-QI 75

N Z Med J. 2023 Nov 10;136(1585):85-102.

ABSTRACT

AIMS: Compare the care patients with non-ST segment elevation acute coronary syndrome (NSTEACS) received in Aotearoa New Zealand depending on the rural-urban category of the hospital they are first admitted to.

METHODS: Patients with NSTEACS investigated with invasive coronary angiogram between 1 January 2014 and 31 December 2019 were included. There were three hospital categories (routine access to percutaneous coronary intervention [urban interventional], other urban [urban non-interventional] and rural) and three ethnicity categories (Māori, Pacific and non-Māori/non-Pacific). Clinical performance measures included: angiography ≤3 days, assessment of left ventricular ejection fraction (LVEF) and prescription of secondary prevention medication.

RESULTS: Of 26,779 patients, 66.2% presented to urban-interventional, 25.6% to urban non-interventional and 8.2% to rural hospitals. A smaller percentage of patients presenting to urban interventional than urban non-interventional and rural hospitals were Māori (8.1%, 17.0% and 13.0%). Patients presenting to urban interventional hospitals were more likely to receive timely angiography than urban non-interventional or rural hospitals (78.5%, 60.8% and 63.1%). They were also more likely to have a LVEF assessment (78.5%, 65.4% and 66.3%). In contrast, the use of secondary prevention medications at discharge was similar between hospital categories. Māori and Pacific patients presenting to urban interventional hospitals were less likely than non-Māori/non-Pacific to receive timely angiography but more likely to have LVEF assessed. However, LVEF assessment and timely angiography in urban non-interventional and rural hospitals were lower than in urban interventional hospitals for both Māori and non-Māori/non-Pacific.

CONCLUSIONS: Patients presenting to urban hospitals without routine interventional access and rural hospitals were less likely to receive LVEF assessment or timely angiography. This disproportionately impacts Māori, who are more likely to live in these hospital catchments.

PMID:37956359

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Non-small cell lung cancer chemotherapy treatment outcomes and ethnicity: a twenty-year single-centre patterns of care study

N Z Med J. 2023 Nov 10;136(1585):24-34.

ABSTRACT

AIM: To investigate the treatment of patients with advanced-stage non-small cell lung cancer (NSCLC) over a 20-year period in a single Aotearoa New Zealand centre with reference to the use of systemic anti-cancer chemotherapy (SACT) and to explore ethnic disparities in treatment and outcomes.

METHOD: Using a SACT database maintained by the Oncology Department at Waikato Hospital, Hamilton, Aotearoa New Zealand from 2000 to 2021 we derived summary statistics for patient factors and SACT regimens by ethnicity (Māori and non-Māori). We investigated Kaplan-Meier all-cause survival by ethnicity and SACT. Logistic regression was used to estimate the odds ratios of surviving 12 months and receiving first and second SACT.

RESULTS: One thousand and fifty-seven patients with advanced NSCLC were included, with 30% identified as Māori and 53% treated with SACT. The median survival for non-Māori and Māori receiving SACT was 11.9 and 8.5 months respectively (unadjusted odds ratio of surviving 12 months: 1.968; 95% CI: 1.352-2.865; p<0.001). Non-Māori receiving SACT were 86.2% more likely to survive 12 months than Māori. There were no ethnic disparities in the proportion of patients receiving first-line SACT; however, non-Māori were 1.5 times more likely to receive a second SACT than Māori.

CONCLUSION: Significant ethnic difference between Māori and non-Māori exists for both survival and receipt of second-line SACT.

PMID:37956355

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Nevin Manimala Statistics

Art Therapy as a Nursing Intervention for Individuals With Schizophrenia

J Psychosoc Nurs Ment Health Serv. 2023 Nov 13:1-10. doi: 10.3928/02793695-20231025-02. Online ahead of print.

ABSTRACT

The aim of the current study was to determine the effects of group art therapy on clinical symptoms, alexithymia, and quality of life among people with schizophrenia. This single-blinded, randomized controlled trial was performed with 66 individuals with schizophrenia from a community mental health center in western Turkey between September 2021 and February 2022. Following art therapy, the intervention group had lower severity of positive, negative, and general psychopathology symptoms; lower levels of alexithymia; and higher levels of psychological health, social relationships, and total quality of life than the control group; and the difference between groups was statistically significant (p < 0.05). Results reveal that art therapy combined with pharmacological therapy contributes to good clinical outcomes among individuals with schizophrenia. This evidence can guide psychiatric nurses to use art therapy to reduce psychopathology severity and increase functionality and quality of life among individuals with schizophrenia. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

PMID:37956349 | DOI:10.3928/02793695-20231025-02

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DriverDBv4: a multi-omics integration database for cancer driver gene research

Nucleic Acids Res. 2023 Nov 13:gkad1060. doi: 10.1093/nar/gkad1060. Online ahead of print.

ABSTRACT

Advancements in high-throughput technology offer researchers an extensive range of multi-omics data that provide deep insights into the complex landscape of cancer biology. However, traditional statistical models and databases are inadequate to interpret these high-dimensional data within a multi-omics framework. To address this limitation, we introduce DriverDBv4, an updated iteration of the DriverDB cancer driver gene database (http:////driverdb.bioinfomics.org//). This updated version offers several significant enhancements: (i) an increase in the number of cohorts from 33 to 70, encompassing approximately 24 000 samples; (ii) inclusion of proteomics data, augmenting the existing types of omics data and thus expanding the analytical scope; (iii) implementation of multiple multi-omics algorithms for identification of cancer drivers; (iv) new visualization features designed to succinctly summarize high-context data and redesigned existing sections to accommodate the increased volume of datasets and (v) two new functions in Customized Analysis, specifically designed for multi-omics driver identification and subgroup expression analysis. DriverDBv4 facilitates comprehensive interpretation of multi-omics data across diverse cancer types, thereby enriching the understanding of cancer heterogeneity and aiding in the development of personalized clinical approaches. The database is designed to foster a more nuanced understanding of the multi-faceted nature of cancer.

PMID:37956338 | DOI:10.1093/nar/gkad1060

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Addressing Burnout in the Primary Care Setting: The Impact of an Evidence-Based Mindfulness Toolkit

Mil Med. 2023 Nov 10;189(Supplement_1):64-70. doi: 10.1093/milmed/usad277.

ABSTRACT

BACKGROUND: Burnout is insidious and manifests over prolonged, repeated exposure to occupational stressors. There is a growing crisis among health care workers (HCWs) due to high levels of burnout and associated adverse outcomes. Identifying and addressing burnout can be problematic due to extensive variances of perceived occupational stressors across HCWs.

PURPOSE: Mindfulness-based training can enhance individual HCWs’ abilities to perceive and constructively respond to stresses endemic in the health care environment. It can reduce the prevalence of burnout in the primary care setting. An evidence-based multimodal Mindfulness-Based Stress Reduction toolkit (MBSR TK) was designed, implemented, and evaluated for its impact on HCWs’ self-reported stress levels (SRSL).

IMPLEMENTATION STRATEGIES: A pre-post-program evaluation explored the impact of a multimodal toolkit program on HCW SRSL with the Mini-Z burnout survey (MZBS). The MBSR TK program, consisting of a 45 minute introduction and 4 biweekly 15 minute mindfulness sessions offering acupressure, meditation, journaling for gratitude, and self-compassion was designed, delivered, and evaluated with HCWs across 2 military primary care clinics in South Texas.

RESULTS: All HCWs across 2 Air Force family practice clinics were invited to participate in all toolkit components. Seventy percent of all HCWs (N = 90) attended the introduction session. Thirty-seven (41%) HCWs completed pre and post MZBSs, and these responses are included in the data analysis section. The most represented HCWs were registered nurses, physician assistants, and technicians, respectively, at 24%, 21%, and 18%. The Wilcoxon Signed-Rank test examined changes in HCWs’ SRSL after participation in the MBSR TK program. HCWs who attended the introduction plus one biweekly session showed statistically significant decreases in self-reported stress (P = 0.018) and burnout (P = 0.045) and a significant increase in electronic health record proficiency (P = 0.033).

CONCLUSIONS: Multimodal mindfulness toolkits to address SRSL burnout are practical, accessible, easily implemented, adaptive to any environment, and can decrease burnout with participation with just one 15 minute session. This MBSR TK implementation effectively lowered self-reported stress in HCWs who are repeatedly challenged to adapt to various settings around the world during peacetime, wars, natural disasters, humanitarian crises, and now, pandemics.

PMID:37956332 | DOI:10.1093/milmed/usad277

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Generically partisan: Polarization in political communication

Proc Natl Acad Sci U S A. 2023 Nov 21;120(47):e2309361120. doi: 10.1073/pnas.2309361120. Epub 2023 Nov 13.

ABSTRACT

American political parties continue to grow more polarized, but the extent of ideological polarization among the public is much less than the extent of perceived polarization (what the ideological gap is believed to be). Perceived polarization is concerning because of its link to interparty hostility, but it remains unclear what drives this phenomenon. We propose that a tendency for individuals to form broad generalizations about groups on the basis of inconsistent evidence may be partly responsible. We study this tendency by measuring the interpretation, endorsement, and recall of category-referring statements, also known as generics (e.g., “Democrats favor affirmative action”). In study 1 (n = 417), perceived polarization was substantially greater than actual polarization. Further, participants endorsed generics as long as they were true more often of the target party (e.g., Democrats favor affirmative action) than of the opposing party (e.g., Republicans favor affirmative action), even when they believed such statements to be true for well below 50% of the relevant party. Study 2 (n = 928) found that upon receiving information from political elites, people tended to recall these statements as generic, regardless of whether the original statement was generic or not. Study 3 (n = 422) found that generic statements regarding new political information led to polarized judgments and did so more than nongeneric statements. Altogether, the data indicate a tendency toward holding mental representations of political claims that exaggerate party differences. These findings suggest that the use of generic language, common in everyday speech, enables inferential errors that exacerbate perceived polarization.

PMID:37956300 | DOI:10.1073/pnas.2309361120