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Nevin Manimala Statistics

Scientists’ Perception of Pilot Study Quality Was Influenced by Statistical Significance and Study Design

J Clin Epidemiol. 2023 May 20:S0895-4356(23)00124-5. doi: 10.1016/j.jclinepi.2023.05.011. Online ahead of print.

ABSTRACT

OBJECTIVES: Preliminary studies play a key role in developing large-scale interventions but may be held to higher or lower scientific standards during the peer review process because of their preliminary study status.

STUDY DESIGN: Abstracts from five published obesity prevention preliminary studies were systematically modified to generate 16 variations of each abstract. Variations differed by four factors: sample size (n=20 vs. n=150), statistical significance (P<.05 vs. P>.05), study design (single group vs. randomized two group), and preliminary study status (presence/absence of pilot language). Using an online survey, behavioral scientists were provided with a randomly selected variation of each of the five abstracts and blinded to the existence of other variations. Respondents rated each abstract on aspects of study quality.

RESULTS: Behavioral scientists (n=271, 79.7% female, median age 34 years) completed 1,355 abstract ratings. Preliminary study status was not associated with perceived study quality. Statistically significant effects were rated as more scientifically significant, rigorous, innovative, clearly written, warranted further testing, and had more meaningful results. Randomized designs were rated as more rigorous, innovative, and meaningful.

CONCLUSION: Findings suggest reviewers place a greater value on statistically significant findings and randomized control design and may overlook other important study characteristics.

PMID:37217107 | DOI:10.1016/j.jclinepi.2023.05.011

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The relationship between iodinated contrast material temperature and adverse reactions: A meta-analysis of 307,329 injections

Clin Imaging. 2023 May 18;100:54-59. doi: 10.1016/j.clinimag.2023.05.006. Online ahead of print.

ABSTRACT

OBJECTIVE: The effect of iodinated contrast material (CM) temperature on injection pressures and viscosity has been well established. However, the effect of extrinsic warming of CM on allergic reactions and extravasations remains unclear. The purpose of this study is to compare the rates of allergic reactions and extravasations between warmed CM to room temperature CM.

METHODS: We conducted a comprehensive systematic search using PubMed, Embase, and Web of Science databases for all studies that assess the impact of warmed CM on adverse reactions. The primary outcomes of our study were allergic reaction and extravasation rates. We calculated weighted pooled odds ratios (OR) and 95% confidence intervals (CI) for all outcomes using the random-effects model. A P-value <0.05 was considered statistically significant. We conducted subgroup analyses based on the viscosity of the CM.

RESULTS: A total of five studies, including 307,329 CM injections (86,676 at room temperature and 220,653 warmed to 37 °C), were included in the analysis. For high viscosity CM, pre-warming was associated with significantly lower allergic reaction rates (OR: 0.59, 95% CI: 0.49-0.72, P < 0.00001). There was no significant difference in rates of extravasation for high viscosity CM (OR: 0.53, 95% CI: 0.20-1.43, P = 0.21).

DISCUSSION: Our meta-analysis suggests that warming CM to 37 °C is a safe and effective approach to reduce the risk of allergic reactions and physiologic reactions during injection of high-viscosity CM. However, there was no significant difference in extravasation rates between warmed and room temperature CM, regardless of viscosity.

PMID:37216743 | DOI:10.1016/j.clinimag.2023.05.006

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Nevin Manimala Statistics

Investigating volatile semiochemical production from Bos taurus and Bos indicus as a novel phenotype for breeding host resistance to ixodid ticks

Ticks Tick Borne Dis. 2023 May 20;14(5):102200. doi: 10.1016/j.ttbdis.2023.102200. Online ahead of print.

ABSTRACT

Ticks and tick-borne diseases cause significant loss in livestock production with about 80% world’s cattle at risk. The cost of chemical control is high and there is an ever-increasing tick resistance to chemical acaricides. Genetic selection as alternative long-term control strategy is constrained by laborious phenotyping using tick counts or scores. This study explored the use of host volatile semiochemicals that may be attractants or repellents to ticks as a phenotype for new tick resistance, with potential to be used as a proxy in selection programmes. Approximately 100 young cattle composed of Bos indicus and Bos taurus were artificially infested with 2,500 African blue tick, Rhipicephalus decoloratus larvae, with daily female tick (4.5 mm) counts taken from day 20 post-infestation. Volatile organic compounds were sampled from cattle before and after tick infestation by dynamic headspace collection, analysed by high-resolution gas chromatography (GC) and subjected to multivariate statistical analysis. Using 6-day repeated measure analysis, three pre-infestation GC peaks (BI938 – unknown, BI966 – 6-methyl-5-hepten-2-one and BI995 – hexyl acetate) and one post-infestation GC peak (AI933 – benzaldehyde / (E)-2-heptenal) were associated with tick resistance (P < 0.01 and P < 0.05 respectively). The high correlation coefficients (r = 0.66) between repeated records with all volatile compounds support the potential predictive value for volatile compounds in selective breeding programmes for tick resistance in cattle.

PMID:37216729 | DOI:10.1016/j.ttbdis.2023.102200

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Predictive plasma biomarkers of long-term increase in hepatic steatosis index after HCV eradication in HIV/HCV-coinfected patients

Biomed Pharmacother. 2023 May 20;164:114913. doi: 10.1016/j.biopha.2023.114913. Online ahead of print.

ABSTRACT

Hepatic steatosis is a common condition found in the liver of hepatitis C virus (HCV)-infected patients, contributing to more severe forms of liver disease. In addition, the human immunodeficiency virus (HIV) may accelerate this process. Alternatively, several immune checkpoint proteins have been reported to be upregulated and correlated with disease progression during HCV and HIV infections. In steatosis, a detrimental immune system activation has been established; however, the role of the immune checkpoints has not been addressed so far. Thus, this study aimed to evaluate the association between plasma immune checkpoint proteins at baseline (before antiviral therapy) with hepatic steatosis index (HSI) increase at the end of follow-up (∼ five years after sustained virologic response (SVR)). We performed a multicenter retrospective study in 62 patients coinfected with HIV/HCV who started antiviral therapy. Immune checkpoint proteins were analyzed at baseline using a Luminex 200TM analyzer. The statistical association analysis was carried out using Generalized Linear Models (GLM) and Partial Least Squares Discriminant Analysis (PLS-DA). Fifty-three percent of the patients showed HSI increase from baseline to the end of follow-up. Higher immune checkpoint protein levels of BTLA, CD137(4-1BB), CD80, GITR, LAG-3, and PD-L1 before HCV therapy were associated with a long-term increase in HSI after successful HCV therapy, suggesting a potential predictive role for early detection of progression towards steatosis in HIV/HCV-coinfected patients.

PMID:37216704 | DOI:10.1016/j.biopha.2023.114913

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The effect of reclined seatback angles on the motion of booster-seated children during lateral-oblique low-acceleration impacts

Accid Anal Prev. 2023 May 20;188:107117. doi: 10.1016/j.aap.2023.107117. Online ahead of print.

ABSTRACT

Belt-positioning boosters (BPB) may prevent submarining in novel seating configurations such as seats with reclined seatbacks. However, several knowledge gaps in the motion of reclined child occupants remain as previous reclined child studies only examined responses of a child anthropomorphic test device (ATD) and the PIPER finite element (FE) model in frontal impacts. The aim of this study is to investigate the effect of reclined seatback angles and two types of BPBs on the motion of child volunteer occupants in low-acceleration far-side lateral-oblique impacts. Six healthy children (3 males, 3 females, 6-8 years, seated height: 66±3.2 cm, weight: 25.2±3.2 kg) were seated on two types of low-back BPB (standard and lightweight) on a vehicle seat and restrained by a 3-point simulated-integrated seatbelt on a low-acceleration sled. The sled exposed the participants to a low-speed lateral-oblique (80° from frontal) pulse (2 g). Three seatback recline angles (25°, 45°, 60° from vertical) with two BPB (standard and lightweight) were tested. A 10-camera 3D-motion-capture system (Natural Point Inc.) was used to capture peak lateral head and trunk displacements and forward knee-head distance. Three seat-belt load cells (Denton ATD Inc) captured peak seatbelt loads. Electromyography (EMG, Delsys Inc) recorded muscle activation. Repeated Measure 2-way ANOVAs were performed to evaluate the effect of seatback recline angle and BPB on kinematics. Tukey’s post-hoc test for pairwise comparisons was used. P-level was set to 0.05. Peak lateral head and trunk displacement decreased with the increasing seatback recline angle (p < 0.005, p < 0.001, respectively). Lateral peak head displacement was greater in the 25° compared to the 60° condition (p < 0.002) and in the 45° condition compared to the 60° condition (p < 0.04). Lateral peak trunk displacement was greater in the 25° condition than the 45° condition (p < 0.009) and the 60° condition (p < 0.001), and in the 45° condition than the 60° condition (p < 0.03). Overall peak lateral head and trunk displacements and knee-head forward distance were slightly greater in the standard than the lightweight BPB (p < 0.04), however these differences between BPBs were small (∼10 mm). Shoulder belt peak load decreased as the reclined seatback angle increased (p < 0.03): the shoulder belt peak load was statistically greater in the 25° condition than the 60° condition (p < 0.02). Muscle activation from the neck, upper trunk, and lower legs showed great activation. Neck muscles activation increased with the increase in seatback recline angle. Thighs, upper arms, and abdominal muscles showed small activation and no effect of conditions. Child volunteers showed decreased displacement suggesting that reclined seatbacks placed the booster-seated children in a more favorable position within the shoulder belt in a low-acceleration lateral-oblique impact, compared to nominal seatback angles. BPB type seemed to minimally influence the children’s motion: the small differences found may have been due to the slight difference in heights between the two BPBs. Future research with more severe pulses is needed to better understand reclined children’s motion in far-side lateral-oblique impacts.

PMID:37216696 | DOI:10.1016/j.aap.2023.107117

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Validation of a symptom scale for COVID-19 patients in ambulatory care

Rev Med Inst Mex Seguro Soc. 2023 May 2;61(3):348-355.

ABSTRACT

BACKGROUND: A symptom scale can be useful for the standardization of clinical evaluations and follow-up of COVID-19 patients in ambultaroy care. Scale development should be accompanied by an assessment of its reliablility and validity.

OBJECTIVE: To develop and measure the psychometric characteristics of a COVID-19 symptom scale to be answered by either healthcare personnel or adult patients in ambulatory care.

MATERIAL AND METHODS: The scale was developed by an expert panel using the Delphi method. We evaluated inter-rater reliability, where we defined a good correlation if Spearman’s Rho was ≥ 0.8; test-retest, where we defined a good correlation if Spearman’s Rho was ≥ 0.7; factor analysis using principal component methodology; and discriminant validity using Mann-Whitney’s U test. A p < 0.05 was considered statistically significant.

RESULTS: We obtained an 8 symptom scale, each symptom is scored from 0-4, with a total minimum score of 0 and a maximum of 32 points. Inter-rater reliability was 0.995 (n = 31), test-retest showed correlation of 0.88 (n = 22), factor analysis detected 4 factors (n = 40) and discriminant capacity of healthy versus sick adults was significant (p < 0.0001, n = 60).

CONCLUSIONS: We obtained a reliable and valid Spanish (from Mexico) symptom scale for COVID-19 ambulatory care, answerable by patients and health care staff.

PMID:37216678

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Vitamin K1 and progression of cardiovascular calcifications in hemodialysis patients: the VitaVasK randomized controlled trial

Clin Kidney J. 2022 Aug 24;15(12):2300-2311. doi: 10.1093/ckj/sfac184. eCollection 2022 Dec.

ABSTRACT

BACKGROUND: Cardiovascular calcifications are prevented by matrix Gla protein (MGP), a vitamin K-dependent protein. Haemodialysis patients exhibit marked vitamin K deficiency. The randomized, prospective, open-label, multicentre VitaVasK trial analysed whether vitamin K1 supplementation reduces progression of coronary artery calcifications (CACs) and thoracic aortic calcifications (TACs).

METHODS: Patients with pre-existing CACs were randomized to continue on standard care or to additionally receive 5 mg of vitamin K1 orally thrice weekly. Hierarchically ordered primary endpoints were progression of TAC and CAC in computed tomography scans at 18 months. Linear mixed effects models with repeated measures at baseline and 12 and 18 months assessed treatment effects after adjusting for study site.

RESULTS: Of 60 randomized patients, 20 dropped out for reasons unrelated to vitamin K1, resulting in 23 control and 17 vitamin K1 patients. The trial was stopped early due to slow recruitment. At 18 months, the average TAC progression was 56% lower in the vitamin K1 compared with the control group (p = .039). CAC significantly progressed within the control group, but not within the vitamin K1 group. Average progression at 18 months was 68% lower in the vitamin K1 compared to the control group (P = .072). Vitamin K1 reduced plasma levels of pro-calcific uncarboxylated MGP by 69% at 18 months. No treatment-related adverse events were noted.

CONCLUSION: Vitamin K1 intervention is a potent, safe and cost-effective approach to correct vitamin K deficiency and to potentially reduce cardiovascular calcification in this high-risk population.

PMID:37216675 | PMC:PMC9664584 | DOI:10.1093/ckj/sfac184

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Association of neutrophil, lymphocyte, platelet ratio with acute kidney injury in sepsis

Rev Med Inst Mex Seguro Soc. 2023 May 2;61(3):342-347.

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) is frequent in sepsis (25 to 51%), with high mortality (40 to 80%) and long-term complications. Despite its importance we do not have accessible markers in intensive care. In other entities (post-surgical and COVID-19) the neutrophil/lymphocyte and platelet (N/LP) ratio has been associated with acute kidney injury; however, this relationship has not been studied in a pathology with a severe inflammatory response such as sepsis.

OBJECTIVE: To demonstrate the association between N/LP with AKI secondary to sepsis in intensive care.

MATERIAL AND METHODS: Ambispective cohort study in patients over 18 years who were admitted to intensive care with a diagnosis of sepsis. The N/LP ratio was calculated from admission up to the seventh day and up to the diagnosis of AKI and outcome. Statistical analysis was performed with chi squared test, Cramer’s V and multivariate logistic regression.

RESULTS: Out of the 239 patients studied, the incidence of AKI developed in 70%. 80.9% of patients with N/LP ratio > 3 had AKI (p < 0.0001, Cramer’s V 0.458, OR 3.05, 95% CI 1.602-5.8) and increased renal replacement therapy (21.1 vs. 11.1%, p = 0.043).

CONCLUSION: N/LP ratio > 3 has a moderate association with AKI secondary to sepsis in the intensive care unit.

PMID:37216673

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Prenatal Exposure to Perfluoroalkyl Substances and Cognitive and Neurobehavioral Development in Children at 6 Years of Age

Environ Sci Technol. 2023 May 22. doi: 10.1021/acs.est.2c06535. Online ahead of print.

ABSTRACT

Epidemiological evidence regarding the effects of prenatal exposure to perfluoroalkyl substances (PFASs) on neurodevelopment in children is inconclusive. In 449 mother-child pairs from the Shanghai-Minhang Birth Cohort Study, we measured the concentrations of 11 PFASs in maternal plasma samples obtained at 12-16 weeks of gestation. We assessed children’s neurodevelopment at 6 years of age by the fourth edition of the Chinese Wechsler Intelligence Scale for Children and Child Behavior Checklist for ages 6-18. We evaluated the association between prenatal exposure to PFASs and children’s neurodevelopment and the effect modification of maternal dietary factors during pregnancy and the child’s sex. We found that prenatal exposure to multiple PFASs was associated with increased scores for attention problems, and the individual effect of perfluorooctanoic acid (PFOA) was statistically significant. However, no statistically significant association between PFASs and cognitive development was observed. Additionally, we found the effect modification of maternal nut intake and child’s sex. In conclusion, this study suggests that prenatal exposure to PFASs was associated with more attention problems, and maternal nut intake during pregnancy may alter the potential effect of PFASs. However, these findings were exploratory because of multiple testing and the relatively small sample size.

PMID:37216669 | DOI:10.1021/acs.est.2c06535

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Impact of hyperglycemia on the prognosis of patients hospitalized for severe pneumonia in COVID-19

Rev Med Inst Mex Seguro Soc. 2023 May 2;61(3):335-341.

ABSTRACT

BACKGROUND: Adequate glycemic control improves the prognosis of patients hospitalized for pneumonia associated with severe COVID-19.

OBJECTIVE: To evaluate the impact of hyperglycemia (HG) on the prognosis of patients hospitalized for severe pneumonia associated with COVID-19 in unvaccinated patients.

MATERIAL AND METHODS: Prospective cohort study. We included patients hospitalized from August 2020 to February 2021, with severe COVID-19 pneumonia, not vaccinated against SARS-CoV-2. Data was collected from admission to discharge. We used descriptive and analytical statistics according to the data distribution. ROC curves were used to determine the cut-off points with the highest predictive performance for HG and mortality, with the IBM SPSS program, version 25.

RESULTS: We included 103 patients, 32% women, 68% men, age 57 ± 13 years; 58% were admitted with HG (191, IQR 152-300 mg/dL) and 42% with normoglycemia (NG < 126 mg/dL). Mortality was higher in HG at admission 34 (56.7%) than in NG 13 (30.2%) (p = 0.008). HG was associated with diabetes mellitus 2 and neutrophilia (p < 0.05). The risk of death increases 1.558 times (95% CI 1.118-2.172) if HG is at admission and 1.43 times (95% CI 1.14-1.79) during hospitalization. Maintaining NG throughout the hospitalization contributed independently to survival (RR = 0.083 [95% CI 0.012-0.571], p = 0.011).

CONCLUSION: HG significantly impacts prognosis by increasing mortality more than 50% during hospitalization for COVID-19.

PMID:37216668