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Nevin Manimala Statistics

Association of GNB3, ACE polymorphisms with POAG and NTG

Ophthalmic Genet. 2023 Nov 24:1-5. doi: 10.1080/13816810.2023.2283415. Online ahead of print.

ABSTRACT

PURPOSE: Primary open-angle glaucoma (POAG) represents the most prevalent form of glaucoma and stands as a foremost contributor to irreversible vision impairment on a global scale. Despite notable strides made in comprehending the genetic underpinnings of POAG, investigations within the context of Russia remain constrained.

METHODS: The study cohort comprised a total of 235 individuals, with 135 of them exhibiting various forms of glaucoma encompassing both POAG and (NTG, while the remaining 100 individuals served as control subjects. Each participant underwent a comprehensive ocular examination to ascertain their ocular health status. Genotyping of the relevant single nucleotide polymorphisms (SNPs) was carried out using the Taq Man genotyping assay. Specifically, the two SNPs under scrutiny were GNB3 rs5443 gene and ACE rs4646994. Statistical analysis was performed to evaluate the association of these SNPs with glaucoma risk.

RESULTS: The presence of the T allele of rs5443 was found to be associated with NTG (p = .004). However, no statistically significant correlation was identified between this SNP and POAG (p = .88).

CONCLUSION: This study provides evidence of an association between the T allele of rs5443 and a reduced susceptibility NTG within the Russian population. These observations augment the comprehension of the genetic underpinnings of glaucoma and hold potential implications for the prospective development of targeted therapeutic interventions.

PMID:37997634 | DOI:10.1080/13816810.2023.2283415

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Nevin Manimala Statistics

Clinical Characteristics and Treatment Experiences of Pediatric Acute Mastoiditis and Its Complications at the University Tertiary Care Center in the 10-Year Prevaccinal Period

Ear Nose Throat J. 2023 Nov 24:1455613231212828. doi: 10.1177/01455613231212828. Online ahead of print.

ABSTRACT

Introduction: We aim to provide an overview of the clinical characteristics and treatment of pediatric acute mastoiditis (AM) and its complications in the prevaccinal pneumococcal period. Materials and methods: Retrospective case series. An analysis of pediatric patients with AM treated at a university tertiary care center from 2008 to 2018 was performed. Results: The research included 121 children, and 27.3% of them had some form of complication. The mean age at presentation of AM was 3.7 years (range = 0-18 years). The most common extracranial complication of AM was a subperiosteal abscess (n = 25, 75.8%) and the most common intracranial complication was meningoencephalitis (n = 2, 6%). The most common pathogen isolated in the complicated AM was Streptococcus pneumoniae (n = 17, 51.5%). A total of 60% of patients reported antibiotic use before hospital admission, mostly third-generation cephalosporins (37.5%). There was a statistically significant difference between age group and occurrence of complications (P = .001). Females had complications more frequently than males (P = .035). There were no statistically significant differences in levels of inflammatory parameters (C-reactive protein and leukocyte count) between patients with or without complications (P = .373 and P = .124; respectively). All patients with complications of AM were surgically treated. Mortality was 0% and all children completely recovered. Conclusion: Extracranial and intracranial complications of AM required surgical treatment and extended antibiotic therapy. Inflammation parameters did not have a predictive role in identifying children with complications of AM. Further investigations will determine whether the introduction of the mandatory pneumococcal vaccine in our country has led to a reduction in the incidence of AM and its complications.

PMID:37997632 | DOI:10.1177/01455613231212828

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Nevin Manimala Statistics

Model validation and selection in metabolic flux analysis and flux balance analysis

Biotechnol Prog. 2023 Nov 24:e3413. doi: 10.1002/btpr.3413. Online ahead of print.

ABSTRACT

13C-Metabolic Flux Analysis (13C-MFA) and Flux Balance Analysis (FBA) are widely used to investigate the operation of biochemical networks in both biological and biotechnological research. Both methods use metabolic reaction network models of metabolism operating at steady state so that reaction rates (fluxes) and the levels of metabolic intermediates are constrained to be invariant. They provide estimated (MFA) or predicted (FBA) values of the fluxes through the network in vivo, which cannot be measured directly. These fluxes can shed light on basic biology and have been successfully used to inform metabolic engineering strategies. Several approaches have been taken to test the reliability of estimates and predictions from constraint-based methods and to compare alternative model architectures. Despite advances in other areas of the statistical evaluation of metabolic models, such as the quantification of flux estimate uncertainty, validation and model selection methods have been underappreciated and underexplored. We review the history and state-of-the-art in constraint-based metabolic model validation and model selection. Applications and limitations of the χ2 -test of goodness-of-fit, the most widely used quantitative validation and selection approach in 13C-MFA, are discussed, and complementary and alternative forms of validation and selection are proposed. A combined model validation and selection framework for 13C-MFA incorporating metabolite pool size information that leverages new developments in the field is presented and advocated for. Finally, we discuss how adopting robust validation and selection procedures can enhance confidence in constraint-based modeling as a whole and ultimately facilitate more widespread use of FBA in biotechnology.

PMID:37997613 | DOI:10.1002/btpr.3413

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Nevin Manimala Statistics

Using geospatial social media data for infectious disease studies: a systematic review

Int J Digit Earth. 2023;16(1):130-157. doi: 10.1080/17538947.2022.2161652. Epub 2023 Jan 3.

ABSTRACT

Geospatial social media (GSM) data has been increasingly used in public health due to its rich, timely, and accessible spatial information, particularly in infectious disease research. This review synthesized 86 research articles that use GSM data in infectious diseases published between December 2013 and March 2022. These articles cover 12 infectious disease types ranging from respiratory infectious diseases to sexually transmitted diseases with spatial levels varying from the neighborhood, county, state, and country. We categorized these studies into three major infectious disease research domains: surveillance, explanation, and prediction. With the assistance of advanced statistical and spatial methods, GSM data has been widely and deeply applied to these domains, particularly in surveillance and explanation domains. We further identified four knowledge gaps in terms of contextual information use, application scopes, spatiotemporal dimension, and data limitations and proposed innovation opportunities for future research. Our findings will contribute to a better understanding of using GSM data in infectious diseases studies and provide insights into strategies for using GSM data more effectively in future research.

PMID:37997607 | PMC:PMC10664840 | DOI:10.1080/17538947.2022.2161652

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Nevin Manimala Statistics

Robust Variance Estimation for Covariate-Adjusted Unconditional Treatment Effect in Randomized Clinical Trials with Binary Outcomes

Stat Theory Relat Fields. 2023;7(2):159-163. doi: 10.1080/24754269.2023.2205802. Epub 2023 Apr 28.

ABSTRACT

To improve precision of estimation and power of testing hypothesis for an unconditional treatment effect in randomized clinical trials with binary outcomes, researchers and regulatory agencies recommend using g-computation as a reliable method of covariate adjustment. However, the practical application of g-computation is hindered by the lack of an explicit robust variance formula that can be used for different unconditional treatment effects of interest. To fill this gap, we provide explicit and robust variance estimators for g-computation estimators and demonstrate through simulations that the variance estimators can be reliably applied in practice.

PMID:37997606 | PMC:PMC10665030 | DOI:10.1080/24754269.2023.2205802

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Nevin Manimala Statistics

Micro-shear bond strength of different surface treatments on a polymer infiltrated ceramic network

F1000Res. 2022 Jul 18;11:798. doi: 10.12688/f1000research.122108.1. eCollection 2022.

ABSTRACT

Background: Polymer infiltrated ceramic networks, or hybrid ceramics, are a combination of infiltrating polymerizable organic monomers into a pre-sintered porous ceramic matrix. In addition to having good mechanical properties, the polymer infiltrated ceramic network must comply with the possibility of adequate bonding to the resinous cement. The surface conditioning of this hybrid material must be carefully considered due to its organic composition and ceramic network. The purpose of this research is to evaluate the effect of hydrofluoric acid and a self-etching ceramic primer, under two different application times, on the bond strength of a polymer infiltrated ceramic network. Methods: Blocks of a polymer infiltrated ceramic network were cut to obtain sheets, and these were randomized into five groups. For the group termed AAS, airborne-particle abrasion with Al 2O 3 (aluminum oxide) of 50µm was used. For groups HF2 and HF6, hydrofluoric acid was used for 20 and 60 seconds respectively, and for the groups MB2 and MB6, a self-etch ceramic primer was applied for 20 and 60 seconds respectively. A silane was applied to the groups AAS, HF2, and HF6 after the treatment. After 24-hour storage in distilled water, a micro-shear bond strength test was performed using a universal mechanical testing machine. All samples were evaluated in a stereomicroscope at 40x and 50x to determine the type of failure. Results: The highest and lowest values of bond strength were reported by groups MB6 and AAS, respectively. Groups HF2, HF6, MB6, and MB2 did not report statistically significant differences. The predominant failure pattern was a mixed failure. Conclusions: With the limitations of the present investigation, the treatments of self-etching ceramic primer and hydrofluoric acid followed by silane were reported to be statistically equal at 20 and 60 seconds.

PMID:37997604 | PMC:PMC10665602 | DOI:10.12688/f1000research.122108.1

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Nevin Manimala Statistics

Revision reverse shoulder arthroplasty has similar outcomes to primary reverse shoulder arthroplasty at 5 Year average follow-up

J Orthop. 2023 Nov 4;46:150-155. doi: 10.1016/j.jor.2023.10.035. eCollection 2023 Dec.

ABSTRACT

BACKGROUND: Shoulder arthroplasty is a successful procedure that provides pain relief and improvements in function and range of motion. Anatomic and reverse shoulder arthroplasty are both effective procedures, and their indications continue to expand. We look at the outcomes of revision reverse total shoulder arthroplasty and compare it to the outcomes of primary reverse and anatomic total shoulder arthroplasty.

METHODS: We identified patients undergoing total shoulder arthroplasty at our institution between the years of 2010 and 2020. Data was prospectively collected and retrospectively reviewed for post-operative range of motion and strength in patients with revision surgery and compared to controls. Measurements were collected preoperatively and postoperatively including range of motion and strength in the affected and unaffected shoulder. We collected patient reported outcome measures in person and via phone to identify subjective outcomes of total shoulder arthroplasty. Average final follow-up was 5.27 years.

RESULTS: Our total patient sample was split between three groups: those with primary anatomic arthroplasty those who underwent primary reverse arthroplasty, and those who were revised to a reverse shoulder arthroplasty. All three groups had significant improvements in abduction and forward elevation from their pre-operative baseline to two years follow-up. Primary reverse had a significant improvement over revision reverse in abduction at one year follow-up. For all other range of motion measurements, there was no statistically significant difference at 2 years between primary and revision reverse shoulder arthroplasty. Patient reported outcomes had a significant increase from pre-op to most recent follow-up in all three groups.

CONCLUSION: Overall, our data suggest there is an improvement in outcomes with both primary and revision surgeries, and that results after revision reverse total shoulder arthroplasty may be comparable to primary reverse total shoulder arthroplasty.

PMID:37997602 | PMC:PMC10663749 | DOI:10.1016/j.jor.2023.10.035

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Nevin Manimala Statistics

Transfer learning of individualized treatment rules from experimental to real-world data

J Comput Graph Stat. 2023;32(3):1036-1045. doi: 10.1080/10618600.2022.2141752. Epub 2022 Nov 30.

ABSTRACT

Individualized treatment effect lies at the heart of precision medicine. Interpretable individualized treatment rules (ITRs) are desirable for clinicians or policymakers due to their intuitive appeal and transparency. The gold-standard approach to estimating the ITRs is randomized experiments, where subjects are randomized to different treatment groups and the confounding bias is minimized to the extent possible. However, experimental studies are limited in external validity because of their selection restrictions, and therefore the underlying study population is not representative of the target real-world population. Conventional learning methods of optimal interpretable ITRs for a target population based only on experimental data are biased. On the other hand, real-world data (RWD) are becoming popular and provide a representative sample of the target population. To learn the generalizable optimal interpretable ITRs, we propose an integrative transfer learning method based on weighting schemes to calibrate the covariate distribution of the experiment to that of the RWD. Theoretically, we establish the risk consistency for the proposed ITR estimator. Empirically, we evaluate the finite-sample performance of the transfer learner through simulations and apply it to a real data application of a job training program.

PMID:37997592 | PMC:PMC10664843 | DOI:10.1080/10618600.2022.2141752

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Nevin Manimala Statistics

Exploring cultural sensitivity during distance simulations in pediatric emergency medicine

AEM Educ Train. 2023 Nov 22;7(6):e10908. doi: 10.1002/aet2.10908. eCollection 2023 Dec.

ABSTRACT

BACKGROUND: Cultural sensitivity (CS) training is vital to pediatric emergency medicine (PEM) curricula. This study aimed to explore CS in Yale PEM fellows and emergency medicine (EM) residents at Indus Hospital and Health Network (IHHN) in Pakistan through distance simulation activities.

METHODS: This mixed-methods analysis of an educational intervention was conducted at Yale University in collaboration with IHHN. We approached seven U.S. PEM fellows and 22 Pakistani EM residents. We performed a baseline CS assessment using the Clinical Cultural Competency Questionnaire (CCCQ). Afterward, the U.S. PEM fellows facilitated the Pakistani EM residents through six distance simulation sessions. Qualitative data were collected through online focus groups. The CCCQ was analyzed using descriptive statistics, and content analysis was used to analyze the data from the focus groups.

RESULTS: Seven U.S. PEM fellows and 18 of 22 Pakistani EM residents responded to the CCCQ at the beginning of the module. The mean (±SD) CCCQ domain scores for the U.S. PEM fellows versus the Pakistani EM residents were 2.56 (±0.37) versus 2.87 (±0.72) for knowledge, 3.02 (±0.41) versus 3.33 (±0.71) for skill, 2.86 (±0.32) versus 3.17 (±0.73) for encounter/situation, and 3.80 (±0.30) versus 3.47 (±0.47) for attitude (each out of 5 points). Our qualitative data analysis showed that intercultural interactions were valuable. There is a common language of medicine among the U.S. PEM fellows and Pakistani EM residents. The data also highlighted a power distance between the facilitators and learners, as the United States was seen as the standard of “how to practice PEM.” The challenges identified were time differences, cultural practices such as prayer times, the internet, and technology. The use of local language during debriefing was perceived to enhance engagement.

CONCLUSION: The distance simulation involving U.S. PEM fellows and Pakistani EM residents was an effective approach in assessing various aspects of intercultural education, such as language barriers, technical challenges, and religious considerations.

PMID:37997591 | PMC:PMC10664395 | DOI:10.1002/aet2.10908

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Nevin Manimala Statistics

An investigation into emergency medicine resident cricothyrotomy competency: Is three the magic number?

AEM Educ Train. 2023 Nov 22;7(6):e10917. doi: 10.1002/aet2.10917. eCollection 2023 Dec.

ABSTRACT

OBJECTIVES: Cricothyrotomy is a high-stakes emergency procedure. Because the procedure is rare, simulation is often used to train residents. The Accreditation Council for Graduate Medical Education (ACGME) requires performance of three cricothyrotomies during residency, but the optimal number of training repetitions is unknown. Additional repetitions beyond three could increase proficiency, though it is unknown whether there is a threshold beyond which there is no benefit to additional repetition. The objective of this study was to establish a minimum number of simulated cricothyrotomy attempts beyond which additional attempts did not increase proficiency.

METHODS: This was a prospective, observational study conducted over 3 years at the simulation center of an academic emergency medicine residency program. Participants were residents participating in a cricothyrotomy training as part of a longitudinal airway curriculum course. The primary outcome was time to successful completion of the procedure as first-year residents. Secondary outcomes included time to completion as second- and third-year residents. Procedure times were plotted as a function of attempt number. Data were analyzed using descriptive statistics, repeated-measures analysis of variance, and correlation analysis. Preprocedure surveys collected further data regarding procedure experience, confidence, and comfort.

RESULTS: Sixty-nine first-year residents participated in the study. Steady improvement in time to completion was seen through the first six attempts (from a mean of 75 to 41 sec), after which no further significant improvement was found. Second- and third-year residents initially demonstrated slower performance than first-year residents but rapidly improved to surpass their first-year performance. Resident mean times at five attempts were faster with each year of residency (first-year 48 sec, second-year 30 sec, third-year 24 sec). There was no statistically significant correlation between confidence and time to complete the procedure.

CONCLUSIONS: Additional repetition beyond the ACGME-endorsed three cricothyrotomy attempts may help increase proficiency. Periodic retraining may be important to maintain skills.

PMID:37997589 | PMC:PMC10664393 | DOI:10.1002/aet2.10917