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Nevin Manimala Statistics

Supervised structural learning of semiparametric regression on high-dimensional correlated covariates with applications to eQTL studies

Stat Med. 2023 Aug 15;42(18):3145-3163. doi: 10.1002/sim.9769. Epub 2023 May 15.

ABSTRACT

Expression quantitative trait loci (eQTL) studies utilize regression models to explain the variance of gene expressions with genetic loci or single nucleotide polymorphisms (SNPs). However, regression models for eQTL are challenged by the presence of high dimensional non-sparse and correlated SNPs with small effects, and nonlinear relationships between responses and SNPs. Principal component analyses are commonly conducted for dimension reduction without considering responses. Because of that, this non-supervised learning method often does not work well when the focus is on discovery of the response-covariate relationship. We propose a new supervised structural dimensional reduction method for semiparametric regression models with high dimensional and correlated covariates; we extract low-dimensional latent features from a vast number of correlated SNPs while accounting for their relationships, possibly nonlinear, with gene expressions. Our model identifies important SNPs associated with gene expressions and estimates the association parameters via a likelihood-based algorithm. A GTEx data application on a cancer related gene is presented with 18 novel eQTLs detected by our method. In addition, extensive simulations show that our method outperforms the other competing methods in bias, efficiency, and computational cost.

PMID:37458069 | DOI:10.1002/sim.9769

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Nevin Manimala Statistics

A computational approach for analysis of intratumoral heterogeneity and standardized uptake value in PET/CT images1

J Xray Sci Technol. 2023 Jul 13. doi: 10.3233/XST-230095. Online ahead of print.

ABSTRACT

BACKGROUND: By providing both functional and anatomical information from a single scan, digital imaging technologies like PET/CT and PET/MRI hybrids are gaining popularity in medical imaging industry. In clinical practice, the median value (SUVmed) receives less attention owing to disagreements surrounding what defines a lesion, but the SUVmax value, which is a semi-quantitative statistic used to analyse PET and PET/CT images, is commonly used to evaluate lesions.

OBJECTIVE: This study aims to build an image processing technique with the purpose of automatically detecting and isolating lesions in PET/CT images, as well as measuring and assessing the SUVmed.

METHODS: The pictures are separated into their respective lesions using mathematical morphology and the crescent region, which are both part of the image processing method. In this research, a total of 18 different pictures of lesions were evaluated.

RESULTS: The findings of the study reveal that the threshold is satisfied by both the SUVmax and the SUVmed for most of the lesion types. However, in six instances, the SUVmax and SUVmed values are found to be in different courts.

CONCLUSION: The new information revealed by this study needs to be further investigated to determine if it has any practical value in diagnosing and monitoring lesions. However, results of this study suggest that SUVmed should receive more attention in the evaluation of lesions in PET and CT images.

PMID:37458060 | DOI:10.3233/XST-230095

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Nevin Manimala Statistics

Evaluation of risk management status in selected departments of educational hospitals of Hamadan University of Medical Sciences

Int J Risk Saf Med. 2023 Jun 21. doi: 10.3233/JRS-220066. Online ahead of print.

ABSTRACT

BACKGROUND: Healthcare organizations are among high-risk organizations due to the nature of their work as well as structural, physical and technological complexities. Accordingly, it is very important to use risk management and control programs in all departments of these organizations.

OBJECTIVE: The present study was conducted for the first time to evaluate the risk management status of the operating room and laboratory departments of Hamadan hospitals in 2022.

METHODS: In this descriptive-observational cross-sectional study, laboratory and operating room departments were selected as the research environment. To conduct this research, a valid and reliable questionnaire was used to collect data, and the data were analyzed using the SPSS 22 statistical software.

RESULTS: The findings of the present study showed that the overall mean score of risk management status for the laboratory and operating room departments was 2.66 ± 0.15 and 2.89 ± 0.13, respectively. Furthermore, there was no statistically significant difference in the mean scores of the research components based on work experience, education level, and gender.

CONCLUSION: It is suggested that the laboratory and operating room departments should focus more on adopting policies and solutions to improve the position of risk management, training and budget allocation for risk management.

PMID:37458049 | DOI:10.3233/JRS-220066

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Nevin Manimala Statistics

Testing a Polygenic Risk Score for Morphological Microglial Activation in Alzheimer’s Disease and Aging

J Alzheimers Dis. 2023 Jul 10. doi: 10.3233/JAD-230434. Online ahead of print.

ABSTRACT

BACKGROUND: Neuroinflammation and the activation of microglial cells are among the earliest events in Alzheimer’s disease (AD). However, direct observation of microglia in living people is not currently possible. Here, we indexed the heritable propensity for neuroinflammation with polygenic risk scores (PRS), using results from a recent genome-wide analysis of a validated post-mortem measure of morphological microglial activation.

OBJECTIVE: We sought to determine whether a PRS for microglial activation (PRSmic) could augment the predictive performance of existing AD PRSs for late-life cognitive impairment.

METHODS: First, PRSmic were calculated and optimized in a calibration cohort (Alzheimer’s Disease Neuroimaging Initiative (ADNI), n = 450), with resampling. Second, predictive performance of optimal PRSmic was assessed in two independent, population-based cohorts (total n = 212,237). Finally, we explored associations of PRSmic with a comprehensive set of imaging and fluid AD biomarkers in ADNI.

RESULTS: Our PRSmic showed no significant improvement in predictive power for either AD diagnosis or cognitive performance in either external cohort. Some nominal associations were found in ADNI, but with inconsistent effect directions.

CONCLUSION: While genetic scores capable of indexing risk for neuroinflammatory processes in aging are highly desirable, more well-powered genome-wide studies of microglial activation are required. Further, biobank-scale studies would benefit from phenotyping of proximal neuroinflammatory processes to improve the PRS development phase.

PMID:37458040 | DOI:10.3233/JAD-230434

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Nevin Manimala Statistics

Neurocognitive Operations Underlying Working Memory Abilities: An Analysis of Latency and Time-Based Parameters

J Alzheimers Dis. 2023 Jul 10. doi: 10.3233/JAD-230288. Online ahead of print.

ABSTRACT

BACKGROUND: The theory of executive attention (Fuster, 2015) suggests considerable plasticity regarding when specific neurocognitive operations are recruited to bring executive tasks to fruition.

OBJECTIVE: We tested the hypothesis that differing neurocognitive operations are recruited upon the initiation of a response, but that other distinct neurocognitive operations are recruited towards the middle or end of a response.

METHODS: The Backward Digit Span Test (BDST) was administered to 58 memory clinic patients (MCI, n = 22; no-MCI, n = 36). Latency to generate all correct 5-span responses was obtained. Statistical analyses found that optimal group classification was achieved using the first and third digit backward. First and third response latencies were analyzed in relation to verbal working memory (WM), visual WM, processing speed, visuospatial operations, naming/lexical access, and verbal episodic memory tests.

RESULTS: For the first response, slower latencies were associated with better performance in relation to verbal WM and visuospatial test performance. For the third response, faster latencies were associated with better processing speed and visuospatial test performance.

CONCLUSION: Consistent with the theory of executive attention, these data show that the neurocognitive operations underlying successful executive test performance are not monolithic but can be quite nuanced with differing neurocognitive operations associated with specific time epochs. Results support the efficacy of obtaining time-based latency parameters to help disambiguate successful executive neurocognitive operations in memory clinic patients.

PMID:37458036 | DOI:10.3233/JAD-230288

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Nevin Manimala Statistics

Efficacy of percutaneous needle electrolysis versus dry needling in musculoskeletal pain: A systematic review and meta-analysis

J Back Musculoskelet Rehabil. 2023 Jul 3. doi: 10.3233/BMR-220408. Online ahead of print.

ABSTRACT

BACKGROUND: Physical therapists use dry needling (DN) and percutaneous needle electrolysis (PNE) to treat musculoskeletal pain.

OBJECTIVE: To investigate the efficacy of PNE vs. DN in the treatment of musculoskeletal pain.

METHODS: This systematic review and meta-analysis was based on the PICOS and PRISMA protocols. The PubMed, PEDro, Cochrane Library, SCOPUS, and Google Scholar databases were searched for randomized clinical trials measuring pain intensity in various musculoskeletal syndromes using PNE and DN. Pain outcome measures were the visual analog scale or the numerical pain rating scale. Risk of bias was assessed according to Cochrane guidelines and quality of evidence was reported using the Grading of Recommendations Assessment, Development, and Evaluation approach (GRADE). Standardized mean differences were calculated using random effects models.

RESULTS: The meta-analysis of the six included studies showed that the overall effect of PNE vs. DN for pain reduction was statistically significant at -0.74 (95% confidence interval [CI], -1.34 to -0.14) with a large effect size (SMD =-0.41; 95% CI, -0.75 to -0.08), albeit clinically insignificant in the short, medium, and long term. Risk of bias was generally low with moderate-level evidence due to the overall effect heterogeneity and the small sample.

CONCLUSIONS: Moderate-quality evidence showed that PNE is slightly more effective than DN in reducing pain. However, because the results were not clinically significant, we cannot recommend the application of PNE over DN. More high-quality studies comparing the two interventions are needed to draw firm conclusions.

PMID:37458028 | DOI:10.3233/BMR-220408

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Nevin Manimala Statistics

Is higher compliance to brace therapy associated with poorer quality of life and self-image? A 36-months follow-up study

J Back Musculoskelet Rehabil. 2023 Jul 6. doi: 10.3233/BMR-220361. Online ahead of print.

ABSTRACT

BACKGROUND: Brace treatment is the most effective tool for avoiding curve progression in moderate adolescent idiopathic scoliosis and high adherence is required to achieve therapeutic success. Despite this, the compliance often is impaired by the concern about the psychological well-being of adolescents.

OBJECTIVE: This 36-month follow-up study investigated if the patients most adherent to brace treatment could report a stronger impairment in the quality of life and body image.

METHODS: 64 adolescents with idiopathic scoliosis responded to the Scoliosis Research Society-22 revised Patient Questionnaire at 12, 24, and 36 months after prescription of a TLSO rigid brace. Retrospectively, participants who wore a brace for more than 75% of the prescribed time were assigned to the good-compliance group (GC); the others formed the poor-compliance group (PC).

RESULTS: At 12 months the GC group showed higher scores in treatment satisfaction and at 36 months they did not differ from the PC group in the overall SRS-22r score. Moreover, they achieved a statistically significant improvement in the scoliosis severity, although they showed lower scores in the self-image domain.

CONCLUSION: In our patient’s cohort, increased brace adherence does not compromise QoL and provides better treatment outcomes. However, more attention is needed to maintain good self-perception.

PMID:37458018 | DOI:10.3233/BMR-220361

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Nevin Manimala Statistics

Musculoskeletal system symptoms in patients with COVID-19 and the impact of these symptoms on quality of life

J Back Musculoskelet Rehabil. 2023 Jul 3. doi: 10.3233/BMR-220297. Online ahead of print.

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a respiratory disease caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and also affects the musculoskeletal system.

OBJECTIVE: This study was conducted to investigate the musculoskeletal symptoms, type of pain and effect on quality of life in patients presenting with pain after COVID-19.

METHODS: This prospective, descriptive study included 97 patients aged 18 years or older who were diagnosed with COVID-19 based on a positive polymerase chain reaction test result, with or without musculoskeletal pain prior to COVID-19 infection. Patients who applied to the post-COVID-19 outpatient clinic with the complaint of pain at least 1 month and maximum 1 year after the diagnosis of COVID-19 were included. Patients’ demographic characteristics and musculoskeletal examination findings were evaluated. The patients were examined, and the questionnaire forms were completed. The pain was assessed using the visual analog scale (VAS), the Douleur-Neuropathique-4 (DN-4) questionnaire, while the quality of life was assessed using the Short Form-36 (SF-36) survey. Patients were divided into groups in terms of gender, age, body mass index. Shapiro-Wilk’s test, the independent samples t-test and the Mann-Whitney U test were used for statistical analyses.

RESULTS: The mean age of the patients was 46.5 ± 13.5 years, 30 of them were male. Pain increased in patients with pre-COVID-19 arthralgia and myalgia (p< 0.001). Post-COVID-19 VAS was significantly higher than pre-COVID-19 VAS (7 ± 1.2 vs. 3.2 ± 1.9, p< 0.05). Pre-COVID-19 patients with myalgia had significantly worse SF-36 physical function, social function, pain, general health perception (p< 0.05). The mean scores of females in the SF-36 physical function, pain were significantly worse than males (p< 0.05). According to DN-4, 41 (42.3%) patients had neuropathic pain. There was moderate negative correlation between VAS, DN-4 and SF-36 (p< 0.05).

CONCLUSIONS: Arthralgia, myalgia, and neuropathic pain, all of which negatively affect the quality of life, are often observed in the patients infected with COVID-19.

PMID:37458011 | DOI:10.3233/BMR-220297

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Nevin Manimala Statistics

Shoulder vibratory exercises improves shoulder external rotation muscle strength and shoulder function: Randomized comparison trial

J Back Musculoskelet Rehabil. 2023 Jul 6. doi: 10.3233/BMR-220190. Online ahead of print.

ABSTRACT

BACKGROUND: Based on electromyography measurements, shoulder vibratory exercises efficiently stimulate shoulder muscles activity. Yet very few studies have supported that shoulder vibratory exercises increased shoulder muscles strength and function, and the noninferiority compared with conventional elastic resistance exercises remains unknown.

OBJECTIVE: This study investigated the effect of vibratory exercises versus conventional elastic resistance exercises with elastic bands on shoulder external rotation muscles strength and functional performance in young adults.

METHODS: 26 young adults (7 males and 19 females, with age 23.89 ± 3.02) were recruited and randomly allocated to shoulder vibratory exercises with FLEXI-BAR (FLEXI-BAR group) or conventional resistance exercises with elastic band (TheraBand group) for 3 times/week, 4 weeks totally. Shoulder external rotator muscles strength test and Underkofler softball distance throw test (USDTT) were performed before and after the training period.

RESULTS: After 4 weeks training, shoulder external rotator muscles strength increased 22.25 ± 15.06 N (P= 0.004, effect size = 1.48) within FLEXI-BAR group and 22.81 ± 14.94 N (P= 0.007, effect size = 1.53) within TheraBand group. There were no statistically significant differences between groups in the three muscle strength tests (P> 0.65). Regarding shoulder function, FLEXI-BAR exercises increased the throw distance 0.81 ± 0.92 meters in USDTT (P= 0.041, effect size = 0.88) while TheraBand exercise did not (P= 0.284), yet there was no statistically significant between group effects (P= 0.608).

CONCLUSIONS: These findings suggest that shoulder vibratory exercises can improve shoulder muscles strength in young adults and can be a useful alternative to the conventional elastic resistance exercises to improve the shoulder muscles strength and function. This provides therapists with more options in terms of choosing training equipment for rehabilitation programs.

PMID:37458007 | DOI:10.3233/BMR-220190

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Nevin Manimala Statistics

Intraoperative analgesic effect of intravertebral lidocaine injection during percutaneous kyphoplasty in the treatment of thoracolumbar compression fractures in elderly patients

J Back Musculoskelet Rehabil. 2023 Jul 6. doi: 10.3233/BMR-220174. Online ahead of print.

ABSTRACT

BACKGROUND: In recent years, percutaneous kyphoplasty (PKP) has been increasingly used in clinical settings.

OBJECTIVE: In this study, we aimed to determine the analgesic effect of intravertebral lidocaine injections in PKP.

METHODS: A total of 60 patients who were treated with PKP were enrolled in this study. Lidocaine hydrochloride was chosen as the medication for the experimental group. Patients were randomly assigned into three groups using a double-blind study design: In group A (20 cases), no drugs were injected into the vertebral body during surgery; group B (20 cases) received intravertebral injection of normal saline; and in group C (20 cases), lidocaine hydrochloride was administered into the vertebral body during surgery. The age of patients, operation time, balloon dilatation pressure, balloon dilatation volume, and amount of bone cement injected were compared across the three groups. A pain visual analog scale (VAS) was used to assess pain suffered by the patients before, during, and 24 hours after the surgery.

RESULTS: Age, operation time, balloon dilatation pressure, balloon dilatation volume, and amount of bone cement injected did not differ significantly among the three groups (P> 0.05). The differences in VAS scores 24 hours before and after surgery were not statistically significant (P> 0.05). Group C had lower intraoperative VAS scores than groups A and B, and the difference was statistically significant (P< 0.01). There was no statistically significant difference between group A and group B (P> 0.05).

CONCLUSION: Intravertebral injections of lidocaine during PKP can successfully reduce intraoperative pain.

PMID:37458006 | DOI:10.3233/BMR-220174