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Nevin Manimala Statistics

Detection of fibular rotational changes in cone beam CT: experimental study in a specimen model

BMC Med Imaging. 2022 Oct 19;22(1):181. doi: 10.1186/s12880-022-00913-3.

ABSTRACT

BACKGROUND: In syndesmotic injuries, incorrect reduction leads to early arthrosis of the ankle joint. Being able to analyze the reduction result is therefore crucial for obtaining an anatomical reduction. Several studies that assess fibular rotation in the incisura have already been published. The aim of the study was to validate measurement methods that use cone beam computed tomography imaging to detect rotational malpositions of the fibula in a standardized specimen model.

METHODS: An artificial Maisonneuve injury was created on 16 pairs of fresh-frozen lower legs. Using a stable instrument, rotational malpositions of 5, 10, and 15° internal and external rotation were generated. For each malposition of the fibula, a cone beam computed tomography scan was performed. Subsequently, the malpositions were measured and statistically evaluated with t-tests using two measuring methods: angle (γ) at 10 mm proximal to the tibial joint line and the angle (δ) at 6 mm distal to the talar joint line.

RESULTS: Rotational malpositions of ≥ 10° could be reliably displayed in the 3D images using the measuring method with angle δ. For angle γ significant results could only be displayed for an external rotation malposition of 15°.

CONCLUSIONS: Clinically relevant rotational malpositions of the fibula in comparison with an uninjured contralateral side can be reliably detected using intraoperative 3D imaging with a C-arm cone beam computed tomography. This may allow surgeons to achieve better reduction of fibular malpositions in the incisura tibiofibularis.

PMID:36261814 | DOI:10.1186/s12880-022-00913-3

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Nevin Manimala Statistics

Efficacy and safety of curcuminoids alone in alleviating pain and dysfunction for knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials

BMC Complement Med Ther. 2022 Oct 19;22(1):276. doi: 10.1186/s12906-022-03740-9.

ABSTRACT

BACKGROUND: Curcuminoids (CURs) are the principal ingredients of Curcuma longa L. [Zingiberaceae] (CL)-an herbal plant used in east Asia to alleviate pain and inflammation. Thus far, the therapeutic effects of CURs for knee osteoarthritis (OA) uncovered by multiple reviews remained uncertain due to broadly involving trials with different agents-combined or CURs-free interventions. Therefore, we formed stringent selection criteria and assessment methods to summarize current evidence on the efficacy and safety of CURs alone in the treatment of knee OA.

METHODS: A series of databases were searched for randomized controlled trials (RCTs) evaluating the efficacy and safety of CURs for knee OA. Clinical outcomes were evaluated using meta-analysis and the minimum clinically important difference (MCID) for both statistical and clinical significance.

RESULTS: Fifteen studies with 1670 patients were included. CURs were significantly more effective than placebo in the improvements of VAS for pain ( WMD: – 1.77, 95% CI: – 2.44 to – 1.09), WOMAC total score ( WMD: – 7.06, 95% CI: – 12.27 to – 1.84), WOMAC pain score ( WMD: – 1.42, 95% CI: – 2.41 to – 0.43), WOMAC function score ( WMD: – 5.04, 95% CI: – 7.65 to – 2.43), and WOMAC stiffness score ( WMD: – 0.54, 95% CI: – 1.03 to – 0.05). Meanwhile, CURs were not inferior to NSAIDs in the improvements of pain- and function-related outcomes. Additionally, CURs did not significantly increase the incidence of adverse events (AEs) compared with placebo ( RR: 1.03, 95% CI: 0.69 to 1.53, P = 0.899, I2 = 23.7%) and NSAIDs (RR: 0.71 0.65, 95% CI: 0.57 0.41 to 0.90 1.03).

CONCLUSIONS: CURs alone can be expected to achieve considerable analgesic and functional promotion effects for patients with symptomatic knee OA in short term, without inducing an increase of adverse events. However, considering the low quality and substantial heterogeneity of present studies, a cautious and conservative recommendation for broader clinical use of CURs should still be made. Further high-quality studies are necessary to investigate the impact of different dosages, optimization techniques and administration approaches on long-term safety and efficacy of CURs, so as to strengthen clinical decision making for patients with symptomatic knee OA.

PMID:36261810 | DOI:10.1186/s12906-022-03740-9

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Nevin Manimala Statistics

Estimating the optimal linear combination of predictors using spherically constrained optimization

BMC Bioinformatics. 2022 Oct 19;23(Suppl 3):436. doi: 10.1186/s12859-022-04953-y.

ABSTRACT

BACKGROUND: In the context of a binary classification problem, the optimal linear combination of continuous predictors can be estimated by maximizing the area under the receiver operating characteristic curve. For ordinal responses, the optimal predictor combination can similarly be obtained by maximization of the hypervolume under the manifold (HUM). Since the empirical HUM is discontinuous, non-differentiable, and possibly multi-modal, solving this maximization problem requires a global optimization technique. Estimation of the optimal coefficient vector using existing global optimization techniques is computationally expensive, becoming prohibitive as the number of predictors and the number of outcome categories increases.

RESULTS: We propose an efficient derivative-free black-box optimization technique based on pattern search to solve this problem, which we refer to as Spherically Constrained Optimization Routine (SCOR). Through extensive simulation studies, we demonstrate that the proposed method achieves better performance than existing methods including the step-down algorithm. Finally, we illustrate the proposed method to predict the severity of swallowing difficulty after radiation therapy for oropharyngeal cancer based on radiation dose to various structures in the head and neck.

CONCLUSIONS: Our proposed method addresses an important challenge in combining multiple biomarkers to predict an ordinal outcome. This problem is particularly relevant to medical research, where it may be of interest to diagnose a disease with various stages of progression or a toxicity with multiple grades of severity. We provide the implementation of our proposed SCOR method as an R package, available online at https://CRAN.R-project.org/package=SCOR .

PMID:36261805 | DOI:10.1186/s12859-022-04953-y

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Nevin Manimala Statistics

Association between water, sanitation and hygiene (WASH) and child undernutrition in Ethiopia: a hierarchical approach

BMC Public Health. 2022 Oct 19;22(1):1943. doi: 10.1186/s12889-022-14309-z.

ABSTRACT

BACKGROUND: Undernutrition is a significant public health challenge and one of the leading causes of child mortality in a wide range of developing countries, including Ethiopia. Poor access to water, sanitation, and hygiene (WASH) facilities commonly contributes to child growth failure. There is a paucity of information on the interrelationship between WASH and child undernutrition (stunting and wasting). This study aimed to assess the association between WASH and undernutrition among under-five-year-old children in Ethiopia.

METHODS: A secondary data analysis was undertaken based on the Ethiopian Demographic and Health Surveys (EDHS) conducted from 2000 to 2016. A total of 33,763 recent live births extracted from the EDHS reports were included in the current analysis. Multilevel logistic regression models were used to investigate the association between WASH and child undernutrition. Relevant factors from EDHS data were identified after extensive literature review.

RESULTS: The overall prevalences of stunting and wasting were 47.29% [95% CI: (46.75, 47.82%)] and 10.98% [95% CI: (10.65, 11.32%)], respectively. Children from households having unimproved toilet facilities [AOR: 1.20, 95% CI: (1.05,1.39)], practicing open defecation [AOR: 1.29, 95% CI: (1.11,1.51)], and living in households with dirt floors [AOR: 1.32, 95% CI: (1.12,1.57)] were associated with higher odds of being stunted. Children from households having unimproved drinking water sources were significantly less likely to be wasted [AOR: 0.85, 95% CI: (0.76,0.95)] and stunted [AOR: 0.91, 95% CI: (0.83, 0.99)]. We found no statistical differences between improved sanitation, safe disposal of a child’s stool, or improved household flooring and child wasting.

CONCLUSION: The present study confirms that the quality of access to sanitation and housing conditions affects child linear growth indicators. Besides, household sources of drinking water did not predict the occurrence of either wasting or stunting. Further longitudinal and interventional studies are needed to determine whether individual and joint access to WASH facilities was strongly associated with child stunting and wasting.

PMID:36261797 | DOI:10.1186/s12889-022-14309-z

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Nevin Manimala Statistics

Prognostic value of patient-reported outcome measures (PROMs) in adults with non-small cell Lung Cancer: a scoping review

BMC Cancer. 2022 Oct 19;22(1):1076. doi: 10.1186/s12885-022-10151-z.

ABSTRACT

BACKGROUND: There is growing interest in the collection and use of patient-reported outcome measures (PROMs) to support clinical decision making in patients with non-small cell lung cancer (NSCLC). However, an overview of research into the prognostic value of PROMs is currently lacking.

AIM: To explore to what extent, how, and how robustly the value of PROMs for prognostic prediction has been investigated in adults diagnosed with NSCLC.

METHODS: We systematically searched Medline, Embase, CINAHL Plus and Scopus for English-language articles published from 2011 to 2021 that report prognostic factor study, prognostic model development or validation study. Example data charting forms from the Cochrane Prognosis Methods Group guided our data charting on study characteristics, PROMs as predictors, predicted outcomes, and statistical methods. Two reviewers independently charted the data and critically appraised studies using the QUality In Prognosis Studies (QUIPS) tool for prognostic factor studies, and the risk of bias assessment section of the Prediction model Risk Of Bias ASsessment Tool (PROBAST) for prognostic model studies.

RESULTS: Our search yielded 2,769 unique titles of which we included 31 studies, reporting the results of 33 unique analyses and models. Out of the 17 PROMs used for prediction, the EORTC QLQ-C30 was most frequently used (16/33); 12/33 analyses used PROM subdomain scores instead of the overall scores. PROMs data was mostly collected at baseline (24/33) and predominantly used to predict survival (32/33) but seldom other clinical outcomes (1/33). Almost all prognostic factor studies (26/27) had moderate to high risk of bias and all four prognostic model development studies had high risk of bias.

CONCLUSION: There is an emerging body of research into the value of PROMs as a prognostic factor for survival in people with NSCLC but the methodological quality of this research is poor with significant bias. This warrants more robust studies into the prognostic value of PROMs, in particular for predicting outcomes other than survival. This will enable further development of PROM-based prediction models to support clinical decision making in NSCLC.

PMID:36261794 | DOI:10.1186/s12885-022-10151-z

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Nevin Manimala Statistics

International medical students’ acculturation and self-rated health status in Hungary: a cross-sectional study

BMC Public Health. 2022 Oct 19;22(1):1941. doi: 10.1186/s12889-022-14334-y.

ABSTRACT

BACKGROUND: Over the past few decades, the number of international students has increased dramatically. These students have to adjust to unfamiliar social, cultural, and educational environments. The concept of acculturation has been applied in multiple studies on various health outcomes. This study investigated the relationship between acculturation and self-rated health (SRH) among international medical students.

METHODS: A cross-sectional study was conducted among international medical students at the University of Szeged, Hungary between April and October 2021. A total of 326 participants filled out questionnaires about sociodemographic characteristics, acculturation, and SRH. The modified Stephenson multigroup acculturation scale (SMAS) was used to assess the acculturation status; the scale defined acculturation as the degree of dominant society immersion (DSI, 12 items) and ethnic society immersion (ESI, 16 items). To measure SRH, participants were asked to rate their current general health and mental health. The data were analyzed by using descriptive statistics and the multiple logistic regression model.

RESULTS: 32.5% of the students reported having poor general and 49.7% poor mental health. We have found that acculturation was associated with SRH in multivariable logistic regression models controlling for sociodemographic characteristic. Bidimensional acculturation, such as ESI and DSI significantly influenced SRH as the likelihood of poor general health decreased (OR = 0.50; 95% CI = 0.31-0.81, P = 0.005), when the ESI was higher, whereas the likelihood of poor mental health decreased (OR = 0.52; 95% CI = 0.35-0.79, P = 0.002) if students had a greater DSI.

CONCLUSION: Both types of immersion can affect the students’ SRH. If the student could integrate better into their own ethnic group, their general health was better, and if they could strongly integrate into the Hungarian society, their mental health was more favorable. Acculturation measures should be promoted by academics and public health professionals in order to better understand their role in the behaviors, health outcomes, and health care use of medical international students. These findings will help professionals shape culturally sensitive prevention and counselling strategies for international student populations.

PMID:36261784 | DOI:10.1186/s12889-022-14334-y

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Nevin Manimala Statistics

Malaria Knowledge-Base and Prevalence of Parasitaemia in Asymptomatic Adults in the Forest Zone of Ghana

Acta Parasitol. 2022 Oct 19. doi: 10.1007/s11686-022-00629-y. Online ahead of print.

ABSTRACT

PURPOSE: To determine the levels of knowledge, awareness and perception of malaria, and to determine the infection status among asymptomatic adults in selected districts.

METHODS: This descriptive, cross-sectional study recruited 849 participants from seven districts in the malaria meso-endemic forest zone of Ghana. Questionnaires were administered to elicit responses from asymptomatic adults on malaria awareness, knowledge and insecticide-treated net (ITN) usage. Capillary blood samples were taken from study subjects for malaria Rapid Diagnostic Test (RDT) and microscopy. Descriptive statistics was used to analyse quantitative and qualitative data.

RESULTS: Ninety-eight percent of participants were aware of malaria, 94.0% owned ITNs but only 35.5% consistently used them. Also, 56.7% correctly associated malaria with mosquitoes and 54.5% identified stagnant water as the breeding site. Twelve percent (12.2%) and 13.1% of the subjects tested positive for malaria via RDT and microscopy, respectively. Of the 111 confirmed malaria cases, 107 had Plasmodium falciparum infections, two had Plasmodium ovale infections and there were two Plasmodium falciparum-Plasmodium ovale mixed infections.

CONCLUSION: Awareness and knowledge of malaria was satisfactory but this did not translate into mosquito avoidance behaviour due to deep-seated perceptions and myths. With the prevalence of asymptomatic parasitaemia observed, this reservoir of infection could be dislodged with appropriate health education targeted at women in the rural communities.

PMID:36261782 | DOI:10.1007/s11686-022-00629-y

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Nevin Manimala Statistics

Particle Property Characterization and Data Curation for Effective Powder Property Modeling in the Pharmaceutical Industry

AAPS PharmSciTech. 2022 Oct 19;23(8):286. doi: 10.1208/s12249-022-02434-2.

ABSTRACT

Computational modeling, machine learning, and statistical data analysis are increasingly utilized to mitigate chemistry, manufacturing, and control failures related to particle properties in solid dosage form manufacture. Advances in particle characterization techniques and computational approaches provide unprecedented opportunities to explore relationships between particle morphology and drug product manufacturability. Achieving this, however, has numerous challenges such as producing and appropriately curating robust particle size and shape data. Addressing these challenges requires a harmonized strategy from material sampling practices, characterization technique selection, and data curation to provide data sets which are informative on material properties. Herein, common sources of error in particle characterization and data compression are reviewed, and a proposal for providing robust particle morphology (size and shape) data to support modeling efforts, approaches for data curation, and the outlook for modeling particle properties are discussed.

PMID:36261755 | DOI:10.1208/s12249-022-02434-2

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Nevin Manimala Statistics

Geoenvironmental approach to investigate surface and groundwater pollution-related problems in water-sensitive regions

Environ Monit Assess. 2022 Oct 19;194(12):928. doi: 10.1007/s10661-022-10593-9.

ABSTRACT

The desert environment is a clean, dynamic system due to its remoteness from human interventions. Yet, sometimes it is approached by anthropogenic activities that change its balanced ecosystem. The present study states that the non-planned construction of wastewater plants has affected the environment and led to water resource deterioration. The presented approach is based on the integration of hydrogeologic data together with remote sensing and GIS applications as well as statistical, chemical, biochemical, and bacteriological analyses of water samples. The groundwater showed high salinity values (up to 13,236 mg/l) where it is extracted from two coastal aquifers; the Middle Miocene aquifer represents the main one, while the Pleistocene aquifer is of limited use. The obtained results reveal the existence of pollution indicators in both stored rainwater and groundwater where the colony bacteria, NO3, chemical and biological oxygen demands, and total organic carbon exceed the permissible limits. The satellite images acquired between 2003 and 2021 demonstrated a land use change through the construction of a wastewater plant with two forests that led to the spreading of the partially treated water over the Marmarica Plateau. The photogeological lineaments are extracted where the plateau is affected by many faults (NE-SW, NW-SE, and E-W) that facilitate surface-groundwater interaction. The results indicate that the studied groundwater becomes vulnerable to the existing pollution sources, with the possibility of being affected by climate change and saltwater intrusion. Therefore, this integrated approach is presented to assess the current environmental problems and suggests a strategy to mitigate the pollution hazards.

PMID:36261750 | DOI:10.1007/s10661-022-10593-9

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Nevin Manimala Statistics

Effectiveness of periodontal treatment to improve glycemic control: an umbrella review

Acta Diabetol. 2022 Oct 19. doi: 10.1007/s00592-022-01991-z. Online ahead of print.

ABSTRACT

AIM: The aim of the present umbrella review was to systematically assess existing evidence on the effect of non-surgical periodontal therapy, both per se’ and with adjuvants, on glycemic control in patients with type 2 diabetes and periodontitis and to combine quantitative data with a meta-analysis.

MATERIALS AND METHODS: A detailed study protocol was registered on PROSPERO (CRD42021222279). Four electronic databases (Medline via Pubmed, EMBASE, Cochrane Database of Systematic Reviews and Scielo) were searched independently and in duplicate to identify potentially eligible systematic reviews up to March 2022. Two pre-calibrated independent reviewers performed study selection, data extraction and quality assessment with two checklists (AMSTAR 2 and PRISMA). Moreover, general characteristics of primary studies included in each systematic review were abstracted, and JADAD scale was used to assess the risk of bias for included randomized controlled trials. Data from the individual studies included in each meta-analysis were analyzed, using both fixed and random effect model. The statistical heterogeneity was calculated using the Q test and the I2 index. The publication bias was evaluated using a funnel plot and Egger’s linear regression method.

RESULTS: Sixteen systematic reviews, published between 2010 and 2021, were included for qualitative synthesis. From these systematic reviews, a total of 27 studies were included in the meta-analysis: all of them were randomized clinical trials, except 1 controlled clinical study. A statistically significant mean difference of – 0.49% and of – 0.38% HbA1c reductions was seen respectively at 3- and 6-month post-treatment, favoring the treatment group (non-surgical periodontal therapy alone) compared to the control group (no treatment). The effect of periodontal treatment with the adjunctive use of antibiotics or laser on the glycemic control was not statistically significant compared to non-surgical periodontal therapy alone.

CONCLUSIONS: The findings of the present study, within its limitations, indicated that non-surgical treatment of periodontitis is an efficacious therapy for improving the glycemic control in type 2 diabetes mellitus patients, both at 3- and 6-month follow-up.

PMID:36261746 | DOI:10.1007/s00592-022-01991-z