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Nevin Manimala Statistics

Understanding how alcohol environment influences youth drinking: A concept mapping study among university students

Adicciones. 2022 Sep 30;0(0):1705. doi: 10.20882/adicciones.1705. Online ahead of print.

ABSTRACT

The aim of the study was to identify the environmental factors that influence alcohol consumption, according to university students, and assess the relative importance and the frequency attributed to each factor. A study using Concept Mapping methodology was performed with a sample of nursing students, who participated in two face-to-face data collection sessions. In session 1, a consensus about the environmental aspects that influence their alcohol consumption was obtained. In session 2, the statements obtained were rated according to their relative importance and frequency in alcohol use (1 = minimum; 5 = maximum). Subsequently, all data were analyzed with the RCMAP of the statistical package R 3.6.1.Approximately 60 students participated in each session. Most were women aged 20 to 24. In session 1, a total of 55 statements were obtained and classified into 7 different clusters: Advertising (9 statements); Family environment (4 statements); Social pressure (12 statements); Responsibilities/norms (4 statements); Holidays and leisure time (7 statements); Emotional situations (8 statements); Accessibility (11 statements). Factors related to social pressure, holidays and leisure time, and alcohol accessibility were considered the most important and frequent in alcohol consumption. In contrast, alcohol advertising was considered the least important (mean 2.6 out of 5) and frequent (mean 2.1 out 5) factor. In conclusion, the factors considered most relevant among nursing students match those having more resources allocated for prevention and health promotion, except for alcohol advertising, which was perceived as less important and frequent compared with the other factors.

PMID:36200225 | DOI:10.20882/adicciones.1705

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Assessment of CBCT-based synthetic CT generation accuracy for adaptive radiotherapy planning

J Appl Clin Med Phys. 2022 Oct 5:e13737. doi: 10.1002/acm2.13737. Online ahead of print.

ABSTRACT

PURPOSE: Cone-beam CT (CBCT)-based synthetic CT (sCT) dose calculation has the potential to make the adaptive radiotherapy (ART) pathway more efficient while removing subjectivity. This study assessed four sCT generation methods using 15 head-and-neck rescanned ART patients. Each patient’s planning CT (pCT), rescan CT (rCT), and CBCT post-rCT was acquired with the CBCT deformably registered to the rCT (dCBCT).

METHODS: The four methods investigated were as follows: method 1-deformably registering the pCT to the dCBCT. Method 2-assigning six mass density values to the dCBCT. Method 3-iteratively removing artifacts and correcting the dCBCT Hounsfield units (HU). Method 4-using a cycle general adversarial network machine learning model (trained with 45 paired pCT and CBCT). Treatment plans were created on the rCT and recalculated on each sCT. Planning target volume (PTV) and organ-at-risk (OAR) structures were contoured by clinicians on the rCT (high-dose PTV, low-dose PTV, spinal canal, larynx, brainstem, and parotids) to allow the assessment of dose-volume histogram statistics at clinically relevant points.

RESULTS: The HU mean absolute error (MAE) and minimum dose gamma index pass rate (2%/2 mm) were calculated, and the generation time was measured for 15 patients using the rCT as the comparator. For methods 1-4 the MAE, gamma index analysis, and generation time were as follows: 59.7 HU, 100.0%, and 143 s; 164.2 HU, 95.2%, and 232 s; 75.7 HU, 99.9%, and 153 s; and 79.4 HU, 99.8%, and 112 s, respectively. Dose differences for PTVs and OARs were all <0.3 Gy except for method 2 (<0.5 Gy).

CONCLUSION: All methods were considered clinically viable. The machine learning method was found to be most suitable for clinical implementation due to its high dosimetric accuracy and short generation time. Further investigation is required for larger anatomical changes between the CBCT and pCT and for other anatomical sites.

PMID:36200179 | DOI:10.1002/acm2.13737

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Distinct MicroRNAs identified in rabbit blood arising from, induced diabetes and a surgically simulated diabetic ischemia complication

Microrna. 2022 Oct 5. doi: 10.2174/2211536611666221005091351. Online ahead of print.

ABSTRACT

BACKGROUND: Diabetic complications have been studied extensively in recent years. There are very few biomarkers in body fluids that can pinpoint a distinct diabetic complication due to insufficient known specific biomarkers for ischemia.

OBJECTIVE: Identifying Micro RNA in animal models for each complication could enable early diagnosis of a given complication if verified in humans. Micro RNA (miRNA) profiling has been done in rodent models for number of diabetic complications like diabetic glomerular injury, atherosclerosis, cognitive impairment, diabetic wound healing, angiopathy and other complications. Due to multiple differences between rodents and humans, the changes in rabbit skin considered closer to humans than even pigs, may better simulate human diabetic complication of ischemia.

METHODS: To study the miRNA profile of rabbits in which diabetes was induced or ischemia was surgically generated, we studied whether diabetes or ischemia induced specific miRNA could be detected. Micro RNA from blood of diabetic rabbits and rabbits with local ischemia was collected in PAXgene Blood RNA tubes specifically designed for miRNA isolation and extracted using the PAX gene miRNA extraction Kit. The isolated RNA was quality controlled using RNA analyzer and further using RNA seq technology was analyzed for distinct miRNAs that were detected in diabetic and non-diabetic rabbits induced with ischemia.

RESULTS: A miRNA found to be expressed in diabetic rabbits and ischemic rabbits but not expressed in untreated rabbits is miRNA-183. Several miRNAs were differentially expressed across comparison groups, and several upregulated miRNAs were identified that are unique to each comparison. In rabbits with a potential diabetic complication of a long-term ischemic model there was one distinct microRNA which was highly significantly upregulated in ischemia rabbit (miRNA-133-3p). One miRNA that was highly significantly upregulated in diabetic rabbit but not in ischemic rabbits was miRNA-3074-5p. Only statistically significant results are considered and analyzed.

CONCLUSION: These findings could lead to a precise and timely diagnosis of a potential single diabetic complication without invasive tissue biopsies and could be a novel tool in the management of diabetic patients developing complications due to progression of diabetes.

PMID:36200149 | DOI:10.2174/2211536611666221005091351

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Adjusting for misclassification of an exposure in an individual participant data meta-analysis

Res Synth Methods. 2022 Oct 5. doi: 10.1002/jrsm.1606. Online ahead of print.

ABSTRACT

A common problem in the analysis of multiple data sources, including individual participant data meta-analysis (IPD-MA), is the misclassification of binary variables. Misclassification may lead to biased estimators of model parameters, even when the misclassification is entirely random. We aimed to develop statistical methods that facilitate unbiased estimation of adjusted and unadjusted exposure-outcome associations and between-study heterogeneity in IPD-MA, where the extent and nature of exposure misclassification may vary across studies. We present Bayesian methods that allow misclassification of binary exposure variables to depend on study- and participant-level characteristics. In an example of the differential diagnosis of dengue using two variables, where the gold standard measurement for the exposure variable was unavailable for some studies which only measured a surrogate prone to misclassification, our methods yielded more accurate estimates than analyses naive with regard to misclassification or based on gold standard measurements alone. In a simulation study, the evaluated misclassification model yielded valid estimates of the exposure-outcome association, and was more accurate than analyses restricted to gold standard measurements. Our proposed framework can appropriately account for the presence of binary exposure misclassification in IPD-MA. It requires that some studies supply IPD for the surrogate and gold standard exposure, and allows misclassification to follow a random effects distribution across studies conditional on observed covariates (and outcome). The proposed methods are most beneficial when few large studies that measured the gold standard are available, and when misclassification is frequent. This article is protected by copyright. All rights reserved.

PMID:36200133 | DOI:10.1002/jrsm.1606

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Neural-hematopoietic-inflammatory axis in nonsmokers, electronic cigarette users, and tobacco smokers

Physiol Rep. 2022 Oct;10(19):e15412. doi: 10.14814/phy2.15412.

ABSTRACT

Amygdala activity in context of the splenocardiac model has not been investigated in healthy, young adults and has not been compared between nonsmokers, electronic cigarette users, and smokers. The purpose of the current study was to determine whether fluorodeoxyglucose positron emission tomography/computer tomography (FDG PET/CT) scans would demonstrate positively correlated metabolic activity in the amygdala, bone marrow, spleen, and aorta, elucidating activation of the splenocardiac axis in otherwise healthy young people who use tobacco products compared to nonusers. Moreover, the study was conducted to evaluate whether electronic cigarette users and tobacco smokers have similar levels of inflammation compared to nonusers. In 45 healthy adults (mean age = 25 years), including nonsmoker (n = 15), electronic cigarette user (n = 16), and smoker (n = 14) groups, metabolic activity in the amygdala, spleen, aorta, bone marrow of thoracic vertebrae, and adjacent erector spinae skeletal muscle was quantified through visualization of radioactive glucose (18 FDG) uptake by FDG-PET/CT. The maximum standardized uptake value for each region was calculated for correlation analyses and comparisons between groups. In correlation analyses, metabolic activity of the amygdala correlated with metabolic activity in the aorta (r = 0.757), bone marrow (r = 0.750), and spleen (r = 0.665), respectively. Metabolic activity in the aorta correlated with 18 FDG uptake in the thoracic vertebrae (r = 0.703) and spleen (r = 0.594), respectively. Metabolic activity in the spleen also correlated with 18 FDG uptake in the bone marrow (r = 0.620). Metabolic activity in the adjacent erector spinae skeletal muscle (our control tissue) was not positively correlated with any other region of interest. Finally, there were no statistically significant mean differences in metabolic activity between the three groups: nonsmokers, electronic cigarette users, and smokers in any target tissue. Amygdala metabolic activity, as measured by 18 FDG uptake in FDG-PET/CT scans, positively correlated with inflammation in the splenocardiac tissues, including: the aorta, bone marrow, and spleen, underscoring the existence of a neural-hematopoietic-inflammatory axis in healthy, young adults.

PMID:36200129 | DOI:10.14814/phy2.15412

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Knowledge of Diabetic Foot Among Nurses at a Tertiary Hospital in Saudi Arabia

Med Arch. 2022 Jun;76(3):190-197. doi: 10.5455/medarh.2022.76.190-197.

ABSTRACT

BACKGROUND: Diabetic foot is the leading cause of hospitalization among patients with diabetes mellitus (DM). Nurses have a significant role in helping diabetic foot patients by educating them about their condition. Therefore, assessing the knowledge of diabetic foot among nurses will help provide better healthcare services to these patients.

OBJECTIVE: This study aimed to assess the knowledge of diabetic foot care among the nursing staff at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia.

METHODS: This cross-sectional study was conducted at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia, from March to May 2020. A total of 172 nurses from different departments of the hospital were randomly selected. A validated questionnaire including 68 yes-or-no questions about diabetic foot management was used for the assessment.

RESULTS: The average total score of the entire questionnaire was 59 (standard deviation, ±7). During our study, the nursing school curriculum was found to be the major source of knowledge for nurses. Statistical significance (p=0.031) was found for the association between educational background and answers to the risk factor questions. According to our results, most nurses indicated that they believed that reporting any changes to the feet and toes and signs of infection to the physician was the best way to prevent the development of DM foot.

CONCLUSION: Specialized training programs beyond basic nursing education will reinforce knowledge and skills, resulting in an expected lower risk of amputation for DM patients.

PMID:36200121 | PMC:PMC9478813 | DOI:10.5455/medarh.2022.76.190-197

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An in Depth Look Into Intracranial Abscesses and Empyemas: a Ten-year Experience in a Single Institute

Med Arch. 2022 Jun;76(3):183-189. doi: 10.5455/medarh.2022.76.183-189.

ABSTRACT

BACKGROUND: As the incidence of intracranial infections increase due to diagnostic procedures improvement, more real-life data is needed to reach a more solid informed management approach.

OBJECTIVE: This study aims to describe and analyse clinical features of intracranial abscesses patients treated at a tertiary hospital in North Jordan during a 10-year period.

METHODS: We retrospectively identified 37 patients treated at King Abdullah University Hospital (KAUH) from 2011 to 2020 in Irbid, North Jordan. Treatment consisted of either aspiration, open craniotomy excision (OCE) or conservative therapy. Extracted variables included demographic data such (age, gender), clinical presentation, lab findings, radiological findings as well as management plan. Retrieved data was compared between the patients who underwent a single operation and those who underwent reoperation after the initial procedure.

RESULTS: Thirty-seven patients with 55 intracerebral abscesses were identified, 29 of whom had intraparenchymal brain abscesses, 4 patients had epidural empyema, and 4 had subdural empyema. The mean age was 28.8 (± 20.7) years, with a male predominance (78.4%). Sixteen patients underwent open craniotomy excision (OCE), 14 patients were treated by aspiration and 7 patients were treated conservatively. When comparing the single operation and the reoperation groups, there was no statistically significant difference across variables.

CONCLUSION: Our study presents valuable insight from a tertiary hospital in north Jordan on intracranial abscesses and empyemas. Our findings confirm that good recovery can be established after aspiration or OCE in the majority of patients. Similar results were obtained when comparing the SOP and the ROP groups.

PMID:36200111 | PMC:PMC9478810 | DOI:10.5455/medarh.2022.76.183-189

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Mapping of space-time patterns of infectious disease using spatial statistical models: a case study of COVID-19 in India

Infect Dis (Lond). 2022 Oct 5:1-17. doi: 10.1080/23744235.2022.2129778. Online ahead of print.

ABSTRACT

INTRODUCTION: Mapping of infectious diseases like COVID-19 is the foremost importance for diseases control and prevention. This study attempts to identify the spatio-temporal pattern and evolution trend of COVID-19 at the district level in India using spatial statistical models.

MATERIALS AND METHODS: Active cases of eleven time-stamps (30 March-2 December, 2020) with an approximately 20-day interval are considered. The study reveals applications of spatial statistical tools, i.e. optimised hotspot and outlier analysis (which follow Gi* and Moran I statistics) and emerging hotspot with the base of space time cube, are effective for the spatio-temporal evolution of disease clusters.

RESULTS: The result shows the overall increasing trend of COVID-19 infection with a Mann-Kendall trend score of 2.95 (p = 0.0031). The spatial clusters of high infection (hotspots) and low infection (coldspots) change their location over time but are limited to the districts of the south-western states (Kerala, Karnataka, Andhra Pradesh, Maharashtra, Gujarat) and the north-eastern states (West Bengal, Jharkhand, Assam, Tripura, Manipur, etc.) respectively.

CONCLUSIONS: A total of eight types of patterns are identified, but the most concerning types are consecutive (7.24% of districts), intensifying (15.13% districts) and persistent (24.34% of districts) which will help health policy makers and the government to prioritize-based resource allocation and control measures.

PMID:36199164 | DOI:10.1080/23744235.2022.2129778

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Use of antimicrobials licensed for systemic administration in UK equine practice

Equine Vet J. 2022 Oct 5. doi: 10.1111/evj.13878. Online ahead of print.

ABSTRACT

BACKGROUND: Judicious antimicrobial use (AMU) is important for preserving therapeutic effectiveness. Large-scale studies of antimicrobial prescribing can provide clinical benchmarks and help identify opportunities for improved stewardship.

OBJECTIVES: To describe systemic AMU in UK equine practice and identify factors associated with systemic and Category B (third and fourth generation cephalosporins, quinolones and polymixins) AMU.

STUDY DESIGN: Retrospective cohort.

METHODS: Anonymised electronic patient records (EPRs) for all equids attended by 39 UK veterinary practices between 1 January and 31 December 2018 were collected via the VetCompass™ programme. Systemic antimicrobial prescriptions were identified using electronic keyword searches. Indications for AMU were determined through manual review of a randomly selected subset of EPRs. The types and frequency of systemic antimicrobials prescribed and indications were summarised using descriptive statistics. Mixed-effects logistic regression was used to evaluate practice- and horse-related risk factors.

RESULTS: Systemic antimicrobials were prescribed to 12,538 (19.5%, 95% CI 19.2-19.8%) of 64,322 equids attended in 2018. Category B antimicrobials were prescribed to 1.9% (95% CI 1.8-2.0%) of attended equids and in 8.9% (95% CI 8.5-9.4%) of antimicrobial courses. Bacteriological culture was performed in 19.1% (95% CI 17.1-21.3%) of Category B antimicrobial courses. The most commonly prescribed antimicrobial classes were potentiated sulphonamides (50.2% of equids receiving antimicrobials) and tetracyclines (33.5% of equids receiving antimicrobials). Integumentary disorders were the most common reason for systemic AMU (40.5% of courses). Urogenital disorders were the most common reason for Category B AMU (31.1% of courses). Increased odds of systemic and Category B AMU were observed in equids <1 year compared to those aged 5-14 years. Breed was associated with AMU, with odds of systemic and Category B AMU highest in Thoroughbreds and Thoroughbred crosses.

MAIN LIMITATIONS: Convenience sample of practices may limit generalisability.

CONCLUSIONS: Empirical use of Category B antimicrobials remains commonplace.

PMID:36199158 | DOI:10.1111/evj.13878

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Genetic association of ANGPT2 with primary open-angle glaucoma

Eye Vis (Lond). 2022 Oct 6;9(1):37. doi: 10.1186/s40662-022-00309-y.

ABSTRACT

BACKGROUND: To determine the association of the ANGPT2 gene with primary open-angle glaucoma (POAG) in Chinese.

METHODS: Six single-nucleotide polymorphisms (SNPs) in ANGPT2 (rs2515487, rs2922869, rs13255574, rs4455855, rs13269021, and rs11775442) were genotyped in a total of 2601 study subjects from two cohorts. One is a Hong Kong Chinese cohort of 484 high tension glaucoma (HTG) and 537 normal tension glaucoma (NTG) patients, and 496 non-glaucoma control subjects. Another cohort is a Shantou Chinese cohort of 403 HTG and 135 NTG patients, and 543 non-glaucoma control subjects. Subgroup analysis by sex was conducted. Outcomes from different cohorts were combined for meta-analysis.

RESULTS: The association of SNP rs11775442 with NTG in the Hong Kong cohort [P = 0.0498, OR = 1.24, 95% confidence interval (CI) 1.00-1.55] after adjusting for age and sex did not reach statistical significance after Bonferroni correction. Other SNPs were not significantly associated with NTG, HTG and POAG in individual cohort or in the combined analyses (P > 0.05). In the subgroup analysis by sex, SNP rs13269021 in the Shantou cohort, but not in the Hong Kong cohort, was significantly associated with NTG in males (P = 0.0081, OR = 1.67, 95% CI: 1.14-2.43) but not in females (P = 0.874). In the combined analyses by sex, no SNPs were significantly associated with NTG, HTG and POAG.

CONCLUSIONS: In the subgroup analysis by sex, a significant association was shown in SNP rs13269021 with NTG in Shantou males, but not in Hong Kong males. Further studies are needed to verify the association between ANGPT2 locus (rs13269021) and NTG in Chinese males.

PMID:36199153 | DOI:10.1186/s40662-022-00309-y