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Nevin Manimala Statistics

Psychological well-being of midlife women: a structural equation modeling approach

Menopause. 2022 Feb 28. doi: 10.1097/GME.0000000000001933. Online ahead of print.

ABSTRACT

OBJECTIVE: Women experience menopause at approximately 50 to 52 years of age, when reproductive aging causes various somatic, psychological, and urogenital symptoms. Women’s changing lifestyles and increasing lifespan make it difficult to pinpoint the factors affecting their well-being during menopause, warranting continuous research in this field. Therefore, this study developed a structural equation model, based on the transactional model of stress and coping, to test the significance of positive and negative factors associated with psychological health during menopause.

METHODS: This study validated a structural equation model based on the empirical data collected using a cross-sectional study. We analyzed 300 questionnaire responses completed between May 15 and July 10, 2020, by South Korean middle-aged women (aged 45-60 y) who agreed to participate. The study’s structural equation model used self-efficacy as an exogenous variable and perceived stress, menopausal management, self-compassion, menopausal symptoms, and psychological well-being as endogenous variables. Educational and economic levels were set as control variables.

RESULTS: We observed statistical support for 9 out of 10 hypotheses; the predictor variables had an explanatory power of 79.5% for psychological well-being. Self-efficacy was positively associated with the psychological well-being of middle-aged menopausal women and appeared to be mediated by perceived stress, menopausal management, menopausal symptoms, and self-compassion.

CONCLUSIONS: To improve the psychological well-being of middle-aged women, it is important to increase their self-efficacy and minimize stress. Moreover, managing menopausal symptoms and increasing self-compassion through effective coping may maximize psychological well-being.

Video Summary:http://links.lww.com/MENO/A933.

PMID:35231003 | DOI:10.1097/GME.0000000000001933

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Nevin Manimala Statistics

Localized prostate cancer: An analysis of the CDC Breast and Prostate Cancer Data Quality and Patterns of Care study (CDC PoC-BP)

Can Urol Assoc J. 2022 Feb 28. doi: 10.5489/cuaj.7580. Online ahead of print.

ABSTRACT

INTRODUCTION: Limited evidence exists on the comparative effectiveness of local treatments for prostate cancer (PCa) due to the lack of generalizability. Using granular national data, we sought to examine the association between radical prostatectomy (RP) and intensity-modulated radiation therapy (IMRT) treatment and survival.

METHODS: Records were abstracted for localized PCa cases diagnosed in 2004 across seven state registries to identify patients undergoing RP (n=3019) or IMRT (n=667). Comorbidity was assessed by the Adult Comorbidity Evaluation-27 (ACE-27). Propensity score matching (PSM) was used to balance covariates between treatment groups. All-cause and PCa-specific mortality were primary endpoints. A subgroup analysis of patients with high-risk PCa (RP, n=89; IMRT, n=95) was conducted.

RESULTS: Following PSM, matched patients (n=502 pairs) treated with either RP or IMRT were well-balanced with respect to covariates. With a median followup of 10.5 years (interquartile range [IQR] 9.9-11.0), the 11-year overall survival (OS) was 71.2% (95% confidence interval [CI] 66.9-75.8) for RP and 62.3% (95% CI 57.4-67.6) for IMRT. IMRT was associated with a 41% increased risk of all-cause mortality (hazard ratio [HR] 1.41, 95% CI 1.13-1.76) but not PCa-specific mortality (HR 1.75, 95% CI 0.84-3.64), as compared to RP. In patients with high-risk PCa, IMRT, as compared to RP, was not associated with statistically significant difference in all-cause (HR 1.53, 95% CI 0.97-2.42) or PCa-specific mortality (HR 1.92, 95% CI 0.69-5.36).

CONCLUSIONS: Despite a low mortality rate at 10 years and possible residual confounding, we found a significantly increased risk of all-cause mortality, but no PCa-specific mortality associated with IMRT as compared to RP in this population-based study.

PMID:35230935 | DOI:10.5489/cuaj.7580

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Predicting Drug-target Interaction Via Self-supervised Learning

IEEE/ACM Trans Comput Biol Bioinform. 2022 Mar 1;PP. doi: 10.1109/TCBB.2022.3153963. Online ahead of print.

ABSTRACT

Recent advances in graph representation learning provide new opportunities for computational drug-target interaction (DTI) prediction. However, it still suffers from deficiencies of dependence on manual labels and vulnerability to attacks. Inspired by the success of self-supervised learning (SSL) algorithms, which can leverage input data itself as supervision, we propose SupDTI, a SSL-enhanced drug-target interaction prediction framework based on a heterogeneous network (i.e., drug-protein, drug-drug, and protein-protein interaction network; drug-disease, drug-side-effect, and protein-disease association network; drug-structure and protein-sequence similarity network). Specifically, SupDTI is an end-to-end learning framework consisting of five components. First, localized and globalized graph convolutions are designed to capture the nodes’ information from both local and global perspectives, respectively. Then, we develop a variational autoencoder to constrain the nodes’ representation to have desired statistical characteristics. Finally, a unified self-supervised learning strategy is leveraged to enhance the nodes’ representation, namely, a contrastive learning module is employed to enable the nodes’ representation to fit the graph-level representation, followed by a generative learning module which further maximizes the node-level agreement across the global and local views by learning the probabilistic connectivity distribution of the original heterogeneous network. Experimental results show that our model can achieve better prediction performance than state-of-the-art methods.

PMID:35230952 | DOI:10.1109/TCBB.2022.3153963

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Nevin Manimala Statistics

Serial prostate magnetic resonance imaging fails to predict pathological progression in patients on active surveillance

Can Urol Assoc J. 2022 Feb 28. doi: 10.5489/cuaj.7541. Online ahead of print.

ABSTRACT

INTRODUCTION: Limited data guide urological practice when employing prostate magnetic resonance imaging (MRI) in active surveillance protocols. To determine the ability of prostate MRI to predict pathological progression in active surveillance patients, we correlated findings of serial MRI with results of surveillance biopsies.

METHODS: Patients on active surveillance with ≥2 prostate MRI and ≥2 prostate biopsies were included. Prostate Imaging-Reporting and Data System (PI-RADS) score upgrade, as assigned by experienced radiologists, was used to assess the ability of imaging to predict pathological biopsy progression. Imaging test statistics and the odds ratio of pathological progression according to MRI upgrade were calculated.

RESULTS: Of 121 patients meeting criteria, 36 (30%) demonstrated MRI upgrade. Biopsy progression was noted in 55 patients (46%). Of these, 20 patients (37%) had biopsy progression predicted by MRI upgrade, while the remaining (n=35) had no lesion upgrade on prostate MRI. Conversely, among those with no biopsy progression (n=66), 16 patients (24%) had a false-positive upgrade on serial MRI. We report a sensitivity and specificity of MRI change for pathological progression of 36% and 76%, respectively. Although MRI change was associated with a positive predictive value of 56% for pathological progression, patients with a high-suspicion lesion (PI-RADS >3) at any time were more likely to experience disease progression, (odds ratio 3.3, 95% confidence interval 1.6-8.0, p<0.01).

CONCLUSIONS: Given its modest sensitivity/specificity, serial prostate MRI should be used judiciously as a surveillance tool. However, when prostate MRI demonstrates a PI-RADS >3 lesion, a high index of suspicion should be maintained, as these patients are more likely to progress on active surveillance.

PMID:35230933 | DOI:10.5489/cuaj.7541

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MiR-501-5p alleviates cardiac dysfunction in septic patients through targeting NR4A3 to prevent its binding with Bcl-2

Cell Cycle. 2022 Mar 1:1-11. doi: 10.1080/15384101.2022.2035618. Online ahead of print.

ABSTRACT

Sepsis-induced myocardial dysfunction is a common complication in septic patients. To date, a limited number of biomarkers that could predict cardiomyocyte apoptosis have been explored. In this study, we successfully established a cecal ligation and puncture (CLP)-induced septic model, and it was found that miR-501-5p expression was down-regulated in peripheral blood samples of septic patients with cardiac dysfunction, lipopolysaccharide (LPS)-induced cardiomyocytes, and the myocardium and peripheral blood in the septic model. Moreover, it was revealed that miR-501-5p overexpression could increase left ventricular diastolic pressure (LVDP), fractional shortening (FS), ejection fraction (EF), and maximum rate of the rise of left ventricular pressure (+dp/dt) in vivo, while it decreased the levels of myocardial injury-related indicators. In addition, LPS induction accelerated apoptosis and elevated the inflammation in HL-1 and HCM cells, which could be reversed by miR-501-5p overexpression. Mechanistically, we considered nuclear receptor subfamily 4 group A member 3 (NR4A3) as the target of miR-501-5p, and it was found that miR-501-5p prevented the binding between NR4A3 and Bcl-2. It was found that miR-501-5p exerted an inhibitory effect on cardiomyocyte apoptosis and inflammation in a NR4A3-dependent manner. Overall, our results may provide evidence for consideration of miR-501-5p in the therapy of sepsis.

PMID:35230891 | DOI:10.1080/15384101.2022.2035618

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A Prospective Analysis of Systemic and Local Aeroallergen Sensitivity in Central Compartment Atopic Disease

Otolaryngol Head Neck Surg. 2022 Mar 1:1945998221082554. doi: 10.1177/01945998221082554. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare systemic allergen sensitivity and local allergen sensitivity in the sinonasal tissue of patients with a recently identified subtype of chronic rhinosinusitis strongly associated with allergy: central compartment atopic disease (CCAD).

STUDY DESIGN: Prospective cohort study.

SETTING: Academic tertiary care rhinology clinic.

METHODS: Fifteen participants with endoscopic and radiographic evidence of CCAD underwent systemic allergy testing with skin testing and measurement of serum specific immunoglobulin E (sIgE) to 15 regionally common aeroallergens. Local allergen sensitivity was determined by measuring sIgE to these same 15 allergens in their sinonasal tissue. sIgE testing was performed by ImmunoCAP assay.

RESULTS: Of the 15 participants, 14 were sensitive to at least 1 allergen locally in the central compartment and systemically on skin or serum testing. Among all participants, 4 were sensitive to allergens on central compartment sIgE testing that they were not sensitive to on skin and serum sIgE testing (range, 1-8 discordant allergens). Comparisons between local and systemic aeroallergen sensitivity results showed statistically significant correlations (P < .05) ranging from weak to strong.

CONCLUSION: Systemic allergy testing is recommended in the initial workup for CCAD. Local allergen sensitivities may be present in a subset of patients with CCAD. Further study of the clinical significance of these sensitivities should be undertaken in CCAD, with evaluation of the role of medical therapies and allergen immunotherapy in the treatment of CCAD.

PMID:35230893 | DOI:10.1177/01945998221082554

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Reviewing the Consequences of Electronic Gaming Machine Misuse in Australian Older Adults: Implications for Addiction Nurses

J Addict Nurs. 2022 Jan-Apr 01;33(1):13-19. doi: 10.1097/JAN.0000000000000445.

ABSTRACT

This review explores contemporary literature exploring electronic gaming machine (EGM) use in the Australian context. EGMs, colloquially known in Australia as pokies (poker machines), lead statistics on gambling losses in Australia and are a substantially different form of gambling when compared with other means, such as sports or casino wagering. This article focuses on Australian literature on EGMs, with comparisons made with international trends. Searches of the Scopus, CINAHL, and Medline electronic journal databases were performed to find literature examining problem gambling through EGM use in older adults. The results of the search found that little literature exists regarding problematic EGM use in older adults; however of the studies that do exist, problem EGM use in the older adult cohort is frequently related to mental ill health as well as alcohol, tobacco, and other substance use. Addiction nurses are in a unique position to assess and detect problematic EGM gambling in older adults; however, few screening tools are used in clinical practice. Given the ease of access and increasing sophistication of EGMs, it is foreseeable that problematic EGM use will be an issue addiction nurses encounter in their future practice and one they should be aware of.

PMID:35230056 | DOI:10.1097/JAN.0000000000000445

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Nevin Manimala Statistics

Young adults after arterial switch operation for transposition of the great arteries in Switzerland: a growing population

Swiss Med Wkly. 2022 Feb 23;152:w30114. doi: 10.4414/smw.2022.w30114. eCollection 2022 Feb 14.

ABSTRACT

BACKGROUND: Adults with transposition of the great arteries (d-TGA) after the arterial switch operation (ASO) are an evolving cohort in adult cardiology. We aimed to analyze cardiac function and cardiac events after transition to the adult clinic in Switzerland.

MATERIALS AND METHODS: Adults with prior ASO enrolled in the Swiss Adult Congenital HEart disease Registry (SACHER) were included. We analyzed initial cardiac anatomy, surgical history, residual lesions and cardiac function at the time of inclusion, as well as cardiac events during follow-up. Patients were classified as complex (with ventricular septal defect) or simple (with intact interventricular septum) d-TGA.

RESULTS: The cohort included 149 patients (99 simple d-TGA, 50 complex d-TGA; age 21±3 years; 71% male, follow-up 27 [15-46] months). Prior to inclusion, patients with complex d-TGA had undergone more interventions related to the left ventricular outflow tract (16% vs. 3%, p = 0.01). Functional and cardiovascular status were similar between the groups. Eleven patients (7%) had a total of 19 cardiac events (5 complications and 14 re-interventions) during follow-up. Patients with complex d-TGA had more cardiac-related complications compared to those with simple d-TGA (8% vs. 1%, p = 0.03). The frequency of re-interventions was not statistically different between the two groups (12% vs. 4%, p = 0.07). During follow-up, an increase in QRS duration was observed. Other parameters of cardiac function remained unchanged.

CONCLUSION: The majority of adult ASO patients have normal functional class and cardiac function. Complex anatomy and residual lesions play a key role when regarding the occurrence of cardiac-related complications during follow-up. The role of QRS prolongation over time needs to be investigated further.

PMID:35230031 | DOI:10.4414/smw.2022.w30114

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Lichen sclerosus in pediatric age: A new disease or unknown pathology? Experience of single centre and state of art in literature

Pediatr Med Chir. 2022 Mar 1;44(1). doi: 10.4081/pmc.2022.275.

ABSTRACT

Lichen Sclerosus (LS) is a chronic inflammatory skin disease with unknown etiology. In pediatric age the main disease “lichenlinked” is the phimosis in male. This is a retrospective study that reports the experience of our clinic and review of the literature. We included all patients affected by pathological phimosis, treated by circumcision between January 2015 and May 2020, older than 6 years old and with an histopathological diagnosis of lichen sclerosus. The aim was to identify prognostic factors based on histological report to plan the clinical management of patients. Statistical analysis was done. We included 207 patients. The mean age of children was 9,78 years (5-18 years, DS±3.29). Based on the histological features we divided patients in 2 groups: early lesions (70/207, 34%) and advanced (137/207, 66%). In term of complications lichen linked we considered meatal stenosis that needed of urethral dilatations. We included 7 patients (7/207, 3,4%). We report P value Statistical Significance in many aspects. An early diagnosis of LS and surgical treatment of foreskin are essential to prevent early and late complications in children. The size of sample is a limit of the study but results encourage our management.

PMID:35230046 | DOI:10.4081/pmc.2022.275

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Cohort profile: the Swiss Cerebral Palsy Registry (Swiss-CP-Reg) cohort study

Swiss Med Wkly. 2022 Feb 21;152:w30139. doi: 10.4414/smw.2022.w30139. eCollection 2022 Feb 14.

ABSTRACT

BACKGROUND: Cerebral Palsy (CP) is a group of permanent disorders of movement and posture that follow injuries to the developing brain. It results in motor dysfunction and a wide variety of comorbidities like epilepsy; pain; speech, hearing and vision disorders; cognitive dysfunction; and eating and digestive difficulties. Central data collection is essential to the study of the epidemiology, clinical presentations, care, and quality of life of patients affected by CP. CP specialists founded the Swiss Cerebral Palsy Registry (Swiss-CP-Reg) in 2017. This paper describes the design, structure, aims and achievements of Swiss-CP-Reg and presents its first results.

METHODS: Swiss-CP-Reg records patients of any age diagnosed with CP who are born, are treated, or live in Switzerland. It collects data from medical records and reports, from questionnaires answered by patients and their families, and from data linkage with routine statistics and other registries. The registry contains information on diagnosis, clinical presentation, comorbidities, therapies, personal information, family history, and quality of life.

RESULTS: From August 2017 to August 2021, 546 participants (55% male, mean age at registration 8 years [interquartile range IQR: 5-12]), were enrolled in Swiss-CP-Reg. Most had been born at term (56%), were less than two years old at diagnosis (73%, median 18 months, IQR: 9-25), and were diagnosed with spastic CP (76%). Most (59%) live with a mild motor impairment (Gross Motor Function Classification System [GMFCS] level I or II), 12% with a moderate motor impairment (GMFCS level III), and 29% with a severe motor impairment (GMFCS level IV or V). In a subset of 170 participants, we measured intelligence quotient (IQ) and saw lower IQs with increasing GMFCS level. Swiss-CP-Reg has a strong interest in research, with four nested projects running currently, and many more planned.

CONCLUSIONS: Swiss-CP-Reg collects and exchanges national data on people living with CP to answer clinically relevant questions. Its structure enables retrospective and prospective data collection and knowledge exchange between experts to optimise and standardise treatment and to improve the health and quality of life of those diagnosed with CP in Switzerland.

PMID:35230014 | DOI:10.4414/smw.2022.w30139