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Nevin Manimala Statistics

Clopidogrel Monotherapy After 1-Month Dual Antiplatelet Therapy in Percutaneous Coronary Intervention: From the STOPDAPT-2 Total Cohort

Circ Cardiovasc Interv. 2022 Aug 1:CIRCINTERVENTIONS122012004. doi: 10.1161/CIRCINTERVENTIONS.122.012004. Online ahead of print.

ABSTRACT

BACKGROUND: The benefit of clopidogrel monotherapy after 1-month dual antiplatelet therapy (DAPT) compared with 12-month DAPT with aspirin and clopidogrel was demonstrated in the STOPDAPT-2 (Short and Optimal Duration of Dual Antiplatelet Therapy After Everolimus-Eluting Cobalt-Chromium Stent-2), but not in the STOPDAPT-2 acute coronary syndrome (ACS); however, both trials were underpowered based on the actual event rates.

METHODS: We obtained the prespecified pooled population of 5997 patients as the STOPDAPT-2 total cohort (STOPDAPT-2: N=3009/STOPDAPT-2 ACS: N=2988; ACS: N=4136/chronic coronary syndrome [CCS]: N=1861), comprising 2993 patients assigned to 1-month DAPT followed by clopidogrel monotherapy, and 3004 patients assigned to 12-month DAPT with aspirin and clopidogrel after percutaneous coronary intervention. The primary end point was the composite of cardiovascular (cardiovascular death, myocardial infarction, definite stent thrombosis, or any stroke) or bleeding (Thrombolysis in Myocardial Infarction major/minor) end points at 1 year.

RESULTS: One-month DAPT was noninferior to 12-month DAPT for the primary end point (2.84% versus 3.04%; hazard ratio [HR], 0.94 [95% CI, 0.70-1.27]; Pnoninferiority=0.001; Psuperiority=0.68). There was no significant risk-difference for the cardiovascular end point between the 1- and 12-month DAPT groups (2.40% versus 1.97%; HR, 1.24 [95% CI, 0.88-1.75]; Pnoninferiority=0.14; Psuperiority=0.23). There was a lower risk of the bleeding end point with 1-month DAPT relative to 12-month DAPT (0.50% versus 1.31%; HR, 0.38 [95% CI, 0.21-0.70]; Psuperiority=0.002). One-month DAPT relative to 12-month DAPT was associated with a lower risk for major bleeding regardless of ACS or CCS (ACS: HR, 0.46 [95% CI, 0.23-0.94]; P=0.03, and CCS: HR, 0.26 [95% CI, 0.09-0.79]; P=0.02; Pinteraction=0.40), while it was associated with a numerical increase in cardiovascular events in ACS patients, but not in CCS patients, although not statistically significant and without interaction (ACS: HR, 1.50 [95% CI, 0.99-2.27]; P=0.053, and CCS: HR, 0.74 [95% CI, 0.38-1.45]; P=0.39; Pinteraction=0.08).

CONCLUSIONS: Clopidogrel monotherapy after 1-month DAPT compared with 12-month DAPT with aspirin and clopidogrel had a benefit in reducing major bleeding events without being associated with increase in cardiovascular events.

REGISTRATION: URL: https://www.

CLINICALTRIALS: gov; Unique identifiers: NCT02619760, NCT03462498.

PMID:35912647 | DOI:10.1161/CIRCINTERVENTIONS.122.012004

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Nevin Manimala Statistics

The Role of Classifications and Measurements of Kyphotic Angle in the Treatment Methods of Upper and Middle Thoracic Vertebral Fractures after Trauma

Neurol Res. 2022 Jul 31:1-7. doi: 10.1080/01616412.2022.2104293. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: Thoracic fractures can lead to death and disability. This retrospective study aimed to evaluate cases of upper and middle thoracic vertebral fractures due to trauma that had been treated, to determine the fracture type and treatment method according to age, sex, cause of injury, neurological status, fracture level, kyphotic angles, and classification methods and to discuss the results regarding that reported in the literature.

PATIENTS AND METHODS: This study included 238 patients who were evaluated for post-traumatic upper and middle thoracic vertebral fractures between January 2012 and December 2020. We classified each patient according to the Dennis, TLICS, ATLICS, and ASIA classifications using neurological examination, radiography, computed tomography, and magnetic resonance imaging. We statistically evaluated the data obtained.

RESULTS: Fifty-five percent of total patients were male. The average age was 51.11. Traffic accidents were the most common causes of trauma, with 67.2%. T8 was most affected. The ASIA classification, the Dennis, TLICS, and ATLICS classifications showed a significant increase in the severity of neurological deficits as the fracture scores increased (p < 0.001). We observed that the increase in the preoperative kyphotic angle caused an increase in the number of deficits according to the classifications (p < 0.001).

CONCLUSION: The ATLICS classification yielded more accurate results than that of the other classifications. In addition, the kyphotic angle was evaluated for upper and middle thoracic fractures, and we concluded it is important in surgical decision making.

PMID:35912638 | DOI:10.1080/01616412.2022.2104293

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Nevin Manimala Statistics

Nanofluids modeling and energy transformation under the influence of mixed convection: Role of aluminum and γ-aluminum nanoparticles

J Appl Biomater Funct Mater. 2022 Jan-Dec;20:22808000221114715. doi: 10.1177/22808000221114715.

ABSTRACT

The analysis of nanofluids under various physical scenarios convinced the researchers and scientists because of their broad range of applications in potential area of the current time like chemical engineering, biomedical engineering and applied thermal engineering etc. To give the final shape of many industrial and engineering processes, enhanced heat transfer desired, therefore, the study of Al2O3-H2O, γAl2O3-H2O, Al2O3-C2H6O2, and γAl2O3– C2H6O2 nanofluids is reported. The model successfully achieved after mathematical operations and by appealing similarity transforms. To examine the behavior of heat transfer, numerical tools utilized and performed the results. It is observed that enhanced heat transfer in Al2O3-H2O, γAl2O3-H2O, Al2O3-C2H6O2, and γAl2O3-C2H6O2 could be attained by setting nanoparticles concentration up to 20%. For Al2O3-H2O, γAl2O3-H2O, optimum heat transfer trends noticed due to their prominent thermophysical values. Also, fewer effects of combined convection on θ(η) examined.

PMID:35912571 | DOI:10.1177/22808000221114715

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Nevin Manimala Statistics

Social Media May Cause Emergent SARMs Abuse by Athletes: A Content Quality Analysis of the Most Popular YouTube Videos

Phys Sportsmed. 2022 Jul 30. doi: 10.1080/00913847.2022.2108352. Online ahead of print.

ABSTRACT

OBJECTIVES: Selective Androgen Receptor Modulators (SARMs) social media interest is at an all-time high. The aim of this study is to analyze the: (1) quality; (2) educational content; and (3) reliability of the most relevant YouTube videos on SARMs to explain growing SARMs abuse by recreational and professional athletes.

METHODS: ‘SARMs’ was queried (November 28, 2021) through the YouTube video library. The top 100 videos filtered by relevance were categorized by source, type of content, educational quality by Global Quality Score (GQS), reliability by Journal of American Medicine Association (JAMA) criteria, YouTube tags, attitude towards SARMs use, and whether the video provided specific support on how to use SARMs. For all outcome variables, descriptive statistics and comparison among source types and category types were performed.

RESULTS: Mean JAMA score was 1.6 ± 0.7 out of 4. Mean GQS score was 2.5 ± 1.1 out of 5. Patient videos were of lower educational quality than athletic trainer videos (GQS: 2.11 ± 0.95 vs. 2.95 ± 1.00, p < 0.01), and videos categorized as user experience were of lower educational quality than videos categorized as general SARMs information (GQS: 1.92 ± 0.90 vs. 2.72 ± 1.07, p < 0.05). User experience and dosing recommendation videos were statistically significantly more positive in attitude than both general SARMs information and SARMS vs. other PEDs.

CONCLUSION: Quality, content, and reliability of SARMs YouTube videos was low. Social media likely causes SARMs abuse through disseminating biased SARMs misinformation. These results serve to educate public health oversight bodies, healthcare providers, and sports team members to better identify signs of SARMs abuse, and promote discussion to discourage SARMs abuse.

PMID:35912528 | DOI:10.1080/00913847.2022.2108352

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Nevin Manimala Statistics

Psychometric properties of two mental health screening tools in southeast Liberia: The Liberian Distress Screener and Patient Health Questionnaire

Transcult Psychiatry. 2022 Aug 1:13634615221107201. doi: 10.1177/13634615221107201. Online ahead of print.

ABSTRACT

Evidence suggests that locally developed and/or adapted screening tools for mental ill-health can have higher validity than directly translated tools developed in other settings. We administered the locally developed Liberian Distress Screener (LDS) and the Liberian-adapted Patient Health Questionnaire-9 (PHQ-9L) to a random sample of 142 outpatients at a regional hospital in Maryland County, Liberia. In the LDS, seven items demonstrated poor model fit and were excluded, resulting in an 11-item screener (LDS-11). Exploratory factor analysis of the 11-item screener (LDS-11) showed a single latent variable construct with significant factor loadings. Cronbach’s alpha revealed good internal consistency (α = 0.81). Rasch analyses showed that “brain hot” and “heart fall down” were the most difficult idioms of distress to endorse while “things playing on the mind” was the easiest. All LDS-11 elements were associated with elevated function impairment, with “things playing on the mind,” “worry too much,” “head is hurting,” and “heart cut/beat fast” achieving statistical significance. One item in the PHQ-9L demonstrated poor model fit and was excluded from psychometric analyses. The resultant eight-item PHQ demonstrated internal consistency (α = 0.76) and Rasch analysis revealed that “moving/talking too slowly/fast” was the most difficult item to endorse, while “not happy when doing things” was the easiest. Twelve items were significantly associated with functional impairment. Exploratory analyses reveal items that demonstrate ease and appropriateness of use for assessing mental distress in this population. Implementation research is needed to incorporate idioms of distress and screeners into Liberia’s mental healthcare system.

PMID:35912513 | DOI:10.1177/13634615221107201

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Nevin Manimala Statistics

Maasai women hearing voices: Implications for global mental health

Transcult Psychiatry. 2022 Aug 1:13634615221111628. doi: 10.1177/13634615221111628. Online ahead of print.

ABSTRACT

There is a sparse literature on women who hear voices globally, even though there are documented gendered dimensions of distress in the context of globalization and climate change and research indicates that trauma and psychosocial stress may be related to an increased prevalence of voice-hearing or auditory verbal hallucinations (AVHs). There is also a gap in the cultural phenomenology of voice-hearing in general, as well as idioms of distress for non-western peoples. This article presents results of a mixed methods study that: 1) estimated community prevalence of voice-hearing among Maasai women in northern Tanzania; 2) examined any demographic correlates and two specific hypothesized correlates (i.e., psychological stress and potentially traumatic events); and 3) engaged women in semi-structured interviews about their everyday lives and the phenomenological experience of voice-hearing. The prevalence of voice-hearing (39.4%) in this nonclinical sample (n = 71) was quite high compared to other studies in sub-Saharan Africa. Most women also reported high psychosocial stress and traumatic life events. They also talked about gendered conditions of social adversity in a context of rapid social, economic, and climate change. Women who reported hearing voices had a statistically significantly higher level of psychological distress, met criteria for severe psychological distress, and reported more potentially traumatic life events. In a logistic regression model, psychosocial stress predicted voice-hearing. The presence of distressing voices may offer a straightforward way to quickly identify people in the community experiencing the most extreme levels of psychosocial stress and traumatic events-a potentially simple but effective screening tool for health workers on the ground.

PMID:35912508 | DOI:10.1177/13634615221111628

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Nevin Manimala Statistics

The effectiveness of therapeutic ultrasound to the mechanically damaged chondrocyte culture

Physiother Theory Pract. 2022 Jul 31:1-10. doi: 10.1080/09593985.2022.2107466. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the efficacy of low intensity (0.1-0.8 Watt/cm2) pulsed ultrasound on chondrocyte cell proliferation and migration.

METHODS: Low-intensity pulsed ultrasound (frequency 3 MHz, duty cycle 25%, and pulse repetition frequency 150 Hz) for 5 minutes at different spatial average intensities was applied on chondrocyte cells. First, the optimum dose with significantly increased proliferation was determined to be 0.5 W/cm2 for 5 minutes of duration. Then, 0.5 W/cm2 ultrasound intensity was applied for durations of 2.5, 5, 7.5, and 10 minutes, and healing was assessed by monitoring cell migration and proliferation.

RESULTS: At the intensity of 0.5 W/cm2 48 hours after the application, a statistically significant increase in proliferation (p = .0089) was observed in chondrocyte cells compared to the control group. Proliferation was analyzed at 4, 8, 24, and 48 hours after applying 0.5 W/cm2 ultrasound for durations of 2.5, 5, 7.5, and 10 minutes. Statistically significant increases were observed at 4 hours (p = .009), 8 hours (p = .032), 24 hours (p = .0084), and 48 hours (p = .00098) with 10 minutes of exposure. For 7.5 min of exposure duration, significant increases were observed at 48 hours (p = .045). In migration for all parameters, no statistically significant improvement (p > .05) was observed.

CONCLUSION: It was shown that low intensity pulsed ultrasound induces cartilage cell proliferation; therefore, it may have a disease-modifying effect in the treatment of osteoarthritis. However, no positive effect was observed on cartilage cell migration.

PMID:35912499 | DOI:10.1080/09593985.2022.2107466

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Nevin Manimala Statistics

An efficient approach for optimizing the cost-effective individualized treatment rule using conditional random forest

Stat Methods Med Res. 2022 Aug 1:9622802221115876. doi: 10.1177/09622802221115876. Online ahead of print.

ABSTRACT

Evidence from observational studies has become increasingly important for supporting healthcare policy making via cost-effectiveness analyses. Similar as in comparative effectiveness studies, health economic evaluations that consider subject-level heterogeneity produce individualized treatment rules that are often more cost-effective than one-size-fits-all treatment. Thus, it is of great interest to develop statistical tools for learning such a cost-effective individualized treatment rule under the causal inference framework that allows proper handling of potential confounding and can be applied to both trials and observational studies. In this paper, we use the concept of net-monetary-benefit to assess the trade-off between health benefits and related costs. We estimate cost-effective individualized treatment rule as a function of patients’ characteristics that, when implemented, optimizes the allocation of limited healthcare resources by maximizing health gains while minimizing treatment-related costs. We employ the conditional random forest approach and identify the optimal cost-effective individualized treatment rule using net-monetary-benefit-based classification algorithms, where two partitioned estimators are proposed for the subject-specific weights to effectively incorporate information from censored individuals. We conduct simulation studies to evaluate the performance of our proposals. We apply our top-performing algorithm to the NIH-funded Systolic Blood Pressure Intervention Trial to illustrate the cost-effectiveness gains of assigning customized intensive blood pressure therapy.

PMID:35912490 | DOI:10.1177/09622802221115876

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Nevin Manimala Statistics

Prevalence and Features of Maxillary Sinus Septa in Patients with Cleft Lip and Palate: Cone Beam Computed Tomography Imaging Technique

Cleft Palate Craniofac J. 2022 Aug 1:10556656221117732. doi: 10.1177/10556656221117732. Online ahead of print.

ABSTRACT

OBJECTIVE: The development of the maxillary sinus is different in patients with cleft lip and palate (CLP) compared to non-CLP individuals. To investigate the prevalence and features of maxillary sinus septa (MSS) in patients with CLP in comparison with the non-CLP population.

DESIGN: Retrospective study.

INTERVENTION: Cone beam computed tomography (CBCT) evaluation.

SETTING: CLP center in Shiraz faculty of dentistry, Iran.

PATIENTS: A total 306 sinuses (88 cleft and 218 noncleft) on 153 images (CLP group: n = 66; control group: n = 87) were examined to determine the prevalence of septa and characterize them.

MAIN OUTCOME MEASURES: Sinus septa were characterized according to height, orientation, angle, origin, and location. The chi-square test, Mann-Whitney U test, and Fisher’s exact test were used for statistical analysis.

RESULTS: The prevalence of septa was 28.9% and 32.1% in the CLP and control groups, respectively. No significant difference was found between the study groups in terms of prevalence, location, and orientation of MSS. The average height and angle of septa were significantly higher in the control group compared to the CLP group. Inferior origin was significantly more prevalent in the control group than in the CLP group (P = .004).

CONCLUSION: There was no difference in the prevalence of MSS between patients with CLP and non-CLP individuals. However, certain features of the septa were different in patients with CLP.

PMID:35912448 | DOI:10.1177/10556656221117732

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Nevin Manimala Statistics

Diagnostic value of hybrid FDG-PET/MR imaging of chronic osteomyelitis

Eur J Hybrid Imaging. 2022 Aug 1;6(1):15. doi: 10.1186/s41824-022-00125-6.

ABSTRACT

BACKGROUND: Magnetic resonance imaging (MRI) and 2-[18F]-fluoro-2-deoxy-D-glucose (18F-FDG) Positron Emission Tomography, paired with Computed Tomography (PET/CT) are commonly used modalities in the complicated diagnostic work-up of osteomyelitis. PET/MRI is a relatively novel hybrid modality with suggested applications in bone infection imaging, based on expert opinion and previous qualitative research. 18F-FDG PET/MRI has the advantages of reduced radiation dose, more soft tissue information, and is deemed more valuable for surgical planning compared to 18F-FDG PET/CT. The goal of this study is to quantitatively assess the diagnostic value of hybrid 18F-FDG PET/MRI for chronic osteomyelitis.

METHODS: A retrospective analysis was performed by a nuclear medicine physician and radiologist on 36 patients with 18F-FDG PET/MRI scans for suspected osteomyelitis. Sensitivity, specificity, and accuracy were determined with the clinical assessment by the orthopaedic surgeon (based on subsequent intraoperative microbiology or long-term follow-up) as the ground truth. Standardized uptake values (SUV) were measured and analysed by means of receiver operating characteristics (ROC).

RESULTS: This first study to quantitatively report the diagnostic value of 18F-FDG PET/MRI yielded a sensitivity, specificity, and accuracy of 78%, 100%, and 86% respectively. Area under the ROC curve was .736, .755, and .769 for the SUVmax, target to background ratio, and SUVmax_ratio respectively. These results are in the same range and not statistically different compared to diagnostic value for 18F-FDG PET/CT imaging of osteomyelitis in literature.

CONCLUSIONS: Based on the aforementioned advantages of 18F-FDG PET/MRI and the diagnostic value reported here, the authors propose 18F-FDG PET/MRI as an alternative to 18F-FDG PET/CT in osteomyelitis diagnosis, if available.

PMID:35909200 | DOI:10.1186/s41824-022-00125-6