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Nevin Manimala Statistics

Maternal verbal scaffolding: association with higher language skills for 20-month-old children with prenatal polysubstance exposure

Early Hum Dev. 2021 Jul 4;160:105423. doi: 10.1016/j.earlhumdev.2021.105423. Online ahead of print.

ABSTRACT

BACKGROUND: The number of children with prenatal polysubstance exposure is increasing. Supportive mother-child interaction is a protective factor, which can ameliorate adverse effects of prenatal polysubstance exposure on developmental outcomes.

AIM: To examine the role of maternal verbal scaffolding on cognitive and language development in children with prenatal polysubstance exposure.

STUDY DESIGN: Pregnant women were recruited, and we prospectively followed mother-child dyads to 20 months of age. This analysis included 66 dyads (33 healthy controls and 33 with prenatal polysubstance exposure). Multivariable linear regression modelling was used to examine the cross-sectional association between maternal scaffolding and Bayley Scales of Infant and Toddler Development (BSID-III) score, as well as an interaction between the study group and scaffolding score.

OUTCOME MEASURES: The BSID-III cognitive and language score was used. Videotaped mother-child play was coded to obtain a maternal verbal scaffolding score. Effect sizes were measured using average differences in scores between groups.

RESULTS: There was no evidence of an association between study group and maternal scaffolding scores. Children in the polysubstance exposure group had lower cognitive and language scores compared to controls, but this association was not statistically significant after controlling for maternal education. Maternal scaffolding was predictive of language scores, with scores increasing by 1.24 points on average (95% CI: 0.42, 2.06) for every 1-point increase in scaffolding score after adjustment for covariates. There was no evidence of a study group-by-scaffolding interaction with respect to the language or cognitive scores.

CONCLUSIONS: Maternal scaffolding during play was associated with language development in children with and without prenatal polysubstance exposure.

PMID:34252844 | DOI:10.1016/j.earlhumdev.2021.105423

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Nevin Manimala Statistics

Brain-Derived Neurotrophic Factor Gene Polymorphism Predicts Response to Continuous Theta Burst Stimulation in Chronic Stroke Patients

Neuromodulation. 2021 Jul 12. doi: 10.1111/ner.13495. Online ahead of print.

ABSTRACT

OBJECTIVES: The efficacy of repetitive transcranial magnetic stimulation (rTMS) in clinically relevant neuroplasticity research depends on the degree to which stimulation induces robust, reliable effects. The high degree of interindividual and intraindividual variability observed in response to rTMS protocols, such as continuous theta burst stimulation (cTBS), therefore represents an obstacle to its utilization as treatment for neurological disorders. Brain-derived neurotrophic factor (BDNF) is a protein involved in human synaptic and neural plasticity, and a common polymorphism in the BDNF gene (Val66Met) may influence the capacity for neuroplastic changes that underlie the effects of cTBS and other rTMS protocols. While evidence from healthy individuals suggests that Val66Met polymorphism carriers may show diminished or facilitative effects of rTMS compared to their homozygous Val66Val counterparts, this has yet to be demonstrated in the patient populations where neuromodulatory therapies are most relevant.

MATERIALS AND METHODS: We examined the effects of BDNF Val66Met polymorphism on cTBS aftereffects in stroke patients. We compared approximately 30 log-transformed motor-evoked potentials (LnMEPs) obtained per time point: at baseline and at 0, 10, 20, and 30 min after cTBS-600, from 18 patients with chronic stroke using single TMS pulses. We used linear mixed-effects regression with trial-level data nested by subject for higher statistical power.

RESULTS: We found a significant interaction between BDNF genotype and pre-/post-cTBS LnMEPs. Val66Val carriers showed decrease in cortical excitability, whereas Val66Met carriers exhibited a modest increase in cortical excitability for 20 min poststimulation, followed by inhibition 30 min after cTBS-600.

CONCLUSIONS: Our findings strongly suggest that BDNF genotype differentially affects neuroplastic responses to TMS in individuals with chronic stroke. This provides novel insight into potential sources of variability in cTBS response in patients, which has important implications for optimizing the utility of this neuromodulation approach. Incorporating BDNF polymorphism genetic screening to stratify patients prior to use of cTBS as a neuromodulatory technique in therapy or research may optimize response rates.

PMID:34252254 | DOI:10.1111/ner.13495

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Nevin Manimala Statistics

The characteristics and risk factors of healthcare-seeking men with lower urinary tract symptoms in China: Initial report from the POInT group

Neurourol Urodyn. 2021 Jul 12. doi: 10.1002/nau.24737. Online ahead of print.

ABSTRACT

AIMS: To investigate the clinical characteristics of health care-seeking men presenting with lower urinary tract symptoms (LUTS) in China and to reveal risk factors for symptom severity.

METHODS: This multicenter, hospital-based, cross-sectional study recruited 1477 eligible male subjects, who were at least 45 years, seeking health care at 9 participating hospitals across the mainland China. The general medical information and subjective symptoms were recorded, followed by the measurement of prostate volume, urodynamic indices, and laboratory tests for kidney function, plus glucose/lipid metabolism. Univariate and multivariate linear regression were employed for the detection of risk factors for symptom severity.

RESULTS: The proportion of mild, moderate, and severe LUTS was 14.6%, 32.6%, and 52.8%, respectively, with 62.2% reporting the triple combination of storage, voiding, and postmicturition symptoms. Median prostate volume was 44.6 ml, and 71.1% were experiencing comorbidities. Thirteen independent risk factors for LUTS severity were identified, namely, nocturnal voiding episodes and the presence of straining and weak steam; the triple combination of symptom subtypes; general and nocturia quality of life; Qmax and bladder outlet obstruction index; and numbers of comorbidities, hypertension, estimated glomerular filtration rate, and cholesterol and glycosylated hemoglobin.

CONCLUSIONS: The majority of health care-seeking LUTS men present with moderate-to-severe and overlapping symptoms, with a high prevalence of both lower urinary tract dysfunction and systemic comorbidities. The evidence from both urological and nonurological independent risk factors demonstrate the multifactorial nature of LUTS, for which a multidisciplinary management is essential.

PMID:34252243 | DOI:10.1002/nau.24737

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Nevin Manimala Statistics

Serum Lateral Flow Assay with Digital Reader for the Diagnosis of Invasive Pulmonary Aspergillosis: A Two Center Mixed Cohort Study

Mycoses. 2021 Jul 12. doi: 10.1111/myc.13352. Online ahead of print.

ABSTRACT

BACKGROUND: Detection of galactomannan (GM) from bronchoalveolar lavage fluid (BALF) or serum is broadly used for diagnosis of invasive aspergillosis (IA), although the sensitivity of GM from serum is lower in non-neutropenic patients. We evaluated the Aspergillus galactomannan lateral flow assay (LFA) with digital readout from serum in a mixed cohort of patients.

METHODS: We performed a retrospective two-center study evaluating the LFA from serum of patients with clinical suspicion of IA obtained between 2015 and 2021 at the University of California San Diego (UCSD) and the Medical University of Graz. The sensitivity and specificity was calculated for proven/probable aspergillosis versus no aspergillosis. Correlation with same-sample GM was calculated using Spearman correlation analysis and kappa statistics.

RESULTS: In total, 122 serum samples from 122 patients were analyzed, including proven IA (n=1), probable IA or coronavirus-associated pulmonary aspergillosis (CAPA) (n=27), and no IA/CAPA/non-classifiable (n=94). At a 0.5 ODI cutoff, the sensitivity and specificity of the LFA was 78.6% and 80.5%. Spearman correlation analysis showed a strong correlation between serum LFA ODI and serum GM ODI (rho 0.459, p<0.0001). Kappa was 0.611 when both LFA and GM were used with a 0.5 ODI cutoff, showing substantial agreement (p<0.001).

DISCUSSION: The LFA with digital read out from serum showed good performance for the diagnosis of probable/proven aspergillosis, with substantial agreement to GM from serum. Like the LFA from BALF, the LFA from serum may serve as a more rapid test compared to conventional GM, particularly in settings where GM is not readily available.

PMID:34252244 | DOI:10.1111/myc.13352

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Nevin Manimala Statistics

A nation-wide birth year-by-year analysis of effectiveness of HPV vaccine in Japan

Cancer Sci. 2021 Jul 12. doi: 10.1111/cas.15060. Online ahead of print.

ABSTRACT

In Japan, the age-adjusted incidence of cervical cancer has been increasing constantly and rapidly among younger women. We set out to accurately confirm the effectiveness of the HPV vaccine in Japan. Data was collected for women born in the fiscal year (FY) 1990 to 1997, who became eligible for their 20-year-old cervical cancer screening between the FY 2010 to 2017. The adjusted incidence of CIN1+ in women born in FY 1990 to 1993, i.e., those who reached the national vaccination target age prior to the introduction of publicly-subsidized HPV vaccinations, referred here after as ‘the pre-introduction generation’, was 1.42% (242/17,040). The incidence in the ‘vaccination generation’ (women born in FY 1994 to 1997, i.e., those who were heavily vaccinated as a group when they were of the nationally targeted age of 13-16) was 1.66% (135/8,020). There was no significant difference between these incidence rates. However, our FY birth year-by-year analysis revealed that the incidence of CIN1+ was obviously lower than that predicted based on just the tendency for CIN1+ seen in the pre-introduction generation. Our analysis revealed that the incidence of CIN3+ was obviously lower in the vaccinated generation than in the pre-introduction generation (p=0.0008) . The incidence of CIN was already tending to increase in both the pre-introduction and vaccination generations. The changes in CIN incidence by individual birth FY must be examined to accurately determine the actual affects of the HPV vaccine for reducing mild cervical lesions.

PMID:34252250 | DOI:10.1111/cas.15060

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Older immigrants perceived health after migration to the United States: Influence of age and level of acculturation

J Am Geriatr Soc. 2021 Jul 12. doi: 10.1111/jgs.17363. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the age-related differences in the association between level of acculturation and perceptions about change in health status after migration in mid- to late-life immigrants.

DESIGN: Cross-sectional study.

SETTING: Nationally representative cohort of legal U.S. immigrants.

PARTICIPANTS: Legal immigrants ≥50 years of age.

MEASUREMENTS: The outcome was perceived change in health status, determined by the survey question, “compared with your health right before you most recently came to the United States to live, would you say that your health is better now, about the same or worse?” The main predictor included age group (50-64, 65-74, and ≥75 years) and secondary variable of interest was level of acculturation. Analyses were adjusted for demographic characteristics, medical, and functional comorbidities.

RESULTS: Immigrants age ≥75 years were more likely to report worse health after migration [RRR 1.93, 95% CI (1.17, 3.17), p < 0.01] compared with immigrants of 50-64 years, but this difference was not statistically significant in the adjusted model. Acculturation level was associated with increased likelihood of reporting worse health status, [RRR 2.10, (1.02, 4.35), p < 0.05] for somewhat acculturated and [RRR 2.55, (1.10, 5.88), p < 0.05] for most acculturated, compared with participants who were not acculturated.

CONCLUSION: The oldest immigrant group (≥75 years) was more likely to report worse health after migration, but this association was no longer significant after accounting for acculturation level and other covariates. Future work should be undertaken to identify specific health needs across older immigrant age groups and identify acculturative stressors that negatively impact health.

PMID:34252200 | DOI:10.1111/jgs.17363

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Nevin Manimala Statistics

RORC gene polymorphism is associated with acute kidney injury following cardiac surgery

Acta Anaesthesiol Scand. 2021 Jul 12. doi: 10.1111/aas.13949. Online ahead of print.

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) is a common complication of cardiopulmonary bypass (CPB), associated with increased mortality in surgical patients. It is well proven that Th17 and its hallmark cytokine, IL-17, contribute to AKI development. Since the RAR-related orphan receptor C (RORC) gene is a master regulator of the Th17 differentiation, we aimed to evaluate the association between its polymorphisms, CPB-AKI and plasma IL-17 levels among Iranian patients undergoing cardiopulmonary bypass.

METHOD: Totally, 138 patients undergoing cardiopulmonary bypass in Bandar Abbas, Iran, were enrolled. The allele and genotype frequencies of the selected SNPs were determined using PCR-SSP. IL-17 serum level was determined using an enzyme-linked immunosorbent assay.

RESULTS: Rs9017 GG genotype and G allele were associated with increased risk of CPB-AKI (OR=3, 95% CI=1.4-6.6 and OR=2.3, 95% CI=1.3-3.9 respectively) while A allele was protective against the disease (OR=0.4, 95% CI=0.3-0.7, P=0.02). There was not a statistically significant interaction between the three genotypes of rs9017 and AKI disease with IL-17 serum level before (P=0.9) and after (P=0.6) the operation. The IL-17 serum level before surgery was significantly higher in patients carrying GG genotype compared to GA genotype (P=0.017).

CONCLUSION: Our results showed that the rs9017 GG genotype was associated with an increased level of IL-17 and risk of CBP-AKI in the Iranian population. Our current results suggest that the rs9017 GG genotype could be a probable predictor of AKI after cardiac surgery.

PMID:34252205 | DOI:10.1111/aas.13949

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The association between internet usage and sleep problems among Japanese adolescents: three repeated cross-sectional studies

Sleep. 2021 Jul 12:zsab175. doi: 10.1093/sleep/zsab175. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: Sleep problems and problematic internet use have important implications for adolescent health; however, there have been no large-scale surveys using comprehensive measures. We examined the association between internet use duration and sleep problems among Japanese adolescents.

METHODS: We used data from the Lifestyle Survey of Adolescents collected in 2012, 2014, and 2017. We calculated the change in sleep status (insomnia, sleep duration, bedtime, and sleep quality) and internet usage (screen time and services such as internet surfing, social media use, streaming such as YouTube, and online gaming). A binary logistic model was estimated for insomnia. Generalized ordered logit models were employed for the ordinal outcomes (sleep duration, bedtime, sleep quality, and multidimensional sleep health). Sampling weights were constructed based on participation rate on survey years and selection rates from population statistics.

RESULTS: We analyzed data from 248,983 adolescents. Sleep status was unchanged; however, many adolescents used more internet services and for longer durations. The odds ratio of internet screen time for all sleep problems (insomnia, shorter sleep duration, later bedtime, and worse sleep quality) gradually declined. Longer internet screen time (> 5 hours) was strongly associated with all sleep problems. Internet services were also associated with sleep problems; particularly, social media use and online gaming were linked to later bedtimes.

CONCLUSIONS: Despite the decreased strength in the association between internet usage and sleep problems, longer internet time was strongly associated with sleep problems. Public health interventions should consider internet use as an intervention target to improve adolescents’ health.

PMID:34252182 | DOI:10.1093/sleep/zsab175

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Cardiometabolic Risk Trajectory among Older Americans: Findings from the Health and Retirement Study

J Gerontol A Biol Sci Med Sci. 2021 Jul 12:glab205. doi: 10.1093/gerona/glab205. Online ahead of print.

ABSTRACT

BACKGROUND: Cardiometabolic risk (CMR) is a key indicator of physiological decline with age; but age-related declines in a nationally representative older U.S. population have not been previously examined.

METHODS: We examined the trajectory of cardiometabolic risk (CMR) over 8 years of aging, from 2006/2008 to 2014/2016, among 3,528 people over age 50 in the Health and Retirement Study. We used growth curve models to examine change in total CMR as well as in individual cardiometabolic biomarkers to understand how baseline differences and rates of change vary across sociodemographic characteristics, by smoking status, and medication use.

RESULTS: Total CMR did not change among respondents who survived over 8 years. Despite significant differences in CMR across demographic and education groups at baseline, the pace of change with age did not differ by these characteristics. Among individual biomarkers, risk levels of diastolic blood pressure, resting heart rate, and total cholesterol decreased over 8 years while glycosylated hemoglobin, waist circumference, and pulse pressure increased over that time. Both the statistical significance levels and the magnitudes of the reduction over time with age in diastolic blood pressure, resting heart rate, and total cholesterol in models adjusted for age, race/ethnicity, gender, smoking, and education were reduced after controlling for blood pressure and cholesterol medication.

CONCLUSIONS: The relatively constant total CMR level over 8 years occurred because some indicators improved with age while some deteriorated in this period. Medication use contributed to the improvement in blood pressure, resting heart rate, and total cholesterol.

PMID:34252185 | DOI:10.1093/gerona/glab205

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Circulating progastrin-releasing peptide in the diagnosis of Small Cell Lung Cancer (SCLC) and in therapeutic monitoring

J Circ Biomark. 2021 Jul 7;10:9-13. doi: 10.33393/jcb.2021.2212. eCollection 2021 Jan-Dec.

NO ABSTRACT

PMID:34252174 | PMC:PMC8267854 | DOI:10.33393/jcb.2021.2212