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Nevin Manimala Statistics

GAD65 autoantibodies and glucose tolerance in offspring born to women with and without type 1 diabetes (The EPICOM study)

Endocrinol Diabetes Metab. 2021 Nov 19:e00310. doi: 10.1002/edm2.310. Online ahead of print.

ABSTRACT

The aims of this study were to examine presence of GAD65 autoantibodies (GAD65aab) in offspring born to women with type 1 diabetes (T1D) and controls and if more were GAD65aab-positive if diagnosed with diabetes or pre-diabetes. This EPICOM study is a prospective follow-up study focussing on pregnancies complicated by maternal T1D. The EPICOM study includes offspring (n = 278) born to mothers with pre-gestational T1D between 1993 and 1999 and matched un-exposed controls (n = 303). Age at the time of follow-up was 16.7 years (13.0-20.4 years). GAD65aab was measured using the Glutamic Acid Decarboxylase Autoantibody RIA kit from RSR© . An Oral Glucose Tolerance Test (OGTT) was performed, and abnormal glucose tolerance was defined as having either diabetes, impaired fasting glucose (IFG) or impaired glucose tolerance (IGT). GAD65aab could be measured in 561 participants. Of these, 17 (3%) were positive for GAD65aab (≥25 U/ml) with 11 (4%) offspring being born to women with T1D and 6 (2%) controls. The difference in GAD65aab status was not statistically significant (p = .2). One was diagnosed with GAD65aab-negative diabetes during the study, 18 were diagnosed with IFG, and 44 with IGT. Overall, more were GAD65aab-positive if diagnosed with abnormal glucose tolerance (p = .03). We found no association between GAD65aab status and HOMA-IR, HOMA-IS, birthweight, mode of delivery or maternal BMI prior to pregnancy. Our study found no overall difference in GAD65 status between offspring born to women with T1D and their matched controls. However, among the participants diagnosed with pre-diabetes more were GAD65-positive.

PMID:34800010 | DOI:10.1002/edm2.310

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Free testosterone levels and their association with body composition in women with chronic kidney disease

Pol Merkur Lekarski. 2021 Oct 22;49(293):329-333.

ABSTRACT

Data concerning the influence of sex hormones on body composition in women with chronic kidney disease (CKD) is limited.

AIM: The aim of our study was to define free testosterone levels and their association with body composition, biochemical markers of nutrition in females with CKD.

MATERIALS AND METHODS: 47 women were included into the study. 13 females treated with hemodialysis formed the hemodialysis group (HD), 24 females with CKD stage IV/V (eGFR < 30 ml/min/1,73 m2) formed the predialysis group (PreD), and 10 females without kidney disease formed the control group (C). Lean tissue mass (LTM) and fat mass (Fat) were measured using bioimpedance spectroscopy. Free testosterone levels were assessed using ELISA (IBL International). Statistical analysis was performed using Statistica v 13.1.

RESULTS: The median free testosterone (fT) levels were 0.7, 0.6, 0.85 pg/ml respectively for HD, PreD and C group. The median fT did not differ significantly between the groups (p=0.24). The mean LTM was 28.5 ±5.6, 27.3 ±4.9, 30.6 ±4.3 kg, mean Fat mass was 22.7 ±8.5, 31.3 ±9.8, 31.6 ±8.5 kg for the HD, PreD and C groups respectively. Positive correlations were observed between fT and LTM (r=0.306, p=0.035) in the whole study group. A negative correlation was observed between fT and age (r=-0.284) but was on the border of statistical significance (p=0.052).

CONCLUSIONS: In women with advanced CKD, median testosterone levels did not differ significantly from those observed in women without kidney failure. Free testosterone levels were associated with the amount of muscle mass in the whole study population.

PMID:34800017

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Nurse editors’ roles and practices

J Nurs Scholarsh. 2021 Nov 19. doi: 10.1111/jnu.12745. Online ahead of print.

ABSTRACT

PURPOSE: While nurse editors carry great responsibility for the scientific literature in the nursing profession, little has been published about this unique role. The purpose of this study was to examine contemporary nurse editors’ roles and practices.

DESIGN: In early 2019, a sample of 129 nurse editors participated in a cross-sectional study using survey methods.

METHODS: The online survey was based on an instrument used in a prior study and included 43 primarily multiple-choice questions. Findings were analyzed using descriptive statistics.

FINDINGS: Beyond the expected roles of journal management, editorial decision making, leadership for the profession, and specific journal focus, some aspects of the nurse editor role have remained unchanged. The role continues to be learned mostly on the job and nurse editors still find satisfaction in helping other nurses publish and disseminate their work. Nurse editors are older and better educated. They also are receiving more manuscripts submitted to their journals and perceive this role as hard work but worth it. This is also the first study to report on the role of other levels of editors.

CONCLUSION: This study provides a description of the current roles and practices of nurse editors. Nurse editors can bring more attention to the role and encourage more nurses to consider this role as an attainable and a satisfying one.

CLINICAL RELEVANCE: Being a nurse editor is a leadership role and one that many nurses may not consider as a career goal. Nurse editors can increase the visibility of this role and engage, encourage, and support nurses who are interested in this role.

PMID:34799979 | DOI:10.1111/jnu.12745

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Optimising CT-chest protocols and the added value of venous-phase contrast timing; Observational case-control

J Med Imaging Radiat Oncol. 2021 Nov 19. doi: 10.1111/1754-9485.13350. Online ahead of print.

ABSTRACT

INTRODUCTION: To optimize CT chest protocol by comparing venous contrast timing with arterial timing for contrast opacification in vessels, qualitative image quality and radiologists’ satisfaction and diagnostic confidence in assessing for potential nodal, pleural and pulmonary disease in general oncology outpatients.

METHOD: Matched case-control study performed following CT protocol update. 92 patients with a range of primary malignancies with 2 CT chests in a 2-year period, one with an arterial phase protocol and the second in the 60 second venous phase, were included. Contrast attenuation in aorta, pulmonary artery and liver were measured. Subjective measurements assessed perivenous artefact, confidence in nodal pleural and pulmonary assessment and presence of pulmonary emboli. Statistical analysis was performed using paired and unpaired t-tests.

RESULTS: Venous-phase CT demonstrated more consistent enhancement of the vessels, with higher attenuation of the nodes, pulmonary and pleural lesions. There was a significant reduction in perivenous beam hardening artefact on venous-phase CT (P < 0.001). Diagnostic confidence was significantly higher for nodal assessment and pleural abnormality visibility (P < 0.001) and pleural assessment (P < 0.05). There was no significant difference in pulmonary mass visibility. There was adequate enhancement to diagnose significant pulmonary emboli (PE) with 4 incidental PEs detected on the venous phase, extending to segmental vessels.

CONCLUSION: Venous-phase CT chest performs better than arterial-phase on all fronts, without compromising assessment of incidental pulmonary emboli. When intravenous contrast is indicated in a routine chest CT (excluding a CT-angiogram), the default timing should be a venous or 60s phase.

PMID:34799981 | DOI:10.1111/1754-9485.13350

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Association Between Heart Failure With Preserved Left Ventricular Ejection Fraction and Impaired Left Atrial Phasic Function in Hypertrophic Cardiomyopathy: Evaluation by Cardiac MRI Feature Tracking

J Magn Reson Imaging. 2021 Nov 19. doi: 10.1002/jmri.28000. Online ahead of print.

ABSTRACT

BACKGROUND: The majority of heart failure (HF) in hypertrophic cardiomyopathy (HCM) manifests as a phenotype with preserved left ventricular (LV) ejection fraction; however, the exact contribution of left atrial (LA) phasic function to HF with preserved ejection fraction (HFpEF) in HCM remains unresolved.

PURPOSE: To define the association between LA function and HFpEF in HCM patients using cardiac magnetic resonance imaging (MRI) feature tracking.

STUDY TYPE: Retrospective.

POPULATION: One hundred and fifty-four HCM patients (HFpEF vs. non-HF: 55 [34 females] vs. 99 [43 females]).

FIELD STRENGTH/SEQUENCE: 3.0 T/balanced steady-state free precession.

ASSESSMENT: LA reservoir function (reservoir strain [εs ], total ejection fraction [EF]), conduit function (conduit strain [εe ], passive EF), booster-pump function (booster strain [εa ] and active EF), LA volume index, and LV global longitudinal strain (LV GLS) were evaluated in HCM patients.

STATISTICAL TESTS: Chi-square test, Student’s t-test, Mann-Whitney U test, multivariate linear regression, logistic regression, and net reclassification analysis were used. Two-sided P < 0.05 was considered statistically significant.

RESULTS: No significant difference was found in LV GLS between the non-HF and HFpEF group (-10.67 ± 3.14% vs. -10.14 ± 4.01%, P = 0.397), whereas the HFpEF group had more severely impaired LA phasic strain (εs : 27.40 [22.60, 35.80] vs. 18.15 [11.98, 25.90]; εe : 13.80 [9.20, 18.90] vs. 7.95 [4.30, 14.35]; εa : 13.50 [9.90, 17.10] vs. 7.90 [5.40, 14.15]). LA total EF (37.91 [29.54, 47.94] vs. 47.49 [39.18, 55.01]), passive EF (14.70 [7.41, 21.49] vs. 18.07 [9.32, 24.78]), and active EF (27.19 [17.79, 36.60] vs. 36.64 [26.63, 42.71]) were all significantly decreased in HFpEF patients compared with non-HF patients. LA reservoir (β = 0.90 [0.85, 0.96]), conduit (β = 0.93 [0.87, 0.99]), and booster (β = 0.86 [0.78, 0.95]) strain were independently associated with HFpEF in HCM patients. The model including reservoir strain (Net Reclassification Index [NRI]: 0.260) or booster strain (NRI: 0.325) improved the reclassification of HFpEF based on LV GLS and minimum left atrial volume index (LAVImin ).

DATA CONCLUSION: LA phasic function was severely impaired in HCM patients with HFpEF, whereas LV function was not further impaired compared with non-HF patients.

LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY: Stage 3.

PMID:34799953 | DOI:10.1002/jmri.28000

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Prevalence of developmental delay among children: A national study based on administrative database of the single-payer National Health Insurance System in Taiwan

Child Care Health Dev. 2021 Nov 20. doi: 10.1111/cch.12932. Online ahead of print.

ABSTRACT

BACKGROUND: Developmental delay (DD) indicates a failure to meet the developmental milestones of most children of the same age. Studies based solely on the ICD coding manual may underestimate the prevalence of DD. Real-world use of rehabilitation data may be useful in the identification of more DD children previously undiagnosed with DD.

AIMS: To estimate the prevalence of DD among children aged 0-6 by age and sex in Taiwan based on modified ICD codes.

METHODS: A list of ICD codes specific to DD (including delays and disabilities requiring early intervention) was generated from the existing ICD codebook and modified based on National Health Insurance (NHI) claims data pertaining to developmental rehabilitation of children aged 0-6. The validity of the codes was subsequently assessed by DD experts in various fields using the consensus development technique. The resulting list was used to estimate the prevalence of DD among children in Taiwan from 2000 to 2015 based on analysis of longitudinal NHI data.

RESULT: Between 2000 and 2015, the prevalence of DD among children aged 0 to 6 years increased from 2.0% to 5.7 % and the sex ratio was 181-197 males per 100 females. The prevalence estimate obtained in this study (5.6%) was 229% higher than existing government statistics (1.6%) published in 2014.

CONCLUSIONS: The codes developed using claims data in this study can be used to estimate the prevalence of DD among children and evaluate the effectiveness of intervention programs. Consistent increases in the prevalence of DD indicate that efforts to promote early intervention have been effective. Nonetheless, the low prevalence rate among 0-2y children with developmental delay and low prevalence rate of female CWDD means that the policy should notice the lack of access to healthcare services for infants and female children, and produce a more equitable or fair distribution of healthcare resources.

PMID:34799877 | DOI:10.1111/cch.12932

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Ex-Vivo MRI of the Normal Human Placenta: Structural-Functional Interplay and the Association With Birth Weight

J Magn Reson Imaging. 2021 Nov 19. doi: 10.1002/jmri.28002. Online ahead of print.

ABSTRACT

BACKGROUND: Advanced magnetic resonance imaging (MRI) methods are increasingly being used to assess the human placenta. Yet, the structure-function interplay in normal placentas and their associations with pregnancy risks are not fully understood.

PURPOSE: To characterize the normal human placental structure (volume and umbilical cord centricity index (CI)) and function (perfusion) ex-vivo using MRI, to assess their association with birth weight (BW), and identify imaging-markers for placentas at risk for dysfunction.

STUDY TYPE: Prospective.

POPULATION: Twenty normal term ex-vivo placentas.

FIELD STRENGTH/SEQUENCE: 3 T/ T1 and T2 weighted (T1 W, T2 W) turbo spin-echo, three-dimensional susceptibility-weighted image, and time-resolved angiography with interleaved stochastic trajectories (TWIST), during passage of a contrast agent using MRI compatible perfusion system that mimics placental flow.

ASSESSMENT: Placental volume and CI were manually extracted from the T1 W images by a fetal-placental MRI scientist (D.L., 7 years of experience). Perfusion maps including bolus arrival-time and full-width at half maximum were calculated from the TWIST data. Mean values, entropy, and asymmetries were calculated from each perfusion map, relating to both the whole placenta and volumes of interest (VOIs) within the umbilical cord and its daughter blood vessels.

STATISTICAL TESTS: Pearson correlations with correction for multiple comparisons using false discovery rate were performed between structural and functional parameters, and with BW, with P < 0.05 considered significant.

RESULTS: All placentas were successfully perfused and scanned. Significant correlations were found between whole placenta and VOIs perfusion parameters (mean R = 0.76 ± 0.06, range = 0.67-0.89), which were also significantly correlated with CI (mean R = 0.72 ± 0.05, range = 0.65-0.79). BW was correlated with placental volume (R = 0.62), but not with CI (P = 0.40). BW was also correlated with local perfusion asymmetry (R = -0.71).

DATA CONCLUSION: Results demonstrate a gradient of placental function, associated with CI and suggest several ex-vivo imaging-markers that might indicate an increased risk for placental dysfunction.

LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 1.

PMID:34799945 | DOI:10.1002/jmri.28002

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Characterization and differentiation of aluminum powders used in improvised explosive devices. Part 2: Micromorphometric method refinement and preliminary statistical analysis

J Forensic Sci. 2021 Nov 19. doi: 10.1111/1556-4029.14946. Online ahead of print.

ABSTRACT

Aluminum (Al) powder is commonly encountered in improvised explosive devices (IEDs) as a metallic fuel due to its availability and low cost. Although available commercially in powder form, amateur bomb-makers also produce their own Al powder via simple methods found online. In order to provide investigative leads and forensic intelligence, it is important to evaluate not only the composition of homemade devices, but also to distinguish between the various forms of Al powder they contain. To achieve this goal, a method using automated microscopy in combination with statistical techniques has been demonstrated to have the potential to provide source discrimination and investigative leads in source attribution of Al powders in IEDs. The present research refined this method and investigated 59 industrially and amateurly produced Al powder sources with seven subsamples per source using two traditional linear discriminant analyses (LDA), one with a standard data split for training and testing, and another using leave-one-out cross-validation. Averaging the classification accuracies for the two LDA-based analyses, LDA has the ability to correctly classify 59.26%, 83.35%, and 80.69% of the samples based on their powder source, type, and production method, respectively. This classification accuracy represents a 3407%, 317%, and 61.38% increase in accuracy from random class assignment, respectively. Further, in most instances of incorrect data attribution to a particular source, the subsample has been misidentified with another sample of the same powder type or production method.

PMID:34799855 | DOI:10.1111/1556-4029.14946

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Applying posterior probability informed thresholds to traditional cranial trait sex estimation methods

J Forensic Sci. 2021 Nov 19. doi: 10.1111/1556-4029.14947. Online ahead of print.

ABSTRACT

Sex estimation methods using traditional cranial nonmetric traits utilize predictive models to produce a final sex estimation, using the resulting model’s score to classify the individual. When sex estimations are assigned from discriminant scoring alone, statistical confidence in the resultant estimate is not always assessed or reported. Although some forensic anthropologists may qualitatively report their confidence in the assessment (e.g., “probable male”), these statements are subjective, not standardized, and not necessarily based on statistical results in a uniform way. The goals of this study were to evaluate how posterior probability-informed thresholds (PPITs) impacted accuracy rates, assess the balance between sample inclusion and accuracy for the proposed PPIT approach, and make recommendations for the use and interpretation of specific thresholds in casework. Using a sample of U.S. Black and White females and males (n = 292), we examined how PPITs can standardize the decision-making process of inferring sex for two methods using nonmetric cranial traits. We found that using PPITs of at least 0.85 increased accuracy (over 92% for some PPITs) yet remained highly inclusive of the sample. PPITs < 0.75 did not produce classification accuracy rates significantly higher than chance, and when using these cranial trait sex estimation methods, cases with posterior probabilities (PPs) <0.75 should be reported as “indeterminate.” The 0.75-0.84 PPIT interval had an accuracy rate of 76%, which was both statistically significantly different from chance as well as from the higher (>0.85) groups, suggesting that although sex estimation at this level may be acceptable, the results hold lower confidence.

PMID:34799862 | DOI:10.1111/1556-4029.14947

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Oral health-related quality of life in children with osteogenesis imperfecta

Eur Arch Paediatr Dent. 2021 Nov 20. doi: 10.1007/s40368-021-00664-9. Online ahead of print.

ABSTRACT

PURPOSE: Osteogenesis imperfecta (OI) results from mutations in the genes involved in the modification or biosynthesis of collagen. This study aimed to assess the oral health-related quality of life (OHRQoL) in children with OI.

METHODOLOGY: Participants were recruited from a highly specialised OI centre for children. The Child Oral-Health Impact Profile-Short Form (COHIP-SF) was used, adding demographic and qualitative questions. Children aged 8-16 years participated between January and October 2019. Statistical analysis was carried out. A higher COHIP-SF score indicates better OHRQoL (maximum score, 76).

RESULTS: One hundred and six (106) children participated (44 female, mean age 11.93 years). COHIP-SF median score was 59. Children reporting mild OI (n = 55) had higher median scores (62) compared to severe OI (n = 7) with median scores of 55 (P = 0.087). When comparing mixed (< 12 years, n = 46) and permanent dentition (≥ 12, n = 60), no significant difference in OHRQoL was seen (P = 0.977). There was no significant difference between severities for each COHIP-SF domain. Limited data on the presence of dentinogenesis imperfecta did not impact overall score (P = 0.109), but was significant in the oral-health domain (P = 0.033).

QUALITATIVE: Common themes were the need for braces, discolouration, pain and function.

CONCLUSION: This study confirmed that children with OI have dental concerns in areas including oral health, functional well-being and socio-emotional well-being. This was related to severity of OI.

PMID:34799841 | DOI:10.1007/s40368-021-00664-9