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Nevin Manimala Statistics

Assessment of Cognitive Function in Young Children with Type 1 Diabetes Mellitus Using Electrophysiological Tests

Pediatr Diabetes. 2022 Jun 14. doi: 10.1111/pedi.13383. Online ahead of print.

ABSTRACT

BACKGROUND/ OBJECTIVES: Diabetes mellitus is a chronic disease that affects many body systems, including the nervous and auditory systems. It is noted that there is a scarcity of research on the effect of diabetes on cognitive functions in particular and auditory functions in general in children with type 1 diabetes. Therefore, this study was designed to assess cognitive and auditory functions in children with type 1 diabetes mellitus and to correlate the reflection of diabetes control on cognitive functions.

METHODS: This study is a case-control study that included 100 children divided into two groups, the patient group, which includes 50 children with type 1 diabetes, and the control group, which consists of 50 healthy children. Subjects in the current study were submitted to pure tone audiometry, speech recognition threshold test, immittancemetry study, and measurement of cortical auditory evoked and P300 potentials (CAEPs and P300). These audiometric measures were statistically analyzed and correlated with the clinical characteristics of the study group.

RESULTS: The latency of P300 and CAEPs was significantly increased while the amplitude of P300 and CAEPs was significantly decreased in the patient group compared to the control group (p <0.001). P300 and CAEPs latency has a positive correlation with HbA1c levels (r = 0.460). Also, there was significant differences between the two groups regarding the hearing threshold at 8000 Hz, and 28% of patients had bilateral sensorineural hearing loss (SNHL) at 8 kHz.

CONCLUSION: The prolonged P300 and CAEPs latency and decreased amplitude in patients indicate a cognitive decline in individuals with type 1 diabetes compared to healthy individuals. HbA1c levels may increase the risk of cognitive impairment in children. In addition, the risk of bilateral sensorineural hearing loss increased at 8 kHz in children with type 1 diabetes mellitus. This article is protected by copyright. All rights reserved.

PMID:35700327 | DOI:10.1111/pedi.13383

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Nevin Manimala Statistics

Chronic disorders, work-unit leadership quality and long-term sickness absence among 33 025 public hospital employees

Scand J Work Environ Health. 2022 Jun 14:4036. doi: 10.5271/sjweh.4036. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to examine the association between work-unit level leadership quality and individual-level long-term sickness absence (LTSA) in the hospital sector and effect modification by chronic disorders.

METHODS: This longitudinal analysis included 33 025 Danish public hospital employees who were followed-up for one year after baseline in March 2014. Leadership quality was assessed by questionnaire with mean responses aggregated by work-unit and characterized in tertiles. LTSA during follow-up was determined from employer records. Chronic disorders at baseline was assessed from the Danish hospital and prescription registers. We performed multilevel logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) adjusting for potential confounders. We evaluated interaction between chronic illness and low leadership quality on multiplicative and additive scales.

RESULTS: We identified employees as healthy (60.8%) or with somatic (31.6%), mental (3.3%), or both somatic and mental (4.3%) disorders. During follow-up, 6% of employees registered a LTSA. Medium and high leadership quality were associated with lower risk of LTSA with OR of 0.84 (95% CI 0.76-0.94) and 0.73 (95% CI 0.65-0.82) respectively, compared to low leadership quality. Associations were similar for healthy employees and employees with only somatic disorders, whereas no association was observed for employees with mental disorders (in presence or absence of somatic disorders). No statistically significant (α=0.05) interactions between leadership quality and chronic disorders on LTSA were observed.

CONCLUSION: The findings suggest that the quality of leadership in work units is associated with risk of long-term sick leave in the Danish public hospital sector and that strong leadership protects employees against LTSA.

PMID:35700335 | DOI:10.5271/sjweh.4036

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Nevin Manimala Statistics

Characteristics of Wild Bird Resistomes and Dissemination of Antibiotic Resistance Genes in Interconnected Bird-Habitat Systems Revealed by Similarity of blaTEM Polymorphic Sequences

Environ Sci Technol. 2022 Jun 14. doi: 10.1021/acs.est.2c01633. Online ahead of print.

ABSTRACT

Wild birds are known to harbor and discharge antibiotic-resistant bacteria (ARB) and their associated antibiotic resistance genes (ARGs). However, assessments of their contribution to the dissemination of antibiotic resistance in the environment are limited to culture-dependent bacterial snapshots. Here, we present a high-throughput sequencing study that corroborates extensive ARG exchange between wild bird feces and their habitats and implies the need to scrutinize high-mobility birds as potential vectors for global propagation of ARGs. We characterized the resistome (281 ARGs) and microbiome of seven wild bird species and their terrestrial and aquatic habitats. The resistomes of bird feces were influenced by the microbial community structure, mobile genetic elements (MGEs), and residual antibiotics. We designated 33 ARGs found in more than 90% of the bird fecal samples as core ARGs of wild bird feces, among which 16 ARGs were shared as core ARGs in both wild bird feces and their habitats; these genes represent a large proportion of both the bird feces (35.0 ± 15.9%) and the environmental resistome (29.9 ± 21.4%). One of the most detected β-lactam resistance genes (blaTEM, commonly harbored by multidrug resistant “superbugs”) was used as molecular marker to demonstrate the high interconnectivity of ARGs between the microbiomes of wild birds and their habitats. Overall, this work provides a comprehensive analysis of the wild bird resistome and underscores the importance to consider genetic exchange between animals and the environment in the One Health approach.

PMID:35700319 | DOI:10.1021/acs.est.2c01633

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Nevin Manimala Statistics

Meta-analysis of the association between periodontal disease, periodontal treatment and carotid intima-media thickness

J Periodontal Res. 2022 Jun 14. doi: 10.1111/jre.13006. Online ahead of print.

ABSTRACT

Periodontal disease is a major threat to oral health and would further contribute to systemic diseases without timely control. We aimed to evaluate the relation between periodontal disease, periodontal treatment and carotid intima-media thickness (CIMT) based on available epidemiological and clinical evidence. PubMed and Scopus were searched for relevant studies through May 2021. Observational studies reporting risk estimates with 95% confidence intervals (95% CIs) for the association between periodontal disease (including periodontitis and gingivitis) and risk of increased CIMT (defined as CIMT value that exceeded the cut-off value of clinical and prognostic significance), as well as interventional studies providing mean values with standard deviations of CIMT before and after periodontal intervention, were included. Random-effect models for meta-analysis were used to calculate the summary effect estimates with 95% CIs. A total of 406 citations were retrieved from electronic databases and 45 full-text articles were screened, leaving 11 articles using ultrasound to measure CIMT with 8744 participants included. Pooled results of seven cross-sectional studies involving 8558 participants indicated that compared to those without periodontitis, patients with periodontitis and those with severe periodontitis had an odds ratio of 1.42 (95% CI: 1.16, 1.75) and 1.70 (95% CI: 1.24, 2.33) for increased CIMT, respectively. Although publication bias was detected in these results, odds ratios corrected by the trim-and-fill method were still statistically significant. Results of four non-randomized controlled trials with 186 patients suggested that periodontal intervention may help reduce CIMT in patients with periodontal disease in the short term. Periodontitis, especially severe periodontitis, was significantly associated with the risk of increased CIMT. Periodontal intervention might help slow the progression of carotid intima-media thickening in patients with periodontal disease in the short term.

PMID:35700316 | DOI:10.1111/jre.13006

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Nevin Manimala Statistics

Elastic analysis of irregularly or sparsely sampled curves

Biometrics. 2022 Jun 14. doi: 10.1111/biom.13706. Online ahead of print.

ABSTRACT

We provide statistical analysis methods for samples of curves in two or more dimensions, where the image, but not the parametrization of the curves, is of interest and suitable alignment/registration is thus necessary. Examples are handwritten letters, movement paths or object outlines. We focus in particular on the computation of (smooth) means and distances, allowing e.g. classification or clustering. Existing parametrization invariant analysis methods based on the elastic distance of the curves modulo parametrization, using the square-root-velocity framework have limitations in common realistic settings where curves are irregularly and potentially sparsely observed. We propose using spline curves to model smooth or polygonal (Fréchet) means of open or closed curves with respect to the elastic distance and show identifiability of the spline model modulo parametrization. We further provide methods and algorithms to approximate the elastic distance for irregularly or sparsely observed curves, via interpreting them as polygons. We illustrate the usefulness of our methods on two datasets. The first application classifies irregularly sampled spirals drawn by Parkinson’s patients and healthy controls, based on the elastic distance to a mean spiral curve computed using our approach. The second application clusters sparsely sampled GPS tracks based on the elastic distance and computes smooth cluster-means to find new paths on the Tempelhof field in Berlin. All methods are implemented in the R-package “elasdics” and evaluated in simulations. This article is protected by copyright. All rights reserved.

PMID:35700308 | DOI:10.1111/biom.13706

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Nevin Manimala Statistics

Prevalence and management of filarial lymphoedema and its associated factors in Lindi district, Tanzania: A community-based cross-sectional study

Trop Med Int Health. 2022 Jun 14. doi: 10.1111/tmi.13792. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the burden and management of filarial lymphoedema and its associated factors in Lindi district, Tanzania.

METHODS: Cross-sectional study involving 954 community members who were screened for filarial lymphoedema by using a checklist. Moreover, lymphoedema patients were examined for the presence of entry lesions, staging of disease, and interviewed on acute dermatolymphangioadenitis (ADLA) attacks, and their current practices on lymphoedema management. Descriptive statistics and logistic regression analyses were performed. A p-value <0.05 was considered statistically significant.

RESULTS: The prevalence of filarial lymphoedema was 7.8%, with the majority in the early stage of lymphoedema (78.4%). The large majority (98.6%) of the patients had lower limb lymphoedema and 46% of lymphoedema patients had entry lesions. More than a half (60.8%) of those lymphoedema patients had experienced ADLA attacks; close to two-thirds (64.8%) had one or two attacks in the past six months. Generally, patients had inappropriate hygiene care practices for filarial lymphoedema management. Inappropriate hygiene care practice for lymphoedema management was associated with an increased risk for the development of advance stage of lymphoedema (AOR= 7.379 95%, CI: 3.535-16.018, p = 0.04).

CONCLUSION: Though LF transmission has drastically declined, chronic manifestations of lymphoedema persist in Lindi district. The recommended disease management practices are deficient, which calls for a programmatic approach for mapping the burden of lymphoedema and implementing its management.

PMID:35700223 | DOI:10.1111/tmi.13792

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Nevin Manimala Statistics

MR Neurography of Lumbosacral Plexus: Incremental Value Over XR, CT, and MRI of L Spine With Improved Outcomes in Patients With Radiculopathy and Failed Back Surgery Syndrome

J Magn Reson Imaging. 2022 Jun 14. doi: 10.1002/jmri.28296. Online ahead of print.

ABSTRACT

BACKGROUND: Lower back pain is often evaluated using magnetic resonance imaging (MRI) and conventional imaging, which provide incomplete information about the etiology of pain and lead to less than optimal management.

HYPOTHESIS: MR neurography (MRN) of the lumbosacral (LS) plexus renders a more accurate diagnosis, alters the management strategy, and clinical outcomes of radiculopathy or failed back surgery Syndrome (FBSS) patients when compared to the conventional imaging modalities.

STUDY TYPE: Retrospective, cross-sectional.

POPULATION: A total of 356 patients (mean age 65.8 ± 12.3; 48.9% female) from single university hospital over 6 years with MRN of LS plexus were included from a cohort of 14,775 total patients with lumbar spine MR imaging.

ASSESSMENT: Conventional imaging obtained before and after MRN of LS plexus was reevaluated and categorized into three levels based on extent of imaging findings’ correlation to presenting clinical symptoms (contributory levels). Clinical notes were reviewed for changes in ordering provider’s recommended management and subsequent patients’ symptom level pre-MRN to post-MRN.

FIELD STRENGTH/SEQUENCE: A 5 T and 3.0 T. T1-weighted (T1W), T2-weighted (T2W), short T1 inversion recovery (STIR), T1 turbo spin echo (T1 TSE), T2 spectral attenuated inversion recovery (T2 SPAIR).

STATISTICAL TESTS: Chi-squared test. Statistical significance was set at P < 0.05.

RESULTS: A total of 356 total patients (174 females) with mean age ± SD was 65.8 ± 12.3 years, 4.2% of patients imaged with lumbar spine MRI. Definitely contributory studies among X-rays, computed tomography, MRI, and MRN were 3 of the 129 (2.3%), 3 of the 48 (6.2%), 35 of the 184 (19.0%), and 283 of the 356 (79.8%), respectively. Pre-MRN vs. post-MRN led to change in recommendation in 219 of the 356 (61.5%) patients and 71 of the 99 (71.7%) patients had improved symptoms.

CONCLUSION: MRN of the LS plexus can provide more corroborative image findings for symptom correlation compared to other imaging modalities for accurate diagnosis, effects patient management and leads to positive clinical outcomes in a small subset of patients with radiculopathy or FBSS.

EVIDENCE LEVEL: 4 TECHNICAL EFFICACY: Stage 5.

PMID:35700216 | DOI:10.1002/jmri.28296

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Nevin Manimala Statistics

A cross-sectional study on COVID-19-related changes in self-medication with antibiotics

PLoS One. 2022 Jun 14;17(6):e0269782. doi: 10.1371/journal.pone.0269782. eCollection 2022.

ABSTRACT

BACKGROUND AND AIM: Dental treatments have been limited to emergency care in many countries worldwide due to the global rapid spread of coronavirus disease-2019 (COVID-19). Fear of contracting the disease in dental clinics has also altered the pattern of dental visits and self-medication. The present study compared self-medication with antibiotics (SMA) and the pattern of dental visits before and after the emergence of COVID-19 pandemic in a referral dental clinic in the north of Iran.

MATERIALS AND METHODS: The data for the present cross-sectional study was collected from 756 patient records retrieved from the archives of the Faculty Clinic of Rasht School of Dentistry during two separate periods: before the COVID-19 pandemic from mid-November 2019 to mid-February 2020, and after the pandemic emergence from mid-April to mid-July 2020. In addition to demographic variables namely age, gender, and place of residence of patients, their smoking status, chief complaint, and SMA were also extracted from patient records. The Chi-square test and binary logistic regression models with 95% confidence interval served for statistical analysis.

RESULTS: In total, 756 patient records (412 records from the pre-pandemic period and 344 records from the post-pandemic period) were evaluated. SMA was significantly more prevalent after the pandemic compared to that before pandemic (OR = 3.39, 95% CI = 2.43-4.73, P<0.001). The number of patients who smoke significantly decreased after the pandemic by 6.6% compared to that in pre-pandemic period. Dental pain, pus discharge, and abscess as the chief complaints of patients were significantly more prevalent during the post-pandemic period; while, dental checkups, tooth hypersensitivity, and esthetic dental problems were significantly more frequent as the chief complaints of patients during the pre-pandemic period.

CONCLUSION: There is indication that during the COVID-19 pandemic, SMA and prevalence of acute dental problems in patients have increased. With regard to the consequences of SMA, there is a need to raise public awareness on this matter.

PMID:35700193 | DOI:10.1371/journal.pone.0269782

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Nevin Manimala Statistics

Genome Wide Association Study of Pregnancy in Childhood Cancer Survivors: A Report from the Childhood Cancer Survivor Study

Cancer Epidemiol Biomarkers Prev. 2022 Jun 14:cebp.0314.2022-3-18 10:35:08.940. doi: 10.1158/1055-9965.EPI-22-0314. Online ahead of print.

ABSTRACT

BACKGROUND: Gonadotoxic treatment-related infertility has a significant impact on quality of life in childhood cancer survivors. Genome-wide association analyses to delineate the risk of infertility in childhood cancer survivors have not been previously reported.

METHODS: Leveraging genotype data from a large survivor cohort, the Childhood Cancer Survivor Study (CCSS), we investigated the role of Single Nucleotide Polymorphisms (SNPs) on future pregnancy or siring a pregnancy in survivors without pelvic, testicular, or brain radiation who had ever been married. We calculated sex-stratified hazard ratios, using Cox proportional hazards modeling, adjusting for birth cohort (before 1965 vs. 1965 or later) and doses of relevant chemotherapies; replication was attempted in the independent St. Jude Lifetime Cohort study (SJLIFE).

RESULTS: In the CCSS cohort, nine SNPs were found to be suggestive (p-value <10-7) or statistically significantly (p-value <5×10-8) associated with pregnancy, however, none of the SNPs were replicated in SJLIFE. Cohorts differed based on the overall pregnancy rate, frequency of sterilizing procedures and birth cohort.

CONCLUSIONS: We were not able to replicate our findings of SNPs associated with pregnancy in childhood cancer survivors.

IMPACT: Future attempts at replication should be considered in cohorts treated in a comparable era. Additionally, understanding the role of genetics in fertility in childhood cancer survivors may be better approached using more advanced sequencing techniques.

PMID:35700038 | DOI:10.1158/1055-9965.EPI-22-0314

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Nevin Manimala Statistics

Association study between polymorphisms in DNA methylation-related genes and testicular germ cell tumor risk

Cancer Epidemiol Biomarkers Prev. 2022 Jun 14:cebp.0123.2022-2-12 14:42:56.847. doi: 10.1158/1055-9965.EPI-22-0123. Online ahead of print.

ABSTRACT

BACKGROUND: Testicular germ cell tumors (TGCTs), histologically classified as seminomas and non-seminomas, are believed to arise from primordial gonocytes, with the maturation process blocked when are subjected to DNA methylation reprogramming. Single-nucleotide polymorphisms (SNPs) in DNA methylation machinery and folate-dependent one-carbon metabolism genes have been postulated to influence the proper establishment of DNA methylation.

METHODS: In this pathway-focused investigation we evaluated the association between 273 selected tag SNPs from 28 DNA methylation-related genes and TGCT risk. We carried out association analysis at individual SNP and gene-based level using summary statistics from the Genome Wide Association Study meta-analysis recently conducted by the international Testicular Cancer Consortium on 10,156 TGCT cases and 179,683 controls.

RESULTS: In individual SNP analyses, seven SNPs, four mapping within MTHFR, were associated with TGCT risk after correction for multiple testing (q-value ≤.05). Queries of public databases showed that three of these SNPs were associated with MTHFR changes in enzymatic activity (rs1801133) or expression level in testis tissue (rs12121543, rs1476413). Gene-based analyses revealed MTHFR (q-value=8.4×10-4), MECP2 (q-value=2×10-3) and ZBTB4 (q-value=0.03) as the top TGCT-associated genes. Stratifying by tumor histology, four MTHFR SNPs were associated with seminoma. In gene-based analysis MTHFR was associated with risk of seminoma (q-value=2.8×10-4), but not with non-seminomatous tumors (q-value=0.22).

CONCLUSIONS: Genetic variants within MTHFR, potentially having an impact on the DNA methylation pattern, are associated with TGCT risk.

IMPACT: This finding suggests that TGCT pathogenesis could be associated to the folate cycle status, and this relation could be partly due to hereditary factors.

PMID:35700037 | DOI:10.1158/1055-9965.EPI-22-0123