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Nevin Manimala Statistics

Geographic Inequalities in Cardiovascular Mortality in the United States: 1999 to 2018

Mayo Clin Proc. 2021 Apr 8:S0025-6196(20)30987-3. doi: 10.1016/j.mayocp.2020.08.036. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the trends in cardiovascular, ischemic heart disease (IHD), stroke, and heart failure mortality in the stroke belt in comparison with the rest of the United States.

PATIENTS AND METHODS: We evaluated the nationwide mortality data of all Americans from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database from 1999 to 2018. Cause-specific deaths were identified in the stroke belt and nonstroke belt populations using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes. The relative percentage gap was estimated as the absolute difference computed relative to nonstroke belt mortality. Piecewise linear regression and age-period-cohort modeling were used to assess, respectively, the trends and to forecast mortality across the 2 regions.

RESULTS: The cardiovascular mortality rate (per 100,000 persons) was 288.3 (95% CI, 288.0 to 288.6; 3,684,273 deaths) in the stroke belt region and 251.2 (95% CI, 251.0 to 251.3; 13,296,164 deaths) in the nonstroke belt region. In the stroke belt region, age-adjusted mortality rates due to all cardiovascular causes (average annual percentage change [AAPC] in mortality rates, -2.4; 95% CI, -2.8 to -2.0), IHD (AAPC, -3.8; 95% CI, -4.2 to -3.5), and stroke (AAPC, -2.8; 95% CI, -3.4 to -2.1) declined from 1999 to 2018. A similar decline in cardiovascular (AAPC, -2.5; 95% CI, -3.0 to -2.0), IHD (AAPC, -4.0; 95% CI, -4.3 to -3.7), and stroke (AAPC, -2.9; 95% CI, -3.2 to -2.2) mortality was seen in the nonstroke belt region. There was no overall change in heart failure mortality in both regions (PAAPC>.05). The cardiovascular mortality gap was 11.8% in 1999 and 15.9% in 2018, with a modest reduction in absolute mortality rate difference (~7 deaths per 100,000 persons). These patterns were consistent across subgroups of age, sex, race, and urbanization status. An estimated 101,953 additional cardiovascular deaths need to be prevented from 2020 to 2025 in the stroke belt to ameliorate the gap between the 2 regions.

CONCLUSION: Despite the overall decline, substantial geographic disparities in cardiovascular mortality persist. Novel approaches are needed to attenuate the long-standing geographic inequalities in cardiovascular mortality in the United States, which are projected to increase.

PMID:33840523 | DOI:10.1016/j.mayocp.2020.08.036

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Nevin Manimala Statistics

Evaluation of the retinal nerve fiber layer with optic coherence tomography in patients with alcohol use disorder

J Fr Ophtalmol. 2021 Apr 8:S0181-5512(21)00173-X. doi: 10.1016/j.jfo.2020.11.009. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to evaluate the retinal nerve fiber layer (RNFL) with optical coherence tomography (OCT) among patients with alcohol and tobacco use disorder.

METHODS: This study included 29 patients and 29 age and gender-matched healthy participants without alcohol dependency. The patients underwent full ophthalmologic examination including visual acuity, intraocular pressure, anterior segment and fundus examinations, and RNFL measurements taken with spectral-domain OCT. The RNFL values of the two groups were compared with each other.

RESULTS: In comparison to the control group, the RNFL was found to be thinner in all quadrants in the group with alcohol and tobacco dependency. The RNFL thinning in the superotemporal, temporal, and inferotemporal quadrants was found to be statistically significant (P-values 0.012, 0.040 and 0.005, respectively).

CONCLUSIONS: Chronic alcohol and tobacco use may cause RNFL thinning. Assessment of RNFL thinning by OCT among patients with alcohol and tobacco dependency might be used to identify visual morbidity.

PMID:33840492 | DOI:10.1016/j.jfo.2020.11.009

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Nevin Manimala Statistics

Contribution of respiratory relaxation techniques during intravitreal injections: A pilot study

J Fr Ophtalmol. 2021 Apr 8:S0181-5512(21)00192-3. doi: 10.1016/j.jfo.2020.09.028. Online ahead of print.

ABSTRACT

PURPOSE: To study the effects of breathing techniques for anxiety, perceived pain, and patient satisfaction while receiving intravitreal injections.

METHOD: This prospective, randomized clinical study included patients admitted for intravitreal anti-VEGF injections. They were randomized into two groups: a relaxation group who listened to a prerecorded relaxation breathing session before and during the injection, and a control group who received the injection without a relaxation session. Statistical analysis was then performed to assess the factors influencing satisfaction, anxiety, and perceived pain.

RESULTS: We included one-hundred four patients in total: 52 in the relaxation group versus 52 in the control group. The relaxation group had a greater decrease in anxiety than the control group (P=0.03) but similar levels of pain (P=0.86). In total, 80.76% of patients in the relaxation group expressed the wish to have a relaxation session during their next injection. Multivariate analysis showed that the patient’s usual level of stress as well as the relaxation session affected the level of anxiety experienced before the injection.

CONCLUSION: Relaxation techniques before and during intravitreal injections decrease anxiety in patients without decreasing pain during IVT. Prerecorded relaxation breathing sessions are non-invasive, inexpensive, easy to set up, and reduce anxiety during intravitreal injections on an outpatient basis.

PMID:33840495 | DOI:10.1016/j.jfo.2020.09.028

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Nevin Manimala Statistics

Antisocial Traits and Neuroticism as Predictors of Suicidal Behaviour in Borderline Personality Disorder: a Retrospective Study

Rev Colomb Psiquiatr. 2021 Apr 8:S0034-7450(21)00045-7. doi: 10.1016/j.rcp.2021.02.006. Online ahead of print.

ABSTRACT

INTRODUCTION: The spectrum of suicidal behaviour (SB) is nuclear in the clinic and management of borderline personality disorder (BPD). The pathological personality traits of BPD intervene as risk factors for SB in confluence with other clinical and sociodemographic variables associated with BPD. The objective of this work is to evaluate the specific personality traits of BPD that are related to SB.

METHODS: A cross-sectional, observational and retrospective study was carried out on a sample of 134 patients diagnosed with BPD according to DSM-5 criteria. The Millon-II, Zuckerman-Kuhlman and Barrat questionnaires were used to assess different personality parameters. Variable comparisons were made using the χ2 test and the Student’s t-test. The association between variables was analysed using multivariate logistic regression.

RESULTS: Statistically significant differences were observed between SB and related factors and the neuroticism-anxiety dimension in the Zuckerman-Kuhlman test. It is also significantly related to the phobic and antisocial subscale of the Millon-II. Impulsivity measured with the Zuckerman-Kuhlman and Barrat tests does not appear to be related to SB.

CONCLUSIONS: The results presented raise the role of phobic, antisocial and neuroticism traits as possible personality traits of BPD related to SB, suggesting an even greater importance within the relationship between BPD and SB than that of impulsivity. Looking to the future, longitudinal studies would increase the scientific evidence for the specified findings.

PMID:33840500 | DOI:10.1016/j.rcp.2021.02.006

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Nevin Manimala Statistics

Deus ex machina? Demystifying rather than deifying machine learning

J Thorac Cardiovasc Surg. 2021 Mar 11:S0022-5223(21)00444-X. doi: 10.1016/j.jtcvs.2021.02.095. Online ahead of print.

NO ABSTRACT

PMID:33840471 | DOI:10.1016/j.jtcvs.2021.02.095

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Nevin Manimala Statistics

Evaluation of heavy metal pollution in coastal sediments of Bandar Abbas, the Persian Gulf, Iran: Mercury pollution and environmental geochemical indices

Mar Pollut Bull. 2021 Apr 7;167:112314. doi: 10.1016/j.marpolbul.2021.112314. Online ahead of print.

ABSTRACT

Mercury has been measured by using Cold Vapor-Atomic Absorption Spectrophotometry in coastal sediments of the Persian Gulf (Bandar Abbas region). The mean concentration of the six stations followed a decreasing order of S6 (3.95) > S1 (3.75) > S4 (3.55) > S5 (3.33) > S2 (2.72) > S3 (2.17), and the mean concentration ± standard error was calculated to be 3.24 ± 0.28 (μgg-1 dry weight) for the heavy element Mercury in the sediments. The statistical investigation indicated that the concentration means of the Mercury existing in transects sediments are meaningfully different from each other (p < 0.05). To properly assess the availability and mobility of elements, Enrichment Factor (EF), Geoaccumulation index (Igeo), Contamination factor (Cf) and Toxicity Risk Index (TRI) were provided. The results show that the pollution caused by Mercury in sediments is highly polluted and the source of the presence of Mercury in the region is human-made.

PMID:33838600 | DOI:10.1016/j.marpolbul.2021.112314

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Nevin Manimala Statistics

The index of ideality of correlation improves the predictive potential of models of the antioxidant activity of tripeptides from frog skin (Litoria rubella)

Comput Biol Med. 2021 Apr 3;133:104370. doi: 10.1016/j.compbiomed.2021.104370. Online ahead of print.

ABSTRACT

It is usually held that good-quality models for the biological activity of peptides must take into account their 3D architecture and descriptors of quantum mechanics. However, the present study shows that it is possible to build up models without these complex calculations. The structure of tripeptides represented by sequences of one-symbol abbreviations of the corresponding amino acids serves to build up quantitative structure-activity relationships for the antioxidant activity of tripeptides from frog skin. The statistical quality of the best model for the validation set is n = 27, r2 = 0.93, RMSE = 0.15.

PMID:33838612 | DOI:10.1016/j.compbiomed.2021.104370

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Nevin Manimala Statistics

We need to do better: A systematic review and meta-analysis of diagnostic test accuracy of restless legs syndrome screening instruments

Sleep Med Rev. 2021 Mar 13;58:101461. doi: 10.1016/j.smrv.2021.101461. Online ahead of print.

ABSTRACT

This systematic review and meta-analysis evaluated the diagnostic accuracy of screening instruments for restless legs syndrome (RLS) and reports sensitivity, specificity, positive (PPV) and negative predictive values (NPV). Searches for primary studies were conducted in electronic databases. Of the 1541 citations identified, 52 were included in the meta-analysis. The methodological quality of each study was evaluated using QUADAS-2. Only 14 studies assessed the reference standard in all participants or in all screen-positives and a selection of screen-negatives. Bivariate meta-analysis of these 14 studies estimated median sensitivity to be 0.88 (0.72-0.96) and specificity 0.90 (0.84-0.93); based on a population prevalence of 5%, the calculated PPV was 0.31 (0.27-0.34). For all 52 studies, with either full or partial verification of RLS status, we constructed best-case scenario sensitivities and specificities at pre-defined levels of prevalence: across all samples, when prevalence is 5%, the median best-case scenario PPV is 0.48 with significant between-study heterogeneity. No RLS screening instruments can currently be recommended for use without an expert clinical interview in epidemiological studies. For conditions with statistically low prevalence such as RLS, the specificity, not the sensitivity, of a screening instrument determines true prevalence. Therefore, future instruments should maximize specificity. We provide guidelines on RLS ascertainment in epidemiological studies that requires a two-step process with clinical interview following a screening test, and given the poor reporting quality of many RLS epidemiological studies, we include an RLS reporting checklist.

PMID:33838561 | DOI:10.1016/j.smrv.2021.101461

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Nevin Manimala Statistics

Prevalence of hemotropic mycoplasmas and coinfection with feline leukemia virus and feline immunodeficiency virus in cats in the Moscow region, Russia

Prev Vet Med. 2021 Mar 26;190:105339. doi: 10.1016/j.prevetmed.2021.105339. Online ahead of print.

ABSTRACT

Feline haemoplasma infection studies are lacking in Russia. This retrospective study was conducted to estimate the prevalence of feline haemoplasmas in domestic cats in the Moscow region, Russia. A risk of haemoplasma coinfection with feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) was also determined. qPCR analysis for feline haemoplasmas was performed on EDTA blood samples from 753 cats from the Moscow region, Russia. Subsets of these samples were tested also for FIV and FeLV by qPCR. Of the 753 blood samples, 104 (13.8 %) were positive for one of the Mycoplasma species. The prevalence of ‘Candidatus Mycoplasma haemominutum’ (CMhm), Mycoplasma haemofelis (Mhf), and ‘Candidatus Mycoplasma turicensis’ (CMt) was 7.6 %, 5.5 %, and 0.7 %, respectively. One sample (0.1 %) was simultaneously infected with two haemoplasmas, namely, Mhf and CMt. Haemoplasma positive cats were more likely to be infected with FIV than haemoplasma negative (17.6 % vs 6.7 %), but these differences were not statistically significant. The prevalence of FeLV was comparable among haemoplasma positive and negative cats (23.5 % vs 25.7 %) All three known species of feline haemoplasma were detected, confirming their presence in Russia. The overall and species-specific rates of haemoplasma infections in Russian cats are generally similar to the rates in the countries of central Europe. This report documents for the first time the prevalence of feline hemotropic mycoplasmas in domestic cats not only in Russia but also in eastern Europe.

PMID:33838591 | DOI:10.1016/j.prevetmed.2021.105339

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Nevin Manimala Statistics

Bevacizumab as maintenance therapy in patients with metastatic colorectal cancer: A meta-analysis of individual patients’ data from 3 phase III studies

Cancer Treat Rev. 2021 Mar 30;97:102202. doi: 10.1016/j.ctrv.2021.102202. Online ahead of print.

ABSTRACT

BACKGROUND: The real impact of bevacizumab maintenance as single agent in metastatic colorectal cancer (mCRC) remains unclear. SAKK-41/06 and PRODIGE-9 failed to demonstrate the non-inferiority and superiority of bevacizumab versus no maintenance, respectively, while AIO-KRK-0207 showed the non-inferiority of maintenance bevacizumab versus bevacizumab and fluoropyrimidines for time to strategy failure.

METHODS: Bibliography electronic databases (PubMed, MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials) were searched for English published clinical trials prospectively randomizing mCRC patients to receive bevacizumab maintenance or not after first-line chemotherapy plus bevacizumab. Individual patients’ data (IPD) were provided by investigators for all included trials. Primary end-points were progression-free survival (PFS) and overall survival (OS), both from the start of induction and maintenance. Univariate and multivariate analyses for PFS and OS were performed.

RESULTS: Three phase III studies – PRODIGE-9, AIO-KRK-0207 and SAKK-41/06 – were included. Considering the different timing of randomization, IPD of patients not progressed during induction and starting maintenance phase entered the analysis. 909 patients were included, 457 (50%) received bevacizumab maintenance. Median PFS from induction start was 9.6 and 8.9 months in bevacizumab group versus no maintenance group, respectively (HR 0.78; 95%CI: 0.68-0.89; p < 0.0001). Subgroups analysis for PFS showed a significant interaction according for RAS status (p = 0.048), with a maintenance benefit limited to RAS wild-type patients. No difference in terms of OS was observed.

CONCLUSIONS: Despite the statistically significant PFS improvement for bevacizumab maintenance, the absolute benefit appears limited. Subgroup analysis shows a differential effect of bevacizumab maintenance in favor of RAS wild-type patients. Considering these results, maintenance therapy with fluoropyrimidine with or without bevacizumab remains the first option. Single agent bevacizumab maintenance can be considered in selected cases, such as cumulative toxicity or patient’s refusal, in particular for RAS wild-type patients.

PMID:33838596 | DOI:10.1016/j.ctrv.2021.102202