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Nevin Manimala Statistics

Making decisions in missing person identification cases with low statistical power

Forensic Sci Int Genet. 2021 Apr 20;54:102519. doi: 10.1016/j.fsigen.2021.102519. Online ahead of print.

ABSTRACT

The present work proposes a general strategy for dealing with missing person identification cases through DNA-database search. Our main example is the identification of abducted children in the last civic-dictatorship of Argentina, known as the “Missing Grandchildren of Argentina”. Particularly we focus on those pedigrees where few, or only distant relatives of the missing person are available, resulting in low statistical power. For such complex cases we provide a statistical method for selecting a likelihood ratio (LR) threshold for each pedigree based on error rates. Furthermore, we provide an open-source user friendly software for computing LR thresholds and error rates. The strategy described in the paper could be applied to other large-scale cases of DNA-based identification hampered by low statistical power.

PMID:34139527 | DOI:10.1016/j.fsigen.2021.102519

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Associations of residential greenness with peripheral and central obesity in China

Sci Total Environ. 2021 May 28;791:148084. doi: 10.1016/j.scitotenv.2021.148084. Online ahead of print.

ABSTRACT

BACKGROUND: Obesity is a well-known risk factor for public health. Recent studies found that greenness exposure may protect against obesity. However, the accumulated evidence on associations of greenness-obesity is inconsistent and most of them are from developed countries.

OBJECTIVES: This study aimed to evaluate the associations of greenness exposure with indicators of peripheral and central obesity.

METHODS: This cross-sectional study was based on a Chinese national Sub-Clinical Outcomes of Polluted Air (SCOPA) prospective cohort across 15 provinces, and 5849 participants with average age of 64.7 were included. Surrounding greenness was estimated with the Enhanced Vegetation Index (EVI), which was calculated at each participant’s residential addresses within a 250 m buffer. Weight, height and waist circumference (WC) were measured, and body mass index (BMI) and the waist-to-height ratio% (WHtR%) were calculated based on those measurements. The relationships between EVI and obese outcomes were explored using multiple linear regression and logistic regression models.

RESULTS: Non-linear associations were observed between EVI and obese indicators. Participants living in Quartile 3 benefited more than in Quartile 4 compared to the lowest quartile (Quartile 1) of greenness. For peripheral obesity, participants living in Quartile 3 of EVI250m had 0.86 kg/m2 (β -0.86, 95% CI: -1.10, -0.61) lower BMI, and 46% (OR 0.54, 95% CI: 0.44-0.66) lower odds of peripheral obesity than in Quartile 1. For central obesity, participants living in Quartile 3 of EVI250m had 1.85 cm (β -1.85, 95% CI: -2.54, -1.15) lower waist circumference, 1.12% (β -1.12, 95% CI: -1.56, -0.67) lower waist-to-height ratio% (WHtR%), and 33% (OR 0.67, 95% CI: 0.57-0.78) lower odds of central obesity than in Quartile 1 of EVI250m.

CONCLUSIONS: Higher levels of greenness were statistically significant associated with lower obesity risk.

PMID:34139501 | DOI:10.1016/j.scitotenv.2021.148084

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Impact of the COVID-19 Pandemic on Psychiatric Hospitalization in a Tertiary Care Hospital of Northern India

Prim Care Companion CNS Disord. 2021 Jun 17;23(3):21m02936. doi: 10.4088/PCC.21m02936.

ABSTRACT

Objective: To study the pattern of admissions in a psychiatry ward during the coronavirus disease 2019 (COVID-19) pandemic and compare the sociodemographic and clinical profiles of patients admitted in 2020 with admissions in 2019.

Methods: The case record files of an inpatient psychiatric unit from March 23 to September 22, 2019, and March 23 to September 22, 2020 were retrieved. Sociodemographic data, admission criteria of the patients, clinical diagnosis (as per ICD-10 criteria), duration of stay in the ward, and details of capacity assessment were assessed. The data collected were tabulated as per coding system and analyzed and compared using statistical analysis system software.

Results: Of a total of 312 admissions, 236 were in 2019 and 76 were in 2020 (P < .05), which was a significant (P < .05) decrease. More patients admitted in 2020 were in the age group of 30-39 years (P < .05), were residents of Chandigarh (P < .05), were housewives by occupation (P < .05), had incomes < 3,500 Indian rupees (US$ 48.01) per month (P < .01), were Hindu, and belonged to extended families (P < .05). The predominant reasons for admission in 2020 were complicated withdrawals, noncompliance to treatment (P < .05), and aggravation of psychiatric illness due to comorbid substance use. The ICD diagnoses schizophrenia, schizotypal and delusional disorder (F20-29) and mood disorders, predominantly mania (F30-31) were significantly higher and mental and behavioral disorder due to psychoactive substance use (F10-19) was lower among patients admitted in 2020.

Conclusions: The results show that the numbers of admissions to the psychiatry ward in 2020 were significantly lower than pre-COVID 2019, and the predominant reasons for admission were complicated withdrawals due to psychoactive substance abuse and noncompliance to treatment. Also, the mean duration of stay was longer in 2020 compared to the previous year.

PMID:34139110 | DOI:10.4088/PCC.21m02936

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A validation study of the LABIRINTO scale for the evaluation of autism spectrum disorder in children aged 2 to 4 years

Trends Psychiatry Psychother. 2021 Jun 15. doi: 10.47626/2237-6089-2020-0141. Online ahead of print.

ABSTRACT

OBJECTIVE: To find evidence of the content, construct, and criterion validity of the LABIRINTO scale for the diagnosis of autism spectrum disorder (ASD) in children aged 24-59 months.

METHODS: The scale was constructed in four stages: 1) items were defined based on an extensive literature review and discussions with autism and child development specialists; 2) child development specialists evaluated each item; 3) a preliminary version of the scale was applied to children diagnosed with ASD to enable any necessary adjustments; 4) the scale was then applied to 27 children with typical development and no neurodevelopmental disorder and 48 children with ASD. According to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the Childhood Autism Rating Scale (CARS), clinical diagnosis constitutes the gold standard.

RESULTS: The scale’s psychometric indexes were appropriate for construct validity, with Kaiser-Meyer-Olkin = 0.94 and root mean square error of approximation = 0.000. Only one factor on the scale had a Cronbach alpha of 0.97. The receiver operating characteristic curve indicated a cutoff of 12, with a sensitivity of 100% and specificity of 100% for distinguishing children with ASD from those with typical development.

CONCLUSION: This study confirmed the validity of the LABIRINTO scale.

PMID:34139117 | DOI:10.47626/2237-6089-2020-0141

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Vaginal bacterial load in the second trimester is associated with early preterm birth recurrence: a nested case-control study

BJOG. 2021 Jun 17. doi: 10.1111/1471-0528.16816. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the association between vaginal microbiome (VMB) composition and recurrent early spontaneous preterm birth (sPTB)/preterm prelabour rupture of membranes (PPROM).

DESIGN: Nested case-control study.

SETTING: UK tertiary referral hospital.

SAMPLE: High-risk women with previous sPTB/PPROM <34+0 weeks gestation who had a recurrence (n=22) or delivered at ≥37+0 weeks without PPROM (n=87).

METHODS: Vaginal swabs collected between 15-22 weeks gestation were analysed by 16S rRNA gene sequencing and 16S quantitative PCR.

MAIN OUTCOME MEASURE: Recurrent early sPTB/PPROM.

RESULTS: 28/109 high-risk women had anaerobic vaginal dysbiosis, with the remainder dominated by lactobacilli (L. iners 36/109, L. crispatus 23/109, or other 22/109). VMB type and diversity were not associated with recurrence. Women with a recurrence, compared to those without, had a higher median vaginal bacterial load (8.64 vs. 7.89 log10 cells/μl, adjusted odds ratio (aOR)=1.90, 95% confidence interval (CI)=1.01-3.56, p=0.047) and estimated Lactobacillus concentration (8.59 vs. 7.48 log10 cells/μl, aOR=2.35, CI=1.20-4.61, p=0.013). A higher recurrence risk was associated with higher median bacterial loads for each VMB type after stratification, although statistical significance was reached only for L. iners-domination (aOR=3.44, CI=1.06-11.15, p=0.040). Women with anaerobic dysbiosis or L. iners-domination had a higher median vaginal bacterial load than women with a VMB dominated by L. crispatus or other lactobacilli (8.54, 7.96, 7.63, and 7.53 log10 cells/μl, respectively).

CONCLUSIONS: Vaginal bacterial load is associated with early sPTB/PPROM recurrence. Domination by lactobacilli other than L. iners may protect women from developing high bacterial loads. Future PTB studies should quantify vaginal bacteria and yeasts.

PMID:34139060 | DOI:10.1111/1471-0528.16816

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HIV and Solid Organ Transplantation: A 15-Year Retrospective Audit at a Tertiary Australian Transplant Centre

Intern Med J. 2021 Jun 17. doi: 10.1111/imj.15423. Online ahead of print.

ABSTRACT

BACKGROUND: The incidence of end-stage organ disease in people living with HIV (PLWH) is increasing, as people live longer due to potent, tolerable antiretroviral therapy. Consequently, the number of PLWH who would benefit from solid organ transplant (SOT) is rising. Solid organ transplantation experience in PLWH in Australia remains limited. The aim of this study was to retrospectively review the outcomes for SOT in PLWH in Victoria, Australia.

METHODS: A retrospective cohort study of PLWH undergoing SOT over a 15-year period was performed. Adult PLWH over 18 years of age were eligible and identified from the Victorian HIV Service database. Descriptive statistics were used to summarise baseline demographics and clinical data, and outcomes following SOT.

RESULTS: Nine virologically-suppressed PLWH underwent SOT from HIV-negative donors; 5 kidneys, 2 livers, and 2 bilateral sequential lung transplants. All patients were male, with a median age of 57.3 years (IQR 54.3-60.1), CD4 count of 485 (IQR 342-835) at transplantation, and comorbidities were common at baseline. After a median follow up of 3.9 years (IQR 2.7-7.6), 8 (89%) patents were alive, 7 (78%) had functioning grafts, though 5 (56%) experienced organ rejection. Infections were common. Two patients required modification to their antiretroviral therapy due to significant drug-drug interactions, prior to transplant, while 5 (56%) had modifications post-SOT. No patients experienced HIV virologic failure.

CONCLUSION: PLWH with end-stage organ disease experience good clinical and functional outcomes, and should be considered for SOT where indicated. However, multidisciplinary planning and care is essential to optomise care in this patient group. This article is protected by copyright. All rights reserved.

PMID:34139100 | DOI:10.1111/imj.15423

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Detecting and Addressing Trauma-related Sequelae in Primary Care

Prim Care Companion CNS Disord. 2021 Jun 17;23(3):20m02781. doi: 10.4088/PCC.20m02781.

ABSTRACT

Objective: The associations between the sequelae of complex trauma symptoms and adult health status, patient engagement in treatment, and the potential impacts on primary care providers are underappreciated despite the potential for adverse outcomes. This study examined the correlations among adult primary care patients’ reports of posttraumatic stress symptoms (PTSS), adverse childhood experiences (ACE), and the impacts of social determinants of health (SDH) with provider diagnoses in the electronic health record.

Methods: Patients in 3 primary care clinics were surveyed. Self-report measures included demographics, trauma symptoms, ACE, and SDH elements. Participant health status and diagnoses were obtained from their electronic health records.

Results: The final sample of 354 participants reported high levels of trauma including PTSS and ACE. Educational attainment, health literacy, material hardship, access to health care, and ACE were all statistically associated with reports of PTSS (P < .05 for all). Despite the prevalence of symptoms and adverse experiences reported by the participants, only 5% were diagnosed with a trauma-related disorder in the electronic health record.

Conclusions: Data analyses revealed a significant discrepancy between participants’ reports of symptoms with a diagnosis of posttraumatic stress disorder by their primary care doctor. Trauma-impacted patients often present with complicated health problems that may influence the encounter in negative ways, including diminishing the primary care doctor’s sense of efficacy and competency if they are not addressed effectively in the encounter. The common nature of ACE, PTSS, and SDH effects indicate that both patients and physicians would benefit from detection and training in strategies for routinely implementing trauma-informed practices.

PMID:34139108 | DOI:10.4088/PCC.20m02781

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Risk factors, Treatment and Outcomes of Subacute Thyroiditis Secondary to COVID-19: A Systematic Review

Intern Med J. 2021 Jun 17. doi: 10.1111/imj.15432. Online ahead of print.

ABSTRACT

BACKGROUND: COVID-19 is known to cause an acute respiratory illness, although clinical manifestations outside of the respiratory tract may occur. Early reports have identified SARS-CoV-2 as a cause of subacute thyroiditis (SAT).

METHODS: A systematic review was conducted in accordance with the PRISMA guidelines. MEDLINE, Web of Science and PubMed databases were queried in February 2021 for studies from December 2019 to February 2021. MeSH search terms “COVID-19”, “SARS-CoV-2” and “coronavirus” along with search terms “thyroiditis”, “thyrotoxicosis”, “thyroid” were used. Descriptive statistics for continuous variables and proportions for categorical variables were calculated.

RESULTS: 15 publications reporting on 17 individual cases of COVID-19 induced SAT were identified. Age ranged from 18 to 69 years old. The majority of the cases were female (14 of 17, 82%). The delay between onset of respiratory symptoms and diagnosis of SAT ranged from 5 to 49 days (mean, 26.5). Systemic inflammatory response syndrome (SIRS) related to viral infection was uncommonly reported at the time of SAT diagnosis. Thyroid ultrasonography frequently reported an enlarged hypoechoic thyroid with decreased vascularity and heterogenous echotexture. Elevated CRP was common at the time of SAT diagnosis, with results ranging from 4.5 to 176 mg/L (mean, 41 mg/L). Anti-thyroid antibodies were frequently negative. SAT specific treatment included corticosteroids for 12/17 (70.5%) patients. Most return to normal thyroid status.

CONCLUSION: COVID-19 associated SAT may be difficult to identify in a timely manner due to potential absence of classic symptoms, as well as cross-over of common clinical features between COVID-19 and thyrotoxicosis. This article is protected by copyright. All rights reserved.

PMID:34139048 | DOI:10.1111/imj.15432

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Mindfulness-based interventions for psychological wellbeing and quality of life in men with prostate cancer: A systematic review and meta-analysis

Psychooncology. 2021 Jun 11. doi: 10.1002/pon.5749. Online ahead of print.

ABSTRACT

OBJECTIVE: Mindfulness-based interventions (MBIs) are increasingly being encouraged for managing treatment-related symptoms but much less is known about the extent to which mindfulness is effective in relieving the psychosocial distress experienced by men with prostate cancer. A systematic review was conducted to synthesise the literature on MBIs for psychological wellbeing and quality of life improvement in men with prostate cancer.

METHODS: Embase, CINAHL, MEDLINE, PsycINFO, PsycArticles and Web of Science were searched up to 7th November 2020. Included studies were assessed for quality using appropriate appraisal tools. Homogeneous study results were pooled in a meta-analysis while narrative synthesis was used to summarise the findings from heterogeneous results. Effect size was expressed as Cohen’s d (95% confidence intervals) and statistical significance (p-value) was set at 0.05.

RESULTS: Four studies comprising three randomised trials and one non-randomised study met the inclusion criteria. MBIs for men with prostate cancer showed small to moderate effect for improving psychological outcomes. The pooled result of quality of life and post-traumatic growth in study participants showed moderate (d = -0.29 [-1.29, 0.71], p = 0.57) and large (d = 0.77 [-0.33,1.88], p = 0.000) effects, respectively.

CONCLUSION: MBI is potentially promising for psychological outcomes, quality of life and post-traumatic growth symptoms improvement in men with prostate cancer but recommendations cannot be made based on current evidence due to limited research and inadequate methodological rigour of published literature. Robust research is needed to draw a reliable conclusion about its sustained effect in men with advanced disease.

PMID:34139035 | DOI:10.1002/pon.5749

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Adult Children’s Educational Attainment and Parent Health in Mid- and Later-Life

J Gerontol B Psychol Sci Soc Sci. 2021 Jun 17:gbab109. doi: 10.1093/geronb/gbab109. Online ahead of print.

ABSTRACT

OBJECTIVES: Intergenerational models of adult health contend that children’s educational attainments influence the health and well-being of their parents. However, it is unclear how much of this association is confounded by background characteristics that predict both children’s educational attainments and parents’ subsequent health, particularly in the U.S.

METHODS: Data from the National Longitudinal Study of Adolescent to Adult Health Parent Study are used to examine how having no children who completed college influences parents’ self-rated health and depressive symptoms. We rely on propensity score methods to more squarely assess this relationship net of potential confounding bias and to test for heterogeneity in the consequences associated with having no children who completed college.

RESULTS: Having no children who completed college is negatively associated with parents’ self-rated health and positively associated with depressive symptoms. After statistically balancing differences in background characteristics between groups, these associations remain, though the magnitude of the coefficients is attenuated. Supplemental matching analyses suggest that while the association between children’s education and self-rated health might be spurious, the association with depressive symptoms is more robust. Additionally, among parents with the highest propensity for having no children who complete college, the consequences on depressive symptoms are greatest.

DISCUSSION: This study pays particular attention to selection-related concerns surrounding the association between offspring educational attainment and parent well-being in the United States. These findings are important given the call for investments in children’s educational opportunities as promoting both the well-being of adult children and their parents.

PMID:34139008 | DOI:10.1093/geronb/gbab109