Categories
Nevin Manimala Statistics

What is the value of statistical testing of observational data?

Vet Surg. 2022 Jul 10. doi: 10.1111/vsu.13845. Online ahead of print.

ABSTRACT

Statistical analysis of medical data aims to reveal patterns that can aid in decision making for future cases and, hopefully, improve patient outcomes. Large and bias-free datasets, such as those produced in formal randomized clinical trials, are necessary to make such analyses as reliable as possible. For a host of reasons, randomized trials are, unfortunately, relatively uncommon in veterinary medicine and surgery, implying that less ideal datasets (mostly observational data) must form the basis for much of our decision making regarding treatment of individual patients under our care. In this review, we first describe the common shortcomings of many observational veterinary datasets when viewed in comparison with their optimal counterparts and highlight how the deficiencies can lead to unreliable conclusions. We illustrate how many of the interpretative problems associated with observational data, predominantly various forms of bias, are not solved, and may even be exacerbated, by statistical analysis. We emphasize the need to examine summary data and its derivation in detail without being lured into relying upon P values to draw conclusions and advocate for completely omitting statistical analysis of many observational datasets. Finally, we present some suggestions for alternative statistical methods, such as propensity scoring and Bayesian methods, which might help reduce the risk of drawing unwarranted, and overconfident, conclusions from imperfect data.

PMID:35810406 | DOI:10.1111/vsu.13845

Categories
Nevin Manimala Statistics

Influence of the seasonal and host related factors on the metazoan parasites of Chelon saliens (Mugilidae) in the Turkish coast of the Black Sea

Ann Parasitol. 2022;68(2):353-365. doi: 10.17420/ap6802.441.

ABSTRACT

The leaping mullet Chelon saliens is one of the economically significant fish species and the revealing its parasite fauna in relation with some ecological and host related factors will provide new data for our current knowledge. A total of 165 leaping mullet were collected from Sinop coasts of the Black Sea in the period from September 2015 to August 2016 and investigated for parasites. Eleven parasite species including Myxobolus parvus, Myxobolus sp., Sphaerospora mugilis (Myxozoa), Ligophorus szidati, Solostamenides mugilis (Monogenea), Schikhobalotrema sparisomae, Saccocoelium tensum, Saccocoelium obesum (Digenea), Hysterothylacium aduncum (Nematoda), Neoechinorhynchus sp. (Acanthocephala) and Ergasilus lizae (Copepoda) have been identified. The overall infection prevalence, mean intensity and mean abundance values were 65.5%, 26.2 and 17.2, respectively. The overall infection prevalence was dominated by L. szidati, followed by M. parvus and Digenea-group. On the other hand, the overall mean intensity values were dominated by Digenea-group, followed by L. szidati and E. lizae, respectively, while the mean abundance values were dominated by L. szidati, followed by Digenea-group and E. lizae. The infection indices of all identified parasites were also calculated in relation with length classes and sex of fish as well as season and the differences were evaluated statistically. Seasonally significant differences in the infection prevalence and mean abundance were found for Digenea-group, Ligophorus szidati and Neoechinorhynchus sp. These differences were also significant in the length classes of Digenea-group and Ligophorus szidati. This study is the first investigation on seasonal and host related dynamics of parasites of C. saliens in the southern coasts of the Black Sea and all investigated factors were found to influence the infection indices of dominating parasite species.

PMID:35810385 | DOI:10.17420/ap6802.441

Categories
Nevin Manimala Statistics

CXCL9 predicts the risk of osteoporotic hip fracture in a prospective cohort of Chinese men – a matched case-control study

J Bone Miner Res. 2022 Jul 10. doi: 10.1002/jbmr.4646. Online ahead of print.

ABSTRACT

Recent experimental work has identified CXCL9 as a promoter for the differentiation of osteoclast progenitors into osteoclasts, with resultant bone resorption. However, no human study has validated an association between this chemokine and osteoporosis or fracture risk. We conducted a matched case-control study nested in the prospective, population-based Singapore Chinese Health Study. Fifty-five men and 119 women with incident hip fractures, occurring median 6.2 years after blood collection, were matched individually to controls by age at recruitment, gender and duration of blood storage. Serum chemokines, CXCL9 and CXCL10, were measured using immunoassays. Multivariable conditional logistic regression models that included age at blood collection, body mass index, smoking and diabetes as covariates were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for association with hip fracture risk. Predictive utility of chemokine for hip fracture risk was examined by comparing area under receiver operating characteristic curves (AUC) between prognostic models with and without the chemokine. Increasing CXCL9 levels were associated with increasing hip fracture risk in men but not in women (Pinteraction =0.002). Comparing extreme quartiles, the OR (95% CI) in the highest quartile was 10.35 (1.90-56.39) in men (Ptrend =0.002) and 1.46 (0.59-3.60) in women (Ptrend =0.32). Adding CXCL9 to a prognostic model that already incorporated age and other risk factors improved the AUC (95% CI) from 0.65 (0.55-0.76) to 0.74 (0.65-0.83) for the predictive utility of hip fractures in men but not in women. Conversely, the association between CXCL10 and hip fracture risk was not statistically significant in either gender. This article is protected by copyright. All rights reserved.

PMID:35810382 | DOI:10.1002/jbmr.4646

Categories
Nevin Manimala Statistics

Effectiveness and safety of original and biosimilar etanercept (Enbrel® vs Benepali®) in bDMARD-naïve patients in a real-world cohort of Portugal

ARP Rheumatol. 2022 Apr-Jun;1(2):109-116.

ABSTRACT

OBJECTIVE: To compare the effectiveness and safety of original (Enbrel®) and biosimilar (Benepali®) etanercept in Biologic Disease-modifying Antirheumatic Drug (bDMARD)-naïve patients, measured by persistence rates over 36 months of follow-up.

METHODS: A retrospective multicentre observational study using data collected prospectively from The Rheumatic Diseases Portuguese Registry (Reuma.pt) was performed, including patients with: age ≥ 18 years old; diagnosis of Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA) or Spondyloarthritis (SpA) (axial or peripheral) with active disease and biologic-naïve who initiated treatment with etanercept as the first line biological treatment after 2010. Kaplan-Meyer and Cox regression were used to calculate the persistence rate in treatment. Disease activity at baseline and follow-up data at 6, 12, 18 and 24 months of treatment were compared. Causes for discontinuing therapy were summarized using descriptive statistics. Statistical significance was assumed for 2-sided p-values <0.05.

RESULTS: We included 1693 patients (413 on Benepali® and 1280 on Enbrel®): 864 diagnosed with RA, 335 with PsA and 494 with SpA. The 3-year persistence rates were not significantly different between both treatment groups in RA, PsA and SpA patients. In the adjusted Cox model, hazard ratios of discontinuation were not statistically different (p>0.05). The proportion of subjects in remission or low disease activity in each disease was similar in both groups. Overall, 535 (31.6%) patients discontinued etanercept (428 patients on Enbrel® and 107 patients on Benepali®). The major cause of discontinuation was inefficacy (57.8%). No differences for the occurrence of inefficacy or adverse effects were found between treatment groups.

CONCLUSIONS: Benepali® and Enbrel® demonstrated similar effectiveness and safety in RA, PsA and SpA in our cohort of patients. These data corroborate that the original and biosimilar drugs have similar quality characteristics and biological activity.

PMID:35810368

Categories
Nevin Manimala Statistics

Epidemiological features of cutaneous leishmaniosis and related factors in Bushehr province, southwest of Iran

Ann Parasitol. 2022;68(2):305-316. doi: 10.17420/ap6802.436.

ABSTRACT

Cutaneous leishmaniosis (CL) is one of the most important known infectious skin diseases, and Iran, as a country at high risk of leishmaniosis. This research was carried out to describe the epidemiological status of cutaneous leishmaniosis during 2011-2018 years in Bushehr province. Total, 929 cutaneous leishmaniosis patients were registered in the Bushehr province during this period. Data analysis was carried out using IBM SPSS Statistics, version 22. The data were analyzed using the descriptive statistics, Chi-square test, and Fisher’s exact test. The highest frequency was related to the age group of 1-10 years (35.1%). The patients consist (60.4%) males and (39.6%) females. The highest and lowest rates of disease were found in 2011 (16.3%) and 2017 (6.6%), respectively, and in January (16.6%) and September (3.2%), respectively. In terms of the ulcer number, (51%) of the cases had one ulcer, and (23%) had (3-5) ulcers. Dry ulcers made up (68.2%) of ulcers, while the wet ulcers made up (31.8%). The hands had accounted for (37%) of ulcers, the face for (25%), and the feet for (21%). Age of cases was significantly associated with the number and site of ulcers (P<0.001). As well, there was a significant relationship between gender and the number of ulcers (P<0.035). This eight-year study confirmed that in Iran, Bushehr province is one of the endemic areas for the cutaneous leishmaniosis. The increase in the patients in 2018, despite its decrease in previous years, is an alert for coming years. Effective disease prevention, control, and treatment measures are essential. Furthermore, the children, who are a vulnerable population, need the special care and treatment.

PMID:35810363 | DOI:10.17420/ap6802.436

Categories
Nevin Manimala Statistics

An open-label, 4-week, prospective clinical study evaluating the efficacy and safety of a novel targeted skin care line addressing five common skin conditions

J Cosmet Dermatol. 2022 Jul 10. doi: 10.1111/jocd.15223. Online ahead of print.

ABSTRACT

BACKGROUND: Common skin conditions, such as irritated, dry, aging and oily skin or dark eye circles with periorbital edema, usually do not require pharmaceutical therapy in form of dermatological drugs. They can, however, still affect the quality of life significantly. With the advent of newer cosmetics, a more targeted treatment of these dermatological conditions has become available to the public. There are few clinical studies investigating the efficacy and safety of cosmetics, leaving consumers exposed to potentially false claims of the cosmetic industry. This study aims to assess the efficacy and safety of a novel skin care series addressing the aforementioned five common skin conditions.

METHODS: This open-label, single-center, 4-week, prospective clinical study evaluated the efficacy and safety of five novel skin care formulations, each targeting one of five common skin issues in 176 study subjects. The primary endpoint parameters for the change of irritated skin, dark and puffy eyes, dry skin, aging skin and oily skin were assessed through validated questionnaires, scales and biomedical devices.

RESULTS: After four weeks of topical application of each formulation of a new targeted skin care, a significant improvement in all primary endpoints was detected. No undesirable effects occurred during this study.

CONCLUSION: This study showed a significant improvement of five common dermatological conditions with a novel targeted skin care series. Moreover, this study leads the way for an overdue critical assessment and certification of cosmetic product claims.

PMID:35810352 | DOI:10.1111/jocd.15223

Categories
Nevin Manimala Statistics

The relationship between nurses’ professional values and caring behaviors

Nurs Forum. 2022 Jul 10. doi: 10.1111/nuf.12778. Online ahead of print.

ABSTRACT

INTRODUCTION: Professional values give meaning and direction to clinical practices by providing a philosophical framework for nursing practices. The internalization of professional values is quite effective in providing professional service and is very important in terms of service quality.

DESIGN: This descriptive study has been conducted to determine the relationship between nurses’ professional values and caring behaviors.

METHODS: A total of 176 nurses participated who worked in hospitals in this study. The data were collected online using the Nurse Information Form, Nurses Professional Values Scale-Revised (NPVS-R), and Caring Behaviors Assessment Tool Nursing Version-Short Form (CBAN-SF). Data analysis was performed using SPSS software, the Mann-Whitney U test, the Kruskall-Wallis test, and the Spearman correlation coefficient.

RESULTS: Of the nurses participating in the study, 66.5% are between the ages of 21-30, 80.7% are female, and 71% are university graduates. No statistically significant difference was found regarding professional values between the mean scores from the NPVS-R and CBAN-SF in terms of the nurses’ age, gender, position, working style, clinic at which they work, or their educational status. The nurses scored high on the NPVS-R and CBAN. A moderate, significant, and positive relationship was found between nurses’ overall scores on the NPVS-R and CBAN-SF.

CONCLUSION: As nurses’ perceptions of professional values increase, their perception toward assessing care behaviors also increases. In addition, a relationship exists between nurses’ education levels and assessment of care behaviors and between their work experience and their perceptions of professional values. Conducting studies on the subject using different designs is recommended.

PMID:35810340 | DOI:10.1111/nuf.12778

Categories
Nevin Manimala Statistics

Repetitive DNA symmetry elements negatively regulate gene expression in embryonic stem cells

Biophys J. 2022 Jul 8:S0006-3495(22)00557-4. doi: 10.1016/j.bpj.2022.07.011. Online ahead of print.

ABSTRACT

Transcription factor (TF) binding to genomic DNA elements constitutes one of the key mechanisms that regulates gene expression program in cells. Both consensus and non-consensus DNA sequence elements influence the recognition specificity of TFs. Based on the analysis of experimentally determined c-Myc binding preferences to genomic DNA, here we statistically predict that certain repetitive, non-consensus DNA symmetry elements can relatively reduce TF-DNA binding preferences. This is in contrast to a different set of repetitive, non-consensus symmetry elements that can increase the strength of TF-DNA binding. Using c-Myc enhancer reporter system containing consensus motif flanked by non-consensus sequences in embryonic stem cells (ESCs), we directly demonstrate that the enrichment in such negatively regulating repetitive symmetry elements is sufficient to reduce the gene expression level as compared with native genomic sequences. Negatively regulating repetitive symmetry elements around consensus c-Myc motif and DNA sequences containing consensus c-Myc motif flanked by entirely randomized sequences show similar expression baseline. A possible explanation for this observation is that rather than complete repression, negatively regulating repetitive symmetry elements play a regulatory role in fine-tuning the reduction of gene expression, most probably by binding TFs other than c-Myc.

PMID:35810331 | DOI:10.1016/j.bpj.2022.07.011

Categories
Nevin Manimala Statistics

Structural brain network measures in elderly patients with cerebral small vessel disease and depressive symptoms

BMC Geriatr. 2022 Jul 9;22(1):568. doi: 10.1186/s12877-022-03245-7.

ABSTRACT

OBJECTIVES: To investigate the relationship between diffusion tensor imaging (DTI) indicators and cerebral small vessel disease (CSVD) with depressive states, and to explore the underlying mechanisms of white matter damage in CSVD with depression.

METHOD: A total of 115 elderly subjects were consecutively recruited from the neurology clinic, including 36 CSVD patients with depressive state (CSVD+D), 34 CSVD patients without depressive state (CSVD-D), and 45 controls. A detailed neuropsychological assessment and multimodal magnetic resonance imaging (MRI) were performed. Based on tract-based spatial statistics (TBSS) analysis and structural network analysis, differences between groups were compared, including white matter fiber indicators (fractional anisotropy and mean diffusivity) and structural brain network indicators (global efficiency, local efficiency and network strength), in order to explore the differences and correlations of DTI parameters among the three groups.

RESULTS: There were no significant differences in terms of CSVD burden scores and conventional imaging findings between the CSVD-D and CSVD+D groups. Group differences were found in DTI indicators (p < 0.05), after adjusting for age, gender, education level, and vascular risk factors (VRF), there were significant correlations between TBSS analysis indicators and depression, including: fractional anisotropy (FA) (r = – 0.291, p < 0.05), mean diffusivity (MD) (r = 0.297, p < 0.05), at the same time, between structural network indicators and depression also show significant correlations, including: local efficiency (ELocal) (r = – 0.278, p < 0.01) and network strength (r = – 0.403, p < 0.001).

CONCLUSIONS: Changes in FA, MD values and structural network indicators in DTI parameters can predict the depressive state of CSVD to a certain extent, providing a more direct structural basis for the hypothesis of abnormal neural circuits in the pathogenesis of vascular-related depression. In addition, abnormal white matter alterations in subcortical neural circuits probably affect the microstructural function of brain connections, which may be a mechanism for the concomitant depressive symptoms in CSVD patients.

PMID:35810313 | DOI:10.1186/s12877-022-03245-7

Categories
Nevin Manimala Statistics

Oral ecological environment modifications by hard-cheese: from pH to microbiome: a prospective cohort study based on 16S rRNA metabarcoding approach

J Transl Med. 2022 Jul 9;20(1):312. doi: 10.1186/s12967-022-03506-4.

ABSTRACT

BACKGROUND: The oral ecosystem conditions dental health, and is known to be positively modified by oral hygiene which cannot always be performed between meals, especially outside home. It is therefore important to identify the practices to be adopted to influence the oral environment in an anticariogenic direction. Milk and cheese are considered functional foods and have a role on oral health. There are several mechanisms by which cheese exerts its beneficial effects on teeth. The aim of the present study was to examine whether short term consumption of hard cheese would affect the oral pH and microbial flora of healthy adults modifying ecological oral environment. The Next Generation Sequencing (NGS) approach was applied to study the effect of Italian Grana Padano (GP), as a prototype of typical hard cheese, on the oral microbiota composition. Finally, we explored Streptococcus mutans/sanguinis ratio as a marker of protective biofilm composition.

METHODS: Nine oral-healthy adults were instructed to eat 25 gr of GP cheese for 5 consecutive days. Three time points were chosen for supragingival samples collection and pH measurement. 16S rRNA-gene sequences were obtained both from oral samples and GP cheese using the MiSeq platform and analyzed against the expanded Human Oral Microbiome Database (eHOMD). ProgPerm was used to perform statistical analyses to investigate strain differential representation after cheese consumption.

RESULTS: Taxonomic analyses of the oral microbiota revealed that Firmicutes was the most abundant phylum, followed by Proteobacteria and Actinobacteria. GP cheese significantly modifies oral pH, causing a shift toward basic conditions which are kept for a few hours. The Streptococcus mutans/Streptococcus sanguinis ratio lowers in the last observed timepoint.

CONCLUSION: Our results reveal that a portion of GP cheese eaten after dinner provides important micronutrients (i.e. calcium, vitamins and some aminoacids such as arginine) and changes oral pH toward basic conditions, resulting in a light modification of the oral microbiome towards the reduction of the overall amount of acidophilic bacteria. Furthermore, the S. mutans/S. sanguinis ratio is reduced, contributing to obtain a more protecting environment towards caries establishment and evolution.

PMID:35810305 | DOI:10.1186/s12967-022-03506-4