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Nevin Manimala Statistics

Comparison of blood pressure measurements on the bare and sleeved arms – what does it uncover?

Blood Press Monit. 2023 Jun 19. doi: 10.1097/MBP.0000000000000660. Online ahead of print.

ABSTRACT

Accurate office blood pressure (BP) measurement remains crucial in diagnosing and managing hypertension. In this study, we aimed to compare BP measurements done over a bare arm versus a sleeved arm, while controlling all other possible sources of variance. We collected BP measurements of 100 hypertensive patients visiting a nephrology and hypertension clinic between January 2019 and December 2023. Measurements were taken by a single operator and according to the updated guidelines. BP measurements were performed first with one arm bare, and the other arm sleeved, with measurements taken simultaneously. Then, measurements were again taken simultaneously after exposing the arm which was first sleeved, and dressing the arm which was bare at first. a nonparametric Wilcoxon was performed to compare each patient’s measurements on each arm. No statistically significant differences were found between the sleeved and the bare arm measurements, with one exception of SBP measured on the left arm (slightly lower SBP on the bare arm). While looking at the absolute value of differences, the median difference was impressive with a 7-8 mmHg systolic difference and 5.5 mmHg diastolic difference. Our study revealed a robust and unpredicted effect of clothing on BP; in some patients, BP was increased while in others decreased. Therefore, we believe there is importance in measuring BP on bare skin, regardless of clothing or sleeve type.

PMID:37334547 | DOI:10.1097/MBP.0000000000000660

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Nevin Manimala Statistics

Characterization of left ventricular diastolic parameters of gated-single-photon emission computed tomography myocardial perfusion imaging in patients with diabetes and normal myocardial perfusion and systolic function

Nucl Med Commun. 2023 Jun 19. doi: 10.1097/MNM.0000000000001721. Online ahead of print.

ABSTRACT

BACKGROUND: Diabetic cardiomyopathy is defined as an independent entity with a specified pathological progression from diastolic dysfunction with preserved ejection fraction to overt heart failure. Myocardial perfusion imaging (MPI) with gated-single-photon emission computed tomography (G-SPECT) has been introduced as a feasible tool to evaluate left ventricular (LV) diastolic function. The aim of this study was to investigate the characteristics of diastolic parameters derived from G-SPECT MPI in diabetic patients compared to patients at very low risk of coronary artery disease (CAD) and with no other CAD risk factors.

METHODS: This cross-sectional study was performed on patients referred to the nuclear medicine department for G-SPECT MPI. Demographic and clinical data, as well as medical history, were extracted from a digital registry system including 4447 patients. Then, two matched groups of patients with only diabetes as cardiac risk factor (n = 126) and those without any identifiable CAD risk factors (n = 126) were selected. Diastolic parameters of MPI, including peak filling rate, time to peak filling rate, mean filling rate at the first third of diastole and second peak filling rate, were derived using quantitative software for eligible cases.

RESULTS: The mean age of the diabetic and nondiabetic groups was 57.1 ± 14.9 and 56.7 ± 10.6 years, respectively (P = 0.823). Comparison of quantitative SPECT MPI parameters between the two groups showed a statistically significant difference only in total perfusion deficit scores, whereas none of the functional parameters, including diastolic and dyssynchrony indices and the shape index, were significantly different. There were also no significant differences in diastolic function parameters between diabetes and nondiabetes patients in the age and gender subgroups.

CONCLUSION: Based on the G-SPECT MPI findings, there is a comparable prevalence of diastolic dysfunction in patients with only diabetes as a cardiovascular risk factor and low-risk patients with no cardiovascular risk factors in the setting of normal myocardial perfusion and systolic function.

PMID:37334545 | DOI:10.1097/MNM.0000000000001721

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Nevin Manimala Statistics

A prediction model on incident chronic kidney disease among individuals with type 2 diabetes in the United States

Diabetes Obes Metab. 2023 Jun 19. doi: 10.1111/dom.15177. Online ahead of print.

ABSTRACT

AIM: Early identification of incident chronic kidney disease (CKD) in individuals with diabetes may help improve patients’ clinical outcomes. This study aimed to develop a prediction equation for incident CKD among people with type 2 diabetes (T2D).

MATERIALS AND METHODS: A time-varying Cox model was applied to data from the ACCORD trial to predict the risk of incident CKD. A list of candidate variables was chosen based on literature reviews and experts’ consultations, including demographic characteristics, vitals, laboratory results, medical history, drug use and health care utilization. Model performance was evaluated. Decomposition analysis was conducted, and external validation was performed.

RESULTS: In total, 6006 patients with diabetes free of CKD were included, with a median follow-up of 3 years and 2257 events. The risk model included age at T2D diagnosed, smoking status, body mass index, high-density lipoprotein, very-low-density lipoprotein, alanine aminotransferase, estimated glomerular filtration rate, urine albumin-creatinine ratio, hypoglycaemia, retinopathy, congestive heart failure, coronary heart disease history, antihyperlipidaemic drug use, antihypertensive drug use and hospitalization. The urine albumin-creatinine ratio, estimated glomerular filtration rate and congestive heart failure were the top three factors that contributed most to the incident CKD prediction. The model showed acceptable discrimination [C-statistic: 0.772 (95% CI 0.767-0.805)] and calibration [Brier Score: 0.0504 (95% CI 0.0477-0.0531)] in the Harmony Outcomes Trial.

CONCLUSION: Incident CKD prediction among individuals with T2D was developed and validated for use in decision support of CKD prevention.

PMID:37334525 | DOI:10.1111/dom.15177

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Nevin Manimala Statistics

Coherent decision making stimulated within the social laser: open quantum systems framework

Philos Trans A Math Phys Eng Sci. 2023 Aug 7;381(2252):20220294. doi: 10.1098/rsta.2022.0294. Epub 2023 Jun 19.

ABSTRACT

We start with a brief review on social laser theory which is newly framed with the notion of an infon-social energy quantum carrying coarse-grained information content. Infons are the excitations of the quantum social-information field. Humans are analogues of atoms-social atoms absorbing and emitting infons. Another new development is coupling of the social laser with the decision making model based on open quantum systems. The role of the environment for social atoms is played by the strong coherent social-information field-the output of social lasing. We analyse a simple quantum master equation generating decision jumps towards the coherent decision directed by the social laser beam. As an illustrative example, we analyse the possibility to create a societal benefit laser, i.e. directed for societal benefit. This article is part of the theme issue ‘Thermodynamics 2.0: Bridging the natural and social sciences (Part 1)’.

PMID:37334450 | DOI:10.1098/rsta.2022.0294

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Nevin Manimala Statistics

Philosophy of thermodynamics

Philos Trans A Math Phys Eng Sci. 2023 Aug 7;381(2252):20220281. doi: 10.1098/rsta.2022.0281. Epub 2023 Jun 19.

ABSTRACT

Thermodynamics is regarded as a universal but not foundational theory because its laws for macroscopic quantities have not been derived from microscopic entities. Thus, to root thermodynamics into the fundamental substance, atomism is revived, thinking that the light quantum is the indivisible and permanent element. Assuming the same basic building blocks constitute everything, the state of any system can be quantified by entropy, the logarithmic probability measure multiplied by Boltzmann’s constant. Then, the change in entropy expresses the system’s evolution toward thermodynamic balance with its surroundings. These natural processes consuming free energy in the least time accumulate sigmoidally, resulting in skewed distributions found throughout nature. In this way, thermodynamics makes sense of phenomena across disciplines and provides a holistic worldview to address questions such as what the world is, how we know about it, what is the meaning of life and how we should live. This article is part of the theme issue ”Thermodynamics 2.0: Bridging the natural and social sciences (Part 1)’.

PMID:37334448 | DOI:10.1098/rsta.2022.0281

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Nevin Manimala Statistics

Breast cancer, alcohol, and phosphate toxicity

J Appl Toxicol. 2023 Jun 18. doi: 10.1002/jat.4504. Online ahead of print.

ABSTRACT

Alcohol consumption is associated with an increased risk of breast cancer, even at low alcohol intake levels, but public awareness of the breast cancer risk associated with alcohol intake is low. Furthermore, the causative mechanisms underlying alcohol’s association with breast cancer are unknown. The present theoretical paper uses a modified grounded theory method to review the research literature and propose that alcohol’s association with breast cancer is mediated by phosphate toxicity, the accumulation of excess inorganic phosphate in body tissue. Serum levels of inorganic phosphate are regulated through a network of hormones released from the bone, kidneys, parathyroid glands, and intestines. Alcohol burdens renal function, which may disturb the regulation of inorganic phosphate, impair phosphate excretion, and increase phosphate toxicity. In addition to causing cellular dehydration, alcohol is an etiologic factor in nontraumatic rhabdomyolysis, which ruptures cell membranes and releases inorganic phosphate into the serum, leading to hyperphosphatemia. Phosphate toxicity is also associated with tumorigenesis, as high levels of inorganic phosphate within the tumor microenvironment activate cell signaling pathways and promote cancer cell growth. Furthermore, phosphate toxicity potentially links cancer and kidney disease in onco-nephrology. Insights into the mediating role of phosphate toxicity may lead to future research and interventions that raise public health awareness of breast cancer risk and alcohol consumption.

PMID:37332052 | DOI:10.1002/jat.4504

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Nevin Manimala Statistics

Correction: Quality Tolerance Limits’ Place in the Quality Management System and Link to the Statistical Trial Design: Case Studies and Recommendations from Early Adopters

Ther Innov Regul Sci. 2023 Jun 10. doi: 10.1007/s43441-023-00546-w. Online ahead of print.

NO ABSTRACT

PMID:37332050 | DOI:10.1007/s43441-023-00546-w

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Nevin Manimala Statistics

miR-155 and miR-92 levels in ALL, post-transplant aGVHD, and CMV: possible new treatment options

J Egypt Natl Canc Inst. 2023 Jun 19;35(1):18. doi: 10.1186/s43046-023-00174-3.

ABSTRACT

BACKGROUND: Acute lymphoblastic leukemia (ALL) is a malignancy that leads to altered blast cell proliferation, survival, and maturation and eventually to the lethal accumulation of leukemic cells. Recently, dysregulated expression of various micro-RNAs (miRNAs) has been reported in hematologic malignancies, especially ALL. Cytomegalovirus infection can induce ALL in otherwise healthy individuals, so a more detailed evaluation of its role in ALL-endemic areas like Iran is required.

METHODS: In this cross-sectional study, 70 newly diagnosed adults with ALL were recruited. The expression level of microRNA-155(miR-155) and microRNA-92(miR-92) was evaluated by real-time SYBR Green PCR. The correlations between the miRNAs mentioned above and the severity of disease, CMV infection, and acute graft vs. host disease after hematopoietic stem cell transplantation (HSCT) were assessed. B cell and T cell ALL distinction in the level of miRNAs was provided.

RESULTS: After the statistical analysis, our results indicated a marked increase in the expression of miR-155 and miR-92 in ALL patients vs. healthy controls (*P = 0.002-*P = 0.03, respectively). Also, it was shown that the expression of miR-155 and miR-92 was higher in T cell ALL compared to B cell ALL (P = 0.01-P = 0.004, respectively), CMV seropositivity, and aGVHD.

CONCLUSION: Our study suggests that the plasma signature of microRNA expression may act as a powerful marker for diagnosis and prognosis, providing knowledge outside cytogenetics. Elevation of miR-155 in plasma can be a beneficial therapeutic target for ALL patients, with consideration of higher plasma levels of miR-92 and miR-155 in CMV + and post-HSCT aGVHD patients.

PMID:37332027 | DOI:10.1186/s43046-023-00174-3

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Nevin Manimala Statistics

Leveraging trans-ethnic genetic risk scores to improve association power for complex traits in underrepresented populations

Brief Bioinform. 2023 Jun 17:bbad232. doi: 10.1093/bib/bbad232. Online ahead of print.

ABSTRACT

Trans-ethnic genome-wide association studies have revealed that many loci identified in European populations can be reproducible in non-European populations, indicating widespread trans-ethnic genetic similarity. However, how to leverage such shared information more efficiently in association analysis is less investigated for traits in underrepresented populations. We here propose a statistical framework, trans-ethnic genetic risk score informed gene-based association mixed model (GAMM), by hierarchically modeling single-nucleotide polymorphism effects in the target population as a function of effects of the same trait in well-studied populations. GAMM powerfully integrates genetic similarity across distinct ancestral groups to enhance power in understudied populations, as confirmed by extensive simulations. We illustrate the usefulness of GAMM via the application to 13 blood cell traits (i.e. basophil count, eosinophil count, hematocrit, hemoglobin concentration, lymphocyte count, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, mean corpuscular volume, monocyte count, neutrophil count, platelet count, red blood cell count and total white blood cell count) in Africans of the UK Biobank (n = 3204) while utilizing genetic overlap shared in Europeans (n = 746 667) and East Asians (n = 162 255). We discovered multiple new associated genes, which had otherwise been missed by existing methods, and revealed that the trans-ethnic information indirectly contributed much to the phenotypic variance. Overall, GAMM represents a flexible and powerful statistical framework of association analysis for complex traits in underrepresented populations by integrating trans-ethnic genetic similarity across well-studied populations, and helps attenuate health inequities in current genetics research for people of minority populations.

PMID:37332016 | DOI:10.1093/bib/bbad232

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Nevin Manimala Statistics

Emotional empowerment through information research and communication to reduce fear of COVID-19 among nursing students: a randomised controlled trial

BMC Nurs. 2023 Jun 19;22(1):209. doi: 10.1186/s12912-023-01370-1.

ABSTRACT

BACKGROUND: Despite an existing body of literature on anxiety reduction using multi-component methods, little is known about the effect of active student participation in research and communication of scientific information on anxiety and fear reduction. The aim of this study is to evaluate the impact of quality scientific information research and the production of informative videos on the preventive aspects of COVID-19 on fear and anxiety reduction.

METHODS: A randomised controlled trial was conducted with 220 undergraduate nursing students in the first year of the nursing degree. The participating students were randomised into two groups. The experimental group carried out an intervention based on a database search for information on preventing COVID-19 and production of a video giving scientific reasons why prevention measures should be followed. In the control group, students created posters and videos about theoretical aspects of one module of the nursing degree. Both groups were surveyed before and after the intervention, measuring their state of resilience, preventive behaviours, level of anxiety, and fear of COVID-19.

RESULTS: The intervention group showed a greater decrease in fear levels after the intervention than those in the control group. There were no differences between the groups in terms of resilience, preventive behaviours, or anxiety. In the experimental group, there was a significant decrease in anxiety levels and fear levels after the intervention compared to the baseline levels.

CONCLUSIONS: An intervention based on active participation in searches for high-quality scientific information and production of information videos on COVID-19 prevention reduced fear and anxiety caused by COVID-19 among nursing students.

TRIAL REGISTRATION: We have retrospectively registered the trial in Open Science Framework and the identification number is https://doi.org/10.17605/OSF.IO/6QU5S .

PMID:37332015 | DOI:10.1186/s12912-023-01370-1