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Nevin Manimala Statistics

Serum Citrulline and Ornithine: Potential Markers of Coeliac Disease Activity

Acta Medica (Hradec Kralove). 2022;65(3):75-82. doi: 10.14712/18059694.2022.22.

ABSTRACT

INTRODUCTION: To date, there is not generally accepted and universal indicator of activity, and functional integrity of the small intestine in patients with coeliac disease. The aim of our study was to investigate whether serum concentrations of the non-essential amino acids citrulline and ornithine might have this function.

METHODS: We examined serum citrulline and ornithine concentrations in a subgroup of patients with proven coeliac disease and healthy controls (blood donors).

RESULTS: A total of 94 patients with coeliac disease (29 men, mean age 53 ± 18 years; 65 women, mean age 44 ± 14 years) and 35 healthy controls (blood donors) in whom coeliac disease was serologically excluded (10 men, mean age 51 ± 14 years; 25 women, mean age 46 ± 12 years) were included in the study. Significantly lower concentrations of serum ornithine were found in patients with coeliac disease (mean 65 ± 3 μmol/L; median 63 μmol/L, IQR 34 μmol/L, p < 0.001). No statistically nor clinically significant differences were found in the citrulline concentrations between the study and control group.

CONCLUSIONS: Serum ornithine (but not citrulline) may be useful for assessing the functional status of the small intestine in uncomplicated coeliac disease. Further studies involving more detailed analysis of dietary and metabolic changes in patients will be needed to reach definitive conclusions.

PMID:36735884 | DOI:10.14712/18059694.2022.22

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Nevin Manimala Statistics

Response adaptive randomization design for a two-stage study with binary response

J Biopharm Stat. 2023 Feb 3:1-11. doi: 10.1080/10543406.2023.2170399. Online ahead of print.

ABSTRACT

Response adaptive randomization has the potential to treat more participants in better treatments in a trial to benefit participants. We propose optimal response adaptive randomization designs for a two-stage study with binary response, having the smallest expected sample size or the fewest expected number of failures. Equal randomization is used in the first stage, and data from the first stage is used to determine the adaptive sample size ratio in the second stage. In the proposed optimal designs, the type I error rate and the statistical power are calculated from the asymptotic normal distributions. The new designs that minimize the expected number of failures have the advantage over the existing optimal randomized designs to substantially reduce the number of failures.

PMID:36735855 | DOI:10.1080/10543406.2023.2170399

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Nevin Manimala Statistics

A Protection Motivation Perspective among Public Users on the Utilization of COVID-19 Mobile Tracing Apps: An Empirical Study

JMIR Form Res. 2023 Jan 24. doi: 10.2196/36608. Online ahead of print.

ABSTRACT

BACKGROUND: Access to data is crucial for decision-making; this fact has become more evident during the pandemic. Data collected using mobile applications can positively influence diagnosis and treatment, the supply chain, and staffing resources of healthcare facilities. Developers and healthcare professionals have worked to create applications that can track a person’s COVID status. For example, these applications can monitor positive COVID test results and vaccination status. Regrettably, people may be concerned about sharing their data with government or private sector organizations developing applications. Understanding user perceptions is essential; without substantial user adoption and the use of mobile tracing apps, the benefits cannot be achieved.

OBJECTIVE: This study aims to assess the factors that positively and negatively affect the use of COVID-tracing apps by examining individuals’ perceptions about sharing data on mobile applications, such as testing regularity, infection, and immunization status.

METHODS: The hypothesized research model was tested using a cross-sectional survey instrument. The survey contained five reflective constructs and four control variables selected after reviewing the literature and interviewing healthcare professionals. A digital copy of the survey was created using Qualtrics. After receiving approval from Institutional Board Review (IRB). Data was collected from 367 participants through Amazon Mechanical Turk (MTurk). The inclusion criteria for participants to complete the anonymized survey included those of any gender who were 18 years and older. We then analyzed the theoretical model using structural equation modeling (SEM).

RESULTS: After analyzing the quality of responses, n=325 participants, 66.46% were male (n=216), and 33.53% were female (n=109). Of the participants in the final dataset, 72.61% were employed. The results of the structural equation modeling showed that perceived vulnerability (β = 0.688, p < .001), Self-efficacy (β = 0.292, p < .001), and an individual’s prior infection with COVID (β = 0.194, p < .05) have statistically significant positive impacts on the intention to use mobile tracing apps. Privacy concerns (β = -0.360, p < .001), risk aversion (β = -0.150, p < .1), and a family members prior infection with COVID (β = – 0.139, p < .05) have statistically significant negative influences on a person’s intention to use mobile tracing apps.

CONCLUSIONS: This study illustrates that various user perceptions affect whether individuals utilize COVID-tracing applications technology. By working collaboratively on legislation and the messaging provided to potential users before releasing an application, developers, healthcare professionals, and policymakers can improve the use of tracking apps. Healthcare professionals need to emphasize disease vulnerability to motivate people to utilize mobile tracing apps which can help reduce the spread of viruses and diseases. In addition, more work is needed at the policy-making level to protect the privacy of users which in return can increase user engagement.

PMID:36735838 | DOI:10.2196/36608

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Nevin Manimala Statistics

Management of the Inferior Alveolar Nerve in Large Sagittal Split Advancements: To Free or Not?

Plast Reconstr Surg. 2023 Feb 2. doi: 10.1097/PRS.0000000000010280. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate whether neurosensory recovery of the inferior alveolar nerve (IAN) is influenced by its location following sagittal split osteotomy (SSO) in patients undergoing large mandibular movements.

METHODS: This was a prospective, split-mouth study of skeletally mature patients undergoing BSSO. Patients were included as study subjects if they underwent BSSO for mandibular advancement > 10 mm and, following the splits, the IAN was freely entering the distal segment (IANDI) on one side and within the proximal segment (IANPR) on the other. Descriptive, bivariate, and Kaplan-Meier statistics were computed.

RESULTS: The study sample included 13 subjects (8 female, mean age 18.7 ± 1.8 years) undergoing 26 SSOs. Eleven subjects underwent bimaxillary surgery; 10 had simultaneous genioplasty. The mean mandibular movement was 12.2 ± 1.4 mm and was not significantly different between sides (p = 0.43). All subjects achieved FSR bilaterally within 1 year of surgery. There was no difference in the median times to FSR based upon the location of the IAN (IANDI = 105 days vs IANPR = 126 days, p = 0.57).

CONCLUSION: In SSO for mandibular advancement with movements > 10 mm, leaving the IAN within the proximal segment may not impact time to FSR.

PMID:36735814 | DOI:10.1097/PRS.0000000000010280

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Nevin Manimala Statistics

Efficacy of Platelet-Rich Plasma Versus Autologous Fat Transfer With Nanofat in the Treatment of Infraorbital Dark Circles: A Single-Blinded Randomized Comparative Clinical Trial

Dermatol Surg. 2023 Feb 2. doi: 10.1097/DSS.0000000000003697. Online ahead of print.

ABSTRACT

BACKGROUND: Treating infraorbital dark circles is one of the commonest aesthetic demands worldwide. Autologous fat transfer is commonly used to treat dark circles by filling the grooves, without effect on skin quality. Platelet-rich plasma has been reported to improve skin quality. Autologous fat can be emulsified and filtered to produce nanofat, which is then injected superficially in the dark circles to improve skin quality and discoloration.

OBJECTIVE: To compare the efficacy of platelet-rich plasma versus combined fat transfer and nanofat in treating infraorbital dark circles.

MATERIALS AND METHODS: 30 patients with infraorbital dark circles of combined etiological factors were randomized into 2 equal groups: Group A treated with platelet-rich plasma and Group B treated with autologous fat transfer with emulsified fat injection.

RESULTS: Excellent and moderate responses were observed in 3 (20%) and 2 (13%) patients in group A versus 7 (46.7%) and 4 (27%) in group B, respectively. Nonresponders were 8 (53.3%) in group A and only 1 patient (6.7%) in group B. The difference was statistically significant regarding improvement (p = .048) and patient satisfaction (p = .032).

CONCLUSION: Autologous fat transfer with nanofat is significantly superior to platelet-rich plasma in improvement and satisfaction.

PMID:36735798 | DOI:10.1097/DSS.0000000000003697

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Nevin Manimala Statistics

LSD-induced increase of Ising temperature and algorithmic complexity of brain dynamics

PLoS Comput Biol. 2023 Feb 3;19(2):e1010811. doi: 10.1371/journal.pcbi.1010811. Online ahead of print.

ABSTRACT

A topic of growing interest in computational neuroscience is the discovery of fundamental principles underlying global dynamics and the self-organization of the brain. In particular, the notion that the brain operates near criticality has gained considerable support, and recent work has shown that the dynamics of different brain states may be modeled by pairwise maximum entropy Ising models at various distances from a phase transition, i.e., from criticality. Here we aim to characterize two brain states (psychedelics-induced and placebo) as captured by functional magnetic resonance imaging (fMRI), with features derived from the Ising spin model formalism (system temperature, critical point, susceptibility) and from algorithmic complexity. We hypothesized, along the lines of the entropic brain hypothesis, that psychedelics drive brain dynamics into a more disordered state at a higher Ising temperature and increased complexity. We analyze resting state blood-oxygen-level-dependent (BOLD) fMRI data collected in an earlier study from fifteen subjects in a control condition (placebo) and during ingestion of lysergic acid diethylamide (LSD). Working with the automated anatomical labeling (AAL) brain parcellation, we first create “archetype” Ising models representative of the entire dataset (global) and of the data in each condition. Remarkably, we find that such archetypes exhibit a strong correlation with an average structural connectome template obtained from dMRI (r = 0.6). We compare the archetypes from the two conditions and find that the Ising connectivity in the LSD condition is lower than the placebo one, especially in homotopic links (interhemispheric connectivity), reflecting a significant decrease of homotopic functional connectivity in the LSD condition. The global archetype is then personalized for each individual and condition by adjusting the system temperature. The resulting temperatures are all near but above the critical point of the model in the paramagnetic (disordered) phase. The individualized Ising temperatures are higher in the LSD condition than the placebo condition (p = 9 × 10-5). Next, we estimate the Lempel-Ziv-Welch (LZW) complexity of the binarized BOLD data and the synthetic data generated with the individualized model using the Metropolis algorithm for each participant and condition. The LZW complexity computed from experimental data reveals a weak statistical relationship with condition (p = 0.04 one-tailed Wilcoxon test) and none with Ising temperature (r(13) = 0.13, p = 0.65), presumably because of the limited length of the BOLD time series. Similarly, we explore complexity using the block decomposition method (BDM), a more advanced method for estimating algorithmic complexity. The BDM complexity of the experimental data displays a significant correlation with Ising temperature (r(13) = 0.56, p = 0.03) and a weak but significant correlation with condition (p = 0.04, one-tailed Wilcoxon test). This study suggests that the effects of LSD increase the complexity of brain dynamics by loosening interhemispheric connectivity-especially homotopic links. In agreement with earlier work using the Ising formalism with BOLD data, we find the brain state in the placebo condition is already above the critical point, with LSD resulting in a shift further away from criticality into a more disordered state.

PMID:36735751 | DOI:10.1371/journal.pcbi.1010811

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Nevin Manimala Statistics

Factors influencing intention to participate in breast cancer screening. An exploratory structural model

PLoS One. 2023 Feb 3;18(2):e0281454. doi: 10.1371/journal.pone.0281454. eCollection 2023.

ABSTRACT

OBJECTIVES: The paper has two objectives. The first one examines whether informing women about the benefits and adverse effects of breast cancer screening could have an effect on three variables: their knowledge, the importance women attach to the future consequences of their current decisions (time perspective), and the degree to which women are worried about developing breast cancer (worry). The second one examines whether these three variables affect their intention to participate in the screening, either directly or indirectly through their feeling of regret if they do not attend the screening (anticipated regret); through their values and the support they receive in making their decisions (decisional conflict); and, through the perceived acceptability and benefits of the screening programme (attitude).

METHODS: Partial least squares-structural equation modelling (PLS-SEM) is used to analyse both objectives and to differentiate between direct, indirect, and moderating effects, due to the incorporation in the model of the three mediating variables (anticipated regret, decisional conflict, and attitude) and a moderating variable (educational level).

RESULTS: Information affects knowledge (objective variable), but not the behavioural variables (time perspective and worry). On the other hand, the level of knowledge has no direct or indirect effect on intention, but behavioural variables do affect it through the mediating variables.

CONCLUSIONS: The variables of the planned behaviour theory are relevant to understand women’s decisions and to be able to take appropriate health policy measures. Doing so, the processes of personalised screening would improve, or there would be the incorporation of shared decision-making in this context; these being demands associated with the most recent goals achieved in health programmes in many countries.

PMID:36735750 | DOI:10.1371/journal.pone.0281454

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Nevin Manimala Statistics

Injury patterns of non-fatal accidents related to ice hockey, an analysis of 7 years of admission to a Level-1 Emergency Centre in Switzerland

PLoS One. 2023 Feb 3;18(2):e0268912. doi: 10.1371/journal.pone.0268912. eCollection 2023.

ABSTRACT

OBJECTIVE: This study was carried out to identify the frequency and types of injuries in adult ice hockey, in order to better understand injury patterns and identify potential areas for injury prevention.

METHODS: We conducted a retrospective database review of acute injuries reported in ice hockey in patients presenting to a Level-1 adult Emergency Centre in Switzerland. Patients between January 1, 2013 and December 31, 2019 and over 16 years of age were identified in our computerised patient database. Each consultation was reviewed to derive information on demographics, playing level and the features of the injury, including location, type, mechanism and consequences. Different age groups were compared, as were amateur and professional players. A statistical analysis was performed.

RESULTS: A total of 230 patients were identified. The most common diagnoses were fracture (28.3%), contusion/abrasion (23.9%), laceration (12.6%) and concussion (10.4%). The most commonly affected body parts were the face (31.3%), the shoulder/clavicle (13.0%) and the head (12.2%). Most lesions were caused by player-player contact (37.4%), contact with the puck (24.3%) and falls (10.9%). In comparison to the younger cohorts, patients >36 years of age more frequently suffered injuries caused by falls, (p < 0.001) and were less frequently injured by player-player contact (p = 0.01813). In amateur players, significantly more injuries were caused by stick contact (OR 0, 95% CI (0.00-0.83), p = 0.02) and surgery was more rarely performed (OR 2.35, 95% CI 0.98-5.46, p = 0.04).

CONCLUSIONS: Injuries continue to play a major role in ice hockey, especially in the face and due to player-player contact. Future investigations should focus on player-player contact and possible effective preventive measures. Players must be encouraged to employ face protection and to wear a mouth guard at all times.

PMID:36735749 | DOI:10.1371/journal.pone.0268912

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Nevin Manimala Statistics

4E analysis of a two-stage refrigeration system through surrogate models based on response surface methods and hybrid grey wolf optimizer

PLoS One. 2023 Feb 3;18(2):e0272160. doi: 10.1371/journal.pone.0272160. eCollection 2023.

ABSTRACT

Refrigeration systems are complex, non-linear, multi-modal, and multi-dimensional. However, traditional methods are based on a trial and error process to optimize these systems, and a global optimum operating point cannot be guaranteed. Therefore, this work aims to study a two-stage vapor compression refrigeration system (VCRS) through a novel and robust hybrid multi-objective grey wolf optimizer (HMOGWO) algorithm. The system is modeled using response surface methods (RSM) to investigate the impacts of design variables on the set responses. Firstly, the interaction between the system components and their cycle behavior is analyzed by building four surrogate models using RSM. The model fit statistics indicate that they are statistically significant and agree with the design data. Three conflicting scenarios in bi-objective optimization are built focusing on the overall system following the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) and Linear Programming Technique for Multidimensional Analysis of Preference (LINMAP) decision-making methods. The optimal solutions indicate that for the first to third scenarios, the exergetic efficiency (EE) and capital expenditure (CAPEX) are optimized by 33.4% and 7.5%, and the EE and operational expenditure (OPEX) are improved by 27.4% and 19.0%. The EE and global warming potential (GWP) are also optimized by 27.2% and 19.1%, where the proposed HMOGWO outperforms the MOGWO and NSGA-II. Finally, the K-means clustering technique is applied for Pareto characterization. Based on the research outcomes, the combined RSM and HMOGWO techniques have proved an excellent solution to simulate and optimize two-stage VCRS.

PMID:36735732 | DOI:10.1371/journal.pone.0272160

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Nevin Manimala Statistics

A risk scoring model to predict progression of retinopathy of prematurity for Indonesia

PLoS One. 2023 Feb 3;18(2):e0281284. doi: 10.1371/journal.pone.0281284. eCollection 2023.

ABSTRACT

INTRODUCTION: Retinopathy of prematurity (ROP) is a serious eye disease in preterm infants. Generally, the progression of this disease can be detected by screening infants regularly. In case of progression, treatment can be instituted to stop the progression. In Indonesia, however, not all infants are screened because the number of pediatric ophthalmologists trained to screen for ROP and provide treatment is limited. Therefore, other methods are required to identify infants at risk of developing severe ROP.

OBJECTIVE: To assess a scoring model’s internal and external validity to predict ROP progression in Indonesia.

METHOD: To develop a scoring model and determine its internal validity, we used data on 98 preterm infants with ROP who had undergone one or more serial eye examinations between 2009 and 2014. For external validation, we analyzed data on 62 infants diagnosed with ROP irrespective of the stage between 2017 and 2020. Patients stemmed from one neonatal unit and three eye clinics in Jakarta, Indonesia.

RESULTS: We identified the duration of oxygen supplementation, gestational age, socio-economic status, place of birth, and oxygen saturation monitor setting as risk factors for developing ROP. We developed two models-one based on the duration of supplemental oxygen and one on the setting of the oxygen saturation monitor. The ROP risk and probabilistic models obtained the same sensitivity and specificity for progression to Type 1 ROP. The agreement, determined with the Kappa statistic, between the ROP risk model’s suitability and the probabilistic model was excellent. The external validity of the ROP risk model showed 100% sensitivity, 73% specificity, 76% positive predictive value, 100% negative predictive value, positive LR +3.7, negative LR 0, 47% pre-test probability, and 77% post-test probability.

CONCLUSION: The ROP risk scoring model can help to predict which infants with first-stage ROP might show progression to severe ROP and may identify infants who require referral to a pediatric ophthalmologist for treatment.

PMID:36735727 | DOI:10.1371/journal.pone.0281284