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Nevin Manimala Statistics

Determinants of atopic dermatitis among children in a general out-patient clinics of a tertiary hospital in North central, Nigeria

Niger J Clin Pract. 2023 Jan;26(1):49-54. doi: 10.4103/njcp.njcp_2025_21.

ABSTRACT

BACKGROUND: Atopic dermatitis (AD) is a chronic, inflammatory, and itchy skin condition that develops in early childhood in the majority of cases.

AIM: The objective of this study is to determine factors associated with atopic dermatitis among children aged 6 months to 14 years seen at the General Out-Patients Clinics of a tertiary hospital in north central Nigeria as well as predictors of having AD.

PATIENTS AND METHODS: This was a descriptive cross-sectional study of 490 eligible children recruited using the systematic random sampling technique. The data collected were analyzed using statistical package for social sciences, version 22. Descriptive and inferential statistics was performed to determine the relationship between independent variables and having AD.

RESULTS: The factors significantly associated with AD from this study include: male sex (χ = 4.78, P = 0.029), Being in nursery school (χ = 77.60, P = 0.000), Nupe ethnicity (χ = 49.06, P = 0.000), mothers and fathers Educational level (χ = 27.80, P = 0.000), having personal or family history of atopy (χ = 31.30, P = 0.000). After all variables that are significant was adjusted; Nursery level of education (OR = 4.076, 95% CI = 1.679-9.891, P = 0.002), Mother’s Level of education (OR = 0.664, 95% CI = 0.442-0.998, P = 0.049), and personal or family history of atopy (OR = 5.585-E12, 95% CI = 5.585-E12-5.585-E12, P = 0.000) were independent predictors of AD.

CONCLUSION: Our data suggest that AD has a specific pattern of inheritance in children and this was predicted by: nursery level of education, mother’s level of education, and family or personal history of atopy. Knowledge of this will provide a better caring strategy for predicting and preventing AD earlier in at risk children.

PMID:36751823 | DOI:10.4103/njcp.njcp_2025_21

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Nevin Manimala Statistics

Preliminary outcome of use of parenterally administered tranexamic acid during primary total knee replacement

Niger J Clin Pract. 2023 Jan;26(1):31-35. doi: 10.4103/njcp.njcp_1827_21.

ABSTRACT

BACKGROUND: Perioperative blood loss and the need for blood transfusion following total knee arthroplasty (TKA) has been a source of concern for many arthroplasty surgeons and patients over the years. Tranexamic acid (TXA) is increasingly being used by surgeons in limiting perioperative blood loss and the subsequent need for transfusion during TKA.

AIM: This study aims to determine the efficacy of TXA in preventing perioperative blood loss, transfusion needs of patients that underwent TKA, complications, and its financial implications of its use in our institution.

PATIENTS AND METHODS: The study was a clinical comparative audit of perioperative blood loss and transfusion needs in primary TKA patients. The study population was divided into two groups of equal numbers (n = 40). Group A, who did not receive perioperative TXA, had TKA prior to the adoption of TXA in our institution, whereas group B, who received TXA, had TKA after TXA was adopted.

RESULTS: The mean postoperative hemoglobin was 9.49 g/dl for group A and 10.15 g/dl for group B (P = 0.021). The mean postoperative blood drainage was 888.25 ml for group A and 821.67 ml for group B (P = 0.397). The number of patients transfused in group A was 17 (42.5%) against 7 (17.5%) in group B. The mean postoperative transfusion volume was 270 ml and 101.25 ml for group A and B, respectively (P = 0.014). The mean total transfusion volume was 450 ml and 277 ml in group A and B, respectively (P = 0.063).

CONCLUSIONS: The use of TXA in TKA was shown to be beneficial in our study as it resulted in a statistically significant reduction in the postoperative transfusion volumes and higher postoperative hemoglobin levels.

PMID:36751820 | DOI:10.4103/njcp.njcp_1827_21

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Nevin Manimala Statistics

Cardiothoracic ratio values and trajectories are associated with risk of requiring dialysis and mortality in chronic kidney disease

Commun Med (Lond). 2023 Feb 7;3(1):19. doi: 10.1038/s43856-023-00241-9.

ABSTRACT

BACKGROUND: The prognostic role of the cardiothoracic ratio (CTR) in chronic kidney disease (CKD) remains undetermined.

METHODS: We conducted a retrospective cohort study of 3117 patients with CKD aged 18-89 years who participated in an Advanced CKD Care Program in Taiwan between 2003 and 2017 with a median follow up of 1.3(0.7-2.5) and 3.3(1.8-5.3) (IQR) years for outcome of end-stage renal disease (ESRD) and overall death, respectively. We developed a machine learning (ML)-based algorithm to calculate the baseline and serial CTRs, which were then used to classify patients into trajectory groups based on latent class mixed modelling. Association and discrimination were evaluated using multivariable Cox proportional hazards regression analyses and C-statistics, respectively.

RESULTS: The median (interquartile range) age of 3117 patients is 69.5 (59.2-77.4) years. We create 3 CTR trajectory groups (low [30.1%], medium [48.1%], and high [21.8%]) for the 2474 patients with at least 2 CTR measurements. The adjusted hazard ratios for ESRD, cardiovascular mortality, and all-cause mortality in patients with baseline CTRs ≥0.57 (vs CTRs <0.47) are 1.35 (95% confidence interval, 1.06-1.72), 2.89 (1.78-4.71), and 1.50 (1.22-1.83), respectively. Similarly, greater effect sizes, particularly for cardiovascular mortality, are observed for high (vs low) CTR trajectories. Compared with a reference model, one with CTR as a continuous variable yields significantly higher C-statistics of 0.719 (vs 0.698, P = 0.04) for cardiovascular mortality and 0.697 (vs 0.693, P < 0.001) for all-cause mortality.

CONCLUSIONS: Our findings support the real-world prognostic value of the CTR, as calculated by a ML annotation tool, in CKD. Our research presents a methodological foundation for using machine learning to improve cardioprotection among patients with CKD.

PMID:36750687 | DOI:10.1038/s43856-023-00241-9

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Nevin Manimala Statistics

The effects of core stabilization exercises on the neuromuscular function of athletes with ACL reconstruction

Sci Rep. 2023 Feb 7;13(1):2202. doi: 10.1038/s41598-023-29126-6.

ABSTRACT

Athletes who have undergone anterior cruciate ligament reconstruction (ACLR) often exhibit persistently impaired kinematics and strength. Core stability training appears to be effective for reducing high-risk landing mechanics and preventing primary anterior cruciate ligament (ACL) injuries; however, there have been few attempts to examine their effects in athletes who have undergone ACLR. This study aimed to investigate the effect of eight weeks of simple core stability training on core endurance, hip strength, and knee kinematics in ACLR athletes. Twenty-six male athletes (20-30 years old) with a history of ACL surgery with hamstring tendon autograft were randomly divided into training (n = 13) and control groups (n = 13). The training group performed core stability exercises for eight weeks before starting their team training; the control group did not receive any intervention. Both groups continued their regular team schedule. The core endurance, hip muscle strength, and knee kinematics were assessed by the McGill test, a hand-held dynamometer, and video-taping, respectively. Analysis of covariance test was used for data analysis. The training group showed a significant increase in core endurance, hip abductor and external rotator strength, knee flexion angle, and a significant decrease in the knee valgus angle during single-leg landing in post-training tests compared to their baseline tests (P < 0.05). Our results demonstrated that core stability exercise alters neuromuscular function to a level that is clinically acceptable and statistically significant. Because of the high incidence rate of secondary ACL injury after ACLR, it is recommended that athletes with a history of ACLR benefit from adding core stability exercises to warm-up routines or tertiary prevention programs even after completing post-operative rehabilitation. It is fast and not time-consuming to perform for athletes to reduce the risk factors of re-injury. Trial registration: This study was registered in the Iranian Registry of Clinical Trials with the number IRCT20190224042827N2, registered on 19 December 2019.

PMID:36750662 | DOI:10.1038/s41598-023-29126-6

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Nevin Manimala Statistics

Translating principles of quality control to cardiovascular magnetic resonance: assessing quantitative parameters of the left ventricle in a large cohort

Sci Rep. 2023 Feb 7;13(1):2205. doi: 10.1038/s41598-023-29028-7.

ABSTRACT

Cardiac magnetic resonance (CMR) examinations require standardization to achieve reproducible results. Therefore, quality control as known as in other industries such as in-vitro diagnostics, could be of essential value. One such method is the statistical detection of long-time drifts of clinically relevant measurements. Starting in 2010, reports from all CMR examinations of a high-volume center were stored in a hospital information system. Quantitative parameters of the left ventricle were analyzed over time with moving averages of different window sizes. Influencing factors on the acquisition and on the downstream analysis were captured. 26,902 patient examinations were exported from the clinical information system. The moving median was compared to predefined tolerance ranges, which revealed an overall of 50 potential quality relevant changes (“alerts”) in SV, EDV and LVM. Potential causes such as change of staff, scanner relocation and software changes were found not to be causal of the alerts. No other influencing factors were identified retrospectively. Statistical quality assurance systems based on moving average control charts may provide an important step towards reliability of quantitative CMR. A prospective evaluation is needed for the effective root cause analysis of quality relevant alerts.

PMID:36750647 | DOI:10.1038/s41598-023-29028-7

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Nevin Manimala Statistics

Dealing with disruptions in railway track inspection using risk-based machine learning

Sci Rep. 2023 Feb 7;13(1):2141. doi: 10.1038/s41598-023-28866-9.

ABSTRACT

Unplanned track inspections can be a direct consequence of any disruption to the operation of on-board track geometry monitoring activities. A novel response strategy to enhance the value of the information for supplementary track measurements is thus established to construct a data generation model. In this model, artificial (synthetic) data is assigned on each measurement point along the affected track segment over a short period of time. To effectively generate artificial track measurement data, this study proposes a NARX (nonlinear autoregressive with exogenous variables) model, which incorporates short-range memory dependencies in the dependent variable and integrates interdependent effects from external factors. Nonlinearities in the proposed model have been determined using an artificial neural network that allowed fast computation of a mapping function in line with the needs of effective disruption management. The risk of over fitting the data generation model, which reflected its generalisation ability, has been effectively managed through risk aversion concept. For the model evaluation, the deviation of track longitudinal level has been taken as a case study, predicted using its degradation rate and track alignment and gauge as exogenous variables. Simulation results on two datasets that are statistically different showed that the data generation model for disrupted track measurements is reliable, accurate, and easy-to-use. This novel model is an essential breakthrough in railway track integrity prediction and resilient operation management.

PMID:36750640 | DOI:10.1038/s41598-023-28866-9

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Nevin Manimala Statistics

Epidemiological and genomic analysis of dengue cases in Guangzhou, China, from 2010 to 2019

Sci Rep. 2023 Feb 7;13(1):2161. doi: 10.1038/s41598-023-28453-y.

ABSTRACT

With a long epidemic history and a large number of dengue cases, Guangzhou is a key city for controlling dengue in China. The demographic information regarding dengue cases, and the genomic characteristics of the envelope gene of dengue viruses, as well as the associations between these factors were investigated from 2010 to 2019, to improve the understanding of the epidemiology of dengue in Guangzhou. Demographic data on 44,385 dengue cases reported to the Notifiable Infectious Disease Report System were analyzed using IBM SPSS Statistics v. 20. Dengue virus isolates from patient sera were sequenced, and phylogenetic trees were constructed using PhyML 3.1. There was no statistical difference in the risk of dengue infection between males and females. Unlike other areas in which dengue is endemic, the infection risk in Guangzhou increased with age. Surveillance identified four serotypes responsible for dengue infections in Guangzhou. Serotype 1 remained prevalent for most of the study period, whereas serotypes 3 and 4 were prevalent in 2012 and 2010, respectively. Different serotypes underwent genotype and sublineage shifts. The epidemiological characteristics and phylogeny of dengue in Guangzhou suggested that although it has circulated in Guangzhou for decades, it has not been endemic in Guangzhou. Meanwhile, shifts in genotypes, rather than in serotypes, might have caused dengue epidemics in Guangzhou.

PMID:36750601 | DOI:10.1038/s41598-023-28453-y

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Nevin Manimala Statistics

Handwriting kinematics during learning to write with the dominant left hand in converted left-handers

Sci Rep. 2023 Feb 7;13(1):2171. doi: 10.1038/s41598-023-28911-7.

ABSTRACT

Converting left-handers to their non-dominant right hand was previously widespread, particularly for handwriting. The present study aimed to explore the extent to which adult, converted left-handers can learn writing with their dominant left hand during a 2-year training program. Eleven converted left-handers participated in the training. Handwriting kinematics were assessed at regular intervals (seven sessions) and compared to those of 11 innate left-handed controls matched for age, gender, and overall handedness score for basic (Finger, Wrist, Circle) and complex (Sentence, Copy) handwriting tasks. Regarding basic tasks in the training group, we found rapid increases in left and right-hand frequency and no significant differences between both hands at any time point, indicating successful hand transfer. After 24 months, training participants significantly surpassed controls for writing frequency in basic tasks with their left hand. For complex tasks, we identified significant increases in the training groups’ left-hand writing frequency and duration between the first and last session. While training participants’ left-hand writing remained significantly slower than their right-hand writing, statistics confirmed final differences between hands only for the duration of the Sentence task. Importantly, left-hand writing in the training group was characterized by lower frequency, lower automaticity, and prolonged duration after 24 months compared to innate left-handers. With training participants’ left-hand writing skills significantly increasing for complex tasks and no final statistically significant differences between hands for frequency and automaticity, the program was considered effective. Nevertheless, within 2 years, training participants did not reach innate left-handers handwriting proficiency for complex tasks. Underlying reasons may be various, such as a non-optimal training program, a sensitive period for learning to write, irreversible neural changes during conversion in childhood, age-related decline of motor learning capacity, or retrograde interference between right- and left-hand writing.

PMID:36750597 | DOI:10.1038/s41598-023-28911-7

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Nevin Manimala Statistics

Optimal spatial evaluation of a pro rata vaccine distribution rule for COVID-19

Sci Rep. 2023 Feb 7;13(1):2194. doi: 10.1038/s41598-023-28697-8.

ABSTRACT

The COVID-19 Vaccines Global Access (COVAX) is a World Health Organization (WHO) initiative that aims for an equitable access of COVID-19 vaccines. Despite potential heterogeneous infection levels across a country, countries receiving allotments of vaccines may follow WHO’s allocation guidelines and distribute vaccines based on a jurisdictions’ relative population size. Utilizing economic-epidemiological modeling, we benchmark the performance of this pro rata allocation rule by comparing it to an optimal one that minimizes the economic damages and expenditures over time, including a penalty representing the social costs of deviating from the pro rata strategy. The pro rata rule performs better when the duration of naturally- and vaccine-acquired immunity is short, when there is population mixing, when the supply of vaccine is high, and when there is minimal heterogeneity in demographics. Despite behavioral and epidemiological uncertainty diminishing the performance of the optimal allocation, it generally outperforms the pro rata vaccine distribution rule.

PMID:36750592 | DOI:10.1038/s41598-023-28697-8

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Nevin Manimala Statistics

Baseline factors and reason for cancellation of elective ophthalmic surgery

Eye (Lond). 2023 Feb 7. doi: 10.1038/s41433-023-02421-2. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the baseline risk factors for elective ophthalmic surgery cancellations and characterise the reasons for cancellation.

METHODS: This is a retrospective, non-randomised study performed at a large tertiary ophthalmic centre. It included a consecutive sample of patients above the age of 18 who had an ophthalmic surgery scheduled at Cole Eye Institute, Cleveland Clinic, OH between January 2012 and December 2019. An automated search pull identified 75,908 scheduled surgeries (63,987 completed and 11,921 cancelled surgeries). Statistical analysis was performed using R (version 3.5.1). Main outcome measures were baseline factors that impact risk for surgery cancellation and reasons for surgery cancellation.

RESULTS: Analysis was performed on 69,963 scheduled surgeries (57.37% Female, 42.63% Male; Mean age of 62.72 years; 59,959 completed and 10,004 cancelled surgeries). Of the 2384 cancelled surgeries with reasons provided, the most common causes of cancellation were patient refusal (38.42%), patient health condition (18.79%), and rescheduling of surgery (15.27%). Female sex, black race, patient age less than 50 years, non-cataract surgeries, regional mean household income greater than $82,900, Medicare insurance, and geographical distance of less than 10 miles from home to the surgery site were each associated with a significantly increased risk of surgery cancellation (p < 0.01).

CONCLUSIONS: This study successfully identified several baseline factors predicting elective ophthalmic surgery cancellation. The clinical insights gained from these lines of enquiry may be used to construct models that not only identify patients at greater risk for cancellation but also highlight which interventions have greatest efficacy in preventing ophthalmic surgery cancellations.

PMID:36750587 | DOI:10.1038/s41433-023-02421-2