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Nevin Manimala Statistics

An exploratory identification of biological markers of chronic musculoskeletal pain in the low back, neck, and shoulders

PLoS One. 2022 Apr 15;17(4):e0266999. doi: 10.1371/journal.pone.0266999. eCollection 2022.

ABSTRACT

OBJECTIVES: This study was an in-depth exploration of unique data from a nationally representative sample of adults living in the United States to identify biomarkers associated with musculoskeletal pain.

METHODS: We performed secondary analyses of 2003-2004 NHANES data. After a first screening of 187 markers, analyses of 31 biomarkers were conducted on participants aged ≥20 years identified in all counties using the 2000 Census Bureau data (n = 4,742). To assess the association of each biomarker with each pain outcome (acute, subacute and chronic low back, neck, and shoulder pain), analyses were carried out using multivariable logistic regression with adjustments for sex, age and body mass index. Biomarkers were considered as continuous variables and categorized at the median of their distributions.

RESULTS: Pain at any site for ≥24 hours during the past month was reported by 1,214 participants. Of these, 779 mentioned that the pain had lasted for ≥3 months (“chronic pain”). α-carotene, ascorbic acid, β-carotene, mercury and total protein had a statistically significant, inverse association with ≥2 chronic pain sites. Acrylamide, alkaline phosphatase, cadmium, cotinine, glycidamide, homocysteine, retinol, triglycerides and white blood cell count were positively associated with ≥2 chronic pain sites. Few biological markers were associated with acute and subacute pain.

CONCLUSIONS: This study identified some biomarkers that were strongly and consistently associated with musculoskeletal pain. These results raise new hypotheses and could have tremendous implications for advancing knowledge in the field. Research on musculoskeletal pain needs to put more effort on the biological dimension of the biopsychosocial model of pain.

PMID:35427389 | DOI:10.1371/journal.pone.0266999

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Nevin Manimala Statistics

Prognostic factors for mortality in bullous pemphigoid: A systematic review and meta-analysis

PLoS One. 2022 Apr 15;17(4):e0264705. doi: 10.1371/journal.pone.0264705. eCollection 2022.

ABSTRACT

OBJECTIVE: To systematically evaluate the prognostic factors for mortality in bullous pemphigoid.

METHODS: PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, China Biology Medicine disc and Wanfang Database were searched to collect literature on the prognostic factors for mortality in bullous pemphigoid. The quality of studies was assessed by Newcastle-Ottawa Quality Assessment Scale. Two researchers extracted relevant data and scored study quality independently. The hazard ratio (HR) was calculated using the random effects model. Study heterogeneity was assessed using both Cochran’s Q test and I2 statistics. The causes of heterogeneity were assessed by subgroup analysis and/ or sensitivity analysis when heterogeneity was significant. When ten or more studies were included as outcome indicators, publication bias was evaluated by funnel plot and Egger’s test.

RESULTS: Out of a total of 1,546 articles retrieved, 15 studies involving 2,435 patients were included. The meta-analysis showed that the mortality of patients with bullous pemphigoid increased with positive bullous pemphigoid 180 antibody (HR = 1.85, 95%CI: 1.25~2.75, P = 0.002); concomitant dementia (HR = 2.26, 95%CI: 1.43~3.59, P<0.001); stroke (HR = 2.09, 95% CI: 1.23-3.55, P = 0.007); heart disease (HR = 1.96, 95% CI: 1.41-2.73, P<0.001) and diabetes mellitus (HR = 2.39, 95% CI: 1.55-3.69, P<0.001). Sex, positive indirect immunofluorescence and hypertension were not associated with prognosis.

CONCLUSION: Positive bullous pemphigoid 180 antibody, dementia, stroke, heart disease and diabetes mellitus were the prognostic factors for mortality in bullous pemphigoid.

PMID:35427358 | DOI:10.1371/journal.pone.0264705

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Nevin Manimala Statistics

Robot-enhanced diabetes care for middle-aged and older adults living with diabetes in the community: A small sample size mixed-method evaluation

PLoS One. 2022 Apr 15;17(4):e0265384. doi: 10.1371/journal.pone.0265384. eCollection 2022.

ABSTRACT

PURPOSE: This study assessed robot-enhanced healthcare in practical settings for the purpose of community diabetes care.

METHODS: A mixed method evaluation collected quantitative and qualitative data on diabetes patients over 45 (N = 30) and community pharmacists (N = 10). It took 15-20 min for the diabetes patients to interact with the robot. Before and after the interaction, questionnaires including a diabetes knowledge test, self-efficacy for diabetes, and feasibility of use of the robot was administered. In-depth interviews with both pharmacists and patients were also conducted.

RESULTS: After interacting with the robot, a statistically significant improvement in diabetes knowledge (p < .001) and feasibility of the robot (p = .012) was found, but self-efficacy (p = .171) was not significantly improved. Five themes emerged from interviewing the diabetes patients: Theme 1: meets the needs of self-directed learning for the elderly; Theme 2: reduces alertness and creates comfortable interaction; Theme 3: vividness and richness enhance interaction opportunities; Theme 4: Robots are not without disadvantages, and Theme 5: Every person has unique tastes. Three themes emerged from interviewing pharmacists: Theme 1: Technology must meet the real needs of the patient; Theme 2: creates new services, and Theme 3: The use of robots must conform to real-life situations.

CONCLUSIONS: Both the diabetes patients and the pharmacist reported more positive feedback on the robot-enhanced diabetes care than concerns. Self-directed learning, comfortable interaction, and vividness were the most focuses when using robot to enhance self-management for the patients. Pharmacists were most receptive to fit conforming with reality and creating new services.

PMID:35427359 | DOI:10.1371/journal.pone.0265384

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Nevin Manimala Statistics

Incorporating the effects of objects in an approximate model of light transport in scattering media

Opt Lett. 2022 Apr 15;47(8):2000-2003. doi: 10.1364/OL.451725.

ABSTRACT

A computationally efficient radiative transport model is presented that predicts a camera measurement and accounts for the light reflected and blocked by an object in a scattering medium. The model is in good agreement with experimental data acquired at the Sandia National Laboratory Fog Chamber Facility (SNLFC). The model is applicable in computational imaging to detect, localize, and image objects hidden in scattering media. Here, a statistical approach was implemented to study object detection limits in fog.

PMID:35427321 | DOI:10.1364/OL.451725

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Nevin Manimala Statistics

COVID-19 and PA Faculty Burnout: A Year into the Pandemic

J Physician Assist Educ. 2022 Apr 15. doi: 10.1097/JPA.0000000000000419. Online ahead of print.

ABSTRACT

PURPOSE: The psychological effects of COVID-19 have been extensive and have affected health care workers and educators alike. The aims of this study were to evaluate how the COVID-19 pandemic has impacted PA faculty and their attitudes toward work.

METHODS: Two quantitative, pre/post surveys were offered to 21 PA faculty at one institution prior to and then one year into the COVID-19 pandemic. PA faculty perceptions of workplace culture and burnout were included in the online surveys.

RESULTS: Data were collected on 17 PA faculty (81% response rate). There was a statistically nonsignificant decrease in faculty disengagement (2.1 v 2.1, p = 0.87) and a statistically significant increase in faculty exhaustion (2.2 v 2.5, p = 0.005). There were statistically significant increases in communication, value, job satisfaction, and wellbeing workplace items.

CONCLUSION: As many workplace protocols remain changed as a result of COVID-19, institutions should monitor and adjust processes to reduce the risk of burnout for faculty.

PMID:35427299 | DOI:10.1097/JPA.0000000000000419

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Nevin Manimala Statistics

Long-Term Visual Prognosis in Patients With Aquaporin-4-Immunoglobulin G-Positive Neuromyelitis Optica Spectrum Disorder

J Neuroophthalmol. 2022 Mar 25. doi: 10.1097/WNO.0000000000001554. Online ahead of print.

ABSTRACT

BACKGROUND: To identify the factors associated with visual prognosis for functional and structural outcomes of optic neuritis (ON) in patients with aquaporin-4-immunoglobulin (AQP4-IgG)-positive neuromyelitis optica spectrum disorder (NMOSD).

METHODS: We included the eyes that experienced at least 1 episode of ON and were followed for at least 2 years after the first attack of ON in patients with AQP4-IgG-positive NMOSD. We performed a retrospective review of clinical data, including ophthalmological examination and orbital MRI, of 34 eyes of 22 patients. Functional outcomes were measured as final visual acuity, visual field index, and mean deviation and structural outcomes as final retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thickness.

RESULTS: The mean age at onset of the first ON was 42.7 ± 13.7, and all patients were female. The poor visual acuity was significantly associated with the worse final visual acuity and thinner RNFL and GCIPL. Older age also showed a negative correlation with RNFL thickness. The number of attacks was not statistically significant for functional and structural outcomes. The lesion involving the intracanalicular optic nerve to the chiasm on orbital MRI showed worse visual acuity and a thinner GCIPL. Rapid high-dose intravenous methylprednisolone pulse therapy within 3 days was statistically significant, with better visual acuity and more preserved GCIPL thickness.

CONCLUSIONS: Our results indicate that the severity of ON rather than the number of recurrences might be critical for the visual prognosis of patients with AQP4-IgG-positive NMOSD. Rapid treatment within 3 days may improve visual outcomes, and a younger age at onset may have better visual outcomes.

PMID:35427249 | DOI:10.1097/WNO.0000000000001554

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Nevin Manimala Statistics

The Presence of Donor-specific Antibodies Around the Time of Pancreas Graft Biopsy With Rejection Is Associated With an Increased Risk of Graft Failure

Transplantation. 2022 Apr 14. doi: 10.1097/TP.0000000000004133. Online ahead of print.

ABSTRACT

BACKGROUND: Donor-specific antibodies (DSA) against HLA are an important biomarker predicting graft injury, rejection (Rej), and failure in various solid-organ transplant recipients. However, the impact of DSA with or without histopathological evidence of rejection among pancreas transplant recipients (PTRs) is unknown.

METHODS: In this study, we included all PTRs at our center between 2005 and 2020, with pancreas allograft biopsy before March 31, 2021, and with DSA checked within 15 d of the biopsy. PTRs were divided into 4 groups based on the biopsy findings on the index biopsy and DSA status as Rej-/DSA-, Rej+/DSA-, Rej-/DSA+, and Rej+/DSA+.

RESULTS: Two hundred two PTRs had a pancreas allograft biopsy during the study period. Thirty-nine were in Rej-/DSA-, 84 Rej+/DSA-, 24 Rej-/DSA+, and 55 Rej+/DSA+. The mean interval from transplant to index biopsy was not statistically different between the 4 groups. The most common type of rejection was T cell-mediated rejection; however, antibody-mediated rejection was more prevalent in the Rej+/DSA+ group. At 5 y postbiopsy, the rate of death-censored graft failure (DCGF) for Rej-/DSA- was 18%, 24% in Rej+/DSA-; 17% in Rej-/DSA+ and 36% in Rej+/DSA+ (P = 0.14). In univariate analysis, mixed rejection (hazard ratio [HR], 3.0; 95% confidence intervals [CI], 1.22-7.39; P = 0.02) along with solitary pancreas transplantation and Rej+/DSA+ were associated with DCGF. In multivariate analysis, compared with Rej-/DSA-, Rej+/DSA+ was significantly associated with DCGF (HR, 2.32; 95% CI, 1.03-5.20; P = 0.04); however, Rej+/DSA- was not (HR, 1.06; 95% CI, 0.32-3.56; P = 0.92).

CONCLUSIONS: PTRs with pancreas allograft rejection and concomitant DSA have an increased risk of DCGF.

PMID:35427295 | DOI:10.1097/TP.0000000000004133

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Nevin Manimala Statistics

A randomized, open-label, single-dose, two-cycle crossover study to evaluate the bioequivalence and safety of lenvatinib and Lenvima® in Chinese healthy subjects

Expert Opin Investig Drugs. 2022 Apr 15. doi: 10.1080/13543784.2022.2067528. Online ahead of print.

ABSTRACT

BACKGROUND: Lenvatinib is a tyrosine kinase receptor inhibitor that inhibits vascular and endothelial growth factor receptor kinase activity. This study evaluated the bioequivalence and safety of lenvatinib developed by Chia Tai Tianqing Pharmaceutical Co., Ltd. with Lenvima® developed by Eisai Manufacturing Ltd.

RESEARCH DESIGN AND METHODS: The fasting and postprandial groups were two independent trials. There were 32 and 31 subjects in the fasting and postprandial groups, respectively. Subjects were randomly divided into two sequences at a ratio of 1:1 for two-cycle crossover administration. Subjects took 10 mg lenvatinib or Lenvima® once per cycle. The wash-out period was 14 days. Plasma drug concentrations were detected by specific liquid chromatography and tandem mass spectrometry (LC-MS/MS) assays. Statistical analysis of major pharmacokinetic (PK) parameters to assess drug bioequivalence was performed. In addition, we evaluated the safety of the drugs throughout the trial.

RESULTS: In the fasting state, the GMRs of Cmax, AUC0-t, and AUC0-∞ were 99.89%, 102.98% and 103.19%, respectively. The 90% CIs were all within 80%-125%. In the postprandial state, the GMRs of Cmax, AUC0-t, and AUC0-∞ were 98.96%, 94.25% and 95.27%, respectively. The 90% CIs were all within 80%-125%. All results met the bioequivalence criteria. Both drugs had good safety and tolerance in this trial.

CONCLUSION: This study showed that lenvatinib and Lenvima® had similar bioequivalence and safety in healthy Chinese subjects under fasting and postprandial conditions.

CLINICAL TRIAL REGISTRATION: This trial is registered at the Chinese Clinical Trial website (http://www.chinadrugtrials.org.cn/index.html # CTR20191172).

PMID:35427205 | DOI:10.1080/13543784.2022.2067528

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Nevin Manimala Statistics

Prevalence of ADHD among Black Youth Compared to White, Latino and Asian Youth: A Meta-Analysis

J Clin Child Adolesc Psychol. 2022 Apr 15:1-16. doi: 10.1080/15374416.2022.2051524. Online ahead of print.

ABSTRACT

OBJECTIVE: To systematically review the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) among Black children and adolescents compared to White, Latino and Asian children and adolescents.

METHOD: Peer-reviewed articles were identified in seven databases and included if they reported prevalence of ADHD among Black children and adolescents living in a minority context and compared rates to at least one of White, Latino or Asian samples. A total of 7050 articles were retrieved and 155 articles were subjected to full evaluation. Twenty-three studies representing 26 independent samples were included.

RESULTS: The pooled sample size was n = 218,445 (k = 26), n = 835,505 (k = 25), n = 493,417 (k = 24), and n = 66,413 (k = 7) of Black, White, Latino, and Asian participants, respectively. Pooled prevalence rate of ADHD was 15.9% (95%CI 11.6% – 20.7%) among Black children and adolescents, 16.6% (95%CI 11.6% – 22.2%) among Whites, 10.1% (95%CI 6.9% – 13.8%) among Latinos and 12.4% (95%CI 1.4% – 31.8%) among Asians. There was no significant difference in prevalence between ethnic groups, whereas both Black and White children and adolescents had marginally statistically significant higher prevalence than Asians. The results of a meta-regression analysis showed no moderating effects of the type of sample and the year of publication of studies. A significant publication bias was observed, suggesting that other moderators were not identified in the present systematic review.

CONCLUSION: In contrast to the assertion in the DSM-5 that clinical identification among Black children and adolescents is lower than among White children and adolescents, the present meta-analysis suggests similar rates of ADHD among these two groups. The importance of considering cultural appropriateness of assessment tools and processes is emphasized.

PMID:35427201 | DOI:10.1080/15374416.2022.2051524

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Nevin Manimala Statistics

Classification of human chronic inflammatory skin disease based on single-cell immune profiling

Sci Immunol. 2022 Apr 15;7(70):eabl9165. doi: 10.1126/sciimmunol.abl9165. Epub 2022 Apr 15.

ABSTRACT

Inflammatory conditions represent the largest class of chronic skin disease, but the molecular dysregulation underlying many individual cases remains unclear. Single-cell RNA sequencing (scRNA-seq) has increased precision in dissecting the complex mixture of immune and stromal cell perturbations in inflammatory skin disease states. We single-cell-profiled CD45+ immune cell transcriptomes from skin samples of 31 patients (7 atopic dermatitis, 8 psoriasis vulgaris, 2 lichen planus (LP), 1 bullous pemphigoid (BP), 6 clinical/histopathologically indeterminate rashes, and 7 healthy controls). Our data revealed active proliferative expansion of the Treg and Trm components and universal T cell exhaustion in human rashes, with a relative attenuation of antigen-presenting cells. Skin-resident memory T cells showed the greatest transcriptional dysregulation in both atopic dermatitis and psoriasis, whereas atopic dermatitis also demonstrated recurrent abnormalities in ILC and CD8+ cytotoxic lymphocytes. Transcript signatures differentiating these rash types included genes previously implicated in T helper cell (TH2)/TH17 diatheses, segregated in unbiased functional networks, and accurately identified disease class in untrained validation data sets. These gene signatures were able to classify clinicopathologically ambiguous rashes with diagnoses consistent with therapeutic response. Thus, we have defined major classes of human inflammatory skin disease at the molecular level and described a quantitative method to classify indeterminate instances of pathologic inflammation. To make this approach accessible to the scientific community, we created a proof-of-principle web interface (RashX), where scientists and clinicians can visualize their patient-level rash scRNA-seq-derived data in the context of our TH2/TH17 transcriptional framework.

PMID:35427179 | DOI:10.1126/sciimmunol.abl9165