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Nevin Manimala Statistics

Factors influencing exclusive breastfeeding practice among under-six months infants in Ethiopia

BMC Pregnancy Childbirth. 2022 Aug 8;22(1):630. doi: 10.1186/s12884-022-04955-x.

ABSTRACT

BACKGROUND: World Health Organization recommends exclusive breastfeeding (EBF) for the first 6 months of life. EBF has sustainable long-term health benefits for both infants and mothers. Despite its benefits, the practice of EBF in Ethiopia is lower than the internationally recommended one. This study aimed at identifying factors influencing EBF practice among under-6 month infants in Ethiopia.

METHODS: This study used data drawn from the 2019 Ethiopian Mini Demographic and Health Survey (2019 EMDHS) data. A multivariable logistic regression model was employed to investigate factors significantly associated with EBF practice among under-6 month infants in Ethiopia. An adjusted odds ratio with 95% confidence interval was used to measure the association of factors with EBF practice.

RESULTS: A total of 566 infants under the age of 6 months were included in the study. The prevalence of exclusive breastfeeding practice was 83% (95% CI: 79.70-86%). Urban residences (AOR: 0.40, 95% CI: 0.22-0.73), mothers having secondary education (AOR: 1.54, 95% CI: 1.29-1.84) and higher education (AOR: 3.18, 95% CI: 0.68-15.02), mothers having ANC visits of 1 to 3 times (AOR: 1.52, 95% CI: 1.24-1.88) and ANC visits of 4 and more times (AOR: 4.27, 95% CI: 1.06-17.25), family size of more than 5 (AOR: 0.45, 95% CI: 0.26-0.88), caesarean births (AOR: 0.63, 95% CI: 0.42-0.95), and deliveries at health facilities (AOR: 2.51, 95% CI: 1.12-5.63) were factors significantly associated with EBF practice among under-6 month infants.

CONCLUSION: In this study, EBF practice among under-6 month infants was significantly associated with place of residence, maternal educational level, ANC visits, family size, mode of delivery, and place of delivery. Therefore, encouraging ANC visit and promotion of institutional (health facility) delivery are recommended. Furthermore, special attention has to be given to mothers with no or less education to make them better aware of the EBF and its benefits to enhance exclusive breastfeeding practice.

PMID:35941576 | DOI:10.1186/s12884-022-04955-x

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Nevin Manimala Statistics

Measuring interictal burden among people affected by migraine: a descriptive survey study

J Headache Pain. 2022 Aug 8;23(1):97. doi: 10.1186/s10194-022-01467-z.

ABSTRACT

BACKGROUND: Previous research has extensively documented the impact of migraine episodes (‘ictal’) on patients’ health-related quality of life. Few studies have looked at the impact of migraine on migraine-free days (‘interictal’). This study was designed to describe interictal burden of migraine in a mixed group of people affected by migraine and to explore patient characteristics associated with interictal burden.

METHODS: People with migraine in the United States (US) and Germany were recruited for a cross-sectional online survey, including a subgroup treated with calcitonin gene-related peptide (CGRP) monoclonal antibody (mAb). The survey included the Migraine Interictal Burden Scale (MIBS-4), Headache Impact Test (HIT-6), and items measuring patient demographics, clinical and treatment background. Data were analyzed using descriptive statistics and linear regression.

RESULTS: Five hundred six people with migraine completed the survey (US: n = 257; Germany: n = 249), of whom 195 had taken a CGRP mAb for three or more months. Participants had a mean of 8.5 (SD = 6.4) Monthly Migraine Days (MMD) and 10.4 (SD = 7.1) Monthly Headache Days (MHD). The mean MIBS-4 score was 6.3 (SD = 3.4), with 67% reporting severe interictal burden (MIBS-4: ≥5). The mean HIT-6 score was 65.3 (SD = 6.0), with 86% reporting severe migraine impact (HIT-6: ≥60). MIBS-4 was correlated with the HIT-6 (r = 0.37), MMD and MHD (both r = 0.27). The HIT-6, MMD, MHD, CGRP mAb treatment, and depression all had an independent positive association with the MIBS-4.

CONCLUSION: Two-thirds of the study sample reported substantial interictal burden. Whilst interictal burden was associated with migraine frequency and impact of migraine attacks, study results also show it represented a distinct aspect of the overall disease burden. Study findings further indicate unique associations between interictal burden and depression. A unique positive association between interictal burden and CGRP mAb treatment suggests a remaining unmet need among people affected by migraine treated with CGRP mAb.

PMID:35941572 | DOI:10.1186/s10194-022-01467-z

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Nevin Manimala Statistics

Impact of adjuvant chemotherapy on T1N0M0 breast cancer patients: a propensity score matching study based on SEER database and external cohort

BMC Cancer. 2022 Aug 8;22(1):863. doi: 10.1186/s12885-022-09952-z.

ABSTRACT

BACKGROUND: There is no clear consensus on the benefits of adjuvant chemotherapy for tumor-node-metastasis (TNM) stage T1 (T1N0M0) breast cancer (BC). Our study investigated the effects of adjuvant chemotherapy on T1N0M0 BC patients.

METHODS: Seventy-five thousand one hundred thirty-nine patients diagnosed with T1N0M0 BC were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Multivariate Cox analyses were performed to investigate the effects of adjuvant chemotherapy on T1a, T1b, and T1cN0M0 BC, including various tumor grades, and four molecular subtypes. Propensity score matching (PSM) was used to eliminate confounding factors and further compare the results between adjuvant chemotherapy and no adjuvant chemotherapy. Additionally, 545 T1N0M0 BC patients treated at the Northern Jiangsu People’s Hospital were included as an independent external validation cohort. Univariate and multivariate Cox analyses were used to confirm the effects of adjuvant chemotherapy in T1a, T1b, and T1cN0M0 BC. Survival curves for the different tumor grades and molecular subtypes were plotted using the Kaplan-Meier method.

RESULTS: Adjuvant chemotherapy demonstrated a statistically significant improvement in overall survival (OS) in T1b and T1c BC, but not in T1a BC. Within T1b BC, adjuvant chemotherapy was found to have effects on grade III, and hormone receptor + (HoR +)/human epidermal growth factor receptor 2 + (HER2 +), HoR-/HER2 + , and HoR-/HER2- molecular subtypes, respectively. Adjuvant chemotherapy was beneficial to OS for grade II/III and T1c BC. Identical results were obtained after PSM. We also obtained similar results with external validation cohort, except that adjuvant chemotherapy made a difference in grade II and T1b BC of the external validation dataset.

CONCLUSIONS: Partial T1N0M0 BC patients with grade III T1bN0M0, patients with tumor grade II and III T1cN0M0, and excluding those with HoR + /HER2- subtype tumors, could obtain OS benefits from adjuvant chemotherapy.

PMID:35941565 | DOI:10.1186/s12885-022-09952-z

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Nevin Manimala Statistics

Ionic liquid treated leaves of Juglans regia as an adsorbent for the removal of methyl orange dye: experimental, computational, and statistical approach

Int J Phytoremediation. 2022 Aug 8:1-16. doi: 10.1080/15226514.2022.2106940. Online ahead of print.

ABSTRACT

The novel biosorbents prepared by surface modification from leaves of Juglans regia plant were exploited for removal of methyl orange dye from aqueous solution. The leaves in the form of dust and charcoal were separately impregnated with 1-butyl-3-methyl imidazolium bromide (I) to obtain adsorbents namely J. regia dust/charcoal impregnated with I (JRDI/JRCI) which were characterized using advanced analytical approaches. The impregnation of ionic liquid was confirmed by the appearance of new bands. Langmuir isotherm fitted well; the calculated adsorption capacity being 59.37 (JRDI) and 102.72 mg g-1 (JRCI). The kinetic study revealed that sorption obeyed the pseudo-first order model; the experimental adsorption capacity being 53.53 (JRDI) and 86.82 mg g-1 (JRCI) at selected conditions of pH 3, initial dye concentration 100 ppm, dosage of adsorbent 0.3 g and contact time 70 min. The mathematical models which predicted adsorption capacity as 51.5 (JRDI) and 82.1 mg g-1 (JRCI) were found at par with experimental values. Fukui condensed functions revealed that adsorbents had electron deficient electrophilic reaction sites while dye had electron-rich nucleophilic reaction sites. The structural properties and good adsorption capability of adsorbents indicate that they could be used as potential, eco-friendly adsorbents for the treatment of negatively charged dye pollutants.

PMID:35939852 | DOI:10.1080/15226514.2022.2106940

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Nevin Manimala Statistics

Comparison of Intraocular Pressure Measurements with Goldmann Applanation Tonometry, Tonopen XL, and Pascal Dynamic Contour Tonometry in Patients with Descemet Membrane Endothelial Keratoplasty

J Glaucoma. 2022 Aug 3. doi: 10.1097/IJG.0000000000002089. Online ahead of print.

ABSTRACT

PURPOSE/AIM OF THE STUDY: To compare intraocular pressure (IOP) measurements measured based on Goldmann applanation tonometry (GAT), Tonopen XL, and Pascal Dynamic Contour Tonometry (DCT) in patients who had undergone Descemet Membrane Endothelial Keratoplasty (DMEK) and to appraise the influence of central corneal thickness (CCT) on IOP measurements.

MATERIALS AND METHODS: Thirty-four eyes (from 34 patients) who underwent DMEK at least one month prior to the study were included. We performed Tonopen XL, GAT, and DCT IOP measurements at 10 min intervals. Bland-Altman plots were used to assess agreement between GAT, Tonopen XL, and DCT. Spearman’s rank correlation was used to calculate the deviation from GAT readings by each device and correlate the readings with the CCT variable.

RESULTS: The mean IOP values with GAT, Tonopen XL, and DCT were 14.9±5.8, 16.2±5.5, and 19.2±5.0, respectively. Statistically significant differences between GAT and Tonopen XL and between GAT and DCT were noted (r=0.942 [0.885-0.971]; P=0.0001 and r=0.942 [0.885-0.971]; P=0.0001, respectively). DCT tended to return a higher IOP relative to GAT and Tonopen XL. CCT and IOP readings obtained by GAT, Tonopen XL, and DCT did not show a statistically significant correlation with each other.

CONCLUSION: IOP as measured with both Tonopen and DCT was found to be higher than GAT in eyes that underwent DMEK surgery although the techniques showed a good correlation. After DMEK surgery, all three measurement techniques can be practical in routine postoperative examinations, however it is recommended to measure IOP with the same device during patient follow-up.

PMID:35939831 | DOI:10.1097/IJG.0000000000002089

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3-year Outcomes of XEN Implant Compared to Trabeculectomy, With or Without Phacoemulsification for Open-angle Glaucoma

J Glaucoma. 2022 Aug 1. doi: 10.1097/IJG.0000000000002090. Online ahead of print.

ABSTRACT

PRCIS: Trabeculectomy surgery reduces the intraocular pressure (IOP) more than the XEN45 implant over 3 years. There is no difference in the number of antiglaucoma medications between the two procedures. The decision to perform either trabeculectomy or XEN45 implantation must be evaluated on a case-by-case basis, taking into account the high rate of needling of the XEN45.

PURPOSE: The aim of this study was to compare the differences between the efficacy and safety of the XEN45 implant and trabeculectomy (TRAB), either alone or in combination with phacoemulsification (PHACO), in patients with open-angle glaucoma (OAG) at 36 months.

METHODS: A retrospective, single-center and comparative study conducted on OAG patients that underwent XEN45 implantation or trabeculectomy from 2016 to 2018. Patients were divided into four groups: group 1 (XEN45 alone); group 2 (XEN45+PHACO); group 3 (TRAB alone); group 4 (TRAB+PHACO). For statistical purposes, groups 1 and 2 were combined (XEN45 implant), while groups 3 and 4 were also combined (TRAB surgery). Intraocular pressure (IOP), number of antiglaucoma medications (NOAM) and adverse events were evaluated. The main outcome measure was the reduction in IOP at 36 months postoperatively.

RESULTS: One hundred and thirty-four patients (134 eyes; 63 XEN45 and 71 TRAB) were included. The mean (95% CI) IOP reduction at the end of the study follow-up was-6.3 (-11.0 to -1.6 mmHg, P=0.025, XEN45 alone),-8.9 (-11.0 to-6.8 mmHg, P<0.001, TRAB alone),-2.5 (-4.5 to -0.4 mmHg, P=0.019, XEN45+PHACO), and-5.6 (-7.7 to-3.4 mmHg, P<0.001, TRAB±PHACO). The proportion of patients achieving an IOP≥6 and≤16 mmHg without treatment at the end of the 36-month follow-up were 50.8% (32/63) in the XEN45 implant and 49.3% (35/71) in the TRAB surgery group, P=0.863. The mean number of antiglaucoma medications was significantly reduced in all the study groups. The needling rate was 19% in XEN45 versus 5.6% in the TRAB group (P=0.030), and 2.81% and 36.6% of eyes in the TRAB group presented anterior chamber (AC) flattening and hyphema, respectively.

CONCLUSIONS: Trabeculectomy surgery lowered IOP significantly more than XEN45 implant with or without phacoemulsification over 3 years and had a significantly lower need for additional needling surgery. Both procedures reduce the number of antiglaucoma medications to a similar rate. These findings are relevant to the informed consent process and patient decisions for one procedure over the other.

PMID:35939830 | DOI:10.1097/IJG.0000000000002090

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Cognitive Training: A Field in Search of a Phenomenon

Perspect Psychol Sci. 2022 Aug 8:17456916221091830. doi: 10.1177/17456916221091830. Online ahead of print.

ABSTRACT

Considerable research has been carried out in the last two decades on the putative benefits of cognitive training on cognitive function and academic achievement. Recent meta-analyses summarizing the extent empirical evidence have resolved the apparent lack of consensus in the field and led to a crystal-clear conclusion: The overall effect of far transfer is null, and there is little to no true variability between the types of cognitive training. Despite these conclusions, the field has maintained an unrealistic optimism about the cognitive and academic benefits of cognitive training, as exemplified by a recent article (Green et al., 2019). We demonstrate that this optimism is due to the field neglecting the results of meta-analyses and largely ignoring the statistical explanation that apparent effects are due to a combination of sampling errors and other artifacts. We discuss recommendations for improving cognitive-training research, focusing on making results publicly available, using computer modeling, and understanding participants’ knowledge and strategies. Given that the available empirical evidence on cognitive training and other fields of research suggests that the likelihood of finding reliable and robust far-transfer effects is low, research efforts should be redirected to near transfer or other methods for improving cognition.

PMID:35939827 | DOI:10.1177/17456916221091830

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Nevin Manimala Statistics

Transition Rates and Efficiency of Collective Variables from Time-Dependent Biased Simulations

J Phys Chem Lett. 2022 Aug 8:7490-7496. doi: 10.1021/acs.jpclett.2c01807. Online ahead of print.

ABSTRACT

Simulations with adaptive time-dependent bias enable an efficient exploration of the conformational space of a system. However, the dynamic information is altered by the bias. Infrequent metadynamics recovers the transition rate of crossing a barrier, if the collective variables are ideal and there is no bias deposition near the transition state. Unfortunately, these conditions are not always fulfilled. To overcome these limitations, and inspired by single-molecule force spectroscopy, we use Kramers’ theory for calculating the barrier-crossing rate when a time-dependent bias is added to the system. We assess the efficiency of collective variables parameter by measuring how efficiently the bias accelerates the transitions. We present approximate analytical expressions of the survival probability, reproducing the barrier-crossing time statistics and enabling the extraction of the unbiased transition rate even for challenging cases. We explore the limits of our method and provide convergence criteria to assess its validity.

PMID:35939819 | DOI:10.1021/acs.jpclett.2c01807

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The Burnout in Canadian Pathology Initiative

Arch Pathol Lab Med. 2022 Aug 8. doi: 10.5858/arpa.2021-0200-OA. Online ahead of print.

ABSTRACT

CONTEXT.—: Burnout affects 44% of physicians, negatively impacts physicians and the patient care that they provide, and can be assessed by the Maslach Burnout Inventory. Forces contributing to physician burnout have been identified and grouped into 7 dimensions. Burnout within pathology has not been well studied.

OBJECTIVE.—: To identify the prevalence of burnout within Canadian pathology, drivers of burnout important in pathology, and pathologist burnout mitigation strategies at an individual and departmental level.

DESIGN.—: An electronic survey was disseminated by participating departmental chiefs and the Canadian Association of Pathologists. Survey content included the Maslach Burnout Inventory and 3 free-text questions, including: “What do you find most stressful about your work?” and “What is working for you, at an individual or departmental level, to mitigate against burnout?” Comparative statistics were performed by using Pearson χ2. Significant relationships were sought between pathologist burnout and potential drivers, using Mann-Whitney and Kruskal-Wallis tests. Responses to the qualitative questions were themed and mapped onto the 7 dimensions of burnout.

RESULTS.—: Four hundred twenty-seven pathologists participated in the survey from all 10 Canadian provinces. The prevalence of burnout in Canadian pathology was 58% (246 respondents), and there were significant differences by gender and years in practice. Drivers of pathologist burnout included workload and chronic work-related pain. The most frequently reported effective departmental strategy to mitigate against burnout mapped to “organizational culture,” and the approach that most individual pathologists have taken to mitigate against burnout involves work-life integration.

CONCLUSIONS.—: Burnout within Canadian laboratory medicine is prevalent, and workload is a major driver.

PMID:35939795 | DOI:10.5858/arpa.2021-0200-OA

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Multianalyte Prognostic Signature Including Circulating Tumor DNA and Circulating Tumor Cells in Patients With Advanced Pancreatic Adenocarcinoma

JCO Precis Oncol. 2022 Jul;6:e2200060. doi: 10.1200/PO.22.00060.

ABSTRACT

PURPOSE: Pancreatic ductal adenocarcinoma (PDAC) is associated with a poor prognosis. Multianalyte signatures, including liquid biopsy and traditional clinical variables, have shown promise for improving prognostication in other solid tumors but have not yet been rigorously assessed for PDAC.

MATERIALS AND METHODS: We performed a prospective cohort study of patients with newly diagnosed locally advanced pancreatic cancer (LAPC) or metastatic PDAC (mPDAC) who were planned to undergo systemic therapy. We collected peripheral blood before systemic therapy and assessed circulating tumor cells (CTCs), cell-free DNA concentration (cfDNA), and circulating tumor KRAS (ctKRAS)-variant allele fraction (VAF). Association of variables with overall survival (OS) was assessed in univariate and multivariate survival analysis, and comparisons were made between models containing liquid biopsy variables combined with traditional clinical prognostic variables versus models containing traditional clinical prognostic variables alone.

RESULTS: One hundred four patients, 40 with LAPC and 64 with mPDAC, were enrolled. CTCs, cfDNA concentration, and ctKRAS VAF were all significantly higher in patients with mPDAC than patients with LAPC. ctKRAS VAF (cube root; 0.05 unit increments; hazard ratio, 1.11; 95% CI, 1.03 to 1.21; P = .01), and CTCs ≥ 1/mL (hazard ratio, 2.22; 95% CI, 1.34 to 3.69; P = .002) were significantly associated with worse OS in multivariate analysis while cfDNA concentration was not. A model selected by backward selection containing traditional clinical variables plus liquid biopsy variables had better discrimination of OS compared with a model containing traditional clinical variables alone (optimism-corrected Harrell’s C-statistic 0.725 v 0.681).

CONCLUSION: A multianalyte prognostic signature containing CTCs, ctKRAS, and cfDNA concentration outperformed a model containing traditional clinical variables alone suggesting that CTCs, ctKRAS, and cfDNA provide prognostic information complementary to traditional clinical variables in advanced PDAC.

PMID:35939771 | DOI:10.1200/PO.22.00060