Tag: statistics

Eur J Neurol. 2022 Jul 15. doi: 10.1111/ene.15496. Online ahead of print.

ABSTRACT

AIMS: To explore associations between plasma neurofilament light chain concentration (pNfL; pg/mL) and disease activity in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and examine the usefulness of pNfL concentrations in determining disease remission.

METHODS: We examined pNfL concentrations in treatment-naïve CIDP patients (n=10) before and after intravenous immunoglobulin (IVIg) induction treatment, differences in pNfL concentrations in patients on maintenance IVIg treatment who had stable (n=15) or unstable disease (n=9), and in clinically stable IVIg-treated patients (n=10) in whom we suspended IVIg to determine disease activity and ongoing need for maintenance IVIg. pNfL concentrations in an age-matched healthy control group were measured for comparison.

RESULTS: Treatment-naïve patients: pNfL concentration was higher in patients before IVIg treatment than healthy controls and subsequently reduced comparable to control group values after IVIg induction. CIDP patients on IVIg treatment: pNfL concentration was significantly higher in unstable patients than stable patients. A pNFL concentration above 16.6 pg/mL identified unstable treated CIDP from stable treated CIDP (sensitivity= 86.7%, specificity= 66.7%, area under ROC= 0.73). Treatment withdrawal group: There was statistically significant correlation between pNfL concentration at time of IVIg withdrawal and the likelihood of relapse (r=0.72, p<0.05), suggesting an association of higher pNfL concentration with active disease.

CONCLUSION: pNfL concentrations may be a sensitive, clinically useful biomarker in assessing subclinical disease activity.

PMID:35837802 | DOI:10.1111/ene.15496

Res Synth Methods. 2022 Jul 15. doi: 10.1002/jrsm.1591. Online ahead of print.

ABSTRACT

The variance-stabilizing Freeman-Tukey double arcsine transform was originally proposed for inference on single proportions. Subsequently, its use has been suggested in the context of meta-analysis of proportions. While some erratic behaviour has been observed previously, here we point out and illustrate general issues of monotonicity and invertibility that make this transform unsuitable for meta-analysis purposes. This article is protected by copyright. All rights reserved.

PMID:35837800 | DOI:10.1002/jrsm.1591

Dermatol Ther. 2022 Jul 15:e15717. doi: 10.1111/dth.15717. Online ahead of print.

ABSTRACT

BACKGROUND: Various treatment methods are used for noninvasive body contouring.

OBJECTIVE: To evaluate the efficacy and safety of a newly designed cryolipolysis device using a three-dimensional cooling method for abdominal fat reduction.

METHODS: Twenty-five participants with clinically apparent abdominal fat tissue participated in the study. The thickness of fat tissue below the umbilicus level was measured using a caliper at baseline and 12 weeks after the first treatment. The height of abdominal subcutaneous fat tissue on ultrasonography and participant satisfaction were assessed at every visit for 16 weeks. All adverse events (AEs) during the study period were recorded. P values <0.05 were considered statistically significant.

RESULTS: Twenty-four participants completed this study; the mean BMI of participants was 29.34±2.36 kg/m² . The mean thickness of abdominal subcutaneous fat was significantly lower at 12 weeks (40.4±6.8 mm, p<0.001) than at baseline (49.3±8.5 mm). Differences in the height of abdominal subcutaneous fat compared to that at baseline were 1.02±0.41 cm (12 weeks, p<0.001) and 1.13±0.44 cm (16 weeks, p<0.001). Rates of abdominal subcutaneous fat reduction at 12 and 16 weeks compared to that at baseline were 28.45% and 31.13%, respectively. The ratio of abdominal circumference to hip circumference at 12 and 16 weeks was significantly decreased compared to that at baseline. Most participants (95.8%) reported improvement in satisfaction scores at 16 weeks. There were no serious AEs during the entire study period.

CONCLUSION: The study demonstrated the efficacy of a noninvasive cryolipolysis device using a three-dimensional cooling method for reducing abdominal subcutaneous fat. This article is protected by copyright. All rights reserved.

PMID:35837791 | DOI:10.1111/dth.15717

Acta Neuropathol Commun. 2022 Jul 14;10(1):103. doi: 10.1186/s40478-022-01399-4.

ABSTRACT

Dementia with Lewy bodies (DLB) is clinically diagnosed when patients develop dementia less than a year after parkinsonism onset. Age is the primary risk factor for DLB and mitochondrial health influences ageing through effective oxidative phosphorylation (OXPHOS). Patterns of stable polymorphisms in the mitochondrial genome (mtDNA) alter OXPHOS efficiency and define individuals to specific mtDNA haplogroups. This study investigates if mtDNA haplogroup background affects clinical DLB risk and neuropathological disease severity. 360 clinical DLB cases, 446 neuropathologically confirmed Lewy body disease (LBD) cases with a high likelihood of having DLB (LBD-hDLB), and 910 neurologically normal controls had European mtDNA haplogroups defined using Agena Biosciences MassARRAY iPlex technology. 39 unique mtDNA variants were genotyped and mtDNA haplogroups were assigned to mitochondrial phylogeny. Striatal dopaminergic degeneration, neuronal loss, and Lewy body counts were also assessed in different brain regions in LBD-hDLB cases. Logistic regression models adjusted for age and sex were used to assess associations between mtDNA haplogroups and risk of DLB or LBD-hDLB versus controls in a case-control analysis. Additional appropriate regression models, adjusted for age at death and sex, assessed associations of haplogroups with each different neuropathological outcome measure. No mtDNA haplogroups were significantly associated with DLB or LBD-hDLB risk after Bonferroni correction.Haplogroup H suggests a nominally significant reduced risk of DLB (OR=0.61, P=0.006) but no association of LBD-hDLB (OR=0.87, P=0.34). The haplogroup H observation in DLB was consistent after additionally adjusting for the number of APOE ε4 alleles (OR=0.59, P=0.004). Haplogroup H also showed a suggestive association with reduced ventrolateral substantia nigra neuronal loss (OR=0.44, P=0.033). Mitochondrial haplogroup H may be protective against DLB risk and neuronal loss in substantia nigra regions in LBD-hDLB cases but further validation is warranted.

PMID:35836284 | DOI:10.1186/s40478-022-01399-4

Clin Hypertens. 2022 Jul 15;28(1):21. doi: 10.1186/s40885-022-00204-7.

ABSTRACT

BACKGROUND: COVID-19 pandemic has aggravated chronic diseases and health disparities especially hypertension because it is more common among vulnerable populations such as older adults.

OBJECTIVE: This study aimed to examine the effects of a public health nursing intervention plus m-Health applications for hypertension management on enhancing the self-care, systolic and diastolic of blood pressure, and quality of life in older adults during the lockdown period in Jordan.

METHODS: A randomized, controlled trial design was performed in Jordan. A total of 120 participants were randomly allocated to three groups (n = 40); interventional group (public health nursing interventions plus m.Health applications) and two control groups (m.Health applications alone group and standard care group).

RESULTS: After 3 months, the interventional group show significantly decreased in systolic blood pressure – 14 (F = 16.74, P = 0.001), greater improvement in self-care maintenance, monitoring, and confidence (+ 30, + 17.75, + 40.27; P < 0.01, respectively) compared to the two control groups. Greater improvement in role limitations due to physical health and due to emotional problems, pain, energy/fatigue, emotional well-being, and social functioning of quality of life (P < 0.05) compared to the standard care group. No statistical significant difference was found in diastolic blood pressure (F = 3.91, P = 0.141), physical functioning (P = 0.613), and general quality of life (P = 0.060).

CONCLUSIONS: This study supports the adoption of technology with nursing intervention as a method of supporting continuity of self-management of chronic illness during the pandemic, and its potential implications for future delivery of health care, not just in Jordan, but across the world.

TRIAL REGISTRATION: Clinical Trial.gov (ID NCT04992000 ). Registered August 12, 2021.

PMID:35836287 | DOI:10.1186/s40885-022-00204-7

Global Health. 2022 Jul 14;18(1):70. doi: 10.1186/s12992-022-00863-z.

ABSTRACT

BACKGROUND: One of the worst pandemics of recent memory, COVID-19, severely impacted the public. In particular, students were physically and mentally affected by the lockdown and the shift from physical person-to-person classrooms to virtual learning (online classes). This increased the prevalence of psychological stress, anxiety, and depression among university students. In this study, we investigated the depression levels in Saudi Arabian university students who were learning virtually because of the COVID-19 pandemic and examined its impact on their educational proficiency.

METHODS: The study focused on two points: first, examining the depression levels among undergraduate students in Saudi Arabia, by adapting the Zung (Self-Rating Depression Scale) questionnaire. Second, whether there is an association between the levels of depression and various distress factors associated with virtual (online) learning resulting from the COVID-19 pandemic and its impact on students’ educational behaviors. The questionnaire was prepared using a monkey survey and shared online, via email, and on WhatsApp groups, with participants in two universities, a public and private university in the largest city of Saudi Arabia. A total of 157 complete responses were received. Data were analyzed using SPSS-24, the chi-square test, descriptive statistics, and multilinear regression.

RESULTS: The results indicated that three-fourths of the university students suffered from different depressive symptoms, half of which had moderate to extreme levels of depression. Our study confirmed that a boring virtual (online) learning method, stress, fear of examinations, and decreased productivity were significantly associated with increased depression. In addition, 75% and 79% of the students suffered from stress and fear of examinations, respectively. About half of the students were associated with increased depression. The outcome also indicated that female students experienced extreme depression, stress, and fear of examinations more than males.

CONCLUSION: These findings can inform government agencies and representatives of the importance of making swift, effective decisions to address students’ depression levels. It is essential to provide training for students to change their educational experience mindset, which might help decrease “depression and stress-related growth.” There is also a need to search for a better virtual teaching delivery method to lessen students’ stress and fear of examinations.

PMID:35836278 | DOI:10.1186/s12992-022-00863-z

J Food Sci. 2022 Jul 14. doi: 10.1111/1750-3841.16249. Online ahead of print.

ABSTRACT

The antimicrobial potential of switchgrass extractives (SE) was evaluated on cut lettuce leaves and romaine lettuce in planta, using rifampicin-resistant Escherichia coli O157:H7 and Salmonella Typhimurium strain LT2 as model pathogens. Cut lettuce leaves were swabbed with E. coli O157:H7 or S. Typhimurium followed by surface treatment with 0.8% SE, 0.6% sodium hypochlorite, or water for 1 to 45 min. For in planta studies, SE was swabbed on demarcated leaf surfaces either prior to or after inoculation of greenhouse-grown lettuce with E. coli O157:H7 or S. Typhimurium; the leaf samples were collected after 0, 24, and 48 h of treatment. Bacteria from inoculated leaves were enumerated on tryptic soy agar plates (and also on MacConkey’s and XLT4 agar plates), and the recovered counts were statistically analyzed. Cut lettuce leaves showed E. coli O157:H7 reduction between 3.25 and 6.17 log CFU/leaf, whereas S. Typhimurium reductions were between 2.94 log CFU/leaf and 5.47 log CFU/leaf depending on the SE treatment durations, from initial levels of ∼7 log CFU/leaf. SE treatment of lettuce in planta, before bacterial inoculation, reduced E. coli O157:H7 and S. Typhimurium populations by 1.88 and 2.49 log CFU after 24 h and 3 h, respectively. However, SE treatment after bacterial inoculation of lettuce plants decreased E. coli O157:H7 populations by 3.04 log CFU (after 0 h) with negligible reduction of S. Typhimurium populations. Our findings demonstrate the potential of SE as a plant-based method for decontaminating E. coli O157:H7 on lettuce during pre- and postharvest stages in hurdle approaches.

PMID:35836257 | DOI:10.1111/1750-3841.16249

BMC Health Serv Res. 2022 Jul 14;22(1):914. doi: 10.1186/s12913-022-08301-x.

ABSTRACT

BACKGROUND: In recent years, the Chinese government has been trying to improve informal-sector workers’ and farmers’ access to healthcare and reduce their financial burdens by introducing a plan of cost-sharing reduction, but the effect on outpatient care utilization remains unknown. Furthermore, scarce evidence has been provided to help understand the impact of cost-sharing reduction on healthcare use in low- and middle-income countries. The policy change of the coinsurance reduction for outpatient care from 75 to 55% for the enrollees of the Urban and Rural Residents Basic Medical Insurance in Taizhou, China in 2015 provides us a good quasi-experimental setting to explore such an impact.

METHODS: We do a quasi-experimental study to explore the impact of coinsurance reduction on outpatient care use among the informal-sector workers and farmers aged 45 and above by estimating a fixed-effects negative binomial model with the difference-in-differences approach and the matching method. Heterogeneous effects in primary care clinics and for the older people aged 60 and above are also examined. Our data is from the China Health and Retirement Longitudinal Study 2013 and 2015.

RESULTS: We find neither statistically significant impact of coinsurance reduction on outpatient care utilization in all health facilities for informal-sector workers and farmers aged 45 and above, nor heterogeneous effects in primary care clinics and for older people aged 60 and above.

CONCLUSIONS: We conclude that the coinsurance reduction cannot effectively improve the informal-sector workers’ and farmers’ utilization of healthcare if the cost-sharing undertaken by patients remains high even after the reduction. Besides, improving healthcare quality in primary care clinics may play a more important role than merely introducing a cost-sharing reduction plan in enhancing the role of primary care clinics as gatekeepers. We propose that only a substantial coinsurance reduction may help influence the utilization of healthcare for informal-sector workers and farmers, and enhancing the healthcare quality in primary care clinics should be given priority in low- and middle-income countries.

PMID:35836258 | DOI:10.1186/s12913-022-08301-x

Ir Vet J. 2022 Jul 14;75(1):16. doi: 10.1186/s13620-022-00223-8.

ABSTRACT

BACKGROUND: Reliable information about national pet dog populations is an important contributor to informed decision-making, both by governments and national dog welfare organisations. In some countries, there is an improved understanding of aspects of the national pet dog population, but as yet limited published information is available in Ireland. The current study reviews the utility of existing data to inform our understanding of recent changes to the pet dog population in Ireland, including both biological and organisational processes.

RESULTS: Based on national data on dog licencing and microchipping registration, pet dog numbers have remained relatively stable in recent years (ie prior to the COVID-19 pandemic). Since 2015, there has been a substantial decrease in the number of dogs managed through dog control centres. Although the completeness of the data are likely variable, there appears to be substantial, and increasing, number of dogs moving from Ireland to other countries, including UK, Sweden, Italy, Germany and Singapore. We also note an increase (albeit much smaller) in the number of dogs being moved into Ireland.

CONCLUSIONS: This study highlights the challenges faced when using existing national data to gain insights into the dog population of Ireland. The linking of existing national databases (individual dog identification, dog licencing, dog control statistics) has the potential to improve both the representativeness and accuracy of information about the Irish pet dog population. In the next phases of our work, we will focus on the work of dog welfare organisations, given both the increased role played by these organisations and the substantial public funding that has been committed in this sector.

PMID:35836251 | DOI:10.1186/s13620-022-00223-8

Environ Health. 2022 Jul 14;21(1):68. doi: 10.1186/s12940-022-00875-7.

ABSTRACT

BACKGROUND: Inorganic arsenic (iAs) is a ubiquitous metalloid and drinking water contaminant. Prenatal exposure is associated with birth outcomes across multiple studies. During metabolism, iAs is sequentially methylated to mono- and di-methylated arsenical species (MMAs and DMAs) to facilitate whole body clearance. Inefficient methylation (e.g., higher urinary % MMAs) is associated with increased risk of certain iAs-associated diseases. One-carbon metabolism factors influence iAs methylation, modifying toxicity in adults, and warrant further study during the prenatal period. The objective of this study was to evaluate folate, vitamin B12, and homocysteine as modifiers of the relationship between biomarkers of iAs methylation efficiency and birth outcomes.

METHODS: Data from the Biomarkers of Exposure to ARsenic (BEAR) pregnancy cohort (2011-2012) with maternal urine and cord serum arsenic biomarkers and maternal serum folate, vitamin B12, and homocysteine concentrations were utilized. One-carbon metabolism factors were dichotomized using clinical cutoffs and median splits. Multivariable linear regression models were fit to evaluate associations between each biomarker and birth outcome overall and within levels of one-carbon metabolism factors. Likelihood ratio tests of full and reduced models were used to test the significance of statistical interactions on the additive scale (α = 0.10).

RESULTS: Among urinary biomarkers, % U-MMAs was most strongly associated with birth weight (β = – 23.09, 95% CI: – 44.54, – 1.64). Larger, more negative mean differences in birth weight were observed among infants born to women who were B12 deficient (β = – 28.69, 95% CI: – 53.97, – 3.42) or experiencing hyperhomocysteinemia (β = – 63.29, 95% CI: – 154.77, 28.19). Generally, mean differences in birth weight were attenuated among infants born to mothers with higher serum concentrations of folate and vitamin B12 (or lower serum concentrations of homocysteine). Effect modification by vitamin B12 and homocysteine was significant on the additive scale for some associations. Results for gestational age were less compelling, with an approximate one-week mean difference associated with C-tAs (β = 0.87, 95% CI: 0, 1.74), but not meaningful otherwise.

CONCLUSIONS: Tissue distributions of iAs and its metabolites (e.g., % MMAs) may vary according to serum concentrations of folate, vitamin B12 and homocysteine during pregnancy. This represents a potential mechanism through which maternal diet may modify the harms of prenatal exposure to iAs.

PMID:35836250 | DOI:10.1186/s12940-022-00875-7