Categories
Nevin Manimala Statistics

Cold-stored leukoreduced whole blood: Extending the time between donation and filtration has minimal impact on in vitro quality

Transfusion. 2021 Jul;61 Suppl 1:S131-S143. doi: 10.1111/trf.16540.

ABSTRACT

BACKGROUND: Leukoreduced whole blood (LR-WB) has received renewed attention as alternative to component-based transfusion in trauma. According to the manufacturer’s instructions, leukoreduction should be carried out within 8 h after collection. This study assessed impact of (1) WB collection bag, (2) LR filtration, and (3) timing of filtration on in vitro quality.

STUDY DESIGN AND METHODS: WB collected into different vendor bags was held at room temperature for <8 h or >16 h but <24 h prior to LR. In vitro quality was assessed before and after filtration, and throughout 3 weeks of storage at 4°C. Cell count and hemoglobin levels were determined by hematology analyzer, platelet activation, and responsiveness to ADP by surface expression of P-selectin by flow cytometry, hemolysis by HemoCue, and metabolic parameters by blood gas analyzer. Hemostatic properties were assessed by rotational thromboelastometry. Plasma protein activities and clotting times were determined by automated coagulation analyzer or quantitative immunoblotting.

RESULTS: Bag type had no impact on WB in vitro quality. LR by filtration had some impact, but is aligned with data in the literature. The time between donation and filtration resulted in some statistically significant differences in metabolic activity, platelet yield, platelet activation, and factor protein activity initially; however, these differences in in vitro quality attributes decreased throughout 21-day cold storage.

CONCLUSION: WB hold time showed only a minor impact on WB in vitro quality, so it may be possible for blood processing facilities to explore extended hold times prior to filtration in order to provide greater operational flexibility.

PMID:34269454 | DOI:10.1111/trf.16540

Categories
Nevin Manimala Statistics

Management of work stress in science education lecturers’ population using rational emotive occupational health coaching: Implication for educational evaluators

J Community Psychol. 2021 Jul 16. doi: 10.1002/jcop.22667. Online ahead of print.

ABSTRACT

INTRODUCTION: Nigerian university lecturers face a lot of works in the day-to-day discharge of their responsibilities as academics. This constitutes a lot of stress for them as documented in the literature. However, literature is scarce on how these lecturers manage their work stress. Thus, the researchers explored the efficacy of rational emotive occupational health coaching (REOHC) on the management of work stress among lecturers.

METHOD: A randomised controlled trial group experimental research design was adopted using a sample size of 84 lecturers in Science Education Departments of the sampled universities. An occupational stress index was used in the gathering of necessary data for the study. The REOHC treatment lasted for 12 weeks after which the participants were posttested and a follow-up measure followed after 3 months of the termination of the treatment. Repeated measures analysis of variance statistical approach was used to analyse the obtained data.

RESULTS: It was revealed that REOHC was significantly (p < 0.05) effective in the management of work stress in a population of science education lecturers in Nigeria.

CONCLUSION: REOHC enables science education lecturers to effectively manage their work stress to maximise their work outputs. This finding implicates the expertise of Educational Evaluators.

PMID:34269427 | DOI:10.1002/jcop.22667

Categories
Nevin Manimala Statistics

Quantification of anti-A of IgM or IgG isotype using three different methodologies

Transfusion. 2021 Jul;61 Suppl 1:S214-S222. doi: 10.1111/trf.16491.

ABSTRACT

BACKGROUND: Reliability of ABO-antibody measurement is important in the context of supplying low-titer ABO incompatible plasma-containing blood products. This study investigated the correlation of anti-A measurements between three different titer methodologies.

METHODS: Thirty-four blood group O individuals were included. IgM and IgG anti-A was measured by three different methods: (1) manual method (Bio-Rad ID-gel card), (2) automated method (Immucor NEO), (3) flow cytometry (FC) with calibration in molecules of equivalent fluorochrome (MEF). Data were log2 transformed to titer steps (TS) and log2 MEF, respectively. All three methods were benchmarked against the 14/300 WHO anti-A/anti-B standard reagent.

RESULTS: The correlation between the manual and automated methods was statistically significant for both IgM (Spearman’s rs = 0.89, p < .0001) and IgG (rs = 0.95, p < .0001). The mean TS difference between the manual and automated methods was 0.61 for IgM (p = .0033) and 2.1 for IgG (p < .0001). The manual method yielded IgM titer results that were generally 1 titer step higher than the automated method, whereas for the IgG titrations the difference was generally a median of 2 TS higher. The FC median log2 MEF level was significantly correlated with TS of IgG and IgM for both manual and automated agglutination-based titer methods (0.69 ≤ r2 ≤ 0.91). With the WHO standard reagent, the manual method produced the expected results while the automated method’s results were 1 TS lower for both IgM and IgG at all dilutions tested.

CONCLUSION: These results indicate that all three methods are suitable for measuring anti-A in group O whole blood.

PMID:34269431 | DOI:10.1111/trf.16491

Categories
Nevin Manimala Statistics

Safety profile of low-titer group O whole blood in pediatric patients with massive hemorrhage

Transfusion. 2021 Jul;61 Suppl 1:S8-S14. doi: 10.1111/trf.16456.

ABSTRACT

BACKGROUND: Low-titer Group O Whole Blood (LTOWB) is used with increasing frequency in adult and pediatric trauma and massive bleeding transfusion protocols. There is a risk of acute hemolytic reactions in non-group O recipients due to the passive transfusion of anti-A and anti-B in the LTOWB. This study investigated the hemolysis risk among pediatric recipients of LTOWB.

STUDY DESIGN AND METHODS: Blood bank records were queried for pediatric recipients of LTOWB between June 2016 and August 2020 and merged with clinical data. The primary outcome was laboratory evidence of hemolysis as manifested by changes in lactate dehydrogenase (LDH), haptoglobin, total bilirubin, reticulocyte count, potassium, and creatinine. Per protocol, these values were collected on hospital days 0-2 for recipients of LTOWB. Transfusion reactions were reported to the hospital’s blood bank.

RESULTS: Forty-seven children received LTOWB transfusion between 2016 and 2020; 21 were group O and 26 were non-group O. The groups were comparable in terms of the total volume of transfused blood products, demographics, and clinical outcomes. The most common indication for LTOWB transfusion was hemorrhagic shock due to trauma. There were no clinically or statistically significant differences in baseline, post-transfusion day 1, or post-transfusion day 2 hemolysis markers between the group O and non-group O LTOWB recipients. There were no adverse events or transfusion reactions reported.

DISCUSSION: Use of up to 40 ml/kg of LTOWB appears to be serologically safe for children in hemorrhagic shock.

PMID:34269441 | DOI:10.1111/trf.16456

Categories
Nevin Manimala Statistics

Statistical modeling of longitudinal medical cost trajectory: renal cell cancer care cost analyses

Biostatistics. 2020 Jul 16:kxab024. doi: 10.1093/biostatistics/kxab024. Online ahead of print.

ABSTRACT

Estimating the current cost of cancer care is important to health policy makers. An indispensable step in cost projection is to estimate cost trajectories from an incident cohort of cancer patients using longitudinal medical cost data, accounting for terminal events such as death, and right censoring due to loss of follow-up. Since the cost of cancer care and survival are correlated, a scientifically meaningful quantity for inference in this context is the mean cost trajectory conditional on survival. We propose a two-stage semiparametric approach to estimate the longitudinal cost trajectories from a joint model of longitudinal medical costs and survival. The longitudinal cost trajectories corresponding to various survival times form a bivariate surface in a triangular area. The cost trajectories are estimated using the tensor products of discretized measurement time and survival, as well as effective ridge penalties for data in 2D arrays. The proposed approach balances the practical considerations of model flexibility, statistical efficiency, and computational tractability. We used the proposed method to estimate the cost trajectories of renal cell cancer patients using the Surveillance, Epidemiology, and End Results-Medicare linked database.

PMID:34269395 | DOI:10.1093/biostatistics/kxab024

Categories
Nevin Manimala Statistics

The link between attitudes toward probationers and job burnout in Turkish probation officers

J Community Psychol. 2021 Jul 16. doi: 10.1002/jcop.22673. Online ahead of print.

ABSTRACT

The goal of the current study was to investigate individual-level factors associated with job burnout among probation officers (POs) and, specifically, to examine if attitudes toward probationers were linked with job burnout in the context of the recently established probation system in Turkey. Participants (N = 115) were recruited from a probation office in Istanbul. Job burnout was assessed via three components: emotional exhaustion, depersonalization, and professional accomplishment. Results of structural equation modeling indicated that more favorable attitudes toward probationers were related to a lower sense of depersonalization and higher experience of professional accomplishment. However, POs’ attitudes toward probationers were not associated with emotional exhaustion. Our findings are discussed in light of the present empirical literature on the contextual factors influential in job burnout. Practical implications for burnout prevention point to the potential effectiveness of working on attitudes among POs toward the people they supervise.

PMID:34269425 | DOI:10.1002/jcop.22673

Categories
Nevin Manimala Statistics

Predictors, time course, and outcomes of persistence patterns in oral anticoagulation for non-valvular atrial fibrillation: a Dutch Nationwide Cohort Study

Eur Heart J. 2021 Jul 16:ehab421. doi: 10.1093/eurheartj/ehab421. Online ahead of print.

ABSTRACT

AIMS : Persistence with direct oral anticoagulants (DOACs) has become a concern in non-valvular atrial fibrillation (NVAF) patients, but whether this affects prognosis is rarely studied. We investigated the persistence with oral anticoagulants (OACs) and its association with prognosis among a nationwide cohort of NVAF patients.

METHODS AND RESULTS : DOAC-naive NVAF patients who started to use DOACs for ischaemic stroke prevention between 2013 and 2018 were included using Dutch national statistics. Persistence with OACs was determined based on the presence of a 100-day gap between the last prescription and the end of study period. In 93 048 patients, 75.7% had a baseline CHA2DS2-VASc score of ≥2. The cumulative incidence of persistence with OACs was 88.1% [95% confidence interval (CI) 87.9-88.3%], 82.6% (95% CI 82.3-82.9%), 77.7% (95% CI 77.3-78.1%), and 72.0% (95% CI 71.5-72.5%) at 1, 2, 3, and 4 years after receiving DOACs, respectively. Baseline characteristics associated with better persistence with OACs included female sex, age range 65-74 years, permanent atrial fibrillation, previous exposure to vitamin K antagonists, stroke history (including transient ischaemic attack), and a CHA2DS2-VASc score ≥2. Non-persistence with OACs was associated with an increased risk of the composite outcome of ischaemic stroke and ischaemic stroke-related death [adjusted hazard ratio (aHR) 1.79, 95% CI 1.49-2.15] and ischaemic stroke (aHR 1.58, 95% CI 1.29-1.93) compared with being persistent with OACs.

CONCLUSION : At least a quarter of NVAF patients were non-persistent with OACs within 4 years, which was associated with poor efficacy of ischaemic stroke prevention. The identified baseline characteristics may help identify patients at risk of non-persistence.

PMID:34269375 | DOI:10.1093/eurheartj/ehab421

Categories
Nevin Manimala Statistics

Corrigendum to: Fast Lasso method for large-scale and ultrahigh-dimensional Cox model with applications to UK Biobank

Biostatistics. 2021 Jul 7:kxab019. doi: 10.1093/biostatistics/kxab019. Online ahead of print.

NO ABSTRACT

PMID:34269393 | DOI:10.1093/biostatistics/kxab019

Categories
Nevin Manimala Statistics

Smaller p-values in genomics studies using distilled auxiliary information

Biostatistics. 2021 Jul 16:kxaa053. doi: 10.1093/biostatistics/kxaa053. Online ahead of print.

ABSTRACT

Medical research institutions have generated massive amounts of biological data by genetically profiling hundreds of cancer cell lines. In parallel, academic biology labs have conducted genetic screens on small numbers of cancer cell lines under custom experimental conditions. In order to share information between these two approaches to scientific discovery, this article proposes a “frequentist assisted by Bayes” (FAB) procedure for hypothesis testing that allows auxiliary information from massive genomics datasets to increase the power of hypothesis tests in specialized studies. The exchange of information takes place through a novel probability model for multimodal genomics data, which distills auxiliary information pertaining to cancer cell lines and genes across a wide variety of experimental contexts. If the relevance of the auxiliary information to a given study is high, then the resulting FAB tests can be more powerful than the corresponding classical tests. If the relevance is low, then the FAB tests yield as many discoveries as the classical tests. Simulations and practical investigations demonstrate that the FAB testing procedure can increase the number of effects discovered in genomics studies while still maintaining strict control of type I error and false discovery rate.

PMID:34269373 | DOI:10.1093/biostatistics/kxaa053

Categories
Nevin Manimala Statistics

Explanatory factors on the acceptance of SARS-CoV-2 vaccine from consumer’s behaviour perspective.

Rev Esp Salud Publica. 2021 Jul 28;95:e202107101.

ABSTRACT

OBJECTIVE: The success of policies to eradicate COVID-19 depends on the acceptance of vaccines among the population. This paper measures the influence on the intention to get vaccinated of three usual variables in studies on consumer behavior: the perception of the efficiency and risk of the vaccine and the social influence.

METHODS: It was used a survey of 600 residents in Spain that was answered during September 2020 has been used. That survey was conveniently stratified by age and monthly income. The impact of the explanatory variables on the intention to use the vaccine was measured with generalized linear models: logistic regression and truncated negative binomial regression. Contro variables were gender, age and monthly income.

RESULTS: We have observed a positive (negative) influence of the variables efficacy perception and social influence (perception of risk), i.e. a ratio of rate use above (below) 1 that is statistically significant (p<0.01 in the case of the first two variables and p<0.05 in the third). Their importance follows the order described above. Neither gender nor age were significant in the intention to get vaccinated, but the income level was. We identified that at the highest income levels there was a greater propensity to reject the vaccine (p<0.1).

CONCLUSIONS: The results may be useful to guide the information policy that health authorities should carry out in order to induce the population to use the SARS-CoV-2 vaccine.

PMID:34267176