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Biomedical subjects

John Neuhaus

Publications and source records attributed to John Neuhaus.

4 recordsLinked to original sources

Safety and efficacy of citrus aurantium for weight loss.

To examine the safety and efficacy of citrus aurantium, an herb now commonly used as a substitute for ephedra in dietary supplements marketed to promote weight loss, we conducted a systematic review. An extensive search of MEDLINE, EMBASE, BIOSIS, and the Cochrane Collaboration Database identified only 1 eligible randomized placebo controlled trial, which followed 20 patients for 6 weeks, demonstrated no statistically significant benefit for weight loss, and provided limited information about the safety of the herb.

Citrus↗

Variability in respiratory protection and the assigned protection factor.

The workplace protection factor (WPF) for a given respirator wearer shows substantial variability from wearing to wearing; this variability is commonly assumed to be lognormal in nature. Further, when multiple WPFs are measured for each of multiple wearers, the aggregated WPFs appear to follow a lognormal distribution. However, the analysis typically applied to WPF data does not apportion variability within versus between wearers. We present an analytical framework based on a normal random effects model of log-transformed penetration P values (P = 1/WPF). Data from seven studies of negative-pressure air-purifying half-mask respirators, and from two studies of hemlet-and-visor type powered air-purifying respirators were analyzed by the method of maximum likelihood in the context of the model. More specifically, analyses were performed for log-transformed P values and for logit-transformed P values. Parameter estimates included within-wearer and between-wearer variance components. In general, the within-wearer component dominated the between-wearer component. We also propose a method for establishing an assigned protection factor, APF, that properly accounts for these variance components. Our method provides an APF satisfying two criteria: (1) for a given wearer, an acceptable WPF distribution has no more than 5% of WPFs below the APF value; and (2) for a wearer population, no more than 5% of wearers have unacceptable WPF distributions. The method incorporates an one-sided confidence limit to account for sampling variability. Alternative confidence limits were computed based on large sample variance estimates of random effects model parameters versus a bootstrap method. In general, there was good agreement between the APF values based on log-transformed versus logit-transformed P data, and between APF values based on the large sample variance estimates versus the bootstrap method. Based on large sample variance estimates for the logit-transformed P data from the seven half-mask studies, estimated APFs ranged from 1.4 to 250, with 5/7 studies yielding an APF </= 5.3. Given these results and related considerations, we recommend that the current half-mask APF be reduced from 10 to 5.

Air Pollution, Indoor↗

Binomial regression with misclassification.

Motivated by a study of human papillomavirus infection in women, we present a Bayesian binomial regression analysis in which the response is subject to an unconstrained misclassification process. Our iterative approach provides inferences for the parameters that describe the relationships of the covariates with the response and for the misclassification probabilities. Furthermore, our approach applies to any meaningful generalized linear model, making model selection possible. Finally, it is straightforward to extend it to multinomial settings.

Bayes Theorem↗

Comorbidity of bipolar disorder and substance abuse in Costa Rica: pedigree- and population-based studies.

BACKGROUND: The purpose of this study was to determine the prevalence of substance use disorders (substance abuse or substance dependence: SA/SD) in a large sample of Bipolar Type I (BPI) patients drawn from the Costa Rican population and to describe the effects of SA/SD on the course of their bipolar disorder. METHOD: 110 subjects from two high-risk (for BPI) Costa Rican pedigrees and 205 unrelated Costa Rican BPI subjects were assessed using structured interviews and a best estimate process. Chi(2) and survival analyses were performed to assess the effect of gender on comorbidity risk, and the effect of comorbidity on the clinical course of BPI. RESULTS: SA/SD (primarily alcohol dependence) occurred in 17% of the BPI patients from the population sample and 35% of the BPI patients from the pedigree sample. Comorbid SA/SD was strongly associated with gender chi(2) = 16.84, P = 0.00004). In comorbid subjects, alcohol dependence tended to predate the first manic episode (chi(2) = 6.54, P < 0.025). History of SA/SD did not significantly alter the prevalence of psychosis or age of onset of mania in BPI subjects. CONCLUSIONS: These results suggest that SA/SD comorbidity rates are lower in this type of population than in BPI patient populations in the US. Gender is a strong predictor of comorbidity prevalence in BPI patients from this population. Although SA/SD may be a risk factor for precipitating BPI in those at risk, in this population comorbid BPI subjects do not have a different onset or course of BPI in comparison to BPI patients without comorbidity.

Bipolar Disorder↗