Category: Nevin Manimala

Biostatistics. 2021 Oct 16:kxab034. doi: 10.1093/biostatistics/kxab034. Online ahead of print.

ABSTRACT

In recent years, a number of methods have been proposed to estimate the times at which a neuron spikes on the basis of calcium imaging data. However, quantifying the uncertainty associated with these estimated spikes remains an open problem. We consider a simple and well-studied model for calcium imaging data, which states that calcium decays exponentially in the absence of a spike, and instantaneously increases when a spike occurs. We wish to test the null hypothesis that the neuron did not spike-i.e., that there was no increase in calcium-at a particular timepoint at which a spike was estimated. In this setting, classical hypothesis tests lead to inflated Type I error, because the spike was estimated on the same data used for testing. To overcome this problem, we propose a selective inference approach. We describe an efficient algorithm to compute finite-sample $p$-values that control selective Type I error, and confidence intervals with correct selective coverage, for spikes estimated using a recent proposal from the literature. We apply our proposal in simulation and on calcium imaging data from the $texttt{spikefinder}$ challenge.

PMID:34654923 | DOI:10.1093/biostatistics/kxab034

Eur Arch Otorhinolaryngol. 2021 Oct 16. doi: 10.1007/s00405-021-07130-8. Online ahead of print.

ABSTRACT

PURPOSE: The present study aims to review the outcomes of coblation supraglottoplasty performed for children with different types of laryngomalacia, and we discuss the factors affecting these outcomes.

METHODS: We retrospectively reviewed the medical records of laryngomalacia patients admitted to the Otorhinolaryngology Department, Mansoura University, from 2010 to 2020. We examined the patient’s demography, symptoms, comorbidities, type of laryngomalacia, oxygen saturation, and final outcomes.

RESULTS: Our study included 235 patients; 122 patients responded to medical therapy, while 113 underwent surgical management. There is a significant relation between the types and therapy they underwent (p ≤ 0.001). Larger percentage within type I underwent medical therapy. There is a statistically significant difference between the studied groups regarding age at surgery. On pairwise comparison, patients with type II had the lowest age significantly at the surgery when compared with each other individual group (p ≤ 0.001). On multivariate regression analysis, the presence of comorbid congenital heart disease, neurological comorbidities significantly increased the risk of failure of surgical intervention by 17.32 and 5.803 folds, respectively.

CONCLUSIONS: Coblation supraglottoplasty is effective and safe to treat severe laryngomalacia. Different morphological types of laryngomalacia require slight surgical variations of coblation supraglottoplasty. The presence of comorbid congenital heart disease, neurological comorbidities significantly increased the risk of failure of surgical intervention.

PMID:34654950 | DOI:10.1007/s00405-021-07130-8

Nat Methods. 2021 Oct 15. doi: 10.1038/s41592-021-01302-4. Online ahead of print.

NO ABSTRACT

PMID:34654918 | DOI:10.1038/s41592-021-01302-4

J Pediatr Endocrinol Metab. 2021 Oct 18. doi: 10.1515/jpem-2021-0458. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of the current prospective randomized control study was to assess efficacy, safety, and non-inferiority of a new liquid L-thyroxine formulation dissolved in glycerol and water (T4^® drops, produced by a Greek pharmaceutical Company, Uni-Pharma, Athens, Greece) in comparison to the standard Tablets form (T4^® tablets, Uni-Pharma, Athens, Greece) in the substitutive treatment of children with congenital hypothyroidism (CH).

METHODS: Thirty-nine children with CH, aged 3-12 years old, were enrolled in the study, after parental Informed Consent has been obtained, while three patients were lost from follow-up. At baseline, all participants had normal thyroid-stimulating hormone (TSH) and Free T4 values. Patients were randomly subdivided according to the assigned treatment in Group A (n=17)-Tablet Form and Group B (n=19)-Liquid Form. TSH and Free T4 levels were evaluated at 0, 2, 4, and 6 months.

RESULTS: TSH values showed a statistically significant difference (p=0.017) between groups only at six months (Group A having higher TSH levels than Group B, albeit within the normal range), while Free T4 levels had no statistical difference throughout the six month study period and were always within the normal range. Moreover, dose adjustments were more frequent in Group A (p=0.038) during the six months. Liquid L-thyroxine substitutive treatment exhibited no statistically significant adverse effects in comparison to the widely used tablets.

CONCLUSIONS: Levothyroxine (LT4) as liquid solution formulation is safe and noninferior to the widely used L-thyroxine Tablets, with less need for dose adjustment, and can therefore be safely used in the treatment of children with CH.

PMID:34653328 | DOI:10.1515/jpem-2021-0458

Ecol Appl. 2021 Oct 15:e02475. doi: 10.1002/eap.2475. Online ahead of print.

ABSTRACT

Assessing the patterns of wildlife attendance to specific areas is relevant across many fundamental and applied ecological studies, particularly when animals are at risk of being exposed to stressors within or outside the boundaries of those areas. Marine mammals are increasingly being exposed to human activities that may cause behavioral and physiological changes, including military exercises using active sonars. Assessment of the population-level consequences of anthropogenic disturbance requires robust and efficient tools to quantify the levels of aggregate exposure for individuals in a population over biologically relevant time frames. We propose a discrete-space, continuous-time approach to estimate individual transition rates across the boundaries of an area of interest, informed by telemetry data collected with uncertainty. The approach allows inferring the effect of stressors on transition rates, the progressive return to baseline movement patterns, and any difference among individuals. We apply the modeling framework to telemetry data from Blainville’s beaked whale (Mesoplodon densirostris) tagged in the Bahamas at the Atlantic Undersea Test and Evaluation Center (AUTEC), an area used by the U.S. Navy for fleet readiness training. We show that transition rates changed as a result of exposure to sonar exercises in the area, reflecting an avoidance response. Our approach supports the assessment of the aggregate exposure of individuals to sonar and the resulting population-level consequences. The approach has potential applications across many applied and fundamental problems where telemetry data are used to characterize animal occurrence within specific areas.

PMID:34653299 | DOI:10.1002/eap.2475

J Burn Care Res. 2021 Oct 15:irab186. doi: 10.1093/jbcr/irab186. Online ahead of print.

ABSTRACT

The hypermetabolic response from burn injury is the highest of the critically ill patient population. When coupled with the hypermetabolic response, preexisting malnutrition may increase the hospital resources used. The goal of this study was to evaluate the rate of malnutrition in burn patients and the associated hospital resource utilization.We collected prospective data on burn patients ≥ 18 years with a burn ≥ 10% TBSA admitted to a regional burn center. Demographics, %TBSA, co-morbidities, length of stay (LOS) and standardized LOS (LOS/%TBSA) were evaluated on 49 patients. A multivariable regression model was constructed. Nutrition assessment was completed within 24-48 hours of admission including an SGA (Subjective Global Assessment) classification. SGA A (well-nourished) was compared to SGA B and C (malnourished). Fourteen patients (28.6%) in this study were malnourished. Malnourished patients were not statistically different with respect to median age (50 versus 39; p = 0.08] and BMI (22.9 versus 26.5; p = 0.08) compared to the well-nourished group. However, malnourished patients had significantly longer median LOS (21.0 versus 11.0 days, p = 0.01) and LOS/%TBSA (1.69 versus 0.83, p = 0.001) than the well-nourished group. Being malnourished was a significant independent predictor of above median LOS/%TBSA (p=0.027) with an odds ratio (OR) of 5.61 (95% C.I. 1.215-25.890).The rate of malnutrition is important given the high metabolic demands of these patients. Malnutrition increased the resource requirements via higher standardized LOS. This underscores the importance of completing SGA on admission to identify malnutrition early on to optimize nutrition intervention during the patients’ hospital stay.

PMID:34653246 | DOI:10.1093/jbcr/irab186

Int J Gynaecol Obstet. 2021 Oct 15. doi: 10.1002/ijgo.13983. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the efficiency, postoperative hysterectomy rate, and influencing factors for therapeutic effect of NovaSure endometrial ablation procedure in abnormal uterine bleeding (AUB) .

METHODS: We conducted a retrospective cohort study of 2152 patients from department of Gynecology, the Third Xiangya Hospital, CSU from October 2010 to December 2018.

RESULTS: From the first year to the eighth year after operation, annual effective rate was above 95.24%, and the differences were not statistically significant. There are statistically significant differences between the effective and the ineffective group with regard to age, intrauterine polyps, total length of the uterus, systemic coagulation disorder, and preoperative hemoglobin. A multivariate logistic regression analysis showed that the risk factors associated with systemic coagulation disorders (P=0.027) and long total uterine length (P=0.003) affected NovaSure efficacy in the treatment of AUB. By December 2019, the postoperative hysterectomy rate was 1.86% (40/2152) and the complication rate was 1.67% (36/2152).

CONCLUSION: NovaSure is a reliable treatment for AUB and serious medical complications due to its simple operation, low amount of bleeding, quick postoperative recovery, and safe and effective short-term and long-term efficacy. However, it should be carefully selected for patients with a total uterus length exceeding 10 cm.

PMID:34653258 | DOI:10.1002/ijgo.13983

PLoS One. 2021 Oct 15;16(10):e0258651. doi: 10.1371/journal.pone.0258651. eCollection 2021.

ABSTRACT

INTRODUCTION: To make valid comparisons across groups, a measurement instrument needs to be measurement invariant across those groups. The present study evaluates measurement invariance for experience of violence among adolescent girls and young women (AGYW) in two informal settlements in Nairobi, Kenya.

METHODS: We used survey data collected from 1,081 AGYW aged 15-22 years from two Nairobi’s informal settlements of Korogocho (n = 617) and Viwandani (n = 464) in 2017 through DREAMS (an initiative aimed at reducing HIV incidence among AGYW with a core package of evidence-based interventions) impact evaluation project. Experience of violence was measured using the 15-item WHO’s violence against women instrument, and factorial (non)invariance assessed within exploratory structural equation modeling (ESEM) framework. Cross-group measurement invariance was assessed using Bayesian Multiple Indicator Multiple Causes (MIMIC) model across site, age groups, self-reported invitation to participate in DREAMS, marital status, currently in school, education level, religion, ethnic groups, ever had sex, slept hungry at night past 4 weeks, and wealth index.

RESULTS: The mean and median ages of the AGYW were 17.9 years and 17 years, respectively. About 59% reported having had sex and 58% of AGYW were in school. The percentage reporting each act of violence varied from 1.6% (“attacked you with a weapon”) to 26.5% (“insult you or make you feel bad about yourself”). About 44% (n = 474) of participants experienced ≥1 acts of violence, and 2.7% (n = 29) experienced at least half of the 15 acts. The structure underlying the 15 items was configurally similar to that proposed by WHO, with three factors reflecting either psychological, physical, or sexual violence. Noninvariance was detected for five items-spread across the three domains. Three of five items showed noninvariance only for sleeping hungry at night in the past 4 weeks. As the majority of items did not show evidence of noninvariance, differences in latent mean scores likely reflect actual differences and may not be attributable to measurement artifacts.

CONCLUSIONS: Using state-of-the-art statistical techniques on a widely used instrument for measuring exposure to violence among women, this study provides support for the subscales of psychological, physical and sexual violence in a Kenyan AGYW population. The instrument supports comparisons across groups within this population. This is crucial when comparing violence against girls/women prevalence rates and to understand challenges and exchange strategies to reduce abuse or violence experienced by AGYW, or women in general.

PMID:34653232 | DOI:10.1371/journal.pone.0258651

J Burn Care Res. 2021 Oct 15:irab185. doi: 10.1093/jbcr/irab185. Online ahead of print.

ABSTRACT

BACKGROUND: Large-volume fluid resuscitation remains irreplaceable in the early-stage management of severe burns. We aimed to explore the relationship between fluid volume and other indicators.

METHOD: Data of severe burn patients with successful resuscitation in the early stage was collected. Correlation and linear regression analyses were performed. Multiple linear regression models, related goodness-of-fit assessment (adjusted R-square and Akaike Information Criterion), scatter plots and paired t-test for two models, and a likelihood ratio test were performed.

RESULTS: 96 patients were included. The median of total burn area (TBA) was 70%TBSA, with full thickness burn area (FTBA)/TBA of 0.4, a resuscitation volume of 1.93 mL/kg/%TBSA. Among volume-correlated indicators, two linear regression models were established (Model 1: TBA × weight and tracheotomy; and Model 2: FTBA × weight, partial thickness burn area (PTBA) × weight, and tracheotomy). For these models, close values of Akaike Information Criterion, adjusted R-squares, outliers of the prediction range, and the result of paired t-test, all suggest similarity between two models estimations, while the likelihood ratio test for coefficients of FTBA × weight and PTBA × weight showed a statistical difference.

CONCLUSION: inhalational injury and decompression surgery only correlated with volume, while Tracheotomy, TBA × weight, FTBA × weight, and PTBA × weight correlated with and were accepted in linear models of volume. Although FTBA and PTBA differed statistically, there may be no need to distinguish them when estimating the resuscitation volume requirements in this patient set. Further study about different depths fluid should be conducted.

PMID:34653244 | DOI:10.1093/jbcr/irab185

PLoS One. 2021 Oct 15;16(10):e0258620. doi: 10.1371/journal.pone.0258620. eCollection 2021.

ABSTRACT

OBJECTIVES: To determine treatment seeking behaviour in those with opioid use disorder (OUD) in the high-income countries.

METHODS: Five databases were searched in November 2019 for quantitative studies that reported OUD treatment seeking behaviour. Data analysis involved determining an overall pooled proportion estimate of treatment seeking behaviour for the two base groups, lifetime treatment and past 12-month or less treatment using the IVhet effect model. Subgroup analysis included heroin OUD, prescription OUD and general OUD. The sensitivity analysis included removal of outliers, separating adults and adolescents and the metaXL sensitivity analysis (studies are excluded if outside the pooled proportion confidence interval of the base case). Systematic review Prospero database registration number [CRD42020159531].

RESULTS: There were 13 quantitative studies included in the systematic review, with all studies being from the United States of America (USA). IVhet models showed that 40% (95% CI: 23%, 58%) and 21% (95% CI: 16%, 26%) sought treatment in their lifetime and past 12 months respectively. Sub-group analysis found that lifetime treatment seeking for prescription OUD, 29% (95% CI: 27%, 31%), was less than for heroin plus combined OUD, 54% (95% CI: 26%, 82%). Most of the pooled results had high heterogeneity statistics except for results of lifetime treatment seeking for prescription OUD and past 12-month treatment seeking for prescription OUD.

CONCLUSION: All included studies in this meta-analysis were from the USA and indicate modest levels of treatment seeking for those with OUD. In particular, this review found that in the USA one in five people with OUD sought OUD treatment in the previous 12 months and two in five people with OUD sought OUD treatment in their lifetime. Further research is urgently required to explore the barriers and facilitators that can improve this low treatment seeking in those with OUD.

PMID:34653220 | DOI:10.1371/journal.pone.0258620