Category: Statistics

J Med Internet Res. 2024 Jun 20;26:e49077. doi: 10.2196/49077.

ABSTRACT

BACKGROUND: Management and prevention of hypertension are important public health issues. Healthy dietary habits are one of the modifiable factors. As Twitter (subsequently rebranded X) is a digital platform that can influence public eating behavior, there is a knowledge gap regarding the information about foods and nutrients recommended for blood pressure control and who disseminates them on Twitter.

OBJECTIVE: This study aimed to investigate the nature of the information people are exposed to on Twitter regarding nutrients and foods for blood pressure control.

METHODS: A total of 147,898 Japanese tweets were extracted from January 1, 2022, to December 31, 2022. The final sample of 2347 tweets with at least 1 retweet was manually coded into categories of food groups, nutrients, user characteristics, and themes. The number and percentage of tweets, retweets, and themes in each category were calculated.

RESULTS: Of the 2347 tweets, 80% (n=1877) of tweets mentioned foods, which were categorized into 17 different food groups. Seasonings and spices, including salt, were most frequently mentioned (1356/1877, 72.2%). This was followed by vegetable and fruit groups. The 15 kinds of nutrients were mentioned in 1566 tweets, with sodium being the largest proportion at 83.1% (n=1301), followed by potassium at 8.4% (n=132). There was misinformation regarding salt intake for hypertension, accounting for 40.8% (n=531) of tweets referring to salt, including recommendations for salt intake to lower blood pressure. In total, 75% (n=21) of tweets from “doctors” mentioned salt reduction is effective for hypertension control, while 31.1% (n=74) of tweets from “health, losing weight, and beauty-related users,” 25.9% (n=429) of tweets from “general public,” and 23.5% (n=4) tweets from “dietitian or registered dietitian” denied salt reduction for hypertension. The antisalt reduction tweets accounted for 31.5% (n=106) of the most disseminated tweets related to nutrients and foods for blood pressure control.

CONCLUSIONS: The large number of tweets in this study indicates a high interest in nutrients and foods for blood pressure control. Misinformation asserting antisalt reduction was posted primarily by the general public and self-proclaimed health experts. The number of tweets from nutritionists, registered dietitians, and doctors who were expected to correct misinformation and promote salt reduction was relatively low, and their messages were not always positive toward salt reduction. There is a need for communication strategies to combat misinformation, promote correct information on salt reduction, and train health care professionals to effectively communicate evidence-based information on this topic.

PMID:38901016 | DOI:10.2196/49077

Lang Speech Hear Serv Sch. 2024 Jun 20:1-17. doi: 10.1044/2024_LSHSS-23-00187. Online ahead of print.

ABSTRACT

PURPOSE: Although children with language-based learning disabilities (LLD) demonstrate significant difficulties with writing, empirical evidence to support interventions is sparse. Therefore, the purpose of this pilot study was to examine the feasibility and promise of a writing intervention for fourth- and fifth-grade students with LLD (WILLD: writing in students with LLD). The intervention components included word-, sentence-, and discourse-level writing processes and instructional practices using self-regulation strategies.

METHOD: Participants for this study were 15 students with LLD, recruited from three different schools. Students’ writing was assessed using a sentence probe task and obtaining an informative paragraph writing sample as a measure of proximal writing outcomes. Trained speech-language pathologists (SLPs) and special educators delivered the intervention in a small-group format over 12 weeks. Using a within-group pre-post design, we examined changes in writing outcomes before and after the intervention.

RESULTS: Results indicated that the intervention helped students improve their informative writing skills; students’ writing quality showed a statistically significant increase, and grammatical errors showed a significant decrease.

CONCLUSIONS: Evidence from this pilot effort indicates that WILLD was feasible and appears to show promise for improving writing outcomes for fourth- and fifth-grade students with LLD when delivered by SLPs and special educators in a small-group format. Implications of the results and directions for future research are discussed.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.26053132.

PMID:38901005 | DOI:10.1044/2024_LSHSS-23-00187

Neurology. 2024 Jul 23;103(2):e209401. doi: 10.1212/WNL.0000000000209401. Epub 2024 Jun 20.

ABSTRACT

BACKGROUND AND OBJECTIVES: We recently developed a model (PROCEED) that predicts the occurrence of persistent perfusion deficit (PPD) at 24 hours in patients with incomplete angiographic reperfusion after thrombectomy. This study aims to externally validate the PROCEED model using prospectively acquired multicenter data.

METHODS: Individual patient data for external validation were obtained from the Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection, Tenecteplase versus Alteplase Before Endovascular Therapy for Ischemic Stroke part 1 and 2 trials, and a prospective cohort of the Medical University of Graz. The model’s primary outcome was the occurrence of PPD, defined as a focal, wedge-shaped perfusion delay on 24-hour follow-up perfusion imaging that corresponds to the capillary phase deficit on last angiographic series in patients with <Thrombolysis in Cerebral Infarction 3 reperfusion after thrombectomy. The model’s performance was evaluated with discrimination, calibration accuracy, and clinical decision curves.

RESULTS: We included 371 patients (38% with PPD). The externally validated model had good discrimination (C-statistic 0.81, 95% CI 0.77-0.86) and adequate calibration (intercept 0.25, 95% CI 0.21-0.29 and slope 0.98, 95% CI 0.90-1.12). Across a wide range of probability thresholds (i.e., depending on the physicians’ preferences on how the model should be used), the model shows net benefit on clinical decision curves, informing physicians on the likelihood of PPD. If a physician’s attitude toward false-positive and false-negative ratings is equal, the model would reduce 13 in 100 unnecessary interventions by correctly predicting complete delayed reperfusion, without missing a patient with PPD.

DISCUSSION: The externally validated model had adequate predictive accuracy and discrimination. Depending on the acceptable threshold probability, the model accurately predicts persistent incomplete reperfusion and may advise physicians whether additional reperfusion attempts should be performed.

PMID:38900979 | DOI:10.1212/WNL.0000000000209401

Diabetes Care. 2024 Jul 1;47(7):1111-1113. doi: 10.2337/dci24-0002.

NO ABSTRACT

PMID:38900950 | DOI:10.2337/dci24-0002

Diabetes Care. 2024 Jul 1;47(7):1227-1237. doi: 10.2337/dc24-0411.

ABSTRACT

BACKGROUND: Evidence is lacking on the risk of suicide-related behaviors (suicidal ideation, suicide attempt, suicide death) in youth with type 1 diabetes (T1D).

PURPOSE: We aimed to 1) determine the prevalence of suicidal ideation, suicide attempts, and suicide deaths in adolescents and young adults (AYA) with T1D aged 10-24 years; 2) compare suicide-related behavior prevalence in youth with and without T1D; and 3) identify factors associated with suicide-related behaviors.

DATA SOURCES: A systematic search was conducted in MEDLINE, Embase, and PsycInfo up to 3 September 2023.

STUDY SELECTION: We included observational studies where investigators reported the prevalence of suicide-related behaviors among AYA aged 10-24 years with T1D.

DATA EXTRACTION: We collected data on study characteristics, data on prevalence of suicide-related behaviors, and data on associated factors.

DATA SYNTHESIS: We included 31 studies. In AYA with versus without T1D, pooled prevalence of suicidal ideation was 15.4% (95% CI 10.0-21.7; n = 18 studies) vs. 11.5% (0.4-33.3; n = 4), respectively, and suicide attempts 3.5% (1.3-6.7; n = 8) vs. 2.0% (0.0-6.4; n = 5). Prevalence of suicide deaths ranged from 0.04% to 4.4% among youth with T1D. Difficulties with T1D self-management were frequently reported to be associated with higher rates of suicide-related behaviors. However, findings on the association of glycemic levels and suicide-related behaviors were inconsistent.

LIMITATIONS: There was a considerable level of heterogeneity in meta-analysis of both suicidal ideation and suicide attempts.

CONCLUSIONS: Suicidal ideation and suicide attempts are prevalent in AYA with T1D. Current evidence does not suggest that these rates are higher among AYA with T1D than rates among those without.

PMID:38900947 | DOI:10.2337/dc24-0411

Science. 2024 Jun 21;384(6702):eadf1329. doi: 10.1126/science.adf1329. Epub 2024 Jun 21.

ABSTRACT

Persistent inflammation driven by cytokines such as type-one interferon (IFN-I) can cause immunosuppression. We show that administration of the Janus kinase 1 (JAK1) inhibitor itacitinib after anti-PD-1 (programmed cell death protein 1) immunotherapy improves immune function and antitumor responses in mice and results in high response rates (67%) in a phase 2 clinical trial for metastatic non-small cell lung cancer. Patients who failed to respond to initial anti-PD-1 immunotherapy but responded after addition of itacitinib had multiple features of poor immune function to anti-PD-1 alone that improved after JAK inhibition. Itacitinib promoted CD8 T cell plasticity and therapeutic responses of exhausted and effector memory-like T cell clonotypes. Patients with persistent inflammation refractory to itacitinib showed progressive CD8 T cell terminal differentiation and progressive disease. Thus, JAK inhibition may improve the efficacy of anti-PD-1 immunotherapy by pivoting T cell differentiation dynamics.

PMID:38900877 | DOI:10.1126/science.adf1329

J Bone Joint Surg Am. 2024 Jun 20. doi: 10.2106/JBJS.24.00368. Online ahead of print.

ABSTRACT

Today, well-designed randomized clinical trials (RCTs) are considered the pinnacle of clinical research, and they inform many practices in orthopaedics. When designing these studies, researchers conduct a power analysis, which allows researchers to strike a balance between (1) enrolling enough patients to detect a clinically important treatment effect (i.e., researchers can be confident that the effect is unlikely due to chance) and (2) cost, time, and risk to patients, which come with enrolling an excessive number of patients. Because researchers will have a desire to conduct resource-efficient RCTs and protect patients from harm, many studies report a p value that is close to the threshold for significance. The concept of the fragility index (FI) was introduced as a simple way to interpret RCT findings, but it does not account for RCT design. The adoption of the FI conflicts with researchers’ goals of designing efficient RCTs that conserve resources and limit ineffective or harmful treatments to patients. The use of the FI may reflect many clinicians’ lack of familiarity with interpreting p values beyond “significant” or “nonsignificant.” Instead of inventing new metrics to convey the same information provided by the p value, greater emphasis should be placed on educating clinicians on how to interpret p values and, more broadly, statistics, when reading scientific studies.

PMID:38900863 | DOI:10.2106/JBJS.24.00368

Health Informatics J. 2024 Apr-Jun;30(2):14604582241260607. doi: 10.1177/14604582241260607.

ABSTRACT

Background: Wearables have the potential to transform healthcare by enabling early detection and monitoring of chronic diseases. This study aimed to assess wearables’ acceptance, usage, and reasons for non-use. Methods: Anonymous questionnaires were used to collect data in Germany on wearable ownership, usage behaviour, acceptance of health monitoring, and willingness to share data. Results: Out of 643 respondents, 550 participants provided wearable acceptance data. The average age was 36.6 years, with 51.3% female and 39.6% residing in rural areas. Overall, 33.8% reported wearing a wearable, primarily smartwatches or fitness wristbands. Men (63.3%) and women (57.8%) expressed willingness to wear a sensor for health monitoring, and 61.5% were open to sharing data with healthcare providers. Concerns included data security, privacy, and perceived lack of need. Conclusion: The study highlights the acceptance and potential of wearables, particularly for health monitoring and data sharing with healthcare providers. Addressing data security and privacy concerns could enhance the adoption of innovative wearables, such as implants, for early detection and monitoring of chronic diseases.

PMID:38900846 | DOI:10.1177/14604582241260607

PLoS One. 2024 Jun 20;19(6):e0304482. doi: 10.1371/journal.pone.0304482. eCollection 2024.

ABSTRACT

This study explains how the gap between theory and empirical research hinders scientific progress in the area of international political economy. To demonstrate this point, I use Chen’s Extended Dependence Theory, which challenges liberal peace theory but fails to provide supporting empirical evidence. Chen contends that it is not trade dependence between two states that fosters peace but a challenger’s trade relations with the defense-pact partners of the target. Although Chen criticizes liberal peace proponents whose primary concern is how to deter war, his empirical analysis is confined to how to decrease (fatal) militarized disputes short of war. I argue that for his theory to succeed, it must be validated against the most severe and intense form of conflict. Using statistical tests and substantive significance, I uncover no peace-building effect, with regards to war, attributable to Extended Dependence. It appears that the Extended Dependence variable exhibits a ceiling effect. Future research should explain why economic ties and security institutions fail to work together to lower the risk of the most destructive form of conflict.

PMID:38900838 | DOI:10.1371/journal.pone.0304482

PLoS One. 2024 Jun 20;19(6):e0305073. doi: 10.1371/journal.pone.0305073. eCollection 2024.

ABSTRACT

Stable isotope methods have been used to study protein metabolism in humans; however, there application in dogs has not been frequently explored. The present study compared the methods of precursor (13C-Leucine), end-products (15N-Glycine), and amino acid oxidation (13C-Phenylalanine) to determine the whole-body protein turnover rate in senior dogs. Six dogs (12.7 ± 2.6 years age, 13.6 ± 0.6 kg bodyweight) received a dry food diet for maintenance and were subjected to all the above-mentioned methods in succession. To establish 13C and 15N kinetics, according to different methodologies blood plasma, urine, and expired air were collected using a specifically designed mask. The volume of CO2 was determined using respirometry. The study included four methods viz. 13C-Leucine, 13C-Phenylalanine evaluated with expired air, 13C-Phenylalanine evaluated with urine, and 15N-Glycine, with six dogs (repetitions) per method. Data was subjected to variance analysis and means were compared using the Tukey test (P<0.05). In addition, the agreement between the methods was evaluated using Pearson correlation and Bland-Altman statistics. Protein synthesis (3.39 ± 0.33 g.kg-0,75. d-1), breakdown (3.26 ± 0.18 g.kg-0.75.d-1), and flux estimations were similar among the four methods of study (P>0.05). However, only 13C-Leucine and 13C-Phenylalanine (expired air) presented an elevated Pearson correlation and concordance. This suggested that caution should be applied while comparing the results with the other methodologies.

PMID:38900837 | DOI:10.1371/journal.pone.0305073